Demographic science aids in understanding the spread and fatality rates of CO...Wouter de Heij
See also:
https://osf.io/fd4rh/?view_only=c2f00dfe3677493faa421fc2ea38e295
and live-blog:
https://food4innovations.blog/2020/03/16/live-blog-over-de-corona-crisis-covid-19-dagelijkse-beschouwingen-van-wouter-de-heij-food4innovations/
Economic analyses of formal and informal dementia care and measurement of qua...Ruby Med Plus
Dementia affects the whole person not just the brain and memory, but also a host of important aspects of daily life . The risk of developing dementia increases exponentially with age and global ageing means that in the next few decades very large numbers of people around the world will enter the age where the incidence of dementia will be highest. One of the biggest challenges of the 21st century seems to be Alzheimer disease (AD) together with other types of dementia.
The ageing of the population across Europe and beyond means that the number of people with dementia will grow in future decades with consequent implications for care provision, care burden and public expenditure. It is no wonder, therefore, that many countries are already preparing for the projected rise in the number of people with dementia by putting in place dedicated action plans and/or dementia strategies.
The Sustainable Development Goals Report 2016Peerasak C.
Foreword
On 1 January 2016, the world officially began implementation of the 2030 Agenda for Sustainable Development—the transformative plan of action based on 17 Sustainable Development Goals—to address urgent global challenges over the next 15 years.
This agenda is a road map for people and the planet that will build on the success of the Millennium Development Goals and ensure sustainable social and economic progress worldwide. It seeks not only to eradicate extreme poverty, but also to integrate and balance the three dimensions of sustainable development—economic, social and environmental—in a comprehensive global vision.
It is vital that we begin implementation with a sense of opportunity and purpose based on an accurate evaluation of where the world stands now.
That is the aim of this report. It presents an overview of the 17 Goals using data currently available to highlight the most significant gaps and challenges.
The latest data show that about one in eight people still lived in extreme poverty, nearly 800 million people suffered from hunger, the births of nearly a quarter of children under 5 had not been recorded, 1.1 billion people were living without electricity, and water scarcity affected more than 2 billion people.
These statistics show how important coordinated global data-generation efforts will be in supplying reliable and timely data for systematic follow-up and progress reviews.
The Goals apply to all societies. Even the wealthiest countries have yet to fully empower women or eliminate discrimination.All nations will need to build the Sustainable Development Goals into their national policies and plans if we are to achieve them.
This first report is a starting point. With collective global action, we can seize the opportunities before us and, together,fulfill the pledge of the 2030 Agenda to leave no one behind.
BAN Ki-Moon
Secretary-General, United Nations "The new agenda is a promise by leaders to all people everywhere. It is a universal, integrated and transformative vision for a better world. It is an agenda for people, to end poverty in all its forms. An agenda for the planet, our common home. An agenda for shared prosperity, peace and partnership. It conveys the urgency of climate action. It is rooted in gender equality and respect for the rights of all. Above all, it pledges to leave no one behind."
BAN Ki-Moon
Secretary-General, United Nations
Non communicable diseases in the Arab World.
Presented by Pr Habiba Ben Romdhane, Head of the Cardiovascular Diseases Epidemiology and Prevention Laboratory - Tunisia.
International Symposium on Social Determinants of NCDs, 6-7 May 2013, Istanbul - Turkey
Demographic science aids in understanding the spread and fatality rates of CO...Wouter de Heij
See also:
https://osf.io/fd4rh/?view_only=c2f00dfe3677493faa421fc2ea38e295
and live-blog:
https://food4innovations.blog/2020/03/16/live-blog-over-de-corona-crisis-covid-19-dagelijkse-beschouwingen-van-wouter-de-heij-food4innovations/
Economic analyses of formal and informal dementia care and measurement of qua...Ruby Med Plus
Dementia affects the whole person not just the brain and memory, but also a host of important aspects of daily life . The risk of developing dementia increases exponentially with age and global ageing means that in the next few decades very large numbers of people around the world will enter the age where the incidence of dementia will be highest. One of the biggest challenges of the 21st century seems to be Alzheimer disease (AD) together with other types of dementia.
The ageing of the population across Europe and beyond means that the number of people with dementia will grow in future decades with consequent implications for care provision, care burden and public expenditure. It is no wonder, therefore, that many countries are already preparing for the projected rise in the number of people with dementia by putting in place dedicated action plans and/or dementia strategies.
The Sustainable Development Goals Report 2016Peerasak C.
Foreword
On 1 January 2016, the world officially began implementation of the 2030 Agenda for Sustainable Development—the transformative plan of action based on 17 Sustainable Development Goals—to address urgent global challenges over the next 15 years.
This agenda is a road map for people and the planet that will build on the success of the Millennium Development Goals and ensure sustainable social and economic progress worldwide. It seeks not only to eradicate extreme poverty, but also to integrate and balance the three dimensions of sustainable development—economic, social and environmental—in a comprehensive global vision.
It is vital that we begin implementation with a sense of opportunity and purpose based on an accurate evaluation of where the world stands now.
That is the aim of this report. It presents an overview of the 17 Goals using data currently available to highlight the most significant gaps and challenges.
The latest data show that about one in eight people still lived in extreme poverty, nearly 800 million people suffered from hunger, the births of nearly a quarter of children under 5 had not been recorded, 1.1 billion people were living without electricity, and water scarcity affected more than 2 billion people.
These statistics show how important coordinated global data-generation efforts will be in supplying reliable and timely data for systematic follow-up and progress reviews.
The Goals apply to all societies. Even the wealthiest countries have yet to fully empower women or eliminate discrimination.All nations will need to build the Sustainable Development Goals into their national policies and plans if we are to achieve them.
This first report is a starting point. With collective global action, we can seize the opportunities before us and, together,fulfill the pledge of the 2030 Agenda to leave no one behind.
BAN Ki-Moon
Secretary-General, United Nations "The new agenda is a promise by leaders to all people everywhere. It is a universal, integrated and transformative vision for a better world. It is an agenda for people, to end poverty in all its forms. An agenda for the planet, our common home. An agenda for shared prosperity, peace and partnership. It conveys the urgency of climate action. It is rooted in gender equality and respect for the rights of all. Above all, it pledges to leave no one behind."
BAN Ki-Moon
Secretary-General, United Nations
Non communicable diseases in the Arab World.
Presented by Pr Habiba Ben Romdhane, Head of the Cardiovascular Diseases Epidemiology and Prevention Laboratory - Tunisia.
International Symposium on Social Determinants of NCDs, 6-7 May 2013, Istanbul - Turkey
A private healthcare insurance for low-income families.
Project Goal:
Improve access to primary healthcare in Caldas, by redesigning the existing Bienestar social business model, in order to expand and replicate it in Colombia and possibly elsewhere.
Growth Redistribution and Inequality Effects on Poverty in NigeriaUNDP Policy Centre
Jude Chukwu (Department of Economics, University of Nigeria and Visiting Research Fellow, IPC-IG) introduced his research, presenting its empirical findings during a presentation on the IPC-IG’s Seminar Series. He delved into the patterns of growth and inequality in Nigeria, as well as on the extent of pro-poorness and inclusiveness of growth in the country.
Poverty implicates a condition where people are unable to afford the minimal standards of food, clothing, healthcare, education, and also not capable to continue traditions that are important to them. Poverty reduction strategies now receive high attention across the world because of the negative impact on the individual and national prosperity. The average poverty rate of about 68.40 percent is a clear indication that a majority of Nigerian citizens sleep below the poverty line despite the presence of poverty reduction programmes. The exploratory research method was deployed for the study in an attempt to explore the impact of NEEDS as a poverty reduction strategy in Nigeria. Through statistical analysis, it was found that NEEDS has not made significant positive impact on poverty reduction in Nigeria.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Philippines HDI Value and Ranking and Highlights of the 5th MDG Progress Reportkukaii
Presentation on the Philippines: Human Development Index Ranking and
Progress in Achieving the Millennium Development Goals by Socioeconomic Planning Secretary Arsenio M. Balisacan (As read by National Statistician Lisa Grace Bersales)
Presented during the National Launch and Press Conference of the 2014 Human Development Report and 5th PHL Progress Report on the MDGs last 20 August 2014.
Predictive analysis WHO's life expectancy dataset using Tableau data visualis...Tarun Swarup
Performed predictive analysis on global Life expectancy dataset (WHO) to analyze the vital factors affecting human health and other societal risks demographically.
Designed a visual dashboard to identify intrinsic patterns in different factors and extract valuable insights to predict life expectancy accordingly.
▪ Infant Death Rate almost reduced by 40% in the last two decades.
▪ Overall adult mortality rate turned down by almost 17% in the previous years.
This 6th edition of the IDF Diabetes Atlas once again sets the standard for evidence on the global epidemiology of diabetes. The new estimates build on the groundwork laid by previous editions, and confirm the precipitous rise in diabetes over
the last few years. An astounding 382 million people are estimated to have diabetes, with dramatic increases seen in countries all over the world. The overwhelming burden of the disease continues to be shouldered by low- and middleincome
countries, where four out of five people with diabetes are living. Socially and economically disadvantaged people in every country carry the greatest burden of diabetes and are often the most
affected financially.
A private healthcare insurance for low-income families.
Project Goal:
Improve access to primary healthcare in Caldas, by redesigning the existing Bienestar social business model, in order to expand and replicate it in Colombia and possibly elsewhere.
Growth Redistribution and Inequality Effects on Poverty in NigeriaUNDP Policy Centre
Jude Chukwu (Department of Economics, University of Nigeria and Visiting Research Fellow, IPC-IG) introduced his research, presenting its empirical findings during a presentation on the IPC-IG’s Seminar Series. He delved into the patterns of growth and inequality in Nigeria, as well as on the extent of pro-poorness and inclusiveness of growth in the country.
Poverty implicates a condition where people are unable to afford the minimal standards of food, clothing, healthcare, education, and also not capable to continue traditions that are important to them. Poverty reduction strategies now receive high attention across the world because of the negative impact on the individual and national prosperity. The average poverty rate of about 68.40 percent is a clear indication that a majority of Nigerian citizens sleep below the poverty line despite the presence of poverty reduction programmes. The exploratory research method was deployed for the study in an attempt to explore the impact of NEEDS as a poverty reduction strategy in Nigeria. Through statistical analysis, it was found that NEEDS has not made significant positive impact on poverty reduction in Nigeria.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Philippines HDI Value and Ranking and Highlights of the 5th MDG Progress Reportkukaii
Presentation on the Philippines: Human Development Index Ranking and
Progress in Achieving the Millennium Development Goals by Socioeconomic Planning Secretary Arsenio M. Balisacan (As read by National Statistician Lisa Grace Bersales)
Presented during the National Launch and Press Conference of the 2014 Human Development Report and 5th PHL Progress Report on the MDGs last 20 August 2014.
Predictive analysis WHO's life expectancy dataset using Tableau data visualis...Tarun Swarup
Performed predictive analysis on global Life expectancy dataset (WHO) to analyze the vital factors affecting human health and other societal risks demographically.
Designed a visual dashboard to identify intrinsic patterns in different factors and extract valuable insights to predict life expectancy accordingly.
▪ Infant Death Rate almost reduced by 40% in the last two decades.
▪ Overall adult mortality rate turned down by almost 17% in the previous years.
This 6th edition of the IDF Diabetes Atlas once again sets the standard for evidence on the global epidemiology of diabetes. The new estimates build on the groundwork laid by previous editions, and confirm the precipitous rise in diabetes over
the last few years. An astounding 382 million people are estimated to have diabetes, with dramatic increases seen in countries all over the world. The overwhelming burden of the disease continues to be shouldered by low- and middleincome
countries, where four out of five people with diabetes are living. Socially and economically disadvantaged people in every country carry the greatest burden of diabetes and are often the most
affected financially.
National Institute on AgingNational Institutes of HealthU..docxvannagoforth
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
Global Health and Aging
2 Global Health and AgingPhoto credits front cover, left to right (Dreamstime.com): Djembe; Sergey Galushko; Laurin Rinder; Indianeye;
Magomed Magomedagaev; and Antonella865.
3
Preface
Overview
Humanity’s Aging
Living Longer
New Disease Patterns
Longer Lives and Disability
New Data on Aging and Health
Assessing the Cost of Aging and Health Care
Health and Work
Changing Role of the Family
Suggested Resources
Contents
Rose Maria Li
1
2
4
6
9
12
16
18
20
22
25
4 Global Health and Aging
5
Preface
The world is facing a situation without precedent: We soon will have more older people than
children and more people at extreme old age than ever before. As both the proportion of older
people and the length of life increase throughout the world, key questions arise. Will population
aging be accompanied by a longer period of good health, a sustained sense of well-being, and
extended periods of social engagement and productivity, or will it be associated with more illness,
disability, and dependency? How will aging affect health care and social costs? Are these futures
inevitable, or can we act to establish a physical and social infrastructure that might foster better
health and wellbeing in older age? How will population aging play out differently for low-income
countries that will age faster than their counterparts have, but before they become industrialized
and wealthy?
This brief report attempts to address some of these questions. Above all, it emphasizes the central
role that health will play moving forward. A better understanding of the changing relationship
between health with age is crucial if we are to create a future that takes full advantage of the
powerful resource inherent in older populations. To do so, nations must develop appropriate
data systems and research capacity to monitor and understand these patterns and relationships,
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well-being. And research needs to be better coordinated if we are to discover the most cost-effective
ways to maintain healthful life styles and everyday functioning in countries at different stages of
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existing knowledge about the prevention and treatment of heart disease, stroke, diabetes, and
cancer.
Managing population aging also requires building needed infrastructure and institutions as soon as
possible. The longer we delay, the more costly and less effective the solutions are likely to be.
Population aging is a powerful and transforming demographic force. We are only just beginning
to comprehend its impact ...
15m people worldwide suffer a stroke every day. What can be done to combat the disease? This report, sponsored by AstraZeneca, assesses current developments and the economic burden of stroke across the regions of the world.
On 1 January 2016, the world officially began implementation
of the 2030 Agenda for Sustainable Development—the
transformative plan of action based on 17 Sustainable
Development Goals—to address urgent global challenges
over the next 15 years.
This agenda is a road map for people and the planet that will
build on the success of the Millennium Development Goals
and ensure sustainable social and economic progress worldwide.
It seeks not only to eradicate extreme poverty, but also
to integrate and balance the three dimensions of sustainable
development—economic, social and environmental—in a
comprehensive global vision.
The new agenda is a promise by leaders to all people everywhere. It is a universal, integrated and transformative vision for a better world. It is an agenda for people, to end poverty in all its forms. An agenda for the planet, our common home. An agenda for shared prosperity, peace and partnership. It conveys the urgency of climate action. It is rooted in gender equality and respect for the rights of all. Above all, it pledges to leave no one behind.
BAN Ki-Moon
Secretary-General, United Nations
Emerging issues in health care in developing countiresShankar Das
Emerging issues in Health care in developing countries, Shaping a fairer and effective health care delivery, Social determinants of health as urgent imperative, good health at low cost, vicious cycle of poverty and ill-health, Das 2013.
По оценкам программы Организации Объединенных Наций по ВИЧ/СПИД UNAIDS, по количеству инфицированных и по методам борьбы с болезнью Россия занимает место в одном ряду с Центральноафриканской Республикой, Демократической Республикой Конго, Индонезией, Нигерией и Южным Суданом. В этих странах не только постоянно увеличивается и без того большое число инфицированных, но они также испытывают недостаток в антиретровирусных препаратах.
La Federación Internacional de Diabetes (IDF) lanza su 7ma Versión del Atlas sobre la Diabetes. Aquí la previa del mismo que estará disponible a partir del 1 de diciempre.
Progress Report of Implementating Sustainable Development Goals in 2018.
UN Secretary-General Antonio Guterres has issued the advance unedited version of the 2018 edition of his yearly report on progress towards the SDGs. The report is based on selected SDG indicators for which data were available, using the latest data as of 10 May 2018.
The report titled, ‘Progress towards the Sustainable Development Goals,’ is produced to inform the UN High-level Political Forum on Sustainable Development (HLPF). The global indicator framework used in the report was developed by the UN Inter-Agency and Expert Group on Sustainable Development Goal Indicators (IAEG-SDGs), and later adopted by the UN General Assembly (UNGA) in July 2017 (resolution 71/313).
3º Congreso Internacional sobre Neurobiología. Guía de tratamiento de psicofa...infobipolar
Programa Científico del 3º Congreso Internacional sobre Neurobiología. Guía de tratamiento de psicofarmacología clínica Más información en www.puedoser.es
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Global impact dementia 2013
1. Policy Brief for Heads of Government
The Global Impact of Dementia 2013–2050
2. 2
ALZHEIMER’S DISEASE INTERNATIONAL · THE GLOBAL VOICE ON DEMENTIA
The Global Impact of Dementia 2013–2050
Although high income countries, including the G8, have borne the brunt of the dementia
epidemic, this is a global phenomenon. Most people with dementia live in low and
middle income countries, and most of the dramatic increases in numbers affected,
through to 2050, will occur in those regions. In a spirit of international cooperation and
solidarity we urge the G8 governments to sponsor intergovernmental action to make
dementia a global priority. Crucially, this must include opening up access to diagnosis
and current evidence-based treatment and care. All countries worldwide are failing in
this basic objective. Action to address this problem should be balanced, as a priority,
with research to improve treatment options and quality of care.
Introduction
Alzheimer’s Disease International (ADI) published
global prevalence data on dementia in the World
Alzheimer Report 2009 1 based on a systematic
review of 154 studies conducted worldwide, and
United Nations population projections through to
the year 2050. We estimated 36 million people with
dementia in 2010, nearly doubling every 20 years to
66 million by 2030 and to 115 million by 2050.
Key findings included
• 58% of those affected lived in low and middle
income countries, underlining the high impact of
the condition in those regions, where awareness
is low, health and social care are poorly
developed and social protection is limited.
• Population ageing is the main driver of projected
increases.
Since 2009, the global evidence base has
expanded, most particularly with a new
systematic review of the prevalence of
dementia in China 3 comprising 75 studies,
most published in Chinese language journals,
and with seven studies from five subSaharan African countries, where previously
only one study from Nigeria had been
available.
The G8 Dementia Summit on 11 December
2013 provides a timely opportunity to
reassess and update evidence on the scale
and the distribution of the global dementia
epidemic, in particular its impact on more
developed (G8, G20, OECD and ‘high
income’ countries) and less developed ‘low
and middle income’ countries.
• We assumed that age-specific prevalence
would remain constant. This assumption is
challenged by recent evidence suggesting a
modest recent decline in dementia prevalence
in some higher income countries (HIC), but an
increase in prevalence in China, likely linked to
recent changes in population health, particularly
exposure to cardiovascular risk factors.
For the current update, we carried out a
limited review, focusing on the new evidence
emerging from China and the sub-Saharan
African regions, and applied the new
prevalence proportions to the latest (2012)
UN population projections 2. Details of the
methodology are provided in Annex 1.
• Since population ageing is occurring at an
unprecedentedly fast rate in middle income
countries, the bulk of the increase in numbers
through to 2050 will occur in those regions. By
2050 71% of those with dementia would be living
in what are currently lower and middle-income
countries (LMIC).
The work on this report has been a joint
effort of the Global Observatory for Ageing
and Dementia Care (Prof Martin Prince,
Dr Maëlenn Guerchet and Dr Matthew Prina),
and the ADI office.
3. 3
POLICY BRIEF FOR HEADS OF GOVERNMENT: THE GLOBAL IMPACT OF DEMENTIA 2013–2050
Results
The prevalences of dementia estimated from the
recent more comprehensive review and metaanalysis of China studies 3 and our own metaanalysis of studies from sub-Saharan Africa were
substantially higher than those used in the 2009
World Alzheimer Report. Age-standardised to a
standard West European population, prevalence
for East Asia increased from 4.98% to 6.99%
and in the sub-Saharan African regions from a
range of 2.07% to 4.00%, to 4.76% (Figure 1).
The net effect, as more data becomes available,
is to further reduce the variation in prevalence
between world regions.
The number of people living with dementia
worldwide in 2013 is estimated at 44.35 million,
reaching 75.62 million in 2030 and 135.46 million
in 2050 (Figure 2). The updated estimates are
higher than our original estimates reported in the
2009 World Alzheimer Report, by 15% in 2030,
and by 17% in 2050.
Standard Prevalence (%)
Figure 1 Original (2009 World Alzheimer Report) and updated age-specific prevalence of dementia (%) by region,
showing impact of new data from Asia East (China) and Sub-Saharan Africa
9
Updated
Original
7
5
2
0
Au
N
S
SS
As
S
Oc
S
As
A
A
A
E
E
E
A
C
L
Af SA
ia
ia sia sia sia uro uro uro me arib atin
e
A E SA C SA S
ric
pe
pe
S
SE
Ce pe
be
ala Pa ania E
Am rica W
en
aN
ntr
W
Ce
E
an
sia cifi
tra
er / M
ntr
al
c
ica
idd
l
al
le
Ea
st
str
People with dementia (millions)
Figure 2 Increase in numbers of people with dementia worldwide (2010-2050), comparing original and
updated estimates
140
135
million
115
million
105
d
ate
Upd
76
66
million
million
70
inal
Orig
44
35
36
million
million
0
2010 2013
2030
2050
4. 4
ALZHEIMER’S DISEASE INTERNATIONAL · THE GLOBAL VOICE ON DEMENTIA
The largest increases in projected numbers of
people with dementia are those for the Asia East
and Sub-Saharan African regions, accounted
for by the higher age-specific prevalence of
dementia estimated in our new reviews of survey
data from those regions (Annex 2). Hence, in
2050 we are now estimating 33.61 million people
with dementia in Asia East (an increase of 49%
from the previous estimate of 22.54 million) and
5.05 million older people with dementia in SSA
(an increase of 136% from the previous estimate
of 2.14 million). However, the new estimates of
numbers of people with dementia are higher for
all GBD regions than those estimated in 2009.
Table 1
This is explained by the underestimation of
current numbers of older people in the previous
UN population estimates (affecting the 2013
figures), and revision upwards of probability of
survival into older age (affecting the 2030 and
2050 projections).
We now estimate that while 32% of people
with dementia live in G8 countries and 38%
in high income countries, 62% live in low and
middle income countries (Table 1). By 2050, the
proportion living in G8 countries will have shrunk
to 21%, while the proportion living in what are
currently low and middle income countries will
have increased to 71%.
Updated estimates of the number of people with dementia living in G8, G20,
OECD, LMIC and HIC countries, and as a percentage of world total
People with dementia millions
(% of world total)
Region
2013
2030
Proportionate increase
(%)
2050
2013-2030
2013-2050
G8
14.02 (32%)
20.38 (27%)
28.91 (21%)
45
106
G20
33.93 (76%)
56.40 (75%)
96.61 (71%)
66
185
OECD
18.08 (41%)
27.98 (37%)
43.65 (32%)
55
142
High income
17.00 (38%)
25.86 (34%)
39.19 (29%)
52
131
Low and middle income
27.84 (62%)
49.76 (66%)
96.27 (71%)
79
246
World
44.35
75.62
71
205
135.46
Millions of people with dementia
Figure 3 Number of people with dementia in low and middle income countries
compared to high income countries
150
125
100
75
Low and middle income countries
50
25
High income countries
0
2013
2015
2020
2025
2030
Year
2035
2040
2045
2050
5. POLICY BRIEF FOR HEADS OF GOVERNMENT: THE GLOBAL IMPACT OF DEMENTIA 2013–2050
Conclusions and implications
1 Dementia, including Alzheimer’s disease,
is one of the biggest global public health
challenges facing our generation. Newly
available data suggests that the current
burden and future impact of the dementia
epidemic has been underestimated,
particularly for the Asia East and Sub-Saharan
African regions.
2 This is a global epidemic – although cases
are disproportionately concentrated in the
world’s richest and most demographically
aged countries, already the clear majority
(62%) of people with dementia live in low and
middle income countries where access to
social protection, services, support and care
are very limited.
3 In the next few decades, the global burden
of dementia will shift inexorably to poorer
countries, particularly rapidly developing
middle income countries that are members of
the G20, but not the G8.
4 The future scale of the dementia epidemic
may be blunted through improvements in
population health, but our best estimates
suggest that only up to 10% of incidence
may thus be avoided 13. Public health and
disease control measures targeting smoking,
underactivity, obesity, hypertension and
diabetes should be prioritised. Education and
other factors that enhance brain and cognitive
development will also improve the brain health
of those entering old age, and reduce the
incidence of dementia in late life.
5 Standard & Poor’s has described global
population ageing as the biggest threat to
the sustainability of sovereign debt. Among
the chronic diseases, dementia makes by far
the largest single contribution to disability
and needs for care among older people. The
current (2010) global societal economic cost
of dementia is US$ 604 billion, or 1% of global
GDP 14. Costs will escalate proportionately
with numbers affected, and with increased
demand for formal care services, particularly
in low and middle income countries 13.
6 Research must be a global priority if we
are to improve the quality and coverage of
care, find treatments that alter the course of
the disease, and identify more options for
prevention.
7 Investment in the search for a cure must be
balanced with initiatives to improve access
to currently available evidence-based
packages of care – these include timely
diagnosis; case management across the
course of the illness; support, education and
training for carers; optimising physical health;
acetylcholinesterase inhibitors; cognitive
stimulation; and non-pharmacological
interventions for behavioural disturbance.
Currently less than half of those in high
income countries and fewer than 10% of
those in LMIC have received a dementia
diagnosis.
8 There are lessons to be drawn from the
HIV epidemic. First, new and dramatically
effective treatments can only be scaled up
when diagnostic and care systems are well
established. Second, affordable access
to new diagnostic technologies and drug
therapies will need rapidly to be extended
to low and middle income country markets,
where most of those who might benefit live.
Third, those countries that where involved
in ‘global trials’ should also benefit from
treatments being made available at subsidised
cost with adequate standards of care in place.
9 ADI and the World Health Organization have,
in their joint report Dementia: a public health
priority 13, called upon all Governments to
make dementia a public and health priority. As
part of this process, all governments should
initiate national debates regarding the future
provision and financing of long-term care
(see World Alzheimer Report 2013: Journey
of Caring 15). However, most are woefully
unprepared for the dementia epidemic with
only 13 countries having funded and sought to
implement a national dementia plan. Without
a plan, the risk is that health and social care
systems will not cope with the increase
in numbers and operate in crisis mode,
escalating costs even further.
10 At the eve of the G8 Dementia Summit in
London, UK, it is not just the G8 countries,
but all nations that must commit to a
sustained increase in dementia research and
a comprehensive plan for collaborative action
involving all relevant government sectors,
industry and civil society. International
cooperation will be essential. There is a
need for a collaborative, global action plan
for governments, industry and non-profit
organisations like Alzheimer associations.
Priorities include; breaking down barriers to
effective research; promoting rapid translation
and ensuring equitable access to promising
technologies and treatments; technical
support for policymaking, health and social
care service and system development.
5
6. 6
ALZHEIMER’S DISEASE INTERNATIONAL · THE GLOBAL VOICE ON DEMENTIA
References
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Report 2009. 2009.
2 United Nations Department of Economic and
Social Affairs Population Division: World Population
Prospects: The 2012 Revision, DVD Edition. 2013.
3 Chan KY, Wang W, Wu JJ, Liu L, Theodoratou E, Car
J, Middleton L, Russ TC, Deary IJ, Campbell H et al:
Epidemiology of Alzheimer’s disease and other forms
of dementia in China, 1990-2010: a systematic review
and analysis. The Lancet 2013, 381(9882):2016-2023.
4 Wu YT, Lee HY, Norton S, Chen C, Chen H, He C,
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5 Jia J, Wang F, Wei C, Zhou A, Jia X, Li F, Tang M, Chu
L, Zhou Y, Zhou C et al: The prevalence of dementia
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6 Hendrie HC, Osuntokun BO, Hall KS, Ogunniyi AO,
Hui SL, Unverzagt FW, Gureje O, Rodenberg CA,
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7 Guerchet M, Houinato D, Paraiso MN, von Ahsen
N, Nubukpo P, Otto M, Clement JP, Preux PM,
Dartigues JF: Cognitive impairment and dementia
in elderly people living in rural Benin, west Africa.
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8 Guerchet M, M’Belesso P, Mouanga AM, Bandzouzi B,
Tabo A, Houinato DS, Paraiso MN, Cowppli-Bony P,
Nubukpo P, Aboyans V et al: Prevalence of dementia in
elderly living in two cities of Central Africa: the EDAC
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9 Paraiso MN, Guerchet M, Saizonou J, Cowppli-Bony
P, Mouanga AM, Nubukpo P, Preux PM, Houinato DS:
Prevalence of dementia among elderly people living
in Cotonou, an urban area of Benin (West Africa).
Neuroepidemiology 2011, 36(4):245-251.
10 Yusuf AJ, Baiyewu O, Sheikh TL, Shehu AU: Prevalence
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Psychogeriatr 2011, 23(3):379-386.
11 Longdon AR, Paddick SM, Kisoli A, Dotchin C, Gray
WK, Dewhurst F, Chaote P, Teodorczuk A, Dewhurst M,
Jusabani AM et al: The prevalence of dementia in rural
Tanzania: a cross-sectional community-based study. Int J
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12 Guerchet M, Banzouzi-Ndamba B, Mbelesso P, Pilleron
S, Clement J-P, Dartigues J-F, Preux P-M.: Prevalence of
dementia in two countries of Central Africa: comparison
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13 World Health Organization and Alzheimer’s Disease
International, Dementia: a public health priority, Geneva
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14 Wimo A, Prince M. World Alzheimer Report 2010; The
Global Economic Impact of Dementia. 2010. London,
Alzheimer’s Disease International
15 World Alzheimer Report 2013, Journey of Caring, An
analysis of long-term care for dementia, http://www.alz.
co.uk/research/world-report-2013
Annex 1: Methods
The prevalence of dementia in China and
Sub-Saharan Africa
Estimation of the number of people with
dementia
The estimates for China were revised based on the recent
meta-analysis published by Chan et al. 3. This metaanalysis included reports for dementia or Alzheimer’s
Disease in mainland China, published in Chinese and
English between 1990 and 2010. The rates applied to the
population estimates were the age-specific prevalence of
dementia in 2010. A new systematic review of dementia
in China has also been recently published 4, together with
a new large multi-centre population-based prevalence
study of dementia in China 5. These studies were not
taken into account in our estimates, but will be included in
any future updates.
The new rates were applied to the new UN population
estimates for each 5-years age band (60-64, to 100 and
over) 2. When rates were not available for one age-band
(i.e. over 90 in SSA and over 100 in China), the rate of
the nearest age-band was applied. As gender-specific
estimates were available neither for China nor SSA,
we applied the age-specific estimates to the whole
population and to each gender separately. In the East Asia
region – composed of China, Hong Kong SAR, Macao
SAR, Chinese Taipei and DPR Korea – the new rates were
applied to mainland China, Hong Kong SAR and Macao
SAR, whereas the East Asia rates from the 2009 Word
Alzheimer Report were maintained for the DPR Korea and
Chinese Taipei.
For Sub-Saharan Africa, we conducted a systematic
review of the literature on the prevalence of dementia with
Pubmed / Medline up to October 2013 using a similar
methodology and inclusion criteria that we used for the
2009 World Alzheimer Report 1 (see online appendix).
We sought and included population-based studies of the
prevalence of dementia among people aged 60 years
and over for which the fieldwork started on or after 1st
January 1980. Prevalence rates were extracted for seven
studies covering five different countries 6-12. A random
effect exponential (Poisson) model was used to assess
the effects of age on the prevalence of dementia. We
then applied the relevant mean ages to the coefficients
estimated from the model, to estimate prevalence in five
year age-bands from 65-69 years to 85 years and over,
for both sexes combined.
For Sub-Saharan Africa, the new rates were applied to
the countries belonging to the following Global Burden
Disease (GBD) regions: SSA West, SSA Central, SSA East
and SSA Southern. Based on the GBD regions, Algeria
belongs to the North Africa / Middle East, so we therefore
applied the EMRO B rates that are used for some of its
neighbours.
For all the other regions, we applied the rates found in
the 2009 World Alzheimer Report to the new population
estimates from the United Nations 2.
8. ALZHEIMER’S DISEASE INTERNATIONAL · THE GLOBAL VOICE ON DEMENTIA
About Alzheimer’s Disease International
Alzheimer’s Disease International (ADI) is the international federation of Alzheimer
associations throughout the world. Each of our 79 members is a non-profit
Alzheimer association supporting people with dementia and their families.
ADI was founded in 1984 and registered as a non-profit organization in the USA.
Based in London, ADI is in official relations with the WHO since 1996 and has
consultative status with the UN since 2012.
ADI’s vision is an improved quality of life for people with dementia and their
families throughout the world. ADI aims to make dementia a global health priority,
to build and strengthen Alzheimer associations, and to raise awareness about
dementia worldwide. Stronger Alzheimer associations are better able to meet the
needs of people with dementia and their carers, and to be the global voice on
dementia.
Global Observatory for Ageing and Dementia Care
The Global Observatory for Ageing and Dementia Care, hosted at the Health
Service and Population Research Department, King’s College London, was
founded in 2013. Supported by Alzheimer’s Disease International and King’s
College London, the Observatory aims to synthesise global evidence for
policymakers and the public through high impact evidence-based reports for
Alzheimer’s Disease International (World Alzheimer Reports 2009, 2010, 2011 and
2013), the World Health Organization (Dementia; a public health priority) and other
relevant intergovernmental organisations. A particular focus is to identify and
promote effective innovations in health and social care policy and practice.
Alzheimer’s Disease International:
The International Federation
of Alzheimer’s Disease and
Related Disorders Societies, Inc.
is incorporated in Illinois, USA,
and is a 501(c)(3) not-for-profit
organization
Alzheimer’s Disease International
64 Great Suffolk Street
London SE1 0BL
UK
Tel: +44 20 79810880
Fax: +44 20 79282357
www.alz.co.uk