| 1. |
- Bixby, H., et al.
(author)
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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
- 2019
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
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Journal article (peer-reviewed)abstract
- Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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| 2. |
- Mishra, A, et al.
(author)
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Diminishing benefits of urban living for children and adolescents' growth and development
- 2023
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 615:7954, s. 874-883
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Journal article (peer-reviewed)abstract
- Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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| 3. |
- Barber, R. M., et al.
(author)
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Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015 : A novel analysis from the global burden of disease study 2015
- 2017
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In: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 390:10091, s. 231-266
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Journal article (peer-reviewed)abstract
- Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright © The Author(s). Published by Elsevier Ltd.
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| 4. |
- Field, Christopher B., et al.
(author)
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Summary for Policymakers
- 2014
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In: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part A: Global and SectoralAspects.. - 9781107415379 ; , s. 1-32
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Book chapter (peer-reviewed)
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| 5. |
- Botvinik-Nezer, Rotem, et al.
(author)
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Variability in the analysis of a single neuroimaging dataset by many teams
- 2020
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 582, s. 84-88
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Journal article (peer-reviewed)abstract
- Data analysis workflows in many scientific domains have become increasingly complex and flexible. Here we assess the effect of this flexibility on the results of functional magnetic resonance imaging by asking 70 independent teams to analyse the same dataset, testing the same 9 ex-ante hypotheses(1). The flexibility of analytical approaches is exemplified by the fact that no two teams chose identical workflows to analyse the data. This flexibility resulted in sizeable variation in the results of hypothesis tests, even for teams whose statistical maps were highly correlated at intermediate stages of the analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Notably, a meta-analytical approach that aggregated information across teams yielded a significant consensus in activated regions. Furthermore, prediction markets of researchers in the field revealed an overestimation of the likelihood of significant findings, even by researchers with direct knowledge of the dataset(2-5). Our findings show that analytical flexibility can have substantial effects on scientific conclusions, and identify factors that may be related to variability in the analysis of functional magnetic resonance imaging. The results emphasize the importance of validating and sharing complex analysis workflows, and demonstrate the need for performing and reporting multiple analyses of the same data. Potential approaches that could be used to mitigate issues related to analytical variability are discussed. The results obtained by seventy different teams analysing the same functional magnetic resonance imaging dataset show substantial variation, highlighting the influence of analytical choices and the importance of sharing workflows publicly and performing multiple analyses.
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| 6. |
- Kehoe, Laura, et al.
(author)
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Make EU trade with Brazil sustainable
- 2019
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In: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Journal article (other academic/artistic)
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| 7. |
- Wilkie, F. L., et al.
(author)
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HUMANS : An English and Spanish neuropsychological test battery for assessing HIV-1-infected individuals - Initial report
- 2004
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In: Applied neuropsychology. - : Taylor & Francis. - 0908-4282 .- 1532-4826. ; 11:3, s. 121-133
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Journal article (peer-reviewed)abstract
- A neuropsychological battery for testing HIV-1-infected individuals in Spanish was developed. We refer to this battery as the HIV/University of Miami Annotated Neuropsychological test battery in Spanish (HUMANS). The HUMANS battery includes recommendations of the National Institute of Mental Health Neuropsychology Workgroup on HIV-1 infection and measures processes in the following 7 cognitive domains: attention, verbal and visual memory, information processing speed, abstraction and executive functioning, language, visuospatial and visuo-constructive, and motor Administration requires approximately 3 to 4 hr The English version of the battery is sensitive to HIV-1 serostatus and Centers for Disease Control clinical disease stage. We report on the test selection, translation, and adaptation of this parallel English battery into Spanish using methods to eliminate linguistically and culturally biased items in some tests. The importance of standardized neuropsychological instruments equivalent in different languages to test HIV-1-positive individuals for impairment is emphasized. Validation and reliability studies are in progress.
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| 8. |
- Suárez-Barraza, Manuel F., et al.
(author)
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In search of “Muda” through the TKJ diagram
- 2016
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In: International Journal of Quality and Service Sciences. - 1756-669X. ; 8:3, s. 377-394
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Journal article (peer-reviewed)abstract
- Purpose: Muda is a Japanese term literally meaning futility, uselessness, idleness, superfluity, waste, wastage or wastefulness. The term was introduced by the Japanese engineer Taiichi Ohno of Toyota Motor Corporation in the 1960s. Therefore, reducing and minimizing Muda is an effective way to increase the operational efficiency and productivity of an organization’s processes. In turn, the technique known as the affinity or TKJ diagram represents a practical way of sorting data or ideas into groups classified by common patterns; it can be regarded as one of the new seven tools of quality. The purpose of this paper is to discover Muda by applying the affinity or TKJ diagram in Mexican organizations. Design/methodology/approach: An exploratory qualitative study was conducted. Using theoretical sampling, the authors identified and analyzed data from a kaizen training course. Each course workshop was organized by the Universidad de las Americas Puebla and consulting firm “Mi Empresa”, and given to employees of various organizations in various sectors over three years from January 2012 to January 2015. Findings: The research provided the first evidence of Muda in Mexican organizations. The Muda of Ohno’s classification was confirmed, but new common patterns of Muda in twenty-first-century organizations also arose. Furthermore, the TKJ diagram proved to be an effective tool of quality to detect it. Research limitations/implications: This paper has the same limitations as all other qualitative research, including analysis subjectivity and questionable generalization of findings. It is also important to highlight the seven KJ diagrams, a seemingly abundant figure. However, it is a small sample for the number of companies and processes to be found in Mexico. Practical implications: This paper may prove to be valuable for practitioners and managers involved in the operations and continuous improvement fields. Getting to know Muda in organizations is of great importance for continuously improving organizational processes. This classification will allow greater insight and easier detection. Originality/value: The study contributes to the limited existing literature on total quality management, lean thinking and kaizen, and subsequently disseminates this information to provide impetus, guidance and support toward improving the quality of organizational processes.
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| 9. |
- Suarez-Barraza, Manuel F., et al.
(author)
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Lean Service: A literature analysis and classification
- 2012
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In: Total Quality Management & Business Excellence. - : Informa UK Limited. - 1478-3363 .- 1478-3371. ; 23:3-4, s. 359-380
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Journal article (peer-reviewed)abstract
- The service sector in the USA accounts for 80% of gross domestic product. However, in spite of the pivotal role of the service sector in the US economy and its impact on daily life, the level of productivity in this sector has been much lower than that of the manufacturing area. This situation has been in existence for some time, but in the current context, there are growing external pressures to reduce costs, increase flexibility, improve quality and cut down on lead times. Companies are thus turning their attention to the manufacturing sector with the aim of implementing their techniques and methods which encourage a 'lean' approach. The purpose of this article is to review the extant literature on the subject that goes under the umbrella-title of 'Lean Service', analyse it, classify it into preliminary categories and suggest possible gaps in the research literature from the point of view of researchers and practitioners. The paper systematically categorises the published literature where the term Lean Service appears, including the early publications on the subject. Then, the categories are revised and analysed methodically. The research found that the literature referring to Lean Service can vary widely from the exploration of the meaning of the concept, its applications (case studies), the setting up of theoretical concepts (models) to the generation of new definitions. Within each category, certain gaps have been identified and possible future lines of research which clarify and distinguish the concept of Lean Service. In addition, within the category of 'applications', sub-categories have been identified such as banks and financial institutions, the health sector, education, the airline industry, and hotels and restaurants. The paper aspires to be of interest as much to researchers as to professionals in the service industry, whether they have middle management responsibilities, or are service managers, and also to all those employees whose work is related to this sector, with the object of understanding the management of service organisations from the Lean Service perspective.
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