Global & Public Health (all articles)
Systematic Analysis: Global Burden and Trends of Nervous System Disorders, 1990–2021
21 Mar, 2024 | 11:10h | UTCStudy Design and Population
This study, a systematic analysis conducted by the Global Burden of Disease Study 2021, aimed to estimate the global, regional, and national health loss attributable to 37 unique nervous system conditions from 1990 to 2021. The researchers estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) across 204 countries. The analysis included morbidity and deaths directly resulting from damage to the central or peripheral nervous system, as well as neurological health loss from conditions where nervous system morbidity is a secondary outcome.
Main Findings
The collective global burden of these nervous system conditions emerged as the leading cause of DALYs in 2021, affecting approximately 3.40 billion individuals (43.1% of the global population) and resulting in 443 million DALYs. Although global DALY counts for these conditions increased by 18.2% from 1990 to 2021, there was a notable decrease in the age-standardised rates of deaths and DALYs by 33.6% and 27.0%, respectively. The conditions contributing most significantly to the age-standardised DALYs were stroke, neonatal encephalopathy, migraine, and Alzheimer’s disease among others.
Implications for Practice
This analysis underscores the critical need for effective prevention, treatment, and rehabilitation strategies for nervous system disorders, which now lead the global disease burden. Highlighting an 18.2% increase in DALY counts over the study period, it calls for heightened public health attention and resource allocation towards these conditions. The findings support the prioritization of nervous system health on the global health agenda and stress the importance of further research into modifiable risk factors and equitable access to care.
Reference
GBD 2021 Nervous System Disorders Collaborators (2024). Systematic Analysis: Global Burden and Trends of Nervous System Disorders, 1990–2021. The Lancet Neurology, Volume(issue), Pages. DOI: https://doi.org/10.1016/S1474-4422(24)00038-3. Access the study here: Link
Meta-Analysis: Effectiveness of therapist-guided remote vs. in-person cognitive behavioral therapy
20 Mar, 2024 | 19:32h | UTCStudy Design and Population: This systematic review and meta-analysis investigated the efficacy of therapist-guided remote cognitive behavioral therapy (CBT) compared to traditional in-person CBT. The authors conducted a comprehensive search across several databases, including MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials, up to July 4, 2023. A total of 54 randomized controlled trials (RCTs) were included, encompassing 5463 adult patients presenting with various clinical conditions. The study meticulously assessed the risk of bias and extracted data using a standardized approach, and outcomes were analyzed using a random-effects model.
Main Findings: The primary analysis focused on patient-important outcomes, comparing the effectiveness of remote and in-person CBT across diverse conditions such as anxiety and related disorders, depressive symptoms, insomnia, chronic pain or fatigue syndromes, body image or eating disorders, tinnitus, alcohol use disorder, and mood and anxiety disorders. The meta-analysis, based on moderate-certainty evidence, found little to no difference in effectiveness between remote and in-person CBT (standardized mean difference [SMD] −0.02, 95% confidence interval −0.12 to 0.07), suggesting that both delivery methods are comparably effective across a range of disorders.
Implications for Practice: The findings indicate that therapist-guided remote CBT is nearly as effective as in-person CBT for treating a variety of mental health and somatic disorders. This supports the potential for remote CBT to significantly increase access to evidence-based care, especially in settings where in-person therapy is not feasible or is limited by geographic, economic, or social barriers. Future research should explore optimizing remote CBT delivery methods to further enhance accessibility and efficacy.
Reference: Zandieh, S. et al (2024). Therapist-guided remote versus in-person cognitive behavioural therapy: a systematic review and meta-analysis of randomized controlled trials. CMAJ, 196(10), E327-E340. [Link]
Meta-Analysis: Efficacy of exercise modalities in major depressive disorder treatment
20 Mar, 2024 | 17:54h | UTCStudy Design and Population: This article presents a systematic review and network meta-analysis of randomized controlled trials to assess the optimal dose and modality of exercise for treating major depressive disorder, comparing its effects to psychotherapy, antidepressants, and control conditions such as usual care or placebo. The review included 218 unique studies encompassing 495 arms with a total of 14,170 participants who met the clinical cutoffs for major depression.
Main Findings: The findings revealed moderate reductions in depression symptoms for several exercise modalities when compared to active controls. Notably, walking or jogging, yoga, and strength training demonstrated the most significant effects. The effectiveness of exercise was found to be proportional to the intensity of the activity prescribed. Among these, yoga and strength training were identified as the most acceptable modalities for participants. However, the overall confidence in these results is low due to the high risk of bias in the included studies, with only one study meeting the criteria for a low risk of bias.
Implications for Practice: The study concludes that exercise, particularly walking or jogging, yoga, and strength training at sufficient intensities, can be an effective treatment for major depressive disorder. These modalities could be recommended alongside traditional treatments such as psychotherapy and antidepressants. Future research should focus on blinding participants and staff to mitigate expectancy effects and improve the reliability of findings. The inclusivity of exercise as a core treatment for depression could significantly impact treatment strategies and patient outcomes.
Reference: Noetel, M., et al. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, e075847. DOI: https://doi.org/10.1136/bmj-2023-075847. Access the study here: [Link]
RCT | Field sobriety tests display insufficient accuracy for detecting THC-specific driving impairment
11 Aug, 2023 | 15:14h | UTCSee also: Visual Abstract
News Release: Can field sobriety tests identify drivers under the influence of cannabis? – University of California – San Diego
Commentary on Twitter
This randomized clinical trial investigates the accuracy of field sobriety tests administered by law enforcement officers to assess functional impairment and driving performance among individuals who have smoked cannabis. https://t.co/pThOOdZGUh
— JAMA Psychiatry (@JAMAPsych) August 2, 2023
M-A | Community-based interventions using holistic assessment and care planning improve independent living in older adults
9 Aug, 2023 | 15:13h | UTC
Global prevalence, years lived with disability, and trends in anemia burden by severity and cause, 1990–2021
3 Aug, 2023 | 13:43h | UTC
Commentary on Twitter
NEW #GBD study by @IHME_UW on the #anaemia burden by severity and cause, 1990–2021?https://t.co/NbiEDSkbGI
Despite a decrease in prevalence, the number of people with anaemia increased globally
In every region females had a higher #anemia YLDs than males pic.twitter.com/oFx4vHRhs1
— The Lancet Haematology (@TheLancetHaem) August 1, 2023
WHO | Seven out of 10 people protected by at least one tobacco control measure
2 Aug, 2023 | 14:14h | UTCNews Release: Seven out of 10 people protected by at least one tobacco control measure – World Health Organization
See also: MPOWER measures
Commentaries:
Expert reaction to WHO report on the global tobacco epidemic 2023 – Science Media Centre
Commentary on Twitter
The MPOWER measures include?
?-onitoring tobacco use
?-rotecting people from tobacco smoke
?-ffering support to quit smoking
?-arning about the dangers of tobacco
?-nforcing tobacco advertising, promotion & sponsorship bans
?-aising taxes on TobaccoLearn more.… pic.twitter.com/ImfGsL8in1
— World Health Organization (WHO) (@WHO) July 31, 2023
Study | Childhood deaths in high-mortality settings mostly preventable; infection, malnutrition top causes
31 Jul, 2023 | 14:05h | UTCInvited Commentary: Need for a Structural Approach to Promote Child Survival – JAMA Network Open
News Release: Eight out of ten child deaths in low-income countries could be prevented – Barcelona Institute for Global Health
New WHO lists of essential medicines
28 Jul, 2023 | 14:23h | UTCNews Release: WHO endorses landmark public health decisions on Essential Medicines for Multiple Sclerosis – World Health Organization
Lists of Essential Medicines
Model Lists of Essential Medicines – World Health Organization
Model Lists of Essential Medicines for Children – World Health Organization
Commentary on Twitter
OUT TODAY: New editions of the WHO Model Lists of Essential Medicines and Essential Medicines for Children which include important new medicines for the treatment of multiple sclerosis, cancer, infectious diseases and cardiovascular conditions, among others… pic.twitter.com/RZYdgc0i65
— World Health Organization (WHO) (@WHO) July 26, 2023
WHO world drowning prevention day 2023
27 Jul, 2023 | 13:12h | UTCWorld Drowning Prevention Day 2023 – World Health Organization
Report: Hidden depths: the global investment case for drowning prevention – World Health Organization
Related:
Prevention of Drowning – Pediatrics
Preventing drowning: an implementation guide – World Health Organization
Global report on drowning: preventing a leading killer – World Health Organization
Hidden Hazards: An Exploration of Open Water Drowning and Risks for Children – Safe Kids Worldwide
Commentary on Twitter (thread – click for more)
It's #WorldDrowningPreventionDay
Every year, drowning claims at least 236,000 lives. It's one of the leading causes of death ? for children & people aged 1-24 years. We can all take action to end drowning ? https://t.co/7CSUGYBk49 pic.twitter.com/r64dbsLnHn— World Health Organization (WHO) (@WHO) July 25, 2023
Global, regional, and national burden of meningitis and its etiologies, 1990–2019
25 Jul, 2023 | 13:55h | UTC
Commentary on Twitter
Although largely preventable, meningitis still causes hundreds of thousands of deaths globally each year.
New @IHME_UW #GBDStudy in @TheLancetNeuro assesses incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990–2019. https://t.co/S3KtMA7DMs pic.twitter.com/AYuSJHsNwK
— The Lancet (@TheLancet) July 20, 2023
Key factors associated with quality of postnatal care: a pooled analysis of 23 countries
25 Jul, 2023 | 13:50h | UTC
New WHO guidance on the role of HIV viral suppression in improving individual health and reducing transmission
24 Jul, 2023 | 13:17h | UTCNews Release: New WHO guidance on HIV viral suppression and scientific updates released at IAS 2023 – World Health Organization
WHO Guidance: The role of HIV viral suppression in improving individual health and reducing transmission – Word Health Organization
Related WHO Guidelines:
WHO recommends optimizing HIV testing services – World Health Organization
Primary health care and HIV: convergent actions – World Health Organization
Systematic Review | Low-level HIV viremia (below 1000 copies/mL) linked to minimal sexual transmission risk
24 Jul, 2023 | 13:15h | UTCThe risk of sexual transmission of HIV in individuals with low-level HIV viraemia – The Lancet
Editorial: HIV is sexually untransmittable when viral load is undetectable – The Lancet
Related: Study: Growing Acceptability of “Undetectable = Untransmittable” but Widespread Misunderstanding of HIV Transmission Risk Persists (several texts on the subject)
Commentary on Twitter
People on ART with low but detectible levels of HIV viral load have almost zero risk of sexually transmitting the virus to others, in-depth review suggests #IAS2023https://t.co/wU26C8cEMK pic.twitter.com/hQHLDqPxO6
— The Lancet (@TheLancet) July 22, 2023
M-A | Exposure to smoke, overcrowding, poor living conditions, and contact with TB cases identified as risk conditions for pediatric TB
24 Jul, 2023 | 12:43h | UTC
M-A | Population-level smoke-free legislation tied to better cardiovascular, respiratory, birth outcomes
19 Jul, 2023 | 14:13h | UTCCommentary: Smoke-Free Legislation Linked to Drop in Adverse Health Outcomes – HealthDay
Systematic Review | Prevalence and risk factors of cardiovascular diseases in young adults across 204 countries, 1990-2019
17 Jul, 2023 | 13:47h | UTC
WHO Guideline | Policies to protect children from the harmful impact of food marketing
12 Jul, 2023 | 13:52h | UTCNews Release: WHO recommends stronger policies to protect children from the harmful impact of food marketing – World Health Organization
Commentary: WHO Launches New Guideline for Protecting Children from Unhealthy Food Marketing – Health Policy Watch
USPSTF | Routine depression screening recommended for adults including pregnant and postpartum women
11 Jul, 2023 | 14:09h | UTCEvidence Report: Depression and Suicide Risk Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Patient Page: Screening for Depression and Suicide Risk in Adults – JAMA
Editorials:
Reframing the Key Questions Regarding Screening for Suicide Risk – JAMA
Suicidality Screening Guidelines Highlight the Need for Intervention Studies – JAMA Network Open
Related:
Global Burden of Disease Study | Understanding global trends of infectious diseases in younger population, 1990-2019
10 Jul, 2023 | 13:54h | UTCNews Release: Global efforts to reduce infectious diseases must extend beyond early childhood – Murdoch Children’s Research Institute
Commentary: Global infectious disease burden shifting from younger to older youth – CIDRAP
AAP Policy Statement | Child pedestrian safety
10 Jul, 2023 | 13:44h | UTCChild Pedestrian Safety – Pediatrics
Technical Report: Epidemiology and Prevention of Child Pedestrian Injury – Pediatrics
News Release: Speed, technology, road design are key factors in reducing pedestrian injuries – AAP News
USPSTF Recommendations | Screen for anxiety disorders in adults, including pregnant and postpartum women
30 Jun, 2023 | 15:03h | UTCEditorial: Are There Reasons to Fear Anxiety Screening? – JAMA
Evidence Report: Anxiety Screening: Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA
Patient Page: Screening for Anxiety Disorders in Adults – JAMA
Author Interview: USPSTF Recommendations: Screening for Depression and Suicide Risk in Adults, and Screening for Anxiety Disorders in Adults – JAMA
Global incidence in hospital-associated infections resistant to antibiotics: an analysis of point prevalence surveys from 99 countries
30 Jun, 2023 | 14:33h | UTC
Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050
26 Jun, 2023 | 01:00h | UTCSummary: This systematic review analyzed the global burden of diabetes, including trends, projections, and attributions to risk factors. It considered data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), covering 204 countries and territories.
In 2021, an estimated 529 million people worldwide were living with diabetes. Regionally, the highest rates were observed in North Africa, the Middle East, and Oceania. Type 2 diabetes accounted for 96% of diabetes cases and 95.4% of diabetes DALYs (disability-adjusted life-years). More than half of global type 2 diabetes DALYs were attributable to high body mass index (BMI).
Predictions suggest that more than 1.31 billion people will have diabetes by 2050, with high prevalence rates in North Africa, the Middle East, and Latin America. The study notes the ongoing challenge of preventing and controlling type 2 diabetes, largely driven by increasing obesity. An understanding of disparities in risk profiles and disease burdens can inform strategies to control diabetes risk factors.
Editorial: Diabetes: a defining disease of the 21st century – The Lancet
News Release: Global diabetes cases to soar from 529 million to 1.3 billion by 2050 – Institute for Health Metrics and Evaluation
Commentary on Twitter (thread – click for more)
Today: More than 529 million people across the globe have diabetes
In the next 30 years: 1.3 billion people are projected to have diabetes
https://t.co/gh2O0K7RY0— Institute for Health Metrics and Evaluation (IHME) (@IHME_UW) June 22, 2023
WHO outlines 40 research priorities on antimicrobial resistance
26 Jun, 2023 | 00:50h | UTCNews release: WHO outlines 40 research priorities on antimicrobial resistance – World Health Organization
Report: Global research agenda for antimicrobial resistance in human health – World Health Organization
Commentary on Twitter
?WHO published its 1st global research agenda for the world’s scientists to address the most urgent human health priorities to combat antimicrobial resistance
It outlines 40 research topics on drug-resistant bacteria,fungi& Mycobacterium TB
H/t @paimadhuhttps://t.co/AOVObnJK5Q pic.twitter.com/owZJwMIDXK— Antibiotic Steward Bassam Ghanem?? (@ABsteward) June 22, 2023