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

Creating a Sex Education Package and Determining Its Effectiveness on Self-Esteem in Primary School Children

Objective: Development of a healthy identity can significantly affect the formation of other traits, including self-esteem and body image, in individuals. The aim of the study was to develop a sexual education program and evaluate its impact on the self-esteem of elementary school children. Methods: It was a quasi-experimental study with a pre-test-post-test design, which included a control group. The statistical population consisted of all elementary school girls in Shiraz (Iran) in 2021, and the sampling method was random from the girls' elementary schools in Shiraz. The participants were 30 female students who were randomly  assigned to two groups, experimental and control, each with 15 individuals. The Cooper Smith Self-Esteem Inventory (SEI) was used to measure self-esteem. Results: The multivariate covariance analysis indicated that the F-statistic for personal and social self-esteem variables was significant (p < 0.001), but not for the family self-esteem variable. Conclusions: Therefore, implementing the sexual education program for elementary school children has a positive and significant effect on personal and social self-esteem

The association between health literacy and pedestrian safety behavior among adults: a cross-sectional study

Abstract Introduction Pedestrians are considered the most vulnerable and complex road users as human behavior constitutes one of the fundamental reasons for traffic-related incidents involving pedestrians. However, the role of health literacy as a predictor of Pedestrian safety behavior remains underexplored. Therefore, the current study was designed to examine the level of health literacy and its association with the safety behavior of adult pedestrians in the city of Tabriz. Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years in the metropolitan area of Tabriz from January to April 2023. Data were collected using the HELIA standard questionnaire (Health Literacy Instrument for adults), comprising 33 items across 5 domains (access, reading, understanding, appraisal, decision-making and behavior), as well as the Pedestrian Behavior Questionnaire (PBQ) consisting of 29 items. Data were analyzed using descriptive and analytical statistics (independent t-tests, ANOVA, and Pearson correlation coefficient) via SPSS-22 software. Results Based on the results, 94% (376 individuals) had excellent health literacy levels, and their safety behavior scores were at a good level. Health literacy and safety behavior were higher among the age group of 31 to 45 years, women, married individuals, those who read books, and individuals with higher education. However, safety behavior showed no significant association with education level (P > 0.05). There was a significant and positive relationship between health literacy and all its domains and pedestrian safety behavior (r = 0.369, P < 0.001). Conclusion This study underscores the significant impact of health literacy on pedestrians’ safety behavior. The findings reveal that higher levels of health literacy are associated with better safety behavior among individuals aged 18 to 63. Demographic factors such as age, gender, marital status, and education level also play a role in shaping both health literacy and safety behavior. By recognizing these relationships, interventions can be tailored to improve health literacy levels and promote safer pedestrian practices, ultimately contributing to a healthier and safer community in Tabriz city

Tetranychus urticae changes its oviposition pattern in the presence of the predatory mites, Phytoseiulus persimilis and Typhlodromus bagdasarjani

Oviposition behaviors in herbivorous mites are affected by several factors i.e. food availability for juveniles and reduced predation risks. We used the twospotted spider mite, Tetranychus urticae Koch (Tetranychidae) to find out whether the previous presence of specialist/ generalist phytoseiid predator individuals, Phytoseiulus persimilis Athias-Henriot/ Typhlodromus bagdasarjani Wainstein & Arutunjan (here, direct effect) or their previous odour perception by prey (here, indirect effect) would affect T. urticae oviposition strategies. Tetranychus urticae female individuals were placed on a leaf disc in a plastic container with predators either on the same disc (direct presence of predator) or on the second disc (receiving odours related to a predator) in the same container. Getting experienced, the prey individuals transferred to the oviposition container to their oviposition pattern parameters get recorded. The ovipositing T. urticae were monitored in two experimental situations: 1. Receiving odours related to the predator- prey interaction from the second leaf disc in the same oviposition container during their oviposition period, and 2. Receiving no odour. Our results showed that when T. urticae females perceived the predator presence in their first container (with either predator species, both direct and indirect effect), they reduced their total egg distances, oviposition rates and oviposition periods significantly regardless of receiving odours related to prey-predator interactions during experiment. Receiving odours during oviposition, T. urticae females decreased their pairwise egg distances in at least 4 and at most 6 pairs of eggs, while when odours were absent during oviposition, the distances decreased in at least 2 and at most 3 pairs of eggs. The direct presence of P. persimilis reduced the prey oviposition period significantly more than that when T. bagdasarjani was present. The spider mites oviposition rate reduction was obviousely more than that in the presence of T. bagdasarjani. The different effects of predator species on T. urticae egg distances were discussed.Na zachowania związane ze składaniem jaj roztoczy roślinożernych wpływa kilka czynników między innymi dostępność pokarmu dla młodych osobników i zmniejszone ryzyko drapieżnictwa. Użyliśmy przędziorka Tetranychus urticae Koch (Tetranychidae), aby dowiedzieć się, czy obecność drapieżnika określonego typu (wyspecjalizowany w drapieżnictwie na Tetranychus urticae przedstawiciel drapieżnych dobroczynkowatych, Phytoseiulus persimilis Athias-Henriot i niewyspecjalizowany Typhlodromus bagdasarjani Wainstein & Arutunjan) wpływają na strategie składania jaj T. urticae. Następnie powtórzyliśmy eksperyment używając zapachu poprzednich ofiar tych drapieżników. Samice Tetranychus urticae umieszczono na krążku z liści w plastikowym pojemniku z drapieżnikami na tym samym krążku (bezpośrednia obec-ność drapieżnika) lub na drugim krążku (odbierającym zapachy związane z drapieżnikiem) w tym samym pojemniku. Po doświadczeniu, ofiary przenoszono do pojemnika, w którym samice składały jaja. Parametry związane ze składaniem jaj T. urticae monitorowano w dwóch grupach doświadczalnych: grupa eksperymentalna otrzymywała zapach związany z interakcją drapieżnik-ofiara, natomiast grupa kontrolna nie otrzymywała zapachu. Nasze wyniki wyka-zały, że gdy samice T. urticae dostrzegły obecność drapieżnika lub jego zapach (w przypadku obu gatunków drapieżników), znacznie zmniejszyły liczbę składanych jaj i odległości między składanymi jajami, a ponadto skracały okres składania jaj, niezależnie od aplikowania za-pachów związanych z interakcją między drapieżnikiem i ofiarą. Jednak aplikacja zapachu podczas składania jaj powodowała zmniejszenie odległości między składanymi jajami w od 4 do 6 par kolejno składanych jaj. W grupie kontrolnej, odległości zmniejszyły się w od 2 lub 3 parach kolejno składanych jaj. Bezpośrednia obecność P. persimilis skróciła okres składania jaj przez ofiarę znacznie bardziej niż obecność T. bagdasarjani. Zmniejszenie szybkości składania jaj przez przędziorki było wyraźnie większe niż w obecności T. bagdasarjani

Comparison of scores of patient safety competencies by AEs occurrence and reporting.

Comparison of scores of patient safety competencies by AEs occurrence and reporting.</p

Socio-demographic characteristics of the participants and patient safety competency scores.

Socio-demographic characteristics of the participants and patient safety competency scores.</p

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Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses’ perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses’ levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, “skills of patient safety” scores were the highest, and “knowledge of patient safety” scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses’ performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the current study and identify interventions that would strengthen patient safety competencies and reduce the occurrence of AEs, and rise their reporting among nurses.</div

Logistic regression analysis results for appropriate events reporting and the occurrence of adverse events.

Logistic regression analysis results for appropriate events reporting and the occurrence of adverse events.</p

Levels of patient safety competencies.

Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses’ perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses’ levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, “skills of patient safety” scores were the highest, and “knowledge of patient safety” scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses’ performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the current study and identify interventions that would strengthen patient safety competencies and reduce the occurrence of AEs, and rise their reporting among nurses.</div

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

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