As little is known about the burden of type 1 (T1DM) and type 2 diabetes (T2DM) in adolescents in Western Europe (WE), we aimed to explore their epidemiology among 10-24 year-olds.
Estimates were ...retrieved from the Global Burden of Diseases Study (GBD) 2019. We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for prevalence, incidence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries.
In 2019, prevalence and disability estimates were higher for T1DM than T2DM among 10-24 years old adolescents in WE. However, T2DM showed a greater increase in prevalence and disability than T1DM in the 30 years observation period in all WE countries. Prevalence increased with age, while only minor differences were observed between sexes.
Our findings highlight the substantial burden posed by DM in WE among adolescents. Health system responses are needed for transition services, data collection systems, education, and obesity prevention.
In 2016, the World Health Assembly adopted the resolution to eliminate viral hepatitis by 2030. This study aims to provide an overview of the burdens of hepatitis B virus (HBV) and hepatitis C virus ...(HCV) in Europe and their changes from 2010 to 2019 using estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
We used GBD 2019 estimates of the burden associated with HBV-related and HCV-related diseases: acute hepatitis, cirrhosis and other chronic liver diseases, and liver cancer. We report total numbers and age-standardised rates per 100 000 for mortality, prevalence, incidence, and disability-adjusted life-years (DALYs) from 2010 to 2019. For each HBV-related and HCV-related disease and each measure, we analysed temporal changes and percentage changes for the 2010-19 period.
In 2019, across all age groups, there were an estimated 2·08 million (95% uncertainty interval UI 1·66 to 2·54) incident cases of acute hepatitis B and 0·49 million (0·42 to 0·57) of hepatitis C in Europe. There were an estimated 8·24 million (7·56 to 8·88) prevalent cases of HBV-related cirrhosis and 11·87 million (9·77 to 14·41) of HCV-related cirrhosis, with 24·92 thousand (19·86 to 31·03) deaths due to HBV-related cirrhosis and 36·89 thousand (29·94 to 45·56) deaths due to HCV-related cirrhosis. Deaths were estimated at 9·00 thousand (6·88 to 11·62) due to HBV-related liver cancer and 23·07 thousand (18·95 to 27·31) due to HCV-related liver cancer. Between 2010 and 2019, the age-standardised incidence rate of acute hepatitis B decreased (-22·14% 95% UI -35·44 to -5·98) as did its age-standardised mortality rate (-33·27% -43·03 to -25·49); the age-standardised prevalence rate (-20·60% -22·09 to -19·10) and mortality rate (-33·19% -37·82 to -28·13) of HBV-related cirrhosis also decreased in this time period. The age-standardised incidence rate of acute hepatitis C decreased by 3·24% (1·17 to 5·02) and its age-standardised mortality rate decreased by 35·73% (23·48 to 47·75) between 2010 and 2019; the age-standardised prevalence rate (-6·37% -8·11 to -4·32), incidence rate (-5·87% -11·24 to -1·01), and mortality rate (-11·11% -16·54 to -5·53) of HCV-related cirrhosis also decreased. No significant changes were observed in age-standardised rates of HBV-related and HCV-related liver cancer, although we observed a significant increase in numbers of cases of HCV-related liver cancer across all ages between 2010 and 2019 (16·41% 2·81 to 30·91 increase in prevalent cases). Substantial reductions in DALYs since 2010 were estimated for acute hepatitis B (-27·82% -36·92 to -20·24), acute hepatitis C (-27·07% -15·97 to -39·34), and HBV-related cirrhosis (-30·70% -35·75 to -25·03). A moderate reduction in DALYs was estimated for HCV-related cirrhosis (-6·19% -0·19 to -12·57). Only HCV-related liver cancer showed a significant increase in DALYs (10·37% 4·81-16·63). Changes in age-standardised DALY rates closely resembled those observed for overall DALY counts, except for HCV-liver related cancer (-2·84% -7·75 to 2·63).
Although decreases in some HBV-related and HCV-related diseases were estimated between 2010 and 2019, HBV-related and HCV-related diseases are still associated with a high burden, highlighting the need for more intensive and coordinated interventions within European countries to reach the goal of elimination by 2030.
Bill & Melinda Gates Foundation.
The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and ...economic change remains insufficiently understood. There is a compelling argument to be made for a comprehensive research agenda to address the questions. With a focus on Europe and taking a health systems approach, we introduce an agenda linked to the 'Health Workforce Research' section of the European Public Health Association. Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. This article highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policy-makers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation. There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. This requires dedicated research funding, new academic education programmes, comparative methodology and knowledge transfer and leadership that can help countries to build a people-centred health workforce.
This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases ...within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.
Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). ...For these causes, the contribution of years lived with disability (YLD) – put simply, ill-health – is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease.
Abstract Objectives The purpose of this study was to analyze the improvement of managerial skills of hospitals’ top managers after a specific management training programme, and to explore possible ...predictors and relations. Methods The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. Results After the training programme, all managers’ skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Conclusions Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations.
The burden of disease and injury in Serbia Janković, Slavenka; Vlajinac, Hristina; Bjegović, Vesna ...
European journal of public health,
02/2007, Letnik:
17, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Background: In the last decade of the 20th century, a considerable effort has been put into the development of summary measures of population health that combine information on mortality and ...non-fatal health outcomes. We used the DALYs (Disability adjusted life years) method to assess the burden of disease and injury in the population of Serbia. Methods: Our study, largely based on the methods developed for the Global burden of disease study, was conducted between October 2002 and September 2003. DALYs, stratified by gender and age, were calculated for 18 selected health conditions for the population of Serbia, Serbia and Montenegro for 2000. Years of life lost (YLL) were calculated using country mortality statistics, while years lived with disability (YLD) were calculated using different sources of information. Also, the YLD/YYL ratio and age-adjusted rates of DALYs were calculated. Results: Ischaemic heart disease, cerebrovascular diseases, lung cancer, unipolar depressive disorders, and diabetes mellitus were responsible for almost two-thirds (70%) of the total burden of 18 selected disorders in Serbia 2000. The leading five causes for males were ischaemic heart disease (26.1 DALY per 1000), stroke (17.9), lung cancer (12.7), road traffic accidents (6.5), and self-inflicted injuries (5.5). For females, the leading five causes were stroke (18.1 DALY per 1000), ischaemic heart disease (14.1), depression (8.7), breast cancer (6.1), and diabetes mellitus (5.2). Conclusions: The final results of the study have shown that the national health priority areas should cover cardiovascular diseases, cancers, and mental health.
Abstract Objective To provide insight of national activities and international assistance in PHC reform and to assess their effects on technical and allocative efficiency as well as financial ...sustainability of primary health care in the Republic of Serbia. Materials and methods Analytical framework of the study consisted of gathering and reviewing of relevant political documents, international assistance project documentation, and analysis of routinely collected national statistical data based on the evaluation model of three groups of criteria: allocative, technical efficiency and financial sustainability in the public sector of Serbia from 2000 to 2007. Time trends were analyzed by Poisson regression models using average annual percentage changes – AAPC, and the percent of targeted change achieved by progress quotient – PQ. Results Allocative efficiency of the PHC during period of 8 years was improved, but technical efficiency was almost unchanged for all service, except for preschool health care. Financial sustainability was also improved measured by indirect indicators of health expenditure. Conclusions Results of this study indicated that we are on the right track with PHC reform, and international support is in accordance with the reform goals. Our approach has been and will remain incremental, gradualist and multi-faceted.
The policy dialog on human resource in health care is one of the central issues of the ongoing health care system reform in the Republic of Serbia. Pharmacists are the third largest health care ...professional group, after nurses and doctors. This study's objective was to analyze population coverage with pharmacists employed in the public sector of health care system of Serbia during 1961 - 2007, and to project their density by 2017. In this respect, additionally, time-series of annual number of enrolled and graduate pharmacy students were modelled. Time trends of routinely collected national statistical data, concerning the pharmacists, were analyzed by join point regression program, according to grid-search method. During the observed period of time, in Serbia, pharmacist workforce production and deployment trends were generally positive, but with different annual dynamic. Key findings were the slow rise of pharmacist workforce density rates per 100,000 population; the insufficient balance between pharmacists workforce supply side (annual number of enrolled and graduated students) and the public health care sector's ability to absorb annual number of pharmacy graduates. For ten years ahead, density rates of publicly active pharmacist workforce would probably increase for 46%, if no policy interventions were planned to adverse trends of pharmacist workforce production and deployment in public health care sector. The study results may be useful for variety of stakeholders to better understand how and why the supply and deployment of pharmacists were changing; and that the coordination among policy interventions is a crucial successes factor for a health workforce development plan implementation. The repercussions of any changes made to the pharmacy workforce, need to be considered carefully in advance.
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