The Future of Telemedicine in Europe and Methods for the Evaluation of Health Services

2012 ◽  
Vol 1 (3) ◽  
pp. 20-26 ◽  
Author(s):  
Paola Di Giacomo
Keyword(s):  
Low Income ◽  
New Technologies ◽  
Controlled Trial ◽  
Evaluation Methods ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Analytical Work ◽  
The One

Despite the accumulation of evidence for the effects of approaches to chronic illness, methodological and analytical work is still needed to develop widely accepted evaluation methods that are scientifically sound and also practicable in routine settings. Given all the diversity and variability of disease management, a key issue for this work concerns the difficulties in establishing a useful “comparator” in settings where it is not practical or possible to execute an evaluation as a randomized controlled trial (RCT). This is indeed an important task because evaluation methods are a precondition to select efficient and effective programs, or components within a program that can address the growing burden of chronic and more in general health conditions. This is evident, in particular, when it comes to new technologies in medicine and implementation and evaluation, in the healthcare sectors, distinguishing low-income countries, on the one-hand, and those in other middle income countries.

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

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.

scholarly journals Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Low Income ◽  
Therapeutic Interventions ◽  
Low Income Countries ◽  
Middle Income ◽  
Major Health ◽  
Middle Income Countries ◽  
Low And Middle Income

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and 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.

scholarly journals Impact of refugee population on development: A comparative analysis for the case of host economies

2018 ◽  
Vol 18 (1) ◽  
pp. 77-96
Author(s):  
Mohamed Kouni
Keyword(s):  
Labor Force ◽  
Direct Effect ◽  
Low Income ◽  
Indirect Effect ◽  
Point Of View ◽  
Low Income Countries ◽  
Middle Income ◽  
Refugee Population ◽  
Low Income Country ◽  
Middle Income Countries

Abstract This study was carried out to investigate the relationship between refugees and development in host economies from a macroeconomic point of view. The results obtained show that this relationship is non-linear. The empirical results demonstrate that refugees have a positive and significant direct effect in high and lower-middle-income countries. A positive and significant indirect effect of refugees through labor force and RD channels is also present in the same groups. In upper-middle-income and low-income countries, the direct effect of refugees is negative and significant. Similarly, the indirect effect of the refugee population on development through labor force channel is also negative and statistically significant. However, the indirect effect of refugees through RD channel is statistically significant only for the low-income country group.

IPRs and Innovation, Technology Transfer, and Economic Welfare

2020 ◽  
pp. 1536-1568
Author(s):  
Juan Manuel Gil ◽  
Luis Angel Madrid ◽  
Carlos Hernán Fajardo
Keyword(s):  
Technology Transfer ◽  
Low Income ◽  
Positive Impact ◽  
Low Income Countries ◽  
Economic Welfare ◽  
Middle Income ◽  
Middle Income Countries ◽  
Transfer Of Technology ◽  
The Difference ◽  
Dissemination Of Technology

The TRIPS agreement states that Intellectual Property Rights (IPRs) protection should contribute to the promotion of technological innovation, economic welfare, and to the transfer and dissemination of technology. However, there is still no consensus on whether IPRs protection has achieved its goal. Thus, the chapter provides a discussion on how the impact of IPRs on innovation, technology transfer, and economic welfare is affected by the difference in the income level of the countries. The results suggest that in high-income and upper middle-income countries, IPRs have a positive impact in these variables. Nevertheless, it seems that in lower middle-income and low-income countries, IPRs have not increased innovation, spurred transfer of technology. or created economic welfare.

Injury prevention and control

2021 ◽  
pp. 361-376
Author(s):  
Corinne Peek-Asa ◽  
Adnan A. Hyder
Keyword(s):  
Injury Prevention ◽  
Low Income ◽  
Prevention And Control ◽  
Low Income Countries ◽  
Middle Income ◽  
Injury Rates ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
And Control

Injuries are among the leading causes of death and disability throughout the world and contribute disproportionately to premature life lost. Injury rates are highest among middle- and low-income countries. According to analyses of the 2016 Global Burden of Disease data, injuries cause over 4.6 million deaths per year, accounting for nearly 8.4% of all deaths and 10.7% of disability-adjusted life years. Many opportunities to implement injury prevention strategies exist, and a systematic approach to injury prevention can help identify the most effective and efficient approaches. Building capacity for injury prevention activities in low- and middle-income countries is an important public health priority.

Interplays Between Methane Emission and Agricultural Output

2020 ◽  
Vol 11 (4) ◽  
pp. 56-69
Author(s):  
Ramesh Chandra Das ◽  
Arundhati Mukherjee
Keyword(s):  
Low Income ◽  
Methane Emissions ◽  
Low Income Countries ◽  
Middle Income ◽  
Agricultural Output ◽  
Methane Generation ◽  
Developed Economies ◽  
Middle Income Countries ◽  
Long Run ◽  
Short Run

There have been debates among the so-called developed economies and less developed and emerging economies on the issue of ‘who is responsible for' the emission of excessive greenhouse gases (GHGs) into the ambient environment. While methane emissions from agriculture and livestock is one of the important elements of GHGs, it is also required for growth of the agriculture and allied activities for all economic categories. The present study, under this backdrop, examines long run and short run linkages between methane emissions and agriculture outputs for high and low to upper middle-income countries for the period 1981-2012. The results show that the series of methane emissions and agriculture output are cointegrated in the 15 member Organization for Economic Co-operation and Development (OECD) group, low income and middle income countries signifying the responsibilities of these income groups in methane emissions. The responsible countries in the OECD are USA, UK, Japan, Germany, and Italy. Further, in short run dynamics, the Granger Causality results show that methane emissions make a cause to agriculture output for 15OECD and low-income countries, and agricultural output is a cause to methane generation for middle and all low to upper middle income countries. China, India, and Brazil cannot be blamed for making excessive methane generation as both the series are not cointegrated for them.

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

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

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