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1.
  • Fitzmauric, C., et al. (författare)
  • 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
  • Ingår i: JAMA Oncology. - : American Medical Association. - 2374-2437 .- 2374-2445. ; 5:12, s. 1749-1768
  • 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.
  • Stanaway, Jeffrey D., et al. (författare)
  • Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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3.
  • Feigin, Valery L., et al. (författare)
  • Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
  • 2019
  • Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
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4.
  • Saffari, M., et al. (författare)
  • Determinants of health-related quality of life in Iranian patients after recovery from COVID-19 : Demographic influences and insomnia
  • 2022
  • Ingår i: International Journal of Public Health Science. - : Intelektual Pustaka Media Utama. - 2252-8806 .- 2620-4126. ; 11:1, s. 220-231
  • Tidskriftsartikel (refereegranskat)abstract
    • The current study sought to identify factors that may affect health-related quality of life (HRQoL) in patients recovering from COVID-19 infection in Iran. In a cross-sectional study 258 patients diagnosed with COVID-19, participants completed a questionnaire approximately one month after hospital discharge when demographic and clinical factors (including insomnia) and HRQoL were assessed. A logistic regression was used. Age, gender, marital status, education, having child, early physician visit, early diagnosis, early hospitalization, symptom type, Rhesus factor, and level of insomnia were associated with various components of HRQoL (p<0.05). In multivariate analyses, poorer physical HRQoL was independently associated with female gender (OR=4.53; 95% CI=2.22-2.29), initial symptom of cough (OR=2.73; 95% CI=1.26-5.94), and insomnia (OR=2.74; 95% CI=1.22-6.14). Poorer mental HRQoL was associated with being age 40 years or older (OR=1.90; 95% CI=1.02-3.54), female gender (OR=2.48; 95% CI=1.26-4.88), initial symptom being cough (OR=3.12; 95% CI=1.46-6.68), and insomnia (sub-threshold insomnia, OR=3.19; 95% CI, 1.51-6.74, to severe insomnia, OR=3.86; 95% CI=1.35-11.07). Healthcare professionals should be aware that older people, female gender, those with initial symptom of cough, and insomnia may be at greater risk for poor quality of life following hospital discharge.
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5.
  • Fan, C. -W, et al. (författare)
  • Weight Stigma Model on Quality of Life Among Children in Hong Kong : A Cross-Sectional Modeling Study
  • 2021
  • Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life (QoL). We recruited 430 dyads of elementary school children [mean age = 10.07 years; nboy = 241 (56.0%); noverweight = 138 (32.1%)] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and perceived weight stigma. Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations.
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6.
  • Mahmoudi, H., et al. (författare)
  • A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19
  • 2021
  • Ingår i: Brain and Behavior. - : John Wiley & Sons. - 2162-3279 .- 2162-3279.
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. Methods: Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. Results: Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r =.334 to 0.454; p <.01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. Conclusion: Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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7.
  • Saffari, M., et al. (författare)
  • Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran : A Quasi-experimental Study
  • 2020
  • Ingår i: Journal of Preventive Medicine and Public Health. - : Korean Society for Preventive Medicine. - 1975-8375 .- 2233-4521. ; 53:4, s. 275-284
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. METHODS: In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores. RESULTS: All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/m2 at baseline to 25.8±2.4 kg/m2 at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold. CONCLUSIONS: A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.
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8.
  • Sanaeinasab, H., et al. (författare)
  • Development and Psychometric Assessment of the COVID-19 Health Literacy Scale : Preliminary Testing and Factor Structure
  • 2022
  • Ingår i: Journal of Health Literacy. - : Mashhad University of Medical Sciences. - 2476-4728. ; 6:4, s. 32-46
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Objective: Improving the health literacy in the different populations regarding COVID-19 may be useful in the control of its prevalence. This study examined the psychometric properties of a newly developed disease-specific measure of health literacy related to COVID-19 to be used as a standard measure. Materials and Methods: Relevant literature was reviewed to identify an item pool, and an expert panel was convened to choose items that might be included in the scale. Content validity ratio (CVR) and content validity index (CVI) was determined and face validity was examined by calculating the impact score in a group of social media users. The factor structure of the initial scale was examined in 590 Iranian individuals participating in online social networks in September 2020. Internal consistency of the scale was assessed by Cronbach’s alpha and test-retest reliability of responses was measured by Pearson correlation coefficients. Results: A five-factor solution for the 51-items scale was obtained through exploratory factor analysis. The five main dimensions were understanding, communication, information seeking, analysis, and behavior. The dimensions explained 47% of the variance in scale scores. Participants whose scores fell in the high category (27%) were significantly different compared to those whose scores fell in the low category (27%) on all dimensions (p<0.001). The CVR values for all items were greater than 0.85 and all items also got CVI values higher than 0.79 based on nine-person expert panel. The Cronbach’s alpha for the overall scale was 0.89, and it was ranged from 0.71 to 0.90. Test-retest reliability for the scale was high (r=0.89). Conclusion: Health Literacy Scale for protect against COVID-19is a valid and reliable measure for Iranian population. This measure should be translated, and administered, in other settings to replicate the results obtained here.
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9.
  • Alimoradi, Z., et al. (författare)
  • Is alexithymia associated with sleep problems? : A systematic review and meta-analysis
  • 2022
  • Ingår i: Neuroscience and Biobehavioral Reviews. - : Elsevier. - 0149-7634 .- 1873-7528. ; 133
  • Tidskriftsartikel (refereegranskat)abstract
    • Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fisher's z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.
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10.
  • Chen, I. -H, et al. (författare)
  • Comparing generalized and specific problematic smartphone/internet use : Longitudinal relationships between smartphone applicationbased addiction and social media addiction and psychological distress
  • 2020
  • Ingår i: Journal of Behavioral Addictions. - : Akademiai Kiado. - 2062-5871 .- 2063-5303. ; 9:2, s. 410-419
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: The literature has proposed two types of problematic smartphone/internet use: generalized problematic use and specific problematic use. However, longitudinal findings on the associations between the two types of problematic use and psychological distress are lacking among EastAsians. The present study examined temporal associations between both generalized and specific problematic use of the smartphone/internet, and psychological distress.Methods: Hong Kong University students (N = 308; 100 males; mean age = 23.75 years; SD ± 5.15) were recruited with followups at three, six, and nine months after baseline assessment. All participants completed the Smartphone Application-Based Addiction Scale (for generalized problematic smartphone/internet use), the Bergen Social Media Addiction Scale (for specific problematic smartphone/internet use), and the Hospital Anxiety and Depression Scale (for psychological distress) in each assessment. Latent growth modeling (LGM) was constructed to understand temporal associations between generalized/specific problematic use and psychological distress.Results: The LGM suggested that the intercept of generalized problematic use was significantly associated with the intercept of psychological distress (standardized coefficient [β] = 0.32; P < 0.01). The growth of generalized problematic use was significantly associated with the growth of psychological distress (β = 0.51; P < 0.01). Moreover, the intercept of specific problematic use was significantly associated with the intercept of psychological distress (β = 0.28; P < 0.01) and the growth of psychological distress (β = 0.37; P < 0.01).Conclusion: The initial level of problematic use of smartphone/internet increased the psychological distress among university students. Helping young adults address problematic use of the smartphone/internet may prevent psychological distress.
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