scholarly journals Temporal trends in the cardiorespiratory fitness of children and adolescents representing 19 high-income and upper middle-income countries between 1981 and 2014

2017 ◽  
Vol 53 (8) ◽  
pp. 478-486 ◽  
Author(s):  
Grant R Tomkinson ◽  
Justin J Lang ◽  
Mark S Tremblay
Keyword(s):  
Children And Adolescents ◽  
Cardiorespiratory Fitness ◽  
Low Income ◽  
Polynomial Regression ◽  
Temporal Trends ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Trends ◽  
Health Related

ObjectiveTo estimate international and national temporal trends in the cardiorespiratory fitness (CRF) of children and adolescents and to examine relationships between temporal trends in CRF and temporal trends in broad socioeconomic and health-related indicators across countries.MethodsData were obtained from a systematic search of studies that explicitly reported 20 m shuttle run test (a validated measure of CRF) descriptive data on apparently healthy individuals aged 9–17 years. Following the estimation of relative peak oxygen uptake (mL/kg/min) as a measure of CRF, sample-weighted temporal trends were estimated at the country–sex–age level using best-fitting linear or polynomial regression models relating the year of testing to mean CRF. Poststratified population-weighted mean changes in absolute and per cent CRF were estimated. Pearson’s correlations were used to describe the association between linear temporal trends in CRF and linear temporal trends in broad socioeconomic and health-related indicators.ResultsTemporal trends were estimated from 965 264 children and adolescents from 19 high-income and upper middle-income countries between 1981 and 2014, using data from 137 studies. Collectively, there was a moderate decline in CRF of 3.3 mL/kg/min (95% CI −3.5 to −3.1), equivalent to a decline of 7.3% (95% CI −7.8% to −6.7%) over the 33-year time period. This international decline diminished with each decade and stabilised near zero around 2000. The decline was larger for boys than girls and was similar for children and adolescents. Trends also differed in magnitude and direction between countries, with most showing declines. There was a strong negative association between country-specific trends in income inequality (Gini index) and trends in CRF across 18 countries; meaning, countries approaching income equality had more favourable trends in CRF.ConclusionsThere has been a substantial decline in CRF since 1981, which is suggestive of a meaningful decline in population health. However, the international trend in CRF has not followed the anticipated trajectory, diminishing and stabilising with negligible change since 2000. CRF data are needed from children in low-income and middle-income countries to more confidently determine true international trends and determine whether temporal trends are similar to those observed in high-income and upper middle-income countries.

scholarly journals Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide

2018 ◽  
Vol 45 (4) ◽  
pp. E13 ◽  
Author(s):  
Michael C. Dewan ◽  
Ronnie E. Baticulon ◽  
Abbas Rattani ◽  
James M. Johnston ◽  
Benjamin C. Warf ◽  
...  
Keyword(s):  
Low Income ◽  
International Collaboration ◽  
Eastern Mediterranean ◽  
Training Needs ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Surgical Workforce ◽  
And Training

OBJECTIVEThe presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally.METHODSA mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform. Respondents answered questions on 5 categories: surgeon demographics and training, hospital and practice details, surgical workforce and access to neurosurgical care, training and equipment needs, and desire for international collaboration. Responses were anonymized and analyzed using Stata software.RESULTSA total of 459 surgeons from 76 countries responded. Pediatric neurosurgeons in high-income and upper-middle-income countries underwent formal pediatric training at a greater rate than surgeons in low- and lower-middle-income countries (89.5% vs 54.4%). There are an estimated 2297 pediatric neurosurgeons in practice globally, with 85.6% operating in high-income and upper-middle-income countries. In low- and lower-middle-income countries, roughly 330 pediatric neurosurgeons care for a total child population of 1.2 billion. In low-income countries in Africa, the density of pediatric neurosurgeons is roughly 1 per 30 million children. A higher proportion of patients in low- and lower-middle-income countries must travel > 2 hours to seek emergency neurosurgical care, relative to high-income countries (75.6% vs 33.6%, p < 0.001). Vast basic and essential training and equipment needs exist, particularly low- and lower-middle-income countries within Africa, South America, the Eastern Mediterranean, and South-East Asia. Eighty-nine percent of respondents demonstrated an interest in international collaboration for the purposes of pediatric neurosurgical capacity building.CONCLUSIONSWide disparity in the access to pediatric neurosurgical care exists globally. In low- and lower-middle-income countries, wherein there exists the greatest burden of pediatric neurosurgical disease, there is a grossly insufficient presence of capable providers and equipped facilities. Neurosurgeons across income groups and geographic regions share a desire for collaboration and partnership.

Globalization and Environment: An Asian Experience

2018 ◽  
Vol 09 (03) ◽  
pp. 1850010 ◽  
Author(s):  
Sudeshna Ghosh
Keyword(s):  
Granger Causality ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Environmental Damage ◽  
Empirical Observation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Run ◽  
Low Middle Income Countries

This paper explores the causal association between globalization and carbon dioxide emanations in a panel set of 17 low- and low-middle-income countries and 12 upper-middle and high-income countries of Asia, respectively. The time series of observations run from 1974 to 2014. The Westerlund (2007) panel cointegration test reveals that there exists a long-run cointegrating relationship in both the panel set of observations between globalization and CO2 emissions. For the panel of upper-middle and high-income countries of Asia the long-run panel (heterogeneous elasticities) shows that globalization does not cause environmental damage, contrary to the observation based on lower- and lower-middle-income countries. The study is in conformity with the Environmental Kuznets Curve Hypothesis. The Granger causality between the variables is explored by utilizing the Dumitrescu and Hurlin (2012) Granger Causality tests. The empirical observation shows that globalization-led environmental causality is valid for lower- and lower-middle-income countries of Asia. So proper sustainable green and clean technology must be adopted for the low-income countries to stop the negation of the growth process in the near future.

scholarly journals Orthopaedic research in low-income countries: A bibliometric analysis of the current literature

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 41
Author(s):  
Simon Matthew Graham ◽  
Ciaran Brennan ◽  
Maritz Laubscher ◽  
Sithombo Maqungo ◽  
David G. Lalloo ◽  
...  
Keyword(s):  
Bibliometric Analysis ◽  
Low Income ◽  
Geographic Origin ◽  
High Income ◽  
Low Income Countries ◽  
Level Of Evidence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Orthopaedic Research ◽  
Level I

Background: To perform a bibliometric analysis and quantify the amount of orthopaedic and trauma literature published from low-income countries (LICs). Methods and methods: The Web of Science database was utilised to identify all indexed orthopaedic journals. All articles published in the 76 orthopaedics journals over the last 10 years were reviewed, to determine their geographic origin. Results: A total of 131 454 articles were published across 76 orthopaedic journals over the last 10 years. Of these, 132 (0.1%) were published from LICs and 3515 (2.7%) were published from lower middle-income countries (LMICs); 85.7% (n = 112 716) of published orthopaedic research was undertaken in a high-income setting. The majority of the studies (n = 90, 74.4%) presented level IV evidence. Only 7.4% (n = 9) were high-quality evidence (level I or II). Additionally, the majority of research (74 articles, 56%) was published in partnership with high-income countries (HICs). Conclusions: There is a stark mismatch between the publication of scientific reports on orthopaedic research and the geographical areas of greatest clinical need. We believe there is an urgent need for orthopaedic research to be carried out in low-income settings to guide treatment and improve outcomes, rather than assuming that evidence from high-income settings will translate into this environment. Level of evidence: IV

scholarly journals Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis

2019 ◽  
Vol 96 (5) ◽  
pp. 322-329 ◽  
Author(s):  
Weiming Tang ◽  
Jessica Mao ◽  
Katherine T Li ◽  
Jennifer S Walker ◽  
Roger Chou ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Risk Ratio ◽  
Low Income ◽  
Case Control ◽  
High Income ◽  
Adverse Outcomes ◽  
Chlamydia Infection ◽  
Case Control Studies ◽  
Middle Income ◽  
Middle Income Countries

BackgroundGenital chlamydia infection in women is often asymptomatic, but may result in adverse outcomes before and during pregnancy. The purpose of this study was to examine the strength of the relationships between chlamydia infection and different reproductive health outcomes and to assess the certainty of the evidence.MethodsThis review was registered and followed the Cochrane guidelines. We searched three databases to quantitatively examine adverse outcomes associated with chlamydia infection. We included pregnancy and fertility-related outcomes. We performed meta-analyses on different study designs for various adverse outcomes using unadjusted and adjusted analyses.ResultsWe identified 4730 unique citations and included 107 studies reporting 12 pregnancy and fertility-related outcomes. Sixty-eight studies were conducted in high-income countries, 37 studies were conducted in low-income or middle-income countries, and 2 studies were conducted in both high-income and low-income countries. Chlamydia infection was positively associated with almost all of the 12 included pregnancy and fertility-related adverse outcomes in unadjusted analyses, including stillbirth (OR=5.05, 95% CI 2.95 to 8.65 for case–control studies and risk ratio=1.28, 95% CI 1.09 to 1.51 for cohort studies) and spontaneous abortion (OR=1.30, 95% CI 1.14 to 1.49 for case–control studies and risk ratio=1.47, 95% CI 1.16 to 1.85 for cohort studies). However, there were biases in the design and conduct of individual studies, affecting the certainty of the overall body of evidence. The risk of adverse outcomes associated with chlamydia is higher in low-income and middle-income countries compared with high-income countries.ConclusionChlamydia is associated with an increased risk of several pregnancy and fertility-related adverse outcomes in unadjusted analyses, especially in low-income and middle-income countries. Further research on how to prevent the sequelae of chlamydia in pregnant women is needed.Trial registration numberCRD42017056818.

scholarly journals Influence of Alcohol and Red Meat Consumption on Life Expectancy: Results of 164 Countries from 1992 to 2013

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 459 ◽  
Author(s):  
Chhabi Lal Ranabhat ◽  
Myung-Bae Park ◽  
Chun-Bae Kim
Keyword(s):  
Alcohol Consumption ◽  
Life Expectancy ◽  
Low Income ◽  
Meat Consumption ◽  
Red Meat ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Consumption

Background: High consumption of red meat, which is carcinogenic to humans, and misuse or abuse of alcohol drinking increase premature death and shortened life expectancy. The aim of this study was to examine the association of alcohol and red meat consumption with life expectancy (LE) by analyzing data from 164 countries using an ecological approach. Design: This was a longitudinal ecological study using data from the United Nation’s (UN) Food and Agriculture Organization (FAO) for 164 countries over the period 1992–2013. In regression analysis, the relationship of alcohol and red meat consumption with LE was estimated using a pooled ordinary least squares regression model. Alcohol and red meat consumption were measured every 5 years. Results: The consumption of alcohol and red meat in high-income countries (HIC) was about 4 times (36.8–143.0 kcal/capita/day) and 5 times (11.2–51.9 kcal/capita/day) higher than that in low-income countries (LIC). Red meat and alcohol consumption had a negative estimated effect on LE in HIC (b = −1.616 p = < 0.001 and b = −0.615, p = 0.003). Alcohol consumption was negatively associated with LE for all income groups, while positive relationships were found for all estimates associated with gross national income (GNI). Conclusions: Red meat and alcohol consumption appeared to have a negative impact on LE in high-income countries (HIC) and upper-middle-income countries (UMIC), although it had no significant association with LE in low-income countries (LIC) or lower-middle-income countries (LMIC). This study suggests reviewing the policies on the gradual reduction of alcohol abuse and the high consumption of red meat, particularly HIC and UMIC.

scholarly journals The burden of serious health-related suffering among cancer decedents: Global projections study to 2060

2020 ◽  
pp. 026921632095756
Author(s):  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
Maja de Brito ◽  
Omar Shamieh ◽  
Richard Harding
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Population Based ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Type ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Health Organization

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential for effective health system planning in response to global policy. Aim: To project the burden of serious health-related suffering associated with death from cancer to 2060 by age, gender, cancer type and World Bank income region. Design: Population-based projections study. Global projections of palliative care need were derived by combining World Health Organization cancer mortality projections (2016–2060) with estimates of serious health-related suffering among cancer decedents. Results: By 2060, serious health-related suffering will be experienced by 16.3 million people dying with cancer each year (compared to 7.8 million in 2016). Serious health-related suffering among cancer decedents will increase more quickly in low income countries (407% increase 2016–2060) compared to lower-middle, upper-middle and high income countries (168%, 96% and 39% increase 2016-2060, respectively). By 2060, 67% of people who die with cancer and experience serious health-related suffering will be over 70 years old, compared to 47% in 2016. In high and upper-middle income countries, lung cancer will be the single greatest contributor to the burden of serious health-related suffering among cancer decedents. In low and lower-middle income countries, breast cancer will be the single greatest contributor. Conclusions: Many people with cancer will die with unnecessary suffering unless there is expansion of palliative care integration into cancer programmes. Failure to do this will be damaging for the individuals affected and the health systems within which they are treated.

scholarly journals Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries

2020 ◽  
Vol 31 (9) ◽  
pp. 1931-1940 ◽  
Author(s):  
Marcello Tonelli ◽  
James A. Dickinson
Keyword(s):  
Early Detection ◽  
Low Income ◽  
Population Based ◽  
Case Finding ◽  
High Income ◽  
Opportunity Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Low And Middle Income

CKD is common, costly, and associated with adverse health outcomes. Because inexpensive treatments can slow the rate of kidney function loss, and because CKD is asymptomatic until its later stages, the idea of early detection of CKD to improve outcomes ignites enthusiasm, especially in low- and middle-income countries where renal replacement is often unavailable or unaffordable. Available data and prior experience suggest that the benefits of population-based screening for CKD are uncertain; that there is potential for harms; that screening is not a wise use of resources, even in high-income countries; and that screening has substantial opportunity costs in low- and middle-income countries that offset its hypothesized benefits. In contrast, some of the factors that diminish the value of population-based screening (such as markedly higher prevalence of CKD in people with diabetes, hypertension, and cardiovascular disease, as well as high preexisting use of kidney testing in such patients) substantially increase the appeal of searching for CKD in people with known kidney risk factors (case finding) in high-income countries as well as in low- and middle-income countries. For both screening and case finding, detection of new cases is the easiest component; the real challenge is ensuring appropriate management for a chronic disease, usually for years or even decades. This review compares and contrasts the benefits, harms, and opportunity costs associated with these two approaches to early detection of CKD. We also suggest criteria (discussed separately for high-income countries and for low- and middle-income countries) to use in assessing when countries should consider case finding versus when they should consider foregoing systematic attempts at early detection and focus on management of known cases.

scholarly journals Population genomics of Cryptosporidium hominis across five continents identifies two subspecies that have diverged and recombined during 500 years of evolution

2021 ◽  
Author(s):  
Swapnil Tichkule ◽  
Simone M. Cacciò ◽  
Guy Robinson ◽  
Rachel M. Chalmers ◽  
Ivo Mueller ◽  
...  
Keyword(s):  
Gene Flow ◽  
Low Income ◽  
Population Genomics ◽  
Balancing Selection ◽  
Public Health Problem ◽  
High Income ◽  
Secondary Contact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractCryptosporidium is a significant public health problem and one of the primary causes of diarrhoea in humans, particularly in very young children living in low- and middle-income countries. While the zoonotic Cryptosporidium parvum and anthroponotic C. hominis species collectively account for most cases globally, the latter is predominant in low- and middle-income countries. Here, we present a comprehensive whole genome study of C. hominis, comprising 114 isolates from 16 countries within five continents. We detect two highly diverged lineages with a distinct biology and demography that have diverged circa 500 years ago. We consider these lineages as two subspecies, and provisionally propose the names C. hominis hominis (clade 1) and C. hominis aquapotentis (clade 2 or gp60 subtype IbA10G2). C. h. hominis is mostly found in low-income countries in Africa and Asia, and it appears to have recently undergone population contraction. In marked contrast, C. h. aquapotentis was found in high-income countries, mainly in Europe, North America and Oceania, and we reveal a signature of population expansion. Moreover, we detected genomic regions of introgression representing gene flow after a secondary contact between the subspecies from low- and high-income countries. We demonstrate that this gene flow resulted in genomic island of high diversity and divergence, and that this diversity at potential virulence genes is maintained by balancing selection, suggesting that they are involved in a coevolutionary arms race.

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