| 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. |
- Enze, Tian, et al.
(författare)
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Airborne Particles removal by Negative Ions Generated in Ambient Air and Inert Gas
- 2017
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Ingår i: In: Proceedings of the 10<sup>th</sup> International Symposium on Heating, Ventilation and Air Conditioning – ISHVAC 2017. 19-22 2017; Jinan, China.
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Konferensbidrag (refereegranskat)abstract
- Airborne particles can be removed by air ions in enclosed environment, but the main drawback of this method is the formation of harmful by-products such as ozone (O3). In this study, we use ambient air and inert gas, including argon (Ar) and Nitrogen (N2) to generate negative ions respectively, and then release those ions into an enclosed chamber with ambient air. We then investigated the particle concentration decay rates and O3 concentration increase in the chamber. We found that the particle concentration decay rates were 0.343 min-1, 0.209 min-1 and 0.274 min-1 when ions were generated in ambient air, Ar and N2 respectively. The ozone concentration does not show a marked increase when using either ambient air or inert gas (Ar and N2) to generate ions. Since the temperature and humidity of ambient air may influence the ozone generation during ionizing, further study should be investigated.
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| 3. |
- Orpana, Heather M., et al.
(författare)
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Global, regional, and national burden of suicide mortality 1990 to 2016 : Systematic analysis for the Global Burden of Disease Study 2016
- 2019
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Ingår i: BMJ (Online). - : BMJ. - 1756-1833 .- 0959-8138. ; 364
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
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| 4. |
- Polak, Joanna, et al.
(författare)
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Improving the performance of heat valve ventilation system : A study on the provided thermal environment
- 2019
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Ingår i: Building and Environment. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0360-1323 .- 1873-684X. ; 164
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Tidskriftsartikel (refereegranskat)abstract
- The current study presents and evaluates the performance of two types of supply air terminal devices applied in a heat valve ventilation (HVV) system with regard to the provided thermal environment in a room heated and ventilated by the HVV system. To that end, air temperature and air velocity patterns and local thermal discomfort due to draught were studied both experimentally and numerically. Using numerical simulations, parametric analysis was carried out for investigating the provided indoor thermal environment for a wider range of boundary conditions. The considered parameters included the influence of cold vertical surfaces, supply airflow rate and temperature, and room heating energy demand. The results showed that both of the applied air terminal devices could avoid temperature stratification within the occupied zone. The maximum air temperature difference between 0.1 and 1.8 m above the floor was 2.1 degrees C when using a circular valve placed in the external wall below the window and 2.6 degrees C in the case when the air was supplied through three nozzles located in the wall opposite to the window in the upper part of the room. In general, placing the air terminal device below the window provided more uniform air temperature distribution and contributed to the prevention of downdraught caused by a cold window surface. The outcomes of this study are relevant to selecting and designing ventilation and air heating systems for low-energy buildings.
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| 6. |
- Sadrizadeh, Sasan, et al.
(författare)
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Numerical simulation of the impact of surgeon posture on airborne particle distribution in a turbulent mixing operating theatre
- 2016
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Ingår i: Building and Environment. - : Elsevier. - 0360-1323 .- 1873-684X. ; 110, s. 140-147
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Tidskriftsartikel (refereegranskat)abstract
- Airborne particles released from surgical team members are major sources of surgical site infections. To reduce the risk of such infections, ultraclean-zoned ventilation systems have been widely applied, as a complement to the ventilation of the main operating theatre. The function of ventilation in an operating theatre is usually determined without considering the influence of the staff members' posture and movements. The question of whether the surgeon's posture during an on-going operation will influence particle distribution within the surgical area has not yet been explored in depth or well documented. In the present study we analysed data from investigation of two positions (bending and straightened up), which represent the most common surgeon and staff-member postures. The investigation was performed by applying the computational fluid dynamics methodology to solve the governing equations for airflow and airborne particle dispersion. Ultraclean-zoned ventilation systems were examined as an addition to the conventional operating theatre. We examined three distinct source strengths (mean value of pathogens emitted from one person per second) due to the variety of staff clothing systems. In the upright posture, the screen units reduced the mean air counts of bacteria and the mean counts of sedimenting bacteria to a standard level for infection-prone surgeries in the surgical area. However, the performance of this system could be reduced drastically by improper Work experience. Surgical garments with a high protective capacity result in lower source strength and thus reduces the particle concentration within the surgical area. These results are useful for developing best practices to prevent or at least reduce the infection rate during a surgical intervention.
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