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In this paper, we analyze the extent to which low-income countries integrate into the global knowledge production network. We develop an (undirected) research collaboration model based on which we identify the drivers of global research collaboration using publication data of the field Business and Economics from the Web of Science and macroeconomic data from the United Nations Educational, Scientific and Cultural Organization Institute for Statistics. Network and dynamic panel regression techniques are employed. Our results show that (i) reciprocal preferential attachment and the homophily between countries reinforce scientific collaboration, (ii) there is no evidence that low-income countries are becoming better integrated into the global knowledge production over the years, despite their active participation in international reserach collaboration, while (iii) high-income countries show a basic willingness to cooperate with them, which, in turn, promotes the integration of low-income countries, although this willingness seems to decline; and (iv) as to low-income countries, they have little choice but to invest more in education and R&D in order to advance in the global knowledge production network. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence from globally diverse samples on the prevalence and correlates of meeting the global guideline of 180 minutes per day of total physical activity (TPA) among 3- to 4-year-olds. Methods: Cross-sectional study involving 797 (49.2% girls) 3- to 4-year-olds from 17 middle- and high-income countries who participated in the pilot phases 1 and 2 of the SUNRISE International Study of Movement Behaviours in the Early Years. Daily step count was measured using thigh-worn activPAL accelerometers. Children wore the accelerometers for at least one 24-hour period. Children were categorized as meeting the TPA guideline based on achieving ≥11,500 steps per day. Descriptive analyses were conducted to describe the proportion of meeting the TPA guideline for the overall sample and each of the sociodemographic variables, and 95% CIs were calculated. Multivariable logistic regression was used to determine the sociodemographic correlates of meeting the TPA guideline. Results: Mean daily step count was 10,295 steps per day (SD = 4084). Approximately one-third of the sample (30.9%, 95% CI, 27.6–34.2) met the TPA guideline. The proportion meeting the guideline was significantly lower among girls (adjusted OR [aOR] = 0.70, 95% CI, 0.51–0.96) and 4-year-olds (aOR = 0.50, 95% CI, 0.34–0.75) and higher among rural residents (aOR = 1.78, 95% CI, 1.27–2.49) and those from lower middle-income countries (aOR = 1.35, 95% CI, 0.89–2.04). Conclusions: The findings suggest that a minority of children might meet the TPA guideline globally, and the risk of not meeting the guideline differed by sociodemographic indicators. These findings suggest the need for more surveillance of TPA in young children globally and, possibly, interventions to improve childhood health and development. [ABSTRACT FROM AUTHOR]

Traditionally, public understanding of drowning survival has focused on swimming capacity, often measured by how far a person can swim. With respect to the high incidence of adult drowning in high-income countries, using the more inclusive concept of water competency may yield a more comprehensive explanatory framework for understanding the reasons behind these drownings. Any competency base required to survive a drowning situation is dynamic, complex, and multi-faceted. Furthermore, perceptions of risk and capacity to cope with that risk are likely to be pivotal to the avoidance of drowning. Adults' perceived water competence was measured against their actual water competence in a pool environment. Adults were tested on their competence in entering and exiting water, floating, and swimming. Despite most adults (98%) being unable to swim more than 100 m in open water, more than half (59%) perceived themselves as good swimmers, and more than quarter (27%) thought they could swim more than 200 m at the post-survey. In conclusion, reality gaps were found in water competence among adult groups. Differences between perceived and actual competence suggest that many adults may underestimate the risk of drowning and overestimate their competency. This provides a plausible explanation as to why many adults drown. [ABSTRACT FROM AUTHOR]

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.

Introduction Methods Results Conclusions Minimally invasive surgery (MIS) has become standard of care in many high‐income countries, but its adoption in low‐ and middle‐income countries (LICs/MICs) has been impeded by resource‐ and training‐related barriers. We hypothesized that trainees in MICs perform MIS procedures less often, and that as procedure complexity increases, the rate of MIS decreases.A 22‐question survey, distributed to representative leaders across Latin America, collected country‐specific graduating trainee case requirements and volumes for four index procedures (cholecystectomy, appendectomy, inguinal hernia repair, colectomy) using MIS or open surgery (OS). USA data was obtained from the Accreditation Council for Graduate Medical Education. Kruskal–Wallis and Mann–Whitney U tests were performed to determine whether the rate of MIS differed across all countries, procedure complexity classes, and high income countries (HICs)/MICs.Seven experts (70% response rate) completed the survey, representing: Brazil, Chile, Ecuador, Guatemala, Mexico, Panama, and Paraguay. The percentage of MIS completed by trainees varied with mean and interquartile ranges as follows: cholecystectomy (60% ± 54%), appendectomy (41% ± 69%), inguinal hernia repair (19% ± 23%), colectomy (16% ± 29%). There was a significant difference in mean MIS experience across the eight countries (H = 17.6, p = 0.014) and between most complex and least complex procedures (p = 0.039). No difference was found between MICs and HICs (p = 0.786).We found a significant difference of general surgery trainee exposure to MIS versus OS across the Americas, but the difference was not significantly associated with World Bank Income Groups. Different trainee experiences with MIS and OS may highlight an opportunity for international and bidirectional collaboration. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodResultsConclusionResearch on legal minors who inject drugs is rare and beset with methodological problems. We explore the potential of register data for researching this population and present illustrative analyses contributing to the knowledge base.We obtained register data with national coverage from three high-income countries and assessed its analytic potential across two research themes. Descriptive analyses of the obtained data explored prevalence, mean age of debut, delay to accessing services, and treatment needs.There were differences in register types and variables collected within and between each country. The analytical potential of register data was assessed as good. Prevalence of injecting debut before the age of 18 (IDU < 18) was 29% (Sweden), 23% (Switzerland), and 5%–9% (Wales). IDU < 18 took longer to access services in each country than those with debut as adults. Complex treatment needs were identified, including mental health, education, and housing.Register data is a viable method for better understanding this small, ‘hidden’ population, albeit with important caveats. Adolescent drug services may need to deliver or link to a range of treatment responses beyond drug use. Innovative outreach, and legal and policy change may be needed to ensure harm reduction access while injecting continues. [ABSTRACT FROM AUTHOR]

Low- and middle-income countries (LMICs) face high burden of common mental disorders (CMDs). Most of the evidence for the Collaborative Care (CC) model effectiveness comes from high-income countries (HICs) and may not generalise to LMICs. A systematic review was conducted to assess effectiveness of CC for CMDs in LMICs. We searched eight-databases, two trial registries (2011-November 2023). Randomised controlled trials (RCTs) of adults (≥18 years) with depression/anxiety diagnosis, reporting remission/change in symptom severity were eligible. Random effects meta-analyses were conducted for: short-(0–6 months), medium-(7–12 months), long-(13–24 months), and very long-term (≥25 months) follow-up. Quality was assessed with Cochrane RoB2 tool. PROSPERO registration: CRD42022380407. Searches identified 7494 studies, 12 trials involving 13,531 participants were included; nine had low-risk of bias. CC was more effective than usual care for depression: dichotomous outcomes (short-term, 7 studies, relative risk (RR) 1.39, 95%CI 1.31, 1.48; medium-term, 6 studies, RR 1.35, 95%CI 1.28, 1.43); and continuous outcomes (short-term, 8 studies, standardised mean difference (SMD) −0.51, 95%CI −0.80, −0.23; medium-term, 8 studies, SMD −0.59, 95%CI −1.00, −0.17). CC was found to be effective at long-term (one study), but not at very long-term. Improvement in anxiety outcomes with CC (2 studies, 340 participants) reported up to 12-months; improvements in quality-of-life were not statistically significant (3 studies, 796 participants, SMD 0.62, 95%CI −0.10, 1.34). Pooled estimates showed high heterogeneity. In LMICs, CC was more effective than usual care for improving depression outcomes at short and medium-term follow-up. A similar improvement was found for anxiety outcomes, but evidence is limited. • Collaborative Care shows effectiveness for treatment of common mental disorders. • Effectiveness established even in the presence of physical comorbidity. • Delivery through task shifting by trained non-mental health workers is effective. • Future research to focus on implementation in low- and middle-income countries [ABSTRACT FROM AUTHOR]

The article discusses the importance of improving stroke care in Australia, highlighting the need for faster access to stroke units and reperfusion treatments. Despite having a national clinical care standard and registry, Australia lags behind other countries in stroke unit admissions and treatment speed. The article introduces the 30/60/90 National Stroke Targets, aiming to improve stroke care by setting specific goals for stroke unit admission rates and reperfusion treatment times. The targets have been endorsed by various Australian stroke organizations and are seen as a crucial step towards enhancing stroke outcomes and establishing a template for quality improvement initiatives in healthcare. [Extracted from the article]

Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, accounting for 74% of deaths annually. Satellite imagery provides previously unattainable data about factors related to NCDs that overcome limitations of traditional, non-satellite-derived environmental data, such as subjectivity and requirements of a smaller geographic area of focus. This systematic literature review determined how satellite imagery has been used to address the top NCDs in the world, including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. Methods: A literature search was performed using PubMed (including MEDLINE), CINAHL, Web of Science, Science Direct, Green FILE, and Engineering Village for articles published through June 6, 2023. Quantitative, qualitative, and mixed-methods peer-reviewed studies about satellite imagery in the context of the top NCDs (cancer, cardiovascular disease, chronic respiratory disease, and diabetes) were included. Articles were assessed for quality using the criteria from the Oxford Centre for Evidence-Based Medicine. Results: A total of 43 studies were included, including 5 prospective comparative cohort trials, 22 retrospective cohort studies, and 16 cross-sectional studies. Country economies of the included studies were 72% high-income, 16% upper-middle-income, 9% lower-middle-income, and 0% low-income. One study was global. 93% of the studies found an association between the satellite data and NCD outcome(s). A variety of methods were used to extract satellite data, with the main methods being using publicly available algorithms (79.1%), preprocessing techniques (34.9%), external resource tools (30.2%) and publicly available models (13.9%). All four NCD types examined appeared in at least 20% of the studies. Conclusion: Researchers have demonstrated they can successfully use satellite imagery data to investigate the world's top NCDs. However, given the rapid increase in satellite technology and artificial intelligence, much of satellite imagery used to address NCDs remains largely untapped. In particular, with most existing studies focusing on high-income countries, future research should use satellite data, to overcome limitations of traditional data, from lower-income countries which have a greater burden of morbidity and mortality from NCDs. Furthermore, creating and refining effective methods to extract and process satellite data may facilitate satellite data's use among scientists studying NCDs worldwide. [ABSTRACT FROM AUTHOR]

AbstractDiagnostic delay for endometriosis is a well-established phenomenon. Despite this, little is known about where in the health care system these delays occur or why they occur. Our review is the first attempt to synthesize and analyze this international evidence. A systematic scoping review with a pre-specified protocol incorporated the literature on diagnostic delay for endometriosis using the social-ecological theoretical framework. Four databases (PubMed, MEDLINE, EMBASE, PsychINFO) were searched from inception to September 2023. The search yielded 403 studies, 23 of which met the inclusion criteria. Most were from high-income country researchers. The average diagnostic delay reported across studies was 6.8 years (range 1.5–11.4 years) but this masked the very wide differences reported between countries. Considering the impact on individuals and the health system, addressing diagnostic delay for endometriosis must remain a priority for researchers, health care providers and policy makers. [ABSTRACT FROM AUTHOR]

Background: There is broad scientific evidence for the effectiveness of individual trauma-focused evidence-based treatments (EBTs) such as "trauma-focused cognitive behavioural therapy" (TF-CBT) for children and adolescents with posttraumatic stress symptoms. However, there is a significant research-to-practice gap resulting in traumatized children in high-income countries in Europe having only very limited access to these treatments. The aim of this study was, therefore, to identify common barriers and successful dissemination and implementation (D&I) strategies of evidence-based trauma-focused treatments (in particular TF-CBT) in seven European countries. Methods: For this study, we chose a mixed-method approach: an online survey among certified European TF-CBT trainers (N = 22) and the collection of country-based narratives from TF-CBT experts in different European countries (Finland, Germany, Italy, Netherlands, Norway, Sweden). Results: Common modifiable barriers to the implementation of TF-CBT were identified on different levels (e.g. government or treatment level), and successful D&I strategies were highlighted across all countries, such as translations of materials. Additionally, the experts from the country narratives put together a broad overview of TF-CBT research in Europe. Conclusions: The results of this study revealed that especially learning collaborations and the development of joint European efforts in funding and researching D&I strategies are crucial for future implementation of trauma-focused EBTs in Europe. [ABSTRACT FROM AUTHOR]

Road traffic is an important source of urban air pollutants. Due to increasingly strict controls of exhaust emissions from road traffic, their contribution to the total emissions has strongly decreased over time in high-income countries. In contrast, non-exhaust emissions from road vehicles are not yet legislated and now make up the major proportion of road traffic emissions in many countries. Brake wear, which occurs due to friction between brake linings and their rotating counterpart, is one of the main non-exhaust sources contributing to particle emissions. Since the focus of brake wear emission has largely been on particulate pollutants, little is currently known about gaseous emissions such as volatile organic compounds from braking and their fate in the atmosphere. This study investigates the oxidative ageing of gaseous brake wear emissions generated with a pin-on-disc tribometer, using an oxidation flow reactor. The results demonstrate, for the first time, that the photooxidation of gaseous brake wear emissions can lead to formation of secondary particulate matter, which could amplify the environmental impact of brake wear emissions. [ABSTRACT FROM AUTHOR]

WHO recently announced a process to review and potentially update the procedures for selecting essential medicines. This announcement presents an opportunity to reflect on the evolution of the WHO Model Lists of Essential Medicines (EML), including the composition of the stakeholders that shape priorities. We contextualised our findings within the broader history of the WHO EML to support future reforms to improve access to essential medicines. The current system allows individuals to propose a medicine for the WHO EML. This makes the EML reactive to applicant priorities. Almost all medicines (687/700; 98·1%) proposed to the WHO EML between 2003 and 2023 came from applicants in high-income countries. Most applications (210/700; 30·0%) were submitted by universities and research institutions, followed by non-governmental organisations (159/700; 22·7%), the UN system (158/700; 22·6%), professional associations (98/700; 14·0%), and the pharmaceutical industry (75/700; 10·7%). Between 1977 and 2023, over half of the Expert Committee members were from low-income and middle-income countries, with an increasing proportion in recent EML updates. Mainly, UN agencies acted as observers between 1977 and 2023. One central question emerges when evaluating whether applicants' geographical distribution translates to the WHO EML's intended purpose: for whom is the EML intended? Over the years, the geographical applicability has blurred. Defining a strategic vision for the WHO EML, including articulating a target audience and structured selection process, would strengthen decision-making processes by providing additional clarity, including to those implementing the guidance, mostly in low-income and middle-income countries. [ABSTRACT FROM AUTHOR]

The study aims to comprehend sustainable behaviors in high-income nations, where human–environment interactions are crucial. Increased transportation needs in industrialized countries highlight the importance of environmental challenges affecting human well-being. Railway passenger carrier, automobile energy efficiency, technology breakthroughs, financial incentives, and public–private partnerships (PPPs) affect congestion and sustainability, which the study analyses for sound policy inferences in a panel of 28 high-income nations from 2000 to 2022. The panel ARDL estimates reveal that railway passenger carrier increases carbon emissions in the short run while it improves them over time, highlighting the importance of urban planning. Environmental pollution, energy use, transportation behavior (including PPPs), and technical innovation have an inverse connection, demonstrating the efficacy of energy-efficient transport methods, research and development, and renewable energy sources. However, economic incentives highly correspond with carbon-intensive habits, emphasizing the need for high-income countries to phase them out. [ABSTRACT FROM AUTHOR]

Background: Dipyrone (Metamizole) is a potent pain reliever and fever reducer with muscle relaxant properties, most commonly used as an analgesic and antipyretic agent. Despite the fact that it has been banned in many high-income countries following confirmed studies of fatal agranulocytosis and adverse drug reactions, it is still widely used in various countries of the world. However, the antipyretic therapeutic indications of dipyrone in febrile children are currently unknown, and there is little information on the advantages and disadvantages of using dipyrone in febrile children. In febrile children, we expected that dipyrone's antipyretic effectiveness wouldn't be any more effective than ibuprofen. Therefore, the purpose of this research is to evaluate the effectiveness of oral dipyrone and oral ibuprofen as antipyretics in febrile children. Methods: Several databases, including PubMed, Scopus, Web of Science, and Cochrane Library, were searched thoroughly using a pre-established search strategy for potential research. The studies included in this analysis comprised randomized controlled trials that compared the antipyretic effects of oral ibuprofen and oral dipyrone in febrile children. Data analysis was carried out using RevMan 5.4 software. Results: Three studies were selected among the 27 publications we discovered to be applicable, and they underwent qualitative and quantitative analysis. The pooled analysis revealed no discernible difference between oral dipyrone and oral ibuprofen in terms of their antipyretic effects (Mean difference (MD) = 0.06; 95% confidence interval (CI): -0.08, 0.20). Conclusion: Both oral dipyrone and ibuprofen are effective in reducing high-temperature levels in febrile children without any significant difference. [ABSTRACT FROM AUTHOR]

Background Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. Methods Five databases were searched from 2014 to 2022, with 14 871 articles screened, 119 papers included and data analysed on 29 159 948 participants. Random effects meta-analyses were conducted to determine overall prevalence, prevalence of stages 3–5 and prevalence in males and females. Influences of age, sex and socio-economic status were assessed in subgroup analyses and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. Results The overall prevalence of CKD was 13.0% [95% confidence interval (CI) 11.3–14.8] and 6.6% (95% CI 5.6–7.8) for stages 3–5. The prevalence was higher in studies of older populations (19.3% for stages 1–5, 15.0% for stages 3–5) and meta-regression demonstrated an association of age, body mass index, diabetes and hypertension with prevalence of stages 3–5. The prevalence of CKD stages 1–5 was similar in males and females (13.1% versus 13.2%), but the prevalence of stages 3–5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low-, middle- and high-income countries, respectively; for stages 3–5, prevalence was 4.0%, 6.7% and 6.8%, respectively. Included studies were at moderate–high risk of bias in the majority of cases (92%) and heterogeneity was high. Conclusion This study provides a comprehensive assessment of CKD prevalence, highlighting important disparities related to age, sex and socio-economic status. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

This paper scrutinizes the objective of inclusion in contemporary science, technology, and innovation (STI) policies by analyzing its manifestations within the broad STI policy language promoting a closer interaction between science and society. We contribute to the STI policy literature by revisiting current conceptualizations that primarily center on marginalized groups. By analyzing the Broader Impacts Criterion and Responsible Research and Innovation frameworks in the USA and the European Union, we show that inclusion in the context of high-income countries is partially decoupling from marginalization and increasingly being instrumentalized to serve impact agendas. Our conceptual framework synthesizing the dimensions of goal setting and agency illustrates the broadening scope of inclusive policies and the emergent decoupling dilemma that has been neglected in the literature. Future research must account for the growing ambiguity of policy language that is facing new legitimacy questions and the blurring of objectives focused on supporting marginalized groups. [ABSTRACT FROM AUTHOR]

Background Before the COVID-19 pandemic, stagnating life expectancy trends were reported in some high-income countries (HICs). Despite previous evidence from country-specific studies, there is a lack of comparative research that provides a broader perspective and challenges existing assumptions. This study aims to examine longevity trends and patterns in six English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom, United States) by combining period and cohort perspectives and to compare them with other HICs. Methods Using data from the Human Mortality and World Health Organization Mortality Databases, we estimated partial life expectancy, lifespan inequality and cohort survival differences for 1970–2021, as well as the contribution of causes of death to the gap in life expectancy between English-speaking countries and the average for other HICs in 2017–19. Results In the pre-pandemic period, the increase in life expectancy slowed in all English-speaking countries, except Ireland, mainly due to stagnating or rising mortality at young-middle ages. Relative to other HICs, those born in Anglophone countries since the 1970s experienced relative survival disadvantage, largely attributable to injuries (mainly suicides) and substance-related mortality (mainly poisonings). In contrast, older cohorts enjoyed advantages for females in Australia and Canada and for males in all English-speaking countries except the United States. Conclusions Although future gains in life expectancy in wealthy societies will increasingly depend on reducing mortality at older ages, adverse health trends at younger ages are a cause for concern. This emerging and avoidable threat to health equity in English-speaking countries should be the focus of further research and policy action. [ABSTRACT FROM AUTHOR]

The October 2024 issue of Politics & Policy (P&P) features a collection of scholarly articles covering various regions around the world. The articles have undergone a rigorous peer review process and have been selected for their strengths in engaging both specialists and generalist readers. The issue highlights three significant themes: welfare policy, violence and democracy concerns in sub-Saharan Africa, and political cohorts and generational analysis in the United States. The editor encourages readers to explore the articles for engaging arguments, literature reviews, and theoretical insights. [Extracted from the article]

Study Background and Aims: There are marked barriers to research and publishing for low- and middle- income country (LMIC) ENT researchers. This could be reflected in LMIC journal characteristics and research, which has never been investigated. We aim to characterize differences in the number, geographic distribution, publishing costs, reach, number of articles, citations, and impact factors of high-income country (HIC) journals compared to LMIC journals. Methods: We included journals listed under the category "Otorhinolaryngology' in three major journal databases. From journal websites, we collected data related to financial model, waiver policy, access, and distribution. Additionally, from the Clarivate Journal Citation Reports 2022, we collected the following journal metrics: total articles, total citations, journal citation indicator, journal impact factor (JIF), 5-year JIF, and JIF without self cites. Results: 79.7% HIC journals offered English editing services, compared with 25.0% of LMIC journals. Additionally, 40.0% of HIC journals are solely open access compared with 92.0% in LMICs. Lower journal metrics were seen in LMIC journals, including 2022 mean total articles (107 HICs vs. 60 LMICs), total citations (4296 vs. 751), journal citation indicator (0.88 vs. 0.35), and journal impact factor (12.68 vs. 0.82). Conclusion: We have identified substantial differences in the distribution, English editing services, and journal metrics of HIC journals compared to LMIC journals. These may point to potential barriers to publishing and research access for those in LMICs. To support LMIC research, future work should evaluate opportunities to increase the number of ENT journals in LMICs, expand open access publishing, improve access to language services, and increase LMIC research impact. [ABSTRACT FROM AUTHOR]

Background: Canada, like many other jurisdictions worldwide, is facing a nursing shortage. At the same time, high-income countries are facing a rapidly ageing and more complex older adult population. Demands for more responsive health care services are driving systems of care to meet the evolving needs of the ageing population. Internationally-educated nurses (IENs) can help fill gaps in the care of older adults, but may need considerable support to work in new social and health care environments. However, the experiences of IENs within the geriatric care literature have not been comprehensively reviewed. This protocol will outline a scoping review to determine: (1) what is known about the experiences and support needs of IENs in geriatric healthcare settings within high income countries? (2) what are current supportive-pathways for IENs in geriatric practice settings? And (3) what are the research gaps in the existing literature on the experiences and support needs of IENs within the context of geriatrics? Methods: A scoping review will be conducted guided by the methodological framework set out by Arksey and O'Malley (2005) and later advanced by Levac, Colquhoun and O'Brien (2010). The search strategy will be applied to seven databases (MEDLINE, PubMed (non-MEDLINE records), PsycINFO, PsychArticles, CINAHL, Scopus, Web of Science). Grey literature will be searched using Google search engines, targeted websites and consultation with content experts. Articles of any publication date will be included. A two-stage screening process will be conducted in duplicate (i.e., two reviewers per stage) to determine eligible articles. Data from eligible articles will be extracted using a piloted charting form. Extracted data will be analyzed using thematic and descriptive analyses. Discussion: The findings of the upcoming will highlight opportunities and recommendations to inform future research and support training to support IENs working with older adults within high income countries. Publication, presentations and stakeholder meetings will disseminate our findings. [ABSTRACT FROM AUTHOR]

Traumatic injury remains a significant public health problem, with the burden highest in low-middle income countries (LMICs) and rural areas.1,2 The far-western region of Nepal, which has the lowest human development index in the country, has a high burden of traumatic injuries.3-5 One hospital in the far-western district of Achham, Bayalpata Hospital, cares for the majority of patients with traumatic injuries – most of whom arrive without any pre-hospital care. The absence of a professionalized pre-hospital program, such as an established Emergency Medical Services (EMS) system, necessitates creative strategies to address this gap.6,7 In this context, implementing a trauma-training program for community health responders (CHRs) offers a promising solution, leveraging local resources to improve early-stage trauma care. [ABSTRACT FROM AUTHOR]

Background: Until local healthcare infrastructure is strengthened, cardiac surgical care in low- and middle-income countries is often provided by non-governmental organizations by way of visiting healthcare teams. This is generally considered to be a cost-effective alternative to transporting patients to high income countries for surgical care, but the costs of cardiac surgery consumables under this model are poorly understood. Our objective was to identify the per-patient cost of cardiac surgery consumables used in single and double valve replacements performed by a non-governmental organization in Rwanda. Methods: Financial data from 2020 were collected from Team Heart, a non-governmental organization that supports cardiac surgical care in Rwanda. A comprehensive list of consumables was generated, including surgical, perfusion, anesthesia, and inpatient supplies and medications. Acknowledging the variability in perioperative needs, the quantities of consumables were calculated from an average of six patients who underwent single or double-valve replacement in 2020. Total costs were calculated by multiplying purchasing price by average quantity per patient. Costs absorbed by the local hospital were excluded from the calculations. Results: The total cost per patient was estimated at $9,450. Surgical supplies comprised the majority of costs ($6,140 per patient), with the most substantial cost being that of replacement valves ($3,500 per valve), followed by surgical supplies ($1,590 per patient). Conclusions: This preliminary analysis identifies a cost of just over $9,000 per patient for consumables used in cardiac valve surgery in Rwanda, which is lower than the estimated costs of transporting patients to centers in high income countries. This work highlights the relative cost effectiveness of cardiac surgical care in low- and middle- income countries under this model and will be instrumental in guiding the allocation of local and international resources in the future. [ABSTRACT FROM AUTHOR]

To systematically investigate how youth with lived experience report their experience of depression in terms of features of depression and in relation to themselves and their environment. We conducted a systematic review of qualitative research around the world that explored the subjective experience of depression among youth (age range, 10-24 years) who had self-reported, screened positive for, or received a formal diagnosis of the disorder. We used multiple databases to search for relevant studies published in any language up until March 2023. Studies were coded regarding features of depression reported by adolescents. We also used thematic synthesis to extract and synthesize descriptions of the lived experience of depression, and to develop analytic themes. The study was registered with PROSPERO, CRD42021218300. We identified a total of 23,424 unique records, and included 39 studies in the final review, representing the views of 884 adolescents with lived experience of depression. Most of the studies were conducted in high-income countries (72.8%), and the majority of participants were female (65%). The most frequently reported features of depression were sadness (present in 92.3% of the studies), social withdrawal (76.9%), and loneliness (69.2%). In addition, we constructed 3 themes that aimed to synthesize youths' accounts of their perceptions and experiences of depression: (1) making sense; (2) factoring in culture and contextual influences; and (3) accessing support and care. Some of the more commonly reported features of depression among youth are not explicitly included in the DSM/ICD diagnostic criteria but are highly relevant and closely connected to the experiences of adolescents. Moreover, contextual interpretations of depression may be more sensitive to capture representations and narratives of depression among youth. Thus, incorporating features of depression reported by adolescents could potentially increase accuracy of detection, promote collaborative work, and enhance therapeutic and care outcomes. In this systematic review, the authors investigated the experience of adolescent depression across the globe. Drawing from 39 qualitative studies representing the views of 884 adolescents from 16 different countries, the authors found that sadness, social withdrawal, and loneliness were the most frequently reported features of depression. The authors argue that contextual interpretations of depression may be more sensitive to capturing representations and narratives of depression than focusing solely on DSM/ICD criteria. The authors suggest that understanding personal narratives can create greater depth of understanding of youth experiences of depression. The lived experience of depression in adolescence: a systematic review of the qualitative literature; https://www.crd.york.ac.uk/prospero/ ; CRD42021218300. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) is a harmful practice that has long-lasting negative impacts on the physical and psychological health of victims. Deemed a global concern, this practice persists in high-income countries (HIC) among certain migrant communities. Given the deleterious effects of the practice, we conducted an updated systematic review of the facilitators and barriers associated with the prevention of FGM in HIC. Method: A systematic review of published qualitative studies of FGM in HIC was conducted from 2012 to 2022. The search resulted in 276 studies. Of these, the majority were from low- and middle-income countries (LMIC) and excluded. A total of 14 studies were deemed fit for inclusion and none were excluded during quality appraisal. Relevant data were extracted from the studies and thematically analyzed to identify prevalent themes. Results: A total of 12 themes were identified and the majority reflected barriers to the prevention of FGM including beliefs about female virtue, beliefs about social sanctions, and the preservation of culture, among others. Facilitators to the prevention of FGM were fewer and included memory and trauma from experiencing FGM, knowledge and awareness of the female anatomy, and legislative protection from FGM due to migration. A few themes, such as religious beliefs, acted as both facilitators and barriers. Conclusion: Findings highlight the importance of shared cultural and social threads among FGM practicing communities in HIC. Interventions can use these findings to guide the development of sociocultural strategies centered on community-level prevention and reduction of FGM in HIC. [ABSTRACT FROM AUTHOR]

Greater use of communication technologies among young people, including mobile phones, social media and communication apps, has coincided with declines in youth alcohol use in many high-income countries. However, little research has unpacked how drinking as a practice within interconnected routines and interactions may be changing alongside these technologies. Drawing on qualitative interviews about drinking with young people aged 16–23 across three similar studies in Australia, the United Kingdom and Sweden, we identify how communication technologies may afford reduced or increased drinking. They may reduce drinking by producing new online contexts, forms of intimacy and competing activities. They may increase drinking by re-organising drinking occasions, rituals and contexts. And they may increase or reduce drinking by enabling greater fluidity and interaction between diverse practices. These countervailing dynamics have likely contributed to shifting drinking patterns and practices for young people that may be obscured beneath the population-level decline in youth drinking. [ABSTRACT FROM AUTHOR]

Mortality after surgery in Africa is twice that in high-income countries. Most deaths occur on wards after patients develop postoperative complications. Family members might contribute meaningfully and safely to early recognition of deteriorating patients. This was a stepped-wedge cluster-randomised trial of an intervention training family members to support nursing staff to take and record patient vital signs every 4 h after surgery. Adult inpatients across four surgical wards (clusters) in a Ugandan hospital were included. Clusters crossed once from routine care to the SMARTER intervention at monthly intervals. The primary outcome was frequency of vital sign measurements from arrival on the postoperative ward to the end of the third postoperative day (3 days). We enrolled 1395 patients between April and October 2021. Mean age was 28.2 (range 5–89) yr; 85.7% were female. The most common surgical procedure was Caesarean delivery (74.8%). Median (interquartile range) number of sets of vital signs increased from 0 (0–1) in control wards to 3 (1–8) in intervention wards (incident rate ratio 12.4, 95% confidence interval [CI] 8.8–17.5, P <0.001). Mortality was 6/718 (0.84%) patients in the usual care group vs 12/677 (1.77%) in the intervention group (odds ratio 1.32, 95% CI 0.1–14.7, P =0.821). There was no difference in length of hospital stay between groups (usual care: 2 [2–3] days vs intervention: 2 [2–4] days; hazard ratio 1.11, 95% CI 0.84–1.47, P =0.44). Family member supplemented vital signs monitoring substantially increased the frequency of vital signs after surgery. Care interventions involving family members have the potential to positively impact patient care. NCT04341558. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacovigilance (PV), or the ongoing safety monitoring after a medication has been licensed, plays a crucial role in pregnancy, as clinical trials often exclude pregnant people. It is important to understand how pregnancy PV projects operate in low- and middle-income countries (LMICs), where there is a disproportionate lack of PV data yet a high burden of adverse pregnancy outcomes. We conducted a scoping review to assess how exposures and outcomes were measured in recently published pregnancy PV projects in LMICs. Methods: We utilized a search string, secondary review, and team knowledge to review publications focusing on therapeutic or vaccine exposures among pregnant people in LMICs. We screened abstracts for relevance before conducting a full text review, and documented measurements of exposures and outcomes (categorized as maternal, birth, or neonatal/infant) among other factors, including study topic, setting, and design, comparator groups, and funding sources. Results: We identified 31 PV publications spanning at least 24 LMICs, all focusing on therapeutics or vaccines for infectious diseases, including HIV (n = 17), tuberculosis (TB; n = 9), malaria (n = 7), pertussis, tetanus, and diphtheria (n = 1), and influenza (n = 3). As for outcomes, n = 15, n = 31, and n = 20 of the publications covered maternal, birth, and neonatal/infant outcomes, respectively. Among HIV-specific publications, the primary exposure-outcome relationship of focus was exposure to maternal antiretroviral therapy and adverse outcomes. For TB-specific publications, the main exposures of interest were second-line drug-resistant TB and isoniazid-based prevention therapeutics for pregnant people living with HIV. For malaria-specific publications, the primary exposure-outcome relationship of interest was antimalarial medication exposure during pregnancy and adverse outcomes. Among vaccine-focused publications, the exposure was assessed during a specific time during pregnancy, with an overall interest in vaccine safety and/or efficacy. The study settings were frequently from Africa, designs varied from cohort or cross-sectional studies to clinical trials, and funding sources were largely from high-income countries. Conclusion: The published pregnancy PV projects were largely centered in Africa and concerned with infectious diseases. This may reflect the disease burden in LMICs but also funding priorities from high-income countries. As the prevalence of non-communicable diseases increases in LMICs, PV projects will have to broaden their scope. Birth and neonatal/infant outcomes were most reported, with fewer reporting on maternal outcomes and none on longer-term child outcomes; additionally, heterogeneity existed in definitions and ascertainment of specific measures. Notably, almost all projects covered a single therapeutic exposure, missing an opportunity to leverage their projects to cover additional exposures, add scientific rigor, create uniformity across health services, and bolster existing health systems. For many publications, the timing of exposure, specifically by trimester, was crucial to maternal and neonatal safety. While currently published pregnancy PV literature offer insights into the PV landscape in LMICs, further work is needed to standardize definitions and measurements, integrate PV projects across health services, and establish longer-term monitoring. [ABSTRACT FROM AUTHOR]

Little is known about the effect of music intervention on perinatal depressive symptoms (PDS), especially the effectiveness of specific aspects of the intervention. This meta-analysis aimed to evaluate the effectiveness of music intervention and explore the role of different intervention features. Six databases were searched from inception to May 21, 2024, to identify randomized controlled trials evaluating the effect of music intervention on PDS. The Cochrane Risk of Bias (RoB) 2.0 tool was used to assess RoB. The meta-analysis of 10 studies including 988 participants showed that music intervention significantly improved PDS (standardized mean difference (SMD): 0.61, 95% confidence interval (CI): 0.91, −0.32), with statistical heterogeneity among the studies (I2 = 78%). Subgroup analysis showed significant effects on pregnant and postpartum women, and women with or without perinatal complications. Effects were also significant in low- and middle-income countries (SMD: 0.79, 95% CI: 1.16, −0.42), music medicine (SMD: 0.82, 95% CI: 1.17, −0.47), and total intervention length of less than 6 weeks (SMD: 0.85, 95% CI: 1.25, −0.45), but not in high-income countries, music therapy, or total intervention length of 6 weeks or more. Hospital intervention (SMD: 0.86, 95% CI: 1.41, −0.31) showed greater effects compared with home intervention and hospital combined with home intervention. Six studies had a high overall RoB and four had some concerns. Music intervention is effective in alleviating PDS. Interventions in low- and middle-income countries, music medicine, total intervention length of less than 6 weeks, and hospital intervention may be advisable. • Music intervention should be promoted for perinatal women without much consideration of their perinatal status or perinatal complications. • Music intervention should be promoted more in low- and middle-income countries. • Larger beneficial effects may be related to the hospital as an intervention site. • Effectiveness is related to music medicine and a total intervention length of less than 6 weeks. [ABSTRACT FROM AUTHOR]

Purpose: Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research. Methods: We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design. Results: Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship. Conclusions: Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal "prestige," and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research. [ABSTRACT FROM AUTHOR]

This paper examined the economic evidence of patient navigation services to increase breast and cervical cancer screenings among historically disadvantaged racial and ethnic populations and people with lower incomes. The literature search strategy for this systematic review included English-language studies conducted in high-income countries that were published from database inception to December 2022. Studies on patients with existing cancer or without healthcare system involvement were excluded. Analysis was completed in January 2023. All monetary values reported are in 2022 U.S. dollars. The search yielded 3 breast cancer, 2 cervical cancer, and 2 multiple cancer studies that combined breast and cervical cancer with other cancer screenings. For breast cancer screening, the intervention cost per person ranged from $109 to $10,245. Two studies reported $154 and $740 as intervention cost per additional person screened. Changes in healthcare cost per person from 2 studies were $202 and $2,437. Two studies reported cost per quality-adjusted life year (QALY) gained of $3,852 and $39,159 while one study reported cost per life year (LY) gained of $22,889. For cervical cancer, 2 studies reported intervention cost per person ($103 and $794) and per additional person screened ($56 and $533) with one study reporting a cost per QALY gained ($924). All estimates of cost per QALY/LY saved for breast cancer screening were below a conservative threshold of $50,000 indicating that patient navigation services for breast cancer screening were cost-effective. There is limited evidence to determine cost-effectiveness of patient navigation services for cervical cancer screening. [ABSTRACT FROM AUTHOR]

Introduction and background: Thermal ablation, a technique that destroys precancerous cervical cells by extreme heat or cold, is predominantly used as a preventive cervical cancer treatment modality in high-income countries. Compared to other treatment methods thermal ablation has numerous advantages in its portability, minimal electricity use and comparable treatment rates, which is convenient for use in low- and middle-income countries (LMICs). Therefore, it is important to understand acceptability among providers and clients and the feasibility of achieving comparable treatment outcomes with other methods in LMICs. Methodology: We conducted a prospective longitudinal, open-label two-arm study from June 2021 to April 2022 at seven health delivery points. In this study, 182 clients were enrolled to receive preventive cancer treatment at baseline and followed up 6 months later to measure treatment outcomes and experiences on the procedure. Eligible consented clients were elected to a preferred method (either thermal ablation as an intervention or cryotherapy as a control group). We also conducted qualitative interviews with 14 service providers in either static or outreach settings. Results: At the 6-month follow-up, the efficacy was comparable among the two groups, 96.5% (95% CI 86.7%-99.1%) clients in the intervention group had successful lesion treatment rate compared to 80.8% (95% CI 69.9%-99.1%) of the control group. Furthermore, 99% of clients in the intervention group would recommend thermal ablation to their family members or peers. Service providers preferred thermal ablation due to its ease of use, lower costs, portability and lower likelihood of adverse events compared to cryotherapy. Conclusion: The study showed the feasibility of implementing thermal ablation as a new preventive cervical cancer treatment modality in Zimbabwe. Furthermore, service providers indicated their preference for thermal ablation due to its ease of use, portability at static settings and lower likelihood of adverse events occurrence. Therefore, we recommend scaling up thermal ablation both at static and outreach sites. [ABSTRACT FROM AUTHOR]

Clinical research is the cornerstone of improvements in cancer care. However, it has been conducted predominantly in high-income countries with few clinical trials available in Brazil and other low-and-middle-income countries (LMIC). Of note, less than one-third of registered clinical trials addressing some of the most commonly diagnosed cancers (breast, lung and cervical) recruited patients from LMIC in the last years. The Institute Project CURA promoted the fourth CURA meeting, discussing barriers to cancer clinical research and proposing potential solutions. A meeting was held in São Paulo, Brazil, in June 2023 with representatives from different sectors: Brazilian Health Regulatory Agency (Anvisa), National Commission of Ethics in Research (CONEP), non-governmental organisations, such as the Latin American Cooperative Oncology Group, the Brazilian Society of Clinical Oncology (SBOC), Contract Research Organisations, pharmaceutical companies and investigators. A total of 16 experts pointed out achievements as shortening the time of regulatory processes involving Anvisa and CONEP, development of staff training programs, maintenance of the National Program of Oncological Attention (PRONON), and the foundation of qualified centres in North and Northeast Brazilian regions. Participants also highlighted the need to be more competitive in the field, which requires optimising ongoing policies and implementing new strategies as decentralisation of clinical research centres, public awareness campaigns, community-centered approaches, collaborations and partnerships, expansion of physiciansdirected policies, exploring the role of the steering committee. Active and consistent reporting of the initiatives might help to propagate ongoing advances, increasing Brazilian participation in clinical cancer research. Engagement of all players is crucial to maintain continuous progress with further improvements in critical points including regulatory timelines and increments in qualified human resources which aligned with new educational initiatives focused on physicians and the general population will expand access to cancer clinical trials in Brazil. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high‐income countries. Methods: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non‐dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high‐income countries. Studies specifically looking at food insecurity during the COVID‐19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle–Ottawa Scale (with modifications for cross‐sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Results: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross‐sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross‐sectional studies including 336 585 participants was equivocal, particularly in the sugar‐sweetened beverage (SSB) consumption post‐hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross‐sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross‐sectional studies, 138 102 participants). A single cross‐sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. Conclusions: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self‐care in food insecure populations. [ABSTRACT FROM AUTHOR]

Depression is a leading cause of disability and poor health worldwide and is expected to rank first worldwide by 2030. The aim of this study is to analyze the transition and trend of depression burden in China and various income-level countries by utilizing the Global Burden of Disease (GBD) database and the Joinpoint regression model. This analysis seeks to comprehend the variations in the burden of depression across different income regions and evaluate their developmental patterns. Based on the GBD 2019 open dataset, this study extracted data on YLD (Years Lived with Disability), DALY (Disability-Adjusted Life Years), and incidence related to depression. The analysis focused on the period between 1990 and 2019, covering global data and distinguishing between high-income, upper-middle-income, lower-middle-income, low-income countries, and China. We utilized the Joinpoint regression model to fit the spatiotemporal trend changes among different income-level countries. Pairwise comparisons were conducted to examine the parallelism and to determine if the differences in trend changes among various regions were statistically significant. From 1990 to 2019, the age-standardized YLD and DALY for depression female were higher than that in male. The YLD total change rate of depression men was higher than that of women. China exhibited the largest disparity in total YLD change rates between genders, reaching 0.08. During 1990 to 2019, the incidence of depression in 2005–2019 increased among females in middle to high-income countries, low-income countries, and China as compare to that of 1990–2005. Notably, China shown the most increase the incidence rate of females (from −0.4 % to 0.84 %). China experienced the most significant change in the YLD of depression during this period (AAPC = 0.45, 95 % CI = 0.41, 0.48, P < 0.01). China's YLD/Incidence rate was higher compared to the global, HICs, UMCs, LMCs, and LICs. In China, the YLD/incidence rate of depression began to rise in 1994, peaking around 2010, and then gradually declining. Since 2010, the growth rate of depression DALYs in China has been higher than the global average, high-income countries, upper-middle-income countries, lower-middle-income countries, and low-income countries. The DALY's AAPC value for the HLCs was the highest (AAPC = 0.24, 95 % CI = 0.22, 0.25, P < 0.01). The UMCs, in comparison to other regions, incidence rate had the highest AAPC value (AAPC = 0.48, 95 % CI = 0.46, 0.50, P < 0.01). Given the significant variations in the burden of depression across countries with different income levels, future strategies aimed at reducing the burden of depression should adopt tailored and differentiated approaches according to each country's specific needs and developmental stages. • Gender Disparities: From 1990 to 2019, the study reveals higher age-standardized YLD and DALY for depression among women compared to men. However, the total change rate for men's YLD was higher than for women. • China's Unique Burden: China exhibited the most significant disparity in total YLD change rates between genders, reaching 0.08. Additionally, it experienced a notable increase in the incidence rate among females, reaching 1.24. • Global and Regional Trends: The research uncovers variations in depression burden among different income countries. High-income countries showed higher age-standardized YLD rates, while low-income countries exhibited the highest change rate in depression incidence. • Gender and Income Disparities: Highlighting gender and income-related variations in depression burden underscores the need for targeted interventions based on socioeconomic and gender-specific factors. [ABSTRACT FROM AUTHOR]

The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) is increasing worldwide. HPV vaccines have shown efficacy in preventing diseases in both males and females. Therefore, there is a need to develop cost-effective strategies for HPV vaccines to prevent HPV-related OPC. This meta-analysis aimed to evaluate cost-effectiveness using the global mean of incremental cost-effectiveness ratios compared to the willingness-to-pay threshold and incremental net benefits (INBs) of HPV vaccination strategies between boys' extension vaccine and girls only. These recommendations will be useful for countries that have not implemented universal HPV vaccines in national programs, such as Taiwan. Studies evaluating the cost-effectiveness of HPV vaccination strategies in the prevention of OPC that included both sexes versus girls only were identified through the Cochrane Library, EMBASE, PubMed, ScienceDirect, and Web of Science databases on February 05, 2024, and a meta-analysis of pooled INBs was performed using a random-effects model. The outcome was an effective measurement of the OPC burden. The results are represented in USD (2024). Fifteen model analyses were included. All the studies were conducted in high-income countries. The global mean of incremental cost-effectiveness ratio was $39,553 (95% CI, $27,008–66,641) per quality-adjusted life years gained, which was below the global mean of the willingness-to-pay threshold of $65,473 (95% CI, $52,138–83,755). Pooled INBs of $9370 (95% CI, $5046–13,695; P < 0.001) favored the extended HPV in boys. HPV vaccination strategies that include boys are cost-effective compared to those with girls only in preventing OPC burden. By implementing a universal HPV vaccination program, countries can receive $9370 in additional monetary benefits per patient. Given its relevance to high-income countries, this study offers key insights that can aid policymakers in Taiwan. [ABSTRACT FROM AUTHOR]

This article revisits the relationship between economic growth and exchange rate misalignments. We aim to test whether undervaluation's impact on growth depends on institutional quality, as suggested in the previous literature. In our analysis, we focus on recent decades characterized by globalization. We use the framework of cross-country growth regressions estimated using the recently developed two-stage instrumental variable method, which allows accounting for cross sectional dependence. In addition, we use external instruments to address the potential endogeneity between economic growth and undervaluation. Our results confirm the positive relationship between undervaluation and growth across all income groups from low-income to high-income countries. The role of institutions in the transmission of undervaluation on growth appears consistently only among lower-middle-income countries. Therefore, while our results point to the positive effects of undervaluation, the support for the hope that countries can successfully compensate for poor institutional quality via the undervaluation of currencies is weaker and limited to specific stages of economic development. [ABSTRACT FROM AUTHOR]

The study set out to investigate whether transparency can mitigate the negative effects volatile capital flows have on growth using cross-section panel data from 21 sub-Saharan African countries from 2000 to 2019. Using the IVQR model, the study finds that at 75th quantile, poor growth performance in SSA is explained mostly by the volatility in debt net inflows compared to other categories of capital, while portfolio net inflow contributes most significantly to the low-level growth for low and medium income countries. Focusing on the interaction between transparency and capital net inflows, the study finds evidence that transparency reduces most of the negative effects of the volatility in debt net inflow compared to other categories of capital inflow. Thus, the study provides evidence that transparency can reduce the negative effects of volatile capital inflows on growth by a significant amount, which varies depending on the type of capital inflow. The implication is that the extent transparency dampens the negative impact of volatile capital flows depend on both the capital type and the level of income of the country concerned. Regarding FDI and FPI, transparency is most effective in reducing volatility of the flow for low income countries, while for debt flows transparency penalizes the volatility of flows for high income countries. On this basis, it recommends that central banks should adopt transparency as a policy tool, particularly in SSA economies with probably low initial transparency to help mitigate the harmful effects of large and volatile capital inflows. [ABSTRACT FROM AUTHOR]

Climate change mitigation is a pressing global challenge that requires reducing CO2 emissions without hindering economic growth. Using an extended Kaya identity, Logarithmic Mean Divisia Index (LMDI), and Tapio decoupling indicator, this paper investigates the spatio-temporal variations, drivers, and decoupling of CO2 emissions from economic growth in 150 countries from 1990 to 2019, considering regional disparities and income-based inequalities. The findings reveal increasing CO2 emissions between 1990 and 2019, with notable fluctuations in certain 5-year intervals. CO2 emission growth varied significantly by region, with countries like China, the USA, India, and Japan experiencing rapid increases. Economic growth emerged as the primary driver of CO2 emission growth, and its impact strengthened over time. Population growth also contributed significantly to CO2 emissions, particularly in middle- and low-income countries. The study identifies energy and carbon intensity as crucial mitigating factors that weaken CO2 emissions, offering hope for effective climate change mitigation. Furthermore, the degree of decoupling between economic growth and CO2 emissions varied among countries in the same region, with high-income countries demonstrating stronger decoupling compared to upper-middle-income countries, which accounted for 71% of global CO2 emission increase. These findings underline the imperative of accounting for income levels and regional differences in formulating CO2 emission mitigation strategies. Also, the study emphasizes the pressing necessity for cohesive global coordination to facilitate the transition toward a low-carbon economy. Such collaborative endeavors are paramount in our collective pursuit to combat climate change effectively, safeguarding the well-being and sustenance of our planet for future generations. As policymakers, it is imperative to integrate these insights into decision-making processes to chart a sustainable and resilient course forward. [ABSTRACT FROM AUTHOR]

Using a panel dataset of contract‐year observations for Major League Baseball (MLB) players, this study looks to understand how job security affects incentives for worker performance. Prior works have found evidence of diminished performance when job security is high in the early years of guaranteed contracts (shirking) and heightened performance when job security is low at the end of contracts when players are hoping to secure new contracts (opportunistic behavior). The focus of this study is on how socio‐economic background interacts with job security to influence performance. Theory and empirical evidence suggest that workers from disadvantaged socio‐economic backgrounds may care more about job security, which could subsequently lead the performance of such workers to be more affected by changes to job security. This hypothesis is tested empirically. In testing this indirectly, evidence of stronger impacts of job security on performance of MLB players from lower income countries relative to those from higher income countries is found. To directly test this hypothesis, data on player socio‐economic backgrounds is hand‐collected. The performance of players from less‐advantaged socio‐economic backgrounds is found to be more affected by job security. Given that job security is common in many work settings, these findings have implications for workers and employers both inside and outside of sports. [ABSTRACT FROM AUTHOR]

Background: Access to GP appointments is increasingly challenging in many high-income countries, with an overstretched workforce and rising demand. Various access systems have been developed and evaluated internationally. Aim: To systematically consolidate the current international evidence base related to different types of GP access systems. Design and setting: Scoping review examining international literature. Method: Literature searches were run across relevant databases in May 2022. Title, abstract, and full-text screenings were carried out. Data from included studies were extracted and mapped to synthesise the components and aims within different GP access systems. Results: In total, 49 studies were included in the review. The majority of these were set in the UK. Some access systems featured heavily in the literature, such as Advanced Access, telephone triage, and online consultations, and others less so. There were two key strategies adopted by systems that related to either changing appointment capacity or modifying patient pathways. Components related to these strategies are summarised and illustrated as a schematic representation. Most rationales behind access systems were practice, rather than patient, focused. 'Add-on' systems and aims for efficiency have become more popular in recent years. Conclusion: This synthesis provides a useful tool in understanding access systems' aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be underinvestigated and potentially overlooked during design and implementation. More recently, digital services have been promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible. [ABSTRACT FROM AUTHOR]

Based on the panel data of 96 countries from 2013 to 2020, this study innovatively adopts the TIMG index to measure global digital economy (DE) and examines the impact of DE on carbon emissions. We find that there is an inverted U-shaped relationship between DE and carbon emissions, and energy intensity is the mediating channel. Heterogeneity analysis reveals that lower-middle-income countries can enter the 'carbon reduction dividend stage' of DE faster than high-income and upper-middle-income countries. Our findings provide empirical evidence and policy references for effectively utilizing DE for carbon reduction. [ABSTRACT FROM AUTHOR]

This paper focuses on age restrictions on access to infertility treatments and eligibility for their public reimbursement, exploring their relevancy in contexts of rising late birth rates (40+). I explore how age‐based reimbursement policies for in vitro fertilization treatments have responded to these fertility trends in 27 high‐income countries and in which regulatory frameworks for medically assisted reproduction (MAR) very late births (45+) have particularly increased. First, I show that while age limits for treatment reimbursement are well aligned with the prevalence of late fertility in some national contexts, in most countries, strict age restrictions are lagging behind the rise in late births. In others, pronatalist policies have prompted permissive age criteria or law revisions, anticipating or adapting to rising trends in late births. Second, the rise in very late births has been limited in some contexts with strict age‐based rules. However, the analysis suggests that the impact of MAR on very late births may also be influenced by contextual factors other than regulations. [ABSTRACT FROM AUTHOR]

AbstractThe shoulder width, as a geometric element, plays a crucial role in enhancing highway safety. Research from high-income countries indicates that improving shoulders on highways leads to substantial safety benefits. However, the safety effectiveness of paved shoulders for low- and middle-income countries (LMICs) highway contexts has limited evidence. This study evaluated the safety effectiveness of the paved shoulder width on 61 km, four-lane, divided rural intercity highways in India. The first objective was to evaluate highway crash patterns using data from 2016 to 2019. The second objective was to evaluate the safety effectiveness of paved shoulder width using the case-control approach. The findings of this study demonstrate a consistent decline in the likelihood of crashes as the shoulder’s width increases within the range of zero to 2.5 m for the 100 m segment length and zero to 1.7 m for the 500 m segment length. Nevertheless, model estimates indicate an increased crash risk for shoulders wider than 2.5 m. The results also suggested that the odds ratio for paved shoulder widths ranging from no shoulder to 2.5 m is likely to follow the crash modification factor from the highway safety manual. The findings of this study hold significant implications for the design policy of shoulder width on rural highways in LMICs. [ABSTRACT FROM AUTHOR]

Early years interventions, particularly those supporting parents in the first 1001 days of their infants life, support healthy development of infants and prevent adverse experiences that can have long term negative impacts. Volunteers are often used to deliver such interventions. This scoping review aimed to explore the roles and characteristics of volunteers across early years interventions and map the evaluation in this field to identify gaps in the literature. A scoping review was conducted according to the Arksey and O'Malley Framework. Academic databases and grey literature sources were searched to identify literature evaluating volunteer-based interventions for parents in the first 1001 days of their infant's life (conception to aged two). Research conducted in the UK or comparable high-income countries since the year 2000 were identified and data relating to the volunteer role, intervention design and evaluation methods were mapped. Sixty-six articles were eligible for inclusion in the review. Volunteers were commonly involved in interventions to provide peer support for a range of parenting related matters, support breastfeeding and the mental and emotional wellbeing of parents. Volunteer roles were categorised based on their background (peers or non-peer volunteers), their responsibilities (provider of peer support, educator or providers of practical support) and the delivery style of their role (in person one to one support, group leader or remote support). Research most often involved exploring the experiences of those involved in receiving or delivering the interventions and measuring outcomes in relation to breastfeeding and parent mental wellbeing. Volunteers play a large role in the provision of early years interventions. Their varied contribution is presented through a typology that will allow comparisons of roles in future research. Further research exploring the impact on the volunteers and the organisation will support decision making around choosing a volunteer led model within early years services. [ABSTRACT FROM AUTHOR]

Energy-inefficient buildings are a major driver of climate change. The aging, energy inefficient housing occupied by low-income households in the US and other high-income countries is a driver of notable environmental and health disparities as well. Public policies for alleviating the financial and health burdens of energy inefficient housing have existed for decades, but fallen short of reaching most households in need. This paper proposes a promising new approach to filling gaps left by public programs -- one that relies on mobilizing the tools of private governance, carbon offsetting and the voluntary carbon market (VCM) to finance energy upgrades for low-income households. We develop a new and readily applicable methodology for calculating energy and carbon savings from efficiency upgrades based on readily accessible publicly available data. Tailored to the needs of estimating energy and carbon savings from efficiency upgrades to low-income units, rentals in particular, this methodology can be fruitfully deployed in monetizing the carbon savings from efficiency driven reductions in household energy use. Specifically, we propose packaging the emission reductions generated through energy savings as carbon offsets, then selling these offsets on the voluntary carbon market to generate financing for energy upgrades to low-income homes not served by public energy efficiency programs. Given the multiple economic and health co-benefits from low-income energy upgrades, we expect that carbon offsets generated through such upgrades will be attractive to many corporate and institutional offset buyers, particularly those who seek to fulfill climate commitments while also advancing economic and human development in their host communities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has wrought unprecedented disruption on global economies, leading to widespread income insecurity among individuals and households. This study investigates the impact of the pandemic on income insecurity across different income groups and assesses the role of social protection measures in mitigating these effects. Using cross-country data, we analyze the prevalence of income reduction and the effectiveness of social assistance programs in high-income, upper middle-income, lower middle-income, and low-income countries. Our findings reveal significant variations in income insecurity and social protection responses across these groups. the pandemic had a significant impact on household incomes globally, with lower-middle-income countries experiencing the most significant income reductions. The average per capita transfer amounts show a general decrease over time, which could be due to the economic strain on governments and the need for more sustainable social protection programs. The correlation between transfer amounts and the proportion of households with reduced income indicates that countries with higher income reduction rates tended to have lower average per capita transfer amounts, suggesting a potential lack of adequate support for those in need. The study highlights the importance of robust social safety nets in cushioning the economic blow of the pandemic, particularly for vulnerable populations in lower-income countries. [ABSTRACT FROM AUTHOR]

Summary: Background: Poor diet quality contributes to morbidity and mortality and affects environmental sustainability. The EAT-Lancet reference diet offers a healthy and sustainable solution. This study aimed to estimate the association between diet cost and dietary quality, measured with an EAT-Lancet Index. Methods: An EAT-Lancet index was adapted to assess adherence to this dietary pattern from 24-h recalls data from the 2012 and 2016 Mexican National Health and Nutrition Surveys (n = 14,242). Prices were obtained from the Consumer Price Index. We dichotomized cost at the median (into low- and high-cost) and compared the EAT-Lancet index scores. We also used multivariate linear regression models to explore the association between diet cost and diet quality. Results: Individuals consuming a low-cost diet had a higher EAT-Lancet score than those consuming a high-cost diet (20.3 vs. 19.4 from a possible scale of 0 to 42; p < 0.001) due to a lower intake of beef and lamb, pork, poultry, dairy, and added sugars. We found that for each one-point increase in the EAT-Lancet score, there was an average decrease of MXN$0.4 in the diet cost (p < 0.001). This association was only significant among low- and middle-SES individuals. Conclusions: Contrary to evidence from high-income countries, this study shows that in Mexico, adhering to the EAT-Lancet reference diet is associated with lower dietar costs, particularly in lower SES groups. These findings suggest the potential for broader implementation of healthier diets without increasing the financial burden. [ABSTRACT FROM AUTHOR]