Global Burden of Green Tobacco Sickness in Farm Workers: A Systematic Review and Meta-Analysis of Prevalence, Gender Disparities, and Socio-Economic Determinants

<p>This study aims to analyze the disclosure distribution of the position regency/city in Central Java based on the linkage of Economic Growth (EG) and Human Development Index (HDI). The study uses secondary data in the form of cross-sectional regional regency/city based on EG and HDI components. Data analysis uses regency/city distribution plot diagram based on EG and HDI components in the Cartesian diagram which divides the space into 4 Quadrants, namely: Quadrant I of the regency/city distribution plots with high EG and HDI, Quadrant II of the regency/city distribution plots with low EG and high HDI, Quadrant III of the regency/city distribution plots with high EG and low HDI, and Quadrant IV of the regency/city distribution plots with low EG and HDI. This study concludes that the position of cities in Central Java in general is in line with the Quadrant I group, the HDI of regency/city in the area of the ex-Semarang and ex-Surakarta residency is in Quadrant I. Other regencies/cities are spread in Quadrant II, III, and IV.</p><p><strong>Keywords</strong><strong> : </strong>human development index, economic growth, Central Java, distribution plot</p><p> </p>

BackgroundThis study aimed to evaluate the global incidence, mortality of gallbladder cancer, and their associations with human development index (HDI), gross domestic products (GDP), smoking, alcohol drinking, and overweight for...

BackgroundDetermining the cost-effectiveness thresholds for healthcare interventions has been a severe challenge for policymakers, especially in low- and middle-income countries. This study aimed to estimate the cost per disability-adjusted life-year (DALY) averted for countries with different levels of Human Development Index (HDI) and Gross Domestic Product (GDP).MethodsThe data about DALYs, per capita health expenditure (HE), HDI, and GDP per capita were extracted for 176 countries during the years 2000 to 2016. Then we examined the trends on these variables. Panel regression analysis was performed to explore the correlation between DALY and HE per capita. The results of the regression models were used to calculate the cost per DALY averted for each country.ResultsAge-standardized rate (ASR) DALY (DALY per 100,000 population) had a nonlinear inverse correlation with HE per capita and a linear inverse correlation with HDI. One percent increase in HE per capita was associated with an average of 0.28, 0.24, 0.18, and 0.27% decrease on the ASR DALY in low HDI, medium HDI, high HDI, and very high HDI countries, respectively. The estimated cost per DALY averted was $998, $6522, $23,782, and $69,499 in low HDI, medium HDI, high HDI, and very high HDI countries. On average, the cost per DALY averted was 0.34 times the GDP per capita in low HDI countries. While in medium HDI, high HDI, and very high HDI countries, it was 0.67, 1.22, and 1.46 times the GDP per capita, respectively.ConclusionsThis study suggests that the cost-effectiveness thresholds might be less than a GDP per capita in low and medium HDI countries and between one and two GDP per capita in high and very high HDI countries.

SummaryBackgroundSurgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.MethodsThis international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.FindingsBetween Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).InterpretationCountries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.FundingDFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.

The Human Development Index (HDI), a concept of global socioeconomic subdivision developed by the United Nations based on three characteristics – life expectancy at birth, education and means of decent living – yields four socioeconomic categories: very high, high, medium and low HDI countries. The Gini coefficient, another index used by economists, reflects the distribution of wealth within national boundaries. HDI and Gini indices elucidate the role of poverty in the epidemiology of HIV/AIDS and cancer and other non-communicable diseases, including the consequences of adoption of affluent lifestyles in low- and middle-income countries. High incidence especially of the cancers of the colon, breast, prostate and stomach characterize cancer epidemiology of the high/very high HDI countries, constituting the so-called “cancers of industrialization.” The concept of “double burden” relates to the persistence of high prevalence of communicable diseases in low and middle HDI countries in addition to acquisition of diseases of affluence characteristic of the high/very HDI countries, including obesity and the related diseases like diabetes and cardiovascular disorders and “cancers of industrialization”. Transition in global cancer epidemiology is illustrated by the inverse relationship between the incidence of breast cancer and that of cervical cancer in high/very high and medium HDI countries. In Uganda, a low HDI country, however, the incidences of both cancers are increasing. External funding of health care is discordant with disease burden in recipient countries of medium and low HDI, indicating the need for reappraisal by both local and external sources in the management of health priorities.

Non-syndromic rod-cone dystrophy (RCD) is the most common condition in inherited retinal diseases. The aim of this study was to evaluate the research output and productivity related to RCD genetics per countries as classified by the human development index (HDI), by analyzing publication frequency and citations, the choice of journals and publishers, since 2000 to date. We have also analyzed the use of next-generation sequencing (NGS) in publications originating from countries with different HDIs. One thousand four hundred articles focusing on non-syndromic RCD were downloaded and analyzed. Citations and published articles were adjusted per one million individuals. The research output is significantly higher in very high HDI countries (86% of the total publications and 95% of the citations) than countries with lower HDIs in all aspects. High and medium HDI countries published together 13.6% of the total articles worldwide and received 4.6% of the citations. On the publication level, the USA (26%), United Kingdom (10%), and Japan (7%) were the top 3 among very high HDI countries, while China (6%) and India (2%) ranked first in high and medium HDI countries respectively. On the citation level, similar profiles were found. Following adjustment for population size, Switzerland (~14%), Jordan (~ 1%) and Morocco (<0.2%) showed the highest rates of publications in very high, high and medium HDI countries respectively. Very high HDI countries published 71% of their papers in first quartile journals (first quartile in Scimago journal rank; Q1), and 23% in Q2 journals. High and medium HDI countries showed a similar profile in quartiles with ~ 40% of their papers published in Q1 journals and ~ 30% in Q2 journals. The first publication using NGS was issued in 2009 in very high HDI countries, while it appeared in 2012 in high HDI countries, and in 2017 in medium HDI countries, with a respective lag of 3 to 8 years compared to very high HDI countries. A profound gap exists between very high HDI countries and the rest of the world. To fill it in, we propose implementing NGS, supporting international collaborations, building capacities and infrastructures, improving accessibility of patients to services, and increasing national and international funding.

Primary healthcare protects vulnerable populations from inequity in COVID-19 vaccination: An ecological analysis of nationwide data from Brazil

BackgroundSocioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities.MethodsData from the 2010 National Oral Health Survey of 9633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:< 0.699 versus high: > 0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed.ResultsAt the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95% CI: 7.93–11.13) and 6.95 (95% CI: 6.43–7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI.ConclusionsThere was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

The etiology of overweight is unclear at the population level, ultimately, however, it must be due to imbalance of energy intake and expenditure. Despite a paucity of comparative data, it is accepted that populations in developing countries expend more energy than those in industrialized countries. We tested this assumption by conducting a meta‐analysis of published doubly labeled water studies. The methods included a search of literature and extraction of relevant data: cohort size, sex, age, weight, body mass index (BMI), total energy expenditure (TEE) and physical activity level (PAL). Cohorts were assigned either developing or industrialized country status by ranking of the U.N. Human Development Index (HDI). Analyses included estimation of TEE and PAL using both fixed and random effects models. Meta‐regression was performed to assess impact of HDI status on TEE or PAL controlling for sex, age, and body size. 89 studies and 166 discrete cohorts were identified. Mean BMI was lower in the low HDI (n=21) than high HDI (n=145) group, 22.8 vs 26.3 (p&lt;0.01). Overall mean TEE was 2555 kcal/d and PAL was 1.73. TEE was associated with weight and sex and inversely associated with age (all p&lt;0.001). PAL was associated with sex (p&lt;0.05). Neither mean TEE nor PAL differed between low or high HDI countries. These data support the idea that energy intake may play a greater role than expenditure in population differences in obesity.

International perspectives: the profession of dietetics

That human ancestry predicts average IQ and socioeconomic outcomes is amongst the most thoroughly replicated findings of the social sciences. Since human ethnic and cultural descent is usually represented on national flags, it was hypothesized herein that national flag symbolism and colors would be predictive of a nation’s average IQ and socioeconomic development. In order to test this hypothesis, national flag symbols and colors were coded, quantified, and correlated with country IQ and Human Development Index (HDI). Both country-level IQ and HDI are positively associated with Christian symbolism, and negatively associated with symbols representing celestial bodies. The color green predicts lower IQ and HDI, while the color white predicts higher IQ and HDI. The color red predicts higher IQ, but not higher HDI, and the color yellow predicts lower HDI, but not lower IQ. The correlations are generally higher for HDI than IQ. With the exception of the color yellow, the correlations with HDI are significant even when controlling for the correlation between HDI and IQ. The present study suggests national flag symbolism and colors as yet another correlate of average group intelligence.

In this study the authors describe the investigation of a 1992 outbreak of green tobacco sickness, a form of nicotine poisoning from dermal exposure, among 47 tobacco workers in a five-county region of central and south-central Kentucky. Cases were identified through medical record searches at participating hospitals, as well as from reports submitted to the Occupational Health Nurses in Agricultural Communities program. A case-control study was undertaken to assess risk factors for green tobacco sickness. In a 20-min telephone interview, 40 cases and 83 controls responded to questions contained in a questionnaire. In 1992, 47 persons (3 were under age 16 y) in the study region sought medical treatment for green tobacco sickness. Twelve persons were hospitalized and 2 required intensive-care treatment. The crude incidence in 1992 was 10.0/1,000 tobacco workers. In 1993, 66 cases (7 were under age 16 y) of green tobacco sickness were identified in the study region (i.e., annual incidence of 14.0/1,000). A case-control study demonstrated that ill workers were younger, and were more likely to have worked in wet conditions, compared with workers who were not ill. Green tobacco sickness is a common problem among tobacco workers that may be prevented by avoiding work in wet tobacco or by use of protective clothing. Children younger than 16 y of age represented 9% of the green tobacco sickness cases in 1992 and 1993. Current occupational safety and health laws do not address protection of tobacco workers with respect to green tobacco sickness.

Objective: Cervical cancer (CC) is the third most common cancer in women after breast and colorectal cancers and is one of the leading causes of cancer death among women in the world. The aim this study is associations of cervix cancer incidence and mortality rates with Human Development Index (HDI).Methods: The Information of the incidence and mortality rates of CC obtained from the GLOBOCAN cancer project in year 2012 and data for the HDI 2013 obtained from the World Bank database. The linear regression models were used for assessment of the HDI effect on CC occurrence rates. Inequality in the age-specific incidence and mortality rates (ASR) of CC according to the HDI were assessed by using concentration index.Results: The results of this study that incidence and mortality rates of CC were very higher in regions with low & median HDI as compared to regions that had very high & high HDI, indeed Death and incidence from CC were more concentrated in low HDI countries. There was significant negative association between cervix cancer incidence and mortality rates with all the components of HDI including life expectancy (B= -0.98, P<0.001), Mean years of schooling (B= -1.86, P<0.001), GNI (B= -0.38, P<0.001), urbanization level (B= -0.29, P<0.001), and age standardized obesity (B= -0.45 , P<0.001).Conclusion: It seems CC significant public health problem in countries with low HDI and requires the implementation of prevention programs and screening for early detection and treatment.

PurposeThe purpose of this study was to investigate the frequency of countries represented in the TOP20 long-distance elite runners ranking during 1997–2020, taking into account the countries’ Human Development Index (HDI), and to verify if the Matthew effect can be observed regarding countries’ representativeness in the raking alongside the years.MethodsThe sample comprised 1852 professional runner athletes, ranked in the Senior World TOP20 half-marathon (403 female and 487 male) and marathon (480 female and 482 male) races, between the years 1997–2020. Information about the countries’ HDI was included, and categorized as “low HDI”, “medium HDI”, “high HDI”, and “very-high HDI”. Athletes were categorized according to their ranking positions (1st–3rd; 4th–10th; > 10th), and the number of athletes per country/year was summed and categorized as “total number of athletes 1997–2000”; “total number of athletes 2001–2010”; and “total number of athletes 2011–2020”. The Chi-square test and Spearman correlation were used to verify potential associations and relationships between variables.ResultsMost of the athletes were from countries with medium HDI, followed by low HDI and very-high HDI. Chi-square test results showed significant differences among females (χ2 = 15.52; P = 0.017) and males (χ2 = 9.03; P = 0.014), in half-marathon and marathon, respectively. No significant association was verified between HDI and the total number of athletes, but the association was found for the number of athletes alongside the years (1997–2000 to 2001–2010: r = 0.60; P < 0.001; 2001–2010 to –2011–2020: r = 0.29; P < 0.001).ConclusionMost of the athletes were from countries with medium HDI, followed by those with low HDI and very-high HDI. The Matthew effect was observed, but a generalization of the results should not be done.

This study investigates the relationship between quality of environment and democracy among different countries over the period of 2002 - 2012. Democracy and accumulated democracy indices have been considered as political inequality variables influencing the quality of the environment among different countries in the reduced form of Kuznets’ environmental curve (EKC) hypotheses model. The empirical analysis is conducted using four panel data sets for countries with different HDI from 2002 to 2012. The results indicate a significant positive relationship between the level of democracy and capital accumulation of democracy among all country groups. This relationship in group of countries with high human development index acts in form of N reversed which is the environmental Kuznets curve. This relationship in groups of countries with high, medium and low human development indices is in form of N. Based on the results, improvement of democracy indices leads to a better environment quality. Therefore, applying the relevant policies with democracy condition improvement in different countries, specifically in countries with low and medium human development indices, can make a positive impact on improving the quality of environment in these countries.