1,297 research outputs found

    The burden and trend of diseases and their risk factors in Australia, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

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    Background: A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019. Methods: In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made. Findings: Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9–77·1) in 1990 to 82·9 years (82·7–83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1–641·3) to 389·2 deaths (381·4–397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4–91·9) of total deaths, followed by injuries (5·7%, 5·3–6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9–3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5–28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019. Interpretation: An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing. Funding: Bill &amp; Melinda Gates Foundation.</p

    Changes in French family medicine residents’ perspectives about patient partners’ participation in teaching: A qualitative study in co-facilitated practice exchange groups

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    International audiencePURPOSE: The patient partner in teaching method is progressively developing for clinical training in France. Practice exchange groups (PEG) co-facilitated by patient partners in teaching are used during the training of family medicine (FM) residents. This study explored the FM residents’ perspectives about patient partner in teaching’s participation in co-facilitated PEGs and how they changed over time. STUDENTS AND METHODS: In 2020, qualitative focus groups were carried out with 26 FM residents before and after a 5-month intervention based on monthly PEGs co-facilitated by patient partners in teaching. A reflective thematic analysis of the focus group interviews was performed according to Braun and Clarke’s approach. RESULTS: FM residents supported patient partners in teaching’s facilitation role and had high expectations concerning their contribution to the development of their skills and competencies. They expected patient partners in teaching to bring their individual experience and also a collective knowledge. Some limitations mentioned by FM residents disappeared over time, such as the loss of the medical group feeling among physicians, while others persisted and required pedagogical support targeted to FM residents before PEG initiation. CONCLUSION: This study shows the good acceptance of patient partners in teaching by FM residents in the context of PEGs. Attention should be paid to make FM residents aware of patient partners in teaching’s missions before their introduction.[Box: see text]

    Women and health professionals’ perspectives on a conditional cash transfer programme to improve pregnancy follow-up: a qualitative analysis of the NAITRE randomised controlled study

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    Objectives Women of low socioeconomic status have been described as having suboptimal prenatal care, which in turn has been associated with poor pregnancy outcomes. Many types of conditional cash transfer (CCT) programmes have been developed, including programmes to improve prenatal care or smoking cessation during pregnancy, and their effects demonstrated. However, ethical critiques have included paternalism and lack of informed choice. Our objective was to determine if women and healthcare professionals (HPs) shared these concerns.Design Prospective qualitative research.Setting We included economically disadvantaged women, as defined by health insurance data, who participated in the French NAITRE randomised trial assessing a CCT programme during prenatal follow-up to improve pregnancy outcomes. The HP worked in some maternities participating in this trial.Participants 26 women, 14 who received CCT and 12 who did not, mostly unemployed (20/26), and - 7 HPs.Interventions We conducted a multicentre cross-sectional qualitative study among women and HPs who participated in the NAITRE Study to assess their views on CCT. The women were interviewed after childbirth.Results Women did not perceive CCT negatively. They did not mention feeling stigmatised. They described CCT as a significant source of aid for women with limited financial resources. HP described the CCT in less positive terms, for example, expressing concern about discussing cash transfer at their first medical consultation with women. Though they emphasised ethical concerns about the basis of the trial, they recognised the importance of evaluating CCT.Conclusions In France, a high-income country where prenatal follow-up is free, HPs were concerned that the CCT programme would change their relationship with patients and wondered if it was the best use of funding. However, women who received a cash incentive said they did not feel stigmatised and indicated that these payments helped them prepare for their baby’s birth.Trial registration number NCT0240285

    The burden and trend of diseases and their risk factors in Australia, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019

    No full text
    Background: A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019. Methods: In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other highincome countries were made. Findings: Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9–77·1) in 1990 to 82·9 years (82·7–83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1–641·3) to 389·2 deaths (381·4–397·6) per 100000 population. In 2019, noncommunicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4–91·9) of total deaths, followed by injuries (5·7%, 5·3–6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9–3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5–28·1). Relative to similar countries, Australia’s ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019. Interpretation: An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing

    L'éruption du volcan Hunga Tonga -Hunga Ha'apai le 15 janvier 2022 : un ébranlement du systÚme Terre à l'échelle planétaire

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    L'Ă©ruption explosive du volcan Hunga Tonga - Hunga Ha’apai (HTHH), le 15 janvier 2022, a produit la plus puissante explosion enregistrĂ©e depuis les explosions du Krakatau et du Tambora dans les annĂ©es 1800, libĂ©rant une Ă©nergie Ă©quivalente Ă  110 mĂ©gatonnes de TNT. Les ondes gĂ©nĂ©rĂ©es sesont propagĂ©es dans le sol, et dans l’atmosphĂšre jusqu’à l’ionosphĂšre. L'onde atmosphĂ©rique la plus Ă©nergĂ©tique observĂ©e sur les baromĂštres correspond au mode de Lamb. De pĂ©riode supĂ©rieure Ă  2000 s, son amplitude est comparable Ă  celle observĂ©e lors de l’éruption du Krakatau en 1883. L’empreinte des perturbations atmosphĂ©riques a Ă©tĂ© caractĂ©risĂ©e Ă  l’échelle planĂ©taire par des rĂ©seaux de mesures au sol, Ă  bord de satellites ou de plateformes aĂ©roportĂ©es. L’analyse combinĂ©e de ces observations a permis d’évaluer les consĂ©quences Ă  court terme de l'Ă©ruption du HTHH. Les mĂ©thodes d'investigation gĂ©ophysiques prĂ©sentĂ©es dans cette note montrent l’apport d’analyses interdisciplinaires pour caractĂ©riser la rĂ©ponse impulsionnelle des enveloppes fluides planĂ©taires (atmosphĂšre, ocĂ©ans et mers) Ă  une Ă©ruption d’une intensitĂ© exceptionnelle

    L'éruption du volcan Hunga Tonga -Hunga Ha'apai le 15 janvier 2022 : un ébranlement du systÚme Terre à l'échelle planétaire

    No full text
    L'Ă©ruption explosive du volcan Hunga Tonga - Hunga Ha’apai (HTHH), le 15 janvier 2022, a produit la plus puissante explosion enregistrĂ©e depuis les explosions du Krakatau et du Tambora dans les annĂ©es 1800, libĂ©rant une Ă©nergie Ă©quivalente Ă  110 mĂ©gatonnes de TNT. Les ondes gĂ©nĂ©rĂ©es sesont propagĂ©es dans le sol, et dans l’atmosphĂšre jusqu’à l’ionosphĂšre. L'onde atmosphĂ©rique la plus Ă©nergĂ©tique observĂ©e sur les baromĂštres correspond au mode de Lamb. De pĂ©riode supĂ©rieure Ă  2000 s, son amplitude est comparable Ă  celle observĂ©e lors de l’éruption du Krakatau en 1883. L’empreinte des perturbations atmosphĂ©riques a Ă©tĂ© caractĂ©risĂ©e Ă  l’échelle planĂ©taire par des rĂ©seaux de mesures au sol, Ă  bord de satellites ou de plateformes aĂ©roportĂ©es. L’analyse combinĂ©e de ces observations a permis d’évaluer les consĂ©quences Ă  court terme de l'Ă©ruption du HTHH. Les mĂ©thodes d'investigation gĂ©ophysiques prĂ©sentĂ©es dans cette note montrent l’apport d’analyses interdisciplinaires pour caractĂ©riser la rĂ©ponse impulsionnelle des enveloppes fluides planĂ©taires (atmosphĂšre, ocĂ©ans et mers) Ă  une Ă©ruption d’une intensitĂ© exceptionnelle

    Association between the Dietary Inflammatory Index and Gastric Disease Risk: Findings from a Korean Population-Based Cohort Study

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    Evidence suggests that diets with high pro-inflammatory potential may play a substantial role in the origin of gastric inflammation. This study aimed to examine the association between the energy-adjusted dietary inflammatory index (E-DIITM) and gastric diseases at baseline and after a mean follow-up of 7.4 years in a Korean population. A total of 144,196 participants from the Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort were included. E-DII scores were computed using a validated semi-quantitative food frequency questionnaire. Multivariate logistic regression and Cox proportional hazards regression were used to assess the association between the E-DII and gastric disease risk. In the prospective analysis, the risk of developing gastric disease was significantly increased among individuals in the highest quartile of E-DII compared to those in the lowest quartile (HRquartile4vs1 = 1.22; 95% CI = 1.08–1.38). Prospective analysis also showed an increased risk in the incidence of gastritis (HRquartile4vs1 = 1.19; 95% CI = 1.04–1.37), gastric ulcers (HRquartile4vs1 = 1.47; 95% CI = 1.16–1.85), and gastric and duodenal ulcers (HRquartile4vs1 = 1.46; 95% CI = 1.17–1.81) in the highest E-DII quartile compared to the lowest quartile. In the cross-sectional analysis, the E-DII score was not associated with the risk of gastric disease. Our results suggest that a pro-inflammatory diet, indicated by high E-DII scores, is prospectively associated with an increased risk of gastric diseases. These results highlight the significance of an anti-inflammatory diet in lowering the risk of gastric disease risk in the general population

    Experimental measurements of the bacterial oxidation of HT in soils: impact over a zone influenced by an industrial release of tritium in HT form.

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    International audienceTritium is a radionuclide released to the atmosphere by nuclear industries in various forms, mainly HTO and to a lesser extent HT. However, some nuclear sites may emit predominantly HT in the atmosphere and it is important to understand the behaviour of this HT form when oxided in the top cm of soils, and that this tritium can then be released into the atmosphere in assimilable HTO form, which has a greater impact in terms of dose. In this work, we adapt the bacterial oxidation model of HT in soils of Ota el al (2007) by laboratory experiments on soils typical of western France, and we have in particular adapted the frequency factor A and the Michaelis-Menten enzymatic reaction parameter (Km) on the basis of an Arrhenius equation in function of the porosity of the soil. We then applied this model to the environment near the reprocessing plant of Orano la Hague (France), which emits a significant amount of HT. Based on the adapted model, and knowing the atmospheric variations of HTO and HT over the period 2013-2016, we estimated that the mean HTO activity in soil due to atmospheric HT reached 0.6 Bq.L-1 (with a peak value of 5 Bq.L-1) while the mean value with all sources taken into account is 6.2 Bq.L-1. Then, in an environment such as that surrounding the Orano La Hague plant, where near-field atmospheric HT activity is very high, the bacterial oxydation contribution to produce HTO in the soil can be considered as approximately 10%. The flux to the atmosphere from these source representing approximately. 1.5 Bq.m-2.d-1. If we compared this value with the direct atmospheric release of HTO around the site (2km around i.e. 13 km2), we estimate 218 Bq.s-1 of HTO was released by the soil, representing only 0.1% of available ambient stock. From this work, it appears clear that this secondary source term from the soil is insignificant at this specific site

    Subcellular specificity of cannabinoid effects in striatonigral circuits

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    Recent advances in neuroscience have positioned brain circuits as key units in controlling behavior, implying that their positive or negative modulation necessarily leads to specific behavioral outcomes. However, emerging evidence suggests that the activation or inhibition of specific brain circuits can actually produce multimodal behavioral outcomes. This study shows that activation of a receptor at different subcellular locations in the same neuronal circuit can determine distinct behaviors. Pharmacological activation of type 1 cannabinoid (CB1) receptors in the striatonigral circuit elicits both antinociception and catalepsy in mice. The decrease in nociception depends on the activation of plasma membrane-residing CB1 receptors (pmCB1), leading to the inhibition of cytosolic PKA activity and substance P release. By contrast, mitochondrial-associated CB1 receptors (mtCB1) located at the same terminals mediate cannabinoid-induced catalepsy through the decrease in intra-mitochondrial PKA-dependent cellular respiration and synaptic transmission. Thus, subcellular-specific CB1 receptor signaling within striatonigral circuits determines multimodal control of behavior
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