| 1. |
- Griswold, Max G., et al.
(författare)
-
Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2018
-
Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
|
|
| 2. |
- Nyström, Anne-Sofie, 1974-, et al.
(författare)
-
Coping with Higher Education Expectations : Wellbeing and Prestige-related Stress in Medicine and Law
- 2018. - 1
-
Ingår i: Social justice in times of crisis and hope. - New York : Peter Lang Publishing Group. - 9781433163692 ; , s. 27-43
-
Bokkapitel (refereegranskat)abstract
- In this chapter we draw on interviews with students and staff on law and medicine programmes in two high-status universities in Sweden and England to explore (di)stress, crisis and wellbeing on these programmes. Thus, our focus is on predominantly, although not exclusively, middle- and upper-class students. There has been a tendency in educational research, and especially research that concentrates on social justice, to focus on disadvantaged groups while their privileged counterparts—who are often cast as successful and “having it all”—are seldom subject to scrutiny (Gaztambide-Fernández & Howard, 2010). While we acknowledge the tremendous importance of research on disadvantaged groups, there are strong arguments for also rendering visible the experiences of privileged, middle- and upper-class students. As Walkerdine, Lucey, and Melody (2001) argue, if we wish to explore the ways in which systems of stratification are produced, reproduced and transformed we need to analyse the production of privilege as well as the production of disadvantage. Furthermore, although middle-class students typically have many privileges relative to their working-class counterparts, it is unreasonable to assume that educational achievement is simply a celebratory success story for middle-class young people (Allan, 2010). For example, Walkerdine et al. in the UK (2001) and Holmqvist (2017) in Sweden vividly portray the anxiety, stress and profound fears of failure experienced by privileged young people who were growing up in a culture where anything less than excellence was regarded as failure. As Francis and Mills (2012) argue, schools can be damaging organisations for pupils and teachers and the implications for social justice are considerable. In this chapter, we focus on H.E. rather than schools to explore the production of stress and anxiety in two high-status programmes, and especially the ways in which stress is heightened by the prestige of the programmes: what we have termed “prestige-related stress.” We focus in particular on the ways in which stress and hard work were normalised on the programmes, how students responded, and the impacts on their wellbeing. We also explore the ways in which social comparisons and changing frames of reference impact student identities and feelings of worth. We begin by briefly outlining our research methods and contexts.
|
|
| 3. |
|
|
