The burden of injury in Central, Eastern, and Western European sub-region : a systematic analysis from the Global Burden of Disease 2019 Study

Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. Results In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. Conclusions Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.Peer reviewe

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation

Timescape of disaster risk governance in contemporary Japan: Neither state of normalcy nor constancy in regulation.

Although the relationship between public policies and disaster risk is apparent, its nature is not so evident. The dominant model, the disaster management cycle, is based on the principle of response and return to normalcy. In addition, it is accepted that policies are based on constant legal development and that risk governance is responsive to successive disasters. The temporal pattern of large nature-triggered and technological disaster events in Japan since the end of WWII has been researched by measuring the duration of events and discontinuities between them as well as the development of the regulation of disaster risk. The evolutionary relationship between these two parameters and other political and economic factors was reconstructed through the notion of disaster timescape. Results do not support the notion of disaster cycle, nor a return to normalcy at the national scale, but a timescape of overlapping and successive events. Furthermore, there is no evidence of a clear association between major events and legal development on disaster risk, neither between this and economic or political crises. Nor is there continual evolution of regulation of disaster risk but, rather, a sequence of long periods of quiescence and acceleration more indicative of policy punctuation. The disaster timescape points to greater complexity with the interaction of multiple driving forces and an unstable balance that goes beyond a simple linear cause and effect. In the disaster timescape, there appear to be overlapping trajectories of environmental, social, political and economic processes

La modelización de los flujos volcánicos para la evaluación de riesgos y la planficación espacial en Hawai

La evaluación de los riesgos causados por el volcán Mauna Loa se ha basado en la modelización de los niveles de riesgo y en el seguimiento de las variables físicas precursoras de una erupción. La aplicación de los estudios a la planificación del territorio no ha sido completa por la falta de un modelo territorial que integre el factor riesgo y por la carencia de una perspectiva sobre la relación entre el origen de los episodios y espacios habitados, modelización que se lleva a cabo analizando la disposición espacial de las coladas por medio de la geometría del terreno

La modelización de los flujos volcánicos para la evaluación de riesgos y la planficación espacial en Hawai

La evaluación de los riesgos causados por el volcán Mauna Loa se ha basado en la modelización de los niveles de riesgo y en el seguimiento de las variables físicas precursoras de una erupción. La aplicación de los estudios a la planificación del territorio no ha sido completa por la falta de un modelo territorial que integre el factor riesgo y por la carencia de una perspectiva sobre la relación entre el origen de los episodios y espacios habitados, modelización que se lleva a cabo analizando la disposición espacial de las coladas por medio de la geometría del terreno

La modelización de los flujos volcánicos para la evaluación de riesgos y la planficación espacial en Hawai

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La modelización de los flujos volcánicos para la evaluación de riesgos y la planficación espacial en Hawai

Texto resumen

Aplicación de los SIG para la gestión de datos de inundaciones históricas en Extremadura (SIGIHEX)

Las inundaciones son el peligro natural de mayor importancia en Extremadura, y que periódicamente producen importantes pérdidas económicas y humanas. Para la eficaz gestión del riesgo y proceso de toma de decisiones es necesario conocer suficientemente el peligro, la exposición y la vulnerabilidad. Identificar las áreas que han sufrido eventos históricos es el primer paso en la evaluación del peligro, de modo que permita identificar las áreas potenciales de riesgo. La utilización de los sistemas de información geográfica permite no sólo facilitar el inventario sino también una ayuda en el proceso de toma de decisiones acerca del análisis, evaluación, preparación y mitigación del riesgo. Se ha desarrollado una aplicación basada en un sistema de información geográfica que facilita la realización del catálogo de avenidas históricas, la actualización en tiempo real de la base de datos y la obtención de información predefinida de varios campos para ser utilizada por usuarios no expertos