It is well documented that earnings inequalities have risen in many high-income countries. Less clear are the linkages between rising income inequality and workplace dynamics, how within- and between-workplace inequality varies across countries, and to what extent these inequalities are moderated by national labor market institutions. In order to describe changes in the initial between- and within-firm market income distribution we analyze administrative records for 2,000,000,000+ job years nested within 50,000,000+ workplace years for 14 high-income countries in North America, Scandinavia, Continental and Eastern Europe, the Middle East, and East Asia. We find that countries vary a great deal in their levels and trends in earnings inequality but that the between-workplace share of wage inequality is growing in almost all countries examined and is in no country declining. We also find that earnings inequalities and the share of between-workplace inequalities are lower and grew less strongly in countries with stronger institutional employment protections and rose faster when these labor market protections weakened. Our findings suggest that firm-level restructuring and increasing wage inequalities between workplaces are more central contributors to rising income inequality than previously recognized.

• Klíčová slova
• administrative data, earnings, inequality, institutions, workplaces,
• MeSH
• lidé MeSH
• mzdy a přídavky trendy   MeSH
• pracoviště psychologie   MeSH
• příjem trendy   MeSH
• socioekonomické faktory * MeSH
• vyspělé země ekonomika   MeSH
• zaměstnání ekonomika   MeSH
• zaměstnanost ekonomika   trendy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH
• Geografické názvy
• Dálný východ MeSH
• Evropa MeSH
• Severní Amerika MeSH
• Skandinávie a severské státy MeSH
• Střední východ MeSH

IMPORTANCE: Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD. OBJECTIVE: To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years. EXPOSURES: Countries' per capita income levels and world region; individuals' socioeconomic demographics. MAIN OUTCOMES AND MEASURES: Self-reported use of aspirin for secondary prevention of CVD. RESULTS: The overall pooled sample included 124 505 individuals. The median age was 52 (IQR, 45-59) years, and 50.5% (95% CI, 49.9%-51.1%) were women. A total of 10 589 individuals had a self-reported history of CVD (8.1% [95% CI, 7.6%-8.6%]). Among individuals with a history of CVD, aspirin use for secondary prevention in the overall pooled sample was 40.3% (95% CI, 37.6%-43.0%). By income group, estimates were 16.6% (95% CI, 12.4%-21.9%) in low-income countries, 24.5% (95% CI, 20.8%-28.6%) in lower-middle-income countries, 51.1% (95% CI, 48.2%-54.0%) in upper-middle-income countries, and 65.0% (95% CI, 59.1%-70.4%) in high-income countries. CONCLUSION AND RELEVANCE: Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.

• MeSH
• Aspirin * terapeutické užití   MeSH
• dospělí MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• kardiovaskulární nemoci * epidemiologie   mortalita   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• rozvojové země ekonomika   statistika a číselné údaje   MeSH
• sekundární prevence * ekonomika   metody   statistika a číselné údaje   MeSH
• senioři MeSH
• vyspělé země ekonomika   statistika a číselné údaje   MeSH
• zpráva o sobě ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• Aspirin * MeSH
• kardiovaskulární látky MeSH

BACKGROUND: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. METHOD: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). RESULTS: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC. CONCLUSION: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer.

• Klíčová slova
• Anastomotic leak, Esophagectomy, Global surgery, Postoperative mortality,
• MeSH
• anastomóza chirurgická škodlivé účinky   metody   MeSH
• dospělí MeSH
• ezofagektomie škodlivé účinky   mortalita   MeSH
• ezofágus patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory jícnu chirurgie   MeSH
• nekróza etiologie   MeSH
• netěsnost anastomózy epidemiologie   etiologie   MeSH
• pooperační období MeSH
• prospektivní studie MeSH
• rozvojové země statistika a číselné údaje   MeSH
• senioři MeSH
• vyspělé země statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: Medical residents work long, continuous hours. Working in conditions of extreme fatigue has adverse effects on the quality and safety of care, and on residents' quality of life. Many countries have attempted to regulate residents' work hours. OBJECTIVES: We aimed to review residents' work hours regulations in different countries with an emphasis on night shifts. METHODS: Standardized qualitative data on residents' working hours were collected with the assistance of experts from 14 high-income countries through a questionnaire. An international comparative analysis was performed. RESULTS: All countries reviewed limit the weekly working hours; North-American countries limit to 60-80 h, European countries limit to 48 h. In most countries, residents work 24 or 26 consecutive hours, but the number of long overnight shifts varies, ranging from two to ten. Many European countries face difficulties in complying with the weekly hour limit and allow opt-out contracts to exceed it. CONCLUSIONS: In the countries analyzed, residents still work long hours. Attempts to limit the shift length or the weekly working hours resulted in modest improvements in residents' quality of life with mixed effects on quality of care and residents' education.

• Klíčová slova
• ACGME, Cross-country analysis, EWTD, Medical residents, Nightshifts, Work hours,
• MeSH
• kurzy a stáže v nemocnici * MeSH
• kvalita života MeSH
• lidé MeSH
• personální obsazení a rozvrh * MeSH
• pracovní zátěž MeSH
• vyspělé země MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level.

• Klíčová slova
• Epidemiology, Hypertension, Lifestyle changes, Pharmacotherapy,
• MeSH
• antihypertenziva terapeutické užití   MeSH
• chudoba * MeSH
• dospělí MeSH
• hypertenze farmakoterapie   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• průřezové studie MeSH
• senioři MeSH
• socioekonomické faktory * MeSH
• srovnání kultur * MeSH
• výsledek terapie MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• zdravý životní styl MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• srovnávací studie MeSH
• Názvy látek
• antihypertenziva MeSH

OBJECTIVE: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons. DESIGN: Population-based study. SETTING: Twenty-seven European countries, the United States, Canada and Japan in 2010. POPULATION: A total of 9 376 252 singleton births. METHOD: We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22-23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings. MAIN OUTCOME MEASURES: Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source. RESULTS: Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22-23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22-23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged. CONCLUSIONS: International comparisons of very preterm birth rates using routine data should exclude births at 22-23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries. TWEETABLE ABSTRACT: International comparisons of VPT rates should exclude births at 22-23 weeks of gestation and terminations of pregnancy.

• Klíčová slova
• Euro-Peristat, international comparisons, preterm birth, stillbirths, very preterm,
• MeSH
• gestační stáří MeSH
• lidé MeSH
• novorozenec MeSH
• porodnost * MeSH
• předčasný porod epidemiologie   MeSH
• těhotenství MeSH
• výsledek těhotenství epidemiologie   MeSH
• vyspělé země MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Japonsko epidemiologie   MeSH
• Kanada epidemiologie   MeSH
• Spojené státy americké epidemiologie   MeSH

BACKGROUND: Unsafe management of human faecal waste represents a major risk for public health, particularly in low- and middle-income countries. Efforts to improve sanitation conditions are considerably sensitive to contextual specifics of natural and social environments. This review operationalises, analyses, and synthesises evidence of how contextual factors and motivations affect different sanitation outcomes with a specific focus on community approaches to rural sanitation. METHODS AND FINDINGS: We operationalised contextual factors and motivations as determinants that influence sanitation conditions independently of the examined intervention. We conducted a systematic search of both peer-reviewed and grey literature with no restriction on the methods After screening the titles and abstracts of 19,198 records obtained through initial searches, we scrutinised the full content of 621 studies for relevance. While 102 of these studies qualified to be assessed for risk of bias and information content, ultimately, just 40 studies met our eligibility criteria. Of these 40 studies from 16 countries, 26 analysed specific interventions and 14 were non-interventional. None of the experimental studies reported the effects of contextual factors or motivations as operationalised in this study and only observational evidence was thus used in our review. We found that sanitation interventions are typically seen as the principal vehicles of change, the main instruments to fix 'deviant' behaviour or ensure access to infrastructure. The programmatic focus of this study on sanitation determinants that act independently of specific interventions questions this narrow understanding of sanitation dynamics. We identified 613 unique observations of quantitatively or qualitatively established relationships between certain contextual factors or motivations and 12 different types of sanitation outcomes. The sanitation determinants were classified into 77 typologically similar groups clustered into 12 broader types and descriptively characterised. We developed a graphical synthesis of evidence in the form of a network model referred to as the sanitation nexus. The sanitation nexus depicts how different groups of determinants interlink different sanitation outcomes. It provides an empirically derived conceptual model of sanitation with an aggregate structure indicating similarities and dissimilarities between sanitation outcomes with respect to how their sets of underlying determinants overlap. CONCLUSION: This study challenged the understanding of context as merely something that should be controlled for. Factors that affect targeted outcomes independently of the analysed interventions should be scrutinised and reported. This particularly applies to interventions involving complex human-environment interactions where generalisability is necessarily indirect. We presented a novel approach to comprehending the contextual factors and motivations which influence sanitation outcomes. Our approach can be analogously applied when mapping and organising underlying drivers in other areas of public and environmental health. The sanitation nexus derived in this study is designed to inform practitioners and researchers about sanitation determinants and the outcomes they influence.

• Klíčová slova
• Community sanitation, Context, Intervention, Motivations, Rural sanitation, Systematic review,
• MeSH
• lidé MeSH
• motivace MeSH
• nakládání s odpady etika   metody   normy   MeSH
• rozvojové země MeSH
• sanitace normy   MeSH
• socioekonomické faktory MeSH
• venkovské obyvatelstvo MeSH
• veřejné zdravotnictví ekonomika   normy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• systematický přehled MeSH

The purpose of this study is to explore the main correlates of male height in 105 countries in Europe & overseas, Asia, North Africa and Oceania. Actual data on male height are compared with the average consumption of 28 protein sources (FAOSTAT, 1993-2009) and seven socioeconomic indicators (according to the World Bank, the CIA World Factbook and the United Nations). This comparison identified three fundamental types of diets based on rice, wheat and milk, respectively. The consumption of rice dominates in tropical Asia, where it is accompanied by very low total protein and energy intake, and one of the shortest statures in the world (∼162-168cm). Wheat prevails in Muslim countries in North Africa and the Near East, which is where we also observe the highest plant protein consumption in the world and moderately tall statures that do not exceed 174cm. In taller nations, the intake of protein and energy no longer fundamentally rises, but the consumption of plant proteins markedly decreases at the expense of animal proteins, especially those from dairy. Their highest consumption rates can be found in Northern and Central Europe, with the global peak of male height in the Netherlands (184cm). In general, when only the complete data from 72 countries were considered, the consumption of protein from the five most correlated foods (r=0.85) and the human development index (r=0.84) are most strongly associated with tall statures. A notable finding is the low consumption of the most correlated proteins in Muslim oil superpowers and highly developed countries of East Asia, which could explain their lagging behind Europe in terms of physical stature.

• Klíčová slova
• Asia, Europe, Genetics, Male height, Nutrition,
• MeSH
• antropometrie MeSH
• celosvětové zdraví * MeSH
• dětská úmrtnost trendy   MeSH
• dieta statistika a číselné údaje   MeSH
• dietní proteiny * MeSH
• dospělí MeSH
• haplotypy MeSH
• hrubý domácí produkt statistika a číselné údaje   MeSH
• kojenec MeSH
• lidé MeSH
• městské obyvatelstvo statistika a číselné údaje   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mléko MeSH
• novorozenec MeSH
• porodnost MeSH
• předškolní dítě MeSH
• pšenice MeSH
• rozvojové země statistika a číselné údaje   MeSH
• rýže (rod) MeSH
• socioekonomické faktory MeSH
• tělesná výška * MeSH
• výdaje na zdravotnictví statistika a číselné údaje   MeSH
• vyspělé země statistika a číselné údaje   MeSH
• zvířata MeSH
• Check Tag
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dietní proteiny * MeSH

BACKGROUND: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. METHODS: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. RESULTS: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. CONCLUSIONS: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

• Klíčová slova
• Stroke services, acute care, high-income countries, low- and middle-income countries, prevention, rehabilitation, stroke quadrangle,
• MeSH
• celosvětové zdraví MeSH
• cévní mozková příhoda * epidemiologie   terapie   MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• rehabilitace po cévní mozkové příhodě * MeSH
• rozvojové země MeSH
• Světová zdravotnická organizace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

AIMS: The aims of this study were to establish cardiac rehabilitation availability and density, as well as the nature of programmes, and to compare these by European region (geoscheme) and with other high-income countries. METHODS: A survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using global burden of disease study ischaemic heart disease incidence estimates. Four high-income countries were selected for comparison (N = 790 programmes) to European data, and multilevel analyses were performed. RESULTS: Cardiac rehabilitation was available in 40/44 (90.9%) European countries. Data were collected in 37 (94.8% country response rate). A total of 455/1538 (29.6% response rate) programme respondents initiated the survey. Programme volumes (median 300) were greatest in western European countries, but overall were higher than in other high-income countries (P < 0.001). Across all Europe, there was on average only 1 CR spot per 7 IHD patients, with an unmet regional need of 3,449,460 spots annually. Most programmes were funded by social security (n = 25, 59.5%; with significant regional variation, P < 0.001), but in 72 (16.0%) patients paid some or all of the programme costs (or ∼18.5% of the ∼€150.0/programme) out of pocket. Guideline-indicated conditions were accepted in 70% or more of programmes (lower for stable coronary disease), with no regional variation. Programmes had a multidisciplinary team of 6.5 ± 3.0 staff (number and type varied regionally; and European programmes had more staff than other high-income countries), offering 8.5 ± 1.5/10 core components (consistent with other high-income countries) over 24.8 ± 26.0 hours (regional differences, P < 0.05). CONCLUSION: European cardiac rehabilitation capacity must be augmented. Where available, services were consistent with guidelines, but varied regionally.

• Klíčová slova
• Cardiac rehabilitation, Europe, survey,
• MeSH
• disparity zdravotní péče ekonomika   MeSH
• dostupnost zdravotnických služeb ekonomika   MeSH
• integrované poskytování zdravotní péče ekonomika   MeSH
• kardiovaskulární rehabilitace ekonomika   MeSH
• lidé MeSH
• náklady na zdravotní péči * MeSH
• nemoci srdce diagnóza   ekonomika   epidemiologie   rehabilitace   MeSH
• příjem * MeSH
• průřezové studie MeSH
• průzkumy zdravotní péče MeSH
• sociální zabezpečení ekonomika   MeSH
• výdaje na zdravotnictví MeSH
• výsledek terapie MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) ekonomika   MeSH
• zdravotnické služby - potřeby a požadavky ekonomika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH