High Human Development Index Research Articles

Is countries\u2019 transparency associated with gaps between countries\u2019 self and external evaluations for IHR core capacity?

BackgroundThis study aims to evaluate the gap between countries’ self-evaluation and external evaluation regarding core capacity of infectious disease control required by International Health Regulations and the influence factors of the gap.MethodsWe collected countries’ self-evaluated scores (International Health Regulations Monitoring tool, IHRMT) of 2016 and 2017, and external evaluation scores (Joint External Evaluation, JEE) from WHO website on 4rd and 27rd November, 2018. There were 127 and 163 countries with IHRMT scores in 2016 and in 2017, and 74 countries with JEE scores included in the analysis. The gap between countries’ self-evaluation and external evaluation was represented by the difference between condensed IHR scores and JEE. Civil liberties (CL) scores were collected as indicators of the transparency of each country. The Human Development Index (HDI) and data indicating the density of physicians and nurses (HWD) were collected to reflect countries’ development and health workforce statuses. Then, chi-square test and logistic regression were performed to determine the correlation between the gap of IHRMT and JEE, and civil liberties, human development, and health workforce status.ResultsCountries’ self-evaluation scores significantly decreased from 2016 to 2017. Countries’ external evaluation scores are consistently 1 to 1.5 lower than self-evaluation scores. There were significantly more countries with high HDI status, high CL status and high HWD status in groups with bigger gap between IHRMT and JEE. And countries with higher HDI status presented a higher risk of having bigger gap between countries’ self and external scores (OR = 3.181).ConclusionOur study result indicated that countries’ transparency represented by CL status do play a role in the gap between IHR and JEE scores. But HDI status is the key factor which significantly associated with the gap. The main reason for the gap in the current world is the different interpretation of evaluation of high HDI countries, though low CL countries tended to over-scored their capacity.

Childhood cancer: Estimating regional and global incidence

BackgroundMost of the world’s population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions. MethodsA Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi’s sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters). ResultsThe BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings. ConclusionDisagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.

Variation in global uptake of the Surgical Safety Checklist.

The Surgical Safety Checklist (SSC) is a patient safety tool shown to reduce mortality and to improve teamwork and adherence with perioperative safety practices. The results of the original pilot work were published 10 years ago. This study aimed to determine the contemporary prevalence and predictors of SSC use globally. Pooled data from the GlobalSurg and Surgical Outcomes studies were analysed to describe SSC use in 2014-2016. The primary exposure was the Human Development Index (HDI) of the reporting country, and the primary outcome was reported SSC use. A generalized estimating equation, clustering by facility, was used to determine differences in SSC use by patient, facility and national characteristics. A total of 85 957 patients from 1464 facilities in 94 countries were included. On average, facilities used the SSC in 75·4 per cent of operations. Compared with very high HDI, SSC use was less in low HDI countries (odds ratio (OR) 0·08, 95 per cent c.i. 0·05 to 0·12). The SSC was used less in urgent compared with elective operations in low HDI countries (OR 0·68, 0·53 to 0·86), but used equally for urgent and elective operations in very high HDI countries (OR 0·96, 0·87 to 1·06). SSC use was lower for obstetrics and gynaecology versus abdominal surgery (OR 0·91, 0·85 to 0·98) and where the common or official language was not one of the WHO official languages (OR 0·30, 0·23 to 0·39). Worldwide, SSC use is generally high, but significant variability exists. Implementation and dissemination strategies must be developed to address this variability.

RASIO TENAGA PENDIDIK, RASIO TENAGA KESEHATAN, DAN CAPAIAN PEMBANGUNAN MANUSIA DI INDONESIA DALAM ANALISIS SPASIAL

AbstractThe achievement of the Human Development Index (HDI) in Indonesia when compared to other countries is still unsatisfactory. Base on UN data, Indonesia is ranked 116th out of 189 countries. The disparity in HDI achievement between regions is also still high. There is a pattern of grouping in the achievement of HDI, where regions with with high HDI are more concentrated in western part of Indonesia. This research was conducted to study how the relationship between the ratio of educators and ratio of health workers to the achievement of HDI with spatial analysis. The control variables used in analyzing these relationships include economic, social, and demographic variables. This study uses secondary data derived from publication of Indeks Pembangunan Manusia, Daerah Dalam Angka , Indikator Kesejahteraan Rakyat and SUSENAS data in 2017 that has been processed by BPS. The unit of analysis in this study is all regency/city in Indonesia. By using a spatial lag regression model, the results of this study show that there is a significant spatial relationship between regency/cities in Indonesia where when is an increase of HDI in a regency/city it will have a positive effect on the regency/city in the surrounding. The ratio of educators at the elementary level and the ratio of health workers to both doctors or non-doctors has a positive and significant effect on HDI achievement. The comparison between spatial regression model and ordinary least square (OLS) model shows that the spatial model is better used to analyze HDI.

By Their Flags Ye Shall Know Them: National Flag Symbolism and Colors Predict Average Country IQ and HDI

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.

The Efficiency of the Financial System: A Comparison of Developed and Less Developed Countries

In this study, our objective is to find whether high-income countries have a more efficient financial system when compared to middle- and low-income countries. We expect high-income countries to have a better, more efficient financial system when compared to other countries. Our second objective is to find whether high-income OECD countries have a more efficient financial system when compared to high-income non-OECD countries. Most OECD countries are seen as developed nations with a very high Human Development Index, while the same cannot be said for some other high-income countries that are not members of OECD (i.e. Saudi Arabia for example). Do these developed nations have a better, more efficient financial system compared to the other high-income nations that are not classified as developed? We expect to find developed nations to have a better, more efficient financial system when compared to non-OECD countries. We examine eight measures of efficiency. These are “net interest margin”, lending-deposit spread”, non-interest income to total income”, “overhead costs to total assets”, “return on assets”, “cost to income ratio”, “credit to government and state-owned enterprises to GDP”, and “stock market turnover ratio”. When we compare the high-income countries to the “middle-income” and “low-income” countries, we find that with respect to six measures, the high-income countries have better “efficiency” values than the other countries. With regard to the “cost to income ratio”, the two groups are not significantly different. Interestingly, with respect to “credit to government and state-owned enterprises to GDP (%)”, we find unexpected results. Contrary to our expectation, we find that, in the high-income countries, financial institutions lend more money to the government and state-owned enterprises when compared to the low- and middle-income countries. When we compare the high-income OECD-member countries to the high-income Non-OECD-member countries, we find that with respect to five measures, the high-income OECD countries have better “efficiency” values than the high-income Non-OECD countries. With respect to three measures, the two groups are not significantly different. Overall, our results indicate that although high-income countries generally have a more efficient financial system, in terms of certain measures (i.e. cost to income ratio and credit to government and state-owned enterprises), they are not doing well. Keywords: efficiency, financial system, OECD, developed countries.

Distribution of Breast Cancer Subtypes Among Nigerian Women and Correlation to the Risk Factors and Clinicopathological Characteristics.

BackgroundBreast cancer in African women differs from the Caucasian. Understanding the profile of Nigerian women with breast cancer will help with preventive measures and treatment. This study focused on the clinico-pathological characteristics, with risk factors of breast cancer patients in Nigeria.MethodsNewly diagnosed female patients with breast cancer were assessed over 12 months. Patients were reviewed using a predesigned proforma which focused on socio-demographic information, clinical information, risk factors and tumor biology.ResultsA total of 251 women were identified; their mean age was 46 years. More than half (62.5%) are premenopausal at presentation, 37.8% with Eastern Cooperative Oncology Group (ECOG) score of 0 and right side (50.2%) as the most common primary site of disease. Less than half of them (43.0%) are estrogen receptor (ER) positive, 27.9% are progesterone receptor (PR) positive, 43.8% and 47.4% are hormone receptor positive and triple negative, respectively. Most patients presented at the latter stage of the disease, stage III (66.9%) and stage IV (18.3%). Only 15.9% are well differentiated and almost all (92.8%) had invasive ductal histological type. Obesity (66.2%) and physical inactivity (41.9%) are the most common risk factors for the disease. A significant relationship was found between immunohistochemistry status and family history of breast cancer, tumor site, previous breast surgery, previous lump and alcohol intake.ConclusionFindings from this study showed that Nigerian breast cancer patients differ from their counterparts in the high human development index (H-HDI) countries in terms of the patients and disease characteristics. In view of this, prevention and treatment options should consider this uniqueness to ensure better outcome.

Examining Anti-Corruption Disclosures, Profitability and Financial Stability Among Extractive Firms in Africa

This study examines the determinants of anti-corruption disclosures and the effect of disclosures on the profitability and financial stability of extractive firms in Africa. The study also tests the presence of convergence in anti-corruption disclosure, profitability, and financial stability of the firms. The study uses an unbalanced panel data of 27 firms operating in 5 African countries covering the period 2006 to 2018. The data was collected from different corporate reports of the firms that form part of the Global Reporting Initiative (GRI) database. The study uses a composite index to measure overall disclosure and individual items are coded as binary. Profitability is measured using the return on asset and return on equity while the z-score measures financial stability. The study uses panel logistic regression for binary dependent variables and panel corrected standard error regression/random effect regression for continuous variables. The results indicate that the determinants of anti-corruption disclosure are: membership in the United Nations Global Compact (UNGC) and Extractive Industry Transparency Initiative, multinational enterprise status, corruption perception index, and human development index. Specifically, UNGC membership and multinational status enhance the disclosure on corruption analysis while countries with a high prevalence of corruption have firms that report more on corruption analysis. Disclosure on corruption training is high among firms that are UNGC signatories, countries with a high human development index, and countries with a high prevalence of corruption. There is a weak effect of firm-level, industry-level, and country-level factors on disclosures on corruption response. There is evidence that corruption disclosure reduces the financial stability of firms. Disclosures on corruption analysis and corruption training are the main factors driving the reduction in financial stability. The effect on profitability is not significant except in the case of disclosure on corruption response which also reduces profitability. There is strong statistical evidence to suggest that anti-corruption disclosure, profitability, and financial stability of extractive firms converge. The study has relevant implications for practitioners, policymakers, and the academic community. It is very beneficial to the GRI Secretariat and other sustainability standard setters. The study uses data that is skewed towards large extractive firms. This study is premier in exploring the nexus between anti-corruption disclosure, profitability, and financial stability in extractive firms in Africa. It is also unique in providing a test of both beta and sigma convergence among the firms.

Dental caries experience and associated factors in 12-year-old-children: a population based-study.

Relevant public policies in oral health have been implemented in Brazil since 2004. Changes in the epidemiological status of dental caries are expected, mainly in the child population. This study aimed to assess the dental caries experience and associated factors among 12-year-old children in the state of São Paulo, Brazil. A cross-sectional population-based study was conducted with data obtained from 415 cities, including a total of 26,325 schoolchildren who were included by the double-stage cluster technique, by lot and by systematic sampling. The statistical model included data from the São Paulo Oral Health Survey (SBSP 2015), the Human Development Index (HDI) and the Social Vulnerability Index (SVI). A theoretical-conceptual model categorized the variables into three blocks, namely, contextual (HDI, SVI, region of residence and fluoridation of water), individual (sex and ethnicity) and periodontal conditions (gingival bleeding, dental calculus and the presence of periodontal pockets), for association with the experience of caries (DMFT). Statistically significant associations were verified by hierarchical multivariate logistic (L) and Poisson (P) regression analyses (p < 0.05). The results showed that 57.7% of 12-year-old children had caries experience. Factors that determined a greater prevalence of dental caries in both models were nonwhite ethnicity (ORL = 1.113, ORP = 1.154) and the presence of gingival bleeding (ORL = 1.204, ORP = 1.255). Male children (ORL = 0.920 ORP = 0.859) and higher HDI (ORL = 0.022), ORP = 0.040) were associated with a lower prevalence of dental caries experience. Water fluoridation was associated with a lower DMFT index (ORP = 0.766). Dental caries experience is still associated with social inequalities at different levels. Policymakers should direct interventions towards reducing inequalities and the prevalence of dental caries among 12-year-old children.

The Burden and Trends of Primary Liver Cancer Caused by Specific Etiologies from 1990 to 2017 at the Global, Regional, National, Age, and Sex Level Results from the Global Burden of Disease Study 2017

Background: Liver cancer is one of the leading causes of cancer-related deaths worldwide. The primary causes of liver cancer include hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol consumption, nonalcoholic fatty liver disease, and other factors. Aims: The objective of this study was to evaluate the global and sex-, age-, region-, country-, and etiology-related liver cancer burden, as well as the trends in liver cancer caused by different etiologies. Methods: The causes of liver cancer from 1990 to 2017, including global, regional, and national liver cancer incidence, mortality, and etiology, were collected from the Global Burden of Disease study 2017, and the time-dependent change in the trends of liver cancer burden was evaluated by annual percentage change. Results: The global liver cancer incidence and mortality have been increasing. There were 950,000 newly-diagnosed liver cancer cases and over 800,000 deaths in 2017, which is more than twice the numbers recorded in 1990. HBV and HCV are the major causes of liver cancer. HBV is the major risk factor of liver cancer in Asia, while HCV and alcohol abuse are the major risk factors in the high sociodemographic index and high human development index regions. The mean onset age and incidence of liver cancer with different etiologies have gradually increased in the past 30 years. Conclusions: The global incidence is still rising and the causes have national, regional, or population specificities. More targeted prevention strategies must be developed for the different etiologic types in order to reduce liver cancer burden.

Global Burden and Trends in Pre- and Post-Menopausal Breast Cancer

Background: Breast cancer has distinct etiologies, prognoses, and patient impact at pre- and post-menopausal ages. We sought to assess the global burden and trends in breast cancer by menopausal status. Methods: Menopausal status was defined using age as a proxy, where breast cancer cases/deaths at >50 years were considered as post-menopausal. Age-standardized breast cancer incidence and mortality rates in 2018 were calculated using GLOBOCAN data. Incidence trends for 1998-2012 were assessed in 44 populations from 41 countries using CI5plus data by calculating the annual average percent change. Findings: Approximately 645,000 pre-menopausal and 1.4 million post-menopausal breast cancer cases were diagnosed in 2018, with approximately 130,000 and 490,000 deaths occurring in each menopausal group, respectively. Proportionally, Low Human Development Index (HDI) countries faced a greater burden of pre-menopausal breast cancer for both incidence and mortality compared to more developed countries. Very High HDI countries had the highest pre- and post-menopausal breast cancer incidence rates (30·6 and 253·6 per 100,000 respectively), while Low and Medium HDI countries had the highest pre-menopausal and post-menopausal mortality rates respectively (8·5 and 53·3 per 100,000 respectively). When examining incidence trends, we observed significantly increasing rates of pre-menopausal breast cancer in 20/44 populations, and significantly increasing rates of post-menopausal breast cancer in 24/44 populations. The increases exclusively at pre-menopausal ages largely occurred in the most developed countries, while the increasing post-menopausal breast cancer burden was most notable in countries under transition. Interpretation: We provide evidence of a rising burden of both pre- and post-menopausal breast cancer worldwide, and wide inequities in breast cancer care. Although early diagnosis and access to treatment remain crucial in developing countries, primary prevention efforts seeking to decrease obesity and alcohol consumption, and increase physical activity and breastfeeding, are warranted in all world regions to curb the future breast cancer burden. Funding Statement: This study was undertaken without any funding. Declaration of Interests: All authors declare no conflicts of interests. Ethics Approval Statement: Not required.

Family Health Policy and prevalence of anemia in women from an urban region with high Human Development Index

Introduction: Iron deficiency anemia, a public health problem.&#x0D; Objective: To analyze the hemoglobin value and the prevalence of anemia in women of reproductive age, mothers of children enrolled in municipal nurseries in a municipality and a high Human Development Index in the Southeast region, in addition to related factors, including being attended by the Family Health Strategy.&#x0D; Methods: A cross-sectional study, in a sample of 230 women aged 15 to 49 years. Collection of data through standardized form. Weight, height, and hemoglobin concentration were measured.&#x0D; Results: The prevalence of anemia in women was 9.6% and the mean hemoglobin concentration was 14.6g/dL. In the bivariate analysis, showed association with anemia the variables: age, having some disease, obstetric intercurrences in the child's study and as a protection factor and to be in the program Family Health Strategy. In the binary logistic analysis, only being attended by the Family Health Strategy demonstrated a significant protective effect against anemia (OR=0,391, p&lt;0,05).&#x0D; Conclusion: Although there is a mild prevalence of anemia, according to World Health Organization criteria, in an urban area with a high Human Development Index, well-managed health care policies, the Family Health Strategy in particular, can contribute to further reduce the prevalence of this condition in the health of women of reproductive age.

Analisis Regresi Ordinal Model Logit untuk Mengidentifikasi Faktor yang Mempengaruhi Indeks Pembangunan Manusia

The Human Development Index (HDI) is an index used to determine the level of quality of human life. HDI became a trend because all local governments are competing to increase the value of their regional HDI. This study aims to identify the factors that influence the HDI of districts/cities in East Java Province in 2017 using the logit model ordinal regression approach. This type of research is a non reactive study using secondary data from the Central Statistics Agency and the East Java Province Health Office in 2017. The study population is all districts/cities of East Java Province. The total research analysis unit was 38 districts/cities. The dependent variable of the study is low, medium, high and very high HDI. The independent variable of the study is the percentage of households behaving clean and healthy, student-teacher ratio (high school level) and open unemployment rate. The results of the analysis using the logit model ordinal regression test (α = 5%) prove there is an influence between the open unemployment rate variable (p = 0.006; β = 0.790) on the HDI. The variable percentage of households behaving clean and healthy and student-teacher ratio (high school level) has no effect on HDI. Both central and regional governments are expected to be able to improve human development in all sectors, especially health, education and the economy.

Analisis Regresi Ordinal Model Logit untuk Mengidentifikasi Faktor yang Mempengaruhi Indeks Pembangunan Manusia

The Human Development Index (HDI) is an index used to determine the level of quality of human life. HDI became a trend because all local governments are competing to increase the value of their regional HDI. This study aims to identify the factors that influence the HDI of districts/cities in East Java Province in 2017 using the logit model ordinal regression approach. This type of research is a non reactive study using secondary data from the Central Statistics Agency and the East Java Province Health Office in 2017. The study population is all districts/cities of East Java Province. The total research analysis unit was 38 districts/cities. The dependent variable of the study is low, medium, high and very high HDI. The independent variable of the study is the percentage of households behaving clean and healthy, student-teacher ratio (high school level) and open unemployment rate. The results of the analysis using the logit model ordinal regression test (α = 5%) prove there is an influence between the open unemployment rate variable (p = 0.006; β = 0.790) on the HDI. The variable percentage of households behaving clean and healthy and student-teacher ratio (high school level) has no effect on HDI. Both central and regional governments are expected to be able to improve human development in all sectors, especially health, education and the economy.

Survival Rate of Breast Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis.

Background:Breast cancer (BC) is one of the main problems of public health around the world. As a consequence, survival rates are one of the most salient indicators for assessing the quality of cancer control and treatment programs.Objectives:The aim of this study is to evaluate the survival rate of breast cancer in the Eastern Mediterranean region at different periods of time.Methods:Medline/PubMed, ProQuest, Scopus, Embase, Web of Knowledge and Google Scholar databases until February 1, 2018. All observational studies (cross-sectional, case-control, and cohort) referring to the survival of breast cancer were included in the study. The heterogeneity and its value were examined by Cochran test and I2 statistics, respectively. Analysis of subgroups performed was based on geographical area and Human Development Index (HDI), using Stata 12 software.Findings:A total of 58 papers were analyzed. Based on a random effect model, the survival rates of breast cancer in different periods—1, 2, 3, 4, 5 and 10 years—were estimated at 93.9, 85, 79.8, 72.6, 69.2, 62.1 and 55.5 percent, respectively. The highest 10-year survival rate was in Iran (59.2%), and the lowest was observed in Bahrain (45%).Conclusions:Evidence suggests that about half of the patients in this area would die before 10 years survival, which is different from more developed countries. Also, high survival rates are associated with high human development index, which can help health policy-makers to better predict the outcomes of patients.

Relationship between the Human Development Index and its Components with Oral Cancer in Latin America

To evaluate the relationship between the Human Development Index (HDI) and its components with oral cancer (OC) in Latin America. Ecological study in 20 Latin American countries in 2010 and 2017, which evaluated the relationship between the Age-Standardized Rates (ASRs) of incidence and mortality from oral cancer and the following indicators: HDI, with its components (income, education, and health indexes); and the Gini and Theil-L indexes. Among the countries with the highest HDI, men from Brazil and Cuba had the highest incidence and mortality ASRs per 100,000 inhabitants (ASR incidence >7.5 and mortality >4.5). Among those with the lowest HDI, Haiti was the most affected country (ASR incidence >4.1 and mortality >3.0). The highest male:female ratio was in Paraguay in both years (incidence >3.5 and mortality >4.0). Mortality from oral cancer is negatively related to the global HDI in both years, with regression coefficients (95% confidence interval) being −5.78 (−11.77, 0.20) in 2010 and −5.97 (−11.38, −0.56) in 2017; and separate (independent) from the income [−4.57 (−9.92, 0.77) in 2010 and −4.84 (−9.52, −0.17) in 2017] and health indexes [−5.81 (−11.10, −0.52) and −6.52 (−11.32, −1.72) in 2017] (p < 0.05) in the countries with lower HDI. Oral cancer incidence and mortality rates vary both among and within Latin American countries according to sex, with a greater burden on men. The HDI is negatively related to mortality from oral cancer in the countries of medium and low HDI.

Headache after ischemic stroke: A systematic review and meta-analysis.

ObjectiveHeadache associated with ischemic stroke is poorly understood. To gain further insight, we systematically reviewed studies examining the prevalence and characteristics of new-onset poststroke headache.MethodsMedline and PubMed databases were queried. A total of 1,812 articles were identified. Of these, 50 were included in this systematic review. Twenty were included in a meta-analysis and meta-regression.ResultsHeadache occurred in 6%–44% of the ischemic stroke population. Most headaches had tension-type features, were moderate to severe, and became chronic in nature. Meta-analysis using an inverse-variance heterogeneity model revealed a pooled prevalence of 0.14 (95% confidence interval [CI] 0.07–0.23) with heterogeneity among studies. Metaregression revealed a significant association between prevalence and study location, the source population's national human development index (HDI), and study quality. We found higher prevalence in European (0.22, 95% CI 0.14–0.30) and North American (0.15, 95% CI 0.05–0.26) studies compared with Middle Eastern and Asian studies (0.08, 95% CI 0.01–0.18). However, within each region, populations from countries with higher HDI (p = 0.03) and studies with higher quality (p = 0.001) had lower prevalence. Calculated crude odds ratios (ORs) showed that posterior circulation stroke (pooled OR 1.92, 95% CI 1.4–2.64; n = 7 studies) and female sex (pooled OR 1.25, 95% CI 1.07–1.46; n = 11 studies) had greater odds of headache associated with ischemic stroke.ConclusionsTaken together, these data suggest that headache is common at the onset of or shortly following ischemic stroke and may contribute to poststroke morbidity. Better understanding of headache associated with ischemic stroke is needed to establish treatment guidelines and inform patient management.

Air pollution embodied in China’s trade with the BR countries: Transfer pattern and environmental implication

Abstract Knowledge about environmental load displacement and its effects of China’s trade with the Belt and road (BR) countries will help develop coordinating policies to jointly promote green development in the regions. This paper presents an empirical study on embodied air pollution displacement of China-BR trade by employing a multi-region input-output model. Embodied air pollution trade and its transfer pattern, as well as the driving force for changes in China’s trade embodied air pollution intensity, are investigated. We found that, in the period of analysis, embodied air pollution displacement between China and the BR countries was aggravated and China was in embodied air pollution trade surplus. Most net transfer mainly came from its energy importers with better air quality and higher Human Development Index. This indicated that the net embodied air pollution transfer from the BR countries to China would not bring significant environmental and sustainability impacts on those suppliers. However, embodied air pollution flowed from the BR countries to China decreased the overall environmental performance and efficiency. Decomposition analysis showed technology effect served the main force driving force for the drops in China’s trade embodied air pollution intensity. The findings are beneficial for policymakers of the BR countries to take measures to promote their sustainable development.

Contextual and socioeconomic variation in early motor and language development

ObjectiveTo compare early motor and language development of children <3 years of age growing up in high-income and low-income contexts.DesignCross-sectional study.SettingWe analysed differences in motor and language skills across study...

Attributable Burden and Expenditure of Cardiovascular Diseases and Associated Risk Factors in Mexico and other Selected Mega-Countries.

Background: This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets. Methods: Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored. Results: Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990–2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come. Conclusions: Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.