18 research outputs found
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990�2015: a systematic analysis for the Global Burden of Disease Study 2015
Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors�the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25 over the same period. All risks jointly evaluated in 2015 accounted for 57·8 (95 CI 56·6�58·8) of global deaths and 41·2 (39·8�42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million 192·7 million to 231·1 million global DALYs), smoking (148·6 million 134·2 million to 163·1 million), high fasting plasma glucose (143·1 million 125·1 million to 163·5 million), high BMI (120·1 million 83·8 million to 158·4 million), childhood undernutrition (113·3 million 103·9 million to 123·4 million), ambient particulate matter (103·1 million 90·8 million to 115·1 million), high total cholesterol (88·7 million 74·6 million to 105·7 million), household air pollution (85·6 million 66·7 million to 106·1 million), alcohol use (85·0 million 77·2 million to 93·0 million), and diets high in sodium (83·0 million 49·3 million to 127·5 million). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens
Haematological characteristics of captive Parma wallabies ( Macropus parma )
Blood was collected from 31 Parma wallabies from five different captive populations. The morphology of erythrocytes, leucocytes and platelets was similar to that previously described for macropodids. The effects of location (population), anaesthesia and analyser on the haematological characteristics of the wallabies were considered. Location had an affect on many of the values, anaesthesia affected some of the leucocyte values, and analyser had little effect
The Use of Group Therapy as a Means of Facilitating Cognitive–Behavioural Instruction for Adolescents With Disruptive Behaviour
Agroindustrialization of the global agrifood economy: bridging development economics and agribusiness research
Late Glacial to Holocene paleoenvironmental change on the northwestern Pacific seaboard, Kamchatka Peninsula (Russia)
We used a new sedimentary record from a small kettle wetland to reconstruct the Late Glacial and Holocene vegetation and fire history of the Krutoberegovo-Ust Kamchatsk region in eastern Kamchatka Peninsula (Russia). Pollen and charcoal data suggest that the Late Glacial landscape was dominated by a relatively fire-prone Larix forest-tundra during the Greenland Interstadial complex (GI 1) and a subarctic steppe during the Younger Dryas (GS1). The onset of the Holocene is marked by the reappearance of trees (mainly Alnus incana) within a fern and shrub dominated landscape. The Holocene Thermal Maximum (HTM) features shifting vegetational communities dominated by Alnus shrubs, diverse forb species, and locally abundant aquatic plants. The HTM is further defined by the first appearance of stone birch forests (Betula ermanii) – Kamchatka's most abundant modern tree species. The Late Holocene is marked by shifts in forest dynamics and forest-graminoid ratio and the appearance of new non-arboreal taxa such as bayberry (Myrica) and meadow rue (Filipendula). Kamchatka is one of Earth's most active volcanic regions. During the Late Glacial and Holocene, Kamchatka's volcanoes spread large quantities of tephra over the study region. Thirty-four tephra falls have been identified at the site. The events represented by most of these tephra falls have not left evidence of major impacts on the vegetation although some of the thicker tephras caused expansion of grasses (Poaceae) and, at least in one case, forest die-out and increased fire activity