Country Level Socioeconomic and Health System Indicators Explain COVID-19 Mortality Worldwide

2020 ◽  
Author(s):  
Mohammad Noorchenarboo ◽  
Seyed Amirreza Mousavi ◽  
Hamed Moehimani
Keyword(s):  
Health System ◽  
Model Fit ◽  
Mortality Data ◽  
Final Model ◽  
Heritage Foundation ◽  
Resource Center ◽  
Country Level ◽  
Backward Elimination ◽  
Surgical Workforce ◽  
Johns Hopkins University

Background: COVID-19 mortality rates differ across countries. We aimed to construct a model that predicts mortality worldwide, by including only country-level socioeconomic and health system indicators and excluding variables related to short-term measures for pandemic management. Methods: COVID-19 mortality data was collected from Johns Hopkins University resource center. Additional sources were public reports from the United Nations, the World Bank and the Heritage Foundation. We implemented multiple linear regression with backward elimination on the selected predictors. Results: The final model constructed on seven Independent variables, significantly predicted COVID-19 mortality rate by country (F-statistic: 29.2, p<0.001). Regression coefficients (95% CI) in descending order of standardized effects: Annual tourist arrivals: 5.43 (4.03, 6.83); health expenditure per capita: 4.43 (2.92, 5.96); GDP (PPP): -4.60 (-6.81, -2.38); specialist surgical workforce per 100000: 2.63 (0.67, 4.59); number of physicians per 1000: -2.32 (-4.3, -0.28); economic freedom score: -1.35 (-2.60, -0.10); and total population: 1.66 (-0.19, 3.52). All VIF values were below 5, showing acceptable collinearity. R-squared (52.65%), adjusted R-squared (50.25%) and predicted R-squared (42.33%) showed strong model fit. Conclusion: limited country-level socioeconomic and health system indicators can explain COVID-19 mortality worldwide; emphasizing the priority of attending to these fundamental structures when planning for pandemic preparedness.

scholarly journals Reconcile the debate over protective effects of BCG vaccine against COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wei Fu ◽  
Pei-Chuan Ho ◽  
Chia-Lun Liu ◽  
Kai-Teh Tzeng ◽  
Nawar Nayeem ◽  
...  
Keyword(s):  
Potential Role ◽  
Early Stage ◽  
Bcg Vaccine ◽  
Protective Effects ◽  
Young Population ◽  
Resource Center ◽  
Country Level ◽  
Johns Hopkins University ◽  
Clinical Scenarios ◽  
Program Data

AbstractWhile awaiting the COVID-19 vaccines, researchers have been actively exploring the effectiveness of existing vaccines against the new virus, among which the BCG vaccine (Bacillus Calmette-Guérin) receives the most attention. While many reports suggest a potential role for BCG immunization in ameliorating SARS-CoV-2 infection, these findings remain controversial. With country-level COVID-19 outbreak data from Johns Hopkins University Coronavirus Resource Center, and BCG program data from World Atlas of BCG Policies and Practices and WHO/UNICE, we estimated a dynamic model to investigate the effect of BCG vaccination across time during the pandemic. Our results reconcile these varying reports regarding protection by BCG against COVID-19 in a variety of clinical scenarios and model specifications. We observe a notable protective effect of the BCG vaccine during the early stage of the pandemic. However, we do not see any strong evidence for protection during the later stages. We also see that a higher proportion of vaccinated young population may confer some level of communal protection against the virus in the early pandemic period, even when the proportion of vaccination in the older population is low. Our results highlight that while BCG may offer some protection against COVID-19, we should be cautious in interpreting the estimated effectiveness as it may vary over time and depend on the age structure of the vaccinated population.

scholarly journals Hippocampal sclerosis dementia: An amnesic variant of frontotemporal degeneration

2013 ◽  
Vol 7 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Chiadi U. Onyike ◽  
Olga Pletnikova ◽  
Kelly L. Sloane ◽  
Campbell Sullivan ◽  
Juan C. Troncoso ◽  
...  
Keyword(s):  
Psychiatric Disorder ◽  
Clinical Diagnosis ◽  
Hippocampal Sclerosis ◽  
Neuronal Loss ◽  
Executive Dysfunction ◽  
Convenience Sample ◽  
Illness Onset ◽  
Work Support ◽  
Resource Center ◽  
Johns Hopkins University

ABSTRACT Objective: To describe characteristics of hippocampal sclerosis dementia. Methods: Convenience sample of Hippocampal sclerosis dementia (HSD) recruited from the Johns Hopkins University Brain Resource Center. Twenty-four cases with post-mortem pathological diagnosis of hippocampal sclerosis dementia were reviewed for clinical characterization. Results: The cases showed atrophy and neuronal loss localized to the hippocampus, amygdala and entorrhinal cortex. The majority (79.2%) had amnesia at illness onset, and many (54.2%) showed abnormal conduct and psychiatric disorder. Nearly 42% presented with an amnesic state, and 37.5% presented with amnesia plus abnormal conduct and psychiatric disorder. All eventually developed a behavioral or psychiatric disorder. Disorientation, executive dysfunction, aphasia, agnosia and apraxia were uncommon at onset. Alzheimer disease (AD) was the initial clinical diagnosis in 89% and the final clinical diagnosis in 75%. Diagnosis of frontotemporal dementia (FTD) was uncommon (seen in 8%). Conclusion: HSD shows pathological characteristics of FTD and clinical features that mimic AD and overlap with FTD. The findings, placed in the context of earlier work, support the proposition that HSD belongs to the FTD family, where it may be identified as an amnesic variant.

scholarly journals Progress against inequalities in mortality: register-based study of 15 European countries between 1990 and 2015

2019 ◽  
Vol 34 (12) ◽  
pp. 1131-1142 ◽  
Author(s):  
Johan P. Mackenbach ◽  
José Rubio Valverde ◽  
Matthias Bopp ◽  
Henrik Brønnum-Hansen ◽  
Giuseppe Costa ◽  
...  
Keyword(s):  
Health Care ◽  
Fixed Effects ◽  
Causes Of Death ◽  
Health Care Expenditure ◽  
European Countries ◽  
Mortality Data ◽  
Factors Associated ◽  
Country Level ◽  
Low Educated ◽  
Inequalities In Mortality

AbstractSocioeconomic inequalities in mortality are a challenge for public health around the world, but appear to be resistant to policy-making. We aimed to identify European countries which have been more successful than others in narrowing inequalities in mortality, and the factors associated with narrowing inequalities. We collected and harmonised mortality data by educational level in 15 European countries over the last 25 years, and quantified changes in inequalities in mortality using a range of measures capturing different perspectives on inequality (e.g., ‘relative’ and ‘absolute’ inequalities, inequalities in ‘attainment’ and ‘shortfall’). We determined which causes of death contributed to narrowing of inequalities, and conducted country- and period-fixed effects analyses to assess which country-level factors were associated with narrowing of inequalities in mortality. Mortality among the low educated has declined rapidly in all European countries, and a narrowing of absolute, but not relative inequalities was seen in many countries. Best performers were Austria, Italy (Turin) and Switzerland among men, and Spain (Barcelona), England and Wales, and Austria among women. Ischemic heart disease, smoking-related causes (men) and amenable causes often contributed to narrowing inequalities. Trends in income inequality, level of democracy and smoking were associated with widening inequalities, but rising health care expenditure was associated with narrowing inequalities. Trends in inequalities in mortality have not been as unfavourable as often claimed. Our results suggest that health care expansion has counteracted the inequalities widening effect of other influences.

scholarly journals Social Comparison and Perceived Breach of Psychological Contract: Their Effects on Burnout in a Multigroup Analysis

2007 ◽  
Vol 10 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Gabriela Topa Cantisano ◽  
J. Francisco Morales Domínguez ◽  
J. Luis Caeiro García
Keyword(s):  
Secondary Schools ◽  
Social Comparison ◽  
Psychological Contract ◽  
Model Fit ◽  
Previous Model ◽  
Final Model ◽  
Multigroup Analysis ◽  
Mediator Role ◽  
The Relationship

This study focuses on the mediator role of social comparison in the relationship between perceived breach of psychological contract and burnout. A previous model showing the hypothesized effects of perceived breach on burnout, both direct and mediated, is proposed. The final model reached an optimal fit to the data and was confirmed through multigroup analysis using a sample of Spanish teachers (N = 401) belonging to preprimary, primary, and secondary schools. Multigroup analyses showed that the model fit all groups adequately.

Chemohormonal therapy in metastatic hormone-sensitive prostate cancer. Sweeney CJ, Chen YH, Carducci M, Liu G, Jarrard DF, Eisenberger M, Wong YN, Hahn N, Kohli M, Cooney MM, Dreicer R, Vogelzang NJ, Picus J, Shevrin D, Hussain M, Garcia JA, DiPaola RS. Department of Medicine; Department of Biostatistics and Computational Biology; Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston; Johns Hopkins University, Baltimore; University of Wisconsin Carbone Cancer Center; School of Medicine and Public Health; Madison; Fox Chase Cancer Center, Temple University Health System, Philadelphia; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis; Mayo Clinic, Rochester, MN; University Hospitals Case Medical Center, Seidman Cancer Center; Cleveland Clinic Taussig Cancer Institute; Both in Cleveland; University of Virginia Cancer Center, Charlottesville; Comprehensive Cancer Centers of Nevada, Las Vegas; Siteman Cancer Center, Washington University School of Medicine, St. Louis; NorthShore University Health System, Evanston, IL; University of Michigan Comprehensive Cancer Center, Ann Arbor; Rutgers Cancer Institute of New Jersey, New Brunswick.N Engl J Med. 2015 Aug 20;373(8):737-46. [Epub 2015 Aug 5]. doi: 10.1056/NEJMoa1503747.

2017 ◽  
Vol 35 (3) ◽  
pp. 123 ◽  
Author(s):  
Eggener Scott
Keyword(s):  
Health System ◽  
Medical Center ◽  
Cleveland Clinic ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
University Hospitals ◽  
University Of Wisconsin ◽  
School Of Medicine ◽  
Johns Hopkins University ◽  
Ann Arbor

Estimating HIV Prevalence and Incidence in Africa from Mortality Data

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Emily Oster
Keyword(s):  
Population Based ◽  
Hiv Prevalence ◽  
Early Years ◽  
Sub Saharan Africa ◽  
Mortality Data ◽  
Country Level ◽  
Hiv Virus ◽  
Current Prevalence ◽  
Prevalence Estimates ◽  
Sub Saharan

Abstract An estimated 33 million people are infected with the HIV virus, with 67% of them in Sub-Saharan Africa. Despite this, knowledge about HIV prevalence in Africa is limited and imperfect. Although population-based testing in recent years has provided reliable information about current prevalence in the general population, we have little reliable data on prevalence in early years of the epidemic. This paper suggests a new methodology for estimating HIV prevalence and incidence using inference from mortality data. This methodology can be used to generate prevalence estimates from early in the epidemic. This information is valuable for understanding how the epidemic has evolved over time and is also likely to be helpful in analyses that explore how policy affects the epidemic or how HIV affects other country-level outcomes.

scholarly journals Predicting COVID-19 in very large countries: The case of Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253146
Author(s):  
V. C. Parro ◽  
M. L. M. Lafetá ◽  
F. Pait ◽  
F. B. Ipólito ◽  
T. N. Toporcov
Keyword(s):  
Health System ◽  
Linear Combination ◽  
Figure Of Merit ◽  
Model Fit ◽  
The Novel ◽  
System Utilization ◽  
Practical Proposal ◽  
Free Parameters ◽  
Using Data

This work presents a practical proposal for estimating health system utilization for COVID-19 cases. The novel methodology developed is based on the dynamic model known as Susceptible, Infected, Removed and Dead (SIRD). The model was modified to focus on the healthcare system dynamics, rather than modeling all cases of the disease. It was tuned using data available for each Brazilian state and updated with daily figures. A figure of merit that assesses the quality of the model fit to the data was defined and used to optimize the free parameters. The parameters of an epidemiological model for the whole of Brazil, comprising a linear combination of the models for each state, were estimated considering the data available for the 26 Brazilian states. The model was validated, and strong adherence was demonstrated in most cases.

scholarly journals Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis

2021 ◽  
Author(s):  
Janet E. Squires ◽  
Alison M. Hutchinson ◽  
Mary Coughlin ◽  
Kainat Bashir ◽  
Janet Curran ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health System ◽  
The United States ◽  
Assessment Tools ◽  
Primary Role ◽  
Structured Interviews ◽  
Stakeholder Perspectives ◽  
Country Level ◽  
Conceptual Clarity ◽  
Level Of Experience

Background: Context is recognized as important to successful knowledge translation (KT) in health settings. What is meant by context, however, is poorly understood. The purpose of the current study was to elicit tacit knowledge about what is perceived to constitute context by conducting interviews with a variety of health system stakeholders internationally so as to compile a comprehensive list of contextual attributes and their features relevant to KT in healthcare. Methods: A descriptive qualitative study design was used. Semi-structured interviews were conducted with health system stakeholders (change agents/KT specialists and KT researchers) in four countries: Australia, Canada, the United Kingdom, and the United States. Interview transcripts were analyzed using inductive thematic content analysis in four steps: (1) selection of utterances describing context, (2) coding of features of context, (3) categorizing of features into attributes of context, (4) comparison of attributes and features by: country, KT experience, and role. Results: A total of 39 interviews were conducted. We identified 66 unique features of context, categorized into 16 attributes. One attribute, Facility Characteristics, was not represented in previously published KT frameworks. We found instances of all 16 attributes in the interviews irrespective of country, level of experience with KT, and primary role (change agent/KT specialist vs. KT researcher), revealing robustness and transferability of the attributes identified. We also identified 30 new context features (across 13 of the 16 attributes). Conclusion: The findings from this study represent an important advancement in the KT field; we provide much needed conceptual clarity in context, which is essential to the development of common assessment tools to measure context to determine which context attributes and features are more or less important in different contexts for improving KT success.

scholarly journals Barriers to increase surgical productivity in Sierra Leone: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056784
Author(s):  
Juul Bakker ◽  
A J van Duinen ◽  
Wouter W E Nolet ◽  
Peter Mboma ◽  
Tamba Sam ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Sierra Leone ◽  
Health Workers ◽  
Health System Strengthening ◽  
Financial Barriers ◽  
Public And Private ◽  
Factors Influencing ◽  
Surgical Workforce ◽  
Training Opportunities

ObjectiveTo explore factors influencing surgical provider productivity and identify barriers against and opportunities to increase individual surgical productivity in Sierra Leone, in order to explain the observed increase in unmet surgical need from 92.2% to 92.7% and the decrease in surgical productivity to 1.7 surgical procedures per provider per week between 2012 and 2017.Design and methodsThis explanatory qualitative study consisted of in-depth interviews about factors influencing surgical productivity in Sierra Leone. Interviews were analysed with a thematic network analysis and used to develop a conceptual framework.Participants and setting21 surgical providers and hospital managers working in 12 public and private non-profit hospitals in all regions in Sierra Leone.ResultsSurgical providers in Sierra Leone experience a broad range of factors within and outside the health system that influence their productivity. The main barriers involve both patient and facility financial constraints, lack of equipment and supplies, weak regulation of providers and facilities and a small surgical workforce, which experiences a lack of recognition. Initiation of a Free Health Care Initiative for obstetric and paediatric care, collaborations with partners or non-governmental organisations, and increased training opportunities for highly motivated surgical providers are identified as opportunities to increase productivity.DiscussionBroader nationwide health system strengthening is required to facilitate an increase in surgical productivity and meet surgical needs in Sierra Leone. Development of a national strategy for surgery, obstetrics and anaesthesia, including methods to reduce financial barriers for patients, improve supply-mechanisms and expand training opportunities for new and established surgical providers can increase surgical capacity. Establishment of legal frameworks and appropriate remuneration are crucial for sustainability and retention of surgical health workers.

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