| 1. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 2. |
- Sayyari, Ali-Akbar, et al.
(författare)
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Methodology of the Comprehensive Program on Prevention and Control of Overweight and Obesity in Iranian Children and Adolescents : The IRAN-Ending Childhood Obesity (IRAN-ECHO) Program
- 2017
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Ingår i: International Journal of Preventive Medicine. - 2008-7802 .- 2008-8213. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization program on Ending Childhood Obesity (WHO-ECHO) has developed a comprehensive and integrated package of recommendations to address childhood obesity. The present study, entitled IRAN-ECHO, was designed and implemented in the framework of the WHO-ECHO program.Methods: The IRAN-ECHO program is implementing multicomponent interventions by considering life course dimensions. The program has two parts: a population approach and an individual approach. The population approach considers different periods in life, including prenatal, infancy, childhood, and adolescence, as well as family and society. The individual approach targets those children or adolescents with overweight or obesity; this part is conducted as a referral system that is now integrated in the current national health system. As part of the population approach, a quasi-experimental study was conducted in six provinces to compare the status before and after implementing parts of the interventions. By intersectoral collaboration with different organizations, multicomponent interventions are conducted for different age groups.Results: The IRAN-ECHO program is being conducted in six provinces, and will be considered in all provinces in the near future. Its main effects could be assessed in future years. Part of this program that was conducted as a quasi-experimental survey comprised 7149 students and showed that a high percentage of students had acceptable knowledge about adverse health effects of overweight and obesity. However, the knowledge about the low nutritional value of unhealthy snacks such as potato chips, puffs, industrial juices, and carbonated drinks was not appropriate. Many participants had the undesirable attitude of skipping one of the main meals when attempting to lose weight.Conclusions: The IRAN-ECHO program is presenting the feasibility of conducting the WHO-ECHO recommendations in Iran. The scope of potential policy recommendations to decrease childhood obesity is extensive and includes various elements. This program considers multisectoral interventions through population and individual approaches. The multicomponent interventions of this program address the obesogenic environment by considering the life course dimensions. It is expected that, by its life course interventions, it could help in primordial and primary prevention of noncommunicable diseases.
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| 3. |
- Schweiker, Marcel, et al.
(författare)
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The Scales Project, a cross-national dataset on the interpretation of thermal perception scales
- 2019
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Ingår i: Scientific data. - : Springer Science and Business Media LLC. - 2052-4463. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Thermal discomfort is one of the main triggers for occupants' interactions with components of the built environment such as adjustments of thermostats and/or opening windows and strongly related to the energy use in buildings. Understanding causes for thermal (dis-)comfort is crucial for design and operation of any type of building. The assessment of human thermal perception through rating scales, for example in post-occupancy studies, has been applied for several decades; however, long-existing assumptions related to these rating scales had been questioned by several researchers. The aim of this study was to gain deeper knowledge on contextual influences on the interpretation of thermal perception scales and their verbal anchors by survey participants. A questionnaire was designed and consequently applied in 21 language versions. These surveys were conducted in 57 cities in 30 countries resulting in a dataset containing responses from 8225 participants. The database offers potential for further analysis in the areas of building design and operation, psycho-physical relationships between human perception and the built environment, and linguistic analyses.
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| 4. |
- Abbaspoor, Zahra, et al.
(författare)
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Translation and cultural adaptation of the Childbirth Experience Questionnaire (CEQ) in Iran
- 2019
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Ingår i: Iranian Journal of Nursing and Midwifery Research. - 1735-9066 .- 2228-5504. ; 24:4, s. 296-300
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Iranian Journal of Nursing and Midwifery Research Published by Wolters Kluwer - Medknow. A standardized method to measure and quantify women's birth experiences is required to study satisfaction of childbirth care. Therefore, this study aimed to translate and culturally adapt the Childbirth Experience Questionnaire (CEQ) for use in Iran. Materials and Methods: This was a cross-sectional study including 203 women who attended 2 hospitals and 2 health centers and met the inclusion criteria in Ahvaz city, between February 2013 and June 2014. After forward and backward translation of the Swedish CEQ into Persian language, content validity was assessed by an expert panel. Scale reliability (internal consistency and test-retest reliability) was assessed with respect to the psychometric properties of the scale. Results: Minor cultural differences were identified and resolved during the translation process. One item was excluded. The intraclass correlation coefficient ranging from 0.63 to 0.90 was satisfactory. Conclusions: The Persian version of the CEQ appears to be valid and reliable; hence, it can be an effective tool in designing childbirth experience interventions and also childbirth care and education interventions for the promotion of positive childbirth experience in Iranian women.
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| 5. |
- Abdi-Jalebi, Mojtaba, et al.
(författare)
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Maximizing and stabilizing luminescence from halide perovskites with potassium passivation
- 2018
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 555, s. 497-501
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Tidskriftsartikel (refereegranskat)abstract
- Metal halide perovskites are of great interest for various high-performance optoelectronic applications. The ability to tune the perovskite bandgap continuously by modifying the chemical composition opens up applications for perovskites as coloured emitters, in building-integrated photovoltaics, and as components of tandem photovoltaics to increase the power conversion efficiency. Nevertheless, performance is limited by non-radiative losses, with luminescence yields in state-of-the-art perovskite solar cells still far from 100 per cent under standard solar illumination conditions. Furthermore, in mixed halide perovskite systems designed for continuous bandgap tunability2 (bandgaps of approximately 1.7 to 1.9 electronvolts), photoinduced ion segregation leads to bandgap instabilities. Here we demonstrate substantial mitigation of both non-radiative losses and photoinduced ion migration in perovskite films and interfaces by decorating the surfaces and grain boundaries with passivating potassium halide layers. We demonstrate external photoluminescence quantum yields of 66 per cent, which translate to internal yields that exceed 95 per cent. The high luminescence yields are achieved while maintaining high mobilities of more than 40 square centimetres per volt per second, providing the elusive combination of both high luminescence and excellent charge transport. When interfaced with electrodes in a solar cell device stack, the external luminescence yield—a quantity that must be maximized to obtain high efficiency—remains as high as 15 per cent, indicating very clean interfaces. We also demonstrate the inhibition of transient photoinduced ion-migration processes across a wide range of mixed halide perovskite bandgaps in materials that exhibit bandgap instabilities when unpassivated. We validate these results in fully operating solar cells. Our work represents an important advance in the construction of tunable metal halide perovskite films and interfaces that can approach the efficiency limits in tandem solar cells, coloured-light-emitting diodes and other optoelectronic applications.
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| 6. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 7. |
- Aghili, Rokhsareh, et al.
(författare)
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Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes : a path analysis model
- 2018
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Ingår i: International Journal of Diabetes in Developing Countries. - : Springer Science and Business Media LLC. - 0973-3930 .- 1998-3832. ; 38:3, s. 289-297
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare the status of psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes (T2D). In this observational study on people with T2D, demographic, self-care behavior, resources, and affective variables as well as health-related quality of life were assessed and compared in insulin-naïve and insulin-experienced considering the number of oral glucose-lowering drugs (OGLDs). Measured variable path analysis was used to test the association among variables and their effect on HbA1c in both groups. In total, 215 insulin-naïve and 165 insulin-experienced patients were recruited in this study. The mean duration of diabetes was 11.7 ± 7.0 years in insulin-experienced and 6.8 ± 5.4 years in insulin-naïve (p < 0.001). The mean hemoglobin A1c (HbA1c) was significantly higher in insulin-experienced subjects irrespective of the number of OGLDs [68 ± 20 mmol/mol (8.4 ± 1.8%) vs. 56 ± 16 mmol/mol (7.3 ± 1.4%); p < 0.001]. Moreover, insulin-experienced subjects had significantly higher level of diabetes-related distress (2.2 ± 0.9 vs. 1.9 ± 0.8), depression (9.5 ± 5.5 vs. 8.1 ± 5.1), anxiety (18.3 ± 12.0 vs. 15.1 ± 10.5), and lower knowledge of insulin use considering the results of 9-item insulin-use subscale of Michigan diabetes knowledge test (mean 3.9 ± 1.8) compared to insulin-naïve subjects (p < 0.05). Higher levels of distress, depression, and anxiety are found in insulin-experienced people with T2D. Therefore, one should be aware that, at the time of insulin need/initiation, people with T2D have reached a more vulnerable state and this should be taken into consideration when implementing a complex insulin initiation plan.
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| 8. |
- Ahlmér, Anna Klara, et al.
(författare)
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Soil moisture remote-sensing applications for identification of flood-prone areas along transport infrastructure
- 2018
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Ingår i: Environmental Earth Sciences. - : Springer. - 1866-6280 .- 1866-6299. ; 77:14
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Tidskriftsartikel (refereegranskat)abstract
- The expected increase in precipitation and temperature in Scandinavia, and especially short-time heavy precipitation, will increase the frequency of flooding. Urban areas are the most vulnerable, and specifically, the road infrastructure. The accumulation of large volumes of water and sediments on road-stream intersections gets severe consequences for the road drainage structures. This study integrates the spatial and temporal soil moisture properties into the research about flood prediction methods by a case study of two areas in Sweden, Vastra Gotaland and Varmland, which was affected by severe flooding in August 2014. Soil moisture data are derived from remote-sensing techniques, with a focus on the soil moisture-specific satellites ASCAT and SMOS. Furthermore, several physical catchments descriptors (PCDs) are analyzed and the result shows that larger slopes and drainage density, in general, mean a higher risk of flooding. The precipitation is the same; however, it can be concluded that more precipitation in most cases gives higher soil moisture values. The lack, or the dimensioning, of road drainage structures seems to have a large impact on the flood risk as more sediment and water can be accumulated at the road-stream intersection. The results show that the method implementing soil moisture satellite data is promising for improving the reliability of flooding.
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| 9. |
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| 10. |
- Ahmadi, Zahra, 1966-
(författare)
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Market orientation and public housing companies in the Swedish declining market
- 2016
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The licentiate thesis consists of three papers with the particular topic in public housing. They discuss how the public housing companies manage the transition to higher economic demands meeting increased customer and market requirements. These studies focus specifically on how the public housing company deal with market challenges associated with the decision to demolish, maintain and/or new construction. Market-oriented perspective can be a tool for the public housing companies to achieve better customer value and enhance economic development. Although the market orientation concept has contributed to valuable improvements in research, the thesis assumes that it is necessary to distinguish between that the public housing companies operate market-oriented to meet customer requirements and their focus on innovation.Paper I develops market/innovation types and then investigates how public housing companies adapt to these types. It was found that economic conditions in the municipality have a major impact on the housing companies, causing them to act innovatively and create superior customer value by innovations. The study confirms that the implementation of market and innovation orientation contributes to competitive advantages in growing markets, while weak economic conditions impair implementation in declining markets.Paper II addresses how public housing companies in declining markets act based on the concept of market intelligence. This study suggested and tested whether there is a positive link between collecting customer information, disseminating it in the organization, and responding to customer needs, and whether this link has an impact on strategic performance. The result shows that weak links exist in the process; the efficiency of intelligence distribution in public housing companies is affected mainly by their responsiveness to customer needs.Paper III also addresses the public housing companies’ market strategies in declining markets. This study, based on a market-strategic perspective, compares how public housing companies act in relation to customer wants compared to the private housing market. The result shows that public housing companies are more engaged in carrying out new construction, renovation, and reconstruction, as well as taking more social responsibility compared to the private sector. In particular, their concern for the customers’ social needs is evident.
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