https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(08)61690-6.pdf

Closing the gap in a generation: health equity through action on the social determinants of health

세계화가 과연 하나의 독립변수로 사용하기에 충분할 정도로 그 의미가 명확하게 규명된 과학적 개념인가의 여부는 학계의 지속적인 의문으로 남아 있다. 특히 최근에는 현저하게 드러나고 있는 각종 반세계화 현상을 바탕으로 세계화에 대한 반론이 거세지고 있으며 일부 세계화론 주창자들조차 ‘현실’로서 세계화 현상에 대한 회의적 시각을 표출하고 있어 그 의문은 더욱 커지고 있다. 이에 따라 세계화를 설명 변수로 삼는 모든 연구 영역에서 세계화의 의미와 세계화와 관련된 연구 성과를 반추해 볼 필요성도 커지고 있다. 본 연구의 목적은 세계화의 의미 분석을 바탕으로 세계화를 안보환경 변화의 독립변수로 삼는 연구의 동향을 분석하고 연구의 방향을 제시하는데 있다. 세계화는 그 설명적 가치와 규범적 판단을 둘러싸고 논란이 계속되고 있는 개념이다. 세계화는 세계화론자를 중심으로 발전되어 온 개념이지만 이들 사이에서도 개념에 대한 합의는 존재하지 않는다. 세계화는 가장 단순하게는 하나의 현상 혹은 사건으로 간주되기도 하지만, 세계화의 본질을 규명하려는 입장에서는 세계화의 원인과 영향에 대한 인과관계는 물론 사회관계 본질이나 권력관계 변화를 적시하는 개념으로 취급하여 왔다. 그러나 세계화를 개념화하려는 노력은 수많은 하부 현상을 단일 요소로 설명해야 하며, 역으로 개념 속에 혼재되어 있는 세계화의 원인, 결과, 설명 및 규범적 판단 요소를 단순화해야 한다는 과제를 안고 있다. 특히 원인과 결과가 혼재되어 있는 세계화 개념은 현상 분석을 위한 설명체제 구성에 가장 큰 장애요인이 되고 있다. 세계화와 안보와의 관계를 다루는 연구는 대체로 세계화에 관한 중도론적 입장에서 안보에 관한 낙관론을 피하고 새로운 위협을 제시하는데 초점을 맞추는데, 이러한 경향은 안보연구에서 세계화를 가장 단순한 수준에서 정의하는 데에서 비롯된다. 그러나 지나치게 단순한 세계화 개념을 적용하는 안보연구는 질적으로 새로운 현상인 세계화를 여전히 국가중심적 시각에서 다루고 모든 안보위협을 테러리즘의 문제로 축소하려는 환원주의의 문제를 야기한다. 이러한 문제를 극복하기 위해서는 세계화 개념의 불완전성을 염두에 둔 세계화 개념에 대한 접근과 일관된 세계화 개념 적용이 요구된다. 또한 세계화 현상으로부터 직접적인 안보 사안을 도출하는 노력에서 한 차원 더 나아가 안보연구의 새로운 방향을 제시해 줄 수 있는 안보환경 변화의 전체적 특성을 분석하는 포괄적 연구가 요구된다.

세계화(globalization)와 안보 연구

Ricardo Lagos Escobar is the former President of Chile, and former Education Minister and Minister of Public Works. An economist and lawyer by qualification, he also worked as an economist for the United Nations. Alireza Marandi is Professor of Pediatrics at Shaheed Beheshti University, Islamic Republic of Iran. He is former two-term Minister of Health (and Medical Education). In addition, he served as Deputy Minister and Advisor to the Minister. He was recently elected to be a member of the Iranian Parliament.

http://epi2008.tempsite.ws/apresentacoes/CONFERENCIA%2023_09_11h45_pdf/Michael%20Marmot.pdf

Closing the gap in a generation

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62189-3.pdf

The state of health in the Arab world, 1990–2010: an analysis of the burden of diseases, injuries, and risk factors

A renaissance in herbal medicine identification: From morphology to DNA

Objective To explore healthcare provider’s perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases. Design and setting We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique. Participants Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers. Results A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was ‘challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was ‘enablers supporting healthcare providers to deal with the COVID-19 pandemic’. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was ‘recommendations to support the healthcare workforce during the COVID-19 crisis’. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers. Conclusion This study provides an initial evidence base of healthcare providers’ experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.

/pdf/perceptions-and-experiences-of-healthcare-providers-during-3p86a4705o.pdf

Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study.

Social Determinants of Health in Countries in Conflict and Crises: The Eastern Mediterranean Perspective

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

/pdf/tuberculosis-and-non-communicable-disease-multimorbidity-an-3nrgpedqm7.pdf

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries.

Zulfiqar A Bhutta and colleagues compare the response in South Asian countries and consider what is needed to contain covid-19 and manage future pandemics

https://www.bmj.com/content/bmj/373/bmj.n1544.full.pdf

Beyond the numbers: understanding the diversity of covid-19 epidemiology and response in South Asia.

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Health research is crucial to managing disease burden. Previous work has highlighted marked discrepancies in research output and disease burden between high-income countries (HICs) and low- and lower-middle-income countries (LI-LMICs) and there is little data to understand whether this gap has bridged in recent years. We conducted a global, country level bibliometric analysis of CVD publications with respect to trends in disease burden and county development indicators. Methods: A search filter with a precision and recall of 0.92 and 0.91 respectively was developed to extract cardiovascular publications from the Web of Science (WOS) for the years 2008–2017. Data for disease burden and country development indicators were extracted from the Global Burden of Disease and the World Bank database respectively. Results: Our search revealed 847,708 CVD publications for the period 2008–17, with a 43.4% increase over the decade. HICs contributed 81.1% of the global CVD research output and accounted for 8.1% and 8.5% of global CVD DALY losses deaths respectively. LI-LMICs contributed 2.8% of the total output and accounted for 59.5% and 57.1% global CVD DALY losses and death rates. Conclusions: A glaring disparity in research output and disease burden persists. While LI-LMICs contribute to the majority of DALYs and mortality from CVD globally, their contribution to research output remains the lowest. These data call on national health budgets and international funding support to allocate funds to strengthen research capacity and translational research to impact CVD burden in LI-LMICs.

https://globalheartjournal.com/articles/10.5334/gh.815/galley/928/download/

Disparities in Cardiovascular Research Output and Disease Outcomes among High-, Middle- and Low-Income Countries - An Analysis of Global Cardiovascular Publications over the Last Decade (2008-2017).

Sameen Siddiqi

Papers

Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study.

Social Determinants of Health in Countries in Conflict and Crises: The Eastern Mediterranean Perspective

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries.

Beyond the numbers: understanding the diversity of covid-19 epidemiology and response in South Asia.

Disparities in Cardiovascular Research Output and Disease Outcomes among High-, Middle- and Low-Income Countries - An Analysis of Global Cardiovascular Publications over the Last Decade (2008-2017).