Healthcare Delivery among Yoruba Bonesetters in Southwest Nigeria and the Need for Collaboration with Orthodox Orthopedic Healthcare Services: A Mixed Method Study

This study covers three purposively chosen states; Ogun, Ondo, and Oyo, in southwestern Nigeria. Primary data were collected using three sets of questionnaires. The respondent-driven sampling (RDS) technique was employed in selecting the respondents for the study. A total of 69 traditional bonesetters (TBS), 130 TBS patients, and 15 orthopedic surgeons were interviewed. The study reveals that majority (91.2%) of the TBS in the study area claimed that they had received an average of 11 patients from orthodox hospitals in the year preceding the survey while about 9.0% of the respondents reported that 78 Soladoye S. Asa, Matthew O. Ilori, and Lawrence A. Akinyoola they had on the average advised 6 patients per year to relocate to orthodox hospitals. The study also reveals the views of TBS areas of need from government to include recognition (93.7%) and integration into the country’s health system (63.5%). A majority (93.3%) of the orthopedic surgeons reported having received patients from TBS, and each surgeon had received, on average, 37 patients per year. All the orthopedic surgeons surveyed believed that TBS lacked knowledge in the management of bone injuries, apart from setting bones. Other issues considered critical by the doctors in the management of fractures by TBS included lack of training in the biology of bones (86.7%) and inability to refer cases to modern health facilities (73.3%). The proportion of orthopedic surgeons who had ever thought of a possible interaction between TBS and orthopedic surgeons was 80.0% while 86.7% would advise the establishment of such interaction. Furthermore, the study reveals that more than half (54.6%) of TBS patients made a TBS clinic their first choice for treatment. The paper concludes that integration will go a long way to improving the health of the population, thereby significantly reducing deaths or disability-adjusted life years (DALYs) lost.

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Trends and Risk Factors of Mortality and Disability-Adjusted Life Years for Cardiovascular Diseases from 1990 to 2017: Systematic Analysis for the Global Burden of Disease Study 2017

SSRN Electronic Journal ◽

10.2139/ssrn.3724861 ◽

2020 ◽

Author(s):

Zhenkun Wang ◽

Zhishui Chen ◽

Congyi Wang ◽

Aihua Du ◽

Hong Liu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Disability Adjusted Life Years ◽

Systematic Analysis ◽

Disability Adjusted Life ◽

Life Years ◽

Disease Study

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Identifying Public Health Problems

10.1093/oso/9780190681050.003.0005 ◽

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.

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

Biomedicines ◽

10.3390/biomedicines9020111 ◽

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.

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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

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyab004 ◽

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.

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

International Journal of STD & AIDS ◽

10.1177/0956462420952989 ◽

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.

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Burden of Stroke in Myanmar

Cerebrovascular Diseases Extra ◽

10.1159/000515123 ◽

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.

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