Medición del grado de resiliencia de los sustentos de los hogares y de la seguridad alimentaria en ambientes de riesgo etíopes

The purpose of this case study, conducted in Amhara region of Ethiopia, is to contribute to ef forts to measuring and assessing resilience properties of household livelihoods constructed in the risky environments. It provides new insights for assessing livelihood vulnerability and designing resilience building programs in areas of protracted food crisis. Based on resilience theory as applied to social-ecological systems with an application of Modern Portfolio Theory, we adapted and measure the four properties of resilience to livelihood systems and tested the expected relationships between system properties as predicted by resilience theory. Household livelihood systems exhibited the ex pected pattern of increasing connectivity with increasing wealth (food income). Similarly, household resilience to food insecurity improves with increasing diversity of livelihood options and diversity de clines with increasing connectivity of the system. This study demonstrates the use of a set of metrics for assessing resilience properties of household livelihoods based on key driving factors.Con este estudio de caso, realizado en la región de Amhara (Etiopía), se pretende contribuir a los esfuerzos para medir y evaluar el grado de resistencia de los sustentos económicos de los hogares construidos en ambientes de riesgo. Así, se proporcionan nuevos conocimientos para evaluar la vulnerabilidad de los medios de subsistencia y diseñar programas de fortalecimiento de la resiliencia en áreas de crisis alimentaria prolongada. Basándonos en la teoría de la resiliencia aplicada a los sistemas socioecológicos, y aplicando la teoría moderna de carteras, adaptamos y medimos las cuatro propiedades de la resiliencia a los sistemas de medios de subsistencia y probamos las relaciones esperadas entre las propiedades predichas por la teoría de la resiliencia. Los sistemas de sustento de los hogares exhibieron el patrón esperado de conectividad creciente con el aumento de la riqueza (ingresos alimentarios). Del mismo modo, la resistencia de los hogares a la inseguridad alimentaria mejora con el aumento de la diversidad de opciones de medios de subsistencia y la disminución de la diversidad a partir del incremento de la conectividad del sistema. Este estudio muestra el uso de un conjunto de métricas con el fin de evaluar las propiedades de resiliencia de los sustentos del hogar basado en factores clave de conducción

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe