scholarly journals Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals

2021 ◽  
Author(s):  
Andrea Brizzi ◽  
Charles Whittaker ◽  
Luciana Servo ◽  
Iwona Hawryluk ◽  
Carlos Augusto Prete ◽  
...  
Keyword(s):  
Rate Model ◽  
Pandemic Preparedness ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Temporal Fluctuations ◽  
Individual Level ◽  
Middle Income Countries ◽  
Hospitalised Patients ◽  
Time Periods ◽  
Healthcare Optimization

The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gamma's spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed prior to Gamma's detection, and were largely transient after Gamma's detection, subsiding with hospital demand. Using a Bayesian fatality rate model, we find that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates are primarily associated with geographic inequities and shortages in healthcare capacity. We project that approximately half of Brazil's COVID-19 deaths in hospitals could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization, and pandemic preparedness are critical to minimize population wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.

scholarly journals Childlessness, Individual Socioeconomic Resources, and Health: Exploring Variation in 20 Countries

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 515-516
Author(s):  
Nekehia Quashie ◽  
Christine Mair ◽  
Radoslaw Antczak ◽  
Bruno Arpino
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Health Indicators ◽  
Data Repository ◽  
Middle Income ◽  
Individual Level ◽  
Socioeconomic Resources ◽  
Middle Income Countries ◽  
Using Data ◽  
The Impact

Abstract Childless older adults may be at risk for poorer health cross-nationally, yet most studies on this topic analyze only a small number of countries and only 1 or 2 health outcomes. To our knowledge, two papers exist that explore associations between childlessness and multiple indicators of health using data from a large number of regionally diverse countries (e.g., 20 countries from North America, Asia, and Europe), but neither study includes an examination of socioeconomic resources. The level of health risk faced by childless older adults is likely to be distinctly shaped by older adults’ socioeconomic resources (e.g., education, income, wealth). Associations between childlessness, socioeconomic resources, and health may also differ by country context. Using harmonized, cross-national data for adults aged 50 and older across 20 high- and middle-income countries (United States (HRS), European Union (SHARE), Mexico (MHAS), and China (CHARLS) from the Gateway to Global Aging data repository), we explore if and how individual-level socioeconomic resources (income, education, wealth) moderate associations between childlessness and five health indicators (self-rated health, ADL limitations, IADL limitations, chronic conditions, and depression). Results suggest that associations between childlessness and health outcomes vary by individual socioeconomic resources in some country contexts, but not in others. We discuss these findings in light of the impact of individual-level socioeconomic resources on older adults’ support options and health outcomes cross-nationally.

Perceived Trust and Confidence for Cryptocurrency Adoption

2022 ◽  
pp. 250-279
Author(s):  
Ewilly Jie Ying Liew ◽  
Wei Li Peh ◽  
Zhuan Kee Leong
Keyword(s):  
Large Scale ◽  
Social Impact ◽  
Public Perceptions ◽  
Middle Income ◽  
Individual Level ◽  
Perceived Trust ◽  
Middle Income Countries ◽  
Regulatory Bodies ◽  
The Individual ◽  
National Databases

This chapter seeks to examine the influence of public perceptions of trust in people and confidence in institutions on cryptocurrency adoption, taking into account the individual-level demographic factors and the regional-level contextual factors. Data is obtained from three large-scale international surveys and national databases and analyzed using R software. The multivariate results demonstrate that individuals' public perceptions of trust and confidence significantly contribute to cryptocurrency adoption. Lower perceived trust in people and higher perceived confidence in civil service and international regulatory bodies increase cryptocurrency adoption, while perceived confidence in political and financial institutions discourages cryptocurrency adoption. Additionally, the univariate results find significant comparisons of gender and perceived trust differences on the predictors of cryptocurrency adoption. This chapter discusses and provides insights on the social impact and future of cryptocurrency adoption, particularly among the upper- and lower-middle-income countries.

PP124 Health Technology Assessment And Feedback For Healthy Workplace Culture In Malaria Care In Low And Middle Income Countries

2018 ◽  
Vol 34 (S1) ◽  
pp. 114-114
Author(s):  
Patrick Okwen ◽  
Raphael Cheabum ◽  
Etienne Che ◽  
Joy Ngwemsi Mbunu ◽  
Miriam Nkangu
Keyword(s):  
Workplace Culture ◽  
Evidence Based ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Children Under Five ◽  
Under Five ◽  
Middle Income Countries ◽  
Percent Improvement ◽  
Evidence Based Care ◽  
Low And Middle Income

Introduction:Malaria is a leading cause of mortality and morbidity in children under five in low and middle income countries (LMICs). Management of malaria in children under five years of age is challenging. One challenge faced by clinical practice in LMICs is lack of evidence to guide practice. This challenge is further compounded by different training backgrounds of team members. In the management of malaria in Cameroon, conflicts usually arise between clinicians, lab technicians and pharmacists resulting in over diagnosis and treatment of malaria. The patient's view is usually not considered. This leads to over diagnosis and over prescriptions for malaria in children under five years of age.Methods:We used the Joanna Briggs Institute (JBI) approach of getting research into practice to organize stakeholder meetings, assess existing evidence in malaria care, develop evidence criteria for management based on levels of evidence, assess the gamut of care for malaria, provide feedback to clinicians and re-assess practice. We used the JBI practical application of clinical evidence system (PACES) and getting research into practice (GRiP) evidence implementation tools in the process to facilitate teamwork, collaboration on evidence and provide feedback.Results:A collaborative approach to assessments and feedback including all healthcare stakeholders significantly improved workplace culture of evidence-based care and staff-to-staff relationships as well as staff-to-patient relationships. Over a period of twelve months, we reported eighty-four percent fewer conflicts between staff and ninety-eight percent fewer conflicts between staff and patients. For malaria management, overall criteria showed a thirty-one percent improvement in compliance with best practice recommendations with evidence levels of Grade 1.Conclusions:The project demonstrated that local leadership and evidence-based care can significantly improve practice in resource limited settings.

scholarly journals Assessing mortality registration in Kerala: the MARANAM study

Genus ◽  
2022 ◽  
Vol 78 (1) ◽  
Author(s):  
Aashish Gupta ◽  
Sneha Sarah Mani
Keyword(s):  
Vital Statistics ◽  
Middle Income ◽  
Registration System ◽  
Individual Level ◽  
Civil Registration ◽  
Middle Income Countries ◽  
Registration Data ◽  
Life Expectancy At Birth ◽  
Sample Registration System ◽  
Low And Middle Income

AbstractComplete or improving civil registration systems in sub-national areas in low- and middle-income countries provide several opportunities to better understand population health and its determinants. In this article, we provide an assessment of vital statistics in Kerala, India. Kerala is home to more than 33 million people and is a comparatively low-mortality context. We use individual-level vital registration data on more than 2.8 million deaths between 2006 and 2017 from the Kerala MARANAM (Mortality and Registration Assessment and Monitoring) Study. Comparing age-specific mortality rates from the Civil Registration System (CRS) to those from the Sample Registration System (SRS), we do not find evidence that the CRS underestimates mortality. Instead, CRS rates are smoother across ages and less variable across periods. In particular, the CRS records higher death rates than the SRS for ages, where mortality is usually low and for women. Using these data, we provide the first set of annual sex-specific life tables for any state in India. We find that life expectancy at birth was 77.9 years for women in 2017 and 71.4 years for men. Although Kerala is unique in many ways, our findings strengthen the case for more careful attention to mortality records within low- and middle-income countries, and for their better dissemination by government agencies.

scholarly journals The prevalence and correlates of the double burden of malnutrition among women in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244362
Author(s):  
Sandra Boatemaa Kushitor ◽  
Lily Owusu ◽  
Mawuli Kobla Kushitor
Keyword(s):  
Normal Weight ◽  
Chi Square ◽  
Double Burden ◽  
Middle Income ◽  
Individual Level ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Chi Square Test ◽  
Double Burden Of Malnutrition ◽  
The Individual

Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15–49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.

scholarly journals Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rachel Wangari Kimani ◽  
Rose Maina ◽  
Constance Shumba ◽  
Sheila Shaibu
Keyword(s):  
Child Outcomes ◽  
Newborn Care ◽  
Middle Income ◽  
Health Crisis ◽  
Mortality And Morbidity ◽  
Innovative Strategies ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Emotional Safety ◽  
Novel Coronavirus

Abstract Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. We propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns.

Mobile Health Literacy to Improve Health Outcomes in Low-Middle Income Countries

2017 ◽  
pp. 1398-1411
Author(s):  
Nafisa Fatima Maria Vaz
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Mobile Phones ◽  
Health Indicators ◽  
Well Being ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Middle Income Countries ◽  
Feasible Solutions ◽  
Improve Health

Despite improvements in health indicators over time, such as decreased mortality and morbidity, significant challenges remain with regard to the quality in the delivery of healthcare in low and middle-income countries (LMIC's), especially in rural and remote regions of developing countries. In the effort to find feasible solutions to these issues, a lot of importance is given to the information and communication technologies (ICTs) The author reviews the evidence of the role mobile phones facilitating health literacy to contribute to improved health outcomes in the LMIC's. This was done by exploring the results of ten projects. The author examines the extent to which the use of mobile phones could help improve health outcomes in two specific ways: in improving health literacy and promoting health and well-being, thus increasing life expectancy in LMIC's. Analysis of the papers indicates that there is important evidence of mobile phones boosting increased access, promoting education and increased health literacy leads to the better health status of the population.

Efetividade do Método Canguru em Relação à Redução da Mortalidade e Morbidade Neonatal

2018 ◽  
Vol 22 (3) ◽  
pp. 186
Author(s):  
Dayane Cristina Da Silva Santos ◽  
Mirian Dos Santos Pereira
Keyword(s):  
Low Income ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Low Income Countries ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Premature Newborn ◽  
Middle Income Countries ◽  
Low Weight

O Método Mãe Canguru (MC) é destinado ao atendimento do recém-nascido prematuro de baixo peso, e visa fortalecer o vínculo mãe-filho, aumentar a competência e a confiança dos pais no cuidado do bebê e incentivar a prática da amamentação. O objetivo do estudo foi demonstrar as evidências que apontam o uso de Método Canguru (MC) como uma alternativa aos cuidados neonatais, enfocando seus benefícios e avaliando se o método reduz a morbidade e mortalidade em neonatos de baixo peso. Trata-se de uma pesquisa descritiva, realizada a partir de um levantamento bibliográfico nas bases de dados BDEnf, Lilacs, SciELO e BIREME, considerando o período de 2000 a 2016. Foram analisados artigos sobre o Método Canguru (MC) e a redução da morbimortalidade neonatal. O estudo evidenciou que o Método Mãe Canguru (MC) reduz as taxas tanto de mortalidade como morbidade neonatal, porém demonstrou que existem poucos estudos referentes a este tema. O Método Mãe Canguru (MC) demonstrou ser mais que uma alternativa para países de baixa renda, nos quais faltam incubadoras ou salas de atendimento neonatal, constituindo-se, também, uma estratégia com múltiplas vantagens para o recém-nascido, tanto o prematuro quanto o nascido a termo. Destacou-se a eficácia do método na diminuição da morbimortalidade do neonato com baixo peso. Os estudos sobre mortalidade e morbidade do Método Mãe-Canguru (MC), em países de baixa e média renda, concluíram que o Método Mãe Canguru (MC) reduz, substancialmente, a mortalidade neonatal em bebês nascidos antes do termo com baixo peso em hospitais. Palavras-chave: Morbimortalidade Neonatal. Método Canguru. Recém-Nascido de Baixo Peso. Abstract: The Kangaroo Mother Method is intended for the care of the low weight premature newborn and aims to strengthen the mother-child bond, increase the parents’ competence and trust in the baby care and encourage the breastfeeding practice. The objective was  demonstrating the evidence supporting the use of KMM as an alternative to neonatal care, focusing on its benefits and evaluating whether the method reduces morbidity and mortality in low weight premature newborn. This is a descriptive research, based on a bibliographic survey in the databases BDEnf, Lilacs, SciELO and BIREME, considering the period from 2000 to 2016.  Articles were analyzed on the Kangaroo Method and the reduction of neonatal morbidity and mortality, the study showed that the Kangaroo Mother Method reduces the rates of both mortality and neonatal morbidity, but has shown that there are few studies related to this topic. The Kangaroo Mother Method has proven to be more than an alternative for low-income countries, where incubators or neonatal care rooms are lacking. It is also a strategy with multiple advantages for the newborn, both premature and full-term. The method efficacy in reducing neonatal morbidity and mortality and low weight was emphasized. Mortality and morbidity studies of the Kangaroo Method in low- and middle-income countries have concluded that the Kangaroo Mother Method substantially reduces neonatal mortality in preterm infants in hospitals and underweight. Keywords: Morbidity and Mortality Neonatal. Kangaroo Method. Low Birth Newborn. 

scholarly journals Global Intake of Major Beverages in Adults by Country Wealth and Sociodemographic Characteristics: Analysis of the Global Dietary Database 2015

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 858-858
Author(s):  
Laura Lara Castor ◽  
Frederick Cudhea ◽  
Peilin Shi ◽  
Jianyi Zhang ◽  
Victoria Miller ◽  
...  
Keyword(s):  
Higher Education ◽  
High Education ◽  
Education Level ◽  
Rural Residence ◽  
Urban Residence ◽  
Middle Income ◽  
Individual Level ◽  
High Education Level ◽  
Middle Income Countries ◽  
Urban Rural

Abstract Objectives Assessing the impact of beverage intake on health has been limited by lack of reliable and standardized individual-level data on a global scale. We provide updated estimates of global intakes of sugar-sweetened beverages (SSBs), fruit juices, and milk, as well as novel estimates of coffee and tea, jointly by country, age, sex, education, and urban-rural residence for adults in 2015. Methods Beverge intake data in the Global Dietary Database were derived from 1144 national and subnational surveys from 1980 through 2015, covering 97.5% of the world's population. Mean intakes and 95% uncertainty intervals were estimated using a Bayesian hierarchical prediction model, and stratified by country (n = 185), urban-rural residence, sex, age group (all ages, 20 age groups), and education level (low, middle, high). The model combined primary data on individual-level intakes with time-varying country-level and survey-level covariates. Results Grouped by World Bank wealth categories, intake of SSBs was highest in low-income countries (LIC) and high-income countries (HIC) (0.7 servings (8-oz)/d each), and lowest in upper-middle income countries UMIC (0.4 s/d). Intakes were generally higher in men, urban residence, and with higher education, except in HIC were intakes did not differ by education. Fruit juice was highest in HIC (0.2 s/d) and lowest in lower-middle income countries (LMIC) (<0.04 s/d); and within countries, generally higher with urban residence and higher education. Coffee intake was highest in HIC (1.2 s/d) and lowest in LIC (0.7 s/d); and generally higher in men and with medium or high education level, without urban-rural differences. Tea intake was highest in HIC (0.8 s/d) and lowest in LMIC (0.5 s/d); and generally higher in women, urban residence, and with high education. Average milk intake ranged from 0.5 s/d in HIC to 0.2 s/d in LIC, LMIC and UMIC; and was generally higher at high education level, without differences by sex or urban-rural residence. Country-specific intakes and temporal trends since 1990 will be presented. Conclusions These novel global results highlight key findings and heterogeneity in intakes of different beverages, informing potential effects on health and corresponding policy priorities. Funding Sources Bill & Melinda Gates Foundation.

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