Low Human Development Index Research Articles

Socio-economic inequality in the nutritional deficiencies among the world countries: evidence from global burden of disease study 2019

BackgroundSocioeconomic inequality in nutritional status as one of the main social determinants of health can lead to inequality in health outcomes. In the present study, the socioeconomic inequality in the burden of nutritional deficiencies among the countries of the world using Global Burden of Disease (GBD) data was investigated.MethodsBurden data of nutritional deficiencies and its subsets including protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and dietary iron deficiency form GBD study and Human Development Index (HDI), a proxy for the socio-economic status of countries, from united nations database were collected. After descriptive statistics, the concentration index (CI) curve was used to measure socioeconomic inequality. CI for nutritional deficiencies was estimated based on Disability Adjusted Life Years (DALY), Years Lived with Disability (YLD), Years of Life Lost (YLL), prevalence, incidence and death indices. Moreover, CI of DALY and prevalence was estimated and reported for four nutritional deficiencies subgroups.ResultsCIs for DALY, YLD, YLL, prevalence, incidence and death rate show negative values and their, which indicates the concentration of nutritional deficiencies burden among lower HDI countries. The highest value of CI (lowest inequality) for DALY was related to iodine deficiency (-0.3401) and the lowest (highest inequality) was related to vitamin A deficiency (-0.5884). Also, the highest value of CI for prevalence was related to protein-energy malnutrition (-0.1403) and the lowest was related to vitamin A deficiency (-0.4308). Results also show the inequality in DALY was greater than the disparity in prevalence for all subgroups of nutritional deficiencies.ConclusionsInequality in burden of nutritional deficiencies and protein-energy malnutrition, iodine deficiency, vitamin A deficiency and dietary iron deficiency are concentrated in countries with low HDI, so there is pro- poor inequality. Findings indicate that although malnutrition occurs more in low-income countries, due to the weakness of health care systems in these countries, the inequality in the final consequences of malnutrition such as DALY becomes much deeper. More attention should be paid to the development of prevention and primary treatment measures in low HDI countries, such as improving nutrition-related health education, nutritional support and early aggressive treatment, and also eliminating hunger.

Noma in a Pacient whitout Sistemic Involvement

Noma, also known as Cancrum oris or gangrenous stomatitis, is an infectious disease of bacterial origin, often in association with other microorganisms, affecting orofacial tissues and manifesting through a sequence of precursors. It begins as necrotizing gingivitis and progresses to necrotizing periodontitis and necrotizing stomatitis. In advanced stages, it can lead to facial mutilations, difficulty in eating, and psychological distress due to social stigma. Untreated, it can result in a mortality rate of up to 90%, mainly due to septicemia, dehydration, and malnutrition. When addressed early, the prognosis is favorable, and by treating its precursors, it is challenging to reach severe stages. The disease is often associated with children in impoverished social conditions, weakened immune systems, and malnutrition, especially in regions with low human development indices, such as sub-Saharan Africa, although some cases have been reported elsewhere. Treatment involves several phases, including debridement of necrotic areas, antibiotics, antimicrobial mouth rinses, and supportive periodontal therapy. Despite its rarity, infection can also occur in developed countries and affect adult patients, sometimes without underlying health conditions. The aim of this article is to report a clinical case of noma in a 31-year-old man, without systemic involvement, who sought treatment at the Maria Aparecida Pedrossian University Hospital in Campo Grande, Mato Grosso do Sul, Brazil, due to swelling in the submental region. After hospitalization, biofilm control and postoperative care, there was a satisfactory improvement in the clinical condition.

Country economic status is strongly associated with burn survival - validation of the (modified) ABSI

BackgroundPredicting burn-related mortality is vital for family counseling, triage, and resource allocation. Several of the burn-specific mortality prediction scores have been developed, including the Abbreviated Burn Severity Index (ABSI) in 1982. However, these scores are not tested for accuracy to support contemporary estimates of the global burden of burn injury. This study compares burn mortality across countries with varying economic levels, as indicated by the Human Development Index (HDI), to assess if a modified ABSI (mABSI) offers enhanced predictive accuracy.MethodsA retrospective study was performed, including over 90,000 patients from seven sources in five continents, including two burn registries and five referral burn centers. Data from 2015 to 2019 were collected, including age, gender, presence of inhalation injury, full-thickness burn, percentage of total body surface area, and outcome. The participating countries were classified based on the HDI and mortality was predicted using both the original and the modified ABSI.ResultsAfter removal of incomplete data, 74,460 sets remained for the analysis. Significant variations in population demographics, sample sizes, total body surface area (TBSA), and age distributions across the studied regions were noted. The modified ABSI demonstrated a smaller deviation from the 95% CI of the true survival probability than the original ABSI in countries with a very high or high HDI, indicating improved accuracy here. In these countries, the original ABSI overestimates mortality. Conversely, in countries with a middle or low HDI, the original ABSI remains more accurate, reflecting the significantly greater burn related mortality in countries with a low HDI.ConclusionIn burn patients, the probability of survival remains highly dependent on the level of development of a country. Our results support the use of the modified ABSI in countries with a (very) high HDI, yet in resource constraint settings, the original ABSI seems to provide more accurate predictions. These findings underscore the need for adaptive models that take into account socioeconomic variables, potentially guiding health policy adjustments and emphasizing the necessity of resource allocation and training in lower HDI countries. Such adaptations could enhance clinical outcomes and reduce disparities in burn care effectiveness globally.

The increasing global burden of cancer: implications for anaesthesia and peri-operative medicine.

Most patients with cancer will require surgery at some point in their lifetime. As the global burden of cancer continues to increase, changes and challenges in cancer epidemiology and care are also borne peri-operatively. Due to its broad scope, a formal systematic electronic literature search was not performed. This narrative review examines how an increasing global burden of cancer affects anaesthesia and peri-operative medicine. We aimed to describe current cancer statistics; economic implications; the increasing survival of individuals with cancer; and the role of anaesthetists in enhancing the quality of life and survival after oncological surgery. Epidemiological reports show wide variation in cancer incidence and mortality worldwide. Countries with a lower human development index will be disproportionately affected by greater increases in cancer burden. At the same time, these countries will also suffer larger deficits in the surgical and anaesthetic workforce. Cancer has significant macro- and micro-economic implications. Thus, public health and policy should address the large economic burden of cancer surgery and care. The improvement in cancer-related survival can be attributed to research focused on a deeper understanding of tumour biology; effective awareness education campaigns and screening programmes; early diagnosis; newer cancer therapies; and patient-centred precision care. Increasing survival brings new global challenges, such as delivering an adequate survivorship care plan and addressing long-term psychosocial concerns in survivors. Anaesthetists are involved in all phases of a patient's cancer journey including facilitating diagnostic procedures; providing comprehensive peri-operative care needs for ablative procedures; provision of critical care; addressing acute and chronic pain; and provision of integrative and palliative care services. Deeper engagement of anaesthetists in cancer care programmes will be instrumental in reducing postoperative complications; improving the quality of life for patients; enhancing population health; and contributing to improved global economies.

Cervical cancer stage distribution and survival outcomes in Africa: a systematic review and meta-analysis.

Cervical cancer is a leading cause of cancer-related deaths among women, with a disproportionate burden in sub-Saharan Africa. Understanding the cervical cancer stage and outcomes is crucial for developing effective interventions and reducing its burden. We aimed to undertake a systematic review and meta-analysis of cervical cancer stage distribution and survival outcomes in Africa. We searched MEDLINE, Embase, PubMed, Cochrane Library, Clarivate Analytics Web of Science, and the World Health Organization African Index Medicus database for publications in all languages from the inception of databases to July 2021. A total of 144 studies published between 1978 and 2021 from 33 African countries were included, encompassing 55,747 patients. We revealed that 53.3% (95% CI 50.9 to 55.6) of cervical cancer cases in Africa were diagnosed at late stages (stage III-IV). This proportion varied significantly across countries and regions, ranging from 7.7% to 86.3%. The study also highlighted disparities by Human Development Index (HDI) grouping, with low HDI countries exhibiting higher proportions of late-stage diagnoses (56.0%, 95% CI 51.6 to 60.4) compared with medium (51.2%, 95% CI 47.5 to 54.9) and high (50.7%, 95% CI 47.0 to 54.5) HDI countries. Notably, there was no stage migration observed over time (p = .53). The median overall survival was 24.0 months (interquartile range, 19.2-39.4). These stage and outcomes data highlight the need for expanding cervical cancer screening and treatment and are crucial for policymakers to develop evidence-based strategies aimed at accelerating the elimination of cervical cancer in Africa. Additionally, standardized data collection and reporting are needed to facilitate better monitoring of cervical cancer outcomes across countries.

Love as a Commitment Device : Evidence from a Cross-Cultural Study across 90 Countries.

Given the ubiquitous nature of love, numerous theories have been proposed to explain its existence. One such theory refers to love as a commitment device, suggesting that romantic love evolved to foster commitment between partners and enhance their reproductive success. In the present study, we investigated this hypothesis using a large-scale sample of 86,310 individual responses collected across 90 countries. If romantic love is universally perceived as a force that fosters commitment between long-term partners, we expected that individuals likely to suffer greater losses from the termination of their relationships-including people of lower socioeconomic status, those with many children, and women-would place a higher value on romantic love compared to people with higher status, those with fewer children, and men. These predictions were supported. Additionally, we observed that individuals from countries with a higher (vs. lower) Human Development Index placed a greater level of importance on romantic love, suggesting that modernization might influence how romantic love is evaluated. On average, participants worldwide were unwilling to commit to a long-term romantic relationship without love, highlighting romantic love's universal importance.

Does national intellectual capital matter for productivity? International evidence

PurposeIn the context of the contemporary globalized environment and the rapid progression of Industry 4.0, the existing literature suggests that national intellectual capital does play a significant role in shaping diverse economic metrics. However, the connection between national intellectual capital and total factor productivity (TFP) has been largely overlooked. This paper examines the effect of national intellectual capital on productivity across 84 countries, encompassing diverse income levels, human development index (HDI) levels and continents.Design/methodology/approachThis study utilizes dynamic ordinary least squares (DOLS), fully modified ordinary least squares (FMOLS), two-stage least squares (2SLS), generalized method of moments (GMM) and pooled mean group (PMG) estimation techniques on a sample of 84 economies from 2000 to 2019.FindingsThe results reveal a significant effect of national intellectual capital on productivity. Countries with robust intellectual capital exhibit enhanced productivity and, by extension, sustainable economic growth. The findings are nuanced, illustrating varied impacts across low, middle and high-income countries and offering insights into tailored strategies for each income group. Nations with lower HDI levels derive significant benefits from investments in intellectual capital, whereas higher HDI countries experience lower returns in productivity gains from additional intellectual capital investments. Interestingly, Latin America exhibits a paradoxical negative effect of national intellectual capital on TFP.Practical implicationsThis paper makes a significant contribution to the literature by extending the discourse on intellectual capital to the national level, an area that has been relatively underexplored. The comparative analysis across income groups, human development index levels and continents enriches the understanding of the multifaceted impacts of intellectual capital on productivity. These insights are valuable for policymakers, researchers and international development agencies, providing a comprehensive perspective on how intellectual capital influences productivity in diverse economic and developmental contexts.Originality/valueTo the best of our knowledge, this is the first empirical study to investigate the impact of national intellectual capital on productivity across 84 countries, considering diverse income levels, HDI levels and continents.

SPATIAL DISTRIBUTION PATTERNS OF POVERTY AND ECONOMIC GROWTH FOR ACHIEVING SUSTAINABLE DEVELOPMENT TARGETS IN EAST JAVA PROVINCE

<p>Poverty and economic growth are still indicators of a country's success in managing its resources and population. Countries in the world have agreed to make poverty alleviation the first sustainable development priority. This article aims to look at the spatial distribution pattern of poverty and regional characteristics, as well as the pattern and structure of economic growth in city districts in East Java Province. The methods used include spatial autocorrelation analysis, regional financial capability analysis, Klassen typology, and regional characteristics analysis. Based on the pattern of poverty distribution for the period 2014 – 2023, poverty in East Java Province tends to change with the dominance of class 2 poverty. Sampang, Pamekasan and Sumenep regencies tend to experience a stable poverty pattern in Class 3. Pockets of poverty are clustered on Madura Island with a percentage poverty is above 18% and the characteristics of a low Human Development Index (HDI) value, low number of (people’s business credit (KUR) recipients, inadequate sanitation, not very high economic growth, and frequent flood disasters. As many as 65.78% of areas in East Java Province have high financial capacity, so that policy direction can be focused on poverty pocket areas with a high percentage of poverty, through increasing HDI, optimizing KUR, fulfilling adequate sanitation, increasing disaster response, and developing leading sectors. for increasing Original Regional Income (PAD) and economic growth.</p>

Pengelompokan Indikator Kesejahteraan Masyarakat Berdasarkan Kabupaten/Kota di Jawa Tengah Tahun 2023 Menggunakan Analisis Cluster

Community welfare is a primary objective of national development, encompassing various aspects such as health, education, and decent employment, all of which play crucial roles in achieving national stability and progress. However, welfare is not solely dependent on economic factors but also on the overall quality of life. Unfortunately, disparities in welfare persist across different regions, influenced by local environmental factors, including access to education, which in turn affects job opportunities and income levels. Inequalities in employment opportunities can potentially slow down national development by reducing the number of individuals capable of contributing productively to key economic sectors. To enhance national development, further analysis of welfare indicators such as the open unemployment rate, human development index, labor force participation rate, and poverty levels is essential. Therefore, this study conducts cluster analysis on welfare indicators across districts/cities in Central Java for the year 2023. Both hierarchical and non-hierarchical (K-Means) clustering methods are employed to identify patterns of inequality by partitioning data into groups based on specific similarities. This approach facilitates a more effective review of policies to address welfare disparities across various regions. The findings indicate that the welfare indicators in Central Java are in a relatively poor condition, with low labor force participation rates, low human development indices, and high poverty rates. The hierarchical and non-hierarchical cluster analysis identified 5 optimal clusters, with all welfare variables having significant influence, requiring four iterations to reach the final centroids.

Inequity in Population Exposure to Accelerated Warming

AbstractRecent temperature records have triggered debate about whether global warming is accelerating. Here, we examine for acceleration and explore possible causes for regional differences using gridded surface temperature data. We find that global and regional warming is accelerating, and on average, regions with low Human Development Index (HDI) experienced much higher accelerated warming in comparison to regions with high HDI. However, some regions of low HDI with a large population experienced slow acceleration due to high local aerosol emissions. Since aerosol negative forcing impacts are short‐lived and localized, rapid future reduction of aerosol emissions without a concurrent reduction in GHG emissions could have major compounding impacts. Such a pathway, similar to most 21st century scenarios, could expose a large fraction of the world's most vulnerable people to sudden warming acceleration and heat stress associated impacts. These results call for targeted climate adaptation strategies directing attention to low‐socioeconomic aerosol masked regions.

Inequality in breast cancer: Global statistics from 2022 to 2050

This study evaluates the global inequalities of breast cancer incidence and mortality from 2022 to 2050 with the latest GLOBOCAN estimates. It focuses on disparities across continents, age groups and Human Development Index (HDI) levels. In 2022, Africa shows the highest positive slope values of age-standardized rates (world) of mortality vs. incidence, both for those under 40 (0.346) and those 40 and older (0.335). These values contrast with those for Asia (0.085, 0.208), Europe (0.002, −0.014), Latin America and the Caribbean (0.17, 0.303), Northern America (−0.078, −0.188), and Oceania (0.166, −0.001). In both age groups, lower HDI levels are correlated with higher slope values and vice versa. Projections to 2050 indicate significant increases in the burden of breast cancer, with persistent yet varied disparities and differences. This highlights the need for differentiated strategies in breast cancer prevention, early-stage diagnosis, and treatment.

The current and future global burden of cancer among adolescents and young adults: a population-based study

Compared with children and older adults, the burden of cancer in adolescents and young adults (ages 15-39) is understudied. We aimed to quantify the global burden of adolescent and young adult cancer in 2022 and 2050, and explore patterns in incidence, mortality, and case fatality. In this population-based study, we used the GLOBOCAN database to quantify the number of new cases and cancer-related deaths, and corresponding age-standardised incidence and mortality rates (ASRs; per 100 000 people aged 15-39 years), in adolescents and young adults. Estimates were quantified for all cancers combined, excluding non-melanoma skin cancer, and 33 specific cancer types. Case fatality was estimated using mortality-to-incidence ratios. Overall and sex-specific estimates were calculated at the world, regional, human development index (HDI), and income level. We estimated the future cancer burden by applying the GLOBOCAN 2022 rates to sex-specific demographic projections for the year 2050 using the UN World Population Prospects 2019 revision. An estimated 1 300 196 cases and 377 621 cancer-related deaths occurred in adolescents and young adults in 2022. Incidence ASRs were 1·9-times higher and mortality ASRs were 1·2-times higher in females than in males (incidence ASR 52·9 vs 28·3; mortality ASR 13·1 vs 10·6). Although the incidence ASR was highest in the high-income countries, the mortality ASR was highest in the low-income countries; as a result, case fatality ranged from 12% in high-income settings to 57% in low-income settings. Of the 33 cancer types included in our analyses, breast or cervical cancer was the most frequently diagnosed cancer and cause of cancer-related death in 163 and 93 countries, respectively; incidence and mortality also varied the most by region for these cancers. Finally, the adolescent and young adult cancer burden globally is projected to increase by about 12% from 2022 to 2050, albeit with declines of 10·7% projected in very high HDI countries. The increase is expected to overwhelmingly impact low HDI settings, where the burden of both cancer cases and deaths is projected to double (a 102·3% increase). Although the adolescent and young adult cancer burden incidence is highest in the most developed settings, transitioning countries have the poorest outcomes and will face the greatest increases in burden by 2050. These findings act as a reference to the global adolescent and young adult cancer community to inform cancer control priorities and decrease global inequities. None.

Current and future burden of breast cancer in Asia: A GLOBOCAN data analysis for 2022 and 2050

BackgroundBreast cancer remains a significant health concern in Asia. This study seeks to analyze the burden of breast cancer in Asia based on the most recent GLOBOCAN 2022 estimates. MethodsData were obtained from GLOBOCAN 2022. Age-standardized rates for incidence and mortality per 100,000 person-years were calculated using direct age standardization with the Segi-Doll World standard population. Pearson's correlation coefficient was utilized to evaluate the relationship between human development index and incidence or mortality rate. The future number of breast cancer cases and deaths by 2050 was estimated based on global demographic projections. ResultsIn 2022, breast cancer accounted for 2296.8 thousand new cases and 666.1 thousand deaths worldwide. In Asia, an estimated 985.4 thousand new cases and 315.1 thousand deaths were reported, corresponding to age-standardized incidence and mortality rates of 34.3 and 10.5 per 100,000, respectively. Both incidence and mortality rates were notably higher among older individuals, especially in countries with high human development index. A positive correlation between human development index and incidence rates was observed, while mortality rates were highest in countries with low human development index. China and India are the leading contributors to both new cases and deaths, with projections indicating that by 2050, around 1.4 million new breast cancer cases and 0.5 million deaths are expected to occur in Asia. ConclusionBreast cancer is the most common cancer among women in Asia. Global collaboration is essential to reduce its growing burden, especially in low-HDI countries facing rising incidence and high mortality rates.

Bladder cancer: a retrospective audit at a single radiation oncology unit of an academic hospital in Johannesburg, South Africa

BackgroundBladder cancer (BCa) is one of the most common urological cancers and remains a leading cause of cancer-related mortality worldwide. Bladder cancer is associated with a range of risk factors, with smoking being one of the most significant contributors. In addition to smoking, exposure to certain chemicals, particularly aromatic amines found in industries such as dye, rubber, leather, and textiles, also increases the risk of bladder cancer. In low-and-middle countries with lower Human Development Index (HDI), data on the underlying causes, incident rate, modes of presentation, treatment, and prognosis of bladder cancer remains unclear and often appear to be inadequate. This study aimed to assess the prevalence, mode of presentation, treatment, and risk factors associated with bladder cancer in Johannesburg, South Africa. By examining these factors, the study seeks to identify possible patterns or predisposing factors that contribute to the development and progression of bladder cancer, which could generate insights that could help to reduce the significant morbidity and mortality associated with this cancer.MethodsThis retrospective study analyzed secondary data from 115 patients who were treated in the radiation oncology unit of an academic hospital between January 2010 and December 2020. By reviewing the medical records of these patients, the study aimed to gather comprehensive information on the prevalence of bladder cancer, modes of presentation, treatment approaches, and associated risk factors. Bladder cancer in this study was assessed using a comprehensive analysis of patient data on demographics, risk factors, clinicopathological aspects, and the specific therapies received. A comparison of patients with squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC) of the bladder was conducted as part of this study. This comparison aimed to explore differences in demographic profiles, risk factors, clinicopathological characteristics, and treatment outcomes between these two histological subtypes.ResultsA total of 115 patients presenting with bladder cancer symptoms were referred to the academic hospital for evaluation and treatment. The incidence rate of bladder cancer was highest among patients with a mean age of 60.7 ± 14.9. Males constituted 60.9% of the cases, resulting in a male-to-female ratio of 1.6:1. The most common risk factors associated with bladder cancer complications included smoking, being male, black ethnicity and increasing age. Transitional cell carcinoma remained the most prevalent histological subtype at the academic hospital, compared to squamous cell carcinoma (SCC). Patients with transitional cell carcinoma (TCC) were more likely to be older (odds ratio (OR): 1.03, 95% Confidence Interval (CI): 1.01–1.06, p = 0.029), male (OR: 2.60, 95% CI:1.10–6.04, p = 0.030). The study also found that most of the TCC cases were among black patients, though white patients were four times more likely to present with TCC compared to SCC (OR:4.22, 95% CI: 1.43–12.48, p = 0.009).ConclusionBladder cancer is still widespread in LMICs, with lower HDI, with elderly males being at risk. To aggressively prevent mortality and morbidity from bladder cancer, bladder cancer health awareness must be maintained to improving prevention, as well as early detection, management and comprehensive patient care and health services for bladder cancer patients. These findings highlight the importance of targeted screening and prevention strategies for high-risk groups, particularly older males with a history of smoking.

Global cancer statistics for adolescents and young adults: population based study.

Accurate and up-to-date estimates of the global cancer burden in adolescents and young adults (AYA) are scarce. This study aims to assess the global burden and trends of AYA cancer, with a focus on socioeconomic disparities, to inform global cancer control strategies. AYA cancer, defined as cancer occurring in individuals aged 15-39, was analyzed using data from the Global Burden of Disease (GBD) 2021 study and the Global Cancer Observatory (GLOBOCAN) 2022 project. We examined the global burden by age, sex, geographic location, and Human Development Index (HDI), as well as its temporal trends. Primary outcomes included age-standardized incidence and mortality rates (ASIR, ASMR) and the average annual percent change (AAPC). In 2022, an estimated 1,300,196 incidental cases and 377,621 cancer-related deaths occurred among AYAs worldwide, with an ASIR of 40.3 per 100,000 and an ASMR of 11.8 per 100,000. The most common cancers were breast, thyroid, and cervical, while the leading causes of death were breast, cervical, and leukemia. The incidence and mortality were disproportionately higher among females (ASIR: 52.9 for females vs. 28.3 for males; ASMR: 13.1 for females vs. 10.6 for males). Countries with higher HDI experienced a higher incidence of AYA cancers (ASIR: 32.0 [low HDI] vs. 54.8 [very high HDI]), while countries with lower HDI faced a disproportionately higher mortality burden (ASMR: 17.2 [low HDI] vs. 8.4 [very high HDI]) despite their relatively low incidence. Disproportionality and regression measures highlighted significant HDI-related inequalities. AYA cancer incidence was stable from 2000 to 2011 (AAPC: - 0.04) but increased from 2012 to 2021 (AAPC: 0.53), driven by growing gonadal and colorectal cancers. Mortality decreased substantially from 2000 to 2011 (AAPC: - 1.64), but the decline slowed from 2012 (AAPC: - 0.32) probably due to increased deaths from gonadal cancers. These trends varied by sex, cancer type, geography, and HDI. AYA cancers present a significant and growing global burden, with marked disparities across sex, geographic locations, and HDI levels. Policymakers should prioritize equitable resource allocation and implement targeted interventions to reduce these inequalities, particularly in low-HDI regions and with regard to gonadal cancers.

Exploring carbon footprints and carbon intensities of Indonesian provinces in a domestic and global context

Within Indonesia, the structure of consumption and production differs significantly across provinces. This implies that carbon footprints and intensities between provinces are also diverse. This paper calculates historical consumption- and production-based carbon emissions at the provincial level using a multi-scale input-output (IO) database for 2010, in which an environmentally extended multi-regional IO (EE MRIO) table for 34 Indonesian provinces is integrated in the global EE MRIO EXIOBASE with data for 43 countries and 5 rest of the world regions. Emissions from consumption are detailed by product and their points of origin, while emissions from production are detailed by industry and their destinations. Our results show the heterogeneity of Greenhouse Gas (GHG) emissions under both sides. The Java region is a net importer of carbon emission, while Sumatra and Kalimantan are net exporters. In the global context, the Asia Pacific region plays important role in national GHG emissions. Services product contributed 57.1% of national consumption-based GHG emissions, followed by manufacture (30.6%), and agriculture (12.3%). On the national level, 63.5% of national GHG emissions are related to household consumption. There is a high disparity across provinces in Indonesia in carbon footprints. Provincial average per capita carbon footprints vary from 2 t CO2e/capita in East Nusa Tenggara to 13.84 t CO2e/capita in East Kalimantan. Carbon intensity also varies from 0.83 kt CO2e/M Euro in Jakarta to 2.37 kt CO2e/M Euro in North Kalimantan. Agriculture and food products dominate household carbon footprints, while construction leads in government carbon footprints. Utilities and transportation services play important roles on national carbon intensities. We further correlated the Human Development Index (HDI) with per capita carbon footprints and expenditure, and find that provinces with similar GHG emissions and expenditure per capita income as Java, tend to have a lower HDI. Understanding development status and province-level characteristics is important for selecting policy strategies.

Relationship between the Human Development Index and public social spending: European experience for Ukraine

This study focuses on the relationship between the Human Development Index (HDI) and public social expenditures, analyzing socio-economic models using the examples of selected European countries and Ukraine. The study used the values of the HDI, GDP, and indicators of public expenditures for social purposes, namely, healthcare, education, leisure, culture and religion, and social protection for the period from 2010 to 2021. The analysis targeted 13 European countries using data sets from Eurostat, the Office for National Statistics of the United Kingdom, the State Statistics Service of Ukraine, and the Ministry of Finance of Ukraine. The input time series were checked for lagged values using the STATISTICA software.Empirical evidence suggests a relationship between HDI and public social spending. An increase in the share of public social expenditures in GDP leads to an increase in HDI and vice versa. European countries with a social-democratic model of development have the highest level of centralization of public expenditure in GDP (34.72%) and the highest HDI (0.930), while countries belonging to the Southern European model have the lowest share of socially oriented public expenditure (30.41%) and the lowest HDI (0.873). In addition, there is a time lag between the investment of public funds in healthcare, education, leisure, culture and religion, and social protection and their impact on HDI changes. Thus, ensuring a high level of HDI is achieved, among other things, through state financial support for the relevant components of the social sphere and social protection. AcknowledgmentThe study is funded by the EU NextGenerationEU through the Recovery and Resilience Plan for Slovakia under project No. 09I03-03-V01-00130.

Systematic review of cost-effectiveness studies on cervical cancer screening across Europe

IntroductionCervical cancer (CC) is a type of cancer with poor prognosis when diagnosed in advanced stage with a big socioeconomic burden. The incidence rates have wide variations among European countries depending on the implementation or not of screening, vaccination programs and the human development index (HDI). Most studies on cost-effectiveness of CC screening programs are carried out in countries with a high HDI, however more recent reviews of screening approaches are coming from countries with lower HDI aiming to identify the best screening strategies. Our study aims to identify which are the currently applied and most cost-effective strategies of CC screening in Europe. Materials and methodsThis is a systematic review conducted in three different databases (PubMed, Scopus and ScienceDirect) and reported following the PRISMA guidelines. General key terms for all databases were the following: cost-effectiveness, cervical cancer, screening, Europe. We included studies in English, Italian, Spanish and Bulgarian, published in the last 25 years, reporting data on cost-effectiveness of CC screening, costs and outcome measures. The methodological quality of the articles was evaluated with a standardized tool. ResultsA total of 262 studies were identified and 22 studies were included in the final analysis. In 90.1 % of the economic studies, the new screening strategy was shown to be more cost-effective compared to the current one or compared to no screening. The optimal strategy mostly involved primary HPV testing, combined with cytology or as stand-alone screening technique. Several scenarios differing on starting age and periodicities for CC screening, combination of techniques and triage, were found to be cost-effective and below the willingness to pay (WTP) threshold. The methodology of all included studies was assessed from 10 to 11 on the JBI standardized tool and Drummond 11-point checklist. ConclusionNumerous cost-effective options for CC screening in different European countries were identified in this systematic review. HPV testing, with or without cytology, mainly starting at 30 years of age and repeated every 5 years or more was the most cost-effective technique. Future studies should focus on the most appropriate CC screening approach for each context and setting, also considering HPV vaccination in Europe.

An Implementation of Ordinal Probit Regression Model on Factor Affecting East Java Human Development Index

An instrument for measuring human development, the Human Development Index (HDI) looks at how well human development has been achieved in relation to a few fundamental aspects of quality of life. In 2023, East Java's HDI showed an increase in the last three years with the latest value of 73.38. Despite the increase, East Java still has the lowest HDI in Java and Bali. This situation suggests the need for an in-depth analysis of the factors that influence HDI. This study aims to identify factors that contribute to HDI to formulate more appropriate policies in the future. The data used is the HDI of East Java in 2023 with ordinal categories. To analyze the ordinal data, the ordinal probit regression method was applied. The results show that the percentage of poor people has a significant influence on HDI. In addition, the classification accuracy of the model is obtained with a value of 50.5%, which indicates that the accuracy of the model in predicting HDI into the right category reaches 50.5%.

Pattern of burden cancer breast and relationshipin to human development index in Iran 2009 to 2019: an observational study based on the Global Burden of Diseases

ObjectiveBreast cancer is one of the most common cancers in women worldwide. This study aims is to investigate the burden of breast cancer in Iran and its relationship with the Human Development Index (HDI) during 2009 to 2019.Study designThe present study is an observational study in Iran during the years 2009 to 2019. Data related to the incidence, mortality, Years of Life with Disability (YLD), Years of Life Lost (YLL) and Disability-Adjusted Life-Years (DALY) of breast cancer in Iran were extracted from the Global Burden of Disease 2019 (GBD-2019) website. Correlation tests are used to check the relationship between these indicators and the human development index.ResultsThe highest incidence rate of breast cancer in 2019 is related to the provinces of Gilan (29 per 100,000) and Tehran (28.55 per 100,000) and the highest rate of death from breast cancer is related to the provinces of Gilan (10.71 per 100,000). and Semnan (9.97 in 100,000). The results showed that there is a positive and significant correlation between DALY (r = 0.626, P < 0.0001), YLL (r = 0.611, P < 0.0001) and, YLD (r = 0.773, P < 0.0001) breast cancer with HDI index. There is a positive and significant correlation between the incidence (r = 0.794, P < 0.0001) and mortality (r = 0.503, P = 0.003) of breast cancer with the HDI index.ConclusionsConsidering that a positive correlation was observed between the incidence and burden of breast cancer and the human development index in the country, it is suggested to implement preventive measures such as public education programs to reduce the incidence and burden of breast cancer and the necessity of screening programs in areas with low human development index. It confirms the diagnosis of disease cases.