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51. Health democracy, from one crisis to another

Author: François Alla, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Admin, Oskar
Subjects: [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Politics, Public Health, Environmental and Occupational Health, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Democracy
Abstract: International audience
Published: 2022

52. The effectiveness of inodilators in reducing short term mortality among patient with severe cardiogenic shock: a propensity-based analysis.

Author: Romain Pirracchio, Jiri Parenica, Matthieu Resche Rigon, Sylvie Chevret, Jindrich Spinar, Jiri Jarkovsky, Faiez Zannad, François Alla, Alexandre Mebazaa, and GREAT network
Subjects: Medicine, Science
Abstract: BackgroundThe best catecholamine regimen for cardiogenic shock has been poorly evaluated. When a vasopressor is required to treat patients with the most severe form of cardiogenic shock, whether inodilators should be added or whether inopressors can be used alone has not been established. The purpose of this study was to compare the impact of these two strategies on short-term mortality in patients with severe cardiogenic shocks.Methods and resultsThree observational cohorts of patients with decompensated heart failure were pooled to comprise a total of 1,272 patients with cardiogenic shocks. Of these 1,272 patients, 988 were considered to be severe because they required a vasopressor during the first 24 hours. We developed a propensity-score (PS) model to predict the individual probability of receiving one of the two regimens (inopressors alone or a combination) conditionally on baseline-measured covariates. The benefit of the treatment regimen on the mortality rate was estimated by fitting a weighted Cox regression model. A total of 643 patients (65.1%) died within the first 30 days (inopressors alone: 293 (72.0%); inopressors and inodilators: 350 (60.0%)). After PS weighting, we observed that the use of an inopressor plus an inodilator was associated with an improved short-term mortality (HR: 0.66 [0.55-0.80]) compared to inopressors alone.ConclusionsIn the most severe forms of cardiogenic shock where a vasopressor is immediately required, adding an inodilator may improve short-term mortality. This result should be confirmed in a randomized, controlled trial.
Published: 2013
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53. Correction: The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis.

Author: Romain Pirracchio, Jiri Parenica, Matthieu Resche Rigon, Sylvie Chevret, Jindrich Spinar, Jiri Jarkovsky, Faiez Zannad, François Alla, and Alexandre Mebazaa
Subjects: Medicine, Science
Published: 2013
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54. Health services research in France: bridging the gap between academia and policymaking

Author: Marine Spaak, François Alla, Daniel Benamouzig, Marion Cipriano, Centre de sociologie des organisations (CSO), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), and Centre de sociologie des organisations (Sciences Po, CNRS) (CSO)
Subjects: medicine.medical_specialty, Bridging (networking), [SDV]Life Sciences [q-bio], academia (organization), Disease cluster, [SHS]Humanities and Social Sciences, Critical mass (sociodynamics), 03 medical and health sciences, 0302 clinical medicine, Political science, medicine, Humans, 030212 general & internal medicine, Policy Making, Publication, ComputingMilieux_MISCELLANEOUS, Publishing, business.industry, Public health, Public Health, Environmental and Occupational Health, Health services research, gray literature, Grey literature, Public relations, health services research, 3. Good health, Work (electrical), interdisciplinary research, public health medicine, France, Health Services Research, Public Health, business, 030217 neurology & neurosurgery
Abstract: Background—We aimed to identify the knowledge producers, the knowledge that they produce and the main areas of interest for health services research (HSR) in France, which is one of the priorities for public health research planning.Methods—A two-phase approach comprising a bibliometric analysis and semi-structured interviews with 20 researchers and 13 staff members of public health bodies was used.Results—In France today, interdisciplinary research teams are being organized in the main cities despite a lack of critical mass. The interviews showed that the term ‘health services research’ is vague with fuzzy boundaries between research, scientific expertise and evaluation. A keyword cluster analysis showed that French HSR is more hospital-centric compared to those countries that publish most frequently. The analysis also revealed a lack of research on methodological aspects.Conclusions—We analyzed the structure of HSR in France and the specificity of the French publications in this field, compared with other countries. The results indicate the obstacles faced by researchers and decision-makers and offer insight into how these barriers may be removed.
Published: 2020

55. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Author: Gregory A. Roth, George A. Mensah, Catherine O. Johnson, Giovanni Addolorato, Enrico Ammirati, Larry M. Baddour, Noël C. Barengo, Andrea Z. Beaton, Emelia J. Benjamin, Catherine P. Benziger, Aimé Bonny, Michael Brauer, Marianne Brodmann, Thomas J. Cahill, Jonathan Carapetis, Alberico L. Catapano, Sumeet S. Chugh, Leslie T. Cooper, Josef Coresh, Michael Criqui, Nicole DeCleene, Kim A. Eagle, Sophia Emmons-Bell, Valery L. Feigin, Joaquim Fernández-Solà, Gerry Fowkes, Emmanuela Gakidou, Scott M. Grundy, Feng J. He, George Howard, Frank Hu, Lesley Inker, Ganesan Karthikeyan, Nicholas Kassebaum, Walter Koroshetz, Carl Lavie, Donald Lloyd-Jones, Hong S. Lu, Antonio Mirijello, Awoke Misganaw Temesgen, Ali Mokdad, Andrew E. Moran, Paul Muntner, Jagat Narula, Bruce Neal, Mpiko Ntsekhe, Glaucia Moraes de Oliveira, Catherine Otto, Mayowa Owolabi, Michael Pratt, Sanjay Rajagopalan, Marissa Reitsma, Antonio Luiz P. Ribeiro, Nancy Rigotti, Anthony Rodgers, Craig Sable, Saate Shakil, Karen Sliwa-Hahnle, Benjamin Stark, Johan Sundström, Patrick Timpel, Imad M. Tleyjeh, Marco Valgimigli, Theo Vos, Paul K. Whelton, Magdi Yacoub, Liesl Zuhlke, Christopher Murray, Valentin Fuster, Noel C. Barengo, Andrea Beaton, Aime Bonny, Jonathan R. Carapetis, Sumeet Chugh, Michael H. Criqui, Nicole K. DeCleene, Joaquim Fernández-Sola, F. Gerry R. Fowkes, Nicholas J. Kassebaum, Walter J. Koroshetz, Awoke T. Misganaw, Ali H. Mokdad, Gláucia M.M. Oliveira, Catherine M. Otto, Mayowa O. Owolabi, Marissa B. Reitsma, Nancy A. Rigotti, Craig A. Sable, Saate S. Shakil, Karen Sliwa, Benjamin A. Stark, Imad I. Tleyjeh, Liesl J. Zuhlke, Mohsen Abbasi-Kangevari, Alireza Abdi, Aidin Abedi, Victor Aboyans, Woldu A. Abrha, Eman Abu-Gharbieh, Abdelrahman I. Abushouk, Dilaram Acharya, Tim Adair, Oladimeji M. Adebayo, Zanfina Ademi, Shailesh M. Advani, Khashayar Afshari, Ashkan Afshin, Gina Agarwal, Pradyumna Agasthi, Sohail Ahmad, Sepideh Ahmadi, Muktar B. Ahmed, Budi Aji, Yonas Akalu, Wuraola Akande-Sholabi, Addis Aklilu, Chisom J. Akunna, Fares Alahdab, Ayman Al-Eyadhy, Khalid F. Alhabib, Sheikh M. Alif, Vahid Alipour, Syed M. Aljunid, François Alla, Amir Almasi-Hashiani, Sami Almustanyir, Rajaa M. Al-Raddadi, Adeladza K. Amegah, Saeed Amini, Arya Aminorroaya, Hubert Amu, Dickson A. Amugsi, Robert Ancuceanu, Deanna Anderlini, Tudorel Andrei, Catalina Liliana Andrei, Alireza Ansari-Moghaddam, Zelalem A. Anteneh, Ippazio Cosimo Antonazzo, Benny Antony, Razique Anwer, Lambert T. Appiah, Jalal Arabloo, Johan Ärnlöv, Kurnia D. Artanti, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Asma T. Awan, Mamaru A. Awoke, Henok T. Ayele, Muluken A. Ayza, Samad Azari, Darshan B. B, Nafiseh Baheiraei, Atif A. Baig, Ahad Bakhtiari, Maciej Banach, Palash C. Banik, Emerson A. Baptista, Miguel A. Barboza, Lingkan Barua, Sanjay Basu, Neeraj Bedi, Yannick Béjot, Derrick A. Bennett, Isabela M. Bensenor, Adam E. Berman, Yihienew M. Bezabih, Akshaya S. Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Boris Bikbov, Mulugeta M. Birhanu, Archith Boloor, Luisa C. Brant, Hermann Brenner, Nikolay I. Briko, Zahid A. Butt, Florentino Luciano Caetano dos Santos, Leah E. Cahill, Lucero Cahuana-Hurtado, Luis A. Cámera, Ismael R. Campos-Nonato, Carlos Cantu-Brito, Josip Car, Juan J. Carrero, Felix Carvalho, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Ester Cerin, Jaykaran Charan, Vijay Kumar Chattu, Simiao Chen, Ken L. Chin, Jee-Young J. Choi, Dinh-Toi Chu, Sheng-Chia Chung, Massimo Cirillo, Sean Coffey, Sara Conti, Vera M. Costa, David K. Cundiff, Omid Dadras, Baye Dagnew, Xiaochen Dai, Albertino A.M. Damasceno, Lalit Dandona, Rakhi Dandona, Kairat Davletov, Vanessa De la Cruz-Góngora, Fernando P. De la Hoz, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Meseret Derbew Molla, Behailu T. Derseh, Rupak Desai, Günther Deuschl, Samath D. Dharmaratne, Meghnath Dhimal, Raja Ram Dhungana, Mostafa Dianatinasab, Daniel Diaz, Shirin Djalalinia, Klara Dokova, Abdel Douiri, Bruce B. Duncan, Andre R. Duraes, Arielle W. Eagan, Sanam Ebtehaj, Aziz Eftekhari, Sahar Eftekharzadeh, Michael Ekholuenetale, Nevine El Nahas, Islam Y. Elgendy, Muhammed Elhadi, Shaimaa I. El-Jaafary, Sadaf Esteghamati, Atkilt E. Etisso, Oghenowede Eyawo, Ibtihal Fadhil, Emerito Jose A. Faraon, Pawan S. Faris, Medhat Farwati, Farshad Farzadfar, Eduarda Fernandes, Carlota Fernandez Prendes, Pietro Ferrara, Irina Filip, Florian Fischer, David Flood, Takeshi Fukumoto, Mohamed M. Gad, Shilpa Gaidhane, Morsaleh Ganji, Jalaj Garg, Abadi K. Gebre, Birhan G. Gebregiorgis, Kidane Z. Gebregzabiher, Gebreamlak G. Gebremeskel, Lemma Getacher, Abera Getachew Obsa, Alireza Ghajar, Ahmad Ghashghaee, Nermin Ghith, Simona Giampaoli, Syed Amir Gilani, Paramjit S. Gill, Richard F. Gillum, Ekaterina V. Glushkova, Elena V. Gnedovskaya, Mahaveer Golechha, Kebebe B. Gonfa, Amir Hossein Goudarzian, Alessandra C. Goulart, Jenny S. Guadamuz, Avirup Guha, Yuming Guo, Rajeev Gupta, Vladimir Hachinski, Nima Hafezi-Nejad, Teklehaimanot G. Haile, Randah R. Hamadeh, Samer Hamidi, Graeme J. Hankey, Arief Hargono, Risky K. Hartono, Maryam Hashemian, Abdiwahab Hashi, Shoaib Hassan, Hamid Y. Hassen, Rasmus J. Havmoeller, Simon I. Hay, Khezar Hayat, Golnaz Heidari, Claudiu Herteliu, Ramesh Holla, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Ayesha Humayun, Ivo Iavicoli, Charles U. Ibeneme, Segun E. Ibitoye, Olayinka S. Ilesanmi, Irena M. Ilic, Milena D. Ilic, Usman Iqbal, Seyed Sina N. Irvani, Sheikh Mohammed Shariful Islam, Rakibul M. Islam, Hiroyasu Iso, Masao Iwagami, Vardhmaan Jain, Tahereh Javaheri, Sathish Kumar Jayapal, Shubha Jayaram, Ranil Jayawardena, Panniyammakal Jeemon, Ravi P. Jha, Jost B. Jonas, Jitendra Jonnagaddala, Farahnaz Joukar, Jacek J. Jozwiak, Mikk Jürisson, Ali Kabir, Tanvir Kahlon, Rizwan Kalani, Rohollah Kalhor, Ashwin Kamath, Ibrahim Kamel, Himal Kandel, Amit Kandel, André Karch, Ayele Semachew Kasa, Patrick D.M.C. Katoto, Gbenga A. Kayode, Yousef S. Khader, Mohammad Khammarnia, Muhammad S. Khan, Md Nuruzzaman Khan, Maseer Khan, Ejaz A. Khan, Khaled Khatab, Gulam M.A. Kibria, Yun Jin Kim, Gyu Ri Kim, Ruth W. Kimokoti, Sezer Kisa, Adnan Kisa, Mika Kivimäki, Dhaval Kolte, Ali Koolivand, Vladimir A. Korshunov, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Vijay Krishnamoorthy, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Vaman Kulkarni, G. Anil Kumar, Nithin Kumar, Om P. Kurmi, Dian Kusuma, Gene F. Kwan, Carlo La Vecchia, Ben Lacey, Tea Lallukka, Qing Lan, Savita Lasrado, Zohra S. Lassi, Paolo Lauriola, Wayne R. Lawrence, Avula Laxmaiah, Kate E. LeGrand, Ming-Chieh Li, Bingyu Li, Shanshan Li, Stephen S. Lim, Lee-Ling Lim, Hualiang Lin, Ziqiang Lin, Ro-Ting Lin, Xuefeng Liu, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Alessandra Lugo, Nirmal K. M, Fabiana Madotto, Morteza Mahmoudi, Azeem Majeed, Reza Malekzadeh, Ahmad A. Malik, Abdullah A. Mamun, Navid Manafi, Mohammad Ali Mansournia, Lorenzo G. Mantovani, Santi Martini, Manu R. Mathur, Giampiero Mazzaglia, Suresh Mehata, Man Mohan Mehndiratta, Toni Meier, Ritesh G. Menezes, Atte Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, Tomasz Miazgowski, Irmina Maria Michalek, Ted R. Miller, Erkin M. Mirrakhimov, Hamed Mirzaei, Babak Moazen, Masoud Moghadaszadeh, Yousef Mohammad, Dara K. Mohammad, Shafiu Mohammed, Mohammed A. Mohammed, Yaser Mokhayeri, Mariam Molokhia, Ahmed A. Montasir, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Jakub Morze, Sumaira Mubarik, Walter Muruet, Kamarul Imran Musa, Ahamarshan J. Nagarajan, Mahdi Nalini, Vinay Nangia, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Bruno R. Nascimento, Vinod C. Nayak, Javad Nazari, Milad Nazarzadeh, Ruxandra I. Negoi, Sandhya Neupane Kandel, Huong L.T. Nguyen, Molly R. Nixon, Bo Norrving, Jean Jacques Noubiap, Brice E. Nouthe, Christoph Nowak, Oluwakemi O. Odukoya, Felix A. Ogbo, Andrew T. Olagunju, Hans Orru, Alberto Ortiz, Samuel M. Ostroff, Jagadish Rao Padubidri, Raffaele Palladino, Adrian Pana, Songhomitra Panda-Jonas, Utsav Parekh, Eun-Cheol Park, Mojtaba Parvizi, Fatemeh Pashazadeh Kan, Urvish K. Patel, Mona Pathak, Rajan Paudel, Veincent Christian F. Pepito, Arokiasamy Perianayagam, Norberto Perico, Hai Q. Pham, Thomas Pilgrim, Michael A. Piradov, Farhad Pishgar, Vivek Podder, Roman V. Polibin, Akram Pourshams, Dimas R.A. Pribadi, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Ivo Rakovac, Pradhum Ram, Sudha Ramalingam, Juwel Rana, Priyanga Ranasinghe, Sowmya J. Rao, Priya Rathi, Lal Rawal, Wasiq F. Rawasia, Reza Rawassizadeh, Giuseppe Remuzzi, Andre M.N. Renzaho, Aziz Rezapour, Seyed Mohammad Riahi, Ross L. Roberts-Thomson, Leonardo Roever, Peter Rohloff, Michele Romoli, Gholamreza Roshandel, Godfrey M. Rwegerera, Seyedmohammad Saadatagah, Maha M. Saber-Ayad, Siamak Sabour, Simona Sacco, Masoumeh Sadeghi, Sahar Saeedi Moghaddam, Saeed Safari, Amirhossein Sahebkar, Sana Salehi, Hamideh Salimzadeh, Mehrnoosh Samaei, Abdallah M. Samy, Itamar S. Santos, Milena M. Santric-Milicevic, Nizal Sarrafzadegan, Arash Sarveazad, Thirunavukkarasu Sathish, Monika Sawhney, Mete Saylan, Maria I. Schmidt, Aletta E. Schutte, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Feng Sha, Saeed Shahabi, Izza Shahid, Masood A. Shaikh, Mahdi Shamali, Morteza Shamsizadeh, Md Shajedur Rahman Shawon, Aziz Sheikh, Mika Shigematsu, Min-Jeong Shin, Jae Il Shin, Rahman Shiri, Ivy Shiue, Kerem Shuval, Soraya Siabani, Tariq J. Siddiqi, Diego A.S. Silva, Jasvinder A. Singh, Ambrish Singh Mtech, Valentin Y. Skryabin, Anna A. Skryabina, Amin Soheili, Emma E. Spurlock, Leo Stockfelt, Stefan Stortecky, Saverio Stranges, Rizwan Suliankatchi Abdulkader, Hooman Tadbiri, Eyayou G. Tadesse, Degena B. Tadesse, Masih Tajdini, Md Tariqujjaman, Berhane F. Teklehaimanot, Mohamad-Hani Temsah, Ayenew K. Tesema, Bhaskar Thakur, Kavumpurathu R. Thankappan, Rekha Thapar, Amanda G. Thrift, Binod Timalsina, Marcello Tonelli, Mathilde Touvier, Marcos R. Tovani-Palone, Avnish Tripathi, Jaya P. Tripathy, Thomas C. Truelsen, Guesh M. Tsegay, Gebiyaw W. Tsegaye, Nikolaos Tsilimparis, Biruk S. Tusa, Stefanos Tyrovolas, Krishna Kishore Umapathi, Brigid Unim, Bhaskaran Unnikrishnan, Muhammad S. Usman, Muthiah Vaduganathan, Pascual R. Valdez, Tommi J. Vasankari, Diana Z. Velazquez, Narayanaswamy Venketasubramanian, Giang T. Vu, Isidora S. Vujcic, Yasir Waheed, Yanzhong Wang, Fang Wang, Jingkai Wei, Robert G. Weintraub, Abrha H. Weldemariam, Ronny Westerman, Andrea S. Winkler, Charles S. Wiysonge, Charles D.A. Wolfe, Befikadu Legesse Wubishet, Gelin Xu, Ali Yadollahpour, Kazumasa Yamagishi, Lijing L. Yan, Srikanth Yandrapalli, Yuichiro Yano, Hiroshi Yatsuya, Tomas Y. Yeheyis, Yigizie Yeshaw, Christopher S. Yilgwan, Naohiro Yonemoto, Chuanhua Yu, Hasan Yusefzadeh, Geevar Zachariah, Sojib Bin Zaman, Muhammed S. Zaman, Maryam Zamanian, Ramin Zand, Alireza Zandifar, Afshin Zarghi, Mikhail S. Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Yunquan Zhang, Wangjian Zhang, Chenwen Zhong, Zhiyong Zou, Yves Miel H. Zuniga, and Christopher J.L. Murray
Subjects: BMI, body mass index, GBD, Global Burden of Diseases, Injuries, and Risk Factors Study, IS, ischemic stroke, 030204 cardiovascular system & hematology, MV, mitral valve, SDI, sociodemographic index, Global Health, UI, uncertainty interval, Global Burden of Disease, GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group, 0302 clinical medicine, Cost of Illness, LDL, low-density lipoprotein, Case fatality rate, Global health, 030212 general & internal medicine, IKF, impaired kidney function, 1102 Cardiorespiratory Medicine and Haematology, Incidence (epidemiology), Health Policy, IHD, ischemic heart disease, 1. No poverty, AC, alcoholic cardiomyopathy, 3. Good health, HICs, high-income countries, Cardiovascular Diseases, DALYs, disability-adjusted life years, TMREL, theoretical minimum risk exposure level, Public Health, HHD, hypertensive heart disease, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, AF, atrial fibrillation, Population health, CVD, cardiovascular disease, LMICs, low- and middle-income countries, PM, particulate matter, 1117 Public Health and Health Services, 03 medical and health sciences, JACC State-of-the-Art Review, RHD, rheumatic heart disease, Environmental health, medicine, Humans, LPA, low physical activity, YLLs, years of life lost, Health policy, Disease burden, PAD, peripheral artery disease, business.industry, SBP, systolic blood pressure, Public health, CKD, chronic kidney disease, The Present and Future, AFL, atrial flutter, Correction, HAP, household air pollution, ICD, International Classification of Diseases, CAVD, calcific aortic valve disease, YLDs, years lived with disability, Years of potential life lost, CHA, congenital heart anomalies, Cardiovascular System & Hematology, Heart Disease Risk Factors, business, population health
Abstract: Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases., Central Illustration, Highlights • The burden of CVD, in number of DALYs and deaths, continues to increase globally. • CVD burden attributable to modifiable risk factors continues to increase globally. • Countries should invest in existing cost-effective public health programs and clinical interventions to target modifiable risks, promote healthy aging across the lifespan, and reduce disability and premature death due to CVD.
Published: 2020

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

Author: Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. 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Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. 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Djalalinia, S, Do, H, Dokova, K, Dorostkar, F, Doshmangir, L, Driscoll, T, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Nahas, N, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, I, El-Jaafary, S, Elyazar, I, Emmons-Bell, S, Erskine, H, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Estep, K, Etemadi, A, Etisso, A, Fanzo, J, Farahmand, M, Fareed, M, Faridnia, R, Farioli, A, Faro, A, Faruque, M, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Feigin, V, Feldman, R, Fereshtehnejad, S, Fernandes, E, Ferrara, G, Ferrari, A, Ferreira, M, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Force, L, Foroutan, M, Franklin, R, Freitas, M, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gakidou, E, Gallus, S, Garcia-Basteiro, A, Gardner, W, Geberemariyam, B, Ayalew Gebreslassie, A, Geremew, A, Gershberg Hayoon, A, Gething, P, Ghadimi, M, Ghadiri, K, Ghaffarifar, F, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Ghiasvand, H, Ghith, N, Gholamian, A, Ghosh, R, Gill, P, Ginindza, T, Giussani, G, Gnedovskaya, E, Goharinezhad, S, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Greaves, F, Grivna, M, Grosso, G, Gubari, M, Gugnani, H, Guimaraes, R, Guled, R, Guo, G, Guo, Y, Gupta, R, Gupta, T, Haddock, B, Hafezi-Nejad, N, Hafiz, A, Haj-Mirzaian, A, Hall, B, Halvaei, I, Hamadeh, R, Hamidi, S, Hammer, M, Hankey, G, Haririan, H, Haro, J, Hasaballah, A, Hasan, M, Hasanpoor, E, Hashi, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Henrikson, H, Herbert, M, Herteliu, C, Heydarpour, F, Hird, T, Hoek, H, Holla, R, Hoogar, P, Hosgood, H, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Hsieh, V, Hu, G, Hu, K, Huda, T, Humayun, A, Huynh, C, Hwang, B, Iannucci, V, Ibitoye, S, Ikeda, N, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Ippolito, H, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Iso, H, Ivers, R, Iwu, C, Iyamu, I, Jaafari, J, Jacobsen, K, Jafari, H, Jafarinia, M, Jahani, M, Jakovljevic, M, Jalilian, F, James, S, Janjani, H, Javaheri, T, Javidnia, J, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Johansson, L, John, O, John-Akinola, Y, Johnson, C, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalani, H, Kalani, R, Kalankesh, L, Kalhor, R, Kanchan, T, Kapoor, N, Matin, B, Karch, A, Karim, M, Kassa, G, Katikireddi, S, Kayode, G, Kazemi Karyani, A, Keiyoro, P, Keller, C, Kemmer, L, Kendrick, P, Khalid, N, Khammarnia, M, Khan, E, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khazaei, S, Kieling, C, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kivimaki, M, Knibbs, L, Knudsen, A, Kocarnik, J, Kochhar, S, Kopec, J, Korshunov, V, Koul, P, Koyanagi, A, Kraemer, M, Krishan, K, Krohn, K, Kromhout, H, Kuate Defo, B, Kumar, G, Kumar, V, Kurmi, O, Kusuma, D, La Vecchia, C, Lal, D, Lalloo, R, Lallukka, T, Lami, F, Landires, I, Lang, J, Langan, S, Larsson, A, Lasrado, S, Lauriola, P, Lazarus, J, Lee, P, Lee, S, Legrand, K, Leigh, J, Leonardi, M, Lescinsky, H, Leung, J, Levi, M, Li, S, Lim, L, Linn, S, Liu, S, Liu, Y, Lo, J, Lopez, A, Lopez, J, Lopukhov, P, Lorkowski, S, Lotufo, P, Lu, A, Lugo, A, Maddison, E, Mahasha, P, Mahdavi, M, Mahmoudi, M, Majeed, A, Maleki, A, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Manda, A, Manguerra, H, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Mantilla Herrera, A, Maravilla, J, Marks, A, Martin, R, Martini, S, Martins-Melo, F, Masaka, A, Masoumi, S, Mathur, M, Matsushita, K, Maulik, P, Mcalinden, C, Mcgrath, J, Mckee, M, Mehndiratta, M, Mehri, F, Mehta, K, Memish, Z, Mendoza, W, Menezes, R, Mengesha, E, Mereke, A, Mereta, S, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mills, E, Mini, G, Miri, M, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei, R, Mirzaei-Alavijeh, M, Misganaw, A, Mithra, P, Moazen, B, Mohammad, D, Mohammad, Y, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, A, Mohammed, H, Mohammed, J, Mohammed, S, Mokdad, A, Molokhia, M, Monasta, L, Mooney, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morawska, L, Morgado-Da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mouodi, S, Mousavi, S, Khaneghah, A, Mueller, U, Mukhopadhyay, S, Mullany, E, Musa, K, Muthupandian, S, Nabhan, A, Naderi, M, Nagarajan, A, Nagel, G, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Najafi, F, Nangia, V, Nansseu, J, Naserbakht, M, Nayak, V, Negoi, I, Ngunjiri, J, Nguyen, C, Nguyen, H, Nguyen, M, Nigatu, Y, Nikbakhsh, R, Nixon, M, Nnaji, C, Nomura, S, Norrving, B, Noubiap, J, Nowak, C, Nunez-Samudio, V, Oancea, B, Odell, C, Ogbo, F, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Omer, M, Ong, K, Onwujekwe, O, Orpana, H, Ortiz, A, Osarenotor, O, Osei, F, Ostroff, S, Otoiu, A, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, Mahesh, P, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Parry, C, Pasovic, M, Pasupula, D, Patel, S, Pathak, M, Patten, S, Patton, G, Toroudi, H, Peden, A, Pennini, A, Pepito, V, Peprah, E, Pereira, D, Pesudovs, K, Pham, H, Phillips, M, Piccinelli, C, Pilz, T, Piradov, M, Pirsaheb, M, Plass, D, Polinder, S, Polkinghorne, K, Pond, C, Postma, M, Pourjafar, H, Pourmalek, F, Poznanska, A, Prada, S, Prakash, V, Pribadi, D, Pupillo, E, Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahman, M, Rajabpour-Sanati, A, Rajati, F, Rakovac, I, Ram, P, Ramezanzadeh, K, Ranabhat, C, Rao, P, Rao, S, Rashedi, V, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Rawassizadeh, R, Rawat, R, Razo, C, Redford, S, Reiner, R, Reitsma, M, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezapour, A, Rhinehart, P, Riahi, S, Ribeiro, D, Rickard, J, Rivera, J, Roberts, N, Rodriguez-Ramirez, S, Roever, L, Ronfani, L, Room, R, Roshandel, G, Roth, G, Rothenbacher, D, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Sadeghi, M, Saeedi, R, Saeedi Moghaddam, S, Safari, Y, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sajadi, S, Salam, N, Salamati, P, Salem, H, Salem, M, Salimzadeh, H, Salman, O, Salomon, J, Samad, Z, Samadi Kafil, H, Sambala, E, Samy, A, Sanabria, J, Sanchez-Pimienta, T, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Schaeffer, L, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Serdar, B, Serre, M, Shadid, J, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Sharafi, K, Sheikh, A, Sheikhtaheri, A, Shibuya, K, Shield, K, Shigematsu, M, Shin, J, Shin, M, Shiri, R, Shirkoohi, R, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, J, Singh, P, Skiadaresi, E, Skou, S, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spencer, C, Spotin, A, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stein, C, Stein, D, Steiner, C, Stockfelt, L, Stokes, M, Straif, K, Stubbs, J, Sufiyan, M, Suleria, H, Suliankatchi Abdulkader, R, Sulo, G, Sultan, I, Tabares-Seisdedos, R, Tabb, K, Tabuchi, T, Taherkhani, A, Tajdini, M, Takahashi, K, Takala, J, Tamiru, A, Taveira, N, Tehrani-Banihashemi, A, Temsah, M, Tesema, G, Tessema, Z, Thurston, G, Titova, M, Tohidinik, H, Tonelli, M, Topor-Madry, R, Topouzis, F, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valdez, P, van Donkelaar, A, Vasankari, T, Vasseghian, Y, Veisani, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vos, T, Vukovic, R, Waheed, Y, Wallin, M, Wang, Y, Watson, A, Wei, J, Wei, M, Weintraub, R, Weiss, J, Werdecker, A, West, J, Westerman, R, Whisnant, J, Whiteford, H, Wiens, K, Wolfe, C, Wozniak, S, Wu, A, Wu, J, Wulf Hanson, S, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, T, Yilgwan, C, Yilma, M, Yip, P, Yonemoto, N, Younis, M, Younker, T, Yousefi, B, Yousefi, Z, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Moghadam, T, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, J, Zhao, X, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Lim, S, Murray, C, GBD 2019 Risk Factors Collaborator, Violante FS, Biosciences, Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Sub Foundations&PhilosophyofNaturSc begr, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Public Health, Bin Sayeed, M. S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.
Subjects: Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract: Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
Published: 2020

57. Ann Epidemiol

Author: Magali Collonnaz, Vincent Le Moing, Nelly Agrinier, François Delahaye, B. Hoen, Marie-Line Erpelding, François Alla, Christine Selton-Suty, François Goehringer, Bernard Iung, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Referral, Epidemiology, media_common.quotation_subject, Population, 01 natural sciences, Cohort Studies, 03 medical and health sciences, Population based cohort, 0302 clinical medicine, Bias, Internal medicine, medicine, Humans, 030212 general & internal medicine, 0101 mathematics, education, Referral and Consultation, media_common, Selection bias, education.field_of_study, Endocarditis, business.industry, 010102 general mathematics, Hazard ratio, medicine.disease, Prognosis, 3. Good health, Infective endocarditis, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, business
Abstract: PURPOSE: Prognostic studies derived from samples of patients managed in tertiary hospitals are subject to referral bias. We aimed to characterise this bias using the example of infective endocarditis (IE). METHODS: We analysed data from a French population-based cohort which included 497 patients with IE in 2008. Patients were admitted directly to a tertiary hospital (group T), or admitted to a non-tertiary hospital and referred to a tertiary hospital (group NTT) or not (group NT). We compared patients' characteristics and survival rates and prognostic factors between groups. RESULTS: Compared to group T (N=291), NTT patients (N=144) were more often males (81.3% vs 72.5%, p=0.046), injection drug users (9.7% vs 4.5%, p=0.033), had more frequent surgical indications (78.5% vs 64.3%, p=0.003). Compared to group NT (N=62), NTT patients were more often males (81.3% vs 67.7%, p=0.034) and had surgical indications more often (78.5% vs 19.4%, p
Published: 2020

58. Current challenges in ageing population health intervention research

Author: Linda Cambon, Karine Pérès, and François Alla
Subjects: Gerontology, Population ageing, Current (fluid), Psychology, Health intervention
Published: 2020

59. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020

60. Eur J Public Health

Author: François Alla, Linda Cambon, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Physician-Patient Relations, 03 medical and health sciences, Policy, 0302 clinical medicine, 030220 oncology & carcinogenesis, Public Health, Environmental and Occupational Health, Humans, MRISP, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Business, 030217 neurology & neurosurgery, 3. Good health
Abstract: For the second year, the number of smokers in France is falling. The results are obvious: 1.6 million fewer smokers between 2016 and 2018, the prevalence of daily smoking among adults fell from 29.4% to 25.4% over this period.1This dramatic change is the result of an ambitious and structured national policy: the National Tobacco Reduction Programme, launched in 2014, followed and strengthened by a National Tobacco Control Programme, launched in 2018 and strongly supported by the Minister of Health. This programme includes 28 actions covering all levels of health promotion, including measures that are known to be very effective, such as increasing the price of tobacco products...
Published: 2020

61. Quelle place pour les registres de morbidité à l'ère des données massives de santé ?

Author: Florence Francis, C. Persoz, J.-M. Gagliolo, C. Terroba, François Alla, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: National health, medicine.medical_specialty, Epidemiology, business.industry, Technological change, media_common.quotation_subject, Public health, Public Health, Environmental and Occupational Health, Context (language use), MRISP, 030501 epidemiology, Data science, Data warehouse, 3. Good health, 03 medical and health sciences, Political science, medicine, Quality (business), [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, Human resources, business, media_common
Abstract: The recent opening of massive health databases, as well as the development of methods and tools adapted to their data processing, questions the French model of “morbidity registry”. In France in 2019, nearly 61 health registries were operating. As defined by law, these registries identify exhaustively all patients with a given disease in a given territory. Established several decades ago, these registries are part of the French surveillance system that is used for research and evaluation purposes. Since the advent of recent technological progress, large-scale databases are made available to researchers and it is possible with these databases to answer questions initially assigned to the registries. What is the place of such registries in this new context: are they obsolete or still useful? Should they be opposed to the new tools or are they complementary to them, and if so, what is their place in the new French public health ecosystem? The objective of this work was to assess the roles and missions of existing registries and to reflect on their positioning in this new environment. The French model of registry is sometimes questioned because of the complexity of its circuits, requiring a significant amount of human resources. However, the data that constitute them, validated by cross-checking information from several sources, are of very high quality, and make it possible to validate the data in the new databases (National Health Data System (NSDS) or Hospital Data Warehouses). Registries and new databases are in fact complementary, and far from jeopardizing this model, the recent opening of these databases represents an opportunity for registries to modernize their operations and respond to new missions.; La mise à disposition récente de bases de données massives en santé, ainsi que le développement de méthodes et d’outils adaptés à leurs traitements, vient remettre en question le modèle français des registres de morbidité. Mis en place il y a plusieurs dizaines d’années, ils font partie intégrante du système de surveillance et répondent à des missions de recherche et d’évaluation. Sous l’influence d’avancées technologiques récentes, des bases de données massives sont rendues accessibles aux chercheurs et permettent ou permettraient de répondre à des questions initialement dévolues aux registres. Quelle est la place des registres dans ce nouveau contexte : sont-ils obsolètes ou toujours utiles, doit-on les opposer aux nouveaux outils ou en sont-ils complémentaires, et le cas échéant, quelle est désormais leur place dans le nouvel écosystème de la santé publique française ? L’objectif de ce travail a été de réaliser un bilan des rôles et missions des registres existants et de réfléchir à leur positionnement dans ce nouvel environnement. Le modèle français des registres est parfois remis en question pour la lourdeur de ses circuits, nécessitant de nombreux moyens humains. Cependant, les données qui les constituent, validées par un recoupement d’informations à partir de plusieurs sources, sont d’une très grande qualité et permettent de valider les données des nouvelles bases (Système national des données de santé (SNDS) ou entrepôts de données hospitaliers). Registres et nouvelles bases de données sont en fait complémentaires, et loin de mettre en péril ce modèle, l’ouverture récente de ces bases constitue pour les registres, une opportunité de moderniser leur fonctionnement et de répondre à de nouvelles missions.
Published: 2020

62. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: William M. Gardner, Rawlance Ndejjo, Govinda Prasad Dhungana, Fereshteh Ansari, Kathleen Pillsbury Hopf, João Pedro Silva, M. Mofizul Islam, Cong Zhu, Abdul Hafiz, Irmina Maria Michalek, Syed Mohamed Aljunid, Leonardo Roever, Mustefa Glagn, Davood Anvari, Tessa M. Pilz, Sameer Vali Gopalani, Joel M. Francis, Man Mohan Mehndiratta, Rakhi Dandona, Abbas Sheikhtaheri, Mansour Ghafourifard, Simon Øverland, David Laith Rawaf, Jaykaran Charan, Akram Pourshams, Mostafa Dianatinasab, Morteza Mahmoudi, Alton Lu, Alyssa N. Sbarra, Lorainne Tudor Car, Franz Castro, Hafiz Ansar Rasul Suleria, Luca Ronfani, Marina Pinheiro, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Hoa Thi Do, Whitney L. Teagle, Sofia Androudi, Carl Abelardo T. Antonio, Myron Anthony Godinho, Bhaskaran Unnikrishnan, Oluchi Ezekannagha, Getinet Ayano, Seyyed Shamsadin Athari, Dimas Ria Angga Pribadi, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Chukwuma David Umeokonkwo, Akshaya Srikanth Bhagavathula, Cuong Tat Nguyen, Amr Hassan, Akine Eshete Abosetugn, Hailay Abrha Gesesew, Anna V. Korotkova, Brijesh Sathian, Marcello Tonelli, Olatunde Aremu, Mohammad Reza Salahshoor, Juan Jesus Carrero, Cameron J. Kneib, Ravi Prakash Jha, David H. Shaw, Hossein Samadi Kafil, Tanuj Kanchan, Khezar Hayat, Hamid Sharifi, Morteza Shamsizadeh, Muktar Omer Omer, Fatemeh Amiri, Hamidreza Pazoki Toroudi, David Edvardsson, Xiu Ju George Zhao, Hannah Han, Leticia Avila-Burgos, Adam E. Berman, Jemal Abdu Mohammed, Thomas Pilgrim, Leila Doshmangir, Mu'awiyyah Babale Sufiyan, David M. Pigott, Hadi Hassankhani, Beatriz Paulina Ayala Quintanilla, Teklemariam Gultie, Arash Ziapour, Seyed Sina Naghibi Irvani, Ilse N. Dippenaar, Jean Jacques Noubiap, Emmanuela Gakidou, Abiyu Mekonnen Gebrehiwot, Maha El Tantawi, Xuefeng Liu, Zulfiqar A. Bhutta, Keyghobad Ghadiri, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Yunquan Zhang, Vera Marisa Costa, Iyad Sultan, Mostafa Hosseini, Abdulaziz Khalid Abu Haimed, Haidong Wang, Kaleab Alemayehu Zewdie, Celine M. Barthelemy, Hosna Janjani, Bartosz Miazgowski, Jobert Richie Nansseu, Arianna Maever L. Amit, John S. Ji, Ata Rafiee, Maria Inês Schmidt, Alireza Rafiei, Somayeh Bohlouli, Joana Morgado-da-Costa, Huong Lan Thi Nguyen, Pradyumna Agasthi, Tiffany K. Gill, Martin McKee, Khaled Khatab, Jae Il Shin, Animut Tagele Tamiru, Giancarlo Logroscino, Hassan Abolhassani, Syed Saoud Zaidi, Sivan Yegnanarayana Iyer Saraswathy, Garumma Tolu Feyissa, Ahmad Daryani, Ziyad Al-Aly, Gebreamlak Gebremedhn Gebremeskel, Michael T. Chung, Amirhossein Sahebkar, Mehedi Hasan, Saeed Shahabi, Diep Ngoc Nguyen, Yohannes Kinfu, Nicholas L S Roberts, Jagadish Rao Padubidri, Mika Shigematsu, Lucero Cahuana-Hurtado, Deepa Jahagirdar, Islam Y. Elgendy, Erkin M. Mirrakhimov, Tanvir M. Huda, Fakher Rahim, Dara K. Mohammad, Yingxi Zhao, Ruxandra Irina Negoi, Vinod C. Nayak, Reinhard Busse, Andrew T. Leever, Muhammad Aziz Rahman, Kathryn Mei Ming Lau, Stefania Mondello, Vivian Chia-Rong Hsieh, Kris J. Krohn, Reza Rawassizadeh, Vishnu Renjith, Jianing Ma, Moses K. Muriithi, Mark G. Shrime, Mayowa O. Owolabi, Nobuyuki Horita, Seyed Hossein Yahyazadeh Jabbari, Daniel Y. Cho, Miloje Savic, Moslem Soofi, Iqbal R. F. Elyazar, Freweini Gebrearegay G. Tela, Jonathan F. Mosser, Palash Chandra Banik, Andre Rodrigues Duraes, Yuan-Pang Wang, Natalie C. Galles, Rashid Abdi Guled, Abdallah M. Samy, Hadi Pourjafar, Roman Topor-Madry, Ayesha Humayun, Leila Zaki, Nuworza Kugbey, Maryam Khayamzadeh, Naznin Hossain, Jiregna Darega Gela, Jordi Alonso, Ruth W Kimokoti, A. A. Fomenkov, Jalal Arabloo, Aletta E. Schutte, Biruk Wogayehu Taddele, Teklehaimanot Gereziher Haile, Diego Augusto Santos Silva, Seyed Mohammad Kazem Aghamir, Maciej Banach, Deanna Anderlini, Moses J. Bockarie, Saleem Muhammad Rana, Randah R. Hamadeh, Farhad Islami, Olalekan A. Uthman, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Kairat Davletov, Soraya Seedat, Alan D. Lopez, Masoud Behzadifar, Benjamin B. Massenburg, Santosh Varughese, Ingan Ukur Tarigan, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Caleb Mackay Salpeter Irvine, Mojgan Gitimoghaddam, G Anil Kumar, Rasmus J. Havmoeller, Hiroyasu Iso, Atte Meretoja, Yasir Waheed, João M. Furtado, Christian Razo, Neeti Kapoor, Mowafa Househ, Rajaa Al-Raddadi, Mohammad Khammarnia, Santi Martini, Feng Sha, Marco Vacante, Jacek A. Kopec, Hunduma Amensisa Bojia, Jacob Olusegun Olusanya, Kate E. LeGrand, Nikolay Ivanovich Briko, Robert S. Bernstein, Arun Balachandran, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Leake G. Gebremeskel, Smita Pakhale, Ejaz Ahmad Khan, Daniel Cury Ribeiro, Yousef Mohammad, Bernhard T. 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M, Tarigan, I, Teagle, W, Tediosi, F, Tefera, Y, Tela, F, Tessema, Z, Thakur, B, Titova, M, Tonelli, M, Topor-Madry, R, Topouzis, F, Tovani-Palone, M, Tran, B, Travillian, R, Troeger, C, Tudor Car, L, Uddin, R, Ullah, I, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Uthman, O, Vacante, M, Valdez, P, Varughese, S, Vasankari, T, Vasseghian, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vongpradith, A, Vos, T, Waheed, Y, Walters, M, Wamai, R, Wang, H, Wang, Y, Weintraub, R, Weiss, J, Werdecker, A, Westerman, R, Wilner, L, Woldu, G, Wolfe, C, Wu, A, Wulf Hanson, S, Xie, Y, Xu, R, Yahyazadeh Jabbari, S, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yearwood, J, Yeshitila, Y, Yip, P, Yonemoto, N, Younis, M, Yousefi, Z, Yousefinezhadi, T, Yusefzadeh, H, Zadey, S, Zahirian Moghadam, T, Zaidi, S, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zewdie, K, Zhang, Y, Zhao, X, Zhao, Y, Zheng, P, Zhu, C, Ziapour, A, Zlavog, B, Zodpey, S, Murray, C, Tampere University, Health Sciences, 10922180 - Schutte, Aletta Elisabeth, Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Abu Haimed, A. K., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., Adelson, J., Adetokunboh, O. O., Adham, D., Advani, S. M., Afshin, A., Agarwal, G., Agasthi, P., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Akinyemi, R. O., Alahdab, F., Al-Aly, Z., Alam, K., Albertson, S. B., Alemu, Y. M., Alhassan, R. K., Ali, M., Ali, S., Alipour, V., Aljunid, S. M., Alla, F., Almadi, M. A. H., Almasi, A., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Almulhim, A. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Amini, S., Amini-Rarani, M., Amiri, F., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Androudi, S., Ansari, F., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, C. 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P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dippenaar, I. N., Do, H. T., Dorostkar, F., Doshmangir, L., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Sayed, I., El Tantawi, M., Elgendy, I. Y., Elyazar, I. R., Eskandari, K., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Ezekannagha, O., Farag, T., Farahmand, M., Faraon, E. J. A., Farinha, C. S. E. S., Farioli, A., Faris, P. S., Faro, A., Fazlzadeh, M., Feigin, V. L., Fernandes, E., Ferrara, P., Feyissa, G. T., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Francis, J. M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gaidhane, A. M., Gakidou, E., Galles, N. C., Gallus, S., Gardner, W. M., Geberemariyam, B. S., Gebrehiwot, A. M., Gebremeskel, L. G., Gebremeskel, G. G., Gesesew, H. A., Ghadiri, K., Ghafourifard, M., Ghashghaee, A., Ghith, N., Gholamian, A., Gilani, S. A., Gill, P. S., Gill, T. K., Ginindza, T. G., Gitimoghaddam, M., Giussani, G., Glagn, M., Gnedovskaya, E. V., Godinho, M. A., Goharinezhad, S., Gopalani, S. V., Goudarzian, A. H., Goulart, B. N. G., Gubari, M. I. M., Guimaraes, R. A., Guled, R. A., Gultie, T., Guo, Y., Gupta, R., Hafezi-Nejad, N., Hafiz, A., Haile, T. G., Hamadeh, R. R., Hameed, S., Hamidi, S., Han, C., Han, H., Handiso, D. W., Hanif, A., Hankey, G. J., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hashi, A., Hassan, S., Hassan, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Hendrie, D., Herteliu, C., Hird, T. R., Ho, H. C., Hole, M. K., Holla, R., Hoogar, P., Hopf, K. P., Horita, N., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsieh, V. C. -R., Hu, G., Huda, T. M., Humayun, A., Hwang, B. -F., Iavicoli, I., Ibitoye, S. E., Ikeda, N., Ilesanmi, O. S., Ilic, M. D., Inbaraj, L. R., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. 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J., Kugbey, N., Kulkarni, V., Kumar, G. A., Kumar, N., Kumar, M., Kurmi, O. P., Kusuma, D., Kyu, H. H., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Landires, I., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lau, K. M. -M., Lauriola, P., Lazarus, J. V., Ledesma, J. R., Lee, P. H., Lee, S. W. H., Leever, A. T., Legrand, K. E., Leigh, J., Leonardi, M., Li, S., Lim, S. S., Lim, L. -L., Liu, X., Logroscino, G., Lopez, A. D., Lopukhov, P. D., Lotufo, P. A., Lu, A., Ma, J., Madadin, M., Mahasha, P. W., Mahmoudi, M., Majeed, A., Malagon-Rojas, J. N., Maleki, S., Malta, D. C., Mansouri, B., Mansournia, M. A., Martini, S., Martins-Melo, F. R., Martopullo, I., Massenburg, B. B., Mastrogiacomo, C. I., Mathur, M. R., Mcalinden, C., Mckee, M., Medina-Solis, C. E., Meharie, B. G., Mehndiratta, M. M., Mehrabi Nasab, E., Mehri, F., Mehrotra, R., Mekonnen, T., Melese, A., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mensah, G. A., Meretoja, T. J., Meretoja, A., Mestrovic, T., Miazgowski, B., Michalek, I. M., Mirrakhimov, E. M., Mirzaei, M., Mirzaei-Alavijeh, M., Mitchell, P. B., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, Y., Mohammad, D. K., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammed, S., Mohammed, J. A., Mokdad, A. H., Monasta, L., Mondello, S., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mousavi Khaneghah, A., Muriithi, M. K., Mustafa, G., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Nansseu, J. R., Nayak, V. C., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Neupane, S., Ngari, K. N., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T., Nguyen, D. N., Nguyen, H. L. T., Nnaji, C. A., Nomura, S., Norheim, O. F., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Ogbo, F. A., Oghenetega, O. B., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Oluwasanu, M. M., Omar Bali, A., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Ortega-Altamirano, D. V. V., Ortiz, A., Ostojic, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., Padubidri, J. R., Pakhale, S., Palladino, R., Pana, A., Panda-Jonas, S., Pangaribuan, H. U., Pathak, M., Patton, G. C., Paudel, S., Pazoki Toroudi, H., Pease, S. A., Peden, A. E., Pennini, A., Peprah, E. K., Pereira, J., Pigott, D. M., Pilgrim, T., Pilz, T. M., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Pourmalek, F., Pourmirza Kalhori, R., Pourshams, A., Prada, S. I., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahim, F., Rahman, M. A., Rajabpour-Sanati, A., Rana, S. M., Ranabhat, C. L., Rao, S. J., Rasella, D., Rashedi, V., Rath, G. K., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Razo, C., Renjith, V., Renzaho, A. M. N., Reshmi, B., Rezaei, N., Riahi, S. M., Ribeiro, D. C., Rickard, J., Roberts, N. L. S., Roever, L., Romoli, M., Ronfani, L., Roshandel, G., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, M., Sadeghi, E., Safari, Y., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salahshoor, M. R., Salem, M. R. R., Salem, H., Salomon, J., Samadi Kafil, H., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Savic, M., Sawyer, S. M., Saxena, D., Sbarra, A. N., Schaeffer, L. E., Schiavolin, S., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Seedat, S., Sha, F., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shamsizadeh, M., Shannawaz, M., Sharafi, K., Sharara, F., Sharifi, H., Shaw, D. H., Sheikh, A., Sheikhtaheri, A., Shetty, B. S. K., Shibuya, K., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shirkoohi, R., Shivakumar, K. M., Shrime, M. G., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, D. A. S., Silva, J. P., Simonetti, B., Simpson, K. E., Singh, J. A., Singh, P., Sinha, D. N., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soyiri, I. N., Spurlock, E. E., Sreeramareddy, C. T., Stanaway, J. D., Steel, N., Stein, C., Stokes, M. A., Sufiyan, M. B., Suleria, H. A. R., Sultan, I., Szumowski, L., Tabares-Seisdedos, R., Tabuchi, T., Tadakamadla, S. K., Taddele, B. W., Tadesse, D. B., Taherkhani, A., Tamiru, A. T., Tanser, F. C., Tareque, M. I., Tarigan, I. U., Teagle, W. L., Tediosi, F., Tefera, Y. G. G., Tela, F. G., Tessema, Z. T., Thakur, B., Titova, M. V., Tonelli, M., Topor-Madry, R., Topouzis, F., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Troeger, C. 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Subjects: Index (economics), Servicios de Salud, SUSTAINABLE DEVELOPMENT GOALS, 030204 cardiovascular system & hematology, universal health coverage, sustaibale develpment goal, global burden of disease, performance, systematic analysis, Global Burden of Disease, 0302 clinical medicine, Universal Health Insurance, RA0421, 11. Sustainability, Per capita, Medical economics, Disease, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, effective coverage of health services, GBD 2019 Universal Health Coverage Collaborators, education.field_of_study, Public health, Medical care, Sjúkdómar, 4. Education, 1. No poverty, Health coverage, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Hälsovetenskaper, 3142 Public health care science, environmental and occupational health, Health services, 3. Good health, Global burden of disease, Health Expenditures, Humans, World Health Organization, Purchasing power parity, Scale (social sciences), Lýðheilsa, universal health coverag, CANCER SURVIVAL, ACCESS, Human, Heilsuhagfræði, medicine.medical_specialty, Health coverage, GBD, GBD, Universal health, GBD 2019, Population, Health expenditures, 3122 Cancers, Population health, 03 medical and health sciences, Health systems, Heilbrigðisvísindi, SDG 3 - Good Health and Well-being, General & Internal Medicine, Development economics, Health Sciences, medicine, Heilbrigðisstefna, Alþjóðaheilbrigðisstofnunin, QUALITY, Global Burden of Disease Study, education, PROGRESS, Disease burden, Health services accessibility, CARE, Heilbrigðisþjónusta, purl.org/pe-repo/ocde/ford#3.02.00 [https], Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, Morbility, Administración de los Servicios de Salud, Medical policy, Business, Heilbrigðiskerfi
Abstract: Publisher's version (útgefin grein), Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC., Lucas Guimaraes Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (Capes) -Finance Code 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG). Olatunji O Adetokunboh acknowledges South African Department of Science & Innovation, and National Research Foundation. Anurag Agrawal acknowledges support from the Wellcome Trust DBT India Alliance Senior Fellowship IA/CPHS/14/1/501489. Rufus Olusola Akinyemi acknowledges Grant U01HG010273 from the National Institutes of Health (NIH) as part of the H3Africa Consortium. Rufus Olusola Akinyemi is further supported by the FLAIR fellowship funded by the UK Royal Society and the African Academy of Sciences. Syed Mohamed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Marcel Ausloos, Claudiu Herteliu, and Adrian Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDSUEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Till Winfried Barnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Juan J Carrero was supported by the Swedish Research Council (2019-01059). Felix Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. Vera Marisa Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundacao para a Ciencia e a Tecnologia (FCT), IP, under the Norma TransitA3ria DL57/2016/CP1334/CT0006. Jan-Walter De Neve acknowledges support from the Alexander von Humboldt Foundation. Kebede Deribe acknowledges support by Wellcome Trust grant number 201900/Z/16/Z as part of his International Intermediate Fellowship. Claudiu Herteliu acknowledges partial support by a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness, Project ID P_40_382. Praveen Hoogar acknowledges the Centre for Bio Cultural Studies (CBiCS), Manipal Academy of Higher Education(MAHE), Manipal and Centre for Holistic Development and Research (CHDR), Kalghatgi. Bing-Fang Hwang acknowledges support from China Medical University (CMU108-MF-95), Taichung, Taiwan. Mihajlo Jakovljevic acknowledges the Serbian part of this GBD contribution was co-funded through the Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Aruna M Kamath acknowledges funding from the National Institutes of Health T32 grant (T32GM086270). Srinivasa Vittal Katikireddi acknowledges funding from the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15), Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15) and an NRS Senior Clinical Fellowship (SCAF/15/02). Yun Jin Kim acknowledges support from the Research Management Centre, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). Kewal Krishan acknowledges support from the DST PURSE grant and UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Manasi Kumar acknowledges support from K43 TW010716 Fogarty International Center/NIMH. Ben Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. Ivan Landires is a member of the Sistema Nacional de InvestigaciA3n (SNI), which is supported by the Secretaria Nacional de Ciencia Tecnologia e Innovacion (SENACYT), Panama. Jeffrey V Lazarus acknowledges support by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]). Peter T N Memiah acknowledges CODESRIA; HISTP. Subas Neupane acknowledges partial support from the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. Shuhei Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). Alberto Ortiz acknowledges support by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. George C Patton acknowledges support from a National Health & Medical Research Council Fellowship. Marina Pinheiro acknowledges support from FCT for funding through program DL 57/2016 -Norma transitA3ria. Alberto Raggi, David Sattin, and Silvia Schiavolin acknowledge support by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4 -Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). Daniel Cury Ribeiro acknowledges support from the Sir Charles Hercus Health Research Fellowship -Health Research Council of New Zealand (18/111). Perminder S Sachdev acknowledges funding from the NHMRC Australia. Abdallah M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. Milena M Santric-Milicevic acknowledges support from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Contract No. 175087). Rodrigo Sarmiento-Suarez acknowledges institutional support from University of Applied and Environmental Sciences in Bogota, Colombia, and Carlos III Institute of Health in Madrid, Spain. Maria Ines Schmidt acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. Sheikh Mohammed Shariful Islam acknowledges a fellowship from the National Heart Foundation of Australia and Deakin University. Aziz Sheikh acknowledges support from Health Data Research UK. Kenji Shibuya acknowledges Japan Ministry of Education, Culture, Sports, Science and Technology. Joan B Soriano acknowledges support by Centro de Investigacion en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Rafael Tabares-Seisdedos acknowledges partial support from grant PI17/00719 from ISCIII-FEDER. Santosh Kumar Tadakamadla acknowledges support from the National Health and Medical Research Council Early Career Fellowship, Australia. Marcello Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary, AB, Canada., "Peer Reviewed"
Published: 2020

63. BMJ Open

Author: Cédric Baumann, Anne Pasquereau, Pierre Arwidson, Linda Cambon, Pierre Bergman, François Alla, Anne-Laurence Le Faou, Aurélie Affret, Amandine Luc, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, medicine.medical_specialty, media_common.quotation_subject, medicine.medical_treatment, Prevalence, 050109 social psychology, preventive medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), medicine, Tobacco Smoking, Humans, 0501 psychology and cognitive sciences, 030212 general & internal medicine, media_common, Preventive healthcare, Text Messaging, clinical trials, business.industry, Public health, 05 social sciences, Smoking, MRISP, General Medicine, Abstinence, 16. Peace & justice, 3. Good health, Clinical trial, Physical therapy, Medicine, Smoking cessation, Smoking Cessation, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Public Health, business
Abstract: ObjectiveTo compare the effectiveness of the mobile e-Tabac Info Service (e-TIS) application (app) for helping adult smokers quit smoking with current practices.DesignPragmatic randomised controlled trial with a 1-year follow-up (2017–2018).SettingFrance, population-wide level.Participants2806 adult smokers who wished to quit smoking were recruited via the website of the French National Mandatory Health Insurance fund. Of them, 1400 were randomised to the e-TIS app arm and 1406 were randomised to the current practices arm (control).InterventionThe app involved personalised interactive contacts that included questionnaires, advice, activities and text messages. All contacts were individually tailored and based on each smoker’s progress.In the control group, recommended practices for quitting smoking were described on a non-interactive website.Primary and secondary outcomes measuresThe primary outcome was 7-day point prevalence abstinence (PPA) at 6 months. The secondary outcomes included continuous abstinence rates at 6 and 12 months, minimum 24-hour point abstinence at 3 months, minimum 30-day point abstinence at 12 months and number and duration of quit attempts.ResultsThere was no difference between the e-TIS and control arms for the primary outcome (12.6% vs 13.7% for 7-day PPA at 6 months, p=0.3949, intention-to-treat analysis). However, e-TIS participants with high levels of exposure to the app, which was defined by the completion of at least eight activities or questionnaires, showed higher rates of smoking cessation than the control participants (17.6% vs 12.9% for 7-day PPA at 6 months, p=0.0169, per-protocol analysis).ConclusionUse of the e-TIS app was not associated with a higher rate of smoking cessation. However, high level of exposure to the e-TIS app may have been more effective than current practices.Trial registration numberNCT02841683.
Published: 2020

64. COVID-19 Vaccine Hesitancy in the French Population of Working Age: A Randomized Experiment of Vaccine Characteristics

Author: Michaël Schwarzinger, Verity Watson, Pierre Arwidson, François Alla, and Stéphane Luchini
Published: 2020

65. Realist evaluation of a theory-based life skills programme aiming to prevent addictive behaviours in adolescents: the ERIEAS study protocol

Author: Romain Gallard, Monique Termote, Aurélie Affret, Emma Martel, Vincent Dejarnac, Judith Martin-Fernandez, Laurence Merchadou, Linda Cambon, Laetitia Moinot, François Alla, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, CHU Bordeaux [Bordeaux], and Admin, Oskar
Subjects: Male, Adolescent, Substance-Related Disorders, media_common.quotation_subject, Psychology, Adolescent, lcsh:Medicine, Legislation, Life skills, preventive medicine, Conformity, Helsinki declaration, Interviews as Topic, Social Skills, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Agency (sociology), Medicine, Humans, realist evaluation, 030212 general & internal medicine, Charter of Fundamental Rights of the European Union, media_common, School Health Services, Medical education, business.industry, 4. Education, 030503 health policy & services, lcsh:R, MRISP, General Medicine, 16. Peace & justice, Behavior, Addictive, Health promotion, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, life skills, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Public Health, 0305 other medical science, business, Psychological Theory, addictions
Abstract: IntroductionAdolescence is a sensitive life stage during which tobacco, alcohol and cannabis are used as ways to learn and adopt roles. There is a great deal of interest in substance use (SU) prevention programmes for young people that work to change representations of these products and help with mobilisation of life skills. Unfortunately, few existing programmes are evidence-based.In France, a programme called Expériences Animées (EA, Animated Experiences) has been developed, inspired by life skills development programmes that have been proven to be successful. The EA programme uses animated short movies and talks with high school and secondary school pupils about the use of psychoactive substances and addictions. By allowing life skills mobilisation and modifying representations and beliefs about SU, it is aimed at delaying initiation of use of psychoactive substances, preventing adolescents from becoming regular consumers, reducing the risks and harms related to the use of these substances and opening the way for adapted support measures.We are interested in understanding how, under what circumstances, through which mechanisms and among which adolescents the EA programme works. Therefore, we have developed the ERIEAS study (‘Evaluation Réaliste de l’Intervention Expériences Animées en milieu Scolaire’; Realist Evaluation of the EA Intervention in Schools).Methods and analysisEA will be conducted in 10 schools. A multi-case approach will be adopted with the aim of developing and adjusting an intervention theory. The study comes under the theory-driven evaluation framework. The investigation methodology will include four stages: (i) elaboration of a middle-range theory; (ii) data collection for validating/adjusting the theory; (iii) data analysis; and (iv) refinement and adjustment of the middle-range theory and definition of the programme’s key functions.Ethics and disseminationThe study will provide evidence-based results to health authorities to help in the rollout of health promotion strategies in schools. It will provide knowledge about the strategic configurations most suitable for leading to life skills mobilisation and change young people’s representations about SU. The project will be carried out with full respect of current relevant legislation (eg, the Charter of Fundamental Rights of the European Union) and international conventions (eg, Helsinki Declaration). It follows the relevant French legislation of the research category on interventional research protocol involving the human person. The protocol was approved by the Comité et Protection des Personnes (CPP), that is, Committee for the Protection of Persons CPP SUD-EST VI n°: AU 1525 and was reported to the Agence Française de Sécurité Sanitaire des Produits de Santé (ANSM) that is, the French National Agency for the Safety of Health Products. It is in conformity with reference methodology MR003 of Bordeaux University Hospital (CNIL n° 2 026 779 v0).Trial registration detailsThis research has been registered on ClinicalTrials.gov (No. NCT04110626).The research project is registered in the European database ID-RCB (No. 2019-A01003-54).
Published: 2020

66. Profil socioéconomique et tabagisme chez les adolescents en centre de formation des apprentis

Author: Laetitia Minary, François Alla, Joëlle Kivits, groupe Resist, T Gagné, Abdou Y. Omorou, Université de Montréal (UdeM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), RESIST, and Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Inequality, Epidemiology, media_common.quotation_subject, Vocational training, Psychological intervention, Socioeconomic factors, Tabagisme, Adolescents, 03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, Socioeconomic status, ComputingMilieux_MISCELLANEOUS, media_common, [SHS.SOCIO]Humanities and Social Sciences/Sociology, 030505 public health, Social network, business.industry, 4. Education, Smoking, Public Health, Environmental and Occupational Health, Targeted interventions, 3. Good health, Vocational education, Milieu d’apprentissage professionnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Smoking status, France, National average, Inégalités sociales, 0305 other medical science, business, Psychology, Demography
Abstract: Background Targeted interventions among vulnerable youth populations represent an important approach to the reduction of health inequalities. We must, however, ensure that impacts are not unequally distributed according to the range of resources available to them. We explore these concerns among youth in vocational training to be enrolled in a smoking cessation intervention by describing (1) their socio-economic profile and (2) the association between their socioeconomic characteristics, their smoking practices, and key factors that could be targeted in interventions. Methods A total of 234 young people aged 15–20 years were recruited in three centers in the Lorraine region in France in 2016–2017 as part of the Social Network and Tobacco Cessation (Reseau social et sevrage tabagique [RESIST]) study. We measured participants’ socio-economic characteristics using their parents’ education and occupational grade. We examined the associations of these characteristics with participants’ smoking habits, intention to quit, nicotine dependence, presence of smokers in their network, and representation of a young smoker. We examined the associations between variables with bivariate tests depending on the nature of the variables. Results Participants were more likely to be from a socio-professional background more modest than the national average (56% versus 33%), but still exhibited considerable socioeconomic variability. Smoking status did not vary significantly according to the educational level of the participants’ parents (from 52% to 57%, P = 0.78) or occupational grade (from 52% to 58%, P = 0.35). Compared to participants whose parents had completed a professional or pre-university degree, participants with parents in the lowest education category were less likely to report not intending to quit (P = 0.01) and more likely to report seriously considering to quit in the next six months (P = 0.03) and to have already tried to quit but failed (P = 0.01). Conclusion It is tempting to define youth in vocational training as a homogeneous group, especially when they share the same school environment, employment status, and income. Our results, however, highlight substantial variability in their socioeconomic profiles and smoking characteristics. Researchers are encouraged to further consider these equity issues to contribute to the reduction of health inequalities.
Published: 2018

67. Effectiveness of guideline-consistent heart failure drug prescriptions at hospital discharge on 1-year mortality: Results from the EPICAL2 cohort study

Author: François Alla, Alexandre Mebazaa, Nelly Agrinier, Nathalie Thilly, Hervé Laborde-Castérot, Isabelle Clerc-Urmès, Ziyad Messikh, Amandine Busson, Marc Soudant, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), EPICAL II, CIC 1433 Epidémiologie clinique, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)
Subjects: Male, Drug, medicine.medical_specialty, media_common.quotation_subject, Adrenergic beta-Antagonists, Angiotensin-Converting Enzyme Inhibitors, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Drug Prescriptions, Ventricular Function, Left, Angiotensin Receptor Antagonists, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, Hospital discharge, Humans, Medicine, Chronic disease management, Prospective Studies, 030212 general & internal medicine, Medical prescription, Propensity Score, ComputingMilieux_MISCELLANEOUS, Aged, Proportional Hazards Models, media_common, Aged, 80 and over, Heart Failure, 2. Zero hunger, Ejection fraction, business.industry, Pharmacoepidemiology, Stroke Volume, Guideline, Middle Aged, medicine.disease, Patient Discharge, 3. Good health, Heart failure, Practice Guidelines as Topic, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Guideline Adherence, Clinical practice guidelines, business, Body mass index, Cohort study
Abstract: We aimed to assess the effectiveness of recommended drug prescriptions at hospital discharge on 1-year mortality in patients with heart failure (HF) and reduced ejection fraction (HFREF).We used data from the EPICAL2 cohort study. HF patients ≥18years old with left ventricular ejection fraction (LVEF)40% and alive at discharge were included and followed up for mortality. Socio-demographic, clinical and therapeutic data were collected at admission. Therapeutic data were collected at discharge and at 6month. Prescription of an angiotensin-converting enzyme (ACE) inhibitor (or an angiotensin II receptor blocker [ARB] in case of ACE inhibitor intolerance) and a β-blocker at discharge were considered "guideline-consistent discharge prescription" (GCDP). A frailty Cox model after propensity score (PS) matching was used to assess the association of GCDP with survival.Among 624 patients included, the mean (SD) age was 73.6 (12.8) years; 65% were male. A total of 412 (65.6%) patients received GCDP, and 82.8% still had guideline consistent prescription at 6months. A total of 166 patients died during the follow-up, 78 in the GCDP group and 88 in the other group. Before PS matching, patients with GCDP were younger (|StDiff|=48.32%) and had higher body mass index (BMI) (|StDiff|=11.71%), lower LVEF (|StDiff|=23.13%) and lower Charlson index (|StDiff|=55.27%) than patients without GCDP. After PS matching, all characteristics were balanced between the two treatment groups, and GCDP was associated with reduced mortality (pooled HR=0.51, 95% CI [0.35-0.73]).Prescription of ACE (or ARB) inhibitors and β-blockers for patients with HFREF may be low despite the evidence for morbidity and mortality improvement with these medications but remains associated with reduced 1-year mortality in unselected HFREF patients.
Published: 2018

68. A nationwide survey of French dentists' knowledge and implementation of current guidelines for antibiotic prophylaxis of infective endocarditis in patients with predisposing cardiac conditions

Author: Philippe Lesclous, Xavier Duval, Bruno Hoen, François Alla, Alexandra Cloitre, Jehan, Frederic, Regenerative Medicine and Skeleton (RMeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Département d’Epidémiologie et Recherche Clinique [AP-HP Hôpital Bichat - Claude Bernard] (CIC‑EC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Service des Maladies Infectieuses et Tropicales [Point-à-Pitre], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Regenerative Medicine and Skeleton research lab (RMeS), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Scoring system, Heart Diseases, MEDLINE, 030204 cardiovascular system & hematology, Nationwide survey, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, medicine, Humans, Endocarditis, Radiology, Nuclear Medicine and imaging, Dentistry (miscellaneous), In patient, Antibiotic prophylaxis, Intensive care medicine, Practice Patterns, Dentists', [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Incidence (epidemiology), Endocarditis, Bacterial, 030206 dentistry, Antibiotic Prophylaxis, Middle Aged, medicine.disease, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Infective endocarditis, Practice Guidelines as Topic, Female, Surgery, France, Guideline Adherence, Oral Surgery, business
Abstract: International audience; Objectives. To prevent infective endocarditis in patients with predisposing cardiac conditions, antibiotic prophylaxis is recommended worldwide, except in the United Kingdom. To determine the relevance of this strategy, investigating how the current guidelines are applied is crucial. The first aim of this study was to assess dentists' implementation of the current guidelines. The secondary aims were to identify relevant areas to improve the training of dentists and to determine temporal trends in practitio-ners' attitudes by comparison with 2 previous surveys conducted in 1991 and 2001.Study Design. An electronic national survey was sent to the 12,000 member practitioners of the French Union for Oral Health.Results. Even though 58.9% of the respondents stated that their knowledge of current guidelines was good, a scoring system showed that only 34.5% had overall knowledge of these guidelines.Conclusions. This study revealed relevant areas to improve the training of dentists, such as knowledge of some cardiac conditions, the potential side effects of the antibiotics used, and the pathogenesis of infective endocarditis. Consequently, dentists' knowledge should be improved before any conclusions can be drawn on the relevance of this antibiotic prophylaxis strategy and its influence on infective endocarditis incidence.
Published: 2018

69. Effectiveness of a patient education programme in heart failure with preserved ejection fraction: Results from the ODIN cohort study using propensity score matching

Author: Emilie Drouet, Christophe Leclercq, Justine Druelle, Matthieu Schockmel, Yves Juillière, Geneviève Mulak, Hervé Laborde-Castérot, François Dany, Nelly Agrinier, Nathalie Thilly, Patrick Jourdain, François Alla, CIC 1433 Epidémiologie clinique, Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier René Dubos [Pontoise], Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], ICARLIM Network, Société française de cardiologie, CHU Saint-Antoine [APHP], CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Odin, Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Male, Health Knowledge, Attitudes, Practice, Time Factors, Health Behavior, Comorbidity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular Function, Left, 0302 clinical medicine, Risk Factors, Cause of Death, Odds Ratio, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Ejection fraction, Smoking, Hazard ratio, Cohort, Age Factors, Patient education, General Medicine, Middle Aged, Markov Chains, 3. Good health, Europe, Treatment Outcome, Score de propension, Female, Cardiology and Cardiovascular Medicine, Monte Carlo Method, Cohort study, medicine.medical_specialty, Alcohol Drinking, Éducation thérapeutique du patient, Diastolic, Mortalité, 03 medical and health sciences, Sex Factors, Patient Education as Topic, Internal medicine, medicine, Humans, Mortality, Propensity Score, Aged, Proportional Hazards Models, Heart Failure, Proportional hazards model, business.industry, Stroke Volume, Cohorte, Confidence interval, Insuffisance cardiaque, Self Care, Logistic Models, Propensity score matching, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart failure with preserved ejection fraction, business
Abstract: Summary Background Patient education programmes (PEP) are recommended for patients with heart failure but have not been specifically assessed in heart failure with preserved ejection fraction (HFpEF). Aim To assess the effectiveness of a structured PEP in reducing all-cause mortality in patients with HFpEF. Methods Patients with HFpEF were selected from the ODIN cohort, designed to assess PEP effectiveness in patients with HF whatever their ejection fraction, included from 2007 to 2010, and followed up until 2013. Baseline sociodemographic, clinical, biological and therapeutic characteristics were collected. At inclusion, patients were invited to participate in the PEP, which consisted of educational diagnosis, education sessions and final evaluation. Education focused on HF pathophysiology and medication, symptoms of worsening HF, dietary recommendations and management of exercise. Propensity score matching and Cox models were performed. Results Of 849 patients with HFpEF, 572 (67.4%) participated in the PEP and 277 (32.6%) did not. Patients who participated in the PEP were younger (67.0 ± 13.1 vs 76.1 ± 13.2 years; standardized difference [StDiff] = −54.6%), less often women (39.7% vs 48.4%; StDiff = −17.6%) and presented more often with hypercholesterolaemia (55.2% vs 35.2%; StDiff 41.2%), smoking (35.1% vs 28.7%; StDiff 13.8%), alcohol abuse (14.1% vs 8.9%; StDiff 16.5%) and ischaemic HF (38.7% vs 29.2%; StDiff 20.0%) than those who did not; they also presented with better clinical cardiovascular variables. After propensity score matching, baseline characteristics were balanced, except hypertension (postmatch StDiff 19.1%). The PEP was associated with lower all-cause mortality (pooled hazard ratio 0.70, 95% confidence interval 0.49–0.99; P = 0.042). This association remained significant after adjustment for hypertension (adjusted pooled hazard ratio 0.68, 95% confidence interval 0.48–0.97; P = 0.036). Conclusions In this investigation, a structured PEP was associated with lower all-cause mortality. Patient education might be considered an effective treatment in patients with HFpEF.
Published: 2018

70. Comparison of Treatment Persistence with Dabigatran or Rivaroxaban versus Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients: A Competing Risk Analysis in the French National Health Care Databases

Author: François Alla, Antoine Pariente, Géric Maura, Cécile Billionnet, Joshua J. Gagne, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Vitamin K, Databases, Factual, medicine.drug_class, Administration, Oral, Hemorrhage, 030204 cardiovascular system & hematology, computer.software_genre, Medication Adherence, Dabigatran, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Rivaroxaban, Atrial Fibrillation, Humans, Medicine, Pharmacology (medical), International Normalized Ratio, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, PharmacoEpi-Drugs, Dose-Response Relationship, Drug, Database, business.industry, Age Factors, Anticoagulants, Atrial fibrillation, Middle Aged, Vitamin K antagonist, medicine.disease, Confidence interval, 3. Good health, Discontinuation, Hospitalization, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, computer, Cohort study, medicine.drug
Abstract: Background Direct oral anticoagulants (DOACs) have been proposed as a more convenient alternative to vitamin K antagonists (VKAs), which are commonly associated with poor treatment persistence in nonvalvular atrial fibrillation (nv-AF). Methods Using data from the French National Healthcare databases (Regime General, 50 million beneficiaries), a cohort study was conducted to compare the 1-year non-persistence rates in nv-AF patients initiating dabigatran (N=11,141) or rivaroxaban (N=11,126) versus VKA (N=11,998). Treatment discontinuation was defined as a switch between oral anticoagulant (OAC) classes or a 60-day gap with no medication coverage, with the additional criterion of no reimbursement for international normalized ratio monitoring during this gap for VKA patients. Considering death as a competing risk, differences between 1-year discontinuation rates were used to compare each DOAC versus VKA. 95% confidence intervals [CIs] were estimated via bootstrapping. Baseline patient characteristics were adjusted using inverse probability of treatment weighting. Subgroup analyses considered DOAC dose at initiation, age, risk of stroke, and bleeding. Results Adjusted 1-year discontinuation rates were higher for dabigatran than for VKA new users (36.8% vs 30.2%; difference: 6.6% [95% CI, 5.5 to 7.6]) and for rivaroxaban versus VKA new users (33.4% vs 30.4%; 3.0% [1.9 to 4.1]). Similar differences were found in all subgroup analyses, except in dabigatran and rivaroxaban patients
Published: 2017

71. Desafíos teóricos y prácticos del universalismo proporcional: una revisión

Author: Jérôme Wittwer, Linda Cambon, Florence Francis-Oliviero, Michael Marmot, François Alla, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Revisión, Inequality, media_common.quotation_subject, RC955-962, fatores socioeconômicos, Psychological intervention, Proportionality (law), política de salud, factores socioeconómicos, socioeconomic factors, Context (language use), Scientific literature, política de saúde, Arctic medicine. Tropical medicine, Sociology, Health equity, Universalism, Equidad en salud, media_common, Public Health, Environmental and Occupational Health, health policy, Epistemology, Identification (information), Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Public aspects of medicine, RA1-1270, Equidade em saúde, Social theory
Abstract: International audience; Objective. In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. Methods. We searched for all articles published until 6th of February 2020, mentioning “Proportionate Universalism” or its synonyms “Targeted universalism” OR “Progressive Universalism” as a topic in all Web of Science databases. Results. This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. Conclusion. This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.; Objetivo. En 2010 se propuso el principio del universalismo proporcional como solución para reducir las desigualdades en materia de salud. Aunque tuvo una gran resonancia, no parece haber sido aplicado ampliamente y no existen directrices sobre cómo aplicarlo. Los dos objetivos específicos de esta revisión sistemática exploratoria fueron: 1) describir el contexto teórico en el que se estableció el universalismo proporcional, y 2) describir cómo los investigadores aplican el universalismo proporcional y las cuestiones metodológicas relacionadas. Métodos. Se buscó en todas las bases de datos de la Web of Science los artículos publicados hasta el 6 de febrero de 2020 que tuvieran como tema “universalismo proporcional” o sus sinónimos “universalismo dirigido” o “universalismo progresivo”. Resultados. Esta revisión de 55 artículos permitió tener una visión global del universalismo proporcional en cuanto a sus fundamentos teóricos y su aplicación práctica. El principio del universalismo proporcional se basa en las teorías sociales del universalismo y el direccionamiento, y propone vincular estos dos aspectos para lograr una reducción efectiva de las desigualdades en materia de salud. Respecto de su aplicación práctica, las intervenciones basadas en este principio son poco frecuentes y dan lugar a diferentes interpretaciones. Todavía existen muchos desafíos metodológicos y éticos en relación con la concepción y la evaluación de las intervenciones relacionadas con el universalismo proporcional, incluida la forma de aplicar la proporcionalidad y la identificación de las necesidades. Conclusión. En esta revisión se llevó a cabo un mapeo de la literatura científica disponible sobre el universalismo proporcional y sus conceptos relacionados. Este principio se basa en teorías sociales. Tal como lo destacaron autores que implementaron intervenciones de universalismo proporcional, su aplicación plantea muchos desafíos, desde el diseño hasta la evaluación. El análisis de las aplicaciones del universalismo proporcional presentado en esta revisión respondió a algunos de ellos, pero los desafíos metodológicos restantes requieren ser abordados en futuras investigaciones.
Published: 2021

72. Développer la recherche en services de santé : Pour accompagner les changements (organisationnels) du système de santé

Author: Daniel Benamouzig and François Alla
Abstract: Les systèmes de santé européens sont confrontés à des transformations majeures des modes de prise en charge, dans un contexte de développement des maladies chroniques et de vieillissement de la population. Cette transition épidémiologique se double d’une transition organisationnelle et plus largement sociale. Ces changements exigent de nouvelles connaissances et de nouvelles évaluations plus précises des services de santé, souvent situées et comparatives. La recherche sur les services de santé s’affirme comme un enjeu stratégique pour les années à venir.
Published: 2017

73. Adherence with direct oral anticoagulants in nonvalvular atrial fibrillation new users and associated factors: a French nationwide cohort study

Author: Antoine Pariente, François Alla, Géric Maura, and Cécile Billionnet
Subjects: Male, pharmacoepidemiology, Vitamin K, Databases, Factual, Epidemiology, Myocardial Ischemia, Comorbidity, 030204 cardiovascular system & hematology, Cohort Studies, 0302 clinical medicine, Rivaroxaban, Atrial Fibrillation, Original Report, Pharmacology (medical), adherence, 030212 general & internal medicine, Aged, 80 and over, education.field_of_study, Age Factors, Atrial fibrillation, Middle Aged, Pharmacoepidemiology, Vitamin K antagonist, Dabigatran, Stroke, Female, France, French health care databases, medicine.drug, Cohort study, medicine.medical_specialty, medicine.drug_class, Population, direct oral anticoagulants, Medication Adherence, 03 medical and health sciences, Internal medicine, Original Reports, medicine, Humans, education, Intensive care medicine, Aged, business.industry, Anticoagulants, medicine.disease, Health Care Surveys, Concomitant, business
Abstract: Purpose Direct oral anticoagulants (DOACs) have been promoted in patients with nonvalvular atrial fibrillation (nv-AF) as a more convenient alternative to vitamin K antagonists. We estimated 1-year dabigatran and rivaroxaban adherence rates in nv-AF patients and assessed associations between baseline patient characteristics and nonadherence. Methods This cohort study included OAC-naive nv-AF patients with no contraindications to OAC, who initiated dabigatran and rivaroxaban, using nationwide data from French national health care databases. One-year adherence was defined by the proportion of days covered of 80% or more over a fixed 1-year period after treatment initiation. Associations between nonadherence and baseline patient characteristics were assessed using multivariate logistic regression models. Results The population was composed of 11 141 dabigatran (women: 48%; mean age: 74 ± 10.7 y; ≥80 y: 34.9%) and 11 126 rivaroxaban (46.5%; 74 ± 10.9 y; 34.8%) new users. One-year adherence was 53.3% in dabigatran-treated and 59.9% in rivaroxaban-treated patients, consistent with numerous subgroup analyses. A switch to vitamin K antagonist was observed in 14.5% of dabigatran and 11.7% of rivaroxaban patients; 10.2% and 5.9% of patients switched to another DOAC, respectively; and 4.3% of patients died in the 2 cohorts. In patients who did not die or switch during the follow-up, 1-year adherence was 69.6% in dabigatran-treated and 72.3% in rivaroxaban-treated patients. Having concomitant ischemic heart diseases was associated with an increased risk of nonadherence in the 2 cohorts. Conclusion In this real-life study, 1-year adherence to DOAC is poor in nv-AF new users. Despite the introduction of DOAC, adherence to OACs may remain a significant challenge in AF patients.
Published: 2017

74. Identifying atrial fibrillation in outpatients initiating oral anticoagulants based on medico-administrative data: results from the French national healthcare databases

Author: Éric Bérigaud, François Alla, Antoine Pariente, Cécile Billionnet, and Géric Maura
Subjects: Database, Epidemiology, business.industry, Deep vein, Atrial fibrillation, 030204 cardiovascular system & hematology, Pharmacoepidemiology, medicine.disease, computer.software_genre, Logistic regression, Thrombosis, Pulmonary embolism, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Ambulatory, medicine, Pharmacology (medical), cardiovascular diseases, 030212 general & internal medicine, business, computer, Stroke
Abstract: Purpose Identifying atrial fibrillation (AF) in outpatients treated with oral anticoagulants (OACs) from claims databases is challenging when the outpatient indication is not available, as OACs are also prescribed for deep vein thrombosis/pulmonary embolism (DVT/PE) that may be treated in the ambulatory setting. An algorithm was developed to identify AF in outpatients initiating OAC from medico-administrative data. Methods Among patients initiating OAC in 2013 in the French healthcare databases, those treated for orthopaedic indications were excluded. Patients with a history of AF or DVT/PE directly identified from available medical data, mainly hospital discharge diagnoses, were considered to be ‘confirmed AF or DVT/PE patients’. Demographics of these patients and their healthcare utilization data prior to OAC initiation were then included in a logistic regression model discriminating AF versus DVT/PE indications. The final model selected, comparing c-index, provided an algorithm identifying AF from among initially unclassified patients assumed to be either AF or DVT/PE outpatients. Results Among 256 418 patients initiating OAC, 37 388 were excluded; 61 329 AF and 59 859 DVT/PE patients were directly identified, leaving 88 488 unclassified patients. The final model (c-index: 0.93) included demographics, cardiologist prescriber, hospitalization for stroke, use of antiarrhythmics/beta-blockers/antihypertensive drugs and undergoing a Holter/echocardiography procedure, thyroid function tests, but no D-dimer tests. With a specificity of 95% (sensitivity: 65%), 41% of the unclassified patients were assumed to be AF outpatients. Similar results were obtained on 250 159 new users in 2014. Conclusion This algorithm combining inpatient and outpatient claims data performed relatively well to identify AF outpatients initiating OAC. Copyright © 2017 John Wiley & Sons, Ltd.
Published: 2017

75. La complexité : concept et enjeux pour les interventions de santé publique

Author: Victoria Pagani, Laetitia Minary, Frédérique Claudot, Linda Cambon, François Alla, and Joëlle Kivits
Subjects: 030505 public health, Managerial economics, Management science, Mechanism (biology), business.industry, Field (Bourdieu), Public health interventions, Public Health, Environmental and Occupational Health, Subject (philosophy), Psychological intervention, Complex interventions, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Health care, 030212 general & internal medicine, Sociology, 0305 other medical science, business
Abstract: Introduction: Since 2000, the notion of “complex interventions” has been emerging in the health research field. “Complex interventions” and “complexity” are commonly used terms, but they are generally not defined. Conceptual ambiguities persist concerning the notion of complexity. The objective of this exploratory review is to characterize the notion of complexity: What is complexity? Where does this notion come from and what does it cover? What are the consequences of complexity in the health field?Methods: To clarify the concept of complexity, a narrative review was conducted in the fields of humanities and social science, managerial economics, psychology and healthcare.Results: The concept of complexity, that can be attributed to Edgar Morin, has been the subject of appropriations, adaptations, and operations in multiple areas. Complexity consists of understanding the factors influencing individual decisions. In the field of healthcare, the concept of complexity is used more pragmatically and is defined by objective characteristics of interventions (defined as complex) or their contexts for the practical purposes of evaluation.Discussion: The notions of complexity and complex interventions have implications for researchers and users of the results of research. In particular, the notion of complexity is designed to provide a better understanding of the mechanism of effectiveness of interventions, support transferability and use by actors and decision-makers.
Published: 2017

76. La Charte d’Ottawa a trente ans : doit-elle encore faire référence ?

Author: François Alla
Subjects: 0301 basic medicine, medicine.medical_specialty, 030109 nutrition & dietetics, Modalities, Public health, Public Health, Environmental and Occupational Health, Subject (philosophy), Charter, 03 medical and health sciences, Health problems, 0302 clinical medicine, Health promotion, Action (philosophy), Software deployment, Law, medicine, 030212 general & internal medicine, Sociology
Abstract: The Ottawa Charter for health promotion is the subject of a number of criticisms. For example, less than 30 years after signature of this agreement, some authors claim that it no longer corresponds to current health problems, that its modalities of action are obsolete, that it is not effective, and even less efficient or even utopian and, consequently, not operational.On the contrary, we believe that the Ottawa Charter represents a relevant response to today’s major challenges. The levers of this Charter have been shown to be effective and efficient and can constitute an integrating framework that can be adapted to contextual and scientific changes in public health. It is therefore not time to abandon this Charter, but, on the contrary, to intensify its deployment.
Published: 2016

77. How to implement a successful smoking cessation intervention for adolescents

Author: François Alla, A Vallata, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), and Vialaron, Sylvie
Subjects: medicine.medical_specialty, business.industry, 4. Education, Smoking, Public Health, Environmental and Occupational Health, Smoking cessation intervention, Guidelines, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Implementation, Physical therapy, medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, ComputingMilieux_MISCELLANEOUS
Abstract: Background Policies and programs implemented to promote smoking cessation among youth present disparate results. These variations are explained by interventions themselves but also by context, population and implementation characteristics. Our objective was to analyze these factors, related to enrollment and participation in a smoking cessation program, implemented in vocational or technical schools. Methods Population factors were studied by a systematic review about determinants of smoking cessation among 10-24 years old, updating a previous one. Contextual and implementation factors were identified by a qualitative multiple cases study. A smoking cessation program, TABADO, had been implemented in 3 regions in France, in 10 vocational or technical schools (1 school/1 case). Data collection included 51 observations, 46 semi-structured interviews, and 3 interdisciplinary seminars. Results The review identified 46 factors probably or possibly related to a successful smoking cessation, both individual (e.g. smoking frequency) and collective (e.g. relationship smoking status, anti-tobacco legislation). The case study allowed us to objectify positive or negative factors that influence the enrollment and the participation in the program (e.g. presence of a referent in the school, combination with the school program). Finally, we identified prerequisites to gather before starting such a program. Conclusions This mixt design highlights factors on which we must focus to increase the success of a smoking cessation program for youth. A key factor is to tailor intervention and implementation modalities to the local context. Results enabled us to product a pragmatic guide, TABADO 2, which is now used in a national scaling process. They also will be used to build an intervention theory, which could be used for any smoking cessation intervention for youth. Acknowledgments: The TABADO IDF study group, Inca, the région Lorraine and the ARS Nouvelle-Aquitaine for their financial support. Key messages A smoking cessation program must be a global strategy, considering contextual, population and organizational factors. Instead of trying to strictly apply a protocol, a complex intervention must be tailored to the context in which it is implemented.
Published: 2019

78. Posttraumatic Stress Disorder Following Myocardial Infarction: A Systematic Review

Author: Cyril Tarquinio, Amanda Kirche, Marie-Jo Brennstuhl, François Alla, Ilona Denis, C. Tarquinio, and Murielle Jacquet-Smailovic
Subjects: Cardiovascular event, 050103 clinical psychology, medicine.medical_specialty, MEDLINE, Myocardial Infarction, Disease, Stress Disorders, Post-Traumatic, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Risk Factors, medicine, Prevalence, Humans, 0501 psychology and cognitive sciences, Myocardial infarction, business.industry, Incidence (epidemiology), 05 social sciences, medicine.disease, 030227 psychiatry, 3. Good health, Causality, Psychiatry and Mental health, Clinical Psychology, Posttraumatic stress, Systematic review, Emergency medicine, business
Abstract: The objective of the present review is to provide an overview of existing research that has reported on the association between posttraumatic stress disorder (PTSD) and ischemic heart disease. Specific focus is given to the incidence of PTSD following myocardial infarction (MI). A systematic review using Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines was performed by searching four bibliographic databases: PubMed, PsychINFO, ScienceDirect, and ProQuest Dissertations and Theses. A total of 39 articles were included in this literature review. The results of these studies suggest that the occurrence of an acute cardiac event is likely to contribute to the development of PTSD. Not only is this type of psychiatric disorder associated with significant suffering and impaired quality of life, but it is also a predictor of an increased risk of recurrent adverse cardiovascular events and mortality. Screening, assessment, and treatment of PTSD and posttraumatic stress symptoms following a major cardiac event are critical for offsetting potential deleterious psychological and physical consequences.
Published: 2019

79. Adherence to ESC guideline‐recommended medications over a 36‐month follow‐up period after hospitalization for heart failure: Results from the EPICAL2 cohort study

Author: Sarah Bitar, François Alla, Nathalie Thilly, Alexandre Mebazaa, Patrick Rossignol, Nelly Agrinier, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Université Paris Diderot - Paris 7 (UPD7), Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Plateforme d'Aide à la Recherche Clinique [CHRU Nancy] (PARC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Epidémiologie Clinique (CIC-EC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)
Subjects: Male, associated factors, trajectories of medication prescriptions, medicine.medical_specialty, pharmacoepidemiology, Epidemiology, 030226 pharmacology & pharmacy, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Pharmacology (medical), heart failure with reduced ejection fraction, 030212 general & internal medicine, Prospective Studies, Medical prescription, Practice Patterns, Physicians', Asthma, Aged, Aged, 80 and over, Heart Failure, COPD, business.industry, Cardiovascular Agents, Stroke Volume, Guideline, Pharmacoepidemiology, medicine.disease, 3. Good health, Europe, Hospitalization, adherence to guideline-recommended medications, Heart failure, Practice Guidelines as Topic, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Guideline Adherence, business, Cohort study, Kidney disease, Follow-Up Studies
Abstract: International audience; PURPOSE: The purpose of the study is to describe the trajectories of oral medication prescriptions in patients with heart failure with reduced ejection fraction (HFrEF) over 3 years after discharge from hospitalization for heart failure. We then evaluated the adherence of these prescriptions to the European Society of Cardiology (ESC) guideline-recommended medications and identified patient characteristics associated with nonadherence.METHODS: We used data from the EPICAL2 cohort study. HFrEF patients who had completed prescriptions at discharge and at 6-month follow-up were included and followed for 36 months. The following medication agents were considered adherent to guidelines: renin-angiotensin system (RAS) blockers [angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin-receptor blocker (ARB)] plus a β-blocker (BB) or RAS blocker plus BB plus mineralocorticoid receptor antagonists (MRAs). The evolution of drug prescriptions and the adherence to ESC guidelines were assessed by using sequence analysis and clustering approaches. Patient characteristics associated with nonadherence were identified by logistic regression analyses.RESULTS: A typology of four therapeutic clusters was obtained, among which two clusters were adherent to recommendations and two were not. The adherent clusters consisted of bitherapy (RAS blockers-BB) and tritherapy (RAS blockers-BB-MRA) for about 64% of patients and remain stable over time. The nonadherent clusters consisted of nonprescription of BB for about 22% of patients or nonprescription of RAS blocker for about 14%. The main reason for nonprescription of BB was a concomitant obstructive airway disease (asthma or COPD) but was a concomitant chronic kidney disease for nonprescription of RAS blocker.CONCLUSION: Adherence to guideline-recommended medications while being hospitalized is of great importance because prescriptions are quite stable over time after discharge. HFrEF patients are most often older, with various comorbidities, such as chronic kidney disease or asthma/COPD, which importantly limit physicians' ability to prescribe recommended drugs, leading to suboptimal adherence to guidelines.
Published: 2019

80. Current challenges in population health intervention research

Author: François Alla, Linda Cambon, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Process management, Epidemiology, Psychological intervention, Context (language use), Population health, Health Promotion, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Medicine, Humans, 030212 general & internal medicine, Population Health, business.industry, 030503 health policy & services, Public health, Research, Public Health, Environmental and Occupational Health, MRISP, Object (philosophy), Intervention research, Research questions, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business
Abstract: Population health interventions (PHIs) are generally complex; their results depend on their interaction with the context of their implementation. Moreover, the distinction between intervention and context is arbitrary: we need rather to consider an ‘interventional system’, including both interventional and contextual components. Evaluation must go beyond effectiveness and must include two key research questions: a viability analysis, to verify that the intervention can be routinised in a real-life context; and a theory-based evaluation, to analyse mechanisms and to understand what produces effects among components and their interactions with each other and with the context. PHI research is a question not only of the object but also of perspectives. This means doing research differently, making use of interdisciplinarity and involving stakeholders. Such an approach may contribute to the development, transfer, implementation and scaling-up of innovative interventions.
Published: 2019

81. Using surgical risk scores in nonsurgically treated infective endocarditis patients

Author: Xavier Duval, Jean-François Obadia, Vincent Le Moing, Bruno Hoen, Thanh Lecompte, Pierre Tattevin, François Alla, Catherine Chirouze, Andrea Perrotti, François Delahaye, Sidney Chocron, Bernard Iung, Giuseppe Gatti, University of Trieste, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Hôpital Jean Minjoz, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Département maladies infectieuses et tropicales [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, University hospital of Trieste, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Hospices Civils de Lyon (HCL), CIC epidémiologie clinique/ essais cliniques, Hôpital Bichat - Claude Bernard, Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), University Hospital , Pointe-à-Pitre, Guadeloupe, Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Infectious Diseases Department, University Hospital, Montpellier Cedex 5, France, Dr. Xavier Duval received grants from Pfizer Inc., New York, USA, outside the submitted work., Cholley, Pascal, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Lyon, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, education, 030204 cardiovascular system & hematology, Risk Assessment, Discriminatory power, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Hospital Mortality, 030212 general & internal medicine, Cardiac Surgical Procedures, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Framingham Risk Score, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Endocarditis, Receiver operating characteristic, Medical treatment, business.industry, valvular heart disease, Endocarditis, Bacterial, medicine.disease, Valvular heart disease, Surgical risk, 3. Good health, Cardiac surgery, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Risk factors, lcsh:RC666-701, Infective endocarditis, Quality of care improvement, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Mortality/Survival, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: The accuracy of surgical scores in predicting in-hospital mortality for nonsurgically treated patients with infective endocarditis (IE) has not yet been explored.Methods: Patients with definite IE who did not undergo valve surgery were selected from the database of seven French administrative areas (Association pour l'Étude et la Prévention de l'Endocardite Infectieuse [AEPEI] Registry, 2008). The patients were scored using (a) six systems specifically devised to predict in-hospital mortality after surgery for IE, (b) three commonly used risk scores for heart surgery, and (c) a risk score for predicting six-month mortality in IE after either surgery or medical therapy. Calibration (Hosmer-Lemeshow test) and discriminatory power (receiver operating characteristic [ROC] analysis) were assessed for each score. Areas under ROC curves were compared one-to-one (Hanley-McNeil method).Results: A total of 192 patients (mean age, 65.2±15.2 years) were considered for analysis. There were 38 (19.8%) in-hospital deaths. Age >70 years (p=0.001), Staphylococcus aureus as causal agent (p=0.05), and severe sepsis (p=0.027) were independent predictors of in-hospital mortality. Despite many differences in the number and type of variables, all but two of the investigated scores showed good calibration (p>0.66). However, discriminatory power was satisfactory (area under ROC curve >0.70) only for three of the scores specific for IE and two of the scores used to predict mortality after cardiac surgery.Conclusions: Among the 10 surgical scores evaluated in this study, five could be adopted to predict in-hospital mortality even for IE patients receiving medical treatment only.
Published: 2019

82. Conventional mood stabilizers and/or second-generation antipsychotic drugs in bipolar disorders: A population-based comparison of risk of treatment failure

Author: Hélène Verdoux, Géric Maura, Bernard Bégaud, Marie Tournier, Jean-Philippe Chaffiol, Elodie Pambrun, Alain Weill, Anke Neumann, François Alla, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Olanzapine, Adult, Male, medicine.medical_specialty, Bipolar Disorder, Databases, Factual, medicine.drug_class, Population, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Antimanic Agents, Internal medicine, medicine, Humans, Cumulative incidence, Bipolar disorder, Treatment Failure, education, Aged, PharmacoEpi-Drugs, education.field_of_study, Risperidone, business.industry, Age Factors, Mood stabilizer, MRISP, Middle Aged, medicine.disease, Antidepressive Agents, Drug Utilization, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Clinical Psychology, Quetiapine, Aripiprazole, Anticonvulsants, Drug Therapy, Combination, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, 030217 neurology & neurosurgery, medicine.drug, Antipsychotic Agents
Abstract: BACKGROUND: The study compared treatment failure when using three therapeutic strategies in bipolar disorders: (i) mood stabilizers (MSs: lithium, valpromide, divalproate, carbamazepine, lamotrigine) without second-generation antipsychotic (SGAP); (ii) SGAPs (aripiprazole, olanzapine, risperidone, quetiapine) without MS; (iii) combination of MSs and SGAPs. METHODS: A historical cohort study was conducted using the French national healthcare databases in 20,086 outpatients aged 21+, newly treated with one of the three treatment strategies in 2011-2012, and diagnosed with a bipolar disorder. A composite outcome was based on indicators of treatment failure identified over 12 months: treatment discontinuation, switch or addition, psychiatric hospitalisation, suicide attempt, and death. For each strategy, the cumulative incidence of treatment failure was calculated while adjusting for covariates by propensity score weighting. RESULTS: A total of 8,225 patients (40.9%) were newly dispensed MSs, 9,342 (46.5%) SGAPs, and 2,519 (12.5%) both MSs and SGAPs. The one-year adjusted cumulative incidence of treatment failure was 75.7% (95%CI 74.9;76.3) in patients using MSs, 75.3% (74.6;76.0) in patients using SGAPs, and 60.5% (58.3;62.6) in patients with the combination. The adjusted difference in incidence for SGAPs compared with MSs was -0.40% (-1.4;0.6 p=0.4) in the whole population, -2.2% (-3.3; -1.2 p < 0.002) in patients under 65 years and +6.7% (4.1;9.1 p < 0.002) in patients 65 years and over. LIMITATIONS: Combinations of MSs and SGAPs could not be directly compared with MS or SGAP monotherapies. CONCLUSIONS: One-year treatment failure was high. Overall, no difference in treatment failure was observed between MS or SGAP strategy but differences might exist depending on age.
Published: 2019

83. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O Lam, Faris Hasan Lami, Van C Lansingh, Sonia Lansky, Heidi J Larson, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Georgy Lebedev, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Jennifer H MacLachlan, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles R J Newton, Frida N Ngalesoni, Josephine W Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Molly R Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S Nyasulu, Christopher M Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew T Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Sk Ong, Eyal Oren, Heather M Orpana, Alberto Ortiz, Justin R Ortiz, Stanislav S Otstavnov, Simon Øverland, Mayowa Ojo Owolabi, Raziye Özdemir, Mahesh P A, Rosana Pacella, Smita Pakhale, Abhijit P Pakhare, Amir H Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Jeyaraj Durai Pandian, Andrea Parisi, Eun-Kee Park, Charles D H Parry, Hadi Parsian, Shanti Patel, Sanghamitra Pati, George C Patton, Vishnupriya Rao Paturi, Katherine R Paulson, Alexandre Pereira, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R Phillips, Frédéric B Piel, David M Pigott, Julian David Pillay, Meghdad Pirsaheb, Farhad Pishgar, Suzanne Polinder, Maarten J Postma, Akram Pourshams, Hossein Poustchi, Ashwini Pujar, Swayam Prakash, Narayan Prasad, Caroline A Purcell, Mostafa Qorbani, Hedley Quintana, D Alex Quistberg, Kirankumar Waman Rade, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Afarin Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Chhabi Lal Ranabhat, Prabhat Ranjan, Puja C Rao, David Laith Rawaf, Salman Rawaf, Christian Razo-García, K Srinath Reddy, Robert C Reiner, Marissa B Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Katya Anne Shackelford, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Farhad Shokraneh, Mark G Shrime, Si Si, Soraya Siabani, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Natacha Torres Da Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Narinder Pal Singh, Prashant Kumar Singh, Virendra Singh, Dhirendra Narain Sinha, Karen Sliwa, Mari Smith, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Dan J Stein, Caitlyn Steiner, Leo G Stewart, Mark A Stokes, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Nuno Taveira, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Belay Tessema, Gizachew Assefa Tessema, Kavumpurathu Raman Thankappan, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, George D Thurston, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Suryakant Tripathi, Christopher E Troeger, Thomas Clement Truelsen, Nu Thi Truong, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, E Murat Tuzcu, Stefanos Tyrovolas, Kingsley N Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Selen Begüm Uzun, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Mitchell Taylor Wallin, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin
Subjects: Overview, Disease, Territory, Causes of death, humanities
Abstract: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group
Published: 2019

84. [Elaboration of prevention norms: Need for ethical reflection]

Author: Victoria, Pagani, François, Alla, Linda, Cambon, and Frédérique, Claudot
Subjects: Primary Prevention, Health Policy, Humans, Public Health
Abstract: Public health tries to modify existing social norms by setting up strategies to promote the emergence of norms that are more adapted to the objectives of good health and well-being. Prevention policies and the corresponding interventions concern health behaviours and are designed to modify the individual's habits, and contribute to defining new ways of being, acting and living. Prevention therefore involves numerous personal, cultural, social and collective values. An ethical reflection concerning the meaning, rationale and justice of these actions is therefore essential. The objective of this study is to characterize the ethical reflection at the time of creation of public health norms.A narrative review, based on the Web of Science database covering journals of the various disciplines concerned, was conducted to address this issue.Thirty-four publications were selected, illustrating the numerous definitions and types of norms used in public health intervention strategies. Many stakeholders are involved in the creation of public health norms specialists, opinion leaders, and social stakeholders. Finally, although some publications stress that the use of prevention norms raises a number of ethical issues, no publication refers to the presence of a structured ethical reflection as part of this process.Ethical reflection is an essential part of prevention interventions and tools. What is the best way of achieving the best results? How to resolve conflicts of interests? These issues must be addressed when developing policies or programmes and can more effectively guide public health strategies and help to improve their acceptability and efficacy in populations.
Published: 2018

85. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author: Haidong, Wang, Amanuel, Alemu, Kalkidan, Hassen, Cristiana, Abbafati, Kaja, M, Foad, Abd Allah, Semaw, Ferede, Haftom, Niguse, Laith, J, Niveen, M, Isaac, Akinkunmi, Rufus, Adesoji, Ifedayo, Morayo, Olatunji, Adetokunboh, Ashkan, Afshin, Rakesh, Aggarwal, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Muktar, Beshir, Amani, Nidhal, Ibthiel, Aichour, Miloud, Taki, Sneha, Aiyar, Ali, Shafqat, Tomi, F, Nadia, Akseer, Ayman, Al Eyadhy, Faris, Hasan, Samer, Alabed, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Deena, Alasfoor, Robert, William, Kefyalew, Addis, Samia, Alhabib, Raghib, Ali, Reza, Alizadeh Navaei, Syed, M, Juma, M, Ala’A, Alkerwi, François, Alla, Shalini, D, Peter, Allebeck, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Elena, Alvarez, Nelson, Alvis Guzman, Azmeraw, T, Emmanuel, A, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Nahla, Anber, Catalina, Liliana, Sofia, Androudi, Hossein, Ansari, Mustafa, Geleto, Carl, Abelardo, Palwasha, Anwari, Johan, Ärnlöv, Megha, Arora, Artaman, Al, Krishna, Kumar, Hamid, Asayesh, Solomon, Weldegebreal, Rana, Jawad, Reza, Assadi, Tesfay, Mehari, Sachin, R, Leticia, Avila Burgos, Euripide, Frinel, Ashish, Awasthi, Beatriz, Paulina, Tesleem, Kayode, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Shivanthi, Balalla, Aleksandra, Barac, Ryan, M, Miguel, A, Suzanne, L, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Bernhard, T, Shahrzad, Bazargan Hejazi, Neeraj, Bedi, Ettore, Beghi, Yannick, Béjot, Bayu, Begashaw, Michelle, L, Aminu, K, Derrick, A, James, R, Isabela, M, Jennifer, Benson, Adugnaw, Berhane, Derbew, Fikadu, Eduardo, Bernabé, Mircea, Beuran, Addisu, Shunu, Neeraj, Bhala, Anil, Bhansali, Soumyadeep, Bhaumik, Zulfiqar, A, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Peter, Bjerregaard, Christopher, D, Dube, Jara, Soufiane, Boufous, Rupert, R, Alexandra, Brazinova, Nicholas, J, Hermann, Brenner, Traolach, S, Gene, Bukhman, Lemma, Negesa, Blair, Randal, Michael, Burch, Zahid, A, Leah, E, Lucero, Cahuana Hurtado, Ismael, Ricardo, Josip, Car, Mate, Car, Rosario, Cárdenas, David, O, Juan, Jesus, Austin, Carter, Carlos, A, Jacqueline, Castillo, Franz, F, Ruben, Estanislao, Ferrán, Catalá López, Honglei, Chen, Peggy, Pei Chia, Mirriam, Chibalabala, Vesper, Hichilombwe, Abdulaal, A, Jee Young, Jasmine, Hanne, Christensen, Devasahayam, Jesudas, Liliana, G, Cirillo, Massimo, Aaron, J, Samantha, M, Josef, Coresh, Michael, H, Elizabeth, A, John, A., Haidong, Wang, Amanuel, Alemu, Kalkidan, Hassen, Cristiana, Abbafati, Kaja, M, Foad, Abd Allah, Semaw, Ferede, Haftom, Niguse, Laith, J, Niveen, M, Isaac, Akinkunmi, Rufus, Adesoji, Ifedayo, Morayo, Olatunji, Adetokunboh, Ashkan, Afshin, Rakesh, Aggarwal, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Muktar, Beshir, Amani, Nidhal, Ibthiel, Aichour, Miloud, Taki, Sneha, Aiyar, Ali, Shafqat, Tomi, F, Nadia, Akseer, Ayman, Al Eyadhy, Faris, Hasan, Samer, Alabed, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Deena, Alasfoor, Robert, William, Kefyalew, Addi, Samia, Alhabib, Raghib, Ali, Reza, Alizadeh Navaei, Syed, M, Juma, M, Ala’A, Alkerwi, François, Alla, Shalini, D, Peter, Allebeck, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Elena, Alvarez, Nelson, Alvis Guzman, Azmeraw, T, Emmanuel, A, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Nahla, Anber, Catalina, Liliana, Sofia, Androudi, Hossein, Ansari, Mustafa, Geleto, Carl, Abelardo, Palwasha, Anwari, Johan, Ärnlöv, Megha, Arora, Al, Artaman, Krishna, Kumar, Hamid, Asayesh, Solomon, Weldegebreal, Rana, Jawad, Reza, Assadi, Tesfay, Mehari, Sachin, R, Leticia, Avila Burgo, Euripide, Frinel, Ashish, Awasthi, Beatriz, Paulina, Tesleem, Kayode, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Shivanthi, Balalla, Aleksandra, Barac, Ryan, M, Miguel, A, Suzanne, L, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Bernhard, T, Shahrzad, Bazargan Hejazi, Neeraj, Bedi, Ettore, Beghi, Yannick, Béjot, Bayu, Begashaw, Michelle, L, Aminu, K, Derrick, A, James, R, Isabela, M, Jennifer, Benson, Adugnaw, Berhane, Derbew, Fikadu, Eduardo, Bernabé, Mircea, Beuran, Addisu, Shunu, Neeraj, Bhala, Anil, Bhansali, Soumyadeep, Bhaumik, Zulfiqar, A, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Peter, Bjerregaard, Christopher, D, Dube, Jara, Soufiane, Boufou, Rupert, R, Alexandra, Brazinova, Nicholas, J, Hermann, Brenner, Traolach, S, Gene, Bukhman, Lemma, Negesa, Blair, Randal, Michael, Burch, Zahid, A, Leah, E, Lucero, Cahuana Hurtado, Ismael, Ricardo, Josip, Car, Mate, Car, Rosario, Cárdena, David, O, Juan, Jesu, Austin, Carter, Carlos, A, Jacqueline, Castillo, Franz, F, Ruben, Estanislao, Ferrán, Catalá López, Honglei, Chen, Peggy, Pei Chia, Mirriam, Chibalabala, Vesper, Hichilombwe, Abdulaal, A, Jee Young, Jasmine, Hanne, Christensen, Devasahayam, Jesuda, Liliana, G, Cirillo, Massimo, Aaron, J, Samantha, M, Josef, Coresh, Michael, H, Elizabeth, A, and John, A.
Subjects: GBD, GBD, mortality, mortality
Abstract: Background Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Sociodemographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled.
Published: 2017

86. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author: Vos, Theo, Amanuel, Alemu, Abajobir, Cristiana, Abbafati, Kaja, M, Abbas, Kalkidan, Hassen, Abate, Foad, Abd Allah, Abdishakur, M, Abdulle, Teshome, Abuka, Abebo, Semaw, Ferede, Abera, Victor, Aboyans, Laith, J, Abu, Raddad, Ilana, N, Ackerman, Abdu, Abdullahi, Adamu, Olatunji, Adetokunboh, Mohsen, Afarideh, Ashkan, Afshin, Sanjay, Kumar, Agarwal, Rakesh, Aggarwal, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Hamid, Ahmadieh, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Sneha, Aiyar, Rufus, Olusola, Akinyemi, Nadia, Akseer, Faris, Hasan, Lami, Al, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Deena, Alasfoor, Kefyalew, Addis, Alene, Raghib, Ali, Reza, Alizadeh Navaei, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Fatma, Al Maskari, Rajaa, Al Raddadi, Ubai, Alsharif, Shirina, Alsowaidi, Khalid, A, Altirkawi, Azmeraw, Amare, T, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Hjalte, Andersen, H, Carl, Abelardo, Antonio, T, Palwasha, Anwari, Johan, Ärnlöv, Artaman, Al, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, W, Asgedom, Reza, Assadi, Tesfay, Mehari, Atey, Niguse, Tadele, Atnafu, Sachin, R, Atre, Leticia, Avila Burgos, Euripide, Frinel, Arthur, G, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Huda, Omer, Saleem, Ba, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Amitava, Banerjee, Marlena, S, Bannick, Aleksandra, Barac, Ryan, M, Barber, Suzanne, L, Barker, Collo, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Sanjay, Basu, Bob, Battista, Katherine, E, Battle, Bernhard, Baune, T, Shahrzad, Bazargan Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Yannick, Béjot, Bayu, Begashaw, Bekele, Michelle, Bell, L, Derrick, A, Bennett, Isabela, Bensenor, M, Jennifer, Benson, Adugnaw, Berhane, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Addisu, Shunu, Beyene, Neeraj, Bhala, Anil, Bhansali, Samir, Bhatt, Zulfiqar, A, Bhutta, Sibhatu, Biadgilign, Kelly, Bienhoff, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Bizuayehu, Dube, Jara, Boneya, Soufiane, Boufous, Rupert, R, Bourne, A, Alexandra, Brazinova, Traolach, S, Brugha, Rachelle, Buchbinder, Lemma, Negesa, Bulto, Bulto, Blair, R, Bumgarner, Zahid, Butt, A, Lucero, Cahuana Hurtado, Ewan, Cameron, Mate, Car, Hélène, Carabin, Jonathan, R, Carapetis, Rosario, Cárdenas, David, O, Carpenter, Juan, Jesus, Carrero, Austin, Carter, Felix, Carvalho, Daniel, C, Casey, Valeria, Caso, Carlos, A, Castañeda, Orjuela, Chris, D, Castle, Ferrán, Catalá López, Hsing Yi, Chang, Jung Chen, Chang, Fiona, J, Charlson, Honglei, Chen, Mirriam, Chibalabala, Chioma, Ezinne, Chibueze, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Devasahayam, Jesudas, Christopher, Liliana, G, Ciobanu, Cirillo, Massimo, Vos, Theo, Amanuel, Alemu, Abajobir, Cristiana, Abbafati, Kaja, M, Abbas, Kalkidan, Hassen, Abate, Foad, Abd Allah, Abdishakur, M, Abdulle, Teshome, Abuka, Abebo, Semaw, Ferede, Abera, Victor, Aboyan, Laith, J, Abu, Raddad, Ilana, N, Ackerman, Abdu, Abdullahi, Adamu, Olatunji, Adetokunboh, Mohsen, Afarideh, Ashkan, Afshin, Sanjay, Kumar, Agarwal, Rakesh, Aggarwal, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Hamid, Ahmadieh, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Sneha, Aiyar, Rufus, Olusola, Akinyemi, Nadia, Akseer, Faris, Hasan, Al, Lami, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Deena, Alasfoor, Kefyalew, Addi, Alene, Raghib, Ali, Reza, Alizadeh Navaei, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Fatma, Al Maskari, Rajaa, Al Raddadi, Ubai, Alsharif, Shirina, Alsowaidi, Khalid, A, Altirkawi, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Hjalte, H, Andersen, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Johan, Ärnlöv, Al, Artaman, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, W, Asgedom, Reza, Assadi, Tesfay, Mehari, Atey, Niguse, Tadele, Atnafu, Sachin, R, Atre, Leticia, Avila Burgo, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Huda, Omer, Ba, Saleem, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Amitava, Banerjee, Marlena, S, Bannick, Aleksandra, Barac, Ryan, M, Barber, Suzanne, L, Barker, Collo, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Sanjay, Basu, Bob, Battista, Katherine, E, Battle, Bernhard, T, Baune, Shahrzad, Bazargan Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Yannick, Béjot, Bayu, Begashaw, Bekele, Michelle, L, Bell, Derrick, A, Bennett, Isabela, M, Bensenor, Jennifer, Benson, Adugnaw, Berhane, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Addisu, Shunu, Beyene, Neeraj, Bhala, Anil, Bhansali, Samir, Bhatt, Zulfiqar, A, Bhutta, Sibhatu, Biadgilign, Kelly, Bienhoff, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Bizuayehu, Dube, Jara, Boneya, Soufiane, Boufou, Rupert, R, A, Bourne, Alexandra, Brazinova, Traolach, S, Brugha, Rachelle, Buchbinder, Lemma, Negesa, Bulto, Bulto, Blair, R, Bumgarner, Zahid, A, Butt, Lucero, Cahuana Hurtado, Ewan, Cameron, Mate, Car, Hélène, Carabin, Jonathan, R, Carapetis, Rosario, Cárdena, David, O, Carpenter, Juan, Jesus, Carrero, Austin, Carter, Felix, Carvalho, Daniel, C, Casey, Valeria, Caso, Carlos, A, Castañeda, Orjuela, Chris, D, Castle, Ferrán, Catalá López, Hsing Yi, Chang, Jung Chen, Chang, Fiona, J, Charlson, Honglei, Chen, Mirriam, Chibalabala, Chioma, Ezinne, Chibueze, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Devasahayam, Jesudas, Christopher, Liliana, G, Ciobanu, and Cirillo, Massimo
Subjects: GBD, GBD, years lived with disability, years lived with disability
Abstract: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. METHODS: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0-11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). INTERPRETATION: The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response.
Published: 2017

87. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author: Emmanuela, Gakidou, Ashkan, Afshin, Amanuel, Alemu, Abajobir, Kalkidan, Hassen, Abate, Cristiana, Abbafati, Kaja, M, Abbas, Foad, Abd Allah, Abdishakur, M, Abdulle, Semaw, Ferede, Abera, Victor, Aboyans, Laith, J, Abu Raddad, Niveen, M, E, Abu Rmeileh, Gebre, Yitayih, Abyu, Isaac, Akinkunmi, Adedeji, Olatunji, Adetokunboh, Mohsen, Afarideh, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Hamid, Ahmadieh, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Rufus, Olusola, Akinyemi, Nadia, Akseer, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Deena, Alasfoor, Kefyalew, Addis, Alene, Komal, Ali, Reza, Alizadeh Navaei, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis Guzman, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Hossein, Ansari, Josep, M, Antó, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Nicholas, Arian, Johan, Ärnlöv, Al, Artaman, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, Weldegebreal, Asgedom, Tesfay, Mehari, Atey, Leticia, Avila Burgos, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Shoshana, H, Ballew, Aleksandra, Barac, Ryan, M, Barber, Suzanne, L, Barker Collo, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Carolina, Batis, Katherine, E, Battle, Bernhard, T, Baune, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Michelle, L, Bell, Derrick, A, Bennett, James, R, Bennett, Isabela, M, Bensenor, Adugnaw, Berhane, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Addisu, Shunu, Beyene, Anil, Bhansali, Zulfiqar, A, Bhutta, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Christopher, D, Blosser, Dube, Jara, Boneya, Ibrahim, R, Bou Orm, Michael, Brauer, Nicholas, J, K, Breitborde, Hermann, Brenner, Traolach, S, Brugha, Lemma, Negesa, Bulto, Bulto, Blair, R, Baumgarner, Zahid, A, Butt, Lucero, Cahuana Hurtado, Rosario, Cárdenas, Juan, Jesus, Carrero, Carlos, A, Castañeda Orjuela, Ferrán, Catalá López, Kelly, Cercy, Hsing Yi, Chang, Fiona, J, Charlson, Odgerel, Chimed Ochir, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Hanne, Christensen, Devasahayam, Jesudas, Christopher, CIRILLO, Massimo, Aaron, J, Cohen, et, a.l., Emmanuela, Gakidou, Ashkan, Afshin, Amanuel, Alemu, Abajobir, Kalkidan, Hassen, Abate, Cristiana, Abbafati, Kaja, M, Abbas, Foad, Abd Allah, Abdishakur, M, Abdulle, Semaw, Ferede, Abera, Victor, Aboyan, Laith, J, Abu, Raddad, Niveen, M, E, Abu, Rmeileh, Gebre, Yitayih, Abyu, Isaac, Akinkunmi, Adedeji, Olatunji, Adetokunboh, Mohsen, Afarideh, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Hamid, Ahmadieh, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Rufus, Olusola, Akinyemi, Nadia, Akseer, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Deena, Alasfoor, Kefyalew, Addi, Alene, Komal, Ali, Reza, Alizadeh Navaei, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis Guzman, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Hossein, Ansari, Josep, M, Antó, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Nicholas, Arian, Johan, Ärnlöv, Al, Artaman, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, Weldegebreal, Asgedom, Tesfay, Mehari, Atey, Leticia, Avila Burgo, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Shoshana, H, Ballew, Aleksandra, Barac, Ryan, M, Barber, Suzanne, L, Barker, Collo, Till, Bärnighausen, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Carolina, Bati, Katherine, E, Battle, Bernhard, T, Baune, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Michelle, L, Bell, Derrick, A, Bennett, James, R, Bennett, Isabela, M, Bensenor, Adugnaw, Berhane, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Addisu, Shunu, Beyene, Anil, Bhansali, Zulfiqar, A, Bhutta, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Christopher, D, Blosser, Dube, Jara, Boneya, Ibrahim, R, Bou, Orm, Michael, Brauer, Nicholas, J, K, Breitborde, Hermann, Brenner, Traolach, S, Brugha, Lemma, Negesa, Bulto, Bulto, Blair, R, Baumgarner, Zahid, A, Butt, Lucero, Cahuana Hurtado, Rosario, Cárdena, Juan, Jesu, Carrero, Carlo, A, Castañeda, Orjuela, Ferrán, Catalá López, Kelly, Cercy, Hsing Yi, Chang, Fiona, J, Charlson, Odgerel, Chimed Ochir, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Hanne, Christensen, Devasahayam, Jesuda, Christopher, Cirillo, Massimo, Aaron, J, Cohen, and Et, a. l.
Subjects: GBD, risk, GBD, risk
Abstract: Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade.
Published: 2017

88. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013

Author: Yong Zhao, Hadi Danawi, Bach Xuan Tran, Gene Bukhman, Vasiliki Stathopoulou, Taavi Tillmann, Nelson Alvis-Guzman, Yongmei Li, Jerry Puthenpurakal Abraham, Sudan Prasad Neupane, Jack Caravanos, Ben Schöttker, Rafael Lozano, Damian G Hoy, Yoshihiro Kokubo, Nicholas J K Breitborde, Sergey Soshnikov, Yukito Shinohara, Randall V. Martin, Michael Brainin, Fernando Perez-Ruiz, Yingfeng Zheng, Santosh Mishra, Julio Cesar Montañez Hernandez, Michael Phillips, Belinda J. Gabbe, Hebe N. Gouda, Ziad A. Memish, Rupert R A Bourne, Guoqing Hu, Emmanuel A. Ameh, Abigail McLain, Michelle L. Bell, Christopher Margono, Marissa Iannarone, Wilkister N. Moturi, Donald H. Silberberg, Carl Abelardo T. Antonio, Nataliya Foigt, Anand Dayama, Yanping Wang, Amanda J. Mason-Jones, Bolajoko O. Olusanya, Monica S. Vavilala, Katherine B Gibney, David Tanne, Sidibe S Kany Roseline, Marcella Montico, Abhishek Singh, Sarah Derrett, Alireza Esteghamati, Seok Jun Yoon, Corine Karema, Rakhi Dandona, David M. Pereira, Kazem Rahimi, Gitanjali M. Singh, Vivekanand Jha, John Hornberger, Anne M. Riederer, Kathryn H. Jacobsen, Andrea Pedroza, Lily Alexander, Fiona M. Blyth, Tommi Vasankari, Kyle J Foreman, Rana J. Asghar, Tilahun Nigatu Haregu, Yousef Khader, Rafael Alfonso-Cristancho, Suzanne Barker-Collo, Lydia S. Atkins, Simerjot K. Jassal, Mohammad Ali Sahraian, Peter Scarborough, Hans W. Hoek, E. Ray Dorsey, Muluken Dessalegn, David C. Schwebel, Gavin Shaddick, Thomas D. Fleming, Mohammad Tavakkoli, Dorairaj Prabhakaran, Mohammad H. Forouzanfar, Christopher C. Mapoma, Jost B. Jonas, Erin C Mullany, Gene F. Kwan, Johanna M. Geleijnse, Antonio Luiz Pinho Ribeiro, Roberto Tchio Talongwa, Tolesa Bekele, Jed D. Blore, Gunn Marit Aasvang, Philimon Gona, Miguel Angel Alegretti, Babak Eshrati, Mitsuru Mukaigawara, Richard F. Gillum, Odgerel Chimed-Ochir, Ubai Alsharif, Richard C. Franklin, Felix Masiye, Richard T. Burnett, Sanjay Krishnaswami, Martin McKee, John J Huang, Lucía Cuevas-Nasu, Wagner Marcenes, Walid Ammar, Knud Juel, Joseph R. Zunt, Martha M Téllez Rojo, Mamta Swaroop, Noela M Prasad, Azmeraw T. Amare, Tim Driscoll, Michael Kravchenko, Heresh Amini, Amir Sapkota, Theo Vos, Charlotte Watts, Dennis Odai Laryea, D. Alex Quistberg, Justin Beardsley, Cheng Huang, Adnan M. Durrani, Sarah V Thackway, Rita Van Dingenen, Manami Inoue, Martha Híjar, Honglei Chen, Amany H. Refaat, Yichong Li, Vineet K. Chadha, Wenzhi Wang, Louisa Degenhardt, Kingsley N. Ukwaja, Nayu Ikeda, James D. Wilkinson, Linh N Bui, Maria Hagströmer, Gonghuan Yang, Ann Kristin Knudsen, David J. Margolis, Soewarta Kosen, Hans Kromhout, Atsushi Goto, Man Mohan Mehndiratta, Thomas N. Williams, Michael Soljak, Yun Jin Kim, Hideaki Toyoshima, Jeyaraj D Pandian, Borja del Pozo-Cruz, Soufiane Boufous, Ivy Shiue, Anders Larsson, Guilherme V. Polanczyk, John Powles, Yara A. Halasa, Robin Room, Ratilal Lalloo, Carolina Batis Ruvalcaba, Panniyammakal Jeemon, Elisabete Weiderpass, Jürgen Rehm, Ejaz Ahmad Khan, Alicia Aleman, Zacharie Tsala Dimbuene, Elena Alvarez, Rachelle Buchbinder, Randah R. Hamadeh, Bryan Hubbell, Sadaf G. Sepanlou, Farhad Islami, Costas A. Christophi, Heidi Stöckl, Ismael R. Campos-Nonato, Nigel Bruce, Edward J Mills, Samuel A L Perry, Taavi Lai, Baffour Awuah, Mete Saylan, Karen J. Courville, Arindam Basu, Vanessa De la Cruz-Góngora, Teresita González de Cosío, Naohiro Yonemoto, Frida Namnyak Ngalesoni, Muluken Azage Yenesew, Atte Meretoja, Michael Brauer, Cyrus Cooper, Giorgia Giussani, Valentina S. Arsic Arsenijevic, Vasiliy Victorovich Vlassov, André Karch, Leilei Duan, Matthew M Coates, Omid Ameli, Gelin Xu, Matthias Endres, Ganesan Karthikeyan, Ione Jayce Ceola Schneider, Mohamed Hsairi, Palwasha Anwari, Mazin J. Al Khabouri, Dariush Mozaffarian, Juan R. Sanabria, Pablo M. Lavados, Sumeet S. Chugh, Johan Ärnlöv, Ivo Rakovac, Maurice Giroud, Haidong Kan, Ibrahim Abdelmageem Mohamed Ginawi, José Luis Texcalac-Sangrador, Luigi Naldi, Erica Leigh Slepak, Deena Alasfoor, James E. Saunders, Richard Matzopoulos, Talal Bakfalouni, Stein Emil Vollset, Andrea Werdecker, Lennert J. Veerman, Lorenzo Monasta, Henrica A. F. M. Jansen, Reyna A Gutiérrez, Brittany Wurtz, Luz Maria Sanchez, Lijing L. Yan, M. Patrice Lindsay, Michele Meltzer, Sanjay Basu, Steven van de Vijver, Alaa Badawi, Thomas Claßen, Young-Ho Khang, Brett M. Kissela, Jun Zhu, In-Hwan Oh, Fiona J Charlson, Maria Cecilia Bahit, Dinorah González-Castell, Rosario Cárdenas, Dan Poenaru, Sayed Saidul Alam, Mitchell T. Wallin, Harish Chander Gugnani, James Leigh, Ferrán Catalá-López, Lidia Morawska, Jim van Os, Stephanie J. London, Kaire Innos, Isabelle Romieu, Fiorella Cavalleri, Adrian Davis, Hwee Pin Phua, Chakib Nejjari, Héctor Gómez Dantés, Boris I. Pavlin, Karen Sliwa, Lynne Gaffikin, Constance D. Pond, Michael F. MacIntyre, Blake Thomson, Norberto Perico, Ronny Westerman, Samantha M. Colquhoun, Michael H. Criqui, Ana Maria Nogales Vasconcelos, Wubegzier Mekonnen, Bulat Idrisov, Ana Basto-Abreu, Andrew G. M. Bulloch, Jasvinder A. Singh, Vinod K. Paul, Emin Murat Tuzcu, Svetlana Popova, Hmwe H Kyu, Richard L. Guerrant, Mohammed I. Albittar, Srikanth Mangalam, Steven E. Lipshultz, Lela Sturua, Semaw Ferede Abera, Eduardo Bernabé, George D. Thurston, Bruno F. Sunguya, Tiffany Ku, Alejandra G. Contreras, Abdullah Sulieman Terkawi, Charles Atkinson, Ashkan Afshin, Heidi J. Larson, Abdullatif Husseini, Jose C. Adsuar, Reza Assadi, Ademola Lukman Adelekan, Joshua A. Salomon, Yousef M. Elshrek, Gokalp Kadri Yentur, Devina Nand, Narayanaswamy Venketasubramanian, Graça Maria Ferreira De Lima, Maheswar Satpathy, Fotis Topouzis, Traolach S. Brugha, Hywel C Williams, Coen H. Van Gool, Andrew H. Kemp, Awoke Misganaw, Amado D Quezada, Norito Kawakami, Bert Brunekreef, Peter Burney, Tati S. Warouw, Jongmin Lee, Inga Dora Sigfusdottir, Marcel Tanner, Solveig A. Cunningham, Benjamin O. Anderson, Tariku Jibat Beyene, Lars Barregard, Xia Wan, Giuseppe Remuzzi, Bernadette Thomas, Lilia S Pedraza, Massimo Cirillo, Alina Rodriguez, Ricky Leung, Farshad Pourmalek, K. Srinath Reddy, Charles D.A. Wolfe, Ulrich O Mueller, Neeraj Bedi, Al Artaman, Lucia Hernandez, Itamar S. Santos, C. Arden Pope, Norlinah Mohamed Ibrahim, Carlo Irwin A. Panelo, Selen Begüm Uzun, Miltiadis K. Tsilimbaris, Anwar Rafay, Daniel Dicker, Melvin Barrientos Marzan, Sajjad Ur Rahman, Mohammed O. Basulaiman, Edgar P. Simard, Mohammad T Mashal, Maysaa El Sayed Zaki, Shiwei Liu, Don C. Des Jarlais, Bo Norrving, Salvador Villalpando, Miia Kivipelto, Yang Liu, Carolina Maria Teixeira, Catalina Medina, Sudha Jayaraman, Josep Maria Haro, Diego De Leo, Angel J Paternina Caicedo, Abigail C. McKay, Eric L. Ding, Mukesh Dherani, Ljiljana Pejin Stokic, Vinay Nangia, Sukanta Saha, Juan Liang, Elisabeth Cardis, Zourkaleini Younoussi, José R Nogueira, Braden Te Ao, Vasco Manuel Pedro Machado, Lionel Racapé, Ting Wu Chuang, Shahab Khatibzadeh, E Filipa de Castro, Barthelemy Kuate Defo, Ulises Trujillo, Alan D. Lopez, Soraya Seedat, Lope H Barrero, Linhong Wang, Daniel Pope, Alexandra Brazinova, Faris Lami, Valentina Colistro, G Anil Kumar, Derek F J Fay, Haidong Wang, Hwashin H. Shin, Raimundas Lunevicius, Suzanne Polinder, Dietrich Plass, David Rojas-Rueda, Stephen S Lim, Tania G Sánchez-Pimienta, K.M. Venkat Narayan, Yuantao Hao, Jung-Chen Chang, Corina Benjet, Seyed-Mohammad Fereshtehnejad, Luciano A. Sposato, Stan Biryukov, Kunihiro Matsushita, Beth E. Ebel, Cleusa P. Ferri, Soumya Swaminathan, K. Ryan Wessells, Gustavo Velasquez-Melendez, Leslie T. Cooper, David O. Carpenter, Nancy Lopez, Bryan L. Sykes, Sandra Nolte, Murray B. Stein, Paul N. Jensen, Fabiola Mejía-Rodríguez, Xiaonong Zou, Bradford D. Gessner, Dhruv S. Kazi, Dragos Virgil Davitoiu, Alejandra Jáuregui, Pouria Heydarpour, Megan Bohensky, Harvey Whiteford, Berrak Bora Basara, Zhengming Chen, Gregory R. Wagner, Paul I. Dargan, Hermann Brenner, Nima Hafezi-Nejad, John Nelson Opio, Scott Weichenthal, Deborah Salvo, Jun She, Tea Lallukka, Carolyn C. Gotay, Stephen G. Waller, Christian Kieling, Shivanthi Balalla, Valery L. Feigin, Qing Lan, Matias Trillini, Adam D M Briggs, Sungroul Kim, Niveen M E Abu-Rmeileh, Renata Micha, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Zulfiqar A Bhutta, Paul S. F. Yip, Grant Nguyen, Ralph L. Sacco, Biju Abraham, Ken Takahashi, Jixiang Ma, Peter A. Meaney, Ayse Abbasoglu Ozgoren, Kimberly Cooperrider, M Rifat Kose, Shams Eldin Ali Hassan Khalifa, Rasmus Havmoeller, Alize J. Ferrari, Kebede Deribe, Nadim E. Karam, George A. Mensah, Bongani M. Mayosi, Konrad Pesudovs, Joanna Moschandreas, Ziad Nahas, James Damsere-Derry, Nsanzimana Sabin, Tonatiuh Barrientos-Gutiérrez, Ying Jiang, Andre Pascal Kengne, Peter Allebeck, Jonas Minet Kinge, Shankuan Zhu, Guy B. Marks, Daniel C Casey, Marco A Avila, Anna Roca, Lalit Dandona, Ami R. Moore, Adansi A. Amankwaa, David Gunnell, Andre Keren, Yohannes Adama Melaku, Nhung T Nguyen, Anthony D. Woolf, Mayuree Rao, Peter J. Allen, Christina Papachristou, Karzan Abdulmuhsin Mohammad, Ravi Kumar Balu, Marie Ng, Marcello Tonelli, Maziar Moradi-Lakeh, Maigeng Zhou, Emmanuela Gakidou, Mohammed K. Ali, Amanda W Pain, Dan J. Stein, Kawkab Shishani, Fortuné Gbètoho Gankpé, Howard J. Hoffman, James Scott, Nadine Steckling, Samia Alhabib, Deborah Jarvis, Kara Estep, Arsène Kouablan Adou, Ricardo Orozco, Holly Hagan, K. C. Astha, Reza Malekzadeh, Klara Dokova, Aliya Naheed, Ernst J. Kuipers, Valeria Caso, Derrick A Bennett, Andrea B. Feigl, Uche S. Uchendu, Holly E. Erskine, Shireen Sindi, Arjun Lakshmana Balaji, Francesco Saverio Violante, Monika Sawhney, Alejandra Cantoral, Ketevan Goginashvili, Raghib Ali, Fan Jiang, Robert G. Weintraub, Homie Razavi, Myriam Tobollik, Howard Hu, Emerito Jose A. Faraon, Irma Khonelidze, Patricia M. Riccio, Eun-Kee Park, Julio Cesar Campuzano, Ibrahim Abubakar, Jürgen C Schmidt, Konstantinos Stroumpoulis, Aref A. Bin Abdulhak, Graeme J. Hankey, Natan M. Bornstein, Mouhanad Hammami, Lee Richardson, Rintaro Mori, Alanur Çavlin, Ruth W Kimokoti, Samir Soneji, Mark J. Nieuwenhuijsen, John Q. Wong, Joseph Frostad, Tom Achoki, Rahman Shiri, Ashish Bhalla, Kurt Straif, Simon I. Hay, Scott B. Patten, Kalpana Balakrishnan, Awoke Misganaw Temesgen, Chandrashekhar T Sreeramareddy, Ryan M Barber, Rosana E. Norman, JianLi Wang, Siyi Shangguan, Luke Nyakarahuka, Kovin Naidoo, Charles D. H. Parry, Mercedes Colomar, H. Ross Anderson, Carlos Magis-Rodriguez, Joan M. Nolla, Muhammad Imran Nisar, Karen Devries, Andrew L. Thorne-Lyman, Denis Nash, Marape Marape, Rajiv Chowdhury, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Daniel Kim, Yuichiro Yano, Luke D. Knibbs, Margaret Robinson, Hilda L Harb, Rogelio Pérez-Padilla, Janet L Leasher, Jonathan L. Wright, Peter Brooks, Cristiana Abbafati, Belinda K Lloyd, Victor Aboyans, Nikhil Tandon, Charles R. Newton, Simón Barquera, Ted R. Miller, Kinnari S. Murthy, Habib Benzian, Glen Mola, Paulo A. Lotufo, Burcu Kucuk Bicer, Peggy Pei-Chia Chiang, Alexander Kraemer, Solomon Meseret Woldeyohannes, Saman Fahimi, Lesley Rushton, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Logan Sandar, Bruce Neal, Teresa Shamah Levy, Karen M. Tabb, Jeffrey A. Towbin, Christopher J L Murray, Ramesh Sahathevan, Aaron Cohen, Chanda Kulkarni, Van C. Lansingh, François Alla, Tasara T. Mazorodze, Murugesan Raju, Saeid Shahraz, Uchechukwu K.A. Sampson, Rajeev Gupta, Neil Pearce, Mustafa Z. Younis, Veena S. Kulkarni, Francisco A García-Guerra, Amanda G. Thrift, Stefan Ma, Samaya Ismayilova, Evariste Gasana, Amitava Banerjee, Aslam Pervaiz, Emilie Agardh, Abraham D. Flaxman, Farshad Farzadfar, Peter W. Gething, Ileana Heredia-Pi, Boris Bikbov, Wanqing Chen, Saad B. Omer, Ruben Castro, Neeraj Bhala, Sara Sheikhbahaei, Hilton Lam, Urbano Fra Paleo, Lidia Sanchez-Riera, Alicia Elena Beatriz Lawrynowicz, Kristen Delwiche, Richard G. Ellenbogen, Max Petzold, Yuri Y Varakin, Guilherme Borges, Guohong Jiang, Francis Guillemin, Kyle R. Heuton, Yohannes Kinfu, Victoria F Bachman, Joseph A Wagner, Carlos A Castañeda-Orjuela, Leonardo Trasande, Abbas Ali Mahdi, Josef Coresh, Chuanhua Yu, Kenji Shibuya, Berrin Serdar, Laetitia Huiart, Xiaofeng Liang, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Natalie Stephens, Francis Apolinary Mhimbira, Jefferson Traebert, Amiran Gamkrelidze, Kjetil Søreide, Samath D Dharmaratne, Robert P. Dellavalle, George Mugambage Ruhago, Lakshmi Vijayakumar, Joannie Lortet-Tieulent, Dipan Bose, Tania C Aburto, Saleem M Rana, Miriam Levi, Mohammad Taghi Hedayati, Rodolfo S Pagcatipunan, Ron T. Gansevoort, H. D. Hosgood, Michael Burch, Mohsen Naghavi, Vegard Skirbekk, Ayfer Pekericli, Walter Mendoza, Pengpeng Ye, Gabrielle deVeber, Ali H. Mokdad, David M. Broday, Koranteng Adofo, Zewdie Aderaw Alemu, Shifalika Goenka, Carrie Beth Peterson, Nicolas J. C. Stapelberg, Edson Serván-Mori, Anil Kaul, Foad Abd-Allah, Marek Majdan, Rahul Gupta, Giancarlo Logroscino, Kardiyoloji, Peterson, Carrie B., Laboratoire de Physique des Solides (LPS), Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Wisconsin Division of Public Health, Laboratoire de psychologie sociale et de psychologie cognitive (LAPSCO), Centre National de la Recherche Scientifique (CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP), Erosion torrentielle neige et avalanches (UR ETGR (ETNA)), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), London South Bank University, Metropolitan Police Service, Hong Kong Baptist University (HKBU), Institut für Informatik [München/Munich] (LMU), Ludwig-Maximilians-Universität München (LMU), Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Insight Centre for Data Analytics [Galway] (INSIGHT), National University of Ireland [Galway] (NUI Galway), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Karolinska Institute, karolinska institute, Department of Molecular Biosciences, Department of Molecular Biosciences [Oslo], Faculty of Mathematics and Natural Sciences [Oslo], University of Oslo (UiO)-University of Oslo (UiO)-Faculty of Mathematics and Natural Sciences [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Centro de Estudios Avanzados en Zonas Aridas (CEAZA), Ecole Polytechnique Fédérale de Lausanne (EPFL), Regional Genetic Service, St Mary's Hospital, Manchester, Laboratoire d'Ingénierie des Matériaux (LIM), Centre National de la Recherche Scientifique (CNRS), Computer Science Department [Bristol], University of Bristol [Bristol], Universität Mannheim [Mannheim], Lawrence Berkeley National Laboratory [Berkeley] (LBNL), Samsung Research &Development Institute India - Bangalore (Groupe Samsung) (SRI-B), Computational Science and Engineering Department [Daresbury] (STFC), Science & Technologie Facilities Council, Multimedia Research Center (MRC), University of Alberta, Division of Biostatistics (Biostat - MINNEAPOLIS), University of Minnesota [Twin Cities], University of Minnesota System-University of Minnesota System, University of Southampton, Imperial College London, Neurology Department, Ichilov Medical Center, Interactions, transferts, ruptures artistiques et culturels - EA 6301 (InTRu), Université de Tours, Institut Jacques Monod (IJM (UMR_7592)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Risk Assessment Sciences Institute, Utrecht University [Utrecht], Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Respiratory Epidemiology and Public Health, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], CIBER de Epidemiología y Salud Pública (CIBERESP), STAR laboratory, Stanford University [Stanford], Unité de recherche Virologie et Immunologie Moléculaires (VIM), Institut National de la Recherche Agronomique (INRA), Tennent Institute of Ophthalmology, National University of Singapore (NUS), Centre de Robotique (CAOR), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Multidisciplinary Nanotechnology Centre, Swansea University, Cyprus International Institute for the Environment and Public Health, Harvard School of Public Health, Genomics Research Center, Academia Sinica, Neuro Rehab Services LLP [New Delhi], Department of Signal Theory and Communications (TSC), Univ. Politec. de Catalunya, King‘s College London, Dept. Mat. Engn. De Ma, Sao Carlos, Fed. Univ. Sao Carlos UFSCar, RESPEC (RESPEC), RESPEC, Advanced Laboratories on Embedded Systems [Roma] (ALES), Department of Biology [Miami], University of Miami [Coral Gables], Health Care, Minister Of Labour-Ministry of Labor, Health and Social Affairs, Department of Nephrology, University Medical Center, University of Groningen, Division of Human Nutrition, Wageningen University and Research Centre [Wageningen] (WUR), Spatial Ecology and Epidemiology Group, University of Oxford [Oxford], College of Medicine, University of Hail, Saudi Arabia, Laboratory of Neurologic Diseases, Mario Negri Institute, Milan, Department of Civil Engineering [Hamirpur], National Institute of Technology [Hamirpur], GEMMA — Environmental Engineering and Microbiology Research Group, Department of Hydraulic, Maritime and Environmental Engineering, Universitat Politècnica de Catalunya [Barcelona] (UPC), Department of Biosciences and Nutrition, Karolinska Institutet [Stockholm], Institut National de Recherche et d'Analyse Physico-Chimique (INRAP), Institut National de Recherche et d'Analyse Physico-chimique (Ariana, Tunisie) (INRAP), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Shahid Beheshti University-Shahid Beheshti University, Center for Applied Medical Research (CIMA), University of Tehran, Secretariat of the Pacific Community, Public Health Division, Sociétés, Acteurs, Gouvernement en Europe (SAGE), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), College of Precision Instrument and Optoelectronics Engineering, Tianjin University, George Washington University (GW), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universiteit Gent [Ghent], Washington State University (WSU), Laboratoire de Physique de l'ENS Lyon (Phys-ENS), École normale supérieure - Lyon (ENS Lyon)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institut de recherche en informatique de Toulouse (IRIT), Université Toulouse 1 Capitole (UT1)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, School of Computer Science - China University of Geosciences (China University of Geosciences (East Area)), Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Université Catholique de Louvain (UCL), Fachbereich Physik [Berlin], Freie Universität Berlin, Div Cyclotron & Radiopharmaceut Sci (DRDO, INMAS), Univ New Delhi, School of Physics and Astronomy, University of St Andrews [Scotland], University of Cape Town, Department of Neuroscience, Department of Computer Science and Engineering [Daejeon] (Chungnam National University), Lawrence University, Gastroenterology & Hepatology, Tata Research Development and Design Center (TRDDC), TCS Innovation Labs, University of Helsinki, Google Inc [Mountain View], Research at Google, Swedish Defense Research Agency (FOI), Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Novartis Pharmaceutical Corporation, Laboratoire de glaciologie et géophysique de l'environnement (LGGE), Observatoire des Sciences de l'Univers de Grenoble [1985-2015] (OSUG [1985-2015]), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Department of Mechanical and Automation Engineering (CAD Laboratory), The Chinese University of Hong Kong [Hong Kong], Università degli studi di Bari, Department of Health and Human Services, National Institutes of Health [Bethesda] (NIH), Centre d'études et de recherche en informatique et communications (CEDRIC), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise (ENSIIE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Heuristique et Diagnostic des Systèmes Complexes [Compiègne] (Heudiasyc), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), College of Information and Electrical Engineering [Beijing] (CIEE), China Agricultural University (CAU), Thales Research and Technology [Palaiseau], THALES, Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Centre d'économie de la Sorbonne (CES), Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS), Paris School of Economics (PSE), École supérieure du professorat et de l'éducation - Académie de Grenoble [2013-2019] (ESPE Grenoble [2013-2019]), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Mathematics, University of Iowa [Iowa City], College of Medicine, Alfaisal University, Saudi Ministry of Health, Institut national des recherches agricoles du Bénin, Centre de Recherches agricoles du Sud, Departments of Epidemiology and Nutrition, Unit of Human Nutrition, Agricultural University of Athens, Department of Animal Science, Pennsylvania State University (Penn State), Penn State System-Penn State System, University of Virginia, University of Virginia [Charlottesville], Epidemiology and Biostatistics Unit, Institute for Maternal and Child Health - IRCCS ‘‘Burlo Garofolo', Jet Propulsion Laboratory (JPL), NASA-California Institute of Technology (CALTECH), Division of Cardiovascular Medicine and Channing Division of Network Medicine, Brigham and Women's Hospital [Boston], American University of Beirut [Beyrouth] (AUB), Department of Chemistry, Scientific Computing Research Unit, Department of dermatology, Milano University-Azienda Ospedaleria Ospedali Riuniti di Bergamo, Mailman School of Public Health, Columbia University [New York], The Georges Institute for International Health, The University of Sydney, Department of epidemiology and Public Health, Faculty of Medicine, Département Optique (OPT), Université européenne de Bretagne - European University of Brittany (UEB)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT), Laboratoire des signaux et systèmes (L2S), Université Paris-Sud - Paris 11 (UP11)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Universitat Pompeu Fabra [Barcelona], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Nutriments Lipidiques et Prévention des Maladies Métaboliques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université de la Méditerranée - Aix-Marseille 2, Department of Neurology Lunds University Hospital Lund, Unit of Functional Bionanomaterials, School of Biosciences, University of Birmingham [Birmingham], Electrical Engineering and Computer Science Department - Case Western Reserve University, Case Western Reserve University [Cleveland], World Health Organization, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Nordic School of Public Health, The James Hutton Institute, Horia Hulubei National Institute for Physics and Nuclear Engineering, Department of Pediatrics, University of Washington [Seattle], Institute of Public Health, Department of Physics, Clarendon Laboratory, Center for TeleInFrastruktur (CTIF), Aalborg University [Denmark] (AAU), Physikalisches Institut [Freiburg], Albert-Ludwigs-Universität Freiburg, Savoirs, Textes, Langage (STL) - UMR 8163 (STL), Centre National de la Recherche Scientifique (CNRS)-Université de Lille, Dept.of Computer Science, Indian Institute of Technology Madras (IIT Madras), Istituto Mario Negri Bergamo, Centro Ricerche e Trapianti Villa Camozzi, Universidade Estadual Paulista Júlio de Mesquita Filho [São José do Rio Preto] (UNESP), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Institut geològic de Catalunya (IGC), Institut Geològic de Catalunya-IGC, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physiologie et Génomique des Poissons (LPGP), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Recherche Agronomique (INRA), Politecnico di Milano [Milan] (POLIMI), Symantec, University of Oviedo, European Microsoft Innovation Center (EMIC), Microsoft Corporation [Redmond, Wash.], Technion - Israel Institute of Technology [Haifa], Laboratoire de Mécanique, Physique et Géosciences (LMPG), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU), Department of Physics, Cavendish Laboratory, University of Cambridge [UK] (CAM), Laboratoire de Probabilités et Modèles Aléatoires (LPMA), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Departments of Applied Physics [New Haven], Yale University [New Haven], Center for Mathematical Modeling (CMM), Department of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM), University of Occupational and Environmental Health [Kitakyushu] (UEOH), Department of Computer Science and Engineering [New Delhi], Indian Institute of Technology Delhi (IIT Delhi), Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), GlaxoSmithKline, Imperial College London-Clinical Imaging Center, Universidade Federal de Pernambuco [Recife] (UFPE), Maclean Building, Benson Lane, Crowmarsh Gifford, Centre for Ecology and Hydrology, Nanoscience Institute (NEST), Dipartimento di Fisica, Università di Pisa, Aristotle University of Thessaloniki, Laboratory Of Immune Cell Biology (LICB), JRC Institute for Environment and Sustainability (IES), European Commission - Joint Research Centre [Ispra] (JRC), Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Laboratorio Nacional de Computação Cientifica [Rio de Janeiro] (LNCC / MCT), Occupational Health Unit, Bologna University Hospital-Sant'Orsola-Malpighi Polyclinic, Royal Institute of Technology [Stockholm] (KTH ), NICTA [Eveleigh], National ICT Australia [Sydney] (NICTA), Division of Solid Mechanics, Lund University [Lund], University of Calgary, BioWare Corp, Manchester Academic Health Sciences Centre, Institut d'Histoire et de Philosophie des Sciences et des Techniques (IHPST), Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS)-Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Ghent University [Belgium] (UGENT), Imaging Sciences and Biomedical Engineering Division [London], Guy's and St Thomas' Hospital [London]-King‘s College London, Children’s Hospital of Philadelphia (CHOP ), Perelman School of Medicine, University of Pennsylvania [Philadelphia], Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Génie Civil et Mécanique (GeM), Université de Nantes - Faculté des Sciences et des Techniques, Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Department of Physiology, Augusta University - Medical College of Georgia, University System of Georgia (USG)-University System of Georgia (USG), Neurorestoration Group, Wolfson Centre for Age-related Diseases-King‘s College London, Electronic Navigation Research Institute (ENRI), Ministry of Land, Infrastructure, Transport and Tourism, Department of Computer Science [KAIST] (CS), Korea Advanced Institute of Science and Technology (KAIST), Centre for Undergraduate Studies, University of the Punjab, Siemens Corporate Research, Siemens AG [Munich], University of Massachusetts [Boston] (UMass Boston), University of Massachusetts System (UMASS), Department of Materials Science, Sichuan University [Chengdu] (SCU), Natl Engn Res Ctr Vegetables, Key Lab Biol & Genet Improvement Hort Crops N Chi, Beijing Acad Agr & Forestry Sci, University Hospital Puerta de Hierro, Madrid, Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), MINES ParisTech - École nationale supérieure des mines de Paris-PSL Research University (PSL), Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Shahid Beheshti University of Medical Sciences, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), MOLTECH-ANJOU (MOLTECH-ANJOU), Université d'Angers (UA)-Centre National de la Recherche Scientifique (CNRS), Universidad de Santiago de Chile [Santiago] (USACH)-Universidad del Desarrollo, Observatoire des Sciences de l'Univers de Grenoble (OSUG), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS), École supérieure du professorat et de l'éducation - Académie de Grenoble (ESPE Grenoble), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Université Grenoble Alpes (UGA), California Institute of Technology (CALTECH)-NASA, Centre National de la Recherche Scientifique (CNRS)-CentraleSupélec-Université Paris-Sud - Paris 11 (UP11), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Universidad de Santiago de Chile [Santiago] (USACH), École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris), King‘s College London-Wolfson Centre for Age-related Diseases, Sichuan University, Universitat de Barcelona, Interne Geneeskunde, Medische Sociologie, MUMC+: MA Psychiatrie (3), MUMC+: Hersen en Zenuw Centrum (3), Psychiatrie & Neuropsychologie, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national des sciences de l'Univers (INSU - CNRS)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national des sciences de l'Univers (INSU - CNRS)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut Mines-Télécom [Paris] (IMT)-Télécom Bretagne-Université européenne de Bretagne - European University of Brittany (UEB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), RS: MHeNs - R2 - Mental Health, Laboratoire de Physique des Solides ( LPS ), Université Paris-Sud - Paris 11 ( UP11 ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de psychologie sociale et de psychologie cognitive ( LAPSCO ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ), Erosion torrentielle neige et avalanches ( UR ETGR ), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture ( IRSTEA ), Hong Kong Baptist University ( HKBU ), Institut für Informatik [München/Munich] ( LMU ), Ludwig-Maximilians-Universität München, Neuroépidémiologie Tropicale ( NET ), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ), Insight Centre for Data Analytics (National University of Ireland Galway (NUIG)) ( INSIGHT ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), University of Oslo ( UiO ) -University of Oslo ( UiO ), Centro de Estudios Avanzados en Zonas Aridas ( CEAZA ), Ecole Polytechnique Fédérale de Lausanne ( EPFL ), Laboratoire d'Ingénierie des Matériaux ( LIM ), Centre National de la Recherche Scientifique ( CNRS ), Lawrence Berkeley National Laboratory [Berkeley] ( LBNL ), Samsung Research &Development Institute India - Bangalore (Groupe Samsung) ( SRI-B ), Computational Science and Engineering Department [Daresbury] ( STFC ), Multimedia Research Center ( MRC ), University of Alberta [Edmonton], Division of Biostatistics ( Biostat - MINNEAPOLIS ), University of Minnesota [Minneapolis], University of Southampton [Southampton], Interactions, transferts, ruptures artistiques et culturels - EA 6301 ( InTRu ), Institut Jacques Monod ( IJM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), University Medical Center Utrecht, Biologie Fonctionnelle et Adaptative ( BFA ), Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, Unité de recherche Virologie et Immunologie Moléculaires ( VIM ), Institut National de la Recherche Agronomique ( INRA ), National University of Singapore ( NUS ), Centre de Robotique ( CAOR ), MINES ParisTech - École nationale supérieure des mines de Paris-PSL Research University ( PSL ), Department of Signal Theory and Communications ( TSC ), RESPEC ( RESPEC ), Advanced Laboratories on Embedded Systems [Roma] ( ALES ), Wageningen University and Research Centre [Wageningen] ( WUR ), Universitat Politècnica de Catalunya [Barcelona] ( UPC ), Institut National de Recherche et d'Analyse Physico-Chimique ( INRAP ), Institut National de Recherche et d'Analyse Physico-chimique (INRAP-Tunisie), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) ( FEMTO-ST ), Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Ecole Nationale Supérieure de Mécanique et des Microtechniques ( ENSMM ) -Université de Technologie de Belfort-Montbeliard ( UTBM ), Tehran University, Sociétés, Acteurs, Gouvernement en Europe ( SAGE ), Université de Strasbourg ( UNISTRA ) -Centre National de la Recherche Scientifique ( CNRS ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Washington State University ( WSU ), Laboratoire de Physique de l'ENS Lyon ( Phys-ENS ), École normale supérieure - Lyon ( ENS Lyon ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Institut des Sciences Chimiques de Rennes ( ISCR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Ecole Nationale Supérieure de Chimie de Rennes-Institut National des Sciences Appliquées ( INSA ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de recherche en informatique de Toulouse ( IRIT ), Institut National Polytechnique [Toulouse] ( INP ) -Université Toulouse 1 Capitole ( UT1 ) -Université Toulouse - Jean Jaurès ( UT2J ) -Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Automatique de Nancy ( CRAN ), Université de Lorraine ( UL ) -Centre National de la Recherche Scientifique ( CNRS ), Université Catholique de Louvain ( UCL ), Freie Universität Berlin [Berlin], Div Cyclotron & Radiopharmaceut Sci ( DRDO, INMAS ), Institut de Physique Nucléaire d'Orsay ( IPNO ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Tata Research Development and Design Center ( TRDDC ), Laboratoire MOLTECH-Anjou [Angers] ( MOLTECH ANJOU ), Université d'Angers ( UA ) -Centre National de la Recherche Scientifique ( CNRS ), University of Helsinki [Helsinki], Swedish Defense Research Agency ( FOI ), Servicio de Neurologia ( SANTIAGO - Neurologie ), Universidad de Santiago de Chile [Santiago] ( USACH ) -Universidad del Desarrollo, Novartis Pharmaceutical Corp., East Hanover NJ 07936, USA, Laboratoire de glaciologie et géophysique de l'environnement ( LGGE ), Observatoire des Sciences de l'Univers de Grenoble ( OSUG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Centre National de la Recherche Scientifique ( CNRS ), Department of Mechanical and Automation Engineering ( CAD Laboratory ), National Institutes of Health ( NIH ), Centre d'étude et de recherche en informatique et communications ( CEDRIC ), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise ( ENSIIE ) -Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Heuristique et Diagnostic des Systèmes Complexes [Compiègne] ( Heudiasyc ), Université de Technologie de Compiègne ( UTC ) -Centre National de la Recherche Scientifique ( CNRS ), College of Information and Electrical Engineering [Beijing] ( CIEE ), China Agricultural University ( CAU ), Queen Mary University of London ( QMUL ), Centre d'économie de la Sorbonne ( CES ), Université Panthéon-Sorbonne ( UP1 ) -Centre National de la Recherche Scientifique ( CNRS ), Paris School of Economics ( PSE ), École supérieure du professorat et de l'éducation - Académie de Grenoble ( ESPE Grenoble ), Université Savoie Mont Blanc ( USMB [Université de Savoie] [Université de Chambéry] ) -Université Grenoble Alpes ( UGA ), PennState University [Pennsylvania] ( PSU ), Jet Propulsion Laboratory ( JPL ), NASA-California Institute of Technology ( CALTECH ), American University of Beirut [Beyrouth], The University of Sydney [Sydney], Département Optique ( OPT ), Université européenne de Bretagne ( UEB ) -Télécom Bretagne-Institut Mines-Télécom [Paris], Laboratoire des signaux et systèmes ( L2S ), Université Paris-Sud - Paris 11 ( UP11 ) -CentraleSupélec-Centre National de la Recherche Scientifique ( CNRS ), Center for Research in Environmental Epidemiology ( CREAL ), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for TeleInFrastruktur ( CTIF ), Aalborg University [Denmark] ( AAU ), Savoirs, Textes, Langage (STL) - UMR 8163 ( STL ), Université de Lille-Centre National de la Recherche Scientifique ( CNRS ), Indian Institute of Technology Madras ( IIT Madras ), Universidade Estadual Paulista Júlio de Mesquita ( UNESP ), Laboratoire de Génie Informatique et Ingénierie de Production ( LGI2P ), IMT - Mines Alès Ecole Mines - Télécom ( IMT - MINES ALES ), Institut geològic de Catalunya ( IGC ), Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Physiologie et Génomique des Poissons ( LPGP ), Institut National de la Recherche Agronomique ( INRA ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Politecnico di Milano [Milan], European Microsoft Innovation Center ( EMIC ), Laboratoire de Mécanique, Physique et Géosciences ( LMPG ), Université Le Havre Normandie ( ULH ), Normandie Université ( NU ) -Normandie Université ( NU ), University of Cambridge [UK] ( CAM ), Laboratoire de Probabilités et Modèles Aléatoires ( LPMA ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Génétique et de Biologie Moléculaire et Cellulaire ( IGBMC ), Université de Strasbourg ( UNISTRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Center for Mathematical Modeling ( CMM ), Universidad de Santiago de Chile [Santiago] ( USACH ), London School of Hygiene and Tropical Medicine ( LSHTM ), University of Occupational and Environmental Health [Kitakyushu] ( UEOH ), Indian Institute of Technology Delhi ( IIT Delhi ), Institut de Recherche sur les Phénomènes Hors Equilibre ( IRPHE ), Aix Marseille Université ( AMU ) -Ecole Centrale de Marseille ( ECM ) -Centre National de la Recherche Scientifique ( CNRS ), Universidade Federal de Pernambuco [Recife] ( UFPE ), Nanoscience Institute ( NEST ), Laboratory Of Immune Cell Biology ( LICB ), JRC Institute for Environment and Sustainability ( IES ), European Commission - Joint Research Centre [Ispra] ( JRC ), Bonn Universität [Bonn], Laboratorio Nacional de Computação Cientifica [Rio de Janeiro] ( LNCC / MCT ), Royal Institute of Technology [Stockholm] ( KTH ), National ICT Australia [Sydney] ( NICTA ), Institut d'Histoire et de Philosophie des Sciences et des Techniques ( IHPST ), Université Panthéon-Sorbonne ( UP1 ) -Département d'Etudes Cognitives - ENS Paris ( DEC ), École normale supérieure - Paris ( ENS Paris ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ), Ghent University [Belgium] ( UGENT ), Children’s Hospital of Philadelphia ( CHOP ), Univeristy of Pennsylvania Medical School, Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique ( LHEEA ), École Centrale de Nantes ( ECN ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche en Génie Civil et Mécanique ( GeM ), Université de Nantes ( UN ) -École Centrale de Nantes ( ECN ) -Centre National de la Recherche Scientifique ( CNRS ), Medical College of Georgia, Electronic Navigation Research Institute ( ENRI ), Department of Computer Science [KAIST] ( CS ), Korea Advanced Institute of Science and Technology ( KAIST ), Laboratoire de l'Accélérateur Linéaire ( LAL ), University of Massachusetts [Boston] ( UMass Boston ), Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H. Ro, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, Kc, Astha, Kyu, Hmwe H, Moradi Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu Rmeileh, Niveen M. E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, Françoi, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charle, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker Collo, Suzanne L, Barquera, Simon, Barregard, Lar, Barrero, Lope H, Barrientos Gutierrez, Tonatiuh, Basto Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Bati, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Bori, Abdulhak, Aref A. Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D. M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G. J, Campos Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda Orjuela, Carlos A, Castro, Ruben E, Catalá López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung Chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas Kd, Colistro, Valentina, Colomar, Mercede, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyru, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas Nasu, Lucia, Damsere Derry, Jame, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E. Filipa, De la Cruz Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, Del Pozo Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. De, Dessalegn, Muluken, Deveber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthia, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F. 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Subjects: Male, Fine particulate matter, Nutrition and Disease, MESH : Sanitation, Health Behavior, Diseases, MESH: Metabolic Diseases, MESH: Global Health, 030204 cardiovascular system & hematology, MESH: Risk Assessment, Global Health, MESH : Nutritional Status, MESH: Occupational Exposure, 0302 clinical medicine, Unsafe Sex, MESH: Risk Factors, Risk Factors, Voeding en Ziekte, Medicine, Air-pollution, MESH : Female, 030212 general & internal medicine, MESH : Risk Assessment, Sanitation, Wasting, 2. Zero hunger, Factors de risc en les malalties, Medicine (all), [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, MESH : Occupational Diseases, MESH: Nutritional Status, All-cause mortality, MESH : Risk Factors, humanities, Environmental Exposure, Female, Humans, Metabolic Diseases, Nutritional Status, Occupational Diseases, Occupational Exposure, Risk Assessment, Tobacco smoking, 3. Good health, Nutritional Statu, MESH : Occupational Exposure, MESH : Metabolic Diseases, Cohort, medicine.symptom, Risk assessment, Blood-pressure, Human, MESH: Occupational Diseases, Risk factors in diseases, Coronary-heart-disease, MESH : Male, MESH: Health Behavior, MESH: Environmental Exposure, Population health, Body-mass index, 03 medical and health sciences, Household cooking, Cardiovascular-disease, Environmental health, General & Internal Medicine, parasitic diseases, Life Science, MESH: Sanitation, Risk factor, MESH : Health Behavior, VLAG, GBD2013, MESH: Humans, business.industry, Risk Factor, Global Burden of Disease Study, 79 behavioural, environmental and occupational, and metabolic risks, Long-term exposure, MESH : Humans, CAUSE-SPECIFIC MORTALITY, MESH: Male, Metabolic Disease, Occupational Disease, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, MALE BRITISH DOCTORS, Years of potential life lost, Relative risk, Malalties, MESH : Global Health, OUTDOOR AIR-POLLUTION, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH : Environmental Exposure, MESH: Female
Abstract: Summary Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5−89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. Funding Bill & Melinda Gates Foundation. Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the fi rst of a series of annual updates of the GBD. Risk factor quantifi cation, particularly of modifi able risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the fi rst level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular fi ltration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5−89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. Funding Bill & Melinda Gates Foundation.
Published: 2015

89. Évaluation de l’impact du « referral bias » sur les résultats des études pronostiques, à partir des données d’une étude de cohorte populationnelle sur l’endocardite infectieuse

Author: François Alla, M. Collonnaz, Nelly Agrinier, B. Hoen, V. Le Moing, F. Delahaye, B. Lung, and Christine Selton-Suty
Subjects: Epidemiology, Public Health, Environmental and Occupational Health
Abstract: Introduction Le « referral bias » est un biais de selection dont l’impact sur les resultats des etudes pronostiques n’a pas encore ete completement evalue. Il survient dans les etudes recrutant les patients en centres tertiaires, melangeant ainsi des patients admis directement dans ces centres et ceux qui y sont transferes, tout en excluant par ailleurs les patients traites exclusivement en centres non tertiaires. Notre objectif etait de caracteriser le « referral bias », a partir d’une etude de cohorte populationnelle sur l’endocardite infectieuse (EI). Methodes Nous avons analyse les donnees de la cohorte EI 2008, incluant 497 patients avec un diagnostic d’EI certaine. Les patients etaient admis directement en centre tertiaire (groupe T), admis en centre non tertiaire puis transferes en centre tertiaire (groupe NTT) ou non transferes (groupe NT). Nous avons compare les caracteristiques des patients, leur survie a un mois, trois mois et un an, entre les groupes, puis identifie les facteurs pronostiques dans l’echantillon total et dans le groupe (NTT + T) a l’aide de modeles de Cox. Resultats Par rapport au groupe T, les patients du groupe NTT etaient plus souvent des hommes (81,3 % versus 72,5 %, p = 0,046), des utilisateurs de drogues intraveineuses (9,7 % versus 4,5 %, p = 0,033), avaient plus souvent des signes echocardiographiques d’EI (97,2 % versus 91,1 %, p = 0,017) et des hemorragies cerebrales (p = 0,029). Par rapport au groupe NT, les patients du groupe NTT etaient plus jeunes (âge median [IQR] 64,5 [23,0] ans versus 72,5 [21,0] ans, p = 0,001), plus souvent des hommes (81,3 % vs 67,7 %, p = 0,034), et presentaient plus frequemment des indications a la chirurgie valvulaire (78,5 % versus 19,4 %, p Conclusion Dans les etudes conduites a partir d’echantillons melangeant des patients admis directement et transferes dans des centres tertiaires, la validite de la description des caracteristiques des patients, des estimations du taux survie et de l’amplitude des HRs peut etre affectee par le « referral bias ».
Published: 2020

90. From research to generalization: scale-up process of a public health intervention in France

Author: Charlotte Kanski, François Alla, Amandine Vallata, Marjorie Cadeville, Joëlle Kivits, Justine Trompette, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Ligue Nationale Contre le Cancer - Paris, Ligue Nationnale Contre le Cancer, Université de Bordeaux (UB), and TABADO IDF
Subjects: medicine.medical_specialty, Medical education, Generalization, Process (engineering), Public health, medicine.medical_treatment, Public Health, Environmental and Occupational Health, Intervention, Smoking cessation, Adolescents, Real -world conditions, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intervention (counseling), medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018

91. Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Author: Mahmoud Zureik, Joël Coste, Fanny Raguideau, Rosemary Dray-Spira, Alain Weill, M. Mezzarobba, Marie Dalichampt, Pierre-Olivier Blotière, Cécile Billionnet, François Alla, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Caisse Nationale d'Assurance Maladie des Travailleurs salariés (CNAMTS), Ministère de l'économie et des finances, Agence nationale de sécurité du médicament et des produits de santé [Saint-Denis] (ANSM), Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, pharmacoepidemiology, Adolescent, Databases, Factual, Epidemiology, Abortion, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Health care, Original Reports, Medicine, Original Report, Humans, Pharmacology (medical), 030212 general & internal medicine, antiepileptic drugs, ComputingMilieux_MISCELLANEOUS, Pregnancy, Epilepsy, algorithm, Ectopic pregnancy, business.industry, Infant, Newborn, Pregnancy Outcome, claims data, Pharmacoepidemiology, Middle Aged, medicine.disease, Therapeutic abortion, 3. Good health, Pregnancy Complications, Gestation, Anticonvulsants, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, pregnancy, Live birth, business, Algorithm, 030217 neurology & neurosurgery, Algorithms, French health care databases
Abstract: Purpose Access to claims databases provides an opportunity to study medication use and safety during pregnancy. We developed an algorithm to identify pregnancy episodes in the French health care databases and applied it to study antiepileptic drug (AED) use during pregnancy between 2007 and 2014. Methods The algorithm searched the French health care databases for discharge diagnoses and medical procedures indicative of completion of a pregnancy. To differentiate claims associated with separate pregnancies, an interval of at least 28 weeks was required between 2 consecutive pregnancies resulting in a birth and 6 weeks for terminations of pregnancy. Pregnancy outcomes were categorized into live births, stillbirths, elective abortions, therapeutic abortions, spontaneous abortions, and ectopic pregnancies. Outcome dates and gestational ages were used to calculate pregnancy start dates. Results According to our algorithm, live birth was the most common pregnancy outcome (73.9%), followed by elective abortion (17.2%), spontaneous abortion (4.2%), ectopic pregnancy (1.1%), therapeutic abortion (1.0%), and stillbirth (0.4%). These results were globally consistent with French official data. Among 7 559 701 pregnancies starting between 2007 and 2014, corresponding to 4 900 139 women, 6.7 per 1000 pregnancies were exposed to an AED. The number of pregnancies exposed to older AEDs, comprising the most teratogenic AEDs, decreased throughout the study period (−69.4%), while the use of newer AEDs increased (+73.4%). Conclusions We have developed an algorithm that allows identification of a large number of pregnancies and all types of pregnancy outcomes. Pregnancy outcome and start dates were accurately identified, and maternal data could be linked to neonatal data.
Published: 2018

92. Clinical Events After Discontinuation of β‐Blockers in Patients Without Heart Failure Optimally Treated After Acute Myocardial Infarction

Author: Nicolas Danchin, Alain Weill, Géric Maura, Anke Neumann, and François Alla
Subjects: Adult, Male, medicine.medical_specialty, Acute coronary syndrome, Time Factors, Databases, Factual, Adrenergic beta-Antagonists, Myocardial Infarction, 030204 cardiovascular system & hematology, Patient Readmission, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Reperfusion therapy, Recurrence, Internal medicine, Health care, Myocardial Revascularization, Secondary Prevention, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, Aged, business.industry, Clinical events, Middle Aged, medicine.disease, Discontinuation, Treatment Outcome, Heart failure, Cardiology, Female, France, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract: Background: β-blockers have been among the first medications shown to improve outcomes after acute myocardial infarction (AMI). With the advent of reperfusion therapy and other secondary-prevention medications, their role has become uncertain, and large-scale experience after AMI in the contemporary era is lacking. In particular, the effect of stopping β-blockers in patients initially treated after AMI is unknown. Methods and Results: Using the French healthcare databases, 73 450 patients ( Conclusions: In routine care of patients without heart failure, revascularized and optimally treated after AMI, discontinuation of β-blockers beyond 1 year after AMI was associated with an increased risk of death or readmission for ACS, while statistical significance was not reached for the association with all-cause mortality. A contemporary randomized clinical trial is needed to precise the role of β-blockers in the long-term treatment after AMI.
Published: 2018

93. Possible relationship between antiphospholipid antibodies and embolic events in infective endocarditis

Author: Christine, Selton-Suty, Charles-Henry, Maigrat, Jean, Devignes, François, Goehringer, Marie-Line, Erpelding, François, Alla, Carine, Thivilier, Olivier, Huttin, Clément, Venner, Yves, Juilliere, Thanh, Doco-Lecompte, Thomas, Lecompte, Catherine, Campagnac, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation Médicale [CHRU Nancy], Service de Cardiologie [Institut Lorrain du Cœur et des Vaisseaux], Service de Cardiologie [CHRU Nancy], Division of Haematology (Div Haemato - GENEVE), and Hôpitaux Universitaires de Genève (HUG)
Subjects: Adult, Male, medicine.medical_specialty, Embolism, 030204 cardiovascular system & hematology, Asymptomatic, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, medicine, Endocarditis, Humans, 030212 general & internal medicine, Platelet activation, Correlation of Data, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Creatinine, business.industry, Middle Aged, medicine.disease, Platelet Activation, stroke, 3. Good health, chemistry, Predictive value of tests, Infective endocarditis, Antibodies, Antiphospholipid, endocarditis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, Cardiology and Cardiovascular Medicine, business, neurologic events
Abstract: ObjectiveAntiphospholipid (aPL) antibodies may activate platelets and contribute to vegetation growth and embolisation in infective endocarditis (IE). We aimed to determine the value of aPL as predictors of embolic events (EE) in IE.MethodsWe studied 186 patients with definite IE (Duke-Li criteria, all types of IE) from the Nanc-IE prospective registry (2007–2012) who all had a frozen blood sample and at least one imaging procedure to detect asymptomatic or confirm symptomatic EE. Anticardiolipin (aCL) and anti-β2-glycoprotein I (β2GPI) antibodies (IgG and IgM) were assessed after the end of patients’ inclusion. The relationship between antibodies and the detection of EE after IE diagnosis were studied with Kaplan-Meier and Cox multivariate analyses.ResultsAt least one EE was detected in 118 (63%) patients (52 cerebral, 95 other locations) after IE diagnosis in 80 (time interval between IE and EE diagnosis: 5.9±11.3 days). At least one aPL antibody was found in 31 patients (17%).Detection of EE over time after IE diagnosis was more frequent among patients with anti-β2GPI IgM (log-rank P=0.0036) and that of cerebral embolisms, among patients with aCL IgM and anti-β2GPI IgM (log-rank P=0.002 and PFactors predictive of EE were anti-β2GPI IgM (HR=3.45 (1.47–8.08), P=0.0045), creatinine (2.74 (1.55–4.84), P=0.0005) and vegetation size (2.41 (1.41–4.12), P=0.0014). Those of cerebral embolism were aCL IgM (2.84 (1.22–6.62), P=0.016) and anti-β2GPI IgM (4.77 (1.79–12.74), P=0.0018).ConclusionThe presence of aCL and anti-β2GPI IgM was associated with EE, particularly cerebral ones, and could contribute to assess the embolic risk of IE.
Published: 2018

94. Transformation of health systems: contribution of population health intervention research

Author: Linda Cambon, François Alla, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), and Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Promotion de la santé, Prévention, business.industry, Public Health, Environmental and Occupational Health, MEDLINE, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Humanities, Hôpital, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018

95. Élaboration des normes de prévention : une réflexion éthique nécessaire

Author: Victoria Pagani, Linda Cambon, Frédérique Claudot, François Alla, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Plateforme d'Aide à la Recherche Clinique [CHRU Nancy] (PARC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 03 medical and health sciences, 030505 public health, 0302 clinical medicine, Prévention, Political science, Ethique, Public Health, Environmental and Occupational Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, 0305 other medical science, Humanities, Santé publique, Norme
Abstract: International audience; Introduction : La santé publique tenterait de modifier les normes sociales existantes en mettant en place des stratégies favorisant l’émergence de normes plus propices à son objectif de bonne santé et de bien-être. Les politiques de prévention et les interventions qui en découlent, en s’intéressant aux comportements de santé, chercheraient à modifier les « habitus » des individus et contribueraient à définir de nouvelles manières d’être, d’agir et de vivre. La prévention met ainsi en jeu de nombreuses valeurs personnelles, culturelles, sociétales et collectives. Ces démarches ne peuvent ainsi s’affranchir d’un questionnement éthique sur leur sens, leur bien-fondé et leur justice. L’objectif de cette étude est de caractériser la prise en compte d’une réflexion éthique lors de la création de la norme de santé publique.Méthodes : Pour répondre à l’objectif, une revue narrative a été conduite. Elle a été effectuée à partir de la base de données Web of Science, celle-ci permettant de couvrir des revues des différents champs disciplinaires concernés.Résultats : Trente-quatre publications ont été retenues qui objectivent de nombreuses définitions et types de normes utilisées par la santé publique dans ses stratégies d’intervention. Un grand nombre d’acteurs intervient dans le processus de création d’une norme de santé publique : spécialistes, leaders d’opinion, acteurs sociaux. Enfin, si certaines publications mettent en avant que l’utilisation de la norme en prévention soulève certains questionnements éthiques, aucune publication ne fait référence à la présence d’une réflexion éthique structurée dans ce processus.Conclusion : Les interventions de prévention et les outils utilisés ne peuvent se passer d’une réflexion éthique. Comment faire pour « bien » faire ? Comment gérer les conflits de valeurs ? Ces questionnements sont nécessaires lorsque l’on conduit des politiques ou des programmes et peuvent orienter plus justement leurs stratégies et contribuer à favoriser leur acceptabilité et leur efficacité auprès des populations.
Published: 2018

96. Addressing complexity in population health intervention research: the context/intervention interface

Author: Linda Cambon, Louise Potvin, Laetitia Minary, François Alla, Joëlle Kivits, Université de Montréal (UdeM), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Ecole de Santé Publique [Nancy], Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL), Fondation ARC pour la Recherche sur le Cancer, Ligue Contre le Cancer, Canadian Institutes of Health Research, Institut National Du Cancer, Institut de Recherche en Santé Publique, Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Université de Montréal [Montréal], Centre d'investigation clinique plurithématique Pierre Drouin ( CIC-P ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Centre de Recherches sur l'Action Politique en Europe ( ARENES ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lorraine ( UL ) -Université de Lorraine ( UL ), and Kivits, Joëlle
Subjects: Theory and Methods, Knowledge management, Public Health Systems Research, [SHS.SOCIO] Humanities and Social Sciences/Sociology, Epidemiology, Interface (Java), health promotion, Psychological intervention, Context (language use), Population health, 03 medical and health sciences, 0302 clinical medicine, Fuzzy Logic, Intervention (counseling), Humans, Medicine, 030212 general & internal medicine, 030505 public health, [SHS.SOCIO]Humanities and Social Sciences/Sociology, Population Health, Scope (project management), business.industry, public health, Public Health, Environmental and Occupational Health, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, methodology, [ SHS.SOCIO ] Humanities and Social Sciences/Sociology, Identification (information), Health promotion, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business
Abstract: BackgroundPublic health interventions are increasingly being recognised as complex and context dependent. Related to this is the need for a systemic and dynamic conception of interventions that raises the question of delineating the scope and contours of interventions in complex systems. This means identifying which elements belong to the intervention (and therefore participate in its effects and can be transferred), which ones belong to the context and interact with the former to influence results (and therefore must be taken into account when transferring the intervention) and which contextual elements are irrelevant to the intervention.DiscussionThis paper, from which derives criteria based on a network framework, operationalises how the context and intervention systems interact and identify what needs to be replicated as interventions are implemented in different contexts. Representing interventions as networks (composed of human and non-human entities), we introduce the idea that the density of interconnections among the various entities provides a criterion for distinguishing core intervention from intervention context without disconnecting the two systems. This differentiates endogenous and exogenous intervention contexts and the mediators that connect them, which form the fuzzy and constantly changing intervention/context interface.ConclusionWe propose that a network framework representing intervention/context systems constitutes a promising approach for deriving empirical criteria to delineate the scope and contour of what is replicable in an intervention. This approach should allow better identification and description of the entities that have to be transferred to ensure the potential effectiveness of an intervention in a specific context.
Published: 2018

97. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Nancy, Fullman, Jamal, Yearwood, Solomon, M, Abay, Cristiana, Abbafati, Foad, Abd-Allah, Jemal, Abdela, Ahmed, Abdelalim, Zegeye, Abebe, Teshome, Abuka, Abebo, Victor, Aboyans, Haftom, Niguse, Abraha, Daisy, M, X, Abreu, Laith, Abu-Raddad, J, Akilew, Awoke, Adane, Rufus, Adesoji, Adedoyin, Olatunji, Adetokunboh, Tara, Ballav, Adhikari, Mohsen, Afarideh, Ashkan, Afshin, Gina, Agarwal, Dominic, Agius, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Miloud, Taki, Eddine, Aichour, Mohammed, Akibu, Rufus, Olusola, Akinyemi, Tomi, Akinyemiju, F, Nadia, Akseer, Faris, Hasan, Lami, Al, Fares, Alahdab, Ziyad, Al-Aly, Khurshid, Alam, Tahiya, Alam, Deena, Alasfoor, Mohammed, I, Albittar, Kefyalew, Addis, Alene, Ayman, Al-Eyadhy, Syed, Danish, Ali, Mehran, Alijanzadeh, Syed, M, Aljunid, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Mahmoud, A, Alomari, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis-Guzman, Azmeraw, T, Amare, Kebede, Amenu, Walid, Ammar, Yaw, Ampem, Amoako, Nahla, Anber, Catalina, Liliana, Andrei, Sofia, Androudi, Carl, Abelardo, Antonio, T, Valdelaine, E, Araújo, M, Olatunde, Aremu, Johan, Ärnlöv, Artaman, Al, Krishna, Kumar, Aryal, Hamid, Asayesh, Ephrem, Tsegay, Asfaw, Solomon, Weldegebreal, Asgedom, Rana, Jawad, Asghar, Mengistu, Mitiku, Ashebir, Netsanet, Abera, Asseffa, Tesfay, Mehari, Atey, Sachin, R, Atre, Madhu, Atteraya, S, Leticia, Avila-Burgos, Euripide, Frinel, Arthur, G, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Animut, Alebel, Ayalew, Henok, Tadesse, Ayele, Rakesh, Ayer, Tambe, Betrand, Ayuk, Peter, Azzopardi, Natasha, Azzopardi-Muscat, Tesleem, Kayode, Babalola, Hamid, Badali, Alaa, Badawi, Maciej, Banach, Amitava, Banerjee, Amrit, Banstola, Ryan, M, Barber, Miguel, Barboza, A, Suzanne, L, Barker-Collo, Till, Bärnighausen, Simon, Barquera, Lope, H, Barrero, Quique, Bassat, Sanjay, Basu, Bernhard, T, Baune, Shahrzad, Bazargan-Hejazi, Neeraj, Bedi, Ettore, Beghi, Masoud, Behzadifar, Meysam, Behzadifar, Bayu, Begashaw, Bekele, Abate, Bekele, Belachew, Saba, Abraham, Belay, Yihalem, Abebe, Belay, Michelle, L, Bell, Aminu, Bello, K, Derrick, A, Bennett, James, Bennett, R, Isabela, M, Bensenor, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Robert, Steven, Bernstein, Mircea, Beuran, Ashish, Bhalla, Paurvi, Bhatt, Soumyadeep, Bhaumik, Zulfiqar, A, Bhutta, Belete, Biadgo, Ali, Bijani, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Hailemichael, Bizuneh, Ian, W, Bolliger, Kaylin, Bolt, Ibrahim, R, Bou-Orm, Kayvan, Bozorgmehr, Oliver, Jerome, Brady, Alexandra, Brazinova, Nicholas, J, Breitborde, K, Hermann, Brenner, Gabrielle, Britton, Traolach, S, Brugha, Zahid, Butt, A, Lucero, Cahuana-Hurtado, Ismael, Ricardo, Campos-Nonato, Julio, Cesar, Campuzano, Josip, Car, Mate, Car, Rosario, Cárdenas, Juan, Jesus, Carrero, Felix, Carvalho, Carlos, A, Castañeda-Orjuela, Jacqueline, Castillo, Rivas, Ferrán, Catalá-López, Kelly, Cercy, Julian, Chalek, 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Ray, Dos Santos, Kadine Priscila Bender, Doyle, Kerrie E., Driscoll, Tim R., Dubey, Manisha, Dubljanin, Eleonora, Duncan, Bruce Bartholow, Echko, Michelle, Edessa, Dumessa, Edvardsson, David, Ehrlich, Joshua R., Eldrenkamp, Erika, El-Khatib, Ziad, Endres, Matthia, Endries, Aman Yesuf, Eshrati, Babak, Eskandarieh, Sharareh, Esteghamati, Alireza, Fakhar, Mahdi, Farag, Tamer, Faramarzi, Mahbobeh, Faraon, Emerito Jose Aquino, Faro, André, Farzadfar, Farshad, Fatusi, Adesegun, Fazeli, Mir Sohail, Feigin, Valery L., Feigl, Andrea B., Fentahun, Netsanet, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, João C., Fijabi, Daniel Obadare, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D., Flor, Luisa Sorio, Foigt, Nataliya, Foreman, Kyle J., Frostad, Joseph J., Fürst, Thoma, Futran, Neal D., Gakidou, Emmanuela, Gallus, Silvano, Gambashidze, Ketevan, Gamkrelidze, Amiran, Ganji, Morsaleh, Gebre, Abadi Kahsu, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gelaw, Yalemzewod Assefa, Geleijnse, Johanna M., Geremew, Demeke, Gething, Peter W., Ghadimi, Reza, Ghasemi Falavarjani, Khalil, Ghasemi-Kasman, Maryam, Gill, Paramjit Singh, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W., Goli, Sriniva, Gomez-Dantes, Hector, Gona, Philimon N., Goodridge, Amador, Gopalani, Sameer Vali, Goryakin, Yevgeniy, Goulart, Alessandra Carvalho, Grada, Ayman, Griswold, Max, Grosso, Giuseppe, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Gupta, Tarun, Gupta, Vipin, Haagsma, Juanita A., Hachinski, Vladimir, Hafezi-Nejad, Nima, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hankey, Graeme J., Harb, Hilda L., Harewood, Heather C., Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Hassen, Hamid Yimam, Havmoeller, Rasmu, Hawley, Caitlin, Hay, Simon I., He, Jiawei, Hearps, Stephen J.C., Hegazy, Mohamed I., Heibati, Behzad, Heidari, Mohsen, Hendrie, Delia, Henry, Nathaniel J., Herrera Ballesteros, Victor Hugo, Herteliu, Claudiu, Hibstu, Desalegn Tsegaw, Hiluf, Molla Kahssay, Hoek, Hans W., Homaie Rad, Enayatollah, Horita, Nobuyuki, Hosgood, H. Dean, Hosseini, Mostafa, Hosseini, Seyed Reza, Hostiuc, Mihaela, Hostiuc, Sorin, Hoy, Damian G., Hsairi, Mohamed, Htet, Aung Soe, Hu, Guoqing, Huang, John J., Iburg, Kim Moesgaard, Idris, Fachmi, Igumbor, Ehimario Uche, Ikeda, Chad, Ileanu, Bogdan Vasile, Ilesanmi, Olayinka S., Innos, Kaire, Irvani, Seyed Sina Naghibi, Irvine, Caleb M.S., Islami, Farhad, Jacobs, Troy A., Jacobsen, Kathryn H., Jahanmehr, Nader, Jain, Rajesh, Jain, Sudhir Kumar, Jakovljevic, Mihajlo M., Jalu, Moti Tolera, Jamal, Amr A., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Józwiak, Jacek, John, Oommen, Johnson, Sarah Charlotte, Jonas, Jost B., Joshua, Vasna, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kalani, Rizwan, Kar, Chittaranjan, Karanikolos, Marina, Karch, André, Karema, Corine Kakizi, Karimi, Seyed M., Kasaeian, Amir, Kassa, Dessalegn Haile, Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassebaum, Nicholas J., Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Kebede, Seifu, Keiyoro, Peter Njenga, Kemp, Grant Rodger, Kengne, Andre Pascal, Kereselidze, Maia, Ketema, Ezra Belay, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalil, Ibrahim A., Khan, Ejaz Ahmad, Khan, Gulfaraz, Khan, Md Nuruzzaman, Khan, Muhammad Ali, Khanal, Mukti Nath, Khang, Young-Ho, Khater, Mona M., Khoja, Abdullah Tawfih Abdullah, Khosravi, Ardeshir, Khubchandani, Jagdish, Kibret, Getiye Dejenu, Kiirithio, Daniel Ngari, Kim, Daniel, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohanne, Kinra, Sanjay, Kisa, Adnan, Kissoon, Niranjan, Kochhar, Sonali, Kokubo, Yoshihiro, Kopec, Jacek A., Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Kravchenko, Michael, Krishan, Kewal, Krohn, Kristopher J., Kuate Defo, Barthelemy, Kumar, G. Anil, Kumar, Pushpendra, Kutz, Michael, Kuzin, Igor, Kyu, Hmwe H., Lad, Deepesh Pravinkumar, Lafranconi, Alessandra, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Lang, Justin J., Lansingh, Van C., Lansky, Sonia, Larsson, Ander, Latifi, Arman, Lazarus, Jeffrey Victor, Leasher, Janet L., Lee, Paul H., Legesse, Yirga, Leigh, Jame, Leshargie, Cheru Tesema, Leta, Samson, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yongmei, Liang, Juan, Liben, Misgan Legesse, Lim, Lee-Ling, Lim, Stephen S., Lind, Margaret, Linn, Shai, Listl, Stefan, Liu, Patrick Y., Liu, Shiwei, Lodha, Rakesh, Lopez, Alan D., Lorch, Scott A., Lorkowski, Stefan, Lotufo, Paulo A., Lucas, Timothy C.D., Lunevicius, Raimunda, Lurton, Grégoire, Lyons, Ronan A., Maalouf, Fadi, Macarayan, Erlyn Rachelle King, Mackay, Mark T., Maddison, Emilie R., Madotto, Fabiana, Magdy Abd El Razek, Hassan, Magdy Abd El Razek, Mohammed, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Mamun, Abdullah A., Manguerra, Helena, Manhertz, Treh, Mansournia, Mohammad Ali, Mantovani, Lorenzo G., Manyazewal, Tsegahun, Mapoma, Chabila C., Margono, Christopher, Martinez-Raga, Jose, Martins, Sheila Cristina Ourique, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, März, Winfried, Massenburg, Benjamin Ballard, Mathur, Manu Raj, Maulik, Pallab K., Mazidi, Mohsen, McAlinden, Colm, McGrath, John J., McKee, Martin, Mehata, Suresh, Mehrotra, Ravi, Mehta, Kala M., Mehta, Varshil, Meier, Toni, Mejia-Rodriguez, Fabiola, Meles, Kidanu Gebremariam, Melku, Mulugeta, Memiah, Peter, Memish, Ziad A., Mendoza, Walter, Mengiste, Degu Abate, Mengistu, Desalegn Tadese, Menota, Bereket Gebremichael, Mensah, George A., Meretoja, Atte, Meretoja, Tuomo J., Mezgebe, Haftay Berhane, Miazgowski, Tomasz, Micha, Renata, Milam, Robert, Millear, Anoushka, Miller, Ted R., Mini, G.K., Minnig, Shawn, Mirica, Andreea, Mirrakhimov, Erkin M., Misganaw, Awoke, Mitchell, Philip B., Mlashu, Fitsum Weldegebreal, Moazen, Babak, Mohammad, Karzan Abdulmuhsin, Mohammadibakhsh, Roghayeh, Mohammed, Ebrahim, Mohammed, Mohammed A., Mohammed, Shafiu, Mokdad, Ali H., Mola, Glen Liddell D., Molokhia, Mariam, Momeniha, Fatemeh, Monasta, Lorenzo, Montañez Hernandez, Julio Cesar, Moosazadeh, Mahmood, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Moreno Velasquez, Ilai, Mori, Rintaro, Morrison, Shane D., Moses, Mark, Mousavi, Seyyed Meysam, Mueller, Ulrich O., Murhekar, Manoj, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Sriniva, Musa, Jonah, Musa, Kamarul Imran, Mustafa, Ghulam, Muthupandian, Saravanan, Nagata, Chie, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Naik, Gurudatta A., Naik, Nitish, Najafi, Farid, Naldi, Luigi, Nangia, Vinay, Nansseu, Jobert Richie Njingang, Narayan, K.M. Venkat, Nascimento, Bruno Ramo, Negoi, Ionut, Negoi, Ruxandra Irina, Newton, Charles R., Ngunjiri, Josephine Wanjiku, Nguyen, Grant, Nguyen, Long, Nguyen, Trang Huyen, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nolte, Ellen, Nong, Vuong Minh, Norheim, Ole F., Norrving, Bo, Noubiap, Jean Jacques N., Nyandwi, Alypio, Obermeyer, Carla Makhlouf, Ofori-Asenso, Richard, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olagunju, Tinuke Oluwasefunmi, Olivares, Pedro R., De Oliveira, Patricia Pereira Vasconcelo, Olsen, Helen E., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortega-Altamirano, Doris V., Ortiz, Alberto, Ozdemir, Raziye, Pa, Mahesh, Pain, Amanda W., Palone, Marcos Roberto Tovani, Pana, Adrian, Panda-Jonas, Songhomitra, Pandian, Jeyaraj D., Park, Eun-Kee, Parsian, Hadi, Patel, Teja, Pati, Sanghamitra, Patil, Snehal T., Patle, Ajay, Patton, George C., Paturi, Vishnupriya Rao, Paudel, Deepak, De Moares Pedroso, Marcel, Pedroza, Sandra P., Pereira, David M., Perico, Norberto, Peterson, Hannah, Petzold, Max, Peykari, Niloofar, Phillips, Michael Robert, Piel, Frédéric B., Pigott, David M., Pillay, Julian David, Piradov, Michael A., Polinder, Suzanne, Pond, Constance D., Postma, Maarten J., Pourmalek, Farshad, Prakash, Swayam, Prakash, V., Prasad, Narayan, Prasad, Noela Marie, Purcell, Caroline, Qorbani, Mostafa, Quintana, Hedley Knewjen, Radfar, Amir, Rafay, Anwar, Rafiei, Alireza, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Muhammad Aziz, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Raju, Sree Bhushan, Ram, Usha, Rana, Saleem M., Rankin, Zane, Rasella, Davide, Rawaf, David Laith, Rawaf, Salman, Ray, Sarah E., Razo-García, Christian Aspacia, Reddy, Priscilla, Reiner, Robert C., Reis, Cesar, Reitsma, Marissa B., Remuzzi, Giuseppe, Renzaho, Andre M.N., Resnikoff, Serge, Rezaei, Satar, Rezai, Mohammad Sadegh, Ribeiro, Antonio L., Rios Blancas, Maria Jesu, Rivera, Juan A., Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Roth, Gregory A., Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Ruhago, George Mugambage, Sabde, Yogesh Damodar, Sachdev, Perminder S., Sadat, Nafi, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salama, Joseph, Salamati, Payman, De Freitas Saldanha, Raphael, Salimzadeh, Hamideh, Salomon, Joshua A., Samy, Abdallah M., Sanabria, Juan Ramon, Sancheti, Parag K., Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, Itamar S., Santric Milicevic, Milena M., Sarker, Abdur Razzaque, Sarrafzadegan, Nizal, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Saxena, Sonia, Saylan, Mete I., Schaeffner, Elke, Schmidhuber, Josef, Schmidt, Maria Inê, Schneider, Ione J.C., Schumacher, Austin E., Schutte, Aletta E., Schwebel, David C., Schwendicke, Falk, Sekerija, Mario, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shafieesabet, Azadeh, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Shams-Beyranvand, Mehran, Sharafi, Heidar, Sharif-Alhoseini, Mahdi, Shariful Islam, Sheikh Mohammed, Sharma, Meenakshi, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shfare, Mebrahtu Teweldemedhin, Shi, Peilin, Shields, Chloe, Shigematsu, Mika, Shinohara, Yukito, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, Shrime, Mark G., Shukla, Sharvari Rahul, Siabani, Soraya, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Diego Augusto Santo, Silva, João Pedro, Silveira, Dayane Gabriele Alve, Singh, Jasvinder A., Singh, Lavanya, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Sinke, Abiy Hiruye, Sisay, Mekonnen, Skirbekk, Vegard, Sliwa, Karen, Smith, Alison, Soares Filho, Adauto Martin, Sobaih, Badr H.A., Somai, Melek, Soneji, Samir, Soofi, Moslem, Sorensen, Reed J.D., Soriano, Joan B., Soyiri, Ireneous N., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Srinivasan, Vinay, Stanaway, Jeffrey D., Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J., Stokes, Mark Andrew, Sturua, Lela, Sufiyan, Muawiyyah Babale, Suliankatchi, Rizwan Abdulkader, Sunguya, Bruno F., Sur, Patrick J., Sykes, Bryan L., Sylaja, P.N., Szoeke, Cassandra E.I., Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Tadesse, Andualem Henok, Taffere, Getachew Redae, Tandon, Nikhil, Tariku, Amare Tariku, Taveira, Nuno, Tehrani-Banihashemi, Arash, Temam Shifa, Girma, Temsah, Mohamad-Hani, Terkawi, Abdullah Sulieman, Tesema, Azeb Gebresilassie, Tesfaye, Dawit Jember, Tessema, Belay, Thakur, J.S., Thomas, Nihal, Thompson, Matthew J., Tillmann, Taavi, To, Quyen G., Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Torre, Anna, Tortajada, Miguel, Tran, Bach Xuan, Tran, Khanh Bao, Tripathi, Avnish, Tripathy, Srikanth Prasad, Troeger, Christopher, Truelsen, Thoma, Tsoi, Derrick, Tudor Car, Lorainne, Tuem, Kald Beshir, Tyrovolas, Stefano, Uchendu, Uche S., Ukwaja, Kingsley Nnanna, Ullah, Irfan, Updike, Rachel, Uthman, Olalekan A., Uzochukwu, Benjamin S. Chudi, Valdez, Pascual Rubén, Van Boven, Job F.M., Varughese, Santosh, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S., Vladimirov, Sergey K., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wagnew, Fasil, Waheed, Yasir, Wallin, Mitchell T., Walson, Judd L., Wang, Yafeng, Wang, Yuan-Pang, Wassie, Molla Mesele, Weaver, Marcia R., Weiderpass, Elisabete, Weintraub, Robert G., Weiss, Jordan, Weldegwergs, Kidu Gidey, Werdecker, Andrea, West, T. 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Sd, Aljunid, Sm, Alomari, Ma, Altirkawi, Ka, Amare, At, Amoako, Ya, Andrei, Cl, Antonio, Cat, Araújo, Vem, Aryal, Kk, Asfaw, Et, Asgedom, Sw, Asghar, Rj, Ashebir, Mm, Asseffa, Na, Atey, Tm, Atre, Sr, Avokpaho, Efga, Ayala Quintanilla, Bp, Ayalew, Aa, Ayele, Ht, Ayuk, Tb, Babalola, Tk, Barber, Rm, Barboza, Ma, Barker-Collo, Sl, Barrero, Lh, Baune, Bt, Bekele, Bb, Belachew, Ab, Belay, Sa, Belay, Ya, Bell, Ml, Bello, Ak, Bennett, Da, Bennett, Jr, Bensenor, Im, Berhe, Df, Bhutta, Za, Bolliger, Iw, Bou-Orm, Ir, Brady, Oj, Breitborde, Njk, Butt, Za, Campos-Nonato, Ir, Campuzano, Jc, Carrero, Jj, Castañeda-Orjuela, Ca, Chang, Hy, Chang, Jc, Chiang, Pp, Chisumpa, Vh, Choi, Jj, Christopher, Dj, Chung, Sc, Ciobanu, Lg, Cortesi, Pa, Criqui, Mh, Cromwell, Ea, Crump, Ja, Daba, Ak, Dachew, Ba, Dadi, Af, Dargan, Pi, Das, Sk, De Neve, Jw, Dellavalle, Rp, Des Jarlais, Dc, Dharmaratne, Sd, Doku, Dt, Dorsey, Er, Dos Santos, Kpb, Doyle, Ke, Driscoll, Tr, Duncan, Bb, Ehrlich, Jr, El-Khatib, Zz, Endries, 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Kim, Yj, Kimokoti, Rw, Kopec, Ja, Koul, Pa, Krohn, Kj, Kumar, Ga, Kyu, Hh, Lad, Dp, Lal, Dk, Lang, Jj, Lansingh, Vc, Lazarus, Jv, Leasher, Jl, Lee, Ph, Leshargie, Ct, Liben, Ml, Lim, Ll, Lopez, Ad, Lorch, Sa, Lotufo, Pa, Lucas, Tcd, Lyons, Ra, Macarayan, Erk, Mackay, Mt, Maddison, Er, Malta, Dc, Mamun, Aa, Mansournia, Ma, Mantovani, Lg, Mapoma, Cc, Martins, Sco, Martins-Melo, Fr, Massenburg, Bb, Mathur, Mr, Maulik, Pk, Mcgrath, Jj, Mehta, Km, Meles, Kg, Memish, Za, Mengiste, Da, Mengistu, Dt, Menota, Bg, Mensah, Ga, Meretoja, Tj, Mezgebe, Hb, Miller, Tr, Mini, Gk, Mirrakhimov, Em, Mitchell, Pb, Mlashu, Fw, Mohammad, Ka, Mohammed, Ma, Mokdad, Ah, Mola, Gl, Montañez Hernandez, Jc, Morrison, Sd, Mousavi, Sm, Mueller, Uo, Murthy, Gv, Musa, Ki, Naik, Ga, Nansseu, Jrn, Narayan, Kv, Nascimento, Br, Negoi, Ri, Newton, Cr, Ngunjiri, Jw, Nguyen, Th, Ningrum, Dna, Nong, Vm, Norheim, Of, Noubiap, Jjn, Obermeyer, Cm, Ogbo, Fa, Oh, Ih, Olagunju, At, Olagunju, To, Olivares, Pr, Oliveira, Ppv, Olsen, He, Olusanya, Bo, Olusanya, Jo, Opio, Jn, Ortega-Altamirano, Dv, Pain, Aw, Palone, Mrt, Pandian, Jd, Park, Ek, Patil, St, Patton, Gc, Paturi, Vr, Pedroso, Mm, Pedroza, Sp, Pereira, Dm, Phillips, Mr, Piel, Fb, Pigott, Dm, Pillay, Jd, Piradov, Ma, Pond, Cd, Postma, Mj, Prasad, Nm, Quintana, Hk, Rahman, Ma, Rahman, Su, Rai, Rk, Raju, Sb, Rana, Sm, Rawaf, Dl, Ray, Se, Razo-García, Ca, Reiner, Rc, Reitsma, Mb, Renzaho, Amn, Ribeiro, Al, Rios Blancas, Mj, Rivera, Ja, Roth, Ga, Ruhago, Gm, Sabde, Yd, Sahraian, Ma, Saldanha, Rf, Salomon, Ja, Samy, Am, Sanabria, Jr, Sancheti, Pk, Sanchez-Niño, Md, Santric Milicevic, Mm, Sarker, Ar, Saylan, Mi, Schmidt, Mi, Schneider, Ijc, Schumacher, Ae, Schutte, Ae, Schwebel, Dc, Sepanlou, Sg, Servan-Mori, Ee, Shaikh, Ma, Shariful Islam, Sm, Shfare, Mt, Shrime, Mg, Shukla, Sr, Sigfusdottir, Id, Silberberg, Dh, Silva, Da, Silva, Jp, Silveira, Dga, Singh, Ja, Singh, Np, Sinha, Dn, Sinke, Ah, Soares Filho, Am, Sobaih, Bha, Sorensen, Rjd, Soriano, Jb, Soyiri, In, Sposato, La, Sreeramareddy, Ct, Stanaway, Jd, Stein, Dj, Stokes, Ma, Sufiyan, Mb, Suliankatchi, Ra, Sunguya, Bf, Sur, Pj, Sykes, Bl, Sylaja, Pn, Tadakamadla, Sk, Tadesse, Ah, Taffere, Gr, Tariku, At, Temsah, Mh, Tesema, Ag, Tesfaye, Dj, Thompson, Mj, To, Qg, Tran, Bx, Tran, Kb, Tripathy, Sp, Tuem, Kb, Ukwaja, Kn, Uthman, Oa, Uzochukwu, Bsc, Valdez, Pr, van Boven, Jfm, Vladimirov, Sk, Vlassov, Vv, Vollset, Se, Wallin, Mt, Walson, Jl, Wang, Yp, Wassie, Mm, Weaver, Mr, Weintraub, Rg, Weldegwergs, Kg, West, Te, White, Rg, Whiteford, Ha, Wolfe, Cd, Wondimkun, Ya, Wyper, Gma, Yan, Ll, Yimer, Nb, Yirsaw, Bd, Yoon, Sj, Younis, Mz, Zaki, Me, Zaman, Sb, Zenebe, Zm, Zimsen, Srm, Zuhlke, Lj, Murray, Cjl, and Lozano, R.
Subjects: Peformance, Coverage, Dánartíðni, Lífslíkur, Life expectancy, GBD, Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best), universal health coverage, Article, access quality health care, health care access and quality index, Nations, Healthcare Acce, Cause-specific mortality, Psychology, Healthcare Access and Quality Index, Mælitæki, States, Medicine (all), Health care, Þjóðir, Public Health, Global Health, Social Medicine and Epidemiology, Quality, Heilbrigðisþjónusta, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Sálfræði, Indicator, Amenable mortality, Transition, we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations, Trends, Inequalities
Abstract: Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations., Bill & Melinda Gates Foundation. Barbora de Courten is supported by a National Heart Foundation Future Leader Fellowship (100864). Ai Koyanagi’s work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII —General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER). Alberto Ortiz was supported by Spanish Government (Instituto de Salud Carlos III RETIC REDINREN RD16/0019 FEDER funds). Ashish Awasthi acknowledges funding support from Department of Science and Technology, Government of India through INSPIRE Faculty scheme Boris Bikbov has received funding from the European Union’s Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement No. 703226. Boris Bikbov acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Panniyammakal Jeemon acknowledges support from the clinical and public health intermediate fellowship from the Wellcome Trust and Department of Biotechnology, India Alliance (2015–20). Job F M van Boven was supported by the Department of Clinical Pharmacy & Pharmacology of the University Medical Center Groningen, University of Groningen, Netherlands. Olanrewaju Oladimeji is an African Research Fellow hosted by Human Sciences Research Council (HSRC), South Africa and he also has honorary affiliations with Walter Sisulu University (WSU), Eastern Cape, South Africa and School of Public Health, University of Namibia (UNAM), Namibia. He is indeed grateful for support from HSRC, WSU and UNAM. EUI is supported in part by the South African National Research Foundation (NRF UID: 86003). Ulrich Mueller acknowledges funding by the German National Cohort Study grant No 01ER1511/D, Gabrielle B Britton is supported by Secretaría Nacional de Ciencia, Tecnología e Innovación and Sistema Nacional de Investigación de Panamá. Giuseppe Remuzzi acknowledges that the work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Behzad Heibati would like to acknowledge Air pollution Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran. Syed Aljunid acknowledges the National University of Malaysia for providing the approval to participate in this GBD Project. Azeem Majeed and Imperial College London are grateful for support from the Northwest London National Insititute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care. Tambe Ayuk acknowledges the Institute of Medical Research and Medicinal Plant Studies for office space provided. José das Neves was supported in his contribution to this work by a Fellowship from Fundação para a Ciência e a Tecnologia, Portugal (SFRH/BPD/92934/2013). João Fernandes gratefully acknowledges funding from FCT–Fundação para a Ciência e a Tecnologia (grant number UID/Multi/50016/2013). Jan-Walter De Neve was supported by the Alexander von Humboldt Foundation. Kebede Deribe is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (201900). Kazem Rahimi was supported by grants from the Oxford Martin School, the NIHR Oxford BRC and the RCUK Global Challenges Research Fund. Laith J Abu-Raddad acknowledges the support of Qatar National Research Fund (NPRP 9-040-3-008) who provided the main funding for generating the data provided to the GBD-IHME effort. Liesl Zuhlke is funded by the national research foundation of South Africa and the Medical Research Council of South Africa. Monica Cortinovis acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Chuanhua Yu acknowleges support from the National Natural Science Foundation of China (grant number 81773552 and grant number 81273179) Norberto Perico acknowledges that work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Charles Shey Wiysonge’s work is supported by the South African Medical Research Council and the National Research Foundation of South Africa (grant numbers 106035 and 108571). John J McGrath is supported by grant APP1056929 from the John Cade Fellowship from the National Health and Medical Research Council and the Danish National Research Foundation (Niels Bohr Professorship). Quique Bassat is an ICREA (Catalan Institution for Research and Advanced Studies) research professor at ISGlobal. Richard G White is funded by the UK MRC and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement that is also part of the EDCTP2 programme supported by the European Union (MR/P002404/1), the Bill & Melinda Gates Foundation (TB Modelling and Analysis Consortium: OPP1084276/OPP1135288, CORTIS: OPP1137034/OPP1151915, Vaccines: OPP1160830), and UNITAID (4214-LSHTM-Sept15; PO 8477-0-600). Rafael Tabarés-Seisdedos was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. Mihajlo Jakovljevic acknowleges contribution from the Serbian Ministry of Education Science and Technological Development of the Republic of Serbia (grant OI 175 014). Shariful Islam is funded by a Senior Fellowship from Institute for Physical Activity and Nutrition, Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. Sonia Saxena is funded by various grants from the NIHR. Stefanos Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral program (reference number CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondos Europeo de Desarrollo Regional. Stefanos was awarded with a 6 months visiting fellowship funding at IHME from M-AES (reference no. MV16/00035 from the Instituto de Salud Carlos III). S Vittal Katikreddi was funded by a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_12017/13 & MC_ UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). Traolach S Brugha has received funding from NHS Digital UK to collect data used in this study. The work of Hamid Badali was financially supported by Mazandaran University of Medical Sciences, Sari, Iran. The work of Stefan Lorkowski is funded by the German Federal Ministry of Education and Research (nutriCARD, Grant agreement number 01EA1411A). Mariam Molokhia’s research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We also thank the countless individuals who have contributed to GBD 2016 in various capacities.
Published: 2018

98. Impact of the interruption of a large heart failure regional disease management program on hospital admission rate: a population-based study

Author: Faiez Zannad, François Alla, Nelly Agrinier, Marc Lavielle, Jean-Marc Boivin, Damien Gonthier, Patrick Rossignol, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Modélisation en pharmacologie de population (XPOP), Centre de Mathématiques Appliquées - Ecole Polytechnique (CMAP), École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS)-Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), École polytechnique (X)-Centre National de la Recherche Scientifique (CNRS), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Faculté de Médecine [Nancy], and Lavielle, Marc
Subjects: Male, medicine.medical_specialty, Regional Disease, Management programme, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Humans, Medicine, 030212 general & internal medicine, Program Development, [MATH.MATH-ST] Mathematics [math]/Statistics [math.ST], ComputingMilieux_MISCELLANEOUS, Aged, Heart Failure, business.industry, medicine.disease, Europe, Hospitalization, Population based study, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Population Surveillance, Heart failure, Hospital admission, Emergency medicine, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Morbidity, Cardiology and Cardiovascular Medicine, business
Abstract: International audience
Published: 2018

99. Adhésion des prescriptions médicamenteuses aux recommandations de la société européenne de cardiologie, après une hospitalisation pour insuffisance cardiaque : résultats de la cohorte Epical2

Author: Nathalie Thilly, Patrick Rossignol, Alexandre Mebazaa, Sarah Bitar, Nelly Agrinier, and François Alla
Subjects: Epidemiology, Public Health, Environmental and Occupational Health
Abstract: Introduction Les objectifs de cette etude etaient d’identifier les typologies des prescriptions medicamenteuses chez les patients atteints d’insuffisance cardiaque a fraction d’ejection reduite (ICFEr) et de decrire l’evolution de ces typologies sur trois ans de suivi apres une hospitalisation pour insuffisance cardiaque (IC). Nous avons evalue l’adhesion de ces prescriptions aux recommandations de la societe europeenne de cardiologie (SEC) et identifie les caracteristiques des patients associees a la non-adhesion. Methodes Les donnees sont issues de la cohorte « Epidemiologie de l’insuffisance cardiaque aigue en Lorraine » (EPICAL2). Les patients presentant une fraction d’ejection (FE) – La bitherapie consistant d’un inhibiteur du systeme renine-angiotensine (ISRA) (un inhibiteur de l’enzyme de conversion de l’angiotensine ou un antagoniste des recepteurs de l’angiotensine II) et d’un β-bloquant (BB) ; – La tritherapie incluant un ISRA, un BB et un antagoniste des recepteurs des mineralocorticoides (ARM). La typologie des prescriptions medicamenteuses et leur evolution ont ete evaluees a l’aide de l’analyse de sequences, suivie d’une analyse de cluster hierarchique. Les caracteristiques des patients associees a la non-adhesion ont ete identifiees par des analyses de regression logistique. Resultats Sur les 354 patients avec ICFEr, l’âge moyen etait de 72,6 (± 12,6) ans et 65 % etaient des hommes. Les analyses ont revele quatre typologies de prescriptions medicamenteuses : deux groupes etaient adherents aux recommandations de la SEC et deux non-adherents. Les groupes adherents etaient constitues des prescriptions de bitherapie (ISRA-BB) et de tritherapie (ISRA-BB-ARM) pour environ 64 % des patients et restaient quasi stables dans le temps. Les groupes non-adherents consistaient en l’absence de BB pour environ 22 % des patients et en l’absence d’un ARM pour environ 14 %. Les patients du premier groupe avaient plus souvent du BPCO ou de l’asthme (p 35 % (p = 0,037). Conclusion L’adhesion aux recommandations de la SEC lors d’une hospitalisation pour IC est d’une importance capitale, vu que les prescriptions sont assez stables dans le temps apres la sortie et que les medicaments principaux semblent etre simplement renouveles en ambulatoire. Les patients atteints d’ICFEr sont le plus souvent des patients âges atteints de diverses comorbidites, telles que la nephropathie chronique ou l’asthme/BPCO, et leur prise en charge medicale devrait necessiter un travail interdisciplinaire (cardiologue, pneumologue, nephrologue, medecin generaliste, infirmiere…) pour optimiser leurs soins therapeutiques.
Published: 2019

100. Evaluation of a knowledge transfer scheme to improve policy making and practices in health promotion and disease prevention setting in French regions: a realist study protocol

Author: Audrey Petit, François Alla, Jeanine Pommier, Laetitia Minary, Linda Cambon, Christine Ferron, Valéry Ridde, Christian Dagenais, Marion Porcherie, Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), University of Montreal Public Health Research Institute (IRSPUM), Département de médecine sociale et préventive [ESPUM-Montréal] (ESPUM), Université de Montréal (UdeM), Department of Psychology [Montréal], McGill University = Université McGill [Montréal, Canada], Fédération Nationale d'Education et de promotion de la Santé (FNES), 2016 general call for projects – Prevention strand, CAMBON-AAP16-PREV-11., IRESP, and Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Complex intervention, Knowledge transfer, Prevention, Public health, Realist evaluation, medicine.medical_specialty, Health Informatics, Health Promotion, Health informatics, Health administration, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Nursing, Preventive Health Services, Humans, Medicine, 030212 general & internal medicine, Policy Making, Health policy, lcsh:R5-920, Information Dissemination, business.industry, 030503 health policy & services, Health Policy, Public Health, Environmental and Occupational Health, Health services research, General Medicine, Public relations, 3. Good health, Cross-Sectional Studies, Health promotion, Research Design, Health education, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Health Services Research, lcsh:Medicine (General), 0305 other medical science, business
Abstract: International audience; Background - Evidence-based decision-making and practice are pivotal in public health. However, barriers do persist and they relate to evidence properties, organisations and contexts. To address these major knowledge transfer (KT) issues, we need to rethink how knowledge is produced and used, to enhance our understanding of decision-making processes, logics and mechanisms and to examine the ability of public health services to integrate research findings into their decisions and operations. This article presents a realist evaluation protocol to assess a KT scheme in prevention policy and practice at local level in France. Methods/design - This study is a comparative multiple case study, using a realist approach, to assess a KT scheme in regional health agencies (ARS) and regional non-profit organisations for health education and promotion (IREPS), by analysing the configurations contexts/mechanisms/outcomes of it. The KT scheme assessed is designed for the use of six reviews of systematic reviews concerning the following themes: nutrition, alcohol, tobacco smoking, physical activity, emotional and sexual life and psychosocial skills. It combines the following activities: supporting the access to and the adaptation of scientific and usable evidences; strengthening professionals' skills to analyse, adopt and use the evidences in the course of their practices and their decision-making process; facilitating the use of evidence in the organisations and processes. RAMESE II reporting standards for realist evaluations was used. Discussion - The aims of this study are to experiment and characterise the factors related to the scheme's ability to enable public health stakeholders to address the challenges of KT and to integrate scientific knowledge into policy and practice. We will use the realist approach in order to document the parameters of successful KT strategies in the specific contexts of preventive health services in France, while seeking to determine the transferability of such strategies.
Published: 2017

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