The global case fatality rate of coronavirus disease 2019 by continents and national income: A meta-analysis.

The aim of this study is to provide a more accurate representation of COVID-19's case fatality rate (CFR) by performing meta-analyses by continents and income, and by comparing the result with pooled estimates. We used multiple worldwide data sources on COVID-19 for every country reporting COVID-19 cases. On the basis of data, we performed random and fixed meta-analyses for CFR of COVID-19 by continents and income according to each individual calendar date. CFR was estimated based on the different geographical regions and levels of income using three models: pooled estimates, fixed- and random-model. In Asia, all three types of CFR initially remained approximately between 2.0% and 3.0%. In the case of pooled estimates and the fixed model results, CFR increased to 4.0%, by then gradually decreasing, while in the case of random-model, CFR remained under 2.0%. Similarly, in Europe, initially, the two types of CFR peaked at 9.0% and 10.0%, respectively. The random-model results showed an increase near 5.0%. In high-income countries, pooled estimates and fixed-model showed gradually increasing trends with a final pooled estimates and random-model reached about 8.0% and 4.0%, respectively. In middle-income, the pooled estimates and fixed-model have gradually increased reaching up to 4.5%. in low-income countries, CFRs remained similar between 1.5% and 3.0%. Our study emphasizes that COVID-19 CFR is not a fixed or static value. Rather, it is a dynamic estimate that changes with time, population, socioeconomic factors, and the mitigatory efforts of individual countries.

Suicide trends and self-harm in Panama: results from the National Mortality Registry and hospital-based data.

PURPOSE: We aimed to (1) to investigate mortality trends due to suicide in Panama at the national and regional levels from 2001 to 2016, (2) to describe the sociodemographic and clinical characteristics of admitted patients with non-fatal self-harm from 2009 to 2017 in a regional hospital, and (3) to examine the association between mental health diagnoses and intentional self-harm, lethality, self-harm repetition and all-cause mortality within this population. METHODS: Using the national mortality registry, annual percentage changes (APC) with 95% confidence intervals (CI) were estimated to evaluate suicide trends over time. Self-harm cases were assessed by trained psychiatrists at a referral hospital through interviews. Logistic regression models were used to estimate the association between mental diagnosis with intent-to-die and lethality, expressed as odds ratios (OR) and 95% CI. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% CI for self-harm repetition and all-cause mortality. RESULTS: The trend of suicide in women declined, with an APC of - 4.8, 95% CI - 7.8, - 1.7, while the trend began to decline from 2006 in men; APC - 6.9, 95% CI - 8.9, - 4.9. Self-harm repetition over 12 months was 1.8%. Having a mental health diagnosis was associated with intentional self-harm (OR 1.5; 95% CI 1.0-2.4) and self-harm repetition (HR 2.7, 95% CI 1.3-5.8). Medication overdose was the preferred method for self-harm, while intentional self-harm by hanging was the preferred method for suicide. CONCLUSIONS: Strategies for prevention and early intervention after self-harm deserve attention. Our findings highlight the importance of data to inform action.

STEM doctorate recipients with disabilities experienced early in life earn lower salaries and are underrepresented among higher academic positions.

There is paucity of data examining disparities in salary and representation for disabled scientists, which is needed to advance inclusion and equity for people with disabilities in STEM. Using data from the 2019 Survey of Doctorate Recipients (United States, N = 1,148,817), we show that doctorate recipients working in Science, Technology, Engineering and Mathematics (STEM) with disabilities experienced early in life (at age <25 yr) earned US$10,580 less per year (95% CI: -$13,661, -$7,499) than non-disabled workers. In the subset of academic workers, doctorate recipients with early disabilities earned $14,360 less (95% CI: -$17,546, -$11,175) than those without disabilities. We observed an underrepresentation of academics with disabilities in higher faculty ranks (χ2: 647.2; P < 0.0001), among Deans/Presidents (χ2: 27.4; P = 0.0004) and among those with tenure (χ2: 525; P < 0.0001). These findings support a need to expand inclusion efforts, provide equal opportunities for career advancement and improve working conditions for people with disabilities in STEM.

Experiences of researchers with disabilities at academic institutions in the United States.

INTRODUCTION: People with disabilities are underrepresented in higher education, facing systematic obstacles such as inaccessible communication and physical environments and difficulties obtaining accommodations. This study aims to shed light on barriers to accessibility and disability inclusion in research institutions through confidential qualitative interviews with researchers with disabilities. METHODS: We recruited participants via virtual flyers. Eligibility criteria included working in the United States (U.S.) as researchers that had applied for grant funding (last five years), and self-identifying as having a disability. We offered participants (total n = 35) the option of either semi-structured one-on-one live or written interviews based on their preference. Two study team members analyzed written and live responses using thematic analysis to identify themes. RESULTS: Themes included identity/visibility, career trajectories, accessibility, accommodations, bias, representation, and inclusion. Some participants reported not disclosing their disabilities at work or during hiring processes due to fear of negative perceptions from peers or potential employers. Experiences around stigma and bias were noted both in professional relationships and when interacting with disability service offices, underscoring difficulties and delays in processes to secure accommodations. Respondents highlighted the lack of disability inclusion and low representation of people with disabilities in academia and elevated the importance of self-advocacy and of role models and mentors in shaping career pathways for future researchers with disabilities. CONCLUSION: Researchers with disabilities encounter systematic barriers at academic institutions, and lack of acknowledgement and research on these experiences has held back institutional and policy changes. To reduce disparities for researchers with disabilities, academic leadership must allocate resources to address ableism, create more inclusive environments, and raise standards beyond compliance with the Americans with Disabilities Act.

Disability inclusion in national surveys.

National surveys are important for understanding the disparities that disabled people experience across social determinants of health; however, limited research has examined the methods used to include disabled people in these surveys. This study reviewed nationally representative surveys administered by the Centers for Disease Control and Prevention (CDC) and the US Census Bureau that collected data in the past 5 years and sampled adults ≥18 years. Data from both publicly available online survey documents and a questionnaire emailed to survey administrators were used to determine whether surveys (1) oversampled disabled people, (2) had a data-accessibility protocol to support data collection, and (3) provided multiple data-collection modalities (eg, phone, paper). Of the 201 surveys identified, 30 met the inclusion criteria for the study. Of these 30 surveys, 1 oversampled disabled people, none had a data-collection accessibility protocol, and 21 provided multiple data-collection modalities. This study highlights barriers and opportunities to including disabled people in national surveys, which is essential for ensuring survey data are generalizable to the US population.

Disparities in influenza vaccination for U.S. adults with disabilities living in community settings by race/ethnicity, 2016-2021.

BACKGROUND: There is a paucity of data examining disparities in influenza vaccination at the intersection of disability and race. OBJECTIVE: To compare the prevalence of influenza vaccination between U.S. adults (≥18 years) with and without disabilities living in community settings, and to examine changes in influenza vaccination over time by disability status and race/ethnicity groups. METHODS: We analyzed cross-sectional data from the Behavioral Risk Factor Surveillance System (2016-2021). We calculated the annual age-standardized prevalence of influenza vaccination (last 12 months) in individuals with and without disabilities (2016-2021), and examined percentage changes (2016-2021) by groups of disability status and race/ethnicity. RESULTS: From 2016 to 2021, the annual age-standardized prevalence of influenza vaccination was consistently lower in adults with disabilities as compared to those without disabilities. In 2016, 36.8% (95%CI: 36.1%-37.4%) of adults with disabilities had an influenza vaccine versus 37.3% (95%CI: 36.9%-37.6%) of those without disabilities. In 2021, 40.7% (95%CI: 40.0%-41.4%) and 44.1% (95%CI: 43.7%-44.5%) of adults with and without disabilities had an influenza vaccine. The percentage change in influenza vaccination from 2016 to 2021 was lower among people with disabilities (10.7%, 95%CI: 10.4%-11.0%; vs. no disability: 18.4%, 95%CI: 18.1%-18.7%). Among adults with disabilities, Asian adults reported the largest percentage increase in influenza vaccination (18.0%, 95% CI: 14.2%, 21.8%; p: 0.07), and Black, Non-Hispanics adults reported the lowest (2.1%, 95% CI: 1.9%, 2.2%; p: 0.59). CONCLUSIONS: Strategies to increase influenza vaccination in the U.S. should address barriers faced by people with disabilities, particularly the intersectional barriers faced by people with disabilities from racial and ethnic minority groups.

A Spanish matrix sentence test for assessing speech reception thresholds in noise.

OBJECTIVE: To develop, optimize, and evaluate a new Spanish sentence test in noise. DESIGN: The test comprises a basic matrix of ten names, verbs, numerals, nouns, and adjectives. From this matrix, test lists of ten sentences with an equal syntactical structure can be formed at random, with each list containing the whole speech material. The speech material represents the phoneme distribution of the Spanish language. The test was optimized for measuring speech reception thresholds (SRTs) in noise by adjusting the presentation levels of the individual words. Subsequently, the test was evaluated by independent measurements investigating the training effects, the comparability of test lists, open-set vs. closed-set test format, and performance of listeners of different Spanish varieties. STUDY SAMPLE: In total, 68 normal-hearing native Spanish-speaking listeners. RESULTS: SRTs measured using an adaptive procedure were 6.2 ± 0.8 dB SNR for the open-set and 7.2 ± 0.7 dB SNR for the closed-set test format. The residual training effect was less than 1 dB after using two double-lists before data collection. CONCLUSIONS: No significant differences were found for listeners of different Spanish varieties indicating that the test is applicable to Spanish as well as Latin American listeners. Test lists can be used interchangeably.

Under-5 Mortality in Central America: 1990-2016.

BACKGROUND AND OBJECTIVES: We aimed to calculate the change in under-5 mortality rates (U5MRs) (1990-2016), to assess countries' status regarding Sustainable Development Goal (SDG) 3.2.1 (reducing the U5MR to ≤25 deaths per 1000 live births by 2030), to list the most important causes of death (1990, 2016), and to examine the association between selected SDG indicators and U5MRs using a linear mixed-effects regression. METHODS: Ecological study in which we used estimates from the Global Burden of Disease Study 2016 for Central American countries. Results were expressed as U5MRs (deaths per 1000 live births), cause-specific mortality rates (deaths per 100 000 population <5 years of age), and regression coefficients with 95% confidence intervals. RESULTS: U5MRs decreased 65% (1990-2016), and in 2016, all countries but Guatemala had met SDG 3.2.1. The main causes of death were diarrheal diseases (1990; 311.1 per 100 000) and lower respiratory infections (LRIs) (2016; 78.1 per 100 000). When disaggregated by country (2016), congenital birth defects were the most important cause of death in all countries except for in Honduras (neonatal preterm birth) and Guatemala (LRIs). Nutritional status; availability of water, sanitation, and hygiene services; coverage of vaccines; and coverage of contraception were associated with a reduction in U5MRs. CONCLUSIONS: Central America has achieved a large reduction in U5MRs. Countries must address both the high mortality caused by LRIs and the rising mortality caused by noncommunicable causes of death through an improvement of SDG indicators that guarantees equitable progress in child survival in the region.

Loudness and auditory steady-state responses in normal-hearing subjects.

This study evaluated the use of multiple auditory steady-state responses (ASSRs) to estimate the growth of loudness in listeners with normal hearing. Individual intensity functions were obtained from measures of loudness growth using the contour test and from the electrophysiological amplitude measures of multiple amplitude-modulated (77-105 Hz) tones (500, 1000, 2000, and 4000 Hz) simultaneously presented to both ears and recorded over the scalp. Slope analyses for the behavioural and electrophysiological intensity functions were separately performed. Response amplitudes of the ASSRs and loudness sensation judgements increase as the stimulus intensity increases for the four frequencies studied. A significant relationship was obtained between loudness and the ASSRs. The results of this study suggest that the amplitude of the ASSRs may be used to estimate loudness growth at least for individuals with normal hearing.