23 research outputs found
Health and social problems associated with recent Novel Psychoactive Substance (NPS) use amongst marginalised, nightlife and online users in six European countries.
Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of ‘herbal blends’ and ‘synthetic cannabinoids obtained pure’ was most reported in Germany, Poland and Hungary, and use of ‘branded stimulants’ and ‘stimulants/empathogens/nootropics obtained pure’ was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted
Synthetic Cathinones—Prevalence and Motivations for Use
This book chapter reviews the prevalence and motivations for use of synthetic cathinones with respect to their availability, legal status, numbers and seized amounts
Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
Background:
The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.
Methods:
We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.
Findings:
Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]).
Interpretation:
Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury
Croll revisited: Why is the northern hemisphere warmer than the southern hemisphere?
The question of why, in the annual-mean, the northern hemisphere (NH) is warmer than the southern hemisphere (SH) is addressed, revisiting an 1870 paper by James Croll. We first show that ocean is warmer than land in general which, acting alone, would make the SH, with greater ocean fraction, warmer. Croll was aware of this and thought it was caused by greater specific humidity and greenhouse trapping over ocean than over land. However, for any given temperature, it is shown that greenhouse trapping is actually greater over land. Instead, oceans are warmer than land because of the smaller surface albedo. However, hemispheric differences in planetary albedo are negligible because the impact of differences in land-sea fraction are offset by the SH ocean and land reflecting more than their NH counterparts. In the absence of a role for albedo differences it is shown that, in agreement with Croll, northward cross-equatorial ocean heat transport (X-OHT) is critical for the warmer NH. This is examined in a simple box model based on the energy budget of each hemisphere. The hemispheric difference forced by X-OHT is enhanced by the positive water vapor-greenhouse feedback, and is partly compensated by the southward atmospheric energy transport. Due to uncertainties in the ocean data, a range of X-OHT is considered. A X-OHT of larger than 0.5 PW is needed to explain the warmer NH solely by X-OHT. For smaller X-OHT, a larger basic state greenhouse trapping in the NH, conceived as imposed by continental geometry, needs to be imposed. Numerical experiments with a GCM coupled to a slab ocean provide evidence that X-OHT is fundamentally important in determining the hemispheric differences in temperature. Therefore, despite some modifications to his theory, analysis of modern data confirms Croll's 140-year-old theory that the warmer NH is partly because of northward X-OHT.close1
Contribution of ocean overturning circulation to tropical rainfall peak in the Northern Hemisphere
Rainfall in the tropics is largely focused in a narrow zonal band near the Equator, known as the intertropical convergence zone. On average, substantially more rain falls just north of the Equator. This hemispheric asymmetry in tropical rainfall has been attributed to hemispheric asymmetries in ocean temperature induced by tropical landmasses. However, the ocean meridional overturning circulation also redistributes energy, by carrying heat northwards across the Equator. Here, we use satellite observations of the Earth's energy budget, atmospheric reanalyses and global climate model simulations to study tropical rainfall using a global energetic framework. We show that the meridional overturning circulation contributes significantly to the hemispheric asymmetry in tropical rainfall by transporting heat from the Southern Hemisphere to the Northern Hemisphere, and thereby pushing the tropical rain band north. This northward shift in tropical precipitation is seen in global climate model simulations when ocean heat transport is included, regardless of whether continents are present or not. If the strength of the meridional overturning circulation is reduced in the future as a result of global warming, as has been suggested, precipitation patterns in the tropics could change, with potential societal consequences.close9