This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demogra...This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.展开更多
Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods...Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.展开更多
BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of pr...BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.展开更多
This study employs Norman Fairclough’s Critical Discourse Analysis(CDA)three-dimensional model,using the Republic of Kazakhstan as a case study,to delve into the discourse construction of China’s Belt and Road Initi...This study employs Norman Fairclough’s Critical Discourse Analysis(CDA)three-dimensional model,using the Republic of Kazakhstan as a case study,to delve into the discourse construction of China’s Belt and Road Initiative(BRI)in Central Asian countries.Through detailed analysis of policy documents,media reports,and public discussions in Central Asian countries,this paper reveals how the BRI constructs specific social practices,discourse events,and textual meanings within these nations.The findings indicate that through this global development strategy,China has not only strengthened its economic ties with Central Asian countries but has also exerted profound influences on political,cultural,and social levels.展开更多
BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is b...BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.展开更多
International tourism is highly dependent on air travel,which enhances destination countries’economic growth and living standards while causing environmental degradation.This study investigates the effect of air trav...International tourism is highly dependent on air travel,which enhances destination countries’economic growth and living standards while causing environmental degradation.This study investigates the effect of air travel on environmental degradation in BRICS nations.The study used feasible generalized least squares(FGLS)to evaluate the environmental Kuznets curve using data spanning 1995 to 2018.The study finds evidence of N-shaped EKC in the economies of the BRICS nations.We also find a positive relationship between tourism,urbanization,and environmental degradation(as measured by CO_(2) and SO_(2) emissions from civil aviation)and a negative relationship between economic development and environmental degradation.To achieve sustainable growth and environmental protection and promote green technology,the BRICS governments should devise policies that address the aviation industry’s short-and long-term needs.展开更多
Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors r...Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed,ScienceDirect,EBSCO,ClinicalKey,and Cochrane Library from inception until December 31,2021.Additional search strategies were snowballing literature search and citation tracking.Results:Eleven articles were included in the scoping review.The cost was the greatest barrier of joining IVF program.Limited access and lack of assisted reproductive technology centers,few qualified infertility trained staff,insufficient government support,low priority in government policy,along with sociocultural factors,such as religion and false beliefs or myths were also majorly considered to be associated obstacles.Conclusions:The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.展开更多
Background:Adolescents are highly vulnerable to depressive symptoms worldwide partially because of limited social supports.However,it still remains largely unknown regarding the associations between social support(s)a...Background:Adolescents are highly vulnerable to depressive symptoms worldwide partially because of limited social supports.However,it still remains largely unknown regarding the associations between social support(s)and depressive symptoms among adolescents living in low-and middle-income countries(LMICs).The aim of this study aimed to explore the associations between different types of social support and depressive symptoms in adolescents from LMICs.Methods:Data were retrieved from the Global School-based Health Survey(GSHS)in which 92,551 adolescents(50.6%females)were included with mean of 15.6 years.Depressive symptoms in the past one month as the dependent variable were measured in combination with social support(was measured by“During the past 30 days,how often were most of the students in your school kind and helpful?”).Multivariable logistic regression and meta-analysis of country-wise estimates were performed to investigate the associations between social support and depressive symptoms,and the heterogeneity of the associations across the countries,respectively.Results:The prevalence of depressive symptoms was 30.9%of adolescents from LMICs.Peer support and parental connectedness were two major factors that were significantly associated with depression symptoms in adolescents.However,the associations of peer support and parental connectedness with depressive symptoms were significant in males and females,respectively.The country-wise analysis indicated that varied inconsistency(small to large)across the associations of peer support and parental connectedness with depressive symptoms in adolescents.Conclusion:Results in this study provides multi-national evidence of the protective roles of social support against depressive symptoms among adolescents.However,the association between social support and depression symptoms may be moderated by sex and types of social support.Although we found that social sup-port may be an important protective factor against depressive symptoms in adolescents from LMICs,specifically designed interventions should be implemented based on sex difference and country difference.展开更多
A complete set of techniques for the design,installation,maintenance and use of vegetable tunnel houses in tropical island countries was developed,which achieved the goals of rain prevention,wind protection,corrosion ...A complete set of techniques for the design,installation,maintenance and use of vegetable tunnel houses in tropical island countries was developed,which achieved the goals of rain prevention,wind protection,corrosion resistance,insect and bird prevention,water-saving irrigation,and economic efficiency,significantly improving the production capacity and technical level of vegetables in Samoa.The techniques have become a key vegetable production technology promoted nationwide in Samoa,with universal promotion value for tropical island countries.展开更多
Multiple ecological and socioeconomic problems have occurred worldwide,raising the awareness of sustainability.This study aims to examine the impact of taxes on Sustainable Development Goals(SDGs)in the context of Org...Multiple ecological and socioeconomic problems have occurred worldwide,raising the awareness of sustainability.This study aims to examine the impact of taxes on Sustainable Development Goals(SDGs)in the context of Organization for Economic Co-operation and Development(OECD)countries.This research used effective average tax(EAT),tax on personal income(TPI),tax on corporate profits(TCP),and tax on goods and services(TGS)as the variables of taxes,and employed secondary data from 38 OECD countries covering 2000–2021.The study also used Breusch-Pagan Lagrange Multiplier(LM),Pesaran Scaled LM,Bias-Corrected Scaled LM,and Pesaran Cross-sectional dependence(CSD)tests to analyze the existence of crosssectional dependency.Then,we established the stationarity of variables through second-generation panel unit root tests(Cross-sectional Augmented Dickey-Fuller(CADF)and Cross-sectional Im,Pesaran,and Shin(CIPS)),and confirmed the long-run cointegration of the variables by using secondgeneration panel cointegration test(Westerlund cointegration test).The results showed that EAT,TPI,TCP,and TGS are positively associated with SDGs.However,the change in TPI has a smaller effect on SDGs than the change in EAT or TCP or TGS.The result of panel causality indicated that EAT,TPI,and TGS have a unidirectional causal relationship with SDGs.The study also found that TCP has a bi-directional causal relationship with SDGs.Moreover,the finding indicated that the OECD countries need to focus on tax policies to achieve the 2030 Agenda for Sustainable Development.This study is based on the theory of optimal taxation(TOT),which suggests that tax systems should be designed to maximize social welfare.Finally,we suggests the importance of taking a comprehensive approach for the managers and policy-makers when analyzing the impact of taxes on SDGs.展开更多
Environmental impact assessment (EIA), a decision-making process for project appraisal and sustainability adopted globally as an administrative process to identify, predict, evaluate, and monitor projects from their f...Environmental impact assessment (EIA), a decision-making process for project appraisal and sustainability adopted globally as an administrative process to identify, predict, evaluate, and monitor projects from their feasibility, preconstruction, construction, and operation stages to mitigate the adverse impacts and enhance the beneficial impacts for the protection of the affected environment, The study objective is to explore global EIA systems and processes and find shortcomings and implications for making the best instrument or tool to protect the natural environment from man-made activities over the project cycle. For this, the relevant literature on the EIA system and process was reviewed and evaluated through the application of quantitative and qualitative approaches, including the assessment of legal instruments and the adoption of EIA methodologies in developing countries. EIA, initiated in the 1970s in the US and Australia, expanded to developing countries and was amended in East and Southeast Asia from the 1970s to the 2000s. The evaluation assessed that the South Asian countries follow UNEP and IAIA guidelines, utilizing national laws and expert consultations, with screening criteria and administrative processes based on established environmental legislation. Ad hoc, checklist, matrix, network, overlay, cost-benefit analysis, and predictive or simulation in EIA practice are used to assess the environmental impacts of development activities. Failure to recommend major projects undermines public trust and prevents mitigation measures from being implemented. Most developing countries have followed EIA to fulfill the legal requirement with shadow-off monitoring and follow-up rather than to upset, reduce, or compensate for the project impacts as per size, location, and severity of the project area. The research and guidelines outlined in the IAIA principles and process have synthesized the best EIA practices worldwide. Public participation, impact coverage, scientific mitigation, transparent evidence-based approaches, monitoring, follow-up, legitimate approaches, and future appraisal opportunities are major concerns to be included in best EIA practice.展开更多
The digital development rights in developing countries are based on establishing a new international economic order and ensuring equal participation in the digital globalization process to achieve people's well-ro...The digital development rights in developing countries are based on establishing a new international economic order and ensuring equal participation in the digital globalization process to achieve people's well-rounded development in the digital society.The relationship between cross-border data flows and the realization of digital development rights in developing countries is quite complex.Currently,developing countries seek to safeguard their existing digital interests through unilateral regulation to protect data sovereignty and multilateral regulation for cross-border data cooperation.However,developing countries still have to face internal conflicts between national digital development rights and individual and corporate digital development rights during the process of realizing digital development rights.They also encounter external contradictions such as developed countries interfering with developing countries'data sovereignty,developed countries squeezing the policy space of developing countries through dominant rules,and developing countries having conflicts between domestic and international rules.This article argues that balancing openness and security on digital trade platforms is the optimal solution for developing countries to realize their digital development rights.The establishment of WTO digital trade rules should inherently reflect the fundamental demands of developing countries in cross-border data flows.At the same time,given China's dual role as a digital powerhouse and a developing country,it should actively promote the realization of digital development rights in developing countries.展开更多
World experience indicates the existence of significant imbalances in the development of countries.The problem of assessing the rational development of the regional and national economy is becoming urgent,since such a...World experience indicates the existence of significant imbalances in the development of countries.The problem of assessing the rational development of the regional and national economy is becoming urgent,since such assessments can prevent development imbalances across countries.The aim of this study is to elaborate a methodology to assess the countries’socio-economic development by integraring 12 modern indices of socio-economic development into the Composite Country Development Index(CCDI).The methodology of this research was based on a set of key indices that described socio-economic development level in four fields(social development,digital development,economic development,and environmental security)and then these indices were integrated into the CCDI.The study further applied factor analysis and R-Studio software to define the gaps of social and economic development in 59 selected countries using the trigonometric function of the angle sine.The correlation analysis confirmed the existence of a close interrelation among the studied countries.This paper noted that due to the emergence of new priorities,it is necessary to revise the assessment methodology of socio-economic development level and expand them to cover the decisive factors.This was confirmed by the results obtained,demonstrating various combinations of the development level in the four fields and their impact on the CCDI.The scientific contribution of this research is to form a methodology(e.g.,the CCDI)for evaluating the socio-economic development level of countries in the world.展开更多
Typhoid fever is a public health challenge mostly concentrated in impoverished, overcrowded areas of the developing world, with lack of safe drinking and sanitation. The most serious complication is typhoid intestinal...Typhoid fever is a public health challenge mostly concentrated in impoverished, overcrowded areas of the developing world, with lack of safe drinking and sanitation. The most serious complication is typhoid intestinal perforation(TIP), observed in 0.8% to 39%, with a striking rate difference between high-income and low-middle-income countries. Although the mortality rate consequent to TIP in resource-poor countries is improved in the last decades, it is still fluctuating from 5% to 80%, due to surgical-and not surgical-related constraints. Huge economic costs and long timelines are required to provide a short-to middle-term solution to the lack of safe water and sanitation. Inherent limitations of the currently available diagnostic tools may lead to under-evaluation as well as over-evaluation of the disease, with consequent delayed treatment or inappropriate, excessive antibiotic use, hence increasing the likelihood of bacterial resistance. There is a need for immunization programs in populations at greatest risk, especially in sub-Saharan Africa. Uniform surgical strategies and guidelines, on the basis of sound or prospective surgical studies and adapted to the local realities, are still lacking. Major drawbacks of the surgical treatment are the frequent delays to surgery, either for late diagnosis or for difficult transports, and the unavailable appropriate intensive care units in most peripheral facilities. As a consequence, poor patient's conditions at presentation, severe peritoneal contamination and unsuitable postoperative care are the foremost determinant of surgical morbidity and mortality.展开更多
Radiation therapy(RT)is considered one of the cornerstone modalities of treatment for different cancer types.The preparation and delivery of RT requires a number of staff members from different disciplines within the ...Radiation therapy(RT)is considered one of the cornerstone modalities of treatment for different cancer types.The preparation and delivery of RT requires a number of staff members from different disciplines within the radiation oncology department.Since the emergence of the corona virus disease 2019(COVID-19)pandemic,RT,similar to other cancer care modalities,has been adapted to minimize patient and staff exposure without compromising the oncological outcomes.This was reflected in the dramatic practice changes that occurred in the past year to address the lockdown restrictions and fulfill the infection control requirements.RT practices differ across regions based on financial and training levels,and developing countries with limited resources have struggled to maintain radiation treatment services at a level equivalent to that in developed countries while following pandemic control guidelines.The response during the COVID-19 pandemic varied between developing countries according to the infection rate and RT technological capabilities.In this editorial,we review recently published articles addressing radiotherapy practice reports during the COVID-19 pandemic in developing countries.展开更多
Hepatitis B virus(HBV)infection is a serious global public health problem.The infection may be transmitted through sexual intercourse,parenteral contact or from an infected mother to the baby at birth and,if contracte...Hepatitis B virus(HBV)infection is a serious global public health problem.The infection may be transmitted through sexual intercourse,parenteral contact or from an infected mother to the baby at birth and,if contracted early in life,may lead to chronic liver disease,including cirrhosis and hepatocellular carcinoma.On the basis of the HBV carrier rate,the world can be divided in 3 regions of high,medium and low endemicity.The major concern is about high endemicity countries,where the most common route of infection remains vertical transmission from mother to child.Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries.The infection rate can be reduced by modifying behavior,improving individual education,testing all blood donations,assuring asepsis in clinical practice and screening all pregnant women.However,availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences.The unsolved problem for poorest countries,where the number of people currently infected is high,is the cost of the vaccine.A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.展开更多
Colorectal cancer(CRC)is one of the leading causes of cancer and cancer-related mortality worldwide.The disease has been traditionally a major health problem in industrial countries,however the CRC rates are increasin...Colorectal cancer(CRC)is one of the leading causes of cancer and cancer-related mortality worldwide.The disease has been traditionally a major health problem in industrial countries,however the CRC rates are increasing in the developing countries that are undergoing economic growth.Several environmental risk factors,mainly changes in diet and life style,have been suggested to underlie the rise of CRC in these populations.Diet and lifestyle impinge on nuclear receptors,on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis.In this respect,the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations.The data from these studies may have important implications for the global prevention and treatment of CRC.展开更多
Hepatitis A is the most common form of acute viral hepatitis in the world.Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the...Hepatitis A is the most common form of acute viral hepatitis in the world.Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development.The anti-hepatitis A virus(HAV)seroprevalence rate is presently decreasing in many parts of the world,but in less developed regions and in several developing countries,HAV infection is still very common in the first years of life and seroprev-alence rates approach 100%.In areas of intermediate endemicity,the delay in the exposure to the virus has generated a huge number of susceptible adolescents and adults and significantly increased the average age at infection.As the severity of disease increases with age,this has led to outbreaks of hepatitis A.Several factors contribute to the decline of the infection rate,including rising socioeconomic levels,increased access to clean water and the availability of a hepatitis A vaccine that was developed in the 1990s.For populations with a high proportion of susceptible adults,implementing vaccination programs may be considered.In this report,we review available epidemiological data and implementation of vaccination strategies,particularly focusing on developing countries.展开更多
Cervical cancer(CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas,the burden from disease remains important because o...Cervical cancer(CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas,the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies,researchers have attempted to find new strategies that are adapted to low- and middle-income countries(LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus(HPV) testing is more effective than cytology for CC screening. Therefore,highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages,HPV-based screening has a low positive predictive value for CC,so that HPVpositive women need to be triaged with further testing to determine optimal management. Visual inspection tests,cytology and novel biomarkers are some options. In this review,we provide an overview of current and emerging screening approaches for CC. In particular,we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care(POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress,but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined.展开更多
AIM:To identify the newest approaches to type 2diabetes(T2DM)prevention and control in the developingworld context.METHODS:We conducted a systematic review of published studies of diabetes prevention and control progr...AIM:To identify the newest approaches to type 2diabetes(T2DM)prevention and control in the developingworld context.METHODS:We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries,as defined by the World Bank.We searched Pub Med using Medical Subject Headings terms.Studies needed to satisfy four criteria:(1)Must be experimental;(2)Must include patients with T2DM or focusing on prevention of T2DM;(3)Must have a lifestyle intervention component;(4)Must be written in English;and(5)Must have measurable outcomes related to diabetes.RESULTS:A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014.India contributed the largest number of trials(11/66).Of the total 66 studies reviewed,all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes.The overwhelming majority of studies reported on diabetes management(56/66),and among these more than half were structured lifestyle education programs.The evidence suggests that lifestyle education led by allied health professionals(nurses,pharmacists)were as effective as those led by physicians or a team of clinicians.The remaining diabetes management interventions focused on diet or exercise,but the evidence to recommend one approach over another was weak.CONCLUSION:Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.展开更多
基金This work was supported by the National Natural Science Foundation of China(71861147003 and 71925009).
文摘This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.
基金funded by the Taylor’s University Flagship Research Grant(TUFR/2017/002/03).
文摘Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.
基金Supported by National Natural Science Foundation of China,No.82260532,and No.32060208.
文摘BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.
基金supported by Teaching and Research Project of North China Institute of Aerospace Engineering(JY-2023-19)Humanities and Social Science Research Project of Hebei Education Department(SQ2024272).
文摘This study employs Norman Fairclough’s Critical Discourse Analysis(CDA)three-dimensional model,using the Republic of Kazakhstan as a case study,to delve into the discourse construction of China’s Belt and Road Initiative(BRI)in Central Asian countries.Through detailed analysis of policy documents,media reports,and public discussions in Central Asian countries,this paper reveals how the BRI constructs specific social practices,discourse events,and textual meanings within these nations.The findings indicate that through this global development strategy,China has not only strengthened its economic ties with Central Asian countries but has also exerted profound influences on political,cultural,and social levels.
文摘BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.
文摘International tourism is highly dependent on air travel,which enhances destination countries’economic growth and living standards while causing environmental degradation.This study investigates the effect of air travel on environmental degradation in BRICS nations.The study used feasible generalized least squares(FGLS)to evaluate the environmental Kuznets curve using data spanning 1995 to 2018.The study finds evidence of N-shaped EKC in the economies of the BRICS nations.We also find a positive relationship between tourism,urbanization,and environmental degradation(as measured by CO_(2) and SO_(2) emissions from civil aviation)and a negative relationship between economic development and environmental degradation.To achieve sustainable growth and environmental protection and promote green technology,the BRICS governments should devise policies that address the aviation industry’s short-and long-term needs.
文摘Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed,ScienceDirect,EBSCO,ClinicalKey,and Cochrane Library from inception until December 31,2021.Additional search strategies were snowballing literature search and citation tracking.Results:Eleven articles were included in the scoping review.The cost was the greatest barrier of joining IVF program.Limited access and lack of assisted reproductive technology centers,few qualified infertility trained staff,insufficient government support,low priority in government policy,along with sociocultural factors,such as religion and false beliefs or myths were also majorly considered to be associated obstacles.Conclusions:The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.
基金supported by National Natural Science Foundation of China(31871115).
文摘Background:Adolescents are highly vulnerable to depressive symptoms worldwide partially because of limited social supports.However,it still remains largely unknown regarding the associations between social support(s)and depressive symptoms among adolescents living in low-and middle-income countries(LMICs).The aim of this study aimed to explore the associations between different types of social support and depressive symptoms in adolescents from LMICs.Methods:Data were retrieved from the Global School-based Health Survey(GSHS)in which 92,551 adolescents(50.6%females)were included with mean of 15.6 years.Depressive symptoms in the past one month as the dependent variable were measured in combination with social support(was measured by“During the past 30 days,how often were most of the students in your school kind and helpful?”).Multivariable logistic regression and meta-analysis of country-wise estimates were performed to investigate the associations between social support and depressive symptoms,and the heterogeneity of the associations across the countries,respectively.Results:The prevalence of depressive symptoms was 30.9%of adolescents from LMICs.Peer support and parental connectedness were two major factors that were significantly associated with depression symptoms in adolescents.However,the associations of peer support and parental connectedness with depressive symptoms were significant in males and females,respectively.The country-wise analysis indicated that varied inconsistency(small to large)across the associations of peer support and parental connectedness with depressive symptoms in adolescents.Conclusion:Results in this study provides multi-national evidence of the protective roles of social support against depressive symptoms among adolescents.However,the association between social support and depression symptoms may be moderated by sex and types of social support.Although we found that social sup-port may be an important protective factor against depressive symptoms in adolescents from LMICs,specifically designed interventions should be implemented based on sex difference and country difference.
文摘A complete set of techniques for the design,installation,maintenance and use of vegetable tunnel houses in tropical island countries was developed,which achieved the goals of rain prevention,wind protection,corrosion resistance,insect and bird prevention,water-saving irrigation,and economic efficiency,significantly improving the production capacity and technical level of vegetables in Samoa.The techniques have become a key vegetable production technology promoted nationwide in Samoa,with universal promotion value for tropical island countries.
文摘Multiple ecological and socioeconomic problems have occurred worldwide,raising the awareness of sustainability.This study aims to examine the impact of taxes on Sustainable Development Goals(SDGs)in the context of Organization for Economic Co-operation and Development(OECD)countries.This research used effective average tax(EAT),tax on personal income(TPI),tax on corporate profits(TCP),and tax on goods and services(TGS)as the variables of taxes,and employed secondary data from 38 OECD countries covering 2000–2021.The study also used Breusch-Pagan Lagrange Multiplier(LM),Pesaran Scaled LM,Bias-Corrected Scaled LM,and Pesaran Cross-sectional dependence(CSD)tests to analyze the existence of crosssectional dependency.Then,we established the stationarity of variables through second-generation panel unit root tests(Cross-sectional Augmented Dickey-Fuller(CADF)and Cross-sectional Im,Pesaran,and Shin(CIPS)),and confirmed the long-run cointegration of the variables by using secondgeneration panel cointegration test(Westerlund cointegration test).The results showed that EAT,TPI,TCP,and TGS are positively associated with SDGs.However,the change in TPI has a smaller effect on SDGs than the change in EAT or TCP or TGS.The result of panel causality indicated that EAT,TPI,and TGS have a unidirectional causal relationship with SDGs.The study also found that TCP has a bi-directional causal relationship with SDGs.Moreover,the finding indicated that the OECD countries need to focus on tax policies to achieve the 2030 Agenda for Sustainable Development.This study is based on the theory of optimal taxation(TOT),which suggests that tax systems should be designed to maximize social welfare.Finally,we suggests the importance of taking a comprehensive approach for the managers and policy-makers when analyzing the impact of taxes on SDGs.
文摘Environmental impact assessment (EIA), a decision-making process for project appraisal and sustainability adopted globally as an administrative process to identify, predict, evaluate, and monitor projects from their feasibility, preconstruction, construction, and operation stages to mitigate the adverse impacts and enhance the beneficial impacts for the protection of the affected environment, The study objective is to explore global EIA systems and processes and find shortcomings and implications for making the best instrument or tool to protect the natural environment from man-made activities over the project cycle. For this, the relevant literature on the EIA system and process was reviewed and evaluated through the application of quantitative and qualitative approaches, including the assessment of legal instruments and the adoption of EIA methodologies in developing countries. EIA, initiated in the 1970s in the US and Australia, expanded to developing countries and was amended in East and Southeast Asia from the 1970s to the 2000s. The evaluation assessed that the South Asian countries follow UNEP and IAIA guidelines, utilizing national laws and expert consultations, with screening criteria and administrative processes based on established environmental legislation. Ad hoc, checklist, matrix, network, overlay, cost-benefit analysis, and predictive or simulation in EIA practice are used to assess the environmental impacts of development activities. Failure to recommend major projects undermines public trust and prevents mitigation measures from being implemented. Most developing countries have followed EIA to fulfill the legal requirement with shadow-off monitoring and follow-up rather than to upset, reduce, or compensate for the project impacts as per size, location, and severity of the project area. The research and guidelines outlined in the IAIA principles and process have synthesized the best EIA practices worldwide. Public participation, impact coverage, scientific mitigation, transparent evidence-based approaches, monitoring, follow-up, legitimate approaches, and future appraisal opportunities are major concerns to be included in best EIA practice.
基金a preliminary result of the Chinese Government Scholarship High-level Graduate Program sponsored by China Scholarship Council(Program No.CSC202206310052)。
文摘The digital development rights in developing countries are based on establishing a new international economic order and ensuring equal participation in the digital globalization process to achieve people's well-rounded development in the digital society.The relationship between cross-border data flows and the realization of digital development rights in developing countries is quite complex.Currently,developing countries seek to safeguard their existing digital interests through unilateral regulation to protect data sovereignty and multilateral regulation for cross-border data cooperation.However,developing countries still have to face internal conflicts between national digital development rights and individual and corporate digital development rights during the process of realizing digital development rights.They also encounter external contradictions such as developed countries interfering with developing countries'data sovereignty,developed countries squeezing the policy space of developing countries through dominant rules,and developing countries having conflicts between domestic and international rules.This article argues that balancing openness and security on digital trade platforms is the optimal solution for developing countries to realize their digital development rights.The establishment of WTO digital trade rules should inherently reflect the fundamental demands of developing countries in cross-border data flows.At the same time,given China's dual role as a digital powerhouse and a developing country,it should actively promote the realization of digital development rights in developing countries.
文摘World experience indicates the existence of significant imbalances in the development of countries.The problem of assessing the rational development of the regional and national economy is becoming urgent,since such assessments can prevent development imbalances across countries.The aim of this study is to elaborate a methodology to assess the countries’socio-economic development by integraring 12 modern indices of socio-economic development into the Composite Country Development Index(CCDI).The methodology of this research was based on a set of key indices that described socio-economic development level in four fields(social development,digital development,economic development,and environmental security)and then these indices were integrated into the CCDI.The study further applied factor analysis and R-Studio software to define the gaps of social and economic development in 59 selected countries using the trigonometric function of the angle sine.The correlation analysis confirmed the existence of a close interrelation among the studied countries.This paper noted that due to the emergence of new priorities,it is necessary to revise the assessment methodology of socio-economic development level and expand them to cover the decisive factors.This was confirmed by the results obtained,demonstrating various combinations of the development level in the four fields and their impact on the CCDI.The scientific contribution of this research is to form a methodology(e.g.,the CCDI)for evaluating the socio-economic development level of countries in the world.
文摘Typhoid fever is a public health challenge mostly concentrated in impoverished, overcrowded areas of the developing world, with lack of safe drinking and sanitation. The most serious complication is typhoid intestinal perforation(TIP), observed in 0.8% to 39%, with a striking rate difference between high-income and low-middle-income countries. Although the mortality rate consequent to TIP in resource-poor countries is improved in the last decades, it is still fluctuating from 5% to 80%, due to surgical-and not surgical-related constraints. Huge economic costs and long timelines are required to provide a short-to middle-term solution to the lack of safe water and sanitation. Inherent limitations of the currently available diagnostic tools may lead to under-evaluation as well as over-evaluation of the disease, with consequent delayed treatment or inappropriate, excessive antibiotic use, hence increasing the likelihood of bacterial resistance. There is a need for immunization programs in populations at greatest risk, especially in sub-Saharan Africa. Uniform surgical strategies and guidelines, on the basis of sound or prospective surgical studies and adapted to the local realities, are still lacking. Major drawbacks of the surgical treatment are the frequent delays to surgery, either for late diagnosis or for difficult transports, and the unavailable appropriate intensive care units in most peripheral facilities. As a consequence, poor patient's conditions at presentation, severe peritoneal contamination and unsuitable postoperative care are the foremost determinant of surgical morbidity and mortality.
文摘Radiation therapy(RT)is considered one of the cornerstone modalities of treatment for different cancer types.The preparation and delivery of RT requires a number of staff members from different disciplines within the radiation oncology department.Since the emergence of the corona virus disease 2019(COVID-19)pandemic,RT,similar to other cancer care modalities,has been adapted to minimize patient and staff exposure without compromising the oncological outcomes.This was reflected in the dramatic practice changes that occurred in the past year to address the lockdown restrictions and fulfill the infection control requirements.RT practices differ across regions based on financial and training levels,and developing countries with limited resources have struggled to maintain radiation treatment services at a level equivalent to that in developed countries while following pandemic control guidelines.The response during the COVID-19 pandemic varied between developing countries according to the infection rate and RT technological capabilities.In this editorial,we review recently published articles addressing radiotherapy practice reports during the COVID-19 pandemic in developing countries.
文摘Hepatitis B virus(HBV)infection is a serious global public health problem.The infection may be transmitted through sexual intercourse,parenteral contact or from an infected mother to the baby at birth and,if contracted early in life,may lead to chronic liver disease,including cirrhosis and hepatocellular carcinoma.On the basis of the HBV carrier rate,the world can be divided in 3 regions of high,medium and low endemicity.The major concern is about high endemicity countries,where the most common route of infection remains vertical transmission from mother to child.Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries.The infection rate can be reduced by modifying behavior,improving individual education,testing all blood donations,assuring asepsis in clinical practice and screening all pregnant women.However,availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences.The unsolved problem for poorest countries,where the number of people currently infected is high,is the cost of the vaccine.A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.
基金Supported by Institutional NRSA,clinical oncology research training program,No.T32 CA079447(Bishehsari F)the Associazione Italiana per la Ricerca sul Cancro(AIRC),Milan to Mariani-Costantini R+3 种基金the Office for Internationalization,G.d’Annunzio University,Chietithe Carichieti Foundation,ChietiMinistero dell’Istruzione,dell’Universitàe della Ricerca(MIUR),Rome,Italythe Fondazione Umberto Veronesi,Milan,Italy and the MRC(5PT57)to Vacca M
文摘Colorectal cancer(CRC)is one of the leading causes of cancer and cancer-related mortality worldwide.The disease has been traditionally a major health problem in industrial countries,however the CRC rates are increasing in the developing countries that are undergoing economic growth.Several environmental risk factors,mainly changes in diet and life style,have been suggested to underlie the rise of CRC in these populations.Diet and lifestyle impinge on nuclear receptors,on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis.In this respect,the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations.The data from these studies may have important implications for the global prevention and treatment of CRC.
文摘Hepatitis A is the most common form of acute viral hepatitis in the world.Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development.The anti-hepatitis A virus(HAV)seroprevalence rate is presently decreasing in many parts of the world,but in less developed regions and in several developing countries,HAV infection is still very common in the first years of life and seroprev-alence rates approach 100%.In areas of intermediate endemicity,the delay in the exposure to the virus has generated a huge number of susceptible adolescents and adults and significantly increased the average age at infection.As the severity of disease increases with age,this has led to outbreaks of hepatitis A.Several factors contribute to the decline of the infection rate,including rising socioeconomic levels,increased access to clean water and the availability of a hepatitis A vaccine that was developed in the 1990s.For populations with a high proportion of susceptible adults,implementing vaccination programs may be considered.In this report,we review available epidemiological data and implementation of vaccination strategies,particularly focusing on developing countries.
文摘Cervical cancer(CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas,the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies,researchers have attempted to find new strategies that are adapted to low- and middle-income countries(LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus(HPV) testing is more effective than cytology for CC screening. Therefore,highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages,HPV-based screening has a low positive predictive value for CC,so that HPVpositive women need to be triaged with further testing to determine optimal management. Visual inspection tests,cytology and novel biomarkers are some options. In this review,we provide an overview of current and emerging screening approaches for CC. In particular,we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care(POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress,but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined.
文摘AIM:To identify the newest approaches to type 2diabetes(T2DM)prevention and control in the developingworld context.METHODS:We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries,as defined by the World Bank.We searched Pub Med using Medical Subject Headings terms.Studies needed to satisfy four criteria:(1)Must be experimental;(2)Must include patients with T2DM or focusing on prevention of T2DM;(3)Must have a lifestyle intervention component;(4)Must be written in English;and(5)Must have measurable outcomes related to diabetes.RESULTS:A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014.India contributed the largest number of trials(11/66).Of the total 66 studies reviewed,all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes.The overwhelming majority of studies reported on diabetes management(56/66),and among these more than half were structured lifestyle education programs.The evidence suggests that lifestyle education led by allied health professionals(nurses,pharmacists)were as effective as those led by physicians or a team of clinicians.The remaining diabetes management interventions focused on diet or exercise,but the evidence to recommend one approach over another was weak.CONCLUSION:Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.
