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- Micah, Angela E., et al.
(författare)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Forskningsöversikt (refereegranskat)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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| 2. |
- Carroll, Thomas X., et al.
(författare)
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Fluorine as a π donor. Carbon 1s photoelectron spectroscopy and proton affinities of fluorobenzenes
- 2006
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Ingår i: Journal of Organic Chemistry. - : American Chemical Society (ACS). - 0022-3263 .- 1520-6904. ; 71:5, s. 1961-1968
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Tidskriftsartikel (refereegranskat)abstract
- The carbon 1s ionization energies for all of the carbon atoms in 10 fluorine-substituted benzene molecules have been measured by high-resolution photoelectron spectroscopy. A total of 30 ionization energies can be accurately described by an additivity model with four parameters that describe the effect of a fluorine that is ipso, ortho, meta, or para to the site of ionization. A similar additivity relationship describes the enthalpies of protonation. The additivity parameters reflect the role of fluorine as an electron-withdrawing group and as a π-electron donating group. The ionization energies and proton affinities correlate linearly, but there are four different correlations depending on whether there are 0, 1, 2, or 3 fluorines ortho or para to the site of ionization or protonation. That there are four correlation lines can be understood in terms of the ability of the hydrogens at the site of protonation to act as a π-electron acceptor. A comparison of the ionization energies and proton affinities, together with the results of electronic structure calculations, gives insight into the effects of fluorine as an electron-withdrawing group and as a π donor, both in the neutral molecule and in response to an added positive charge.
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| 4. |
- Novak, Iona, et al.
(författare)
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Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy : Advances in Diagnosis and Treatment
- 2017
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Ingår i: JAMA pediatrics. - : American Medical Association. - 2168-6203 .- 2168-6211. ; 171:9, s. 897-907
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Forskningsöversikt (refereegranskat)abstract
- Importance: Cerebral palsy describes the most common physical disability in childhood and occurs in 1 in 500 live births. Historically, the diagnosis has been made between age 12 and 24 months but now can be made before 6 months' corrected age.Objectives: To systematically review best available evidence for early, accurate diagnosis of cerebral palsy and to summarize best available evidence about cerebral palsy-specific early intervention that should follow early diagnosis to optimize neuroplasticity and function.Evidence Review: This study systematically searched the literature about early diagnosis of cerebral palsy in MEDLINE (1956-2016), EMBASE (1980-2016), CINAHL (1983-2016), and the Cochrane Library (1988-2016) and by hand searching. Search terms included cerebral palsy, diagnosis, detection, prediction, identification, predictive validity, accuracy, sensitivity, and specificity. The study included systematic reviews with or without meta-analyses, criteria of diagnostic accuracy, and evidence-based clinical guidelines. Findings are reported according to the PRISMA statement, and recommendations are reported according to the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument.Findings: Six systematic reviews and 2 evidence-based clinical guidelines met inclusion criteria. All included articles had high methodological Quality Assessment of Diagnostic Accuracy Studies (QUADAS) ratings. In infants, clinical signs and symptoms of cerebral palsy emerge and evolve before age 2 years; therefore, a combination of standardized tools should be used to predict risk in conjunction with clinical history. Before 5 months' corrected age, the most predictive tools for detecting risk are term-age magnetic resonance imaging (86%-89% sensitivity), the Prechtl Qualitative Assessment of General Movements (98% sensitivity), and the Hammersmith Infant Neurological Examination (90% sensitivity). After 5 months' corrected age, the most predictive tools for detecting risk are magnetic resonance imaging (86%-89% sensitivity) (where safe and feasible), the Hammersmith Infant Neurological Examination (90% sensitivity), and the Developmental Assessment of Young Children (83% C index). Topography and severity of cerebral palsy are more difficult to ascertain in infancy, and magnetic resonance imaging and the Hammersmith Infant Neurological Examination may be helpful in assisting clinical decisions. In high-income countries, 2 in 3 individuals with cerebral palsy will walk, 3 in 4 will talk, and 1 in 2 will have normal intelligence.Conclusions and Relevance: Early diagnosis begins with a medical history and involves using neuroimaging, standardized neurological, and standardized motor assessments that indicate congruent abnormal findings indicative of cerebral palsy. Clinicians should understand the importance of prompt referral to diagnostic-specific early intervention to optimize infant motor and cognitive plasticity, prevent secondary complications, and enhance caregiver well-being.
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| 5. |
- Smets, Benoît, et al.
(författare)
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Detailed multidisciplinary monitoring reveals pre- and co-eruptive signals at Nyamulagira volcano (North Kivu, Democratic Republic of Congo)
- 2014
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Ingår i: Bulletin of Volcanology. - : Springer Science and Business Media LLC. - 0258-8900 .- 1432-0819. ; 76:787, s. 1-35
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a thorough description of Nyamulagira’s January 2010 volcanic eruption (North Kivu, Democratic Republic of Congo), based on a combination of field observation and ground-based and space-borne data. It is the first eruption in the Virunga Volcanic Province that has been described by a combination of several modern monitoring techniques. The 2010 eruption lasted 26 days and emitted ∼45.5 × 106 m3 of lava. Field observations divided the event into four eruptive stages delimited by major changes in effusive activity. These stages are consistent with those described by Pouclet (1976) for historical eruptions of Nyamulagira. Co-eruptive signals from ground deformation, seismicity, SO2 emission and thermal flux correlate with the eruptive stages. Unambiguous pre-eruptive ground deformation was observed 3 weeks before the lava outburst, coinciding with a small but clear increase in the short period seismicity and SO2 emission. The 3 weeks of precursors contrasts with the only precursory signal previously recognized in the Virunga Volcanic Province, the short-term increase of tremor and long period seismicity, which, for example, were only detected less than 2 h prior to the 2010 eruption. The present paper is the most detailed picture of a typical flank eruption of this volcano. It provides valuable tools for re-examining former—mostly qualitative—descriptions of historical Nyamulagira eruptions that occurred during the colonial period.
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