scholarly journals A systematic comparison of key features of ischemic stroke prevention guidelines in low- and middle-income vs. high-income countries

2017 ◽  
Vol 375 ◽  
pp. 360-366 ◽  
Author(s):  
Hernán Bayona ◽  
Mayowa Owolabi ◽  
Wuwei Feng ◽  
Paul Olowoyo ◽  
Joseph Yaria ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Prevention ◽  
High Income ◽  
Middle Income ◽  
Systematic Comparison ◽  
Prevention Guidelines ◽  
Key Features ◽  
Low And Middle Income

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

scholarly journals Atrial fibrillation in low- and middle-income countries: a narrative review

2020 ◽  
Vol 22 (Supplement_O) ◽  
pp. O61-O77
Author(s):  
Itamar S Santos ◽  
Alessandra C Goulart ◽  
Rodrigo D Olmos ◽  
G Neil Thomas ◽  
Gregory Y H Lip ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Outcomes ◽  
Economic Burden ◽  
Stroke Prevention ◽  
Public Health Problem ◽  
High Income ◽  
Narrative Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Preventing premature non-communicable disease mortality necessitates a thorough review of one of the most important risk factors for stroke, which is atrial fibrillation (AF). The latter and AF-related stroke are still considered to be problems of high-income countries and are frequently overlooked in low- and middle-income countries (LMICs). In this narrative review, we provide an overview of studies that evaluated at least one of the following determinants of AF burden in LMICs: current epidemiology and trends, stroke prevention, health outcomes, and economic burden. Studies focusing on samples close to the general population (including community- and primary care-based samples) indicate sex-specific prevalence rates up to 7.4% in LMICs. Although AF prevalence is still higher in high-income countries than LMICs, the gap in AF burden between these two groups has been reducing in the past three decades. Oral anticoagulant (OAC) therapy for stroke prevention is underused in LMICs, and there are little data on OAC therapy in relation to stroke risk scores, such as CHA2DS2-VASc. Available data also points to higher morbidity and mortality for patient with AF in LMICs than their counterparts in high-income countries. Data on the consequent economic burden in LMICs is scarce, but it is reasonable to consider it will follow the same trend as that observed for health outcomes. Raising the visibility of AF as a public health problem in LMICs is necessary as a first step to providing adequate care for patients with this condition.

scholarly journals Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines
Keyword(s):  
English Language ◽  
Economic Status ◽  
High Income ◽  
Dietary Guidelines ◽  
Systemic Review ◽  
Healthy Children ◽  
Future Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

scholarly journals Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Medical Training ◽  
Skills Training ◽  
High Income ◽  
Training Methods ◽  
Middle Income ◽  
Training Outcomes ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>

scholarly journals Experiences of menstruation in high income countries: a systematic review, qualitative meta-synthesis and comparison to low- and middle-income countries

2021 ◽  
Author(s):  
Dani Jennifer Barrington ◽  
Hannah Robinson ◽  
Emily Wilson ◽  
Julie Hennegan
Keyword(s):  
Cultural Context ◽  
Research Policy ◽  
Integrated Model ◽  
High Income ◽  
Policy And Practice ◽  
Middle Income ◽  
Negative Experiences ◽  
Middle Income Countries ◽  
Protocol Registration ◽  
Low And Middle Income

Background: There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can inform intervention approaches. Methods and findings: Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts.Conclusions: We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifestReview protocol registration: The review protocol registration is PROSPERO: CRD42019157618.

scholarly journals Capital account opening and economic growth——an empirical test based on systematic GMM

2021 ◽  
Vol 235 ◽  
pp. 01019
Author(s):  
Siming Jia
Keyword(s):  
Economic Growth ◽  
Empirical Test ◽  
Statistical Significance ◽  
High Income ◽  
Capital Account ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Differences ◽  
The Impact ◽  
Low And Middle Income

This paper collected panel data of 74 countries from 1990 to 2017, and based on the Chinn-It index to depict the degree of capital account opening. Under the framework of the neoclassical economic growth model, the impact of capital account opening on economic growth was empirically tested by systematic GMM. The results show that: first, taking the overall capital account openness as the explanatory variable, the coefficient of the capital account openness of the whole sample is significantly positive. Further, considering the national differences found that high income countries capital account openness coefficient is significantly positive, but in low and middle-income countries capital account openness coefficient on economic and statistical significance were not significant, indicating that high income countries made open dividends, while in low and middle-income countries and earnings in the capital account liberalization. Finally, it proposes to open the capital account sub-projects step by step, strengthen prudent supervision in the process of further opening the capital account, and improve the regulatory legal system.

Academic and Scientific Authorship Practices: A Survey Among South African Researchers

2018 ◽  
Vol 13 (4) ◽  
pp. 412-420 ◽  
Author(s):  
Elsie Breet ◽  
Jan Botha ◽  
Lyn Horn ◽  
Leslie Swartz
Keyword(s):  
South African ◽  
Empirical Studies ◽  
High Income ◽  
Middle Income ◽  
Perceived Ability ◽  
Middle Income Countries ◽  
Scientific Authorship ◽  
Level Of Agreement ◽  
Low And Middle Income

Empirical studies of authorship practices in high-income countries have been conducted, while research on this issue is scarce in low- and middle-income countries. A survey was conducted among South African researchers who have published in peer-reviewed journals, to explore their understanding of and ability to apply academic authorship criteria. A total of 967 researchers participated in the survey; 88% of respondents had knowledge of academic authorship criteria, while only 52% found it easy to apply the criteria. More respondents experienced disagreement regarding who qualifies for coauthorship compared with authorship order (59% vs. 48%). Disagreement was mostly linked to different ways of valuing or measuring contributions. Level of agreement with academic authorship criteria was higher than the perceived ability to apply the criteria.

scholarly journals Alzheimer’s Disease Diagnostics Must Be Globally Accessible

2021 ◽  
pp. 1-3
Author(s):  
Nicholas Clute-Reinig ◽  
Suman Jayadev ◽  
Kristoffer Rhoads ◽  
Anne-Laure Le Ny
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Low Cost ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disease Diagnostics ◽  
Low And Middle Income

Dementia and Alzheimer’s disease (AD) are global health crises, with most affected individuals living in low- or middle-income countries. While research into diagnostics and therapeutics remains focused exclusively on high-income populations, recent technological breakthroughs suggest that low-cost AD diagnostics may soon be possible. However, as this disease shifts onto those with the least financial and structural ability to shoulder its burden, it is incumbent on high-income countries to develop accessible AD healthcare. We argue that there is a scientific and ethical mandate to develop low-cost diagnostics that will not only benefit patients in low-and middle-income countries but the AD field as a whole.

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