4451
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Matsuyama Y, Aida J, Watt RG, Tsuboya T, Koyama S, Sato Y, Kondo K, Osaka K. Dental Status and Compression of Life Expectancy with Disability. J Dent Res 2017; 96:1006-1013. [PMID: 28605598 DOI: 10.1177/0022034517713166] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This study examined whether the number of teeth contributes to the compression of morbidity, measured as a shortening of life expectancy with disability, an extension of healthy life expectancy, and overall life expectancy. A prospective cohort study was conducted. A self-reported baseline survey was given to 126,438 community-dwelling older people aged ≥65 y in Japan in 2010, and 85,161 (67.4%) responded. The onset of functional disability and all-cause mortality were followed up for 1,374 d (follow-up rate = 96.1%). A sex-stratified illness-death model was applied to estimate the adjusted hazard ratios (HRs) for 3 health transitions (healthy to dead, healthy to disabled, and disabled to dead). Absolute differences in life expectancy, healthy life expectancy, and life expectancy with disability according to the number of teeth were also estimated. Age, denture use, socioeconomic status, health status, and health behavior were adjusted. Compared with the edentulous participants, participants with ≥20 teeth had lower risks of transitioning from healthy to dead (adjusted HR, 0.58 [95% confidence interval (CI), 0.50-0.68] for men and 0.70 [95% CI, 0.57-0.85] for women) and from healthy to disabled (adjusted HR, 0.52 [95% CI, 0.44-0.61] for men and 0.58 [95% CI, 0.49-0.68] for women). They also transitioned from disabled to dead earlier (adjusted HR, 1.26 [95% CI, 0.99-1.60] for men and 2.42 [95% CI, 1.72-3.38] for women). Among the participants aged ≥85 y, those with ≥20 teeth had a longer life expectancy (men: +57 d; women: +15 d) and healthy life expectancy (men: +92 d; women: +70 d) and a shorter life expectancy with disability (men: -35 d; women: -55 d) compared with the edentulous participants. Similar associations were observed among the younger participants and those with 1 to 9 or 10 to 19 teeth. The presence of remaining teeth was associated with a significant compression of morbidity: older Japanese adults' life expectancy with disability was compressed by 35 to 55 d within the follow-up of 1,374 d.
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Affiliation(s)
- Y Matsuyama
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - J Aida
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - R G Watt
- 2 Department of Epidemiology and Public Health, University College London, London, UK
| | - T Tsuboya
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Koyama
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Y Sato
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - K Kondo
- 3 Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,4 National Center for Geriatrics and Gerontology, Obu, Japan
| | - K Osaka
- 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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4452
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Wang B, Congdon N, Bourne R, Li Y, Cao K, Zhao A, Yusufu M, Dong W, Zhou M, Wang N. Burden of vision loss associated with eye disease in China 1990 -2020: findings from the Global Burden of Disease Study 2015. Br J Ophthalmol 2017; 102:220-224. [PMID: 28607177 DOI: 10.1136/bjophthalmol-2017-310333] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/02/2017] [Accepted: 05/17/2017] [Indexed: 11/04/2022]
Abstract
AIMS To assess the burden of vision loss due to eye disease in China between 1990 and 2015, and to predict the burden in 2020. METHODS Data from the GBD 2015 (Global Burden of Diseases, Injuries, and Risk Factors Study 2015) were used. The main outcome measures were prevalence and years lived with disability (YLDs) for vision loss due to cataract, glaucoma, macular degeneration, other vision loss, refraction and accommodation disorders and trachoma. RESULTS Prevalence for eye diseases increased steadily from 1990 to 2015, and will increase until 2020. From 1990 to 2015, the most common eye disorder was refraction and accommodation disorders. From 1990 to 2015, the vision loss burden due to eye disease decreased for those aged 0-14 years, and increased for those aged 15 years and above, with the most notable increases occurring among those aged 50 years and above. China ranked 10th when comparing YLDs for vision loss due to eye disease with the other members of the G20 (Group of Twenty, an international forum for the governments from 20 major economies) . Age-standardised YLD rates for vision loss due to eye disease declined in all 19 countries, except for China. The burden from vision loss due to eye disease ranked 12th and 11th among all causes of health loss in China in 1990 and 2015, respectively. CONCLUSION Alone among major economies, China has experienced an increase in the burden of age-standardised vision loss from eye disease over the last two decades. In the future, China may expect a growing burden of vision loss due to population growth and ageing.
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Affiliation(s)
- Bingsong Wang
- Beijing Institute of Ophthalmology, Beijing, China.,Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Orbis International, New York, New York, USA
| | - Rupert Bourne
- Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK
| | - Yichong Li
- Clinical Research Institute, Peking University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing, China
| | - Aiping Zhao
- Beijing Institute of Ophthalmology, Beijing, China
| | | | - Wenlan Dong
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing, China.,Beijing Tongren Hospital, Capital Medical University, Beijing, China
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4453
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Abstract
BACKGROUND Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. METHODS Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. RESULTS There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. CONCLUSION More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems.
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Affiliation(s)
- Mahshid Moghei
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | | | - Wanrudee Isaranuwatchai
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Nizal Sarrafzadegan
- Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Paul Oh
- University Health Network, University of Toronto, Canada
| | | | - Sherry L Grace
- School of Kinesiology and Health Science, York University, Toronto, Canada; University Health Network, University of Toronto, Canada
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4454
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O'Connell NE, Cook CE, Wand BM, Ward SP. Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines. Best Pract Res Clin Rheumatol 2017; 30:968-980. [PMID: 29103554 DOI: 10.1016/j.berh.2017.05.001] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/07/2017] [Accepted: 04/23/2017] [Indexed: 12/01/2022]
Abstract
Given the scale and cost of the low back pain problem, it is imperative that healthcare professionals involved in the care of people with low back pain have access to up-to-date, evidence-based information to assist them in treatment decision-making. Clinical guidelines exist to promote the consistent best practice, to reduce unwarranted variation and to reduce the use of low-value interventions in patient care. Recent decades have witnessed the publication of a number of such guidelines. In this narrative review, we consider three selected international interdisciplinary guidelines for the management of low back pain. Guideline development methods, consistent recommendations and inconsistencies between these guidelines are critically discussed.
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Affiliation(s)
- Neil E O'Connell
- Health Economics Research Group, Institute of Environment, Health and Societies, Department of Clinical Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, United Kingdom.
| | - Chad E Cook
- Department of Orthopaedics, Duke University, 2200 W. Main St. Ste B230, Durham, NC 27705, USA
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Stephen P Ward
- Department of Pain Medicine, Brighton and Sussex University Hospitals NHS Trust, Eastern Rd, Brighton, BN2 5BE, United Kingdom
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4455
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Aledavood T, Triana Hoyos AM, Alakörkkö T, Kaski K, Saramäki J, Isometsä E, Darst RK. Data Collection for Mental Health Studies Through Digital Platforms: Requirements and Design of a Prototype. JMIR Res Protoc 2017; 6:e110. [PMID: 28600276 PMCID: PMC5483244 DOI: 10.2196/resprot.6919] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 02/13/2017] [Accepted: 04/02/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental and behavioral disorders are the main cause of disability worldwide. However, their diagnosis is challenging due to a lack of reliable biomarkers; current detection is based on structured clinical interviews which can be biased by the patient's recall ability, affective state, changing in temporal frames, etc. While digital platforms have been introduced as a possible solution to this complex problem, there is little evidence on the extent of usability and usefulness of these platforms. Therefore, more studies where digital data is collected in larger scales are needed to collect scientific evidence on the capacities of these platforms. Most of the existing platforms for digital psychiatry studies are designed as monolithic systems for a certain type of study; publications from these studies focus on their results, rather than the design features of the data collection platform. Inevitably, more tools and platforms will emerge in the near future to fulfill the need for digital data collection for psychiatry. Currently little knowledge is available from existing digital platforms for future data collection platforms to build upon. OBJECTIVE The objective of this work was to identify the most important features for designing a digital platform for data collection for mental health studies, and to demonstrate a prototype platform that we built based on these design features. METHODS We worked closely in a multidisciplinary collaboration with psychiatrists, software developers, and data scientists and identified the key features which could guarantee short-term and long-term stability and usefulness of the platform from the designing stage to data collection and analysis of collected data. RESULTS The key design features that we identified were flexibility of access control, flexibility of data sources, and first-order privacy protection. We also designed the prototype platform Non-Intrusive Individual Monitoring Architecture (Niima), where we implemented these key design features. We described why each of these features are important for digital data collection for psychiatry, gave examples of projects where Niima was used or is going to be used in the future, and demonstrated how incorporating these design principles opens new possibilities for studies. CONCLUSIONS The new methods of digital psychiatry are still immature and need further research. The design features we suggested are a first step to design platforms which can adapt to the upcoming requirements of digital psychiatry.
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Affiliation(s)
| | | | - Tuomas Alakörkkö
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Kimmo Kaski
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Jari Saramäki
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Richard K Darst
- Department of Computer Science, Aalto University, Espoo, Finland
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4456
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Gliedt JA, Schneider MJ, Evans MW, King J, Eubanks JE. The biopsychosocial model and chiropractic: a commentary with recommendations for the chiropractic profession. Chiropr Man Therap 2017; 25:16. [PMID: 28593041 PMCID: PMC5461754 DOI: 10.1186/s12998-017-0147-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/29/2017] [Indexed: 12/21/2022] Open
Abstract
There is an increasing awareness, interest and acceptance of the biopsychosocial (BPS) model by all health care professionals involved with patient care. The areas of spine care and pain medicine are no exception, and in fact, these areas of health care are a major centerpiece of the movement from the traditional biomedical model to a BPS model of patient assessment and delivery of care. The chiropractic approach to health care has a history that is grounded in key aspects of the BPS model. The profession has inherently implemented certain features of the BPS model throughout its history, perhaps without a full understanding or realization. The purpose of this paper is to present an overview of the BPS model, its relationship with spine care and pain management, and to discuss the BPS model, particularly psychosocial aspects, in the context of its historical relationship with chiropractic. We will also provide recommendations for the chiropractic profession as it relates to successful adoption of a full integration of the BPS model.
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Affiliation(s)
| | | | - Marion W. Evans
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Starkville, MS USA
| | - Jeff King
- Medical College of Wisconsin, Department of Neurosurgery, Milwaukee, WI USA
| | - James E. Eubanks
- Brody School of Medicine, East Carolina University, Greenville, NC USA
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4457
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Epidemiological Effectiveness and Cost of a Fungal Meningitis Outbreak Response in New River Valley, Virginia: Local Health Department and Clinical Perspectives. Disaster Med Public Health Prep 2017; 12:38-46. [PMID: 28578748 DOI: 10.1017/dmp.2017.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We evaluated the effectiveness and cost of a fungal meningitis outbreak response in the New River Valley of Virginia during 2012-2013 from the perspective of the local public health department and clinical facilities. The fungal meningitis outbreak affected 23 states in the United States with 751 cases and 64 deaths in 20 states; there were 56 cases and 5 deaths in Virginia. METHODS We conducted a partial economic evaluation of the fungal meningitis outbreak response in New River Valley. We collected costs associated with the local health department and clinical facilities in the outbreak response and estimated the epidemiological effectiveness by using disability-adjusted life years (DALYs) averted. RESULTS We estimated the epidemiological effectiveness of this outbreak response to be 153 DALYs averted among the patients, and the costs incurred by the local health department and clinical facilities to be $30,413 and $39,580, respectively. CONCLUSIONS We estimated the incremental cost-effectiveness ratio of $198 per DALY averted and $258 per DALY averted from the local health department and clinical perspectives, respectively, thereby assisting in impact evaluation of the outbreak response by the local health department and clinical facilities. (Disaster Med Public Health Preparedness. 2018;12:38-46).
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4458
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Abstract
415 million people live with diabetes worldwide, and an estimated 193 million people have undiagnosed diabetes. Type 2 diabetes accounts for more than 90% of patients with diabetes and leads to microvascular and macrovascular complications that cause profound psychological and physical distress to both patients and carers and put a huge burden on health-care systems. Despite increasing knowledge regarding risk factors for type 2 diabetes and evidence for successful prevention programmes, the incidence and prevalence of the disease continues to rise globally. Early detection through screening programmes and the availability of safe and effective therapies reduces morbidity and mortality by preventing or delaying complications. Increased understanding of specific diabetes phenotypes and genotypes might result in more specific and tailored management of patients with type 2 diabetes, as has been shown in patients with maturity onset diabetes of the young. In this Seminar, we describe recent developments in the diagnosis and management of type 2 diabetes, existing controversies, and future directions of care.
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Affiliation(s)
- Sudesna Chatterjee
- Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, UK; Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, UK; Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, UK; Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
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4459
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Franssen FME, Soriano JB. Reply: Lung Function Abnormalities in Smokers with Ischemic Heart Disease. Am J Respir Crit Care Med 2017; 195:1537-1538. [DOI: 10.1164/rccm.201612-2515le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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4460
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Vegetarian Nutrition for the Older Adult: Vitamin B12, Iron, and Zinc. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4461
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Jones J, Sim TF, Hughes J. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management-A Narrative Review of Current Practices. PHARMACY 2017; 5:E30. [PMID: 28970442 PMCID: PMC5597155 DOI: 10.3390/pharmacy5020030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/05/2017] [Accepted: 05/26/2017] [Indexed: 01/08/2023] Open
Abstract
Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED.
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Affiliation(s)
- Joshua Jones
- School of Pharmacy, Curtin University, Western Australia 6102, Australia.
| | - Tin Fei Sim
- School of Pharmacy, Curtin University, Western Australia 6102, Australia.
| | - Jeff Hughes
- School of Pharmacy, Curtin University, Western Australia 6102, Australia.
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4462
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4463
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Baldwin JN, McKay MJ, Moloney N, Hiller CE, Nightingale EJ, Burns J. Reference values and factors associated with musculoskeletal symptoms in healthy adolescents and adults. Musculoskelet Sci Pract 2017; 29:99-107. [PMID: 28351022 DOI: 10.1016/j.msksp.2017.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/15/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Insufficient attention has been given to individuals who report musculoskeletal symptoms yet experience minimal disability. OBJECTIVES To examine musculoskeletal symptoms among healthy individuals, and compare demographic, psychological and physical factors between individuals with and without symptoms. DESIGN Cross-sectional observational study. METHOD Data were from the 1000 Norms Project which recruited 1000 individuals aged 3-101 years. Participants were healthy by self-report and had no major physical disability. Musculoskeletal symptoms (ache/pain/discomfort, including single-site and multi-site symptoms) were assessed in adolescents (11-17y) and adults (18-101y) using the Extended Nordic Musculoskeletal Questionnaire (NMQ-E). To compare individuals with single-site, multi-site and no symptoms, body mass index, grip strength, 6-min walk, 30-s chair stand and timed up-and-down stairs (all participants), and mental health, sleep difficulties, self-efficacy and physical activity (adults), were collected. RESULTS /findings: Socio-demographic characteristics were similar to the Australian population. Twelve-month period prevalence of all symptoms was 69-82%; point prevalence was 23-39%. Adults with single-site symptoms were more likely to be overweight/obese and had lower sit-to-stand and stair-climbing performance (p < 0.05). Adults with multi-site symptoms were more likely to be female and overweight/obese, had lower mental health, greater sleep difficulties and lower grip strength, 6-min walk and sit-to-stand performance (p < 0.05). Differences were only observed among 50-59, 60-69, 70-79 and 80-101 year-olds. CONCLUSIONS Normative reference data for the NMQ-E have been generated. Musculoskeletal symptoms are common among healthy individuals. In older adults, musculoskeletal symptoms are linked with overweight/obesity, lower mental health, sleep difficulties and lower physical performance, emphasising the importance of multi-dimensional assessments in musculoskeletal disorders.
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Affiliation(s)
- Jennifer N Baldwin
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia.
| | - Marnee J McKay
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Niamh Moloney
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia; Department of Health Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Claire E Hiller
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Elizabeth J Nightingale
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Joshua Burns
- Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, University of Sydney, Australia; Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), Australia
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4464
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Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, Trigueros JA, Cosío BG, Casanova C, Riesco JA, Simonet P, Rigau D, Soriano JB, Ancochea J. Spanish COPD Guidelines (GesEPOC) 2017. Pharmacological Treatment of Stable Chronic Obstructive Pulmonary Disease. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.arbr.2017.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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4465
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Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, Pinho C, Bhutta ZA, Dandona L, Ferrari A, Ghiwot TT, Hay SI, Kinfu Y, Liang X, Lopez A, Malta DC, Mokdad AH, Naghavi M, Patton GC, Salomon J, Sartorius B, Topor-Madry R, Vollset SE, Werdecker A, Whiteford HA, Abate KH, Abbas K, Damtew SA, Ahmed MB, Akseer N, Al-Raddadi R, Alemayohu MA, Altirkawi K, Abajobir AA, Amare AT, Antonio CAT, Arnlov J, Artaman A, Asayesh H, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Bacha U, Betsu BD, Barac A, Bärnighausen TW, Baye E, Bedi N, Bensenor IM, Berhane A, Bernabe E, Bernal OA, Beyene AS, Biadgilign S, Bikbov B, Boyce CA, Brazinova A, Hailu GB, Carter A, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Chitheer AA, Choi JYJ, Ciobanu LG, Crump J, Dandona R, Dellavalle RP, Deribew A, deVeber G, Dicker D, Ding EL, Dubey M, Endries AY, Erskine HE, Faraon EJA, Faro A, Farzadfar F, Fernandes JC, Fijabi DO, Fitzmaurice C, Fleming TD, Flor LS, Foreman KJ, Franklin RC, Fraser MS, Frostad JJ, Fullman N, Gebregergs GB, Gebru AA, Geleijnse JM, Gibney KB, Gidey Yihdego M, Ginawi IAM, Gishu MD, Gizachew TA, Glaser E, Gold AL, Goldberg E, Gona P, Goto A, Gugnani HC, Jiang G, Gupta R, Tesfay FH, Hankey GJ, Havmoeller R, Hijar M, Horino M, Hosgood HD, Hu G, Jacobsen KH, Jakovljevic MB, Jayaraman SP, Jha V, Jibat T, Johnson CO, Jonas J, Kasaeian A, Kawakami N, Keiyoro PN, Khalil I, Khang YH, Khubchandani J, Ahmad Kiadaliri AA, Kieling C, Kim D, Kissoon N, Knibbs LD, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kulikoff R, Kumar GA, Lal DK, Lam HY, Larson HJ, Larsson A, Laryea DO, Leung J, Lim SS, Lo LT, Lo WD, Looker KJ, Lotufo PA, Magdy Abd El Razek H, Malekzadeh R, Markos Shifti D, Mazidi M, Meaney PA, Meles KG, Memiah P, Mendoza W, Abera Mengistie M, Mengistu GW, Mensah GA, Miller TR, Mock C, Mohammadi A, Mohammed S, Monasta L, Mueller U, Nagata C, Naheed A, Nguyen G, Nguyen QL, Nsoesie E, Oh IH, Okoro A, Olusanya JO, Olusanya BO, Ortiz A, Paudel D, Pereira DM, Perico N, Petzold M, Phillips MR, Polanczyk GV, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rahman M, Rai RK, Ram U, Rankin Z, Remuzzi G, Renzaho AMN, Roba HS, Rojas-Rueda D, Ronfani L, Sagar R, Sanabria JR, Kedir Mohammed MS, Santos IS, Satpathy M, Sawhney M, Schöttker B, Schwebel DC, Scott JG, Sepanlou SG, Shaheen A, Shaikh MA, She J, Shiri R, Shiue I, Sigfusdottir ID, Singh J, Silpakit N, Smith A, Sreeramareddy C, Stanaway JD, Stein DJ, Steiner C, Sufiyan MB, Swaminathan S, Tabarés-Seisdedos R, Tabb KM, Tadese F, Tavakkoli M, Taye B, Teeple S, Tegegne TK, Temam Shifa G, Terkawi AS, Thomas B, Thomson AJ, Tobe-Gai R, Tonelli M, Tran BX, Troeger C, Ukwaja KN, Uthman O, Vasankari T, Venketasubramanian N, Vlassov VV, Weiderpass E, Weintraub R, Gebrehiwot SW, Westerman R, Williams HC, Wolfe CDA, Woodbrook R, Yano Y, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaki MES, Zegeye EA, Zuhlke LJ, Murray CJL, Vos T. Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr 2017; 171:573-592. [PMID: 28384795 PMCID: PMC5540012 DOI: 10.1001/jamapediatrics.2017.0250] [Citation(s) in RCA: 250] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/16/2017] [Indexed: 01/06/2023]
Abstract
Importance Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. Objective To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Evidence Review Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Findings Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. Conclusions and Relevance Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.
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Affiliation(s)
- Nicholas Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hmwe Hmwe Kyu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Leo Zoeckler
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Katie Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Christine Pinho
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurgaon-122002, National Capital Region, India
| | - Alize Ferrari
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Yohannes Kinfu
- Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alan Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - George C Patton
- Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia
| | - Joshua Salomon
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Benn Sartorius
- School of Nursing and Public Health, University of KwaZulu-Natal, South African Medical Research Council/University of KwaZulu-Natal Gastrointestinal Cancer Research Center, Durban, South Africa
| | - Roman Topor-Madry
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Stein Emil Vollset
- Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Harvey A Whiteford
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Kaja Abbas
- Department of Population Health, Virginia Tech, Blacksburg
| | | | | | - Nadia Akseer
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | | | | | | | | | | | - Carl A T Antonio
- Department of Health Policy and Administration, University of Philippines-Manila, Manila, Philippines
| | - Johan Arnlov
- Department of Medical Services, Uppsala University, Uppsala, Sweden
- Dalarna University, Uppsala, Sweden
| | - Al Artaman
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | | | | | | | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | - Adugnaw Berhane
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | | | | | | | - Boris Bikbov
- Department of Nephrology Issues of Transplanted Kidney, V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia
| | - Cheryl Anne Boyce
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alexandra Brazinova
- Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia
| | | | - Austin Carter
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Ferrán Catalá-López
- University of Valencia, Valencia, Spain
- Health Research Institute and CIBERSAM, Valencia, Spain
| | - Fiona J Charlson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - John Crump
- Departmentà Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | | | - Amare Deribew
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gabrielle deVeber
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | - Daniel Dicker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Eric L Ding
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | - Holly E Erskine
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | | | - Andre Faro
- Federal University of Sergipe, Aracaju, Brazil
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Joao C Fernandes
- Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal
| | - Daniel Obadare Fijabi
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | | | - Thomas D Fleming
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Luisa Sorio Flor
- Escola Nacional de Saúde Pública Sergio Arouca/Fiocruz, Rio De Janeiro, Brazil
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Maya S Fraser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Joseph J Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Katherine B Gibney
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Mahari Gidey Yihdego
- Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Mizan-Tepi University, Ethiopia
| | | | | | | | - Elizabeth Glaser
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Audra L Gold
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ellen Goldberg
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Harish Chander Gugnani
- Department of Microbiology, Departments of Epidemiology and Biostatistics, St James School of Medicine, the Quarter, Anguilla
| | - Guohong Jiang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | | | | | - Masako Horino
- Nevada Division of Public and Behavioral Health, Carson City, Nevada
| | | | - Guoqing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | | | | | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- University of Oxford, Oxford, United Kingdom
| | - Tariku Jibat
- Wageningen University, Wageningen, Netherlands
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Catherine O Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jost Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karlas University, Heidelberg, Germany
| | - Amir Kasaeian
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ibrahim Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Christian Kieling
- Federal University of Rio Grande de Sul, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Niranjan Kissoon
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke D Knibbs
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Rachel Kulikoff
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | | | - Hilton Y Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Heidi J Larson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anders Larsson
- Department of Medical Services, Uppsala University, Uppsala, Sweden
| | | | - Janni Leung
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Loon-Tzian Lo
- UnionHealth Associates LLC, St Louis, Missouri
- Alton Mental Health Center, Alton, Illinois
| | - Warren D Lo
- Department of Pediatrics, Department of Neurology, The Ohio State University, Columbus
| | | | - Paulo A Lotufo
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Reza Malekzadeh
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Mazidi
- Institute of Genetics and Developmental Biology, Key State Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Peter A Meaney
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | | | | | | | - George A Mensah
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Charles Mock
- School of Medicine, School of Global Health, University of Washington, Seattle
| | | | | | - Lorenzo Monasta
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Ulrich Mueller
- Federal Institute for Population Research, Wiesbaden, Germany
| | - Chie Nagata
- National Center for Child Health and Development, Tokyo, Japan
| | - Aliya Naheed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Grant Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Quyen Le Nguyen
- Institute for Global Health, Duy Tan University, Da Nang, Vietnam
| | - Elaine Nsoesie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - In-Hwan Oh
- Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
| | | | | | | | | | - Deepak Paudel
- UK Department for International Development, Lalitpur, Nepal
| | | | - Norberto Perico
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | - Max Petzold
- Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | - Mostafa Qorbani
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Contect International Health Consultants, Lahore, Punjab, Pakistan
| | - Vafa Rahimi-Movaghar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahfuzar Rahman
- Research and Evaluation Division, Building Resources Access Communities, Dhaka, Bangladesh
| | | | - Usha Ram
- International Institute for Population Sciences, Mumbai, India
| | - Zane Rankin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | - Luca Ronfani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Rajesh Sagar
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Institute of Health Care and Social Sciences, FOM University, Essen, Germany
| | | | - James G Scott
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sadaf G Sepanlou
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amira Shaheen
- Department of Public Health, An-Najah University, Nablus, Palestine
| | | | - June She
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Work Organizations, Disability Program, University of Helsinki, Helsinki, Finland
| | - Ivy Shiue
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | | | | | - Naris Silpakit
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alison Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Jeffrey D Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Caitlyn Steiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Karen M Tabb
- University of Illinois at Urbana-Champaign, Champaign
| | | | | | - Bineyam Taye
- Department of Biology, Colgate University, Hamilton, New York
| | - Stephanie Teeple
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Bernadette Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alan J Thomson
- Adaptive Knowledge Management, Victoria, British Columbia, Canada
| | - Ruoyan Tobe-Gai
- National Center for Child Health and Development, Tokyo, Japan
| | | | | | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | | | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden
- Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | | | | | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | | | | | - Rachel Woodbrook
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | | | - Seok-Jun Yoon
- Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea
| | | | | | | | | | | | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. THE LANCET. INFECTIOUS DISEASES 2017; 17:909-948. [PMID: 28579426 PMCID: PMC5589208 DOI: 10.1016/s1473-3099(17)30276-1] [Citation(s) in RCA: 708] [Impact Index Per Article: 101.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/15/2017] [Accepted: 03/23/2017] [Indexed: 02/07/2023]
Abstract
Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide. Methods We estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platform shared across most causes of death in the GBD 2015 study. We modelled diarrhoeal morbidity, including incidence and prevalence, using a meta-regression platform called DisMod-MR. We estimated aetiologies for diarrhoeal diseases using a counterfactual approach that incorporates the aetiology-specific risk of diarrhoeal disease and the prevalence of the aetiology in diarrhoea episodes. We used the Socio-demographic Index, a summary indicator derived from measures of income per capita, educational attainment, and fertility, to assess trends in diarrhoeal mortality. The two leading risk factors for diarrhoea—childhood malnutrition and unsafe water, sanitation, and hygiene—were used in a decomposition analysis to establish the relative contribution of changes in diarrhoea disability-adjusted life-years (DALYs). Findings Globally, in 2015, we estimate that diarrhoea was a leading cause of death among all ages (1·31 million deaths, 95% uncertainty interval [95% UI] 1·23 million to 1·39 million), as well as a leading cause of DALYs because of its disproportionate impact on young children (71·59 million DALYs, 66·44 million to 77·21 million). Diarrhoea was a common cause of death among children under 5 years old (499 000 deaths, 95% UI 447 000–558 000). The number of deaths due to diarrhoea decreased by an estimated 20·8% (95% UI 15·4–26·1) from 2005 to 2015. Rotavirus was the leading cause of diarrhoea deaths (199 000, 95% UI 165 000–241 000), followed by Shigella spp (164 300, 85 000–278 700) and Salmonella spp (90 300, 95% UI 34 100–183 100). Among children under 5 years old, the three aetiologies responsible for the most deaths were rotavirus, Cryptosporidium spp, and Shigella spp. Improvements in safe water and sanitation have decreased diarrhoeal DALYs by 13·4%, and reductions in childhood undernutrition have decreased diarrhoeal DALYs by 10·0% between 2005 and 2015. Interpretation At the global level, deaths due to diarrhoeal diseases have decreased substantially in the past 25 years, although progress has been faster in some countries than others. Diarrhoea remains a largely preventable disease and cause of death, and continued efforts to improve access to safe water, sanitation, and childhood nutrition will be important in reducing the global burden of diarrhoea. Funding Bill & Melinda Gates Foundation.
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4467
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Watkins DA, Zühlke LJ, Narula J. Moving Forward the RHD Agenda at Global and National Levels. Glob Heart 2017; 12:1-2. [PMID: 28552219 DOI: 10.1016/j.gheart.2017.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- David A Watkins
- Department of Paediatrics, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Liesel J Zühlke
- Department of Paediatrics, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa; Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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4468
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Sanchez-Niño MD, Zheng-Lin B, Valiño-Rivas L, Sanz AB, Ramos AM, Luño J, Goicoechea M, Ortiz A. Lesinurad: what the nephrologist should know. Clin Kidney J 2017; 10:679-687. [PMID: 28979780 PMCID: PMC5622894 DOI: 10.1093/ckj/sfx036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/03/2017] [Indexed: 01/06/2023] Open
Abstract
Lesinurad is an oral inhibitor of the monocarboxylic/urate transporter URAT1 encoded by the SLC22A12 gene. Market authorization was granted in February 2016 in Europe and December 2015 in the USA. As a potentially nephrotoxic uricosuric drug acting on the kidney, nephrologists should become familiar with its indications and safety profile. The approved indication is treatment of gout in combination with a xanthine oxidase (XO) inhibitor in adult patients who have not achieved target serum uric acid levels with an XO inhibitor alone. It is not indicated for asymptomatic hyperuricaemia or for patients with estimated creatinine clearance <45 mL/min. The only authorized daily dose is 200 mg and cannot be exceeded because of the nephrotoxicity risk. Nephrotoxicity is thought to be related to uricosuria. At the 200 mg/day dose, serum creatinine more than doubled in 1.8% of lesinurad patients (versus 0% in placebo) and in 11% of these it was not reversible. In addition, it is subject to a risk management plan given the potential association with cardiovascular events. In randomized clinical trials, the association of lesinurad with either allopurinol or febuxostat achieved a greater reduction in serum uric acid (∼1 mg/dL lower) than the XO inhibitors alone, and this allowed the serum uric acid target to be met in a higher proportion of patients, which was the primary endpoint. However, no clinical differences were observed in gout flares or tophi, although these were not the primary endpoints.
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Affiliation(s)
- Maria Dolores Sanchez-Niño
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
- REDINREN, Madrid, Spain
| | - Binbin Zheng-Lin
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
| | - Lara Valiño-Rivas
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
- REDINREN, Madrid, Spain
| | - Ana Belen Sanz
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
- REDINREN, Madrid, Spain
| | - Adrian Mario Ramos
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
- REDINREN, Madrid, Spain
| | - Jose Luño
- REDINREN, Madrid, Spain
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marian Goicoechea
- REDINREN, Madrid, Spain
- Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Alberto Ortiz
- Department of Nephrology, IIS-Fundacion Jimenez Diaz, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Fundacion Renal Iñigo Alvarez de Toledo (FRIAT), Madrid, Spain
- REDINREN, Madrid, Spain
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4469
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Jakovljevic M, Varavikova EA, Walter H, Wascher A, Pejcic AV, Lesch OM. Alcohol Beverage Household Expenditure, Taxation and Government Revenues in Broader European WHO Region. Front Pharmacol 2017; 8:303. [PMID: 28603498 PMCID: PMC5445193 DOI: 10.3389/fphar.2017.00303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/10/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mihajlo Jakovljevic
- Health Economics and Pharmacoeconomics, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Elena A. Varavikova
- Federal Research Institute for Public Health Organization and Information (CNIIOIZ), Ministry of HealthMoscow, Russia
| | - Henriette Walter
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
| | | | - Ana V. Pejcic
- Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Otto M. Lesch
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
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4470
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Guzman-Castillo M, Ahmadi-Abhari S, Bandosz P, Capewell S, Steptoe A, Singh-Manoux A, Kivimaki M, Shipley MJ, Brunner EJ, O'Flaherty M. Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study. LANCET PUBLIC HEALTH 2017; 2:e307-e313. [PMID: 28736759 PMCID: PMC5500313 DOI: 10.1016/s2468-2667(17)30091-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Reliable estimation of future trends in life expectancy and the burden of disability is crucial for ageing societies. Previous forecasts have not considered the potential impact of trends in disease incidence. The present prediction model combines population trends in cardiovascular disease, dementia, disability, and mortality to forecast trends in life expectancy and the burden of disability in England and Wales up to 2025. Methods We developed and validated the IMPACT-Better Ageing Model—a probabilistic model that tracks the population aged 35–100 years through ten health states characterised by the presence or absence of cardiovascular disease, dementia, disability (difficulty with one or more activities of daily living) or death up to 2025, by use of evidence-based age-specific, sex-specific, and year-specific transition probabilities. As shown in the English Longitudinal Study of Ageing, we projected continuing declines in dementia incidence (2·7% per annum), cardiovascular incidence, and mortality. The model estimates disability prevalence and disabled and disability-free life expectancy by year. Findings Between 2015 and 2025, the number of people aged 65 years and older will increase by 19·4% (95% uncertainty interval [UI] 17·7–20·9), from 10·4 million (10·37–10·41 million) to 12·4 million (12·23–12·57 million). The number living with disability will increase by 25·0% (95% UI 21·3–28·2), from 2·25 million (2·24–2·27 million) to 2·81 million (2·72–2·89 million). The age-standardised prevalence of disability among this population will remain constant, at 21·7% (95% UI 21·5–21·8) in 2015 and 21·6% (21·3–21·8) in 2025. Total life expectancy at age 65 years will increase by 1·7 years (95% UI 0·1–3·6), from 20·1 years (19·9–20·3) to 21·8 years (20·2–23·6). Disability-free life expectancy at age 65 years will increase by 1·0 years (95% UI 0·1–1·9), from 15·4 years (15·3–15·5) to 16·4 years (15·5–17·3). However, life expectancy with disability will increase more in relative terms, with an increase of roughly 15% from 2015 (4·7 years, 95% UI 4·6–4·8) to 2025 (5·4 years, 4·7–6·4). Interpretation The number of older people with care needs will expand by 25% by 2025, mainly reflecting population ageing rather than an increase in prevalence of disability. Lifespans will increase further in the next decade, but a quarter of life expectancy at age 65 years will involve disability. Funding British Heart Foundation.
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Affiliation(s)
| | - Sara Ahmadi-Abhari
- Department Epidemiology and Public Health, University College London, London, UK
| | - Piotr Bandosz
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.,Department of Prevention and Medical Education, Medical University of Gdansk, Gdansk, Poland
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Andrew Steptoe
- Department Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Department Epidemiology and Public Health, University College London, London, UK.,Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - Mika Kivimaki
- Department Epidemiology and Public Health, University College London, London, UK
| | - Martin J Shipley
- Department Epidemiology and Public Health, University College London, London, UK
| | - Eric J Brunner
- Department Epidemiology and Public Health, University College London, London, UK
| | - Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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4471
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Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, Ahmed M, Aksut B, Alam T, Alam K, Alla F, Alvis-Guzman N, Amrock S, Ansari H, Ärnlöv J, Asayesh H, Atey TM, Avila-Burgos L, Awasthi A, Banerjee A, Barac A, Bärnighausen T, Barregard L, Bedi N, Belay Ketema E, Bennett D, Berhe G, Bhutta Z, Bitew S, Carapetis J, Carrero JJ, Malta DC, Castañeda-Orjuela CA, Castillo-Rivas J, Catalá-López F, Choi JY, Christensen H, Cirillo M, Cooper L, Criqui M, Cundiff D, Damasceno A, Dandona L, Dandona R, Davletov K, Dharmaratne S, Dorairaj P, Dubey M, Ehrenkranz R, El Sayed Zaki M, Faraon EJA, Esteghamati A, Farid T, Farvid M, Feigin V, Ding EL, Fowkes G, Gebrehiwot T, Gillum R, Gold A, Gona P, Gupta R, Habtewold TD, Hafezi-Nejad N, Hailu T, Hailu GB, Hankey G, Hassen HY, Abate KH, Havmoeller R, Hay SI, Horino M, Hotez PJ, Jacobsen K, James S, Javanbakht M, Jeemon P, John D, Jonas J, Kalkonde Y, Karimkhani C, Kasaeian A, Khader Y, Khan A, Khang YH, Khera S, Khoja AT, Khubchandani J, Kim D, Kolte D, Kosen S, Krohn KJ, Kumar GA, Kwan GF, Lal DK, Larsson A, Linn S, Lopez A, Lotufo PA, El Razek HMA, Malekzadeh R, Mazidi M, Meier T, Meles KG, Mensah G, Meretoja A, Mezgebe H, Miller T, Mirrakhimov E, Mohammed S, Moran AE, Musa KI, Narula J, Neal B, Ngalesoni F, Nguyen G, Obermeyer CM, Owolabi M, Patton G, Pedro J, Qato D, Qorbani M, Rahimi K, Rai RK, Rawaf S, Ribeiro A, Safiri S, Salomon JA, Santos I, Santric Milicevic M, Sartorius B, Schutte A, Sepanlou S, Shaikh MA, Shin MJ, Shishehbor M, Shore H, Silva DAS, Sobngwi E, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadele Atnafu N, Tesfay F, Thakur JS, Thrift A, Topor-Madry R, Truelsen T, Tyrovolas S, Ukwaja KN, Uthman O, Vasankari T, Vlassov V, Vollset SE, Wakayo T, Watkins D, Weintraub R, Werdecker A, Westerman R, Wiysonge CS, Wolfe C, Workicho A, Xu G, Yano Y, Yip P, Yonemoto N, Younis M, Yu C, Vos T, Naghavi M, Murray C. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 2017; 70:1-25. [PMID: 28527533 PMCID: PMC5491406 DOI: 10.1016/j.jacc.2017.04.052] [Citation(s) in RCA: 2365] [Impact Index Per Article: 337.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 02/05/2023]
Abstract
Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.
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Affiliation(s)
| | | | | | | | | | - Gebre Abyu
- Mekelle University, Addis Ababa, Ethiopia
| | | | | | - Tahiya Alam
- University of Washington, Seattle, Washington
| | - Khurshid Alam
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | | | | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | | | | | | | - Jonathan Carapetis
- The University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | | | - Ferrán Catalá-López
- University of València/INCLIVA Health Research Institute and CIBERSAM, València, Spain
| | | | | | | | | | | | | | | | - Lalit Dandona
- University of Washington, Seattle, Washington; Public Health Foundation of India, New Delhi, India
| | - Rakhi Dandona
- University of Washington, Seattle, Washington; Public Health Foundation of India, New Delhi, India
| | - Kairat Davletov
- Republican Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | | | | | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | | | | | | | - Talha Farid
- University of Louisville, Louisville, Kentucky
| | | | - Valery Feigin
- Auckland University of Technology, Auckland, New Zealand
| | | | - Gerry Fowkes
- University of Edinburgh, Edinburgh United Kingdom
| | | | | | - Audra Gold
- University of Washington, Seattle, Washington
| | - Philimon Gona
- University of Massachusetts Boston, Boston, Massachusetts
| | - Rajeev Gupta
- Eternal Heart Care Center and Research Institute, Jaipur, India
| | | | | | | | | | - Graeme Hankey
- The University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | - Simon I Hay
- University of Washington, Seattle, Washington; University of Oxford, Oxford, United Kingdom
| | - Masako Horino
- Nevada Division of Public and Behavioral Health, Carson City, Nevada
| | | | | | - Spencer James
- Denver Health/University of Colorado, Denver, Colorado
| | | | | | - Denny John
- International Center for Research on Women, New Delhi, India
| | - Jost Jonas
- Ruprecht-Karls Universitaet Heidelberg, Heidelberg, Germany
| | - Yogeshwar Kalkonde
- Society for Education, Action and Research in Community Health, Gadchiroli, India
| | | | | | - Yousef Khader
- Jordan University of Science and Technology, Irbid, Jordan
| | - Abdur Khan
- University of Louisville, Louisville, Kentucky
| | | | - Sahil Khera
- New York Medical College, Valhalla, New York
| | - Abdullah T Khoja
- Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | | | - Daniel Kim
- Northeastern University, Boston, Massachusetts
| | | | - Soewarta Kosen
- Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia
| | | | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | - Gene F Kwan
- Boston University School of Medicine, Boston, Massachusetts
| | | | | | | | - Alan Lopez
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | - Toni Meier
- Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | | | - Atte Meretoja
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ted Miller
- Pacific Institute for Research & Evaluation, Beltsville, Maryland
| | | | | | | | | | | | - Bruce Neal
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Frida Ngalesoni
- Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | | | | | - Mayowa Owolabi
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - George Patton
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Dima Qato
- University of Illinois at Chicago, Chicago, Illinois
| | | | | | | | | | - Antônio Ribeiro
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Saeid Safiri
- Maragheh University of Medical Sciences, Maragheh, Iran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J S Thakur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Vasiliy Vlassov
- National Research University Higher School of Economics, Moscow, Russia
| | | | | | | | | | | | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | | | | | | | - Gelin Xu
- Nanjing University School of Medicine, Nanjing, China
| | | | - Paul Yip
- University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | - Theo Vos
- University of Washington, Seattle, Washington
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4472
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Bhuia MR, Nwaru BI, Weir CJ, Sheikh A. Models for estimating and projecting global, regional and national prevalence and disease burden of asthma: protocol for a systematic review. BMJ Open 2017; 7:e015441. [PMID: 28515197 PMCID: PMC5791547 DOI: 10.1136/bmjopen-2016-015441] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Models that have so far been used to estimate and project the prevalence and disease burden of asthma are in most cases inadequately described and irreproducible. We aim systematically to describe and critique the existing models in relation to their strengths, limitations and reproducibility, and to determine the appropriate models for estimating and projecting the prevalence and disease burden of asthma. METHODS We will search the following electronic databases to identify relevant literature published from 1980 to 2017: Medline, Embase, WHO Library and Information Services and Web of Science Core Collection. We will identify additional studies by searching the reference list of all the retrieved papers and contacting experts. We will include observational studies that used models for estimating and/or projecting prevalence and disease burden of asthma regarding human population of any age and sex. Two independent reviewers will assess the studies for inclusion and extract data from included papers. Data items will include authors' names, publication year, study aims, data source and time period, study population, asthma outcomes, study methodology, model type, model settings, study variables, methods of model derivation, methods of parameter estimation and/or projection, model fit information, key findings and identified research gaps. A detailed critical narrative synthesis of the models will be undertaken in relation to their strengths, limitations and reproducibility. A quality assessment checklist and scoring framework will be used to determine the appropriate models for estimating and projecting the prevalence anddiseaseburden of asthma. ETHICS AND DISSEMINATION We will not collect any primary data for this review, and hence there is no need for formal National Health Services Research Ethics Committee approval. We will present our findings at scientific conferences and publish the findings in the peer-reviewed scientific journal.
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Affiliation(s)
- Mohammad Romel Bhuia
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Bright I Nwaru
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
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4473
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Toxoplasma gondii and schizophrenia: a review of published RCTs. Parasitol Res 2017; 116:1793-1799. [PMID: 28508166 DOI: 10.1007/s00436-017-5478-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/02/2017] [Indexed: 12/19/2022]
Abstract
Over the last 60 years, accumulating evidence has suggested that acute, chronic, and maternal Toxoplasma gondii infections predispose to schizophrenia. More recent evidence suggests that chronically infected patients with schizophrenia present with more severe disease. After acute infection, parasites form walled cysts in the brain, leading to lifelong chronic infection and drug resistance to commonly used antiparasitics. Chronic infection is the most studied and closely linked with development and severity of schizophrenia. There are currently four published randomized controlled trials evaluating antiparasitic drugs, specifically azithromycin, trimethoprim, artemisinin, and artemether, in patients with schizophrenia. No trials have demonstrated a change in psychopathology with adjunctive treatment. Published trials have either selected drugs without evidence against chronic infection or used them at doses too low to reduce brain cyst burden. Furthermore, trials have failed to achieve sufficient power or account for confounders such as previous antipsychotic treatment, sex, age, or rhesus status on antiparasitic effect. There are currently no ongoing trials of anti-Toxoplasma therapy in schizophrenia despite ample evidence to justify further testing.
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4474
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Rabe KF, Watz H. Chronic obstructive pulmonary disease. Lancet 2017; 389:1931-1940. [PMID: 28513453 DOI: 10.1016/s0140-6736(17)31222-9] [Citation(s) in RCA: 602] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/09/2017] [Accepted: 02/14/2017] [Indexed: 02/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease. However, without a global political and economic effort to reduce tobacco use, to regulate environmental exposure, and to find alternatives to the massive use of biomass fuel, COPD will remain a major health-care problem for decades to come.
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Affiliation(s)
- Klaus F Rabe
- LungenClinic Grosshansdorf, Airway Research Centre North, German Centre for Lung Research, Grosshansdorf, Germany; Department of Medicine, Christian Albrechts University Kiel, Kiel, Germany.
| | - Henrik Watz
- Pulmonary Research Institute, Airway Research Centre North, German Centre for Lung Research, Grosshansdorf, Germany
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4475
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Cornely OA, Lass-Flörl C, Lagrou K, Arsic-Arsenijevic V, Hoenigl M. Improving outcome of fungal diseases - Guiding experts and patients towards excellence. Mycoses 2017; 60:420-425. [PMID: 28497502 DOI: 10.1111/myc.12628] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 11/30/2022]
Abstract
Invasive fungal infections are on the rise and during recent years understanding the epidemiology of fungal infections improved. Over 1 billion people are affected and 25 million patients are at imminent risk of severe organ damage or death due to fungal infection. The European Confederation of Medical Mycology (ECMM), founded in 1993, is the roof organisation of 23 National Medical Mycology Societies in Europe. ECMM fights fungal infections at various levels, by creating and distributing scientific knowledge and promoting scientific exchange. In response to the increasing prevalence and management complexity of invasive fungal infections, ECMM recently launched three additional initiatives (https://www.ecmm.info/). (i) ECMM together with other European infectious diseases societies created a comprehensive set of European guidelines for the diagnostic and therapeutic management of invasive fungal infections. (ii) ECMM founded the ECMM Academy awarding fellow status (FECMM) to outstanding researchers who advanced medical mycology. The academy aims at strengthening networking activities between these researchers. (iii) Centres throughout the world can apply for ECMM Excellence Center Status. Following such application on site auditing of up to three levels of mycological work (clinical, microbiological, epidemiological/clinical trials) evaluates the excellence of a centre along predefined criteria. All three initiatives share a common ambition; they aim at improving outcome of fungal diseases through guiding experts and patients towards excellence. Acknowledging fungal infections as a global problem, all three initiatives explicitly reach out beyond European borders.
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Affiliation(s)
- Oliver A Cornely
- CECAD Cluster of Excellence, University of Cologne, Cologne, Germany.,Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katrien Lagrou
- National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Valentina Arsic-Arsenijevic
- Faculty of Medicine University of Belgrade, Institute of Microbiology and Immunology, National Medical Mycology Reference Laboratory, Belgrade, Serbia
| | - Martin Hoenigl
- Section of Infectious Diseases and Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA
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4476
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Ong JJY, Chan YC. Medical Undergraduate Survey on Headache Education in Singapore: Knowledge, Perceptions, and Assessment of Unmet Needs. Headache 2017; 57:967-978. [DOI: 10.1111/head.13110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Jonathan Jia Yuan Ong
- Division of Neurology; Department of Medicine, National University Hospital; Singapore
| | - Yee Cheun Chan
- Division of Neurology; Department of Medicine, National University Hospital; Singapore
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4477
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Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J Clin Periodontol 2017; 44:456-462. [PMID: 28419559 DOI: 10.1111/jcpe.12732] [Citation(s) in RCA: 584] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The global burden of periodontal diseases remains high. Population growth trends, changes in risk factors and improved tooth retention will increase the socio-economic burden of periodontitis that is responsible for 3.5 million years lived with disability, 54 billion USD/year in lost productivity and a major portion of the 442 billion USD/year cost for oral diseases. METHODS In the context of the Milan World Exhibition 2015 "Feeding the Planet, Energy for Life," a green paper was developed and offered for global consultation by the European Federation of Periodontology. The final draft was endorsed by professional organizations around the world and is presented to stakeholders as a call for global action. RESULTS Specific actions for the public, policymakers, educators and professional organizations have been identified in the areas of prevention, detection and care. These actions align public interest and knowledge, need for self-care, professional intervention and policies to the best scientific evidence to proactively promote periodontal health and effectively manage the global burden of periodontal diseases, in accordance with WHO/UN priorities and strategies for tackling common non-communicable diseases via the Common Risk Factor Approach. CONCLUSIONS A strong and coherent body of evidence allows identification of actionable preventive, diagnostic and therapeutic strategies to effectively promote periodontal health and general wellbeing, and better manage the socio-economic consequences. Action requires consideration of the specific national scenarios.
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Affiliation(s)
- Maurizio S Tonetti
- European Research Group on Periodontology, ERGOPerio, Genova, Italy.,Department of Periodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Søren Jepsen
- Department of Periodontology, University of Bonn, Bonn, Germany
| | - Lijian Jin
- Department of Periodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Joan Otomo-Corgel
- Department of Periodontology, University of California Los Angeles, Los Angeles, CA, USA
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4478
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ACE and SGLT2 inhibitors: the future for non-diabetic and diabetic proteinuric renal disease. Curr Opin Pharmacol 2017; 33:34-40. [PMID: 28482281 DOI: 10.1016/j.coph.2017.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 03/17/2017] [Indexed: 01/03/2023]
Abstract
Most chronic nephropathies progress relentlessly to end-stage kidney disease. Research in animals and humans has helped our understanding of the mechanisms of chronic kidney disease progression. Current therapeutic strategies to prevent or revert renal disease progression focus on reduction of urinary protein excretion and blood pressure control. Blockade of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors and/or angiotensin II type 1 receptor blockers is the most effective treatment to achieve these purposes in non-diabetic and diabetic proteinuric renal diseases. For those individuals in which nephroprotection by RAS blockade is only partial, sodium-glucose linked cotransporter-2 (SGLT2) inhibitors could be a promising new class of drugs to provide further renoprotective benefit when added on to RAS blockers.
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4479
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Krug E, Cieza A. Strengthening health systems to provide rehabilitation services. The Canadian Journal of Occupational Therapy 2017; 84:72-73. [PMID: 28462663 DOI: 10.1177/0008417417705853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Etienne Krug
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention World Health Organization Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Alarcos Cieza
- Disability and Rehabilitation Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention World Health Organization Avenue Appia 20, 1211 Geneva 27, Switzerland
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4480
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Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, Trigueros JA, Cosío BG, Casanova C, Antonio Riesco J, Simonet P, Rigau D, Soriano JB, Ancochea J. Spanish Guidelines for Management of Chronic Obstructive Pulmonary Disease (GesEPOC) 2017. Pharmacological Treatment of Stable Phase. Arch Bronconeumol 2017; 53:324-335. [PMID: 28477954 DOI: 10.1016/j.arbres.2017.03.018] [Citation(s) in RCA: 333] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 03/23/2017] [Accepted: 03/29/2017] [Indexed: 01/04/2023]
Abstract
The clinical presentation of chronic obstructive pulmonary disease (COPD) varies widely, so treatment must be tailored according to the level of risk and phenotype. In 2012, the Spanish COPD Guidelines (GesEPOC) first established pharmacological treatment regimens based on clinical phenotypes. These regimens were subsequently adopted by other national guidelines, and since then, have been backed up by new evidence. In this 2017 update, the original severity classification has been replaced by a much simpler risk classification (low or high risk), on the basis of lung function, dyspnea grade, and history of exacerbations, while determination of clinical phenotype is recommended only in high-risk patients. The same clinical phenotypes have been maintained: non-exacerbator, asthma-COPD overlap (ACO), exacerbator with emphysema, and exacerbator with bronchitis. Pharmacological treatment of COPD is based on bronchodilators, the only treatment recommended in low-risk patients. High-risk patients will receive different drugs in addition to bronchodilators, depending on their clinical phenotype. GesEPOC reflects a more individualized approach to COPD treatment, according to patient clinical characteristics and level of risk or complexity.
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Affiliation(s)
- Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España.
| | | | - Myriam Calle
- Servicio de Neumología, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - Jesús Molina
- Centro de Salud Francia, Dirección Asistencial Oeste, Madrid, España
| | - Pere Almagro
- Servicio de Medicina Interna, Hospital Universitario Mutua de Terrassa, Terrassa, España
| | | | | | - Borja G Cosío
- Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, España; CIBER de Enfermedades Respiratorias (CIBERES), España
| | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación, Hospital Universitario La Candelaria, Tenerife, España
| | | | - Pere Simonet
- Centro de Salud Viladecans-2, Dirección Atención Primaria Costa de Ponent-Institut Català de la Salut, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, España
| | - David Rigau
- Centro Cochrane Iberoamericano, Barcelona, España
| | - Joan B Soriano
- Instituto de Investigación Hospital Universitario de La Princesa (IISP), Universidad Autónoma de Madrid, Consultor Metodológico y de Investigación de SEPAR, Madrid, España
| | - Julio Ancochea
- Servicio de Neumología, Hospital Universitario de La Princesa, Instituto de Investigación, Hospital Universitario de La Princesa (IISP), Universidad Autónoma de Madrid, Madrid, España
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4481
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Munro G, Jansen-Olesen I, Olesen J. Animal models of pain and migraine in drug discovery. Drug Discov Today 2017; 22:1103-1111. [PMID: 28476535 DOI: 10.1016/j.drudis.2017.04.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/16/2017] [Accepted: 04/26/2017] [Indexed: 12/18/2022]
Abstract
Preclinical research activities in relation to pain typically involve the 'holy trinity' of nociceptive, inflammatory and neuropathic pain for purposes of target validation and defining target product profiles of novel analgesic compounds. For some reason it seems that headache or migraine are rarely considered as additional entities to explore. Frontline medications used in the treatment of, for example, inflammatory pain, neuropathic pain and migraine (NSAIDs versus pregabalin/duloxetine versus triptans) reveal distinct differences in pathophysiology that partially explain this approach. Nevertheless, for many patients enduring chronic pain, regardless of aetiology, high unmet needs remain. By focusing more on commonalities shared between neuropathic pain and headache disorders such as migraine, drug discovery efforts could be spread more efficiently across a larger indication area. Here, some of the most commonly used models and methods employed within 'pain and migraine' drug development will be presented. Recent advances within these disciplines suggest that, with the addition of a few extra carefully chosen ancillary models and/or endpoints, the relative value in terms of resources used, reciprocal flow of information and net worth of a 'typical' package could be increased substantially for the pain and migraine fields.
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Affiliation(s)
- Gordon Munro
- Department of Neurology, Danish Headache Center, Glostrup Research Institute, Nordre Ringvej 69, 2600 Glostrup, Denmark.
| | - Inger Jansen-Olesen
- Department of Neurology, Danish Headache Center, Glostrup Research Institute, Nordre Ringvej 69, 2600 Glostrup, Denmark
| | - Jes Olesen
- Department of Neurology, Danish Headache Center, Glostrup Research Institute, Nordre Ringvej 69, 2600 Glostrup, Denmark
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4482
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Gouveia-Figueira S, Goldin K, Hashemian SA, Lindberg A, Persson M, Nording ML, Laurell K, Fowler CJ. Plasma levels of the endocannabinoid anandamide, related N-acylethanolamines and linoleic acid-derived oxylipins in patients with migraine. Prostaglandins Leukot Essent Fatty Acids 2017; 120:15-24. [PMID: 28515018 DOI: 10.1016/j.plefa.2017.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 01/01/2023]
Abstract
There is evidence that patients with migraine have deficient levels of the endogenous cannabinoid receptor ligand anandamide (AEA). It is not known, however, if this is a localised or generalised phenomenon. In the present study, levels of AEA, related N-acylethanolamines (NAEs) and linoleic acid-derived oxylipins have been measured in the blood of 26 healthy women and 38 women with migraine (26 with aura, 12 without aura) who were matched for age and body-mass index. Blood samples were taken on two occasions: the first sample near the start of the menstrual cycle (when present) and the second approximately fourteen days later. For a subset of migraine patients, two additional blood samples were taken, one during a migraine attack and one approximately 1 month later (to be at the same stage in the menstrual cycle, when present). NAEs and oxylipins were measured by liquid chromatography coupled to mass spectrometry. Twenty-nine lipids were quantified, of which 16 were found to have a high reproducibility of measurement. There were no significant differences in the levels of AEA, the related NAEs stearoylethanolamide and oleoylethanolamide or any of the nine linoleic acid-derived oxylipins measured either between migraine patients with vs. without aura, or between controls and migraine patients (after stratification to take into account whether or not the individuals had regular menstruation cycles) in either of the first two samples. Levels of linoleoylethanolamide were lower in the patients with vs. without aura on the second sample but not in the first sample, but the biological importance of this finding is unclear. Due to time-dependent increases in their concentrations ex vivo prior to centrifugation, AEA and oleoylethanolamide levels in the samples collected during migraine attacks were not analysed, but for the other fourteen lipids, there were no significant differences in plasma concentrations during migraine vs. one month later. It is concluded that migraine is not associated with a generalised (as opposed to localised) deficiency in these lipids.
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Affiliation(s)
| | - Kristina Goldin
- Department of Neurology, Östersund Hospital, SE-83183 Östersund, Sweden
| | - Sanaz A Hashemian
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | - Agneta Lindberg
- Clinical Research Center, Region Jämtland Härjedalen, Östersund Hospital, SE-83183 Östersund, Sweden
| | - Monica Persson
- Clinical Research Center, Region Jämtland Härjedalen, Östersund Hospital, SE-83183 Östersund, Sweden
| | - Malin L Nording
- Department of Chemistry, Umeå University, SE-90187 Umeå, Sweden
| | - Katarina Laurell
- Department of Neurology, Östersund Hospital, SE-83183 Östersund, Sweden; Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | - Christopher J Fowler
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden.
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4483
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Araújo VEMD, Bezerra JMT, Amâncio FF, Passos VMDA, Carneiro M. Aumento da carga de dengue no Brasil e unidades federadas, 2000 e 2015: análise do Global Burden of Disease Study 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20Suppl 01:205-216. [DOI: 10.1590/1980-5497201700050017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/06/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Descrever as principais métricas sobre dengue geradas pelo Global Burden of Disease (GBD) Study 2015, para o Brasil e suas 27 unidades federadas, nos anos de 2000 e 2015. Métodos: As métricas descritas foram: taxas de incidência e de mortalidade por dengue, padronizadas por idade, years of life lost (YLL), years lived with disability (YLD) e disability adjusted life years (DALY) (frequência absoluta e taxas padronizadas por idade). As métricas estimadas foram apresentadas com intervalos de incerteza (II 95%) para 2000 e 2015, acompanhadas da variação relativa percentual. Resultados: Verificou-se aumento de 232,7% no número de casos e de 639,0% no número de mortes entre os anos de 2000 e 2015 no país. A taxa de incidência variou 184,3% e a taxa de mortalidade mostrou-se baixa, mas com aumento de 500,0% no período avaliado. As taxas de YLL, YLD e DALY aumentaram 420,0, 187,2 e 266,1%, respectivamente. Em 2015, DALY foi semelhante entre mulheres e homens (21,9/100.000). O DALY aumentou mais que o dobro em todas as unidades da federação. Conclusão: O aumento acentuado de dengue ao longo dos anos associa-se à introdução e/ou circulação de um ou mais sorotipos do vírus e crescente proporção de pacientes acometidos pela forma grave da doença. Apesar da baixa taxa de mortalidade, a dengue contribui para considerável perda de anos saudáveis de vida no Brasil por acometer elevado número de pessoas, de todas as faixas etárias, ocasionando algum grau de incapacidade durante a infecção sintomática, e em razão dos óbitos, principalmente, em crianças.
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Affiliation(s)
| | | | | | | | - Mariângela Carneiro
- Universidade Federal de Minas Gerais, Brazil; Universidade Federal de Minas Gerais, Brazil
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4484
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Bonadiman CSC, Passos VMDA, Mooney M, Naghavi M, Melo APS. A carga dos transtornos mentais e decorrentes do uso de substâncias psicoativas no Brasil: Estudo de Carga Global de Doença, 1990 e 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20Suppl 01:191-204. [DOI: 10.1590/1980-5497201700050016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/20/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: Os transtornos mentais e decorrentes do uso de substâncias psicoativas (TM) são altamente prevalentes, gerando elevado custo social e econômico. Objetivo: Descrever a carga dos TM no Brasil e Unidades Federativas (UFs), em 1990 e 2015. Métodos: Estudo descritivo da carga de doença dos TM, por meio de estimativas padronizadas por idade do Global Burden of Disease Study 2015: anos de vida perdidos por morte prematura (YLL); anos vividos com incapacidade (YLD); e anos de vida perdidos por morte ou incapacidade (DALY=YLL+YLD). Resultados: No Brasil, apesar da baixa taxa de mortalidade, observa-se alta carga para os TM desde 1990, com elevados YLD. Em 2015, esses transtornos foram responsáveis por 9,5% do total de DALY, ocupando a 3ª e a 1ª posições na classificação de DALY e YLD, respectivamente, com destaque para os transtornos depressivos e de ansiedade. Os transtornos decorrentes do uso de drogas apresentaram a maior elevação das taxas de DALY entre 1990 e 2015 (37,1%). A maior proporção de DALY ocorreu na idade adulta e no sexo feminino. Não houve diferenças substanciais na carga dos TM entre as UFs. Conclusão: Apesar da baixa mortalidade, os TM são altamente incapacitantes, indicando necessidade de ações preventivas e protetivas, principalmente na atenção primária em saúde. A homogeneidade das estimativas em todas as UFs, obtidas a partir de estudos realizados majoritariamente nas regiões Sul e Sudeste, provavelmente não reflete a realidade do Brasil, e indica necessidade de estudos em todas as regiões do país.
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Affiliation(s)
| | | | - Meghan Mooney
- Institute for Health Metrics and Evaluation, Estados Unidos
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Estados Unidos
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4485
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Almagro P, Soriano JB. Underdiagnosis in COPD: a battle worth fighting. THE LANCET RESPIRATORY MEDICINE 2017; 5:367-368. [DOI: 10.1016/s2213-2600(17)30133-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
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4486
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Krug E, Cieza A. Strengthening health systems to provide rehabilitation services. Neuropsychol Rehabil 2017; 29:672-674. [PMID: 28457193 DOI: 10.1080/09602011.2017.1319391] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Etienne Krug
- a Department for Management of Noncommunicable Diseases , Disability, Violence and Injury Prevention, World Health Organization , Geneva 27 , Switzerland
| | - Alarcos Cieza
- a Department for Management of Noncommunicable Diseases , Disability, Violence and Injury Prevention, World Health Organization , Geneva 27 , Switzerland
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4487
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Corrêa RDA, José BPDS, Malta DC, Passos VMDA, França EB, Teixeira RA, Camargos PAM. Carga de doença por infecções do trato respiratório inferior no Brasil, 1990 a 2015: estimativas do estudo Global Burden of Disease 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20Suppl 01:171-181. [DOI: 10.1590/1980-5497201700050014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/08/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: Infecções do trato respiratório inferior (ITRi) apresentam incidência e mortalidade significativas no mundo. Este artigo apresenta o impacto das ITRi na carga de doença, segundo as métricas utilizadas no estudo Global Burden of Disease 2015 (GBD 2015) para o Brasil, em 1990 e 2015. Métodos: Análise de estimativas do GBD 2015: anos de vida perdidos por morte prematura (YLLs), anos vividos com incapacidade (YLDs) e anos de vida perdidos por morte ou incapacidade (DALYs = YLLs + YLDs). Resultados: As ITRi foram a terceira causa de mortalidade no Brasil em 1990 e 2015, com 63,5 e 47,0 mortes/100 mil habitantes, respectivamente. Embora o número absoluto de óbitos tenha aumentado 26,8%, houve redução de 25,5% nas taxas de mortalidade padronizadas por idade, sendo a redução mais marcante em menores de 5 anos. Também houve redução progressiva da carga da doença, expressa em DALYs. Discussão: Apesar da redução da carga da doença no período, as ITRi foram importante causa de incapacidade e a terceira causa de mortes no Brasil em 2015. O aumento do número de óbitos ocorreu devido ao aumento e envelhecimento populacional. A redução das taxas de mortalidade acompanhou a melhora das condições socioeconômicas, do acesso mais amplo aos cuidados de saúde, da disponibilidade nacional de antibióticos e das políticas de vacinação adotadas no país. Conclusão: Apesar das dificuldades socioeconômicas vigentes, constatou-se uma redução progressiva da carga das ITRi, principalmente na mortalidade e na incapacidade, e entre os menores de cinco anos de idade.
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4488
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Carabali M, Lim JK, Velez DC, Trujillo A, Egurrola J, Lee KS, Kaufman JS, DaSilva LJ, Velez ID, Osorio JE. Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction. Int J Infect Dis 2017; 58:27-36. [PMID: 28284914 PMCID: PMC5421161 DOI: 10.1016/j.ijid.2017.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. METHODS A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. RESULTS A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. CONCLUSIONS These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.
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Affiliation(s)
- Mabel Carabali
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | - Jacqueline Kyungah Lim
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Diana Carolina Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Andrea Trujillo
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge Egurrola
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Kang Sung Lee
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Luiz Jacinto DaSilva
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Ivan Dario Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge E Osorio
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia; Department of Pathobiological Sciences, University of Wisconsin, Madison, Wisconsin, USA
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4489
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Groeneweg R, van Assen L, Kropman H, Leopold H, Mulder J, Smits-Engelsman BCM, Ostelo RWJG, Oostendorp RAB, van Tulder MW. Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial. Chiropr Man Therap 2017; 25:12. [PMID: 28465824 PMCID: PMC5408403 DOI: 10.1186/s12998-017-0141-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/05/2017] [Indexed: 12/16/2022] Open
Abstract
Background Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical therapy, particularly active exercise therapy (PT) in patients with non-specific neck pain. Methods Patients neck pain, aged between 18–70 years, were included in a pragmatic randomized controlled trial with a one-year follow-up. Primary outcome measures were global perceived effect and functioning (Neck Disability Index), the secondary outcome was pain intensity (Numeric Rating Scale for Pain). Outcomes were measured at 3, 7, 13, 26 and 52 weeks. Multilevel analyses (intention-to-treat) were the primary analyses for overall between-group differences. Additional to the primary and secondary outcomes the number of treatment sessions of the MTU group and PT group was analyzed. Data were collected from September 2008 to February 2011. Results A total of 181 patients were included. Multilevel analyses showed no statistically significant overall differences at one year between the MTU and PT groups on any of the primary and secondary outcomes. The MTU group showed significantly lower treatment sessions compared to the PT group (respectively 3.1 vs. 5.9 after 7 weeks; 6.1 vs. 10.0 after 52 weeks). Conclusions Patients with neck pain improved in both groups without statistical significantly or clinically relevant differences between the MTU and PT groups during one-year follow-up. Trial registration ClinicalTrials.gov Identifier: NCT00713843.
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Affiliation(s)
- Ruud Groeneweg
- Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, Geert Grooteplein 21, 6525 EX Nijmegen, The Netherlands.,Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.,Avans+, University of Applied Science, Heerbaan 14-40, 4817 NL Breda, The Netherlands
| | - Luite van Assen
- Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, Geert Grooteplein 21, 6525 EX Nijmegen, The Netherlands
| | - Hans Kropman
- Avans+, University of Applied Science, Heerbaan 14-40, 4817 NL Breda, The Netherlands
| | - Huco Leopold
- Avans+, University of Applied Science, Heerbaan 14-40, 4817 NL Breda, The Netherlands
| | - Jan Mulder
- Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, Geert Grooteplein 21, 6525 EX Nijmegen, The Netherlands
| | - Bouwien C M Smits-Engelsman
- Department of Health and Rehabilitation Sciences, University of Cape Town, Anzio Road 7935, Cape Town, South Africa
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics & EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Rob A B Oostendorp
- Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Health Care, Geert Grooteplein 21, 6525 EX Nijmegen, The Netherlands.,Department of Manual Therapy, Vrije Universiteit Brussel, Faculty of Medicine and Pharmacy, Brussels, Belgium
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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4490
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Ivandic I, Kamenov K, Rojas D, Cerón G, Nowak D, Sabariego C. Determinants of Work Performance in Workers with Depression and Anxiety: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050466. [PMID: 28445433 PMCID: PMC5451917 DOI: 10.3390/ijerph14050466] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 04/17/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
Abstract
Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person’s life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total (N = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings.
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Affiliation(s)
- Ivana Ivandic
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany.
| | - Kaloyan Kamenov
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Diego de León 62, 28006 Madrid, Spain.
| | - Diego Rojas
- Departamento de Estudios, Servicio Nacional de la Discapacidad (Senadis), Ministerio de Desarrollo Social, Catedral 1575, 8340309 Santiago, Chile.
| | - Gloria Cerón
- Departamento de Estudios, Servicio Nacional de la Discapacidad (Senadis), Ministerio de Desarrollo Social, Catedral 1575, 8340309 Santiago, Chile.
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, 80336 Munich, Germany.
| | - Carla Sabariego
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany.
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4491
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Hotez P, Aksoy S. PLOS Neglected Tropical Diseases: Ten years of progress in neglected tropical disease control and elimination … More or less. PLoS Negl Trop Dis 2017; 11:e0005355. [PMID: 28426662 PMCID: PMC5398476 DOI: 10.1371/journal.pntd.0005355] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This year PLOS Neglected Tropical Diseases (PLOS NTDs) celebrates its tenth anniversary following the publication of the first issue in 2007 [1]. When PLOS NTDs was founded, the framework of the neglected tropical diseases (NTDs) as an alternative to “other diseases” (as they were then referred to in the Millennium Development Goals) was just getting started—especially for Africa [2, 3]. In the decade since, PLOS NTDs has overseen enormous successes in NTD control and elimination. Here, we want to briefly review the ten year progress made towards the control or elimination of the diseases now identified by the WHO as NTDs. Many of the details are highlighted in PLOS NTDs papers cited here, but the summary information is based on the recently released Global Burden of Disease (GBD) Study 2015 (also launched with Gates Foundation support) that summarized past-decade changes in disease prevalence, mortality, or disability rates (from the years 2005 to 2015) [4–6], as well as the GBD Study 2013 that summarizes disease prevalence changes over a longer time horizon from 1990 to 2013 [7].
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Affiliation(s)
- Peter Hotez
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine at Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- Center for Health and Biosciences, James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America
- Scowcroft Institute of International Affairs, Bush School of Government and Public Service, College Station, Texas, United States of America
- * E-mail: (PH); (SA)
| | - Serap Aksoy
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
- * E-mail: (PH); (SA)
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4492
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Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:60-75. [DOI: 10.1007/s00586-017-5099-2] [Citation(s) in RCA: 294] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/19/2017] [Accepted: 04/10/2017] [Indexed: 01/08/2023]
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4493
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Affiliation(s)
- Sara Lustigman
- Molecular Parasitology, New York Blood Center, New York, NY, United States of America
- * E-mail:
| | - Alexandra Grote
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, United States of America
| | - Elodie Ghedin
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, United States of America
- College of Global Public Health, New York University, New York, NY, United States of America
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4494
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Applying a systems approach to thyroid physiology: Looking at the whole with a mitochondrial perspective instead of judging single TSH values or why we should know more about mitochondria to understand metabolism. BBA CLINICAL 2017; 7:127-140. [PMID: 28417080 PMCID: PMC5390562 DOI: 10.1016/j.bbacli.2017.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/20/2017] [Accepted: 03/28/2017] [Indexed: 12/17/2022]
Abstract
Classical thinking in endocrine physiology squeezes our diagnostic handling into a simple negative feedback mechanism with a controller and a controlled variable. In the case of the thyroid this is reduced to TSH and fT3 and fT4, respectively. The setting of this tight notion has no free space for any additions. In this paper we want to challenge this model of limited application by proposing a construct based on a systems approach departing from two basic considerations. In first place since the majority of cases of thyroid disease develop and appear during life it has to be considered as an acquired condition. In the second place, our experience with the reversibility of morphological changes makes the autoimmune theory inconsistent. While medical complexity can expand into the era of OMICS as well as into one where manipulations with the use of knock-outs and -ins are common in science, we have preferred to maintain a simple and practical approach. We will describe the interactions of iron, magnesium, zinc, selenium and coenzyme Q10 with the thyroid axis. The discourse will be then brought into the context of ovarian function, i.e. steroid hormone production. Finally the same elemental players will be presented in relation to the basic mitochondrial machinery that supports the endocrine. We propose that an intact mitochondrial function can guard the normal endocrine function of both the thyroid as well as of the ovarian axis. The basic elements required for this function appear to be magnesium and iron. In the case of the thyroid, magnesium-ATP acts in iodine uptake and the heme protein peroxidase in thyroid hormone synthesis. A similar biochemical process is found in steroid synthesis with cholesterol uptake being the initial energy-dependent step and later the heme protein ferredoxin 1 which is required for steroid synthesis. Magnesium plays a central role in determining the clinical picture associated with thyroid disease and is also involved in maintaining fertility. With the aid of 3D sonography patients needing selenium and/or coenzyme Q10 can be easily identified. By this we firmly believe that physicians should know more about basic biochemistry and the way it fits into mitochondrial function in order to understand metabolism. Contemplating only TSH is highly reductionistic. Outline Author's profiles and motivation for this analysis The philosophical alternatives in science and medicine Reductionism vs. systems approach in clinical thyroid disease guidelines The entry into complexity: the involvement of the musculoskeletal system Integrating East and West: teachings from Chinese Medicine and from evidence based medicine (EBM) Can a mathematical model represent complexity in the daily thyroid practice? How effective is thyroxine treatment? Resolving the situation of residual symptoms in treated patients with thyroid disease Importance of iron, zinc and magnesium in relation to thyroid function Putting together new concepts related to thyroid function for a systems approach Expanding our model into general aspects of medicine
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4495
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Wu YC, Lin LK, Song CJ, Su YX, Tu YK. Comparisons of periodontal regenerative therapies: A meta-analysis on the long-term efficacy. J Clin Periodontol 2017; 44:511-519. [PMID: 28278363 DOI: 10.1111/jcpe.12715] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
AIM We conducted a meta-analysis for the long-term differences in treatment outcomes between periodontal regeneration therapies and flap operation. METHODS A systematic literature search was conducted using the EMBASE, PubMed and Cochrane databases up to June 2016. Treatment outcomes were changes in probing pocket depth and clinical attachment level. We extracted data reported at different time points after periodontal surgery and incorporated all data into the same model. The restricted cubic spline regression was used to estimate the non-linear trend in treatment outcomes. As some studies reported outcomes at multiple time points, we considered several correlation structures for data reported by the same study. RESULTS A total of 52 randomized controlled trials were included in our longitudinal meta-analysis. The follow-up length ranged from 0.5 year to 10 years. The trends in the treatment outcomes were similar under different correlation structures. Enamel matrix derivatives (EMD) and guided tissue regeneration (GTR) achieved greater probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain than flap operation (FO) in the long-term follow up, but no differences were found between EMD and GTR. CONCLUSION Compared with FO, periodontal regeneration surgeries achieved greater PPD reduction and gain in CAL after 1 year, and its effects may last for 5-10 years.
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Affiliation(s)
- Yun-Chun Wu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Liang-Ko Lin
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Cheng-Jie Song
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Xuan Su
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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4496
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4497
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Zukeran MS, Ribeiro SML. The Importance of Nutrition in a Conceptual Framework of Frailty Syndrome. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0195-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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4498
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Souliotis K, Kousoulakou H, Hillas G, Bakakos P, Toumbis M, Loukides S, Vassilakopoulos T. Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach. Front Public Health 2017; 5:67. [PMID: 28424767 PMCID: PMC5380663 DOI: 10.3389/fpubh.2017.00067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/20/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. METHODS A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal. RESULTS Patients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs. CONCLUSION Asthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.
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Affiliation(s)
- Kyriakos Souliotis
- Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece
| | - Hara Kousoulakou
- Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece
| | - Georgios Hillas
- Department of Pulmonary and Critical Care Medicine, Medical School, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Bakakos
- 1st Respiratory Medicine Department, “Sotiria” Hospital for Thoracic Diseases, University of Athens Medical School, Athens, Greece
| | - Michalis Toumbis
- 6th Pulmonary Department, “Sotiria” Hospital for Thoracic Diseases, Athens, Greece
| | - Stelios Loukides
- 2nd Respiratory Medicine Department, “Attikon” Hospital, University of Athens Medical School, Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Pulmonary and Critical Care Medicine, Medical School, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
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4499
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Xie JY, De Felice M, Kopruszinski CM, Eyde N, LaVigne J, Remeniuk B, Hernandez P, Yue X, Goshima N, Ossipov M, King T, Streicher JM, Navratilova E, Dodick D, Rosen H, Roberts E, Porreca F. Kappa opioid receptor antagonists: A possible new class of therapeutics for migraine prevention. Cephalalgia 2017; 37:780-794. [PMID: 28376659 DOI: 10.1177/0333102417702120] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Stress is the most commonly reported migraine trigger. Dynorphin, an endogenous opioid peptide acting preferentially at kappa opioid receptors (KORs), is a key mediator of stress responses. The aim of this study was to use an injury-free rat model of functional cephalic pain with features of migraine and medication overuse headache (MOH) to test the possible preventive benefit of KOR blockade on stress-induced cephalic pain. Methods Following sumatriptan priming to model MOH, rats were hyper-responsive to environmental stress, demonstrating delayed cephalic and extracephalic allodynia and increased levels of CGRP in the jugular blood, consistent with commonly observed clinical outcomes during migraine. Nor-binaltorphimine (nor-BNI), a long-acting KOR antagonist or CYM51317, a novel short-acting KOR antagonist, were given systemically either during sumatriptan priming or immediately before environmental stress challenge. The effects of KOR blockade in the amygdala on stress-induced allodynia was determined by administration of nor-BNI into the right or left central nucleus of the amygdala (CeA). Results KOR blockade prevented both stress-induced allodynia and increased plasma CGRP. Stress increased dynorphin content and phosphorylated KOR in both the left and right CeA in sumatriptan-primed rats. However, KOR blockade only in the right CeA prevented stress-induced cephalic allodynia as well as extracephalic allodynia, measured in either the right or left hindpaws. U69,593, a KOR agonist, given into the right, but not the left, CeA, produced allodynia selectively in sumatriptan-primed rats. Both stress and U69,593-induced allodynia were prevented by right CeA U0126, a mitogen-activated protein kinase inhibitor, presumably acting downstream of KOR. Conclusions Our data reveal a novel lateralized KOR circuit that mediated stress-induced cutaneous allodynia and increased plasma CGRP in an injury-free model of functional cephalic pain with features of migraine and medication overuse headache. Selective, small molecule, orally available, and reversible KOR antagonists are currently in development and may represent a novel class of preventive therapeutics for migraine.
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Affiliation(s)
- Jennifer Y Xie
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Milena De Felice
- 2 School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Caroline M Kopruszinski
- 3 Department of Pharmacology, Biological Sciences Section, Federal University of Parana, Curitiba, Brazil
| | - Nathan Eyde
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Justin LaVigne
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Bethany Remeniuk
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Pablo Hernandez
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Xu Yue
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Naomi Goshima
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Michael Ossipov
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Tamara King
- 4 Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, ME, USA
| | - John M Streicher
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | - Edita Navratilova
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA
| | | | - Hugh Rosen
- 6 Scripps Research Institute, La Jolla, CA, USA
| | - Ed Roberts
- 6 Scripps Research Institute, La Jolla, CA, USA
| | - Frank Porreca
- 1 Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, USA.,5 Mayo Clinic, Phoenix, AZ USA
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4500
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Islam MR, Rahman MS, Islam Z, Nurs CZB, Sultana P, Rahman MM. Inequalities in financial risk protection in Bangladesh: an assessment of universal health coverage. Int J Equity Health 2017; 16:59. [PMID: 28376808 PMCID: PMC5381038 DOI: 10.1186/s12939-017-0556-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 03/30/2017] [Indexed: 01/31/2023] Open
Abstract
Background Financial risk protection and equity are major components of universal health coverage (UHC), which is defined as ensuring access to health services for all citizens without any undue financial burden. We investigated progress towards UHC financial risk indicators and assessed variability of inequalities in financial risk protection indicators by wealth quintile. We further examined the determinants of different financial hardship indicators related to healthcare costs. Methods A cross-sectional, three-stage probability survey was conducted in Bangladesh, which collected information from 1600 households from August to November 2011. Catastrophic health payments, impoverishment, and distress financing (borrowing or selling assets) were treated as financial hardship indicators in UHC. Poisson regression models were used to identify the determinants of catastrophic payment, impoverishment and distress financing separately. Slope, relative and concentration indices of inequalities were used to assess wealth-based inequalities in financial hardship indicators. Results The study found that around 9% of households incurred catastrophic payments, 7% faced distress financing, and 6% experienced impoverishing health payments in Bangladesh. Slope index of inequality indicated that the incidence of catastrophic health payment and distress financing among the richest households were 12 and 9 percentage points lower than the poorest households respectively. Multivariable Poisson regression models revealed that all UHC financial hardship indicators were significantly higher among household that had members who received inpatient care or were in the poorest quintile. The presence of a member with chronic illness in a household increased the risk of impoverishment by nearly double. Conclusion This study identified a greater inequality in UHC financial hardship indicators. Rich households in Bangladesh were facing disproportionately less financial hardship than the poor ones. Households can be protected from financial hardship associated with healthcare costs by implementing risk pooling mechanism, increasing GDP spending on health, and properly monitoring subsidized programs in public health facilities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0556-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Md Rashedul Islam
- Department of Computer Science, Uttara Commerce College, Dhaka, Bangladesh
| | - Md Shafiur Rahman
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan
| | - Zobida Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | | | - Papia Sultana
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Mizanur Rahman
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan. .,Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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