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- James, SL, et al.
(författare)
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Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study
- 2020
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Ingår i: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. - : BMJ. - 1475-5785. ; 26:SUPP_1Supp 1, s. 125-153
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Tidskriftsartikel (refereegranskat)abstract
- While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.MethodsIn this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.ResultsGBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.ConclusionsGBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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| 3. |
- James, SL, et al.
(författare)
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Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017
- 2020
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Ingår i: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. - : BMJ. - 1475-5785. ; 26:SUPP_1Supp 1, s. 96-114
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Tidskriftsartikel (refereegranskat)abstract
- Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.MethodsWe reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).FindingsIn 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).InterpretationInjuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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- Ni, Sha
(författare)
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Tracing marine hypoxic conditions during warm periods using a microanalytical approach
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Deoxygenation, i.e. loss of oxygen from the oceans, often considerably influences the aquatic organisms and the wholeecosystem and changes biogeochemical cycles. It results in increasing bottom areas of hypoxia (<2 mg/l dissolved oxygen),which has been primarily attributed to global warming and increased eutrophication. It is vital to study the present-dayanthropogenically-induced environmental changes in coastal settings such as hypoxia and their outcomes. The Baltic Sea ishighly sensitive to hypoxia, which has occurred during several warm periods in the past. The studies of comparable hypoxicevents during the warm periods in the past can help us better understand the cause, severity, and potential outcomes ofenvironmental changes in the present day.In this thesis, I reconstructed the past environmental conditions, i.e. water temperature, salinity, and oxygen concentrationsfrom eight sites in the Baltic Sea using a multi-method approach including synchrotron X-ray spectroscopy and plasmaanalytical methods. I used trace elements and stable isotopes analyses on benthic foraminifera from two warm periods in thepast, the Eemian (130 – 115 thousand years before present AD 1950, ka BP) and the Holocene (11.5 ka BP to present) to studyhow the extent and severity of hypoxia and other environmental factors have varied in the Baltic Sea over time.During the Eemian period, the bottom water in the southern and western Baltic Sea show larger seasonal variations. There wasa rapid salinity increase in the early Eemian due to a wider and deeper passage from the North Sea to the Baltic Sea. Thetemperature differences between cold and warm seasons were increasing in the first half of the Eemian period. During the mid- andlate-Eemian, the bottom water became more stagnant with lower oxygen content. The trends agree with the simulationresults, indicating influences from North Atlantic Oscillation and precipitation-evaporation balance. During the Holoceneperiod, the bottom water salinity increased dramatically ~7,700–7,500 years ago and decreased ~4,100–2,500 years ago,coinciding with the variations in bottom water oxygen content and temperature. The reconstructions were based on species-specificcalibration and the geochemistry of ‘clean’ foraminiferal calcite without contamination from authigenic minerals. Thediagenetic coatings on foraminifera formed under extremely low oxygen conditions in the deepest basin in the Baltic Sea werehighly enriched in multiple elements, which could significantly alter the foraminiferal geochemistry. The study can be used asguidance for interpreting foraminiferal trace element analyses from extreme environmental conditions. The calibration studyfrom the low oxygen basin, the Santa Barbara Basin, shows the importance of species-specific calibrations under a restrictedoxygen environment and improved the application of oxygen proxy using trace elements, i.e. manganese incorporation inforaminiferal calcite.
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