In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma...In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.展开更多
Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving re...Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving responsibilities often results in burnout,adding to the burden on caregivers.This issue also affects society and healthcare systems through increased costs and greater demands for support services.Understanding the factors contributing to caregiver burden is crucial for creating effective interventions to address these challenges.The aim of this study is to describe the extent of caregiver burden and identify some factors related to burden among caregivers of chronically ill elderly people.By gaining insight into these relationships,this study seeks to identify strategies to reduce the burden on caregivers.Methods:This study utilized a cross-sectional design to examine caregivers of the elderly with chronic diseases receiving treatment in the public healthcare facility.Data collection involved administering structured questionnaires that gathered information on the demographic characteristics of both the elderly and their caregivers,the level of social support received,the functional status of patients as measured by daily activity indices,and the level of caregiver burden.Description was used to elaborate the characteristics of participants.Mann-Whitney,Kruskal-Wallis,and Spearman's correlation test were applied to explore the relationship between variables.Statistical significance was determined at P value<0.05.Results:Caregivers of the elderly with chronic diseases had a moderate care burden score(22.62±11.24,CI:95%).The patients'level of dependence,relationship with the patients,and time spent as a caregiver were factors related to caregiver burden(P<0.05).Conclusions:Those who care for elderly people with chronic diseases suffered great burden.The finding had found a number of factors that influence the caregivers'weight loss.Healthcare providers should consider these relevant factors when developing intervention plans to reduce caregiver burden.展开更多
BACKGROUND Family caregivers of cirrhosis patients(CPs)often experience burden,stress,and depression.Investigating whether these conditions improve following the patient undergoing liver transplantation(LT)is crucial,...BACKGROUND Family caregivers of cirrhosis patients(CPs)often experience burden,stress,and depression.Investigating whether these conditions improve following the patient undergoing liver transplantation(LT)is crucial,as it would elucidate the compre-hensive benefits of the procedure and demonstrate the positive impacts not only on the patients but also on their caregivers and society.AIM To compare the levels of burden,stress and depression among family caregivers of cirrhotic and liver transplant patients.METHODS This cross-sectional observational study evaluated caregivers of CPs and LT recipients at a quaternary Brazilian hospital.Instruments included identification cards,interview scripts,the caregiver burden scale Inventory,Lipp’s Stress Symptom Inventory,and the Beck Depression Inventory-Second Edition.Psychometric analyses involved confirmatory factor analysis and calculation of McDonald’s omega and composite reliability.Factor scores were compared with the Mann-Whitney U test,with effect size as the rank-biserial correlation coefficient(r).Statistical analysis was performed with R software(P<0.05).RESULTS Seventy-seven CP caregivers and 65 LT recipient caregivers were included.Most were female(CP:85.7%vs LT:84.6%)and the patients’spouses(76.6%vs 63.1%).The median age and caregiving duration were 55.4(23.3-76.3)vs 54.6(25.7-82.1)and 3.9(1-20)vs 8(1.5-24)years,respectively(P=0.001).LT caregivers were less likely to be at risk of overload(21.5%vs 49.4%),to be under stress(33.8%vs 36.4%)and to show symptoms of depression(15.4%vs 35.1%).Compared with LT caregivers,CP caregivers had greater median factor scores for burden(general tension,P=0.012;isolation,P=0.014;disappointment,P=0.004),depression(P=0.008),and stress(P=0.047),with small to moderate effect sizes.The disappointment(r=0.240)and depression(r=0.225)dimensions had the largest effect sizes.CONCLUSION Family caregivers of LT recipients are less likely to exhibit symptoms of burden,stress,and depression,suggesting that the benefits of LT extend to the patients’family members.展开更多
Objective The Asia-Pacific region has a high chronic obstructive pulmonary disease(COPD)burden,but studies on its trends are limited.Using the Global Burden of Disease(GBD)2019 data,we analyzed COPD trends in 36 count...Objective The Asia-Pacific region has a high chronic obstructive pulmonary disease(COPD)burden,but studies on its trends are limited.Using the Global Burden of Disease(GBD)2019 data,we analyzed COPD trends in 36 countries and territories from 1990 to 2019 and predicted future incidence trends through 2034.Methods COPD data by age and sex from the GBD 2019 database were analyzed for incidence,prevalence,mortality,and disability-adjusted life years(DALY)rates from 1990 to 2019.Joinpoint regression identified significant annual trends,and age-standardized incidence rates were predicted through 2034 using age-period-cohort models.Results The incidence,prevalence,mortality,and disease burden of COPD have been decreasing,and the incidence rates will continue to decrease or remain stable until 2034 in most selected countries and territories,except for a few Southeastern Asian countries.The Lao People’s Democratic Republic and Vietnam are projected to experience an increase in COPD incidence from 165.3 per 100,000 in 2019 to 177 per 100,000 in 2034 and from 179.9 per 100,000 in 2019 to 192.5 per 100,000 in 2034,respectively.Older males had a higher incidence than any other sex or age group.The sex gap in incidence rates continues to widen,though it is smaller and less significant in the younger age group than in those in the older one.Conclusion COPD rates are expected to decline until 2034 but remain a health risk,especially in countries with rising rates.Urgent action on tobacco control,air pollution,and public education is needed.展开更多
BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receivi...BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.展开更多
Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,preva...Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.展开更多
Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impac...Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impact of filial piety values on the burden of caring for patients.Methods:192 caregivers of CHF patients in the hospital were selected as the main objects of this study.The main method was convenient sampling.Through a questionnaire survey of 192 CHF patients'caregivers,a unified investigation was conducted from the aspects of patient"'s general condition,objective burden,anxiety and depression degree and relationship quality,etc.The structural equation model was constructed and adjusted by analyzing data entry and variable correlation.Finally,path analysis was used to conduct inferential research on the direct and indirect influencing factors of control burden.Results:More than half of the patients'caregivers had a caregiving burden,and the practical caregiving dimension had the highest score.The total effect values of patient-related factors,including anxiety degree,number of concomitant diseases and half-year readmission rate,were 0.36,0.31 and 0.20,respectively(P<0.05).The total effect values of filial piety,anxiety degree,average care time and understanding degree of disease directly derived from the caregivers themselves were-0.38,0.29,0.29 and-0.23,respectively(P<0.05).In addition,the influence of filial piety values on the caregiver burden was more obvious,and the direct effect value of the value was-0.41(P<0.001).Conclusion:Most caregivers of CHF patients have a certain objective burden of care,and there are many factors that affect it,among which the degree of filial piety value is the most important.This finding provides a clear goal for caregivers to develop measures to improve the caregiver burden.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden ...Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years.Methods:Using data from the Global Burden of Disease(GBD)2021 database,we conducted descriptive analyses of NVL prevalence in China,calculated age-standardized prevalence rates(ASPR)and age-standardized disability-adjusted life years rates(ASDR)to compare burden differences between sexes and age groups,and applied an autoregressive integrated moving average(ARIMA)model to predict NVL trends for the next 15 years.The model selection was based on best-fit criteria to ensure reliable projections.Results:From 1990 to 2021,China’s ASPR of NVL rose from 10096.24/100000 to 15624.54/100000,and ASDR increased from 101.75/100000 to 158.75/100000.In 2021,ASPR(16551.70/100000)and ASDR(167.69/100000)were higher among females than males(14686.21/100000 and 149.76/100000,respectively).China ranked highest globally in both NVL cases and disability-adjusted life years(DALYs),with female burden significantly exceeding male burden.Projections indicated this trend and sex gap will persist until 2036.Compared with 1990,the prevalence cases and DALYs increased by 239.20%and 238.82%,respectively in 2021,with the highest burden among females and the 55−59 age group.The ARIMA model predicted continued increases in prevalence and DALYs by 2036,with females maintaining a higher burden than males.Conclusion:This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years.Public health policies should prioritize NVL prevention and control,with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.展开更多
In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and quali...In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.展开更多
Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on ...Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.展开更多
Background Mental disorders pose a significant global health burden,especially after the coronavirus disease2019 pandemic.Aims This study aimed to characterise trends in the burden of mental disorders among adolescent...Background Mental disorders pose a significant global health burden,especially after the coronavirus disease2019 pandemic.Aims This study aimed to characterise trends in the burden of mental disorders among adolescents and young adults by sex,age,sociodemographic index(SDI)quintile,region and country from 1990 to 2021.Methods Estimates and 95%uncertainty intervals(UIs)for disability-adjusted life years(DALYs)were extracted from the Global Burden of Diseases Study 2021.The number and rate of DALYs,as well as the percentage change from 1990 to 2021,were estimated by sex,age,SDI quintile,region and country.Results The number of DALYs for mental disorders increased from 26.1(95%UI 19.3 to 34.4)million to 36.3(95%UI 26.6 to 48.1)million.The DALY rate increased from 1687.8(1245.3 to 2225.4)per 100000 population in1990 to 1923.71408.7 to 2548.4)per 100000 population in 2021,representing a 14%(12%to 16%)increase.Females(16%(13%to 18%))and individuals aged 15-19years(16%(13%to 18%))showed the greatest increase in DALY rates.Between 1990 and 2021,DALY rates rose significantly across all SDI quintiles and regions,except East Asia(-5%(-9%to-1%)).The most rapid increases were observed in parts of Latin America,particularly for anxiety and depressive disorders.Conclusions The global burden of mental disorders among adolescents increased significantly from 1990 to2021,necessitating attention to policies targeting high-risk populations and specific regions.展开更多
Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading pr...Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.展开更多
Introduction This study aimed to either identify or develop and validate a patient-reported outcome measure(PROM)to assess treatment burden related to general practice for patients with multimorbidity,which can be use...Introduction This study aimed to either identify or develop and validate a patient-reported outcome measure(PROM)to assess treatment burden related to general practice for patients with multimorbidity,which can be used alongside the MultiMorbidity Questionnaire part 1(MMQ1)without overwhelming the target population with redundant items.Methods We conducted a systematic literature review to identify all existing PROMs measuring treatment burden.If no suitable PROM was found,our plan was to:(1)develop a draft PROM using items from existing instruments,(2)carry out group and individual interviews with patients with multimorbidity to ensure the PROM’s understandability,clarity,completeness and relevance and(3)undertake psychometric validation with a diverse sample of primary care patients with chronic conditions.Results We did not identify an eligible PROM in the literature review.The draft PROM consisted of 30 items divided into six domains;Information about treatment,Challenges with medication,Medical appointments,Self-monitoring,Health behaviour and Challenges in the contact to the health system.In the psychometric validation,neither these domains nor any other theoretical constellation of items had adequate psychometric properties.Individual items had good criterion validity and sensitivity to change.Conclusions In this study,we developed a 30-item PROM with high content validity where various individual items showed adequate criterion validity and sensitivity to change,making these items useful as a supplemental measure to the MMQ1.Trial registration number NCT05676541 Registration Date:16 December 2022.展开更多
Background:Esophageal cancer(EC)is a lethalmalignancy.The sociodemographic index(SDI)is a critical factor influencing the disease burden of EC.Risk factors,including alcohol use and diet,vary significantly by SDI leve...Background:Esophageal cancer(EC)is a lethalmalignancy.The sociodemographic index(SDI)is a critical factor influencing the disease burden of EC.Risk factors,including alcohol use and diet,vary significantly by SDI level,affecting the disease outcomes.This study utilized the Global Burden of Disease Study 2021 database to determine the age-standardized mortality rates(ASMR)and age-standardized disability-adjusted life-year rates(ASDRs)for EC attributable to alcohol use and a diet low in vegetables across countries with different SDI.Methods:Data from the Global Burden of Disease Study 2021,covering from 1990 to 2021,were analyzed for 204 areas categorized into quintiles based on the SDI.Exposure levels for alcohol and vegetable intake were defined,and data were standardized using the global population structure to ensure comparability.Trend lines for the disease burden were plotted using R version 4.3.0(R Foundation for Statistical Computing,Vienna,Austria).Statistical analyses were conducted using Joinpoint 4.9.1.0(The Division of Cancer Control and Population Sciences,USA)regression to assess temporal trends in mortality and ASDRs,focusing on the annual percent change and average annual percent change across various SDI categories.Results:From 1990 to 2021,the ASMR and ASDR for EC decreased globally across all SDI levels and in both sexes.The areas with a middle SDI initially had the highest rates but experienced the fastest declines,falling below high-middle–SDI countries by 2021.The ASMRs attributable to alcohol use generally declined,except in low-middle–and low-SDI nations.The greatest rates among males and the total population were found in high-middle–SDI nations,whereas high-SDI nations had the highest rates among females.The ASMRs associated with a diet low in vegetables decreased in all areas.Conclusions:Despite the overall declining trend in the EC burden associated with alcohol use and diets low in vegetables,EC remains a significant global health concern.Strengthening the focus on key populations,implementing public health policies to reduce alcohol consumption,and promoting increased vegetable intake may collectively reduce the global burden of EC.展开更多
Objective:To investigate the temporal trends of the burden of type 2 diabetes mellitus(T2DM)in China attributed to low-fiber diet from 1990 to 2019,highlighting the importance of dietary fiber in T2DM prevention.Metho...Objective:To investigate the temporal trends of the burden of type 2 diabetes mellitus(T2DM)in China attributed to low-fiber diet from 1990 to 2019,highlighting the importance of dietary fiber in T2DM prevention.Methods:Using data from the GBD 2019,age-and sex-specific mortality and DALYs related to T2DM attributed to a low-fiber diet in China were analyzed through join-point regression and age-period-cohort model analysis.Results:In 2019,T2DM deaths and disability-adjusted life years(DALYs)attributed to a low-fiber diet in China totaled 2887 and 182251,respectively.Males under 60 years had higher mortality and DALYs rates than females,but the trend reversed for those over 60.The ASMR and ASDR decreased by 43%and 38%since 1990,respectively.Before 2008,female age-standardized mortality rate(ASMR)and age-standardized disability-adjusted life years rate(ASDR)were higher than males,but it was reversed after 2010.Both male and female ASDR decreased,while the relative risk of mortality increased with age.The period effect on T2DM burden remained stable,while the cohort effect declined.Conclusion:The burden of T2DM attributed to a low-fiber diet in China showed an initial increase followed by a decrease from 1990 to 2019.The burden was higher among the elderly,with gender-specific differences among age groups.展开更多
Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever...Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.展开更多
In the contemporary period,cancer has emerged as a significant challenge to global public health.According to the International Agency for Research on Cancer(IARC),there were 19.965 million new cases of malignant tumo...In the contemporary period,cancer has emerged as a significant challenge to global public health.According to the International Agency for Research on Cancer(IARC),there were 19.965 million new cases of malignant tumors worldwide in 2022,resulting in 9.737 million deaths(1,2).As a populous nation,China accounts for approximately24.2%of the global incidence of new cases and 26.4%of the total cancer-related deaths.Consequently,China ranks first globally in both the incidence and mortality rates of malignant tumors(3).展开更多
The coronavirus disease 2019 pandemic has left an indelible mark on global mental health,with widespread psychological consequences that persist beyond the acute phase of the virus.This review synthesizes current evid...The coronavirus disease 2019 pandemic has left an indelible mark on global mental health,with widespread psychological consequences that persist beyond the acute phase of the virus.This review synthesizes current evidence on the postpandemic mental health burden across diverse populations,highlighting elevated rates of depression,anxiety,posttraumatic stress,and substance use disorders linked to prolonged social isolation,economic instability,and grief.We examine disparities in psychological outcomes among vulnerable groups(e.g.,healthcare workers,survivors,marginalized communities)and identify key challenges in addressing these issues,including fragmented healthcare systems,stigma,and the limited scalability of interventions.Emerging evidence on resilience factors(e.g.,social support and adaptive coping)is also discussed.Finally,we propose critical priorities for future research,including longitudinal studies on the chronic mental health effects,the development of culturally tailored interventions,and the integration of digital mental health solutions.This review distinctively addresses enduring post-pandemic mental health challenges,integrating neurobiological insights,equity-focused interventions,and critical perspectives on digital solutions,gaps underrepresented in prior syntheses.By charting a roadmap for multidisciplinary collaboration,this review aims to inform policymakers and researchers in mitigating the long-term psychological aftermath of the pandemic.展开更多
文摘In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.
基金Da Nang University of Medical Technology and PharmacyDa Nang C Hospital for the invaluable support they provided in facilitating this research。
文摘Objective:The aging population is growing rapidly,leading to a rise in chronic diseases and placing significant physical,emotional,and financial strain on caregivers.Managing chronic conditions alongside caregiving responsibilities often results in burnout,adding to the burden on caregivers.This issue also affects society and healthcare systems through increased costs and greater demands for support services.Understanding the factors contributing to caregiver burden is crucial for creating effective interventions to address these challenges.The aim of this study is to describe the extent of caregiver burden and identify some factors related to burden among caregivers of chronically ill elderly people.By gaining insight into these relationships,this study seeks to identify strategies to reduce the burden on caregivers.Methods:This study utilized a cross-sectional design to examine caregivers of the elderly with chronic diseases receiving treatment in the public healthcare facility.Data collection involved administering structured questionnaires that gathered information on the demographic characteristics of both the elderly and their caregivers,the level of social support received,the functional status of patients as measured by daily activity indices,and the level of caregiver burden.Description was used to elaborate the characteristics of participants.Mann-Whitney,Kruskal-Wallis,and Spearman's correlation test were applied to explore the relationship between variables.Statistical significance was determined at P value<0.05.Results:Caregivers of the elderly with chronic diseases had a moderate care burden score(22.62±11.24,CI:95%).The patients'level of dependence,relationship with the patients,and time spent as a caregiver were factors related to caregiver burden(P<0.05).Conclusions:Those who care for elderly people with chronic diseases suffered great burden.The finding had found a number of factors that influence the caregivers'weight loss.Healthcare providers should consider these relevant factors when developing intervention plans to reduce caregiver burden.
文摘BACKGROUND Family caregivers of cirrhosis patients(CPs)often experience burden,stress,and depression.Investigating whether these conditions improve following the patient undergoing liver transplantation(LT)is crucial,as it would elucidate the compre-hensive benefits of the procedure and demonstrate the positive impacts not only on the patients but also on their caregivers and society.AIM To compare the levels of burden,stress and depression among family caregivers of cirrhotic and liver transplant patients.METHODS This cross-sectional observational study evaluated caregivers of CPs and LT recipients at a quaternary Brazilian hospital.Instruments included identification cards,interview scripts,the caregiver burden scale Inventory,Lipp’s Stress Symptom Inventory,and the Beck Depression Inventory-Second Edition.Psychometric analyses involved confirmatory factor analysis and calculation of McDonald’s omega and composite reliability.Factor scores were compared with the Mann-Whitney U test,with effect size as the rank-biserial correlation coefficient(r).Statistical analysis was performed with R software(P<0.05).RESULTS Seventy-seven CP caregivers and 65 LT recipient caregivers were included.Most were female(CP:85.7%vs LT:84.6%)and the patients’spouses(76.6%vs 63.1%).The median age and caregiving duration were 55.4(23.3-76.3)vs 54.6(25.7-82.1)and 3.9(1-20)vs 8(1.5-24)years,respectively(P=0.001).LT caregivers were less likely to be at risk of overload(21.5%vs 49.4%),to be under stress(33.8%vs 36.4%)and to show symptoms of depression(15.4%vs 35.1%).Compared with LT caregivers,CP caregivers had greater median factor scores for burden(general tension,P=0.012;isolation,P=0.014;disappointment,P=0.004),depression(P=0.008),and stress(P=0.047),with small to moderate effect sizes.The disappointment(r=0.240)and depression(r=0.225)dimensions had the largest effect sizes.CONCLUSION Family caregivers of LT recipients are less likely to exhibit symptoms of burden,stress,and depression,suggesting that the benefits of LT extend to the patients’family members.
基金supported by a major project of the Zhejiang Natural Science Foundation(LD21G030001).
文摘Objective The Asia-Pacific region has a high chronic obstructive pulmonary disease(COPD)burden,but studies on its trends are limited.Using the Global Burden of Disease(GBD)2019 data,we analyzed COPD trends in 36 countries and territories from 1990 to 2019 and predicted future incidence trends through 2034.Methods COPD data by age and sex from the GBD 2019 database were analyzed for incidence,prevalence,mortality,and disability-adjusted life years(DALY)rates from 1990 to 2019.Joinpoint regression identified significant annual trends,and age-standardized incidence rates were predicted through 2034 using age-period-cohort models.Results The incidence,prevalence,mortality,and disease burden of COPD have been decreasing,and the incidence rates will continue to decrease or remain stable until 2034 in most selected countries and territories,except for a few Southeastern Asian countries.The Lao People’s Democratic Republic and Vietnam are projected to experience an increase in COPD incidence from 165.3 per 100,000 in 2019 to 177 per 100,000 in 2034 and from 179.9 per 100,000 in 2019 to 192.5 per 100,000 in 2034,respectively.Older males had a higher incidence than any other sex or age group.The sex gap in incidence rates continues to widen,though it is smaller and less significant in the younger age group than in those in the older one.Conclusion COPD rates are expected to decline until 2034 but remain a health risk,especially in countries with rising rates.Urgent action on tobacco control,air pollution,and public education is needed.
基金Supported by Key Research Fund of Wannan Medical College,No.WK2021ZF15Research Foundation for Advanced Talents of Wannan Medical College,No.YR202213+3 种基金Foundation of Anhui Educational Committee,No.2023AH051759Excellent Youth Research Project of Anhui UniversitiesNo.2023AH030107Horizontal Project of Wannan Medical College,No.622202504003 and No.662202404013.
文摘BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.
基金supported by the National Key Research and Development Program of China(2018YFC1315301).
文摘Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.
文摘Objective:To analyze the burden of caregivers of CHF patients in the current environment,to explore the related burden and influencing factors of caring for patients with chronic heart failure,and to explore the impact of filial piety values on the burden of caring for patients.Methods:192 caregivers of CHF patients in the hospital were selected as the main objects of this study.The main method was convenient sampling.Through a questionnaire survey of 192 CHF patients'caregivers,a unified investigation was conducted from the aspects of patient"'s general condition,objective burden,anxiety and depression degree and relationship quality,etc.The structural equation model was constructed and adjusted by analyzing data entry and variable correlation.Finally,path analysis was used to conduct inferential research on the direct and indirect influencing factors of control burden.Results:More than half of the patients'caregivers had a caregiving burden,and the practical caregiving dimension had the highest score.The total effect values of patient-related factors,including anxiety degree,number of concomitant diseases and half-year readmission rate,were 0.36,0.31 and 0.20,respectively(P<0.05).The total effect values of filial piety,anxiety degree,average care time and understanding degree of disease directly derived from the caregivers themselves were-0.38,0.29,0.29 and-0.23,respectively(P<0.05).In addition,the influence of filial piety values on the caregiver burden was more obvious,and the direct effect value of the value was-0.41(P<0.001).Conclusion:Most caregivers of CHF patients have a certain objective burden of care,and there are many factors that affect it,among which the degree of filial piety value is the most important.This finding provides a clear goal for caregivers to develop measures to improve the caregiver burden.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
基金supported by the Natural Science Foundation of Hunan Province(2023JJ30817)Hunan Provincial Natural Science Foundation-Hengyang City Joint Fund Project(2025JJ70129)+1 种基金Changsha Natural Science Foundation(kq2403057)China。
文摘Objective:Near vision loss(NVL)is one of the leading causes of visual impairment worldwide,exerting a profound impact on individual quality of life and socio-economic development.This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years.Methods:Using data from the Global Burden of Disease(GBD)2021 database,we conducted descriptive analyses of NVL prevalence in China,calculated age-standardized prevalence rates(ASPR)and age-standardized disability-adjusted life years rates(ASDR)to compare burden differences between sexes and age groups,and applied an autoregressive integrated moving average(ARIMA)model to predict NVL trends for the next 15 years.The model selection was based on best-fit criteria to ensure reliable projections.Results:From 1990 to 2021,China’s ASPR of NVL rose from 10096.24/100000 to 15624.54/100000,and ASDR increased from 101.75/100000 to 158.75/100000.In 2021,ASPR(16551.70/100000)and ASDR(167.69/100000)were higher among females than males(14686.21/100000 and 149.76/100000,respectively).China ranked highest globally in both NVL cases and disability-adjusted life years(DALYs),with female burden significantly exceeding male burden.Projections indicated this trend and sex gap will persist until 2036.Compared with 1990,the prevalence cases and DALYs increased by 239.20%and 238.82%,respectively in 2021,with the highest burden among females and the 55−59 age group.The ARIMA model predicted continued increases in prevalence and DALYs by 2036,with females maintaining a higher burden than males.Conclusion:This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years.Public health policies should prioritize NVL prevention and control,with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.
文摘In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.
基金supported by the National Natural Science Foundation of China (82070055 and 82470054)the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, Grant No.2023LNJJ18)。
文摘Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.
基金supported by the Jiangsu Province Colleges'Qinglan'ProjectScientific research project of Jiangsu Provincial Health Commission(MQ2024002)Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX25_3212)。
文摘Background Mental disorders pose a significant global health burden,especially after the coronavirus disease2019 pandemic.Aims This study aimed to characterise trends in the burden of mental disorders among adolescents and young adults by sex,age,sociodemographic index(SDI)quintile,region and country from 1990 to 2021.Methods Estimates and 95%uncertainty intervals(UIs)for disability-adjusted life years(DALYs)were extracted from the Global Burden of Diseases Study 2021.The number and rate of DALYs,as well as the percentage change from 1990 to 2021,were estimated by sex,age,SDI quintile,region and country.Results The number of DALYs for mental disorders increased from 26.1(95%UI 19.3 to 34.4)million to 36.3(95%UI 26.6 to 48.1)million.The DALY rate increased from 1687.8(1245.3 to 2225.4)per 100000 population in1990 to 1923.71408.7 to 2548.4)per 100000 population in 2021,representing a 14%(12%to 16%)increase.Females(16%(13%to 18%))and individuals aged 15-19years(16%(13%to 18%))showed the greatest increase in DALY rates.Between 1990 and 2021,DALY rates rose significantly across all SDI quintiles and regions,except East Asia(-5%(-9%to-1%)).The most rapid increases were observed in parts of Latin America,particularly for anxiety and depressive disorders.Conclusions The global burden of mental disorders among adolescents increased significantly from 1990 to2021,necessitating attention to policies targeting high-risk populations and specific regions.
文摘Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.
基金supported by the public agreement between the Danish Regions and the General Practitioners’Organization 2022–2024.
文摘Introduction This study aimed to either identify or develop and validate a patient-reported outcome measure(PROM)to assess treatment burden related to general practice for patients with multimorbidity,which can be used alongside the MultiMorbidity Questionnaire part 1(MMQ1)without overwhelming the target population with redundant items.Methods We conducted a systematic literature review to identify all existing PROMs measuring treatment burden.If no suitable PROM was found,our plan was to:(1)develop a draft PROM using items from existing instruments,(2)carry out group and individual interviews with patients with multimorbidity to ensure the PROM’s understandability,clarity,completeness and relevance and(3)undertake psychometric validation with a diverse sample of primary care patients with chronic conditions.Results We did not identify an eligible PROM in the literature review.The draft PROM consisted of 30 items divided into six domains;Information about treatment,Challenges with medication,Medical appointments,Self-monitoring,Health behaviour and Challenges in the contact to the health system.In the psychometric validation,neither these domains nor any other theoretical constellation of items had adequate psychometric properties.Individual items had good criterion validity and sensitivity to change.Conclusions In this study,we developed a 30-item PROM with high content validity where various individual items showed adequate criterion validity and sensitivity to change,making these items useful as a supplemental measure to the MMQ1.Trial registration number NCT05676541 Registration Date:16 December 2022.
基金The Science and Technology Planning Project of Shantou in 2021(No.210616086490125)the Guangdong Department of Education’s SpecialGrant for Key Area Programs(No.2021ZDZX2023)the National Natural Science Foundation of China(No.82072607,No.81871975)all provided funding for this work.
文摘Background:Esophageal cancer(EC)is a lethalmalignancy.The sociodemographic index(SDI)is a critical factor influencing the disease burden of EC.Risk factors,including alcohol use and diet,vary significantly by SDI level,affecting the disease outcomes.This study utilized the Global Burden of Disease Study 2021 database to determine the age-standardized mortality rates(ASMR)and age-standardized disability-adjusted life-year rates(ASDRs)for EC attributable to alcohol use and a diet low in vegetables across countries with different SDI.Methods:Data from the Global Burden of Disease Study 2021,covering from 1990 to 2021,were analyzed for 204 areas categorized into quintiles based on the SDI.Exposure levels for alcohol and vegetable intake were defined,and data were standardized using the global population structure to ensure comparability.Trend lines for the disease burden were plotted using R version 4.3.0(R Foundation for Statistical Computing,Vienna,Austria).Statistical analyses were conducted using Joinpoint 4.9.1.0(The Division of Cancer Control and Population Sciences,USA)regression to assess temporal trends in mortality and ASDRs,focusing on the annual percent change and average annual percent change across various SDI categories.Results:From 1990 to 2021,the ASMR and ASDR for EC decreased globally across all SDI levels and in both sexes.The areas with a middle SDI initially had the highest rates but experienced the fastest declines,falling below high-middle–SDI countries by 2021.The ASMRs attributable to alcohol use generally declined,except in low-middle–and low-SDI nations.The greatest rates among males and the total population were found in high-middle–SDI nations,whereas high-SDI nations had the highest rates among females.The ASMRs associated with a diet low in vegetables decreased in all areas.Conclusions:Despite the overall declining trend in the EC burden associated with alcohol use and diets low in vegetables,EC remains a significant global health concern.Strengthening the focus on key populations,implementing public health policies to reduce alcohol consumption,and promoting increased vegetable intake may collectively reduce the global burden of EC.
文摘Objective:To investigate the temporal trends of the burden of type 2 diabetes mellitus(T2DM)in China attributed to low-fiber diet from 1990 to 2019,highlighting the importance of dietary fiber in T2DM prevention.Methods:Using data from the GBD 2019,age-and sex-specific mortality and DALYs related to T2DM attributed to a low-fiber diet in China were analyzed through join-point regression and age-period-cohort model analysis.Results:In 2019,T2DM deaths and disability-adjusted life years(DALYs)attributed to a low-fiber diet in China totaled 2887 and 182251,respectively.Males under 60 years had higher mortality and DALYs rates than females,but the trend reversed for those over 60.The ASMR and ASDR decreased by 43%and 38%since 1990,respectively.Before 2008,female age-standardized mortality rate(ASMR)and age-standardized disability-adjusted life years rate(ASDR)were higher than males,but it was reversed after 2010.Both male and female ASDR decreased,while the relative risk of mortality increased with age.The period effect on T2DM burden remained stable,while the cohort effect declined.Conclusion:The burden of T2DM attributed to a low-fiber diet in China showed an initial increase followed by a decrease from 1990 to 2019.The burden was higher among the elderly,with gender-specific differences among age groups.
基金the Military Program for Clinical Cultivation Specialty and Chinese Preventive Medicine Association.
文摘Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.
文摘In the contemporary period,cancer has emerged as a significant challenge to global public health.According to the International Agency for Research on Cancer(IARC),there were 19.965 million new cases of malignant tumors worldwide in 2022,resulting in 9.737 million deaths(1,2).As a populous nation,China accounts for approximately24.2%of the global incidence of new cases and 26.4%of the total cancer-related deaths.Consequently,China ranks first globally in both the incidence and mortality rates of malignant tumors(3).
文摘The coronavirus disease 2019 pandemic has left an indelible mark on global mental health,with widespread psychological consequences that persist beyond the acute phase of the virus.This review synthesizes current evidence on the postpandemic mental health burden across diverse populations,highlighting elevated rates of depression,anxiety,posttraumatic stress,and substance use disorders linked to prolonged social isolation,economic instability,and grief.We examine disparities in psychological outcomes among vulnerable groups(e.g.,healthcare workers,survivors,marginalized communities)and identify key challenges in addressing these issues,including fragmented healthcare systems,stigma,and the limited scalability of interventions.Emerging evidence on resilience factors(e.g.,social support and adaptive coping)is also discussed.Finally,we propose critical priorities for future research,including longitudinal studies on the chronic mental health effects,the development of culturally tailored interventions,and the integration of digital mental health solutions.This review distinctively addresses enduring post-pandemic mental health challenges,integrating neurobiological insights,equity-focused interventions,and critical perspectives on digital solutions,gaps underrepresented in prior syntheses.By charting a roadmap for multidisciplinary collaboration,this review aims to inform policymakers and researchers in mitigating the long-term psychological aftermath of the pandemic.
