RESUMO
In 2024, a significant portion of the global population will participate in elections, creating an opportunity to analyze how information spreads and how users behave on social media. This study examines the media landscape on Facebook by analyzing posts from political parties and major news outlets in Europe, Mexico, and India. By identifying key topics and measuring public engagement, we uncover patterns in political discourse. Using Principal Component Analysis, we explore how these topics are related and distinguish trends in audience interaction. Our findings show how certain topics resonate differently across political groups, providing insights into the relationship between media content, political ideology, and user engagement during elections.
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Política , Mídias Sociais , Humanos , México , Índia , Europa (Continente)RESUMO
BACKGROUND: As a female-specific health problem, pelvic organ prolapse (POP) causes serious damage to the physical and psychological health of numerous women, which poses a significant challenge to women's health care worldwide, especially in developing countries. We conducted an in-depth analysis of trends in the incidence of POP over the past 30 years globally and in Brazil, Russia, India, China, and South Africa (BRICS countries). MATERIALS AND METHODS: Data on the incidence of POP were obtained by location (5 countries), age (15-94 years old), year (1990-2019) from the Global Burden of Disease Study 2019. Age-period-cohort model was used to estimate the net drift, local drift, age effects, period and cohort effects between 1990 and 2019. RESULTS: The all-age incidence rate for POP in 2019 increased from 283.28/100,000 (95% UI: 229.97, 340.34) in China to 444.81/100,000 (369.92, 526.15) in Brazil, whereas the age-standardized incidence rate in 2019 was highest in India 400.06/100,000 (325.98, 476.91) and lowest in China 187.74/100,000 (154.21, 224.43). There was an emerging transition of incidences from the young population (15-39 years) to the middle and older population (≥ 40 years) in Brazil and India. The current findings reflect the different age, period, and cohort effects on POP incidence trends at global and BRICS levels. CONCLUSIONS: The BRICS countries have made different progress in reducing the prevalence of POP. We fully recognize the diversity of internal environments in the BRICS countries and suggest an incremental approach to advancing POP prevention matters based on possible policy-driven human and financial resources in a given setting.
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Prolapso de Órgão Pélvico , Humanos , Pessoa de Meia-Idade , Adulto , Prolapso de Órgão Pélvico/epidemiologia , Feminino , Idoso , Incidência , Adolescente , Adulto Jovem , Índia/epidemiologia , Brasil/epidemiologia , China/epidemiologia , Idoso de 80 Anos ou mais , Estudos de Coortes , África do Sul/epidemiologia , Carga Global da Doença/tendências , Federação Russa/epidemiologia , Distribuição por IdadeRESUMO
This volume makes a notable contribution with a deep and extensive analysis to achieve the movement from Yoga Philosophy to Yoga Psychology for the promotion of integration with Modern Psychology, a task hitherto unrealized despite the burgeoning attention to Yoga. This commentary is constrained by my own limited knowledge of traditional Indian philosophy in making a thorough examination of Paranjpe's contribution beyond attention to selected concepts and sporadic illustrations from the original volume. Yoga practice is, Paranjpe informs us, just the tip of an immense consolidation of knowledge, deep intellectual thought and theoretical consideration about the embodied sense of self, health and well-being. Spirituality is foundational to the theory and practice of yoga. This volume has immense potential relevance for contemporary psychological theory and practice in an attempt to highlight embodied and spiritual considerations of human existence. With some notable exceptions, modern psychology has adopted the positivistic paradigm that systematically rejects traditional knowledge systems. Through intercultural translation (a concept I borrow from Santos, 2018), Paranjpe successfully transcends this divide and provides detailed possibilities about why and how this knowledge can relate to, inform and expand the science of human being and becoming that is inclusive, built for mutuality rather than domination; travelling on the path of dialogue between diverse knowledge systems.
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Yoga , Humanos , Espiritualidade , Conhecimento , ÍndiaRESUMO
BACKGROUND: Ischemic stroke, accounting for 85% of stroke cases, leads to severe disabilities and increased mortality. Its global incidence rose by 87.55% from 1990 to 2019, posing significant health and economic burdens. The BRICS-plus nations-Brazil, Russia, India, China, South Africa, and five others-represent a large global population, presenting unique public health challenges. This study aims to evaluate the epidemiological trends and variations in the burden of ischemic stroke across BRICS-plus nations in a timely manner. METHODS: Data on the number, all-age rate, age-standardized rate, and relative change in ischemic stroke disability-adjusted life years (DALYs) from 1992 to 2021 within BRICS-plus were obtained from the Global Burden of Disease Study (GBD) 2021. Relationships between the DALYs rate and the Socio-demographic Index (SDI) were evaluated using Pearson correlation analyses. Additionally, age-period-cohort modeling was employed to estimate net drift, local drift, age, period, and cohort effects over the past three decades. RESULTS: From 1992 to 2021, total DALYs due to ischemic stroke increased by 47.14%, while the age-standardized DALYs rate decreased by 33.79%. All BRICS-plus countries exhibited a declining trend in the age-standardized DALYs rate over the past three decades. Egypt reported the highest age-standardized DALYs rate (2,462.60 per 100,000 population) in 2021, whereas the most substantial reduction of 59.37% was observed in Brazil. The annual net drift in the ischemic stroke DALYs rate ranged from -3.04% for Brazil to -0.48% for Egypt among the ten countries. A significant positive correlation was observed between the DALYs rate of ischemic stroke and SDI values. Countries exhibited similar age effect patterns, with an increasing risk of DALYs rate with advancing age. Period and cohort effects highlighted declines in observed nations, indicating improved ischemic stroke management strategies. CONCLUSION: The burden of ischemic stroke showed an overall declining trend across the BRICS-plus from 1992 to 2021, but persistent health inequalities between these countries were driven by socioeconomic disparities. Furthermore, it emphasizes the necessity for targeted interventions across age, period, and cohort dimensions to address the distinct challenges posed by ischemic stroke in these rapidly developing countries.
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AVC Isquêmico , Humanos , Pessoa de Meia-Idade , Adulto , Idoso , Masculino , Feminino , AVC Isquêmico/epidemiologia , Índia/epidemiologia , Brasil/epidemiologia , Anos de Vida Ajustados por Deficiência , Carga Global da Doença/tendências , África do Sul/epidemiologia , China/epidemiologia , Federação Russa/epidemiologia , Efeito de Coortes , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais , Saúde Global/estatística & dados numéricos , Fatores Etários , Incidência , Efeitos Psicossociais da DoençaRESUMO
Introduction: The COVID-19 pandemic has greatly impacted the way that the world views vaccines. While safe and effective, COVID-19 vaccines were, and continue to be met with hesitancy and misinformation. We aimed to understand public perceptions and trust in COVID-19 vaccinations and how the pandemic has impacted perceptions of non-COVID-19 vaccines. Methods: Survey data were collected between August 7, 2023-August 16, 2023, from 7,000 respondents aged 18 years and older from the United States (n = 1,000); Nigeria (n = 1,000); United Kingdom (n = 1,000); France (n = 1,000); Canada (n = 1,000); Brazil (n = 1,000); and India (n = 1,000). Results: Trust in COVID-19 vaccines was highest in Brazil (84.6%) and India (80.4%) and lowest in the United States (63.5%) and France (55.0%). 47.5% of respondents agreed that they trust traditional protein-based vaccines more than mRNA vaccines, 13.5% disagree and 39.0% are neutral about their trust in protein-based versus mRNA vaccines. Overall, 53.9% of respondents reported that the COVID-19 pandemic impacted their perceptions of vaccines with half of these respondents (51.7%) reporting that the pandemic made them think that other vaccines are more important as they understand how critical vaccines can be at preventing serious illnesses. Discussion: These data can be used by health system decision makers, public health and researchers to understand how vaccine trust impacts perceptions of COVID-19 and influenza vaccines globally and develop tailored interventions that address local concerns.
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Vacinas contra COVID-19 , COVID-19 , Vacinas contra Influenza , Confiança , Humanos , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adolescente , Estados Unidos , Adulto Jovem , Influenza Humana/prevenção & controle , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Idoso , SARS-CoV-2 , Canadá , Nigéria , Conhecimentos, Atitudes e Prática em Saúde , Índia , BrasilRESUMO
OBJECTIVE: To assess whether there is any difference in the genetic association between Class II division 1 (div. 1) and division 2 (div. 2) malocclusions using PAX9 (rs8004560) gene single nucleotide polymorphism (SNP). MATERIAL AND METHODS: Sixty patients from the Orthodontics department of Subharti Dental College and Hospital (Meerut, India) were divided into two groups: Group 1 (Class II div. 1 malocclusion) and Group 2 (Class II div. 2 malocclusion). Then, 3 mL of blood was collected from each participant. DNA extraction was done, and Sanger Sequencing was performed from extracted DNA samples. RESULTS: A statistically significant difference was found in the distribution of alleles among Class II div. 1 and Class II div. 2 malocclusions. The homozygous GG allele was the most prevalent among Class II div. 1 patients (76.7%), while the heterozygous AG allele was the most prevalent among Class II div. 2 patients (53.5%). Since GG was the most prevalent allele, it was used as a reference, and AA/AG were compared with GG to confirm the association. The results showed that individuals with the AG genotype seemed to be more susceptible to the development of skeletal Class II div. 2 malocclusion. CONCLUSION: The homozygous GG allele was the most prevalent among Class II div. 1 patients, while the heterozygous AG allele was the most prevalent among Class II div. 2 patients, suggesting that there could be a difference between the genetic association of both malocclusions.
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Má Oclusão Classe II de Angle , Fator de Transcrição PAX9 , Polimorfismo de Nucleotídeo Único , Humanos , Fator de Transcrição PAX9/genética , Má Oclusão Classe II de Angle/genética , Feminino , Masculino , Alelos , Adolescente , Centros de Atenção Terciária , Índia , Criança , GenótipoRESUMO
OBJECTIVES: Maternal hypertensive disorder (MHD) is a leading cause of significant maternal and fetal mortality and morbidity. The BRICS nations are crucial in the global MHD landscape, given their large populations and varied healthcare infrastructures. This investigation evaluates the incidence trends of MHD in BRICS countries from 1992 to 2021. STUDY DESIGN AND METHODS: Data on the number, all-age rate, age-standardized rate (ASR), and the relative change of MHD incidence from this study were sourced from the Global Burden of Disease (GBD) 2021 public dataset to investigate temporal trends in MHD incidence over three decades globally and in BRICS countries. The age-period-cohort (APC) model was used to estimate net drift, local drift, age-specific curves, and period (cohort) relative risks. RESULTS: A 15.87% increase in global MHD cases, alongside a 13.40% decrease in age-standardized incidence rates from 1992 to 2021. MHD incidence rates are declining across various BRICS age groups, except in China and Russian Federation, where most groups exhibit increasing trends. Annual net drift in MHD incidence ranges from - 4.25% in India to 2.38% in China. A shift in the age distribution of MHD cases from younger to older within the childbearing age range is observed in all BRICS nations. Countries exhibit similar age-effect patterns, with decreasing risk with increasing age, and varying period and cohort effects, indicative of differential control measures and temporal incidence trends. CONCLUSIONS: Global and BRICS-specific reductions in MHD incidence vary in magnitude. Customized preventive strategies, leveraging existing resources, are advisable for BRICS nations to address pregnancy complications. Enhancing primary healthcare and maternal care quality, particularly for older mothers, is imperative.
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Hipertensão Induzida pela Gravidez , Humanos , Feminino , Incidência , Adulto , Gravidez , China/epidemiologia , Índia/epidemiologia , Adulto Jovem , Hipertensão Induzida pela Gravidez/epidemiologia , Brasil/epidemiologia , Federação Russa/epidemiologia , África do Sul/epidemiologia , Estudos de Coortes , Carga Global da Doença/tendências , Pessoa de Meia-Idade , Adolescente , Distribuição por IdadeRESUMO
BACKGROUND: In low- and middle-income countries, resource constraints remain a critical factor limiting access to cervical cancer preventive measures. The option of single-dose immunization could help improve access to human papillomavirus vaccination and attain cervical cancer elimination. METHODS: With simulation models adapted to country-specific data and scenarios for single-dose protection derived from International Agency for Research on Cancer India vaccine trial data, we estimated the expected impact of single-dose vaccination in India, Rwanda, and Brazil, three countries with varying profiles of cervical cancer risk and vaccination timelines. In combination with single-dose vaccination, we explored different resource reallocation strategies based on dose efficiency, elimination attainment, and cervical cancer cases prevented, with the existing 2-dose program as a comparator. RESULTS: Assuming lifelong single-dose protection, switching from 2-dose to 1-dose vaccination and reallocating resources to female catch-up could prevent 467-1336, 94-194, and 15-207 additional cervical cancer cases (per 100â000 women born) in cohorts aged 11-30 years in India, Rwanda, and Brazil, respectively. Resource reallocation to improve the current routine coverage could help eliminate cervical cancer in India and across all Brazilian states but not in Rwanda. For each country, we found a dose-efficient reallocation strategy (or a combination of strategies) together with 1-dose vaccination that could prevent more cervical cancers vs 2-dose vaccination, even in the worst-case scenario of single-dose protection. CONCLUSION: Adopting single-dose vaccination with resource reallocation is a resource-efficient approach to enhance progress toward cervical cancer elimination. The overall impact of vaccination can be maximized by fine-tuning resource reallocation to a country's needs.
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Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Humanos , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/epidemiologia , Feminino , Vacinas contra Papillomavirus/administração & dosagem , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/epidemiologia , Índia/epidemiologia , Adolescente , Adulto , Ruanda/epidemiologia , Adulto Jovem , Criança , Brasil/epidemiologia , Países em Desenvolvimento , Vacinação/métodos , Papillomavirus HumanoRESUMO
BACKGROUND: Examining trajectories of undernutrition and overnutrition separately limits understanding of the double burden of malnutrition. We investigated transitions between normal, stunting, overweight and concurrent stunting and overweight (CSO) and associations with sociodemographic factors in children and adolescents. METHODS: We used data from the Young Lives cohort in India, Peru and Vietnam, which follow children 1-15 (N = 5413) and 8-22 years (N = 2225) over five rounds between 2002 and 2016. We estimated transitions between nutritional states using a Markov chain model and estimated sociodemographic associations employing a logit parametrization. RESULTS: Transitions into stunting peaked in ages 1-5 years (India: 22.9%, Peru: 17.6%, Vietnam: 14.8%), while stunting reversal was highest during adolescence across all countries. Transitions into overweight peaked in ages 19-22, while overweight reversal increased in ages 1-5 and 12-15 years. Transitions away from stunting to overweight were rare; more commonly, stunted individuals developed overweight while remaining stunted, leading to a CSO state. In Peru, 20.2% of 19-year-olds who were stunted reached CSO by age 22, with 4% shifting from stunted to overweight. Reversion to a normal state is least likely for those in a CSO state. Household wealth gradually reduced the likelihood of transitioning into stunting [odds ratios (ORs) for wealthiest quartile in Peru: 0.29, 95% confidence interval (CI) 0.20-0.41; India: 0.43, 95% CI 0.32-0.57; Vietnam: 0.36, 95% CI 0.26-0.50), with stunting reversal only being more likely in the two wealthiest quartiles across all countries (ORs for wealthiest quartile in Peru: 2.39, 95% CI 1.57-3.65; India: 1.28, 95% CI 1.05-1.54; Vietnam: 1.89, 95% CI 1.23-2.91). In Vietnam, only the richest quartile was at higher risk of transitioning into overweight (OR 1.87, 95% CI 1.28-2.72), while in Peru and India, the risk gradually rose across all wealth quartiles (ORs for wealthiest quartile in Peru: 2.84, 95% CI 2.14-3.77; India: 2.99, 95% CI 1.61-5.54). CONCLUSIONS: Childhood and adolescence represent critical periods for prevention and reversal of stunting and overweight, thereby averting the development of CSO later in life. Context-specific interventions are crucial for preventing disparate transitions towards the double burden of malnutrition across socioeconomic groups.
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Transtornos do Crescimento , Sobrepeso , Humanos , Peru/epidemiologia , Vietnã/epidemiologia , Índia/epidemiologia , Transtornos do Crescimento/epidemiologia , Adolescente , Masculino , Pré-Escolar , Feminino , Sobrepeso/epidemiologia , Adulto Jovem , Criança , Lactente , Estudos Longitudinais , Estado Nutricional , Cadeias de Markov , Fatores Socioeconômicos , Desnutrição/epidemiologia , AdultoRESUMO
This study examines how stock market returns in emerging BRICS economies respond to growing physical and transition climate risks. To capture the physical climate risk, we use the frequency of natural disasters, the number of people affected by natural disasters, temperature anomaly, and precipitation anomaly. For transition risk, we included two climate-policy uncertainty measures. First, we conduct a panel-level analysis using a cross-sectionally augmented autoregressive distributed lag model. Second, for country-level analysis, we applied the augmented autoregressive distributed lag model to the monthly dataset from January-2000 to March-2023. The empirical results show that an increase in transition climate risk causes a significant and negative shock to stock returns, both in the short- and long-term in the panel and across each BRICS country. Second, we find that physical climate risk indicators have a significant and negative impact on stock returns in China, India, and South Africa, but not in Brazil or Russia. We conclude that the impact of physical climate risk on stock returns is country-specific, and that the impact of transition climate risk is widespread. These findings provide important insights for investors, regulators, hedgers, portfolio managers, and policymakers regarding policy formulation and future investment strategies.
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Mudança Climática , Investimentos em Saúde , China , Índia , África do Sul , Brasil , Federação Russa , Humanos , Desastres NaturaisRESUMO
OBJECTIVE: This study develops successful ageing profiles across six low- and middle-income countries (LMIC) and examines associations with fruit and vegetable (F&V) intake. DESIGN: A cross-sectional analysis was conducted in mid-aged and older adults from the WHO Study of Global Ageing. Participants without chronic disease, cognitive impairment, depression or disability and with good physical, cardiovascular and respiratory function were considered to have successfully aged. Associations between F&V intake (serves/d) and successful ageing were examined using log-binomial regression adjusting for key confounders. SETTING: China, Ghana, India, Mexico, Russia and South Africa. PARTICIPANTS: A total of 28 785 men and women aged 50 years and over. RESULTS: Successful ageing ranged from 4 % in Mexico to 15 % in China. After adjustment, only Ghana showed an association between fruit intake and successful ageing, with an inverse association identified (prevalence ratio (PR) = 0·87, 95 % CI 0·78, 0·98). An inverse association between vegetable intake and successful ageing was found in China (0·97, 0·95, 0·98) but no other country. An inverse association was shown for both China (0·98, 0·96, 0·99) and Ghana (0·92, 0·84, 1·00) when considering fruit and vegetables combined. CONCLUSIONS: Associations between F&V intake and successful ageing are inconsistent. Further studies on LMIC countries are needed to meet the challenges of the ageing population.
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Dieta , Frutas , Verduras , Humanos , Estudos Transversais , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Gana , China , África do Sul , México , Dieta/estatística & dados numéricos , Federação Russa , Índia , Envelhecimento/fisiologia , Organização Mundial da Saúde , Envelhecimento Saudável , Países em DesenvolvimentoRESUMO
Background: Anxiety disorders are a significant global mental health concern, contributing to substantial disability-adjusted life years (DALYs) and imposing considerable social and economic burdens. Understanding the epidemiology of anxiety disorders within the BRICS nations (Brazil, Russian Federation, India, China, and South Africa) is essential due to their unique socio-economic landscapes and ongoing transformations. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 database to evaluate anxiety disorder incidence trends in BRICS countries from 1992 to 2021. The Age-Period-Cohort (APC) model with an intrinsic estimator (IE) algorithm was employed to disentangle the effects of age, period, and cohort on incidence rates. Data were categorized into 5-year age groups, and 95% uncertainty intervals (UIs) were calculated to account for data variability. Results: From 1992 to 2021, the global number of anxiety disorders cases increased by 73.44%, with age-standardized incidence rates rising by 21.17%. Among BRICS nations, India experienced the largest increase in cases (113.30%), while China had the smallest increase (2.79%). Globally, young (15-49 years) and oldest (80-94 years) age groups showed predominantly positive local drift values, indicating rising incidence rates. Brazil and India mirrored this trend, while China and South Africa mostly exhibited negative local drift values. Russia Federation had mixed trends with younger groups showing negative and older groups positive local drift values. The incidence of anxiety disorders exhibited an "M-shaped" age pattern with peaks at 10-14 and 35-39 years. Period effects were stable globally but varied in BRICS countries, with Brazil showing a decline and India an increase. Cohort effects were stable globally but showed increasing trends in Brazil and India post-1955-1959 cohort. Conclusion: This study highlights a significant increase in anxiety disorders incidence globally and within BRICS nations over the past three decades, with marked variations across countries. The distinct trends observed in age, period, and cohort effects call for age-specific and gender-sensitive mental health policies. Continuous monitoring, research, and tailored public health strategies are essential to address the rising burden of anxiety disorders and improve mental health outcomes in these rapidly evolving regions.
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Transtornos de Ansiedade , Carga Global da Doença , Humanos , Incidência , Transtornos de Ansiedade/epidemiologia , Adulto , Pessoa de Meia-Idade , Adolescente , Índia/epidemiologia , África do Sul/epidemiologia , Carga Global da Doença/tendências , Brasil/epidemiologia , Masculino , China/epidemiologia , Feminino , Adulto Jovem , Federação Russa/epidemiologia , Estudos de Coortes , Idoso , Fatores EtáriosRESUMO
BACKGROUND: Research, mainly conducted in Europe and North America, has shown an inequitable burden of internalising mental health problems among adolescents from poorer households. We investigated whether these mental health inequalities differ across a diverse range of countries and multiple measures of economic circumstances. METHODS: In this longitudinal observational cohort study, we analysed data from studies conducted in eight countries (Australia, Ethiopia, India, Mexico, Peru, South Africa, the UK, and Viet Nam) across five global regions. All studies had self-reported measures of internalising symptoms using a validated scale at two timepoints in adolescence; a measure of household income, household consumption expenditure, or subjective wealth; and data collected between 2000 and 2019. Household income (measured in four countries), consumption expenditure (six countries), and adolescents' subjective assessment of household wealth (five countries) were measured in mid-adolescence (14-17 years). The primary outcome (internalising symptoms, characterised by negative mood, affect, and anxiety) was measured later in adolescence between age 17 and 19 years. Analyses were linear regression models with adjustment. Effect estimates were added to random-effects meta-analyses to aid understanding of cross-country differences. FINDINGS: The overall pooled sample of eight studies featured 18â910 adolescents (9568 [50·6%] female and 9342 [49·4%] male). Household income had a small or null association with adolescents' internalising symptoms. Heterogeneity (I2 statistic) was 71·04%, falling to 39·71% after adjusting for baseline symptoms. Household consumption expenditure had a stronger association with internalising symptoms (decreases of 0·075 SD in Peru [95% CI -0·136 to -0·013], 0·034 SD in South Africa [-0·061 to -0·006], and 0·141 SD in Viet Nam [-0·202 to -0·081] as household consumption expenditure doubled). The I2 statistic was 74·24%, remaining similar at 74·83% after adjusting for baseline symptoms. Adolescents' subjective wealth was associated with internalising symptoms in four of the five countries where it was measured. The I2 statistic was 57·09% and remained similar after adjusting for baseline symptoms (53·25%). We found evidence for cross-country differences in economic inequalities in adolescents' internalising symptoms, most prominently for inequalities according to household consumption expenditure. Subjective wealth explained greater variance in symptoms compared with the objective measures. INTERPRETATION: Our study suggests that economic inequalities in adolescents' mental health are prevalent in many but not all countries and vary by the economic measure considered. Variation in the magnitude of inequalities suggests that the wider context within countries plays an important role in the development of these inequalities. FUNDING: Wellcome Trust.
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Fatores Socioeconômicos , Humanos , Adolescente , Masculino , Feminino , Estudos Longitudinais , Reino Unido/epidemiologia , México/epidemiologia , África do Sul/epidemiologia , Peru/epidemiologia , Austrália/epidemiologia , Índia/epidemiologia , Etiópia/epidemiologia , Vietnã/epidemiologia , Adulto Jovem , Renda/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Ansiedade/epidemiologiaRESUMO
PURPOSE: The aim of the present study was to conceptualize and develop a novel context-based working memory (WM) task which would possess the potential to assess the context-based WM in an Indian scenario and incorporate a task-linked metacognitive facet to understand an individual's self-perception of performance. METHODS: Employing the ADDIE instructional design model, comprising Analysis, Design, Development, Implementation and Evaluation phases, the present study focused on the initial four phases. In the Analysis-phase, the needs and objectives for creating a context-based WM task were identified. Design-phase included task conceptualization and content validation of the conceptualized context-based WM task. In the Develop-phase, the designed context-based WM task was developed in an animated video format. Five content experts and fifteen lay experts were involved in the content validation process. In the Implementation-phase, a pilot study was done on ten adults to assess the feasibility of the novel context-based WM task. RESULTS: The task obtained good content validation index and understandability scores on the Patient Education Materials Assessment Tool. Preliminary data trends from the implementation-phase revealed the task's potential to detect age-related WM differences. Significantly correlated with established WM tasks, the novel Activity Ordering Task (AOT) effectively measured WM-spans. Observed discrepancies between performance and prediction/postdiction spans during metacognitive facet administration highlighted the AOT's utility in evaluating metacognition. CONCLUSION: Addressing the limitations of context in traditional tasks, the AOT appears to be a promising tool that not only measures WM but also assesses metacognition, thereby enhancing its utility beyond an everyday WM assessment.
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Memória de Curto Prazo , Metacognição , Humanos , Memória de Curto Prazo/fisiologia , Adulto , Metacognição/fisiologia , Feminino , Masculino , Projetos Piloto , Adulto Jovem , Índia , Testes Neuropsicológicos , Pessoa de Meia-IdadeRESUMO
PURPOSE: Chronic Cough (CC) is an emerging area of practice in speech language pathology. Behavioral treatment for managing CC has gained attention in the recent past. This study aimed to devise a comprehensive behavioural therapy program for CC by involving allied health professionals (AHPs), who are typically involved in management of CC. METHODS: A qualitative methodology was used to devise a behavioral treatment module for CC. Practice patterns of medical professionals, AHPs and yoga practitioners for CC were gathered through semi-structured interviews. A constant comparative framework was used to recruit participants until data saturation was achieved. The interview transcripts were analyzed to identify relevant components for the module. A post-interview survey was conducted to finalize the module through a consensus-based approach. RESULTS: Three themes and respective sub-themes were identified from analysis. The module was developed based on the treatment strategies followed by professionals and was labeled 'Comprehensive Cough Therapy Program (CCTP)'. This comprised four components - similar to what is available in literature - patient education, breathing exercises, laryngeal hydration, and cough control strategies. This was devised using inputs from the interviews and evidence in the literature. CONCLUSION: In line with global guidelines, this behavioral treatment module can serve as a possible management option for CC.
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Tosse , Pesquisa Qualitativa , Humanos , Tosse/terapia , Doença Crônica , Índia , Masculino , Feminino , Pessoal Técnico de Saúde , Terapia Comportamental/métodos , Educação de Pacientes como Assunto , Yoga , Adulto , Exercícios Respiratórios , Entrevistas como Assunto , Tosse CrônicaRESUMO
BACKGROUND: Locally advanced cervical cancer is treated with chemoradiotherapy (standard of care), but many patients still relapse and die from metastatic disease. We investigated chemoradiotherapy with or without induction chemotherapy to determine whether induction chemotherapy improves both progression-free survival and overall survival. METHODS: The INTERLACE trial was a multicentre, randomised phase 3 trial done at 32 medical centres in Brazil, India, Italy, Mexico, and the UK. Adults (aged ≥18 years) with locally advanced cervical cancer (FIGO 2008 stage IB1 disease with nodal involvement, or stage IB2, IIA, IIB, IIIB, or IVA disease) were randomly assigned (1:1), by minimisation, using a central electronic system, to standard cisplatin-based chemoradiotherapy (once-a-week intravenous cisplatin 40 mg/m2 for 5 weeks with 45·0-50·4 Gy external beam radiotherapy delivered in 20-28 fractions plus brachytherapy to achieve a minimum total 2 Gy equivalent dose of 78-86 Gy) alone or induction chemotherapy (once-a-week intravenous carboplatin area under the receiver operator curve 2 and paclitaxel 80 mg/m2 for 6 weeks) followed by standard cisplatin-based chemoradiotherapy. Stratification factors were recruiting site, stage, nodal status, three-dimensional conformal radiotherapy or intensity modulated radiotherapy, age, tumour size, and histology (squamous vs non-squamous). Primary endpoints were progression-free survival and overall survival within the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT01566240, and EUDRACT, 2011-001300-35. FINDINGS: Between Nov 8, 2012, and Nov 17, 2022, 500 eligible patients were enrolled and randomly assigned to the chemoradiotherapy alone group (n=250) or the induction chemotherapy with chemoradiotherapy group. Of 500 patients, 354 (70%) had stage IIB disease and 56 (11%) stage IIIB disease. Pelvic lymph nodes were positive in 215 (43%) patients. 230 (92%) patients who received induction chemotherapy had at least five cycles. Median interval between induction chemotherapy and chemoradiotherapy was 7 days. Four or more cycles of cisplatin were given to 212 (85%) participants in the induction chemotherapy with chemoradiotherapy group and to 224 (90%) of participants in the chemoradiotherapy alone group. 462 (92%) participants received external beam radiotherapy and brachytherapy with a median overall treatment time of 45 days. After a median follow-up of 67 months, 5-year progression-free survival rates were 72% in the induction chemotherapy with chemoradiotherapy group and 64% in the chemoradiotherapy alone group with a hazard ratio (HR) of 0·65 (95% CI 0·46-0·91, p=0·013). 5-year overall survival rates were 80% in the induction chemotherapy with chemoradiotherapy group and 72% in the chemoradiotherapy alone group, with an HR of 0·60 (95% CI 0·40-0·91, p=0·015). Grade 3 or greater adverse events were reported in 147 (59%) of 250 individuals in the induction chemotherapy with chemoradiotherapy group versus 120 (48%) of 250 individuals in the chemoradiotherapy alone group. INTERPRETATION: Short-course induction chemotherapy followed by chemoradiotherapy significantly improves survival of patients with locally advanced cervical cancer. FUNDING: Cancer Research UK and University College London-University College London Hospitals Biomedical Research Centre.
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Carboplatina , Quimiorradioterapia , Cisplatino , Quimioterapia de Indução , Paclitaxel , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/terapia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/tratamento farmacológico , Pessoa de Meia-Idade , Quimiorradioterapia/métodos , Cisplatino/administração & dosagem , Cisplatino/uso terapêutico , Adulto , Paclitaxel/administração & dosagem , Carboplatina/administração & dosagem , Carboplatina/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estadiamento de Neoplasias , Intervalo Livre de Progressão , Índia , Braquiterapia/métodos , MéxicoRESUMO
Distrust in science has been linked to scepticism over vaccines and climate change. Using data from nationally representative surveys administered in eight key countries for global efforts to mitigate climate change and COVID-19 (Australia, Brazil, China, India, Japan, South Africa, the UK and US), we find that distrust in scientists was an important predictor variable for most sceptics, who were sceptical of one issue but not both, in February 2021, when most countries had experienced their first wave of the pandemic. However, the association was significantly weaker among the segment of hardcore sceptics who were both climate sceptics and antivaxxers. We demonstrate that these individuals tended to possess many of the typical sceptic characteristics such as high distrust in social institutions and rightward political orientation, which are (collectively) suggestive of an underlying sceptic mindset rather than a specific distrust of scientists. Our results suggest that different types of sceptics necessitate different strategies to dispel scepticism.
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COVID-19 , Mudança Climática , Opinião Pública , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Inquéritos e Questionários , Confiança/psicologia , Atitude , SARS-CoV-2/isolamento & purificação , China/epidemiologia , Austrália , Feminino , Masculino , Pandemias , Brasil , Índia/epidemiologia , Japão , África do Sul/epidemiologiaRESUMO
We demonstrate a transnationally situated dialogue as a method to bring ethnographic and historical research in Brazil, East Africa (Kenya, Tanzania and Uganda), India, Russia and Spain into conversation to show three cancer epistemics sites (research, detection, and care access) where the politics of cancer epistemics are at play. First, in the field of research, we show how certain ways of knowing, and certain questions about and interests in cancer, are privileged over others. Using examples from Spain and East Africa, we highlight how a shift towards microbiological and high-technology research has outpriced many more locally grounded research agendas, ignoring questions of industrial and capital accountability in cancer aetiology. Second, we look at ways of making cancer visible, how knowledge is mobilised in cancer detection and screening, where and for whom. We discuss the increased individualisation of risk which is reframing cancer surveillance and therapeutic agendas. Using examples from India, Spain and Brazil, we demonstrate how the epistemics of cancer detection generate discourses of blame and responsibility at the individual level and accentuate existing inequities whilst simultaneously absorbing patients and their families into complex networks of surveillance. Lastly, we examine how the epistemics of cancer implicate the very possibilities of accessing cancer care, shaping care pathways and possibilities for patients. With ethnographic examples from India, Russia and Brazil, we demonstrate how an orientation towards the individual shifts attention away from the commercialisation of healthcare and dominance of logics of profit in therapeutics. Throughout the paper, we point towards what is holding these cancer discourses together and grapple with how the politics of cancer epistemics are at play across the globe, even if they appear to be taking many different forms. Our approach highlights how practices are mirrored in the framing, implementation, detection and care of cancer with far-reaching effects.
Assuntos
Neoplasias , Política , Humanos , Espanha , Federação Russa , Brasil , Índia , África Oriental , Acessibilidade aos Serviços de Saúde , ConhecimentoRESUMO
BACKGROUND: Accurate assessment of body composition during infancy is an important marker of early growth. This study aimed to develop anthropometric models to predict body composition in 3-24-month-old infants from diverse socioeconomic settings and ethnic groups. METHODS: An observational, longitudinal, prospective, multi-country study of infants from 3 to 24 months with body composition assessed at three monthly intervals using deuterium dilution (DD) and anthropometry. Linear mixed modelling was utilized to generate sex-specific fat mass (FM) and fat-free mass (FFM) prediction equations, using length(m), weight-for-length (kg/m), triceps and subscapular skinfolds and South Asian ethnicity as variables. The study sample consisted of 1896 (942 measurements from 310 girls) training data sets, 941 (441 measurements from 154 girls) validation data sets of 3-24 months from Brazil, Pakistan, South Africa and Sri Lanka. The external validation group (test) comprised 349 measurements from 250 (185 from 124 girls) infants 3-6 months of age from South Africa, Australia and India. RESULTS: Sex-specific equations for three age categories (3-9 months; 10-18 months; 19-24 months) were developed, validated on same population and externally validated. Root mean squared error (RMSE) was similar between training, validation and test data for assessment of FM and FFM in boys and in girls. RMSPE and mean absolute percentage error (MAPE) were higher in validation compared to test data for predicting FM, however, in the assessment of FFM, both measures were lower in validation data. RMSE for test data from South Africa (M/F-0.46/0.45 kg) showed good agreement with validation data for assessment of FFM compared to Australia (M/F-0.51/0.33 kg) and India(M/F-0.77/0.80 kg). CONCLUSIONS: Anthropometry-based FFM prediction equations provide acceptable results. Assessments based on equations developed on similar populations are more applicable than those developed from a different population.
Assuntos
Antropometria , Composição Corporal , Humanos , Lactente , Masculino , Feminino , Estudos Prospectivos , Antropometria/métodos , Estudos Longitudinais , Pré-Escolar , Austrália , Índia , África do Sul , BrasilRESUMO
OBJECTIVES: To develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. METHODS: The MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). RESULTS: The greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. CONCLUSION: MULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multiethnic populations.