Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING: Bill & Melinda Gates Foundation

Gaming on the edge: using seams in ubicomp games

Outdoor multi-player games are an increasingly popular application area for ubiquitous computing, supporting experimentation both with new technologies and new user experiences. This paper presents an outdoor ubicomp game that exploits the gaps or seams that exist in complex computer systems. Treasure is designed so that players move in and out of areas of wireless network coverage, taking advantage not only of the connectivity within a wireless ‘hotspot’ but of the lack of connectivity outside it. More broadly, this paper discusses how the notion of seamful design can be a source of design ideas for ubicomp games

Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016.

OBJECTIVES: This paper presents detailed analysis of the global and regional burden of chronic respiratory disease arising from occupational airborne exposures, as estimated in the Global Burden of Disease 2016 study. METHODS: The burden of chronic obstructive pulmonary disease (COPD) due to occupational exposure to particulate matter, gases and fumes, and secondhand smoke, and the burden of asthma resulting from occupational exposure to asthmagens, was estimated using the population attributable fraction (PAF), calculated using exposure prevalence and relative risks from the literature. PAFs were applied to the number of deaths and disability-adjusted life years (DALYs) for COPD and asthma. Pneumoconioses were estimated directly from cause of death data. Age-standardised rates were based only on persons aged 15 years and above. RESULTS: The estimated PAFs (based on DALYs) were 17% (95% uncertainty interval (UI) 14%-20%) for COPD and 10% (95% UI 9%-11%) for asthma. There were estimated to be 519 000 (95% UI 441,000-609,000) deaths from chronic respiratory disease in 2016 due to occupational airborne risk factors (COPD: 460,100 [95% UI 382,000-551,000]; asthma: 37,600 [95% UI 28,400-47,900]; pneumoconioses: 21,500 [95% UI 17,900-25,400]. The equivalent overall burden estimate was 13.6 million (95% UI 11.9-15.5 million); DALYs (COPD: 10.7 [95% UI 9.0-12.5] million; asthma: 2.3 [95% UI 1.9-2.9] million; pneumoconioses: 0.58 [95% UI 0.46-0.67] million). Rates were highest in males; older persons and mainly in Oceania, Asia and sub-Saharan Africa; and decreased from 1990 to 2016. CONCLUSIONS: Workplace exposures resulting in COPD, asthma and pneumoconiosis continue to be important contributors to the burden of disease in all regions of the world. This should be reducible through improved prevention and control of relevant exposures

Factors That Influence the Dissemination of Knowledge in Technology Transfer Among Malaysian Manufacturing Employees

The meaning of technology transfer is so wide but mostly involving some form of technology-related exchange. However, in this particular paper, technology transfer is consider as a concept to examine the process of  disseminating knowledge and skills that a person owned to another person in order to generate higher productivity with new approach of producing a particular product or service. Although, many researchers have explored the evolution of technology transfer, nonetheless some drivers are yet to be explored in a Malaysian manufacturing industry. This study, therefore attempts to determine the relationship between absorptive capacity, transfer capacity, communication motivation and learning intent and technology transfer performance. A survey methodology was used in a Japanese multinational company based in Klang Valley, Malaysia. A total of 117 questionnaires were received. Results show that absorptive capacity is the most significant to influence technology transfer performance

Critical success factors for preventing E-banking fraud

E-Banking fraud is an issue being experienced globally and is continuing to prove costly to both banks and customers. Frauds in e-banking services occur as a result of various compromises in security ranging from weak authentication systems to insufficient internal controls. Lack of research in this area is problematic for practitioners so there is need to conduct research to help improve security and prevent stakeholders from losing confidence in the system. The purpose of this paper is to understand factors that could be critical in strengthening fraud prevention systems in electronic banking. The paper reviews relevant literatures to help identify potential critical success factors of frauds prevention in e-banking. Our findings show that beyond technology, there are other factors that need to be considered such as internal controls, customer education and staff education etc. These findings will help assist banks and regulators with information on specific areas that should be addressed to build on their existing fraud prevention systems

Factors supporting and preventing academics from becoming lifelong learners

In present circumstances, it has become inevitable for individuals to continue obtaining new information and skills throughout their lives. Having learned to learn and information literate individuals are able to meet their learning needs both in career and personal terms by themselves. The important aspect is the individual feels the need to learn and knows how and where to meet these needs. Feeling those can be considered as the basic requirement to make efforts in order to meet them. However, the surrounding circumstances may support or prevent meeting these needs. Since the situation of being a lifelong learner will be examined based on the present working conditions, the study is designed as embedded multiple case study. Maximum variety is ensured in the study group by taking into account the various academic titles, gender, and fields of study. The interview form is developed based on the literature and revised according to the opinions of specialists. The data has been collected by doing individual interviews with academics and a content analysis has been performed. In conclusion of the analysis performed, such themes as the need to become lifelong learners, the factors supporting to become lifelong learners and the factors preventing from becoming lifelong learners have been reached. © 2018, Sciedu Press. All rights reserved