8 research outputs found
Corria, Filiberto -- 1977-92 -- Correspondence, Individual -- letter, 1977-12-18
No full textLetter from Gener, Luis Barcelo to Sabin, Albert B. dated 1977-12-18.Sabin Collection Fair Use Policy</a
Export promoting subsidies and what to do about them
No full textThis paper addresses the questions of what is a subsidy, which subsidies affect international trade, and why countries may wish to subsidize, particularly exporting industries. It considers the effects of these subsidies on other countries and why trading partners may wish to outlaw or countervail such export promoting subsidies. The paper then outlines the provisions of the GATT and the Subsidies Code as they relate to subsidies; this is followed by some data on the extent to which these provisions have been used, and by a consideration of the purposes for which they appear, in fact, to have been used. The question is then raised as to whether or not the proscribing/countervailing approach is in fact the best way to constrain subsidies and whether, if such control is desired, other approaches may be preferable and feasible.Environmental Economics&Policies,Economic Theory&Research,TF054105-DONOR FUNDED OPERATION ADMINISTRATION FEE INCOME AND EXPENSE ACCOUNT,Tax Law,Banks&Banking Reform
The myth of minority : cultural change in Valencia in the thirteenth century at the time of the conquests of James I of Aragon
No full textThe history of the Iberian Peninsula is intricate and complex. Like most regions of
Western Europe in the Middle Ages, it suffered invasion, occupation, political change and an almost constant re–alignment of social alliances. Yet the thirteenth century saw one of the most massive shifts in the balance of power recorded in western history. In the space of fifty years, Islamic rule within the peninsula was ended for good, with the last vestiges of Muslim territory erased from the southern peninsula by the fifteenth century. Christian ascendancy heralded the arrival of a mixed policy of tolerance, as questions began to be asked about the nature of living together with other cultures and religions and whether this new rule – this new Christian rule – needed to tolerate the existence of others in its midst.
The most dramatic shift in policy occurred in the middle of the thirteenth century, as the campaigns of the two great northern kingdoms of Leon–Castile and Aragon–Catalonia moved southwards. The most dramatic outcome – due to the size of the Muslim population – was the relatively swift conquest of, in the case of Ferdinand III, the main towns of Andalucia and, in the case of James I, king of Aragon, the region of Valencia by 1245. Yet it is important when examining the campaigns of these great warrior kings not
to be overwhelmed by the idea of the religious ethos for the conquest. Some historians have chosen to interpret the thirteenth–century conquests as the Christian reaction for the centuries of subjugation under Muslim rule. The reasoning behind the conquests was far more complex than that of a mere idealistic crusade. In the case of thirteenth–century Christian expansion, desire for territory, sovereignty, inheritance, taxation and inter-territorial rivalry had just as much of a part to play as a desire to overcome the Muslim ‘infidel.’ It is the conquest of Valencia which will form the major focal point of this paper, examining the historical precedent for conquest, the nature of Muslim rule, the ulterior motives of the Christians, the
position of Muslims and Jews in existing Christian society (as well as under the
conquerors) and the role of James I in both consolidating and changing that culture.
The programme of this thesis is divided into two main parts. In the first part, the paper will explore the impact of historical events up to the birth of James; how these events both shaped him as a king and as a warrior; and how domestic concerns may have provided a greater incentive than religious missionaries spreading Crusading fever amongst Western kingdoms. It will review the impact of those close to the king; on the nature of his conquest; on his ideology; and how his attitude towards his conquered subjects was shaped. External political and geographical pressures impacted both upon the king’s campaigning and, ultimately, how complete the conquest was.
In the second part, the thesis will focus on the communities themselves and the changes that occurred as the conquests progressed further and further southwards. It will
contrast the circumstances and fortunes of those conquered with the lives of minority
cultures who were already subjects in the Christian realms. It will examine the idea of
hierarchy within minority culture and the social mores that had an even more direct
impact upon community life than the military campaigning. Most important of all, it will
question the idea of convivencia and the concept of tolerance and ‘living together.
Medical Nutrition Therapy and Physical Exercise for Acute and Chronic Hyperglycemic Patients with Sarcopenia
No full textHyperglycemia; Nutritional formulae; Physical exerciseHiperglucemia; Fórmulas nutricionales; Ejercicio físicoHiperglucèmia; Fórmules nutricionals; Exercici físicA wide range of factors contribute to the overlap of hyperglycemia—acute or chronic—and sarcopenia, as well as their associated adverse consequences, which can lead to impaired physical function, reduced quality of life, and increased mortality risk. These factors include malnutrition (both overnutrition and undernutrition) and low levels of physical activity. Hyperglycemia and sarcopenia are interconnected through a vicious cycle of events that mutually reinforce and worsen each other. To explore this association, our review compiles evidence on: (i) the impact of hyperglycemia on motor and muscle function, with a focus on the mechanisms underlying biochemical changes in the muscles of individuals with or at risk of diabetes and sarcopenia; (ii) the importance of the clinical assessment and control of sarcopenia under hyperglycemic conditions; and (iii) the potential benefits of medical nutrition therapy and increased physical activity as muscle-targeted treatments for this population. Based on the reviewed evidence, we conclude that a regular intake of key functional nutrients, together with structured and supervised resistance and/or aerobic physical activity, can help maintain euglycemia and improve muscle status in all patients with hyperglycemia and sarcopenia.Medical writing services were sponsored by Fresenius Kabi. Nevertheless, Fresenius Kabi was not involved in the literature review or the selection of content for the publication, which was carried out exclusively at the discretion of the author
Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys
No full textBackground Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure >= 140 mm Hg or diastolic blood pressure >= 90 mm Hg), and diabetes (fasting plasma glucose >= 7.0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3.9% (95% CI 2.2-6.3) in 1980, to 18.6% (14.3-23.3) in 2014, in men; and from 12.2% (8.2-17.0) in 1980, to 30.5% (25.7-35.5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5.2% (2.1-10.4) in men and 6.4% (2.6-10.4) in women in 1980, to 11.1% (6.4-17.3) in men and 13.6% (8.2-21-0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27.6% (22.3-33.2) in men and 19.9% (15.8-24-4) in women in 1980, to 15.5% (11.1-20.9) in men and 10.7% (7.7-14.5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countries. Copyright (C) 2019 The Author(s). Published by Elsevier.Wellcome TrustAlliance for Health Policy and Systems ResearchBernard Lown Scholars in Cardiovascular Health Program at Harvard T H Chan School of Public HealthBloomberg PhilanthropiesFONDECYT via CIENCIACTIVA/CONCYTECBritish CouncilBritish EmbassyNewton-Paulet FundDFID/MRC/Wellcome Global Health TrialsFogarty International CenterGrand Challenges CanadaInternational Development Research Center CanadaInter-American Institute for Global Change ResearchMedical Research CouncilNational Cancer InstituteNational Heart, Lung, and Blood InstituteNational Institute of Mental HealthSwiss National Science FoundationWellcomeWorld Diabetes FoundationAcademy of Medical Sciences Springboard AwardRoyal SocietyUniv Peruana Cayetano Heredia, Lima, PeruImperial Coll London, London, EnglandPontificia Univ Catolica Chile, Santiago, ChileUniv West Indies, Cave Hill, BarbadosUniv Sao Paulo, Sao Paulo, SP, BrazilMiami Vet Affairs Healthcare Syst, Miami, FL USAUniv Kent, Canterbury, Kent, EnglandCleveland Clin, Cleveland, OH 44106 USAYale Univ, New Haven, CT 06520 USACaja Costarricense Seguro Social, San Jose, Costa RicaInst Mexicano Seguro Social, Mexico City, DF, MexicoInst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, MexicoUniv Cuenca, Cuenca, EcuadorUniv Fed Pelotas, Pelotas, BrazilPan Amer Hlth Org, Washington, DC USAUniv Pernambuco, Recife, PE, BrazilDalhousie Univ, Halifax, NS, CanadaUniv Fed Maranhao, Sao Luis, Maranhao, BrazilCAFAM Univ Fdn, Bogota, ColombiaUniv Republica, Montevideo, UruguayCtr Educ Med & Invest Clin, Buenos Aires, DF, ArgentinaUniv Amsterdam, Amsterdam, NetherlandsCanadian Fitness & Lifestyle Res Inst, Ottawa, ON, CanadaUniv Fed Juiz de Fora, Juiz De Fora, BrazilUniv Estadual Paulista, Sao Paulo, SP, BrazilUniv Fed Santa Catarina, Florianopolis, SC, BrazilUniv Montreal, Montreal, PQ, CanadaUniv Vale Rio dos Sinos, Sao Leopoldo, BrazilNatl Council Sci & Tech Res, Buenos Aires, DF, ArgentinaUniv West Indies, Kingston, JamaicaMinist Hlth, Buenos Aires, DF, ArgentinaInst Nacl Salud Publ, Mexico City, DF, MexicoUniv Fed Sao Paulo, Sao Paulo, SP, BrazilHosp Clin Porto Alegre, Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilMcGill Univ, Montreal, PQ, CanadaAndes Clin Cardiometab Studies, Timotes, VenezuelaNatl Inst Hyg Epidemiol & Microbiol, Havana, CubaUniv ICESI, Cali, ColombiaUniv Estadual Montes Claros, Montes Claros, MG, BrazilKings Coll London, London, EnglandInst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, ArgentinaNatl Inst Publ Hlth, Mexico City, DF, MexicoUniv Autonoma Bucaramanga, Bucaramanga, ColombiaKingston Gen Hosp, Kingston, ON, CanadaHeart Inst, Sao Paulo, SP, BrazilFdn Oftalmol Santander, Bucaramanga, ColombiaSimon Fraser Univ, Burnaby, BC V5A 1S6, CanadaInst Trop Med, Antwerp, BelgiumMinist Salud Publ, Havana, CubaHarvard TH Chan Sch Publ Hlth, Boston, MA USAWest Virginia Univ, Morgantown, WV 26506 USAFundacao Oswaldo Cruz, Rene Rachou Res Inst, Rio De Janeiro, BrazilUniv Fed Ouro Preto, Ouro Preto, BrazilHosp Israelita Albert Einstein, Sao Paulo, SP, BrazilEmory Univ, Atlanta, GA 30322 USAGorgas Mem Inst Hlth Studies, Panama City, PanamaSTAT Canada, Ottawa, ON, CanadaUniv Med Sci, Havana, CubaGorgas Mem Inst Publ Hlth, Panama City, PanamaUniv Puerto Rico, Med Sci Campus, San Juan, PR 00936 USAUniv Wisconsin, Madison, WI 53706 USAMinas Gerais State Secretariat Hlth, Belo Horizonte, MG, BrazilUniv Nove de Julho, Sao Paulo, SP, BrazilPubl Hlth Agcy Canada, Ottawa, ON, CanadaUniv Ind Santander, Bucaramanga, ColombiaNatl Inst Hlth, Lima, PeruUniv Sao Paulo, Clin Hosp, Sao Paulo, SP, BrazilHosp Italiano Buenos Aires, Buenos Aires, DF, ArgentinaUniv Ctr Occidental Lisandro Alvarado, Barranquilla, ColombiaEpidemiol & Microbiol Inst, Havana, CubaUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilWHO, Geneva, SwitzerlandMiddlesex Univ, London, EnglandUniv Estadual Paulista, Sao Paulo, SP, BrazilAlliance for Health Policy and Systems Research: HQHSR1206660Bernard Lown Scholars in Cardiovascular Health Program at Harvard T H Chan School of Public Health: BLSCHP-1902Newton-Paulet Fund: 223-2018Newton-Paulet Fund: 224-2018DFID/MRC/Wellcome Global Health Trials: MR/M007405/1Fogarty International Center: R21TW009982Fogarty International Center: D71TW010877Grand Challenges Canada: 0335-04International Development Research Center Canada: IDRC 106887International Development Research Center Canada: 108167Inter-American Institute for Global Change Research: IAI CRN3036Medical Research Council: MR/P008984/1Medical Research Council: MR/P024408/1Medical Research Council: MR/P02386X/1National Cancer Institute: 1P20CA217231National Heart, Lung, and Blood Institute: HHSN268200900033CNational Heart, Lung, and Blood Institute: 5U01HL114180National Heart, Lung, and Blood Institute: 1UM1HL134590National Institute of Mental Health: 1U19MH098780Swiss National Science Foundation: 40P740-160366Wellcome: 074833/Z/04/ZWellcome: 093541/Z/10/ZWellcome: 107435/Z/15/ZWellcome: 103994/Z/14/ZWellcome: 205177/Z/16/ZWellcome: 214185/Z/18/ZWorld Diabetes Foundation: WDF15-122
Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants
No full textAbstractBackground: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher.Methods: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure.Findings: We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7–128.3) in men and 122.3 mm Hg (121.0–123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9–79.5) for men and 76.7 mm Hg (75.9–77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4–27.1) in men and 20.1% (17.8–22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence.Interpretation: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.Abstract
Background: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher.
Methods: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure.
Findings: We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7–128.3) in men and 122.3 mm Hg (121.0–123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9–79.5) for men and 76.7 mm Hg (75.9–77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4–27.1) in men and 20.1% (17.8–22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence.
Interpretation: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants
No full textZhou B, Carrillo-Larco RM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. LANCET. 2021;398(10304):957-980.Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier
Repositioning of the global epicentre of non-optimal cholesterol
No full textHigh blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world
