The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

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 −0.34 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 = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) 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)

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: 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 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). 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. Funding Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders 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.MethodsWe 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.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). 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.InterpretationAs 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

Challenges for African sports scientists: Bridging the gap between theory and practice

Africa has a long history and tradition of sport participation when viewed from the perspectives of pre-colonial, colonial and independent Africa. The continent has contributed immensely to the field of sport, be it athletes or personnel. The marvelous performances in sprint events by athletes from the west coasts, the domination of the middle and long distance events by athletes from East Africa (Kenya in particular), Ethiopia and Magreb states (Morroco and Tunisia), the excellent performances in boxing (South Africa) and swimming by athletes from South Africa and Egypt are few of the notable achievements in the World of Sport. The reasons for these remarkable achievements have not been fully scientifically studied until recently when some discernible efforts were made at studying African athletes by African Sports Scientists (Coetzer, et al, 1993; de Ridder & Amusa, 1997; Noakes, 1997; Amusa, 2003; Toriola et al, 2003). What makes a successful African athlete could be understood by employing the discipline of sports sciences. In Africa Sports Science is still in its infancy. Its resource base is essentially situated at tertiary institutions where researches have traditionally been targetted at internationally recognised athletes. This discipline involves the development and integration of well organised and institutionalised programmes of testing and training, and the collaboration of such other disciplines like medicine, physiology, nutrition, psychology and biomechanics to mention just a few. Backed by reliable statistics on performance results and achievements of African athletes in major world competitions, this paper discusses the collaborations in the fields of sport science to unravel the unsolved issues surrounding the African athletes. The paper benchmarks sport science practices in developed countries like (East) Germany, Australia, U.S.A. and Canada with success stories at the scientific development of athletes. This paper also raises serious concern regarding the low level of expertise of African coaches and technical support staff in applying the limited findings of sports research, and in translating theory into practice. This probably reduces the potential of sports persons to benefit from the scientific and medical research findings. The paper finally recommends four main areas of focus in sport science practices in Africa. These are: (1) The need to develop strategies to study the uniqueness of African athletes, (2) the quest to establish Research Training/Sport Science Institutes/Centres comparable in functions with those of Germany, Australia and U.S.A., (3) the need to determine the underlying factors that have contributed so far to the success of African athletes, and (4) the need to develop key performance areas in Sports Science Research in Africa. These needs call for harmonious integration of diverse Applied Science disciplines, collaborative/interdisciplinary approaches, and initiatives by Africa sports scientists and sports physicians with a view to produce far better results, athletes, coaches and technical persons who will be better equipped with relevant current knowledge and skills in the science of sports. Key Words: African sports scientists, theory, practice, performance factors, multidisciplinary approach. AJPHERD. Vol.10(1) 2004: 1-1

8th All Africa Pre-Games' Scientific Congress - Report and Declaration

No abstract availabl

A comparative analysis of the perception and understanding of physical education and school sport among South African children aged 6-15 years

Physical Education (PE) and School Sport (SS) in South Africa demonstrate extremes and inequities. Contrast is visible in all aspects of South African life, but most significantly in education. White and urban schools are relatively problem free, whereas black and rural schools have been adversely affected by the past governments' apartheid and separate development policies (Walter, 1994). Some schools have well developed facilities, while the majority have next to nothing. PE teachers are qualified in some cases and grossly unqualified in many others. PE programmes in white schools and urban cities offer a wide and balanced variety of activities while in others opportunities are limited to a few movement activities. As a school subject PE has been neglected, misunderstood, seen as being of little importance and regarded as inferior when compared to other subjects in the school curriculum (Walter, 1994). In order to find out the status of PE and school sport among school children aged 6- 15years, we administered the Sport in Education (SpinEd) project questionnaire (Bailey, 2005) to 897 school children in two provinces and contrasting geographical locations in South Africa. The questionnaire focused on five main themes/domains that refer to specific aspects of children's development and understanding through PE and school sport, i.e. physical development, lifestyle development, affective development, social development and cognitive development. The results showed some disparity in the perception and understanding of PE and SS among the respondents' age group and geographical location, specifically with regard to ‘feeling' about PE and SS, ‘values' (importance) of PE and SS, ‘comparison' of PE and SS with other school subjects and ‘self-rating' on PE and SS. Responses to each of the five themes/domains varied across age group, and geographical location, indicating the fact that children need to achieve the five most important developmental competencies – foundational (knowledge), practical skills (psychomotor), reflexive (affective), physical (growth) and social skills for holistic development and for PE and SS to adequately address the needs of post-independent South Africa. Keywords: physical education, holistic development, new South Africa, reflexive competency, school sports African Journal for Physical, Health Education, Recreation and Dance Vol. 12(3) 2006: 220-23

The changing phases of Physical education in Africa: Can a uniquely African model emerge?

Africa has a rich tradition of culture, history, sport and social institutions. Various countries throughout the continent have demonstrated these. The rich traditional games, plays, dances and arts of the continent have stood the test of time. They were used for various purposessocialization, initiation, ceremonies, recreation, etc. Archaeological discoveries continue to associate the continent with the origin of man, including physical culture. The practice of physical education is deeply rooted in the cultural fabric of various ethnic communities who developed physical prowess as an integral part of the traditional process associated with practices such as food gathering, hunting, pastoral activities, inter-tribal conflicts, etc. These cultural activities were grounded in traditional education wherein physical prowess was highly revered. These historical practices mark the first phase in the evolution of PE in Africa. The second phase is characterized by the contact with the “western world” which marked the beginning of the erosion of the traditional education and the establishment of colonial and missionary models of education that regarded the indigenous physical activities as primitive, immoral and anti-Christianity. Western (colonial) formalized PE and Sport placed emphasis on military drills, physical training (PT) formalized activities and training of teachers. As many African countries were colonized by various western powers, a number of PE syllabi which emphasized the above skills were introduced to the respective countries; for example, the 1933 syllabus was introduced by Britain to all her colonies. The striking element of this (colonial) system of education was the lack of relevance to the cultures and values of indigenous African populations. In third phase attainment of independence by most African countries resulted in significant developments in education (i.e. concerning PE and Sport) which was aimed at restoring those dignities and values which were repressed, maimed and destroyed during the colonial times. Most African countries redefined their education, including PE and Sport. Specifically, PE contributed to sport development and the emergent of the continent as a sport power. However, no discernible pattern of PE and Sport emerged. It was the story of old wine in a new bottle. The post-independence period and the last decade of the 20th Century marked the fourth phase in the evolution of PE and Sport wherein the disciplines experienced serious setbacks following the prevailing socioeconomic challenges around the world. Several PE and Sport programmes collapsed due to lack of funding. Yet Africa (and indeed no country) did not still evolve a discernible pattern or model of its own. The 21st Century PE and Sport in Africa is still a replica of the colonial and postindependence model. The political changes on the continent did not lead to any concomitant changes in the structures of PE and Sport. This article discusses the above phases and concludes that for PE and Sport to succeed in Africa, there must emerge models that are uniquely African. They must be developed in Africa by Africans and for the benefit of Africans. Any model which continues to follow either the western or oriental models may not be sustainable.Key words: Physical Education and Sport, curriculum development, African renaissance, culture traditional games.