Search

• The study reveals a three-fold increase in both incidence and prevalence of epilepsy. • Throughout the study period, 153,532 DALYs were lost due to epilepsy. • Organic, including symptomatic, mental disorders were the most comorbid conditions. • Mortality was significantly associated with systemic atrophies and cerebral palsy. This study is designed to estimate the epidemiology of epilepsy in Kazakhstan, using a large-scale administrative health database during 2014–2020. Using the Unified National Electronic Health System of Kazakhstan over a seven-year span, we explored incidence and prevalence rates, disability-adjusted life years (DALY), and all-cause mortality. Regression models using Cox proportional hazards were used to analyze the sociodemographic, mental, behavioral, and neurological factors affecting survival. Overall analyses were performed using STATA (V.16). The total cohort comprised of 82,907 patients, with a significant increase in the incidence of epilepsy from 26.15 in 2014 to 88.80 in 2020 per 100,000 people. Similar trends were observed in the prevalence rates, which tripled from 26.06 in 2014 to 73.10 in 2020. While mortality rates fluctuated, the elderly and children had the greatest rates of 9.97 and 2.98 per 1000 person-years respectively. DALYs revealed a substantial disease burden, with 153,532 DALYs (824.5 per 100,000) being lost during the study period. A few comorbidities, such as cerebral palsy (adjusted hazard ratio (aHR) 2.23) and central nervous system atrophy (aHR, 27.79), markedly elevated all-cause mortality. Furthermore, extrapyramidal and movement disorders (aHR 2.16, p = 0.06) and demyelinating diseases of the central nervous system (aHR 6.36, p = 0.06) showed a trend toward increased mortality risk. To the best of our knowledge, this is the first study from Central Asia exploring a large epilepsy cohort. The findings highlight the need for targeted interventions to address the growing burden of epilepsy, particularly among children, male sex, and those with neurological comorbities. [ABSTRACT FROM AUTHOR]

Assuring food safety is increasingly important in emerging and developing economies. Despite being a public good, food safety in these economies is often addressed through limited private sector innovations while the public health costs and impact of food-borne diseases are largely unknown. This study estimates annual private and public costs and benefits of a quality-based milk payment system (QBMPS) in Kenya. Private costs and benefits were estimated using a partial budget analysis. From a private perspective, results show that participating farmers benefit most from the QBMPS, with a net profit of about USD 0.02 USD/kg) from an additional investment cost USD 0.0125/kg to produce Grade A milk. The cooperatives and processor have a net loss of 0.025 USD/kg milk, mainly driven by testing and initial investment costs. Disease burden was calculated using the Disability Adjusted Life Years (DALYs), while direct and indirect health costs were calculated using an incidence-based analysis. We estimate an annual disease burden of 53,000 DALYs from milk-related infectious diseases and a generated health benefit of 13 KES/kg due to reduction in disease incidence if 15% of Kenya's milk goes through the QBMPS. These health benefits justify public and private sector support for a QBMPS. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives Medical Review Journal / Arsiv Kaynak Tarama Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Healthcare-associated infections (HAIs) are an increasing public health threat. Measuring disease burden in disability-adjusted life-years (DALYs) allows the combination of morbidity and mortality into one figure, as it represents the summation of years lived with disability and years of life lost.Aim: To evaluate the incidence, attributable deaths and burden of the most significant HAIs in Italy.Methods: Prevalence data from the study sample of the 2016 national Point Prevalence Survey of HAIs in acute-care settings were used to estimate the incidence of five HAIs. The methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project was employed for DALY calculations, adapting the disease models to the Italian population.Findings: We estimated a total of 641,065 (95% uncertainty interval, UI 585,543.00-699,207.90) new yearly cases of HAIs and 29,375 (95% UI 23,705.97-35,905.80) deaths in Italy in 2016. The total annual DALYs were estimated to be 424,657.45 (95% UI 346,240.35-513,357.28), corresponding to 702.53 DALYs (95% UI 575.22-844.66) per 100,000 general population. Bloodstream infections accounted for the majority of total DALYs (59%), healthcare-associated pneumonia for 29%, surgical site infections for 9%, CDI for 2% and urinary tract infections accounted for less than 1% of total DALYs.Conclusion: Results of this study suggest HAIs have a substantial burden in Italy. Reducing the burden of HAIs through infection prevention and control efforts is an achievable goal. This study provides data that could be used to guide policy-makers in the implementation of these measures. [ABSTRACT FROM AUTHOR]

India is going through an epidemiologic and demographic transition made possible by increased investment in health sector and sustained development. The country has more than 2 million people infected with human immunodeficiency virus (HIV). Information on cost-effectiveness of competing interventions is a useful contributor to decisions concerning allocation and prioritization of healthcare resources. This paper aims to study the cost, health outcomes as measured by disability-adjusted life-years (DALYs), and cost-effectiveness per DALY averted of prophylaxis for tuberculosis, diarrhea, and mouth ulcers in HIV-infected adults. Data were analyzed on 375 HIV-infected persons enrolled at the ART Centre in New Delhi between April 2004 and April 2006. Using estimates of the age of onset of HIV infection, cost of medicines, and antiretroviral regimen followed, we used standard methods to calculate the cost per DALY as a measure of cost-effectiveness. Sensitivity analysis was conducted to determine the robustness of cost-effectiveness results by making reasonable changes in underlying assumptions. The results revealed that the incremental cost-effectiveness ratio for tuberculosis prophylaxis was ₹4821.48 ($78.86) per DALY averted compared with no prophylaxis, followed by diarrhea (₹8299.08, $135.74) and mouth ulcers (₹20 058.14, $328.07). The estimates are less than the per capita gross domestic product of India, indicating that the current treatments are highly cost-effective. This will help policymakers understand the best opportunities to improve population health and help researchers to develop more standardized methods in the area, thus improving quality and comparability across cost per DALY studies. [ABSTRACT FROM AUTHOR]

Objective: To determine the cost-effectiveness of building and maintaining a dedicated pediatric operating room (OR) in Uganda from the societal perspective. Background: Despite the heavy burden of pediatric surgical disease in lowincome countries, definitive treatment is limited as surgical infrastructure is inadequate to meet the need, leading to preventable morbidity and mortality in children. Methods: In this economic model, we used a decision tree template to compare the intervention of a dedicated pediatric OR in Uganda for a year versus the absence of a pediatric OR. Costs were included from the government, charity, and patient perspectives. OR and ward case-log informed epidemiological and patient outcomes data, and measured cost per disability adjusted life year averted and cost per life saved. The incremental costeffectiveness ratio (ICER) was calculated between the intervention and counterfactual scenario. Costs are reported in 2015 US$ and inflated by 5.5%. Findings: In Uganda, the implementation of a dedicated pediatric OR has an ICER of $37.25 per disability adjusted life year averted or $3321 per life saved, compared with no existing operating room. The ICER is well below multiple cost-effectiveness thresholds including one times the country's gross domestic product per capita ($694). The ICER remained robust under 1-way and probabilistic sensitivity analyses. Conclusion: Our model ICER suggests that the construction and maintenance of a dedicated pediatric operating room in sub-Saharan Africa is verycost effective if hospital space and personnel pre-exist to staff the facility. This supports infrastructure implementation for surgery in sub-Saharan Africa as a worthwhile investment. [ABSTRACT FROM AUTHOR]

Background/purpose: Foodborne disease is a global health problem. We aim to provide the first national estimate on disease burden from foodborne illnesses in Taiwan.Methods: We adopted the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group (FERG) methodology framework, and used a hazard-based incidence approach to calculate disability-adjusted life year (DALY) lost to foodborne diseases. Estimated annual incidences and associated medical costs are based on the National Health Insurance research database. We redistributed incidence of unspecified acute gastroenteritis to specific foodborne pathogens, using reported bacteria, virus, parasite survey results in such cases as the reference. The percentage of foodborne illnesses not seeking medical attention is based on data reported from a nationwide survey.Results: During 2012-2015, 3,895,914 (90% confidence interval [CI]: 3,493,530-4,442,690) foodborne illnesses (1,445,384 sought medical care, with 50 deaths) occurred annually, which caused a total loss of 4974 (90%CI: 4671-5367) DALYs in Taiwan. The annual medical cost was NT$1.3 billion. Young (<5 years) children had the highest incidence. Among the 53% of foodborne illnesses cases with identifiable causal microorganisms, non-typhoid Salmonella, norovirus, and Vibrio parahaemolyticus were leading pathogens (annual foodborne incidence: 185,977, 157,656, and 99,351, respectively). Cases caused by non-typhoid Salmonella peaked in summer, while that caused by norovirus peaked in winter.Conclusion: Foodborne illnesses cause a substantial disease burden in Taiwan. Establishment of active surveillance and investigation mechanisms for the leading foodborne pathogens is warranted. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper explores the role of knowledge, standards, and metrics in global health. Our point of departure is the observation that the emergence of 'global health' as a domain of research, policy, and practice in the last three decades or so has coincided with an increased interest in the validation and use of measures of health, such as the Disability Adjusted Life Year (DALY), in monitoring and assessing health equity across territories and populations. This 'elective affinity' between global health and health metrics has become the focus of scholarly debate in the social sciences. In this paper, we seek to contextualise and critically discuss the different positions in this debate. We suggest that emplacing health metrics within the neo-liberal logic of health production --one where the 'mechanisms of life' are aligned with the maximisation of economic productivity- does not fully capture the interactive relationship between health measurement and the politics of health. Instead, we argue that this relationship has been characterised by controversy and uncertainty about how to interlock normative ideals and approaches to knowledge-making about health. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Exposure to natural rubber latex, primarily through the use of gloves, is a well-recognized cause of occupational asthma. We investigated latex glove use among Australian workers and estimated the resultant burden of occupational asthma among healthcare workers (HCWs). Methods Data were collected in 2014 as part of the Australian Work Exposures Study-Asthma, a telephone survey investigating the prevalence of current occupational exposure to asthmagens, including latex. We estimated adjusted prevalence ratios (aPRs) to determine variables associated with the use of latex gloves among HCWs and calculated the asthma-related disability-adjusted life years due to latex exposure among HCWs. Results Latex gloves were used by 22% of respondents. Almost two-thirds (63%) of HCWs reported wearing latex gloves, with 26% using powdered latex gloves. The use of latex gloves was more common among those employed in micro companies (less than 5 employees) than large companies (200+ employees) (aPR = 1.5, 95% confidence interval 1.1-2.0). Latex exposure in HCWs was estimated to contribute 3% of the total asthma-related burden. Discussion Latex gloves are widely used by Australian workers and by HCWs in particular. Conclusions This is the first estimate of the burden of asthma attributable to occupational exposure to latex among HCWs. These results can be used to guide decisions regarding the control of occupational exposure to latex. [ABSTRACT FROM AUTHOR]

Sewage treatment plants (STPs) are one of the sources of pathogens discharged into surface water. An investigation was carried out over the duration of 12 months in Henan Province, China, to evaluate the health influence of municipal wastewater effluent discharge on water quality of the receiving water. A discharge-based quantitative microbial risk assessment (QMRA) was employed, taking into account the vegetables consumption habits of the Chinese, population subgroups with different immune statuses and ages, to evaluate the incremental disease burden from agricultural irrigation and swimming exposure scenarios associated with increased concentration of the protozoan Cryptosporidium and/or Giardia in the receiving river. The results shown that all the STP influent samples contained Cryptosporidium and Giardia with average density of 142.31 oocysts/L and 1187.06 cysts/L, respectively. The QMRA results demonstrated that the estimated additional health burdens due to discharged effluent for both parasites were slightly violated the threshold of 10 −6 DALYs per person per year set by WHO. Mitigation measures should be planned and executed by season since more disease burdens were borne during hot season than other seasons. The sensitivity analysis highlighted the great importance of stability of STP treatment process. This study provides useful information to improve the safety of surface water and deduce the disease burden of the protozoa in Henan Province and other region inside and outside China. [ABSTRACT FROM AUTHOR]

Copyright of Tecnología y Ciencias del Agua is the property of Instituto Mexicano de Tecnologia del Agua (IMTA) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The burden of injury is increasing worldwide; planning for its impact on population health and health systems is urgently needed, particularly in low- and middle-income countries (LMICs). This study aimed to model the burden of fractures and project costs to eliminate avertable fracture-related disability-adjusted life-years (i.e., a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or premature death; DALYs) in Sierra Leone and Nepal.Methods: Data from nationwide, cluster-randomized, community-based surveys of surgical need in Sierra Leone and Nepal were used to model the incidence and prevalence of fractures stratified by met and unmet needs. DALYs incurred from treated and untreated fractures were estimated. Additionally, the investment necessary to eliminate avertable incident fracture DALYs was modeled through 2025 using published cost per DALY averted estimates.Results: The incidence of treated and untreated fractures in Sierra Leone was 570 and 1004 fractures per 100,000 persons, respectively. There could be more than 2 million avertable fracture DALYs by 2025 in Sierra Leone and 2.5 million in Nepal requiring an estimated US$ 4,049,932 (range US$ 2,011,500-6,088,364) and US$ 4,962,402 (range US$ 2,464,701-7,460,103) to address this excess burden, respectively.Conclusion: This study identified a significant burden of untreated fractures in both countries, and an opportunity to avert more than 4.5 million DALYs in 10 years in a cost-effective manner. Prioritizing funding mechanisms for orthopaedic care and implants should be considered given the large burden of untreated fractures found in both countries and the long-term savings and functional benefit from properly treated fractures. [ABSTRACT FROM AUTHOR]

Minimizing environmental impacts due to logistics activities have long been recognized as part of a way to promote a sustainable supply chain. Facility location decisions play a critical role in strategic design of supply chain and hence have a long-term impact on its cost and environmental performance. In this study, Operations research and Life-cycle impact assessment techniques are used to estimate the burden on local population's health caused by facility location decisions. Specifically, our primary goal is to minimize the impacts on local population's health quantified in terms of Disability Adjusted Life Year (DALY). A mixed integer linear programming model is developed based on a case study located in Can Tho city, Vietnam. Geographic information system (GIS) mapping software is used to estimate the number of affected population. The results of the study show that population density along different parts of transportation routes is the main factor influencing the selection of optimal solutions. [ABSTRACT FROM AUTHOR]

Road traffic noise is one of the most ubiquitous urban environmental pollutants. This paper brings together three related works – in which the author has been involved or is currently completing - that together illustrate essential input to good policy development for the management of the health consequences of this pollutant. These include a guidance document on burden of disease from environmental noise; an assessment of exposure, response, and exposure-response, to road traffic noise in a densely-populated Asian city; and a current systematic evidence review of the effectiveness, in health terms, of interventions to control environmental noise. These provide examples of the nature of the quantitative evidence available to promote noise management through policy interventions. [ABSTRACT FROM AUTHOR]

The standard way in which disaster damages are measured involves examining separately the number of fatalities, of injuries, of people otherwise affected, and the financial damage that natural disasters cause. Here, we implement a novel way to aggregate these separate measures of disaster impact and apply it to two catastrophic events from 2011: the Christchurch (New Zealand) earthquakes and the Greater Bangkok (Thailand) flood. This new measure, which is similar to the World Health Organization’s calculation of Disability Adjusted Life Years (DALYs) lost due to the burden of diseases and injuries, is described in detail in Noy [7] . It allows us to conclude that New Zealand lost 180 thousand lifeyears as a result of the 2011 events, and Thailand lost 2644 thousand lifeyears. In per capita terms, the loss is similar, with both countries losing about 15 days per person due to the 2011 catastrophic events in these two countries. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Diabetes is one of the main contributors to ill health and premature mortality worldwide and its prevalence has been rising during the last decades. Aim The aim of the present study was to quantify the burden of disease in terms of deaths and loss of healthy life years (DALYs) attributed to diabetes by its demographic levels in the State of Qatar. Materials and methods The methods were largely based on the established Global Burden of Disease methodology and use the burden of disease in terms of disability adjusted life years (DALYs) and the years lost due to disability (YLD) as the outcome measure. We calculated years lost due to disability (YLD) and years life lost (YLL) attributable to diabetes. The study was conducted during the period from June 2013 to January 2014. Results The study findings revealed that disability adjusted life years (DALYs) has been increasing across the years and reached to 4.35 in 2011 from 2.58 in 2007. DALYs for men was remarkably higher than women during the period (2007–2011). Diabetes mellitus was the 6th leading cause of disease burden in Qatar (3.8%). The YLD showed a sharp increase in men (2.52 in 2011 from 1.34 in 2007) and women (1.05 in 2011 from 0.33 in 2007) during the year 2011. YLL portion of women enlarged considerably in 2011 (0.10) compared to 2010 (0.04). YLL for men and women was fluctuating across the years with a decrease in 2011 (18%) from 2007 (35%). Men and women in the age group 30–44 years had the highest peak across the years. Conclusion The study findings revealed that diabetes disease burden was considerably high in Qatar, particularly in the working age group. DALYs has been increasing across the years. [ABSTRACT FROM AUTHOR]

Copyright of DYNA - Ingeniería e Industria is the property of Publicaciones Dyna SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although road traffic noise is the most important source of environmental noise emission in large cities, little is known about health burden. The present study was conducted to estimate the burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017. Using noise maps provided by the municipality of Tehran, we calculated population exposure distribution in term of L dn and L night and the number of DALYs lost due to ischemic heart disease, hypertension, high sleep disturbance, annoyance and stroke endpoints based on the World Health Organization Environmental Noise Guidelines for the European Region. We applied published dose-response functions to estimate the traffic noise burden for high sleep disturbance and annoyance. We estimated 61,284 DALYs or 697 DALYs per 100,000 population attributed to traffic noise in Tehran for the reference year 2017. Highly sleep disturbance with a share of 58.74% of the DALYs was recognized as the most important contributor of disease burden, and noise annoyance with a share of 23.12% was ranked next. Ischemic heart disease (11.71%), stroke (5.12%), and hypertension (1.31%) were ranked third to fourth, respectively, in terms of the burden of disease caused by environmental noise. A considerable fraction of the population of Tehran lives in areas with an environmental noise higher than the standard level. The findings showed that traffic noise pollution is an important environmental risk factor in Tehran imposes the greatest burden on the community, mainly through highly sleep disturbance and noise annoyance endpoints. [Display omitted] • Estimate the exposure to traffic noise in the Tehran in 2017. • Estimate the burden of diseases attributed to traffic noise. • Only in 2017, about 61,284 DALYs attributed to traffic noise in Tehran. • Highly sleep disturbance is the most important contributor of disease burden. [ABSTRACT FROM AUTHOR]

• Combined LCA and MFA shows that informal e-waste sector is best at dismantling. • e-waste recyclers recovered 93% or more of the original mass of the four products. • Informal e-waste recycling offers environmental benefits through avoided emissions. • Crucial to avoid cable burning and improper lead disposal in landfilled CRT screens. • E-waste recycling provides important sources of income in low-income communities. The informal e-waste recycling sector has potential for both harmful environmental releases and environmental benefits associated with avoided emissions from recovered materials. Four household appliances (washing machine, refrigerator, Cathode Ray Tube (CRT) television, fan) were selected for a combined Material Flow Analysis and Life Cycle Assessment (LCA) analysis of their end-of-life treatment. Data collection took place in an informal e-waste recycling community in Thailand, recording the weight of materials recovered for each appliance, along with the number of each appliance recycled for one entire village. The LCA determined the avoided emissions and damages (human health, ecosystem quality, climate change, and resource use) per kg material recovered, per product, and for an entire recycling community, with a benefit of 2.7 to 25.4 kg CO 2 eq avoided per product piece. Informal e-waste recycling appears relatively efficient in material recovery and economically beneficial. Recyclers recovered 93% or more of the original mass of the products. Just over 460,000 kg of waste devices were processed each year, with a net value added of 2.1 million Thai Baht. Each year, the normalized environmental net benefits amount to 0.2 DALYs for human health, 60,000 kg CO 2 eq in climate change impacts, and nearly 400,000 MJ in avoided resource damages each month. Informal e-waste recycling was found to have net benefits in terms of avoided emissions, in particular due to recovery of PCBs, copper, steel and plastic with the exception of improper disposal of hazardous materials of lead in landfilled CRT screens and burned cables. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: The conceptualization of disability has shifted from a medical to a social model with a consequent focus away from impairments and toward activities and participation. The International Classification of Functioning, Disability and Health (ICF) provides a common point of reference and a common language in a developing disability discourse. Objectives: We sought to apply a model for the measurement of disability based on the activity and participation constructs of the ICF to persons with movement difficulty as a result of injury-related causes. Methods: Data from sample adults aged 18 years and over in the 2001-2006 National Health Interview Survey (NHIS) were used for analysis. Disability among adults with injury-related movement difficulty was assessed through measures of difficulty performing basic actions (movement, sensory, emotional, and/or cognitive functioning); and limitations of complex activities (defined through measures of self-care, social participation, and work participation). SUDAAN 9.0 was used in all analyses to account for the complex sampling design and weighting of the NHIS data. Results: Approximately 16% of noninstitutionalized adults who reported movement difficulty mentioned injury as a cause. On average, between 2001 and 2006, about 7.6 million adults had injury-related movement difficulty in the United States. Overall, 50% of adults who experienced injury-related movement difficulty also experienced some complex activity limitation. Conclusions: Using NHIS data, we have demonstrated the applicability of an approach using basic actions difficulty and complex activity limitations to measure functioning and participation in individuals with a specific type and cause of difficulty: injury-related movement difficulty. The operationalization of these constructs provides a possible tool to monitor progress toward the attainment of the equalization of opportunities among people with injury-related movement difficulty. [Copyright &y& Elsevier]

Copyright of Revista Ambiente e Água is the property of Revista Ambiente e Agua and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Global climate change (GCC) may have serious and irreversible impacts. Improved methods are needed to predict and quantify health impacts, so that appropriate risk management strategies can be focused on vulnerable areas. The disability-adjusted life year (DALY) is proposed as an effective tool in environmental health impact assessment (HIA). The DALY accounts for years of life lost to premature death and/or morbidity. Both the DALY and the determinants-of-health approach are applied to HIA of GCC in Bangladesh. Based on historical data, a major storm event may result in approximately 290 DALY per 1000 population, including both deaths and injuries, compared to a current all-cause rate of about 280 per 1000 in the region. A more precise result would require a large input of data; however, this level of analysis may be sufficient to rank risks, and to motivate and target risk management efforts. [Copyright &y& Elsevier]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Western Europe had the highest prevalence of MS during 1990 to 2017. • The Middle East North Africa (MENA) region had an increasing trend for MS incidence during 1990 to 2017. • The age group of 25–29 years had the highest risk of MS in all regions during 1990 to 2017. Females had higher incidence, prevalence, and DALY of MS compare to males in all regions during 1990 to 2017. • The incidence of MS in Iran was constantly increasing during 1990 to 2017 and surpassed Western Europe since 2013. Multiple sclerosis (MS) is the most common immune mediated disorder of the central nervous system (CNS). This study compares the worldwide occurrence and epidemiologic burden of MS in the Middle East and Northern Africa (MENA) region and Western Europe from 1990 to 2017. This study used data from the global burden of disease (GBD) studies. Initially, all age and age-specific values were estimated and then, these values were compared among the mentioned areas. In addition, the changes of sex distribution of MS according to incidence, prevalence, and disability-adjusted life years (DALYs) were calculated. The trend of MS incidence was also compared among the MENA region countries. According to MS incidence per 100,000 populations during 1990 to 2017, the occurrence of new cases has decreased slightly in the world (from 0.7 to 0.65) and Western Europe (from 2.55 to 2.50). Except Iran with a sharp rise of 2 to 2.8, there was a slow increase in the MENA region (from 0.9 to 1). The MS prevalence, between 1990 and 2017, in all ages was stable in the world and the MENA region except a steady increase in Iran and highest value in Western Europe. In this study, we determined the age-specific incidence of MS in all regions from 1990 to 2017. Although data showed a different trend of changes between age groups and regions, the group age 25–29 years had the highest risk of MS incidence. Based on gender, the incidence, prevalence, and DALY of MS in all regions were higher in female. From 1990 to 2017, Western Europe had the highest MS prevalence and the MENA region had a relatively stable trend for MS incidence. In particular, in Iran, the MS incidence has been constantly increasing and has surpassed Western Europe since 2013. [ABSTRACT FROM AUTHOR]