| 1. |
- Fitzmauric, C., et al.
(författare)
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Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017 : A Systematic Analysis for the Global Burden of Disease Study
- 2019
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Ingår i: JAMA Oncology. - : American Medical Association. - 2374-2437 .- 2374-2445. ; 5:12, s. 1749-1768
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs).Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
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| 2. |
- Komatsu, Kimberly J., et al.
(författare)
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Global change effects on plant communities are magnified by time and the number of global change factors imposed
- 2019
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 116:36, s. 17867-17873
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Tidskriftsartikel (refereegranskat)abstract
- Accurate prediction of community responses to global change drivers (GCDs) is critical given the effects of biodiversity on ecosystem services. There is consensus that human activities are driving species extinctions at the global scale, but debate remains over whether GCDs are systematically altering local communities worldwide. Across 105 experiments that included over 400 experimental manipulations, we found evidence for a lagged response of herbaceous plant communities to GCDs caused by shifts in the identities and relative abundances of species, often without a corresponding difference in species richness. These results provide evidence that community responses are pervasive across a wide variety of GCDs on long-term temporal scales and that these responses increase in strength when multiple GCDs are simultaneously imposed.Global change drivers (GCDs) are expected to alter community structure and consequently, the services that ecosystems provide. Yet, few experimental investigations have examined effects of GCDs on plant community structure across multiple ecosystem types, and those that do exist present conflicting patterns. In an unprecedented global synthesis of over 100 experiments that manipulated factors linked to GCDs, we show that herbaceous plant community responses depend on experimental manipulation length and number of factors manipulated. We found that plant communities are fairly resistant to experimentally manipulated GCDs in the short term (<10 y). In contrast, long-term (≥10 y) experiments show increasing community divergence of treatments from control conditions. Surprisingly, these community responses occurred with similar frequency across the GCD types manipulated in our database. However, community responses were more common when 3 or more GCDs were simultaneously manipulated, suggesting the emergence of additive or synergistic effects of multiple drivers, particularly over long time periods. In half of the cases, GCD manipulations caused a difference in community composition without a corresponding species richness difference, indicating that species reordering or replacement is an important mechanism of community responses to GCDs and should be given greater consideration when examining consequences of GCDs for the biodiversity–ecosystem function relationship. Human activities are currently driving unparalleled global changes worldwide. Our analyses provide the most comprehensive evidence to date that these human activities may have widespread impacts on plant community composition globally, which will increase in frequency over time and be greater in areas where communities face multiple GCDs simultaneously.
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| 3. |
- ENGBERG, ARON
(författare)
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Walking on the Pages of the Word of God : Self, Land, and Text Among Evangelical Volunteers in Jerusalem
- 2016. - 1st
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the last thirty years, the Evangelical relationship with the State of Israel has drawn much academic and popular attention, particularly from historical, theological, and political perspectives. This dissertation engages with this literature but also complements it with an ethnographic account of the discursive practices of Evangelical Zionists through which, it is suggested, much of the religious significance of the contemporary state is being produced. The study is based on ethnographic fieldwork among Evangelical volunteer workers in Jerusalem, focusing on their stories about themselves, the land, and the biblical text. The volunteers are located at three Christian ministries in Jerusalem – the International Christian Embassy Jerusalem (ICEJ), theBridges for Peace (BFP), and the Christian Friends of Israel (CFI) – all of which consider their work in Israel a natural consequence of biblical promises to Israel and their responsibility as Christians to “bless the Jewish people”. After introducing the theoretical and socio-cultural context in which this study is located, Chapter Three analyses the volunteers’ “coming-to-Israel” stories and the ways in which agency and selftransformation are understood therein. The analysis suggests that the ritual-like performance of these narratives situates the encounter with Israel as a religious conversion process and Israel as a religious symbol. Chapter Four discusses the volunteers’ narrative production of Israel as a sacred space that has a unique ability to mediate divine presence. It also shows how Israel’s special status is being negotiated both in relation to the encounter with material realities and with ideas about religious fetishism. The final analytical chapter focuses on “biblical literalism” as a textual ideology and on how this ideology becomes manifest in discourses about Bible prophecy and the “Hebraic roots of Christian faith”. It is suggested that these two discursive domains are deeply embedded in contestations about the authenticity of Evangelical religious forms: while the former often serves as empirical evidence for the truth of the biblical scripture, the latter constructs a historical narrative within which Evangelical Zionism is positioned as a rediscovery of authentic biblical faith. Ultimately, this study suggests that the beliefs and practices of Evangelical Christians engaged with Israel not only represent a recalibration of the relationship between Christianity and Judaism and between faith and politicsthemselves, but also a more fundamental reordering of the ways in which God is understood to relate to the world. While deeply embedded in Evangelical narrative traditions, the ideational and physical encounter with Israel also requires a renegotiation of Evangelical religion. This process involves questions of biblical reading practices and the meanings of signs and their social functions, and it invites Evangelical Zionists to negotiate the proper location of human and divine agency as well as the relationship between materiality and divine presence. For the volunteers the “realization of Israel’s spiritual significance” is a highly transformative experience, but rather than being a definite rupture from the past it is part of a broader process of increasingreligious commitment.
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| 4. |
- Oliver, Brant J., et al.
(författare)
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A Hybrid Markov-SPC Approach to Assess Cost Differences in Urgent Care Utilization Using Patient-Reported Data in Inflammatory Bowel Disease
- 2024
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Ingår i: The Permanente Journal. - : The Permanente Federation. - 1552-5767 .- 1552-5775. ; 28:3, s. 234-244
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCost is a key outcome in quality and value, but it is often difficult to estimate reliably and efficiently for use in real-time improvement efforts. We describe a method using patient-reported outcomes (PROs), Markov modeling, and statistical process control (SPC) analytics in a real-time cost-estimation prototype designed to assess cost differences between usual care and improvement conditions in a national multicenter improvement collaborative—the IBD Qorus Learning Health System (LHS).MethodsThe IBD Qorus Learning Health System (LHS) collects PRO data, including emergency department utilization and hospitalizations from patients prior to their clinical visits. This data is aggregated monthly at center and collaborative levels, visualized using Statistical Process Control (SPC) analytics, and used to inform improvement efforts. A Markov model was developed by Almario et al to estimate annualized per patient cost differences between usual care (baseline) and improvement (intervention) time periods and then replicated at monthly intervals. We then applied moving average SPC analyses to visualize monthly iterative cost estimations and assess the variation and statistical reliability of these estimates over time.ResultsWe have developed a real-time Markov-informed SPC visualization prototype which uses PRO data to analyze and monitor monthly annualized per patient cost savings estimations over time for the IBD Qorus LHS. Validation of this prototype using claims data is currently underway.ConclusionThis new approach using PRO data and hybrid Markov–SPC analysis can analyze and visualize near real-time estimates of cost differences over time. Pending successful validation against a claims data standard, this approach could more comprehensively inform improvement, advocacy, and strategic planning efforts.
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