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Group Results within the Age of Neoliberal Capitalism: A good Investigation regarding Work as well as Employability throughout Asia.
Objectives HIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia. Design A cross-sectional survey. Setting 27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV. Participants A total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively. Outcome measures The economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold. Results The mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p less then 0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p less then 0.001). This figure was higher for drug-resistant TB (62%). Conclusions HIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.Introduction Cardiovascular disease (CVD) is currently the leading cause of death worldwide. In Africa where infectious diseases are still the leading cause of death, the contribution of non-communicable diseases led by CVDs has significantly increased in recent years. The rise of CVDs in Africa is attributed at least in part to the adoption of sedentary behaviours and unhealthy eating habits, which are linked with urbanisation and westernisation of cultures. Dietary attributes associated with CVD risk have been less investigated in Africa. However, evidence from developed nations has reported a protective effect of healthy dietary patterns such as plant-based diets (PBDs) on cardiometabolic health. The current protocol is for a review aiming to assess existing evidence on the association of PBDs with CVD risk profile in African populations. Methods and analysis This protocol was developed following the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. We willed to resolve any discrepancies. Data will be extracted from studies that are eligible for the review. Meta-analysis will be performed for studies with similar or comparable methods and reported outcome measures. This will be performed overall, and by major study-level characteristics. Heterogeneity in the estimates across studies will be assessed and quantified with the use of Cochrane Q and I2 statistics, respectively. Publication biases will be investigated through funnel plots and Egger test of bias. Relevant sensitivity analyses will be performed to confirm the robustness of the findings. Ethics and dissemination The review will analyse data from published studies; therefore, it does not require ethical approval. The findings of the review will be submitted as part of a PhD thesis at Stellenbosch University, South Africa. Additionally, the findings will be presented at conferences and published in a peer-reviewed journal. Prospero registration number CRD42020159862.Objectives To assess variation in antibiotic prescribing practices among village doctors in a rural region of Shandong province, China. Design, setting and participants Almost all outpatient encounters at village clinics result in a prescription being issued. Elimusertib Prescriptions were collected over a 2.5-year period from 8 primary care village clinics staffed by 24 doctors located around a town in rural Shandong province. A target of 60 prescriptions per clinic per month was sampled from an average total of around 300. Prescriptions were analysed at both aggregate and individual-prescriber levels, with a focus on diagnoses of likely viral acute upper respiratory tract infections (AURIs), defined as International Classification of Diseases, 10th Revision codes J00 and J06.9. Main outcome measures Proportions of prescriptions for AURIs containing (1) at least one antibiotic, (2) multiple antibiotics, (3) at least one parenteral antibiotic; classes and agents of antibiotics prescribed. Results In total, 14 471 prescrirescriber practices are significant even in a small homogenous setting and should be accounted for when developing targets and interventions to improve antibiotic use.Introduction The sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented at the front lines of care to increase effectiveness and efficiency; however, little is known about how sustainability is conceptualised and measured in programme evaluations. Objectives We aimed to describe theoretical frameworks, definitions and measures of sustainability, as applied in published evaluations of healthcare improvement programmes and interventions. Design Systematic integrative review. Methods We searched six academic databases, CINAHL, Embase, Ovid MEDLINE, Emerald Management, Scopus and Web of Science, for peer-reviewed English journal articles (July 2011-March 2018). Articles were included if they assessed programme sustainability or sustained outcomesns of service improvement programmes and interventions seldom used theoretical frameworks. Embedding implementation science and healthcare service researchers into the healthcare system is a promising strategy to improve the rigour of programme sustainability evaluations.
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