Upper-middle Income Research Articles

Vulnerable voices: using topic modeling to analyze newspaper coverage of climate change in 26 non-Annex I countries (2010–2020)

News media influence how climate change is represented, understood, and discussed in the public sphere. To date, media and climate change research has primarily focused on Annex I countries, or treated non-Annex I countries as a homogenous bloc, despite the global nature of climate change and its geographically uneven impacts. This study uses a mixed-method approach, combining machine learning (topic modeling), econometrics, and qualitative analyses, to investigate newspaper coverage of climate change in 26 non-Annex I countries. We compiled a dataset of 95 216 news articles (dated between 2010 and 2020 from 50 sources) in 26 lower-middle and upper-middle income non-Annex I countries. In line with previous research results, we find that most common topics represented are international governance of climate change, the economics of energy transitions, and the impacts of climate change. Advancing current research understanding, we also demonstrate heterogeneity in coverage between non-Annex I countries and discover that a country’s vulnerability to climate change is positively associated with the diversity of topics (based on an article-level entropy index) portrayed by its domestic news media outlets.

The Role of Nurses in Rehabilitation in Primary Health Care for Ageing Populations: A Secondary Analysis from a Scoping Review.

With the ageing of the global population and the rise in noncommunicable diseases, there is an increased need for rehabilitation services, especially those that address the specific needs of ageing populations. Through their proximity to patients, nurses play a critical role in providing rehabilitation interventions for older adults in primary health care. However, they are not yet established as typical rehabilitation providers and further research is needed to clarify their role and competencies to optimize rehabilitation interventions for ageing populations. Therefore, this secondary analysis of a scoping review aims to describe the role of nurses in the provision of rehabilitation interventions to ageing populations in primary health care. This review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. It is built on all inclusion and exclusion criteria from the primary analysis and focused on studies including nurses and taking place in primary health care. Data analysis included descriptive statistics, as well as qualitative analysis on the role of nurses. A total of 68 studies from high- and upper-middle income countries were included. Nurses typically had a managerial and clinical role (76%) and worked in multidisciplinary teams (54%), most often with physical therapists. Nurses provided 355 interventions, with assessments (n = 106; 30%), and coordination and management of the rehabilitation process (n = 105; 30%) being the most frequent ones. They had 117 different job titles and little information was available about their educational background. This paper contributes to a better understanding of the key role nurses play in providing rehabilitation interventions to ageing populations in primary health care. Matching nurses' competencies with their level of proficiency is essential to ensure quality care in rehabilitation.

Accuracy of the Wound Healing Questionnaire in the diagnosis of surgical-site infection after abdominal surgery in low- and middle-income countries.

Telemedicine is being adopted for postoperative surveillance but requires evaluation for efficacy. This study tested a telephone Wound Healing Questionnaire (WHQ) to diagnose surgical site infection (SSI) after abdominal surgery in low- and middle-income countries. A multi-centre, international, prospective study was embedded in the FALCON trial; a factorial RCT testing measures to reduce SSI in seven low- and middle-income countries (NCT03700749). It was conducted according to a pre-registered protocol (SWAT126) and reported according to STARD guidelines. The reference test was in-person review by a trained clinician at 30 postoperative days according to US Centres for Disease Control criteria. The index test was telephone administration of an adapted WHQ at 27 to 30 postoperative days by a researcher blinded to the outcome of in-person review. The sum of item response scores generated an overall score between 0 and 29. The primary outcome was the diagnostic accuracy of the WHQ, defined as the proportion of SSI correctly identified by the telephone WHQ, and summarized using the area under the receiving operator characteristic curve (AUROC) and diagnostic test accuracy statistics. Patients were included from three upper-middle income (396 patients, 13 hospitals), three lower-middle income (746 patients, 19 hospitals), and one low-income country (54 patients, 4 hospitals). 90.3% (1088 of 1196) patients were successfully contacted. Those with non-midline incisions (adjusted odds ratio: 0.36, 95% c.i. 0.17 to 0.73, P=0.005) or a confirmed diagnosis of SSI on in-person assessment (odds ratio: 0.42, 95% c.i. 0.20 to 0.92, P=0.006) were harder to reach. The questionnaire correctly discriminated between most patients with and without SSI (AUROC 0.869, 95% c.i. 0.824 to 0.914), which was consistent across subgroups. A representative cut-off score of ≥4 displayed a sensitivity of 0.701 (0.610-0.792), specificity of 0.911 (0.878-0.943), positive predictive value of 0.723 (0.633-0.814) and negative predictive value of 0.901 (0.867-0.935). SSI can be diagnosed using a telephone questionnaire (obviating in-person assessment) in low resource settings.

Clinical practice applicability and relevance to non-specialists of a paediatric EEG online learning tool

BackgroundPaediatric electroencephalography (EEG) training is inadequate amongst healthcare practitioners and technicians managing children with epilepsy in sub-Saharan Africa. An entry level handbook was developed for healthcare practitioners in sub-Saharan Africa and subsequently made globally accessible via the International Child Neurology Teaching Network.AimTo investigate the usefulness of a paediatric online EEG handbook.MethodA survey of the ICNApedia online EEG handbook was circulated (December 2021–June 2022), to all 108 handbook registered participants (39 countries) via the research electronic data capture (REDCap) from the University of Cape Town (UCT).ResultsFifty participants from 25 countries responded: 8 from high income, 16 upper-middle income, 21 lower-middle income and 5 from low-income. 32 (64%) fully and 18 (36%) partially completed the survey. 35/50 (70%) had completed the handbook and seven respondents had partially completed the handbook. Responses supported the handbook as a good entry point to learn EEGs, especially for paediatrics. Likert scale ratings supported the handbook as relevant for gaining/enhancing knowledge and improving diagnosis and management of patients with confidence. The handbook was considered user friendly, comprehensible, and provided a practical experience. For improving EEG reading skills the handbook helped skills development via reinforcement and good illustrations. 29/32 (90%) of respondents confirmed that they are using learnt skills from the handbook in their current work.ConclusionIn resource limited settings non-specialist clinicians often provide extended services including EEG interpretation. The survey supports that the handbook is supporting this niche skills area, especially for the accessibility of knowledge gained. The handbook will continue to be adapted in-line with survey feedback.

Empowering Women through Tourism and Financial Development: Empirical Evidence from Upper Middle-Income Economies

The concept of women’s empowerment in this study focuses on international tourism, economic growth, financial development and financial inclusion among others as integral aspects that would help achieve the Sustainable Development Goals. Using panel data from 15 Upper Middle-Income Countries between 1995 and 2017, the study employs cutting edge approaches such as fixed-effect models, random effect models, GMM and robust LS regressions to identify major impacts. The results show a strong relationship between these factors regarding women’s empowerment with clear impacts on self-employment among the women and increased participation in serviceability and industrial areas. In particular, these factors play a very important role in total employment of women. The analysis reinforces the ability of international tourism, economic growth, financial development and financial inclusion to facilitate women’s empowerment in Upper Middle-Income Countries. This study illuminates the complex realities that guide how a woman participates in power structures, which partly exposes broad aspiration of sustainable development.

Modeling the global impact of reducing out-of-pocket costs for children's surgical care.

Over 1.7 billion children lack access to surgical care, mostly in low- and middle-income countries (LMICs), with substantial risks of catastrophic health expenditures (CHE) and impoverishment. Increasing interest in reducing out-of-pocket (OOP) expenditures as a tool to reduce the rate of poverty is growing. However, the impact of reducing OOP expenditures on CHE remains poorly understood. The purpose of this study was to estimate the global impact of reducing OOP expenditures for pediatric surgical care on the risk of CHE within and between countries. Our goal was to estimate the impact of reducing OOP expenditures for surgical care in children for 149 countries by modeling the risk of CHE under various scale-up scenarios using publicly available World Bank data. Scenarios included reducing OOP expenditures from baseline levels to paying 70%, 50%, 30%, and 10% of OOP expenditures. We also compared the impact of these reductions across income quintiles (poorest, poor, middle, rich, richest) and differences by country income level (low-income, lower-middle-income, upper-middle-income, and high-income countries).Reducing OOP expenditures benefited people from all countries and income quintiles, although the benefits were not equal. The risk of CHE due to a surgical procedure for children was highest in low-income countries. An unexpected observation was that upper-middle income countries were at higher risk for CHE than LMICs. The most vulnerable regions were Africa and Latin America. Across all countries, the poorest quintile had the greatest risk for CHE. Increasing interest in financial protection programs to reduce OOP expenditures is growing in many areas of global health. Reducing OOP expenditures benefited people from all countries and income quintiles, although the benefits were not equal across countries, wealth groups, or even by wealth groups within countries. Understanding these complexities is critical to develop appropriate policies to minimize the risks of poverty.

Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings

BackgroundThere is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. MethodsThis was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study.ResultsAmong the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00–1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h.ConclusionsqSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions.Graphical

Exploring the impact of macro-determinant factors on energy resource depletion: Evidence from a worldwide cross-country panel data analysis

The depletion of energy resources stands out as one of humanity's major challenges. Therefore, understanding the determinant factors that could potentially affect the depletion rate of energy resources is emerging as one of the main research interests of academics in this field, and this study intends to contribute by filling this gap. This paper aims to investigate the influence of different factors that can be categorised into six main categories, such as education, governance quality, sustainability, technological advancements, economic development, and health expenditures, on the depletion of energy resources in a large sample of 132 countries clustered according to their income level, for a 14-year period (2007–2020). To this end, we propose six composite indices that we developed to capture each of the six categories of macroeconomic factors. Following the panel data analysis conducted for each cluster of countries, classified based on World Bank income classification, our findings suggest that the most determinant factors for the energy depletion rate are education (for upper-middle income), governance quality (for high-income), technology advancements (for low-income), economic development (for high, upper-middle, and low-income), and health expenditures and diseases (for high, lower-middle, and low-income countries).

Availability of substance use screening and treatment within HIV clinical sites across seven geographic regions within the IeDEA consortium

BackgroundOverwhelming evidence highlights the negative impact of substance use on HIV care and treatment outcomes. Yet, the extent to which alcohol use disorder (AUD) and other substance use disorders (SUD) services have been integrated within HIV clinical settings is limited. We describe AUD/SUD screening and treatment availability in HIV clinical sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. MethodsIn 2020, 223 IeDEA HIV clinical sites from 41 countries across seven geographic regions completed a survey on capacity and practices related to management of AUD/ SUD. Sites provided information on AUD and other SUD screening and treatment practices. ResultsSites were from low-income countries (23%), lower-middle-income countries (38%), upper-middle income countries (17%) and high-income counties (23%). AUD and SUD screening using validated instruments were reported at 32% (n=71 located in 12 countries) and 12% (n=27 located in 6 countries) of the 223 sites from 41 countries, respectively. The North American region had the highest proportion of clinics that reported AUD screening (76%), followed by East Africa (46%); none of the sites in West or Central Africa reported AUD screening. 31% (n=69) reported both AUD screening and counseling, brief intervention, psychotherapy, or Screening, Brief Intervention, and Referral to Treatment; 8% (n=18) reported AUD screening and detox hospitalization; and 10% (n=24) reported both AUD screening and medication. While the proportion of clinics providing treatment for SUD was lower than those treating AUD, the prevalence estimates of treatment availability were similar. ConclusionsAvailability of screening and treatment for AUD/SUD in HIV care settings is limited, leaving a substantial gap for integration into ongoing HIV care. A critical understanding is needed of the multilevel implementation factors or feasible implementation strategies for integrating screening and treatment of AUD/SUD into HIV care settings, particularly for resource-constrained regions.

On the conflict of natural resources abundance and export upgrading in upper-middle and high-income countries

Globalization created immense competition among economies in international markets, which spurs the need for export upgrading and the effective use of natural resources to avoid the Dutch Disease phenomenon. This study investigates the direct and indirect effect of natural resources via infrastructure development on export upgrading. This research constructs a panel of 55 countries with upper-middle-income (UM) and high-income (HI) economies from 2010 to 2018. Export upgrading is measured from export sophistication score based on SITC 3-digit level exports and GDP per capita (PPP, constant US$ 2017). Moreover, the principal component analysis is applied to logistic (LGC), banking (BNK), digitalization (DGT), and telecommunication (TLC) sectoral infrastructure to measure the development level of infrastructure. To overcome the problem of cross-sectional dependence, this study applies within estimator with Driscoll-Kraay standard errors. This study explores the indirect influence of natural resource rent as a moderator between export sophistication and infrastructure development. On the other hand, natural resources positively impact export upgrading via infrastructure development. The thought behind this indirect effect is that a country effectively boosts its production structure and exports when it uses the money it earns from natural resources and the government earnings collected during the boom in the aggregate economic activity generated by natural resources to develop its banking, telecommunication, logistics, and information technology. Our results suggest that to avoid the phenomenon of Dutch Disease, such countries should invest earnings earned from natural resources in developing sectoral infrastructure.

Physical late effects of treatment among survivors of childhood cancer in low- and middle-income countries: a systematic review.

Physical late effects of treatment are well-documented among childhood cancer survivors in high-income countries, but whether prevalence and risk factors are comparable in low- and middle-income countries (LMICs) is unclear. We conducted a systematic review to assess physical late effect outcomes among childhood cancer survivors in LMICs. Five health sciences databases were searched from inception to November 2022 in all languages. We included observational studies conducted in LMICs that evaluated physical late effects of treatment in childhood cancer survivors. Mean or median cohort follow-up must have been ≥ 5 years from original cancer diagnosis. Sixteen full articles and five conference abstracts were included. Studies were conducted in lower-middle (n = 12, 57%) or upper-middle income (n = 9, 43%) countries; nearly half (n = 9, 43%) were conducted in India. Five cohorts (24%) were comprised entirely of 5-year survivors. Subsequent malignant neoplasms were reported in 0-11% of survivors (n = 10 studies). Hypothyroidism and metabolic syndrome prevalence ranged from 2-49% (n = 4 studies) and 4-17% (n = 5 studies), respectively. Gonadal dysfunction ranged from 3-47% (n = 4 studies). Cardiac dysfunction ranged from 1-16% (n = 3 studies). Late effects of the musculoskeletal and urinary systems were least investigated. Substantial knowledge gaps exist in LMIC childhood cancer survivorship. No low-income country data were found. In middle-income countries, late effects were defined and assessed variably and limited by selection bias and small sample sizes. Survivors in LMICs can experience physical late effects of treatment, though additionally systematically collected data from survivor cohorts are needed to fill knowledge gaps.

Global burden of potentially life-threatening maternal conditions: a systematic review and meta-analysis

BackgroundPotentially life-threatening maternal conditions (PLTCs) is an important proxy indicator of maternal mortality and the quality of maternal health services. It is helpful to monitor the rates of severe maternal morbidity to evaluate the quality of maternal care, particularly in low- and lower-middle-income countries. This study aims to systematically identify and synthesize available evidence on PLTCs.MethodsWe searched studies in English from 2009‒2023 in PubMed, the National Library of Medicine (NLM) Gateway, the POPLINE database, and the Science Direct website. The study team independently reviewed the illegibility criteria of the articles. Two reviewers independently appraised the included articles using the Joanna Briggs Instrument for observational studies. Disputes between the reviewers were resolved by consensus with a third reviewer. Meta-analysis was conducted in Stata version 16. The pooled proportion of PLTCs was calculated using the random effects model. The heterogeneity test was performed using the Cochrane Q test, and its level was determined using the I2 statistical result. Using Egger's test, the publication bias was assessed.ResultThirty-two cross-sectional, five case–control, and seven cohort studies published from 2009 to 2023 were included in the meta-analysis. The highest proportion of PLTC was 17.55% (95% CI: 15.51, 19.79) in Ethiopia, and the lowest was 0.83% (95% CI: 0.73, 0.95) in Iraq. The pooled proportion of PLTC was 6.98% (95% CI: 5.98–7.98). In the subgroup analysis, the pooled prevalence varied based on country income level: in low-income 13.44% (95% CI: 11.88–15.00) I2 = 89.90%, low-middle income 7.42% (95% CI: 5.99–8.86) I2 = 99.71%, upper-middle income 6.35% (95% CI: 4.21–8.50) I2 = 99.92%, and high-income 2.67% (95% CI: 2.34–2.99) I2 = 99.57%. Similarly, it varied based on the diagnosis criteria; WHO diagnosis criteria used 7.77% (95% CI: 6.10–9.44) I2 = 99.96% at P = 0.00, while the Centers for Disease Controls (CDC) diagnosis criteria used 2.19% (95% CI: 1.89–2.50) I2 = 99.41% at P = 0.00.ConclusionThe pooled prevalence of PLTC is high globally, predominantly in low-income countries. The large disparity of potentially life-threatening conditions among different areas needs targeted intervention, particularly for women residing in low-income countries. The WHO diagnosis criteria minimize the underreporting of severe maternal morbidity.Trial registrationCRD42023409229.

Systemic Banking Crises in Upper Middle Income Developing Economies and Turkey: A Comparative Econometric Analysis

Bu çalışmada, sistemik banka krizleri incelenmiş, seçilmiş üst orta gelir grubundaki gelişmekte olan ekonomiler ve Türkiye’de sistemik banka krizleri ekonometrik olarak analiz edilmiştir. 1980-2022 dönemini kapsayan yıllık verilerden oluşan iki örneklem kullanılmıştır. İlk örneklemde, Dünya Bankası sınıflandırmasında üst orta gelir grubunda yer alan ve örneklem döneminde iki veya daha fazla sistemik bankacılık krizi yaşanmış aralarında Türkiye’nin de olduğu yedi ülkenin verileri bulunmaktadır. İkinci örneklemde ise, aynı dönem için sadece Türkiye’ye dair veriler yer almaktadır. İlk örneklemdeki veriler panel probit, ikinci örneklemdeki veriler ise probit yöntemiyle analiz edilerek, sistemik banka krizleri üzerinde kredilerdeki mutlak değişimin, büyüme hızı ve enflasyonun etkileri araştırılmıştır. Elde edilen bulgular hem gelişmekte olan ülkelerde hem de Türkiye’de kredilerin GSYİH’ye oranındaki mutlak değişmelerin sistemik banka krizlerini güçlü şekilde açıkladığını, bu ilişkinin Türkiye’de daha güçlü olduğunu göstermiştir. Diğer yandan, büyüme hızındaki düşüşlerin ve enflasyon oranlarındaki artışların sistemik banka krizi olasılığını güçlendirdiği de belirlenmiştir.

Scope of services provided to childhood cancer patients by the Brazilian Pediatric Palliative Care Network.

Brazil is a developing and an Upper Middle Income, categorized by the World Bank. Therefore, it is a country that needs a special vision for children with oncological diseases who require Pediatric Palliative Care. This study aimed to understand the specificities of services that provide oncology services in comparison to those that do not provide oncological care. This is a descriptive, cross-sectional, and online survey study. A questionnaire was created by a multidisciplinary group of leaders from the Brazilian Pediatric Palliative Care Network and then the survey was distributed using a snowball strategy. Of the 90 services that answered the questionnaire, 40 (44.4%) attended oncologic patients. The Southeast represented most of the services (57.57%), followed by the Northeast, with 18.89% (17 services), the South with 12.22% (11 services), and the Center West with 8.89% (8 services). No differences were observed in access to opioid prescriptions between the services. It was observed that those services that attended oncologic patients had a tendency to dedicate more time to Pediatric Palliative Care. The distribution of services that cover oncology and those that do not, are similar in the different regions of Brazil. In Brazil, there are difficulties in accessing opioids in pediatrics: access to opioid prescriptions without differences revealed that even pediatric oncologists might have difficulty with this prescription, and this should improve. It is concluded that education in Pediatric Palliative Care is the key to improvements in the area.

A Cross-Sectional Survey of Fixed-Dose Combination Antihypertensive Medicine Prescribing in Twenty-Four Countries, Including Qualitative Insights.

Treatment inertia, non-adherence and non-persistence to medical treatment contribute to poor blood pressure (BP) control worldwide. Fixed dose combination (FDC) antihypertensive medicines simplify prescribing patterns and improve adherence. The aim of this study was to identify factors associated with prescribing FDC antihypertensive medicines and to understand if these factors differ among doctors worldwide. A cross-sectional survey was conducted online from June 2023 to January 2024 to recruit doctors. We collaborated with an international network of researchers and clinicians identified through institutional connections. A passive snowballing recruitment strategy was employed, where network members forwarded the survey link to their clinical colleagues. The survey instrument, developed through a literature review, interviews with academic and clinical researchers, and pilot testing, assessed participants perspectives on prescribing FDC antihypertensive medicines for hypertension. Participants rated their level of agreement (5-point Likert scale) with statements representing six barriers and four facilitators to FDC use. Data from 191 surveys were available for analysis. 25% (n = 47) of participants worked in high-income countries, 38% (n = 73) in upper-middle income, 25% (n = 48) in lower-middle income, 6% (n = 10) in low-income countries. Forty percent (n = 70) of participants were between 36-45 years of age; two thirds were male. Cost was reported as a barrier to prescribing FDC antihypertensive medicines [51% (n = 87) agreeing or strongly agreeing], followed by doctors' confidence in BP measured in clinic [40%, (n = 70)], access [37%, (n = 67)], appointment duration [35%, (n = 61)], concerns about side-effects [(21%, n = 37)], and non-adherence [12%, (n = 21)]. Facilitators to FDC antihypertensive polypills prescribing were clinician facing, such as access to educational supports [79%, (n = 143)], more BP measurement data [67%, (n = 120)], a clinical nudge in health records [61%, (n = 109)] and patient-facing including improved patient health literacy [49%, (n = 88)]. The levels of agreement and strong agreement across all barriers and facilitators were similar for participants working in higher or lower income countries. Across all countries, participants rated FDC antihypertensive medications highly valuable for managing patients with non-adherence, (82% reported high or very high value), for patients with high pill burden (80%). Cost and access were the most common barriers to prescribing FDCs across high- and low-income countries. While greater educational support for clinicians was perceived as the leading potential facilitator of FDC use, this seems unlikely to be effective without addressing access.

Utjecaj izravnih stranih ulaganja, bankovnih kredita i salda tekućeg računa bilanca plaćanja na gospodarski rast prema razini dohotka

According the literature, it appears that foreign direct investment (FDI), bank credit (CRDT) and current account balance (CAB) are key factors that determine economic growth as they influence funds needed in order for a country to keep its growth. In other words, FDI, CRDT and CAB set the ground for sustainable development. In this study covering 44 countries and the period of 1977-2017, the impact of FDI, CRDT and CAB on economic growth is investigated on the basis of income level. In this regard, 44 countries are divided into 4 groups: high income level (HIL), upper middle income level (UMIL), lower middle income level (LMIL) and low income level (LIL). In the study, the panel data approach is used. As per the results, FDI is a key factor for growth and especially, it is important for LMIL and LIL countries. As the income level increases, its positive effect on economic growth decreases. Current account deficit has a positive effect for UMIL countries, while it has a negative effect for HIL and LMIL countries. As for CRDT, it affects the growth of HIL countries only and its impact is negative.

Harmonising dietary datasets for global surveillance: methods and findings from the Global Dietary Database.

The Global Dietary Database (GDD) expanded its previous methods to harmonise and publicly disseminate individual-level dietary data from nutrition surveys worldwide. Analysis of cross-sectional data. Global. General population. Comprehensive methods to streamline the harmonisation of primary, individual-level 24-h recall and food record data worldwide were developed. To standardise the varying food descriptions, FoodEx2 was used, a highly detailed food classification and description system developed and adapted for international use by European Food Safety Authority (EFSA). Standardised processes were developed to: identify eligible surveys; contact data owners; screen surveys for inclusion; harmonise data structure, variable definition and unit and food characterisation; perform data checks and publicly disseminate the harmonised datasets. The GDD joined forces with FAO and EFSA, given the shared goal of harmonising individual-level dietary data worldwide. Of 1500 dietary surveys identified, 600 met the eligibility criteria, and 156 were prioritised and contacted; fifty-five surveys were included for harmonisation and, ultimately, fifty two were harmonised. The included surveys were primarily nationally representative (59 %); included high- (39 %), upper-middle (21 %), lower-middle (27 %) and low- (13 %) income countries; usually collected multiple recalls/ records (64 %) and largely captured both sexes, all ages and both rural and urban areas. Surveys from low- and lower-middle v. high- and upper-middle income countries reported fewer nutrients (median 17 v. 30) and rarely included nutrients relevant to diet-related chronic diseases, such as n-3 fatty acids and Na. Diverse 24-h recalls/records can be harmonised to provide highly granular, standardised data, supporting nutrition programming, research and capacity development worldwide.

Auditory Risk Factors at Birth and Language Development at 2 Years of Age: A Longitudinal Analysis.

Aim. To analyze the relationship between auditory risk factors at birth and subsequent language development in toddlerhood. Methods. Participants are 136 children from a longitudinal birth cohort follow-up at age 2 years. They were divided into 2 groups: One comprising 105 children without hearing risk factors at birth and another comprising 31 children with auditory risk factors at birth but normal hearing. Results. In children with and without risk factors, the combination of socio-emotional, socio-economic, and auditory risk factors at birth significantly predicted language development at age 2 years. Family socio-economic status had a significant impact on overall child development, even after controlling for socio-emotional development and the presence of risk factors. Conclusions. The study was conducted in an upper-middle income country with a socialized health care system. It underscores the importance of a holistic approach to early childhood language development, taking into account biological, socioeconomic, and emotional factors.

Peer-reviewed publications in orthopaedic surgery from lower income countries: A comparative analysis.

Musculoskeletal (MSK) disease is a substantial global burden, especially in lower income countries. However, limited research has been published on MSK health by scholars from these countries. We aimed to study the distribution of authorships, including trends in peer-reviewed orthopaedic publications based on each author's affiliated institution's country income status. Based on a bibliometric search, 119 orthopaedic-related journals were identified using the Journal Citation Reports database. Details of all scientific articles published in these journals between 2012 and 2021 were used to study trends and association between each of the author's affiliated institution's country income status, using the World Bank Classification. Of the 133,718 unique articles, 87.6% had at least one author affiliation from a high-income country (HIC), 7.0% from an upper-middle income country (UMIC), 5.2% from a lower-middle income country (LMIC), and 0.2% from a low-income country (LIC). Overall, these articles were cited 1,825,365 times, with 92.5% of citations from HIC-affiliated authors and<0.1% from LIC-affiliated authors. Over the 10-year study period, HIC-affiliated articles demonstrated the largest increase in the number of publications (9107-14,619), compared to UMIC-affiliated (495-1214), LMIC-affiliated (406-874), and LIC-affiliated articles (4-28). There are large and persistent disparities in orthopaedic research publications based on the country income status of the author's affiliated institution, especially in the higher impact orthopaedic journals. Efforts should be made to increase opportunities for scholars from LICs and LMICs to publish their research in high-impact orthopaedic journals.

THE IMPACT OF FINANCIAL STABILITY AND ECONOMIC FREEDOMS ON ECONOMIC GROWTH: EVIDENCE FROM DEVELOPING COUNTRIES WITH NEW QUANTITATIVE MODELS

This study examines the effect of financial stability and economic freedom levels of developing countries on economic growth. A financial stability index was calculated in this study to represent the financial stability of developing countries, whereby the Heritage Foundation "Economic Freedom Index" was used to represent their economic freedom. Econometric analyzes were conducted within the framework of the 2000-2020 period in 16 developing countries of the upper-middle income bracket. As a result of the models estimated utilizing the Moment Quantile Regression Method (MM-QR), it was observed that the effect of economic freedom and financial stability on economic growth is positive and statistically significant for the country group. These research findings hold significant implications for policy makers, economists and researchers.