754 research outputs found
Social Phobia in Persian Adults with Stuttering
Background: Stuttering is a communication disorder. It is expected that
stuttering may have negative impact on individualsā mental and emotional
health, which may affect their quality of life. Therefore, this paper aims to study
components of social phobia inventory in Persian adults with stuttering and
compare the likelihood (odds) of social phobia in the stuttering group to that in
the control group.
Methods: Using social phobia inventory, this case-control study compared
social phobia in 33 adults with stuttering and 33 age-gender-education matched
subjects with fluent speech. All the participants were 18 years or above.
Results: Independent t-test showed that the total score of the social phobia
inventory. Its fear component has significant statistical differences between
group of adults with and without stuttering. Moreover, the adults with stuttering
have over two times more social phobia symptoms than that in ones who donāt.
Conclusion: Our results suggest that social phobia should be considered in
therapy programs for adults with stuttering. In addition to restructuring speech,
a part of the treatment program should address peopleās social phobia, especially
their feeling of fear, in order to curtail some of the negative consequences
associated with stuttering
Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019
BACKGROUND: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of ā0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = ā0.41), inflammatory bowel disease (AAPC = ā0.72), multiple sclerosis (AAPC = ā0.26), psoriasis (AAPC = ā0.77), and atopic dermatitis (AAPC = ā0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. FUNDING: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)
Global, regional, and national burden of disorders affecting the nervous system, 1990ā2021: a systematic analysis for the Global Burden of Disease Study 2021
BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378ā521), affecting 3Ā·40 billion (3Ā·20ā3Ā·62) individuals (43Ā·1%, 40Ā·5ā45Ā·9 of the global population); global DALY counts attributed to these conditions increased by 18Ā·2% (8Ā·7ā26Ā·7) between 1990 and 2021. Age-standardised rates of deaths per 100ā000 people attributed to these conditions decreased from 1990 to 2021 by 33Ā·6% (27Ā·6ā38Ā·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27Ā·0% (21Ā·5ā32Ā·4). Age-standardised prevalence was almost stable, with a change of 1Ā·5% (0Ā·7ā2Ā·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990ā2021: a systematic analysis for the Global Burden of Disease Study 2021
Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2Ā·5th and 97Ā·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2Ā·63 billion (95% UI 2Ā·44ā2Ā·85) in 2010 to 2Ā·88 billion (2Ā·64ā3Ā·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14Ā·2% (95% UI 10Ā·7ā17Ā·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4Ā·1% (1Ā·8ā6Ā·3) in 2020 and 7Ā·2% (4Ā·7ā10Ā·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212Ā·0 million [198Ā·0ā234Ā·5] DALYs), followed by ischaemic heart disease (188Ā·3 million [176Ā·7ā198Ā·3]), neonatal disorders (186Ā·3 million [162Ā·3ā214Ā·9]), and stroke (160Ā·4 million [148Ā·0ā171Ā·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47Ā·8% (43Ā·3ā51Ā·7) and for diarrhoeal diseases decreased by 47Ā·0% (39Ā·9ā52Ā·9). Non-communicable diseases contributed 1Ā·73 billion (95% UI 1Ā·54ā1Ā·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6Ā·4% (95% UI 3Ā·5ā9Ā·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16Ā·7% [14Ā·0ā19Ā·8]), depressive disorders (16Ā·4% [11Ā·9ā21Ā·3]), and diabetes (14Ā·0% [10Ā·0ā17Ā·4]). Age-standardised DALY rates due to injuries decreased globally by 24Ā·0% (20Ā·7ā27Ā·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61Ā·3 years (58Ā·6ā63Ā·6) in 2010 to 62Ā·2 years (59Ā·4ā64Ā·7) in 2021. However, despite this overall increase, HALE decreased by 2Ā·2% (1Ā·6ā2Ā·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation