scholarly journals Thromboprophylaxis in lower limb immobilisation after injury (TiLLI)

2019 ◽  
Vol 37 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Daniel Horner ◽  
Steve Goodacre ◽  
Abdullah Pandor ◽  
Timothy Nokes ◽  
Jonathan Keenan ◽  
...  
Keyword(s):  
Lower Limb ◽  
Significant Loss ◽  
Pharmacological Agents ◽  
Pharmacological Prophylaxis ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Venous Thromboembolic ◽  
Dosing Regimens ◽  
Event Rates ◽  
Proportional Reduction

Venous thromboembolic disease is a major global cause of morbidity and mortality. An estimated 10 million episodes are diagnosed yearly; over half of these episodes are provoked by hospital admission/procedures and result in significant loss of disability adjusted life years. Temporary lower limb immobilisation after injury is a significant contributor to the overall burden of venous thromboembolism (VTE). Existing evidence suggests that pharmacological prophylaxis could reduce overall VTE event rates in these patients, but the proportional reduction of symptomatic events remains unclear. Recent studies have used different pharmacological agents, dosing regimens and outcome measures. Consequently, there is wide variation in thromboprophylaxis strategies, and international guidelines continue to offer conflicting advice for clinicians. In this review, we provide a summary of recent evidence assessing both the clinical and cost effectiveness of thromboprophylaxis in patients with temporary immobilisation after injury. We also examine the evidence supporting stratified thromboprophylaxis and the validity of widely used risk assessment methods.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

Health and Well-Being in Adolescence

2018 ◽  
Author(s):  
Susan M. Sawyer ◽  
George C. Patton
Keyword(s):  
Adolescent Health ◽  
Social Determinants ◽  
Well Being ◽  
Brain Maturation ◽  
Health Determinants ◽  
Physical And Mental Health ◽  
Disability Adjusted Life ◽  
Life Years ◽  
High Benefit ◽  
Health And Well Being

This chapter describes how the profile of physical and mental health and well-being changes across adolescence. The biological context of healthy adolescent growth and development is reviewed, including secular patterns of puberty and brain maturation. The structural and social determinants of adolescent health are then described. Adolescent health outcomes, including patterns of risk behaviors, emerge from the interaction between biological influences and social health determinants. Estimates of mortality and disability-adjusted life years are used to describe three patterns of adolescent health and well-being that vary by age, sex, and national wealth. Globally, the burden of disease increases across adolescence, varying markedly between and within countries. Comprehensive, multisectoral, evidence-informed actions are required that match these conspicuous adolescent health problems, emerging health risks, and major social determinants. Such actions, including quality education and health services, differ greatly from those that benefit younger children yet have similarly high benefit–cost ratios.

scholarly journals Burden of foodborne disease in the Netherlands: from science to policy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Mughini Gras
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Cost Of Illness ◽  
Disease Burden ◽  
Food Groups ◽  
Source Attribution ◽  
Productivity Losses ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Animal Contact

Abstract In the Netherlands, the Ministry of Health mandates the National Institute for Public Health and the Environment (RIVM) to provide annual updates of the number of illnesses, disease burden and cost-of-illness caused by an agreed-upon standard panel of 14 enteric pathogens. These pathogens are mainly transmitted by food, but also via direct contact with animals, environment-mediated and human-to-human transmission routes. The disease burden is expressed in DALYs (Disability Adjusted Life Years), a metric integrating morbidity and mortality into one unit. Furthermore, the cost-of-illness (COI) related to these 14 pathogens is estimated and expressed in euros. The COI estimates include healthcare costs, the costs for the patient and/or his family, such as travel expenses, as well as costs in other sectors, for example due to productivity losses. Moreover, using different approaches to source attribution, the estimated DALYs and associated COI estimates are attributed to five major transmission pathways (i.e. food, environment, direct animal contact, human-human transmission, and travel) and 11 food groups within the foodborne pathway itself. The most recent DALY and COI estimates referring to the year 2018 show that the 14 pathogens in question are cumulatively responsible for about 11,000 DALYs and €426 million costs for the Dutch population in 2018, with a share for foodborne transmission being estimated at 4,300 DALYs and €171 million costs, which is comparable to previous years. These estimates have been providing vital insights for policy making as to guide public health interventions and resource allocation for over two decades in the Netherlands. Herewith, the approach and outcomes of the burden of disease and COI estimates in the Netherlands will be presented, with a focus on how these estimates enable policy-makers and the scientific community to monitor trends, generate scientific hypotheses, and undertake public health actions.

scholarly journals Sex-Dependent End-of-Life Mental and Vascular Scenarios for Compensatory Mechanisms in Mice with Normal and AD-Neurodegenerative Aging

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 111
Author(s):  
Aida Muntsant ◽  
Francesc Jiménez-Altayó ◽  
Lidia Puertas-Umbert ◽  
Elena Jiménez-Xarrie ◽  
Elisabet Vila ◽  
...  
Keyword(s):  
Life Expectancy ◽  
End Of Life ◽  
Mortality Rates ◽  
Disability Adjusted Life Years ◽  
Pharmacological Interventions ◽  
Compensatory Mechanisms ◽  
Healthy Life ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Bidirectional Interactions

Life expectancy decreases with aging, with cardiovascular, mental health, and neurodegenerative disorders strongly contributing to the total disability-adjusted life years. Interestingly, the morbidity/mortality paradox points to females having a worse healthy life expectancy. Since bidirectional interactions between cardiovascular and Alzheimer’s diseases (AD) have been reported, the study of this emerging field is promising. In the present work, we further explored the cardiovascular–brain interactions in mice survivors of two cohorts of non-transgenic and 3xTg-AD mice, including both sexes, to investigate the frailty/survival through their life span. Survival, monitored from birth, showed exceptionally worse mortality rates in females than males, independently of the genotype. This mortality selection provided a “survivors” cohort that could unveil brain–cardiovascular interaction mechanisms relevant for normal and neurodegenerative aging processes restricted to long-lived animals. The results show sex-dependent distinct physical (worse in 3xTg-AD males), neuropsychiatric-like and cognitive phenotypes (worse in 3xTg-AD females), and hypothalamic–pituitary–adrenal (HPA) axis activation (higher in females), with higher cerebral blood flow and improved cardiovascular phenotype in 3xTg-AD female mice survivors. The present study provides an experimental scenario to study the suggested potential compensatory hemodynamic mechanisms in end-of-life dementia, which is sex-dependent and can be a target for pharmacological and non-pharmacological interventions.

Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990–2019: estimates from Global Burden of Disease Study 2019

2021 ◽  
Author(s):  
Rajesh Sharma
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Asian Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standardized Mortality Rate

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.

Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990–2017: an interrupted time series study

2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães
Keyword(s):  
Time Series ◽  
Antiretroviral Therapy ◽  
Burden Of Disease ◽  
Interrupted Time Series ◽  
People Living With Hiv ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Hiv Aids

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.

scholarly journals Burden of Stroke in Myanmar

2021 ◽  
pp. 49-51
Author(s):  
Narayanaswamy Venketasubramanian ◽  
Yee Mon Khine ◽  
Ohnmar Ohnmar ◽  
Myat Po Po Kyaw Khin ◽  
Min Thit Win
Keyword(s):  
Rural Areas ◽  
Mechanical Thrombectomy ◽  
Disability Adjusted Life Years ◽  
Stroke Units ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Lower Blood ◽  
Life Years Lost ◽  
Standardized Mortality Rate ◽  
Age And Sex

Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There are only 10 stroke units in the whole country. Doctors are aware of the importance of hypertension in stroke prevention and the need for physiotherapy after stroke, but, until recently and in rural areas, they also tend to use steroids and neuroprotectants, and lower blood pressure aggressively acutely after stroke; antiplatelets are not widely used. Thrombolysis service is available at some tertiary centers but mechanical thrombectomy is not yet available.

scholarly journals COPD awareness in the urban slums and rural areas around Pune city in India

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Deesha Deepak Ghorpade ◽  
Anchala Raghupathy ◽  
Jyoti Deepak Londhe ◽  
Sapna Jitendra Madas ◽  
Nisha Vijay Kale ◽  
...  
Keyword(s):  
Tobacco Smoking ◽  
Rural Areas ◽  
Total Population ◽  
Health Workers ◽  
Urban Slum ◽  
Urban Slums ◽  
Cross Sectional ◽  
Rural Villages ◽  
Disability Adjusted Life ◽  
Life Years

AbstractCOPD is the second leading cause of death and disability adjusted life years (DALYs) in India, yet, it remains poorly recognized. We aimed to study the level of awareness of COPD in urban slums of Pune city in India and its neighboring rural areas. All male and female subjects above the age of 30 years residing in 13 randomly selected slums of Pune city (total population of 3000) and 7 randomly selected neighboring rural villages (total population of 3000) were invited to participate in this cross-sectional community survey. After obtaining written informed consent, 13 trained community health workers (CHWs) administered a questionnaire that captured their level of awareness of COPD. Of the 6000 subjects approached, 5420 residents (mean age ± SD = 48.0 ± 13.5 years; 38% males) consented and answered all questions. The number of people who had ever heard the word COPD was 49/5420 [0.9% (0.6–1.1%); 0.7% (0.5–1.3%) of the urban slum dwellers and 1.15% (0.5–1.3%) of rural residents]. Among those who had never heard the word COPD (n = 5371), when asked what was the name of the disease caused by long-term tobacco smoking, 38% said cancer, 16.7% said asthma, and 4.4% said TB. Among those who had heard the word COPD (n = 49), 6.1% said it was a disease of the heart, and 61% attributed COPD to smoke and dust pollution and 20% to tobacco smoking. The level of awareness of COPD in the Indian community is extremely low, highlighting the need to have nationwide mass awareness programs in India.

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