Publications
182 results found
Affinito G, Palladino R, Carotenuto A, et al., 2022, Multiple sclerosis in the campania region (South Italy) 2015-2020: incidence algorithm validation, 38th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis, Publisher: SAGE PUBLICATIONS LTD, Pages: 939-939, ISSN: 1352-4585
Palladino R, Marrie RA, Chataway J, 2022, The interface of frailty, depression, vascular disease, and mortality in over 12,000 people with Multiple Sclerosis in England: a population-based retrospective cohort study, 38th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis, Publisher: SAGE PUBLICATIONS LTD, Pages: 994-995, ISSN: 1352-4585
Valdecantos RL, Palladino R, Lo Vecchio A, et al., 2022, Organisational and Structural Drivers of Childhood Immunisation in the European Region: A Systematic Review, VACCINES, Vol: 10
Dallera G, Palladino R, Filippidis FT, 2022, Corruption in health care systems: trends in informal payments across twenty eight EU countries, 2013-2019, Health Affairs, Vol: 41, Pages: 1342-1352, ISSN: 0278-2715
Corruption is a major challenge in health care systems across the European Union (EU), where it manifests most visibly as informal payments from patients to providers. A higher prevalence of informal payments has been associated with lower public health care expenditure. EU member states have experienced significant changes in public health care expenditure throughout the 2000s. Given the lack of research on the topic, we explored trends in informal payments using representative data from twenty-eight EU member states during the period 2013-19 and in relation to changes in public health care expenditure. Overall, we found that informal payments increased in 2019 compared with 2013, whereas the perception of corruption decreased. Although higher public health care expenditure was associated with less corruption, we found a smaller effect size between informal payments and this expenditure throughout the study period. Our results suggest that informal payments may be driven by other factors, although the directionality of this relationship requires further investigation. Moreover, additional public health care investments may be insufficient to confront corruption unless coupled with measures to limit wasteful spending and increase transparency. Policy makers should understand that factors external to health systems, including media coverage and cultural and political factors, should be explored to explain country-level differences in corruption.
Palladino R, Mercogliano M, Fiorilla C, et al., 2022, Association between COVID-19 and Sick Leave for Healthcare Workers in a Large Academic Hospital in Southern Italy: An Observational Study, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 19
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- Citations: 3
Bryazka D, Reitsma MB, Griswold MG, et al., 2022, Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020, The Lancet, Vol: 400, Pages: 185-235, ISSN: 0140-6736
BackgroundThe health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.MethodsFor this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol.FindingsThe burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male.InterpretationThere is stron
Moccia M, Affinito G, Ronga B, et al., 2022, Emergency medical care for multiple sclerosis: A five-year population study in the Campania Region (South Italy), EUROPEAN JOURNAL OF NEUROLOGY, Vol: 29, Pages: 144-144, ISSN: 1351-5101
Armocida B, Monasta L, Sawyer S, et al., 2022, Burden of non-communicable diseases among adolescents aged 10–24 years in the EU, 1990–2019: a systematic analysis of the Global Burden of Diseases Study 2019, The Lancet Child & Adolescent Health, Vol: 6, Pages: 367-383, ISSN: 2352-4642
BackgroundDisability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU.MethodsEstimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10–14 years, 15–19 years, and 20–24 years), and by sex. Spearman's correlation was conducted between DALY rates for NCDs and the Socio-demographic Index (SDI) of each EU Member State.FindingsIn 2019, NCDs accounted for 86·4% (95% uncertainty interval 83·5–88·8) of all YLDs and 38·8% (37·4–39·8) of total deaths in adolescents aged 10–24 years. For NCDs in this age group, neoplasms were the leading causes of both mortality (4·01 [95% uncertainty interval 3·62–4·25] per 100 000 population) and YLLs (281·78 [254·25–298·92] per 100 000 population), whereas mental disorders were the leading cause for YLDs (2039·36 [1432·56–2773·47] per 100 000 population) and DALYs (2040·59 [1433·96–2774·62] per 100 000 population) in all EU Member States, and in all studied age groups. In 2019, among adolescents aged 10–24 years, males had a higher mortality rate per 100 000 population due to NCDs than females (11·66 [11·04–12·28] vs 7·89 [7·53–8·23]), whereas females presented a higher DALY rate per 100 000 population due to NCDs (8003·25 [5812·78–10&thi
Moccia M, Loperto I, Santoni L, et al., 2022, Healthcare resource utilization and costs for extended interval dosing of natalizumab in multiple sclerosis, Publisher: FUTURE MEDICINE LTD, Pages: 109-116, ISSN: 1758-2024
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- Citations: 3
Palladino R, More A, Greenfield G, et al., 2022, Evaluation of the North West London Diabetes Foot Care Transformation Project: a mixed-methods evaluation, International Journal of Integrated Care, Vol: 22, Pages: 1-9, ISSN: 1568-4156
Introduction: Diabetes foot ulceration (DFU) presents an enormous burden to those living with diabetes and to the local health systems and economies. There is an increasing interest in implementing integrated care models to enhance the quality of care for people living with diabetes and related complications and the value of co-production approaches to achieve sustainable change. This paper aims to describe the evaluation methodology for the North West London (NWL) Diabetes Foot Care Transformation project. Description: A mixed methods design including: i) a quasi-experimental quantitative analysis assessing the impact of the implementation of the local secondary care multi-disciplinary diabetes foot team clinics on service utilisation and clinical outcomes (amputations and number of healed patients); ii) a phenomenological, qualitative study to explore patient and staff experience; and iii) a within-trial cost-effectiveness analysis (pre and post 2017) to evaluate the programme cost-effectiveness.Discussion and Conclusion: Demonstrating the impact of multidisciplinary, integrated care models and the value of co-production approaches is important for health providers and commissioners trying to improve health outcome. Evaluation is also needed to identify strategies to overcome barriers which might have reduced the impact of the programme and key elements for improvement.
Abbadessa G, Miele G, Di Pietro A, et al., 2022, Multiple sclerosis and genetic polymorphisms in fibrinogen-mediated hemostatic pathways: a case-control study, NEUROLOGICAL SCIENCES, Vol: 43, Pages: 2601-2609, ISSN: 1590-1874
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- Citations: 5
Palladino R, Alfano R, Moccia M, et al., 2022, Association between institutional affiliations of academic editors and authors in medical journals, Journal of General Internal Medicine, Vol: 37, Pages: 2911-2913, ISSN: 0884-8734
Cousin E, Duncan BB, Stein C, et al., 2022, Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019, The Lancet Diabetes & Endocrinology, Vol: 10, Pages: 177-192, ISSN: 2213-8587
BackgroundDiabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.MethodsWe used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals.FindingsIn 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−
Lavorgna L, Iaffaldano P, Abbadessa G, et al., 2022, Disability assessment using Google Maps (vol 17, pg 1, 2021), NEUROLOGICAL SCIENCES, Vol: 43, Pages: 1481-1481, ISSN: 1590-1874
Lavorgna L, Iaffaldano P, Abbadessa G, et al., 2022, Disability assessment using Google Maps, NEUROLOGICAL SCIENCES, Vol: 43, Pages: 1007-1014, ISSN: 1590-1874
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- Citations: 7
Affinito G, Santoni L, Montella E, et al., 2022, NATALIZUMAB UTILIZATION IN TERMS OF DOSING INTERVAL AND COSTS: A 2015-2019 POPULATION-BASED STUDY, Publisher: ELSEVIER SCIENCE INC, Pages: S49-S49, ISSN: 1098-3015
Cirillo M, Cavallo P, Palladino R, et al., 2022, Relationship of the Intake of Water and Other Beverages With Renal Endpoints: Cross-Sectional and Longitudinal Data-Observational, Population-Based Study, JOURNAL OF RENAL NUTRITION, Vol: 32, Pages: 68-77, ISSN: 1051-2276
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- Citations: 3
Montuori P, Loperto I, Paolo C, et al., 2021, Bodybuilding, dietary supplements and hormones use: behaviour and determinant analysis in young bodybuilders, BMC Sports Science, Medicine and Rehabilitation, Vol: 13, Pages: 1-11, ISSN: 2052-1847
BackgroundAmong athletes, bodybuilders are more predisposed to the use of dietary supplements (DS) and hormones (H) to increase in adaptations to physical training and performance. The purpose of the study was to identify social, psychological, and organisational factors that are associated with the use of food supplements and hormones in young bodybuilders of the metropolitan area of Naples.Methods107 athletes, practicing bodybuilding, were consecutively recruited in 30 gyms, randomly selected in the metropolitan area of Naples. Athletes were administered an anonymous questionnaire. The questionnaire consists of 5 sections (socio-demographic, frequency and reasons for bodybuilding, knowledge, attitudes and behaviours). Descriptive statistics were performed using T-test and Chi-square statistics. A score was created for knowledge, attitudes, behaviours. Multivariable logistic regression models were employed to assess association between each score and the use of DS and H. Statistical analyses were carried out using STATA 15.Results81.31% of the subjects reported to use DS while 35.51% H. Females are less likely to practise bodybuilding frequently than males (OR 0.18 (95% CI 0.05–0.69), p = 0.01). Subjects who have attended high school or university have a lower probability of taking DS (OR 0.17 (95% CI 0.04–0.65), p = 0.01). H users also use supplements more frequently (OR 61.21 (95% CI 3.99–939.31), p < 0.001). Those who scored higher on knowledge scores are more likely to take DS (OR 1.53 (95% CI 1.11–2.12), p < 0.001). Attitudes are correlated with the use of DS; those who scored higher were less likely to use DS (OR 0.77 (95% CI 0.30–0.98), p = 0.03). People who use DS are 30 times more likely to use H at the same time (OR 30.25 (95% CI 2.51–365.24), p < 0.001). Subjects who have a higher score for knowledge and attitudes are less like
Ward JL, Azzopardi PS, Francis KL, et al., 2021, Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019, The Lancet, Vol: 398, Pages: 1593-1618, ISSN: 0140-6736
BackgroundDocumentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.MethodsWe report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017).FindingsIn 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or mater
Micah AE, Cogswell IE, Cunningham B, et al., 2021, Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050, The Lancet, Vol: 398, Pages: 1317-1343, ISSN: 0140-6736
BackgroundThe rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.MethodsWe estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050.FindingsIn 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geogra
Palladino R, Marrie RA, Majeed A, et al., 2021, Management of vascular risk in people with multiple sclerosis in England: a population-based matched cohort study, MS Conference, Publisher: SAGE PUBLICATIONS LTD, Pages: 219-219, ISSN: 1352-4585
Palladino R, Affinito G, Triassi M, 2021, The impact of COVID-19 on School of Medicine students' performance: an interrupted time series study, Publisher: OXFORD UNIV PRESS, ISSN: 1101-1262
Moccia M, Affinito G, Capacchione A, et al., 2021, Interferon beta for the treatment of multiple sclerosis in the Campania Region of Italy: merging the real-life to routinely collected healthcare data, 37th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 707-708, ISSN: 1352-4585
Moccia M, Affinito G, Santoni L, et al., 2021, Dimethyl fumarate and fingolimod utilization and costs for multiple sclerosis: a population-based study in the Campania Region of Italy, Publisher: SAGE PUBLICATIONS LTD, Pages: 663-663, ISSN: 1352-4585
Petracca M, Palladino R, Droby A, et al., 2021, Impact of demographics, socioeconomic status and comorbidities on disability outcomes in African-American and Caucasian patients with multiple sclerosis, Publisher: SAGE PUBLICATIONS LTD, Pages: 254-255, ISSN: 1352-4585
Capasso N, Palladino R, Montella E, et al., 2021, Prevalence of SARS-CoV-2 antibodies in multiple sclerosis: The hidden part of the iceberg, 25th World Congress of Neurology (WCN), Publisher: ELSEVIER, ISSN: 0022-510X
Moccia M, Affinito G, Capacchione A, et al., 2021, Interferon beta for the treatment of multiple sclerosis in the Campania Region of Italy: Merging the real-life to routinely collected healthcare data, PLoS One, Vol: 16, Pages: 1-7, ISSN: 1932-6203
BackgroundWe aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS).MethodsWe included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence.ResultsLooking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p<0.01). Adherence was lower for Betaferon®/Extavia® (Coeff = -0.05; 95%CI = -0.10, -0.01; p = 0.02), and Avonex® (Coeff = -0.06; 95%CI = -0.11, -0.02; p<0.01), when compared with Rebif® and Plegridy® (Coeff = 0.08; 95%CI = 0.01, 0.16; p = 0.02). AHR and costs for MS hospital admissions were higher for Betaferon®/Extavia® (IRR = 2.38; 95%CI = 1.01, 5.55; p = 0.04; Coeff = 14.95
Palladino R, Chataway J, Majeed A, et al., 2021, Interface of multiple sclerosis, depression, vascular disease, and mortality a population-based matched cohort study, Neurology, Vol: 97, Pages: E1322-E1333, ISSN: 0028-3878
Background and Objectives To assess whether the association among depression, vascular disease, and mortality differs in people with multiple sclerosis (MS) compared with age-, sex-, and general practice–matched controls.Methods We conducted a population-based retrospective matched cohort study between January 1, 1987, and September 30, 2018, that included people with MS and matched controls without MS from England, stratified by depression status. We used time-varying Cox proportional hazard regression models to test the association among MS, depression, and time to incident vascular disease and mortality. Analyses were also stratified by sex.Results We identified 12,251 people with MS and 72,572 matched controls. At baseline, 21% of people with MS and 9% of controls had depression. Compared with matched controls without depression, people with MS had an increased risk of incident vascular disease regardless of whether they had comorbid depression. The 10-year hazard of all-cause mortality was 1.75-fold greater in controls with depression (95% confidence interval [CI] 1.59–1.91), 3.88-fold greater in people with MS without depression (95% CI 3.66–4.10), and 5.43-fold greater in people with MS and depression (95% CI 4.88–5.96). Overall, the interaction between MS status and depression was synergistic, with 14% of the observed effect attributable to the interaction. Sex-stratified analyses confirmed differences in hazard ratios.Discussion Depression is associated with increased risks of incident vascular disease and mortality in people with MS, and the effects of depression and MS on all-cause mortality are synergistic. Further studies should evaluate whether effectively treating depression is associated with a reduced risk of vascular disease and mortality.
Paulson KR, Kamath AM, Alam T, et al., 2021, Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019, The Lancet, Vol: 398, Pages: 870-905, ISSN: 0140-6736
BackgroundSustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival.MethodsWe completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index.FindingsGlobal U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019.
Palladino R, Bollon J, Ragazzoni L, et al., 2021, Effect of timing of implementation of the lockdown on the number of deaths for COVID-19 in four European countries, Disaster Medicine and Public Health Preparedness, Vol: 15, Pages: e40-e42, ISSN: 1935-7893
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