SIGNIFICANT PREDICTORS OF INTEREST IN GERIATRICS AMONG LOW, MIDDLE, AND HIGH INCOME COUNTRIES

Abstract Even though the demands for physicians with geriatric related specialties are higher than the available experts around the world, some countries and economies seem to be more impacted by the workforce shortage than others. This systematic review consolidated scientific evidence reporting the significant predictors of interest in pursuing a geriatric career among medical students’ in different countries. A 20-year (1998 – 2018) systematic literature review of high-quality primary research articles was conducted using PubMed, ERIC (EBSCO), Embase and Cochrane Library. Eleven articles (n =11) met the eligibility and quality assessment criteria. For analysis, studies were categorized into (i) low- and middle-income countries and (ii) high income countries, based on the WHO and the World Bank’s income grouping for the 2019 fiscal year. Medical students involved in this review were n = 1,683 representing students from different fields of medicine and year groups. The two most significant predictors of interest in geriatrics in the high-income countries were (1) positive attitudes towards the elderly and (ii) participation in a geriatric related intervention. Lack of published peer-reviewed articles from the low and middle-income countries limited the researchers’ ability to evaluate the similarities and differences between the two income groups. There is an overall need to stimulate interest in geriatric specialization among medical students. Leaders of the LMICs should invest in geriatric education and research in order to promote interest in the field, increase the geriatric workforce, and ultimately, improve the quality of life of the elderly in their respective countries

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Evidence Based Dentistry among Dentists in Low and Middle Income Countries: A Systematic Review

East African Health Research Journal ◽

10.24248/eahrj.v5i2.662 ◽

2021 ◽

Vol 5 (2) ◽

pp. 129-136

Author(s):

Irene Kida Minja ◽

Edda Tandi Lwoga

Keyword(s):

Systematic Review ◽

Scientific Evidence ◽

Grey Literature ◽

Cochrane Library ◽

Evidence Based ◽

Middle Income ◽

Hand Search ◽

Middle Income Countries ◽

Evidence Based Dentistry ◽

Low And Middle Income

Purpose of this systematic review was to bring together studies of evidence-based practice among dentists in low- and middle-income countries, where its use has been reported to be limited. The protocol was registered in PROSPERO. Methodology: We searched the evidence (in English only) from medical databases including PubMed, EBSCO, The Cochrane Library, CINAHL, ScienceDirect, HINARI summon, and SCOPUS and Web of Science via Research4Life, grey literature, hand search from relevant articles, and augmented results on Google scholar.Published reports were retrieved from relevant websites and organizations. Studies included those that looked at key factors that facilitate or hinder Evidence Based Dentistry (EBD), as well as outcomes in terms of: knowledge, attitudes and skills of EB practice among dentists; and the methodology used and their relevance in future EBD strategies.Main focus was on dentists, as practitioners and faculty members. Studies on students and non-dental personnel were excluded.Findings:A total of 4568 records were retrieved and five potentially relevant articles were selected after title/abstract screening. Two articles were excluded after full text screening, and therefore Three papers were included in this review. The studies report limited knowledge,unsatisfactory attitude towards EBD and lowpractice of EBD and use of scientific evidence databases. None of the studies reported implementation of EBD nor evaluation thereof. The main barriers that constrained application of EBD ranged from lack of interest to infrastructural limitations. Originality: The current review showed that there is a need to strategised implementation of EBD in this region.

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Disability and treatment of specific mental and physical disorders across the world

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.039107 ◽

2008 ◽

Vol 192 (5) ◽

pp. 368-375 ◽

Cited By ~ 204

Author(s):

Johan Ormel ◽

Maria Petukhova ◽

Somnath Chatterji ◽

Sergio Aguilar-Gaxiola ◽

Jordi Alonso ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

High Income ◽

World Health ◽

Role Functioning ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Physical Disorders ◽

Low And Middle Income

BackgroundAdvocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion.AimsTo establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries.MethodCommunity epidemiological surveys were administered in 15 countries through the World Health Organization World Mental Health (WMH) Survey Initiative.ResultsRespondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders.ConclusionsDespite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.

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Injury Prevention Research and Global Child Health

10.1542/9781610021906-part04-ch19 ◽

2018 ◽

pp. 339-358

Author(s):

Nichole L. Hodges ◽

Gary A. Smith

Keyword(s):

Public Health ◽

Injury Prevention ◽

High Income ◽

Public Health Approach ◽

Unintentional Injuries ◽

Middle Income ◽

Mortality And Morbidity ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Injuries are a leading cause of death and disability among children throughout the world. It is estimated that 735,500 children and teens younger than 20 years die from unintentional injuries annually. Although injuries are one of the most common causes of pediatric mortality globally, they do not affect all regions of the world equally. Low- and middle-income countries not only experience pediatric injuries at a much higher rate than high-income countries, but they also have greater total injury-related mortality and morbidity. An estimated 97% of all pediatric unintentional injury-related deaths occur in low-and middle-income countries. This chapter will describe the global public health burden and leading causes of unintentional injuries to children. We will also discuss the application of the public health approach and the principles of injury prevention to child injury. Best practices and case studies will be presented to highlight innovative research studies and evidence-based injury prevention strategies that have been implemented in low-, middle-, and high-income countries. The chapter closes with an overview of current research gaps and suggestions for advancing the field. This chapter will not discuss intentional injury specifically, which, in the editors’ assessment, deserves a detailed and comprehensive thesis— not achievable in a single chapter.

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Representative Estimates of COVID-19 Infection Fatality Rates from Three Locations in India

10.1101/2021.01.05.21249264 ◽

2021 ◽

Author(s):

R. Cai ◽

P. Novosad ◽

V. Tandel ◽

S. Asher ◽

A. Malani

Keyword(s):

Random Sample ◽

High Income ◽

Fatality Rate ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Using Data ◽

Low And Middle Income

AbstractThere are very few estimates of the age-specific infection fatality rate (IFR) of SARS-CoV-2 in low- and middle-income countries. India reports the second highest number of SARS-CoV-2 infections in the world. We estimate age-specific IFR using data from seroprevalence surveys in Mumbai (population 12 million) and Karnataka (population 61 million), and a random sample of economically distressed migrants in Bihar with mortality followup. Among men aged 50–89, IFR is 0.12% in Karnataka (95% C.I. 0.09%–0.15%), 0.53% in Mumbai (0.52%–0.54%), and 5.64% among migrants in Bihar (0–11.16%). IFR in India is approximately twice as high for men as for women, is heterogeneous across contexts, and rises much less at older ages than in comparable studies from high income countries.

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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052439 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2439

Author(s):

Brendon Stubbs ◽

Kamran Siddiqi ◽

Helen Elsey ◽

Najma Siddiqi ◽

Ruimin Ma ◽

...

Keyword(s):

Health Survey ◽

Low Income ◽

World Health ◽

Low Income Countries ◽

Multivariable Logistic Regression Analysis ◽

World Health Survey ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

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Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review

Nutrients ◽

10.3390/nu13020681 ◽

2021 ◽

Vol 13 (2) ◽

pp. 681

Author(s):

Ritu Rana ◽

Marie McGrath ◽

Ekta Sharma ◽

Paridhi Gupta ◽

Marko Kerac

Keyword(s):

At Risk ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

World Health ◽

Cochrane Library ◽

Breastfeeding Support ◽

Middle Income ◽

Middle Income Countries ◽

Breastfeeding Practices ◽

Low And Middle Income

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother–infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers’ knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

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

Nutrients ◽

10.3390/nu13031038 ◽

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.

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