The Burden of Stroke in Kurdistan Province,Iran From 2011 to 2017

ObjectivesThe aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017.MethodsIncidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs).ResultsThe burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively.ConclusionsThe burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.     

1990-2019年中国动脉粥样硬化心血管病疾病负担变化及其危险因素分析

目的 量化分析1990-2019年我国动脉粥样硬化心血管病（ASCVD）疾病负担及其主要危险因素影响的变化趋势。方法 利用2019年全球疾病负担（GBD2019）研究结果,以伤残调整寿命年（DALY）及其年龄标准化率为指标,分析1990-2019年我国ASCVD疾病负担和危险因素归因疾病负担的变化情况,并采用Gupta建立的分解法对人口增长、老龄化、年龄别患病率和疾病严重程度所致的DALY变化进行了量化分析。结果 2019年我国61.00%的心血管病疾病负担由ASCVD所致,缺血性心脏病的DALY较1990年增长了133.66%,其中29.57%可归因于人口增长、108.74%归因于人口老龄化、8.87%归因于年龄别患病率的增加、-13.53%归因于疾病严重程度;缺血性卒中的DALY较1990年增长了138.64%,归因于上述4部分的变化率依次为30.95%、123.38%、55.80%和-71.49%。2019年高血压依然是ASCVD首要危险因素,其次是高LDL-C,归因于饮酒的年龄标准化DALY率较1990年增幅最大（486.01%）,年均增长10.93%。结论 1990-2019年,人口老龄化是我国ASCVD疾病负担大幅增长最主要的原因,而其他可改变危险因素的不利趋势,特别是代谢性危险因素的持续流行同样不容忽视。     

Estimation of the Impact of Migraine on Self-rated Health: A Cross-sectional Study in Slovenia

AimWith the aim of providing a foundation for evidence-based public health actions, as well as the more individualised clinical treatment of migraine in Slovenia, the objective of our study was to assess the association between poor self-rated health (PSRH) and migraine, adjusted for selected comorbidity and socioeconomic factors.MethodsThe survey, conducted between August and December 2014, involved included 6,262 adults aged 15 years and over. Binary logistic regression was used in univariate as well as multivariate analysis. Three multivariate models were defined: MODEL 1 (migraine and comorbidities related to the physical dimension of health); MODEL 2 (comorbidities related to the mental dimension of health); MODEL 3 (demographic and socioeconomic factors).ResultsIn univariate as well as all three multivariate models, the odds of PSRH were statistically significantly higher in migraine sufferers in comparison to non-sufferers (univariate model: ORmigraine=yes vs. migraine=no=2.22 (p<0.001); MODEL 1: ORmigraine=yes vs. migraine=no=2.27 (p<0.001); MODEL 2: ORmigraine=yes vs. migraine=no=1.51 (p=0.002); MODEL 3: ORmigraine=yes vs. migraine=no=1.56 (p=0.001)).ConclusionMigraine is an important PSRH-related factor. Comorbidities related to the physical dimension of health do not reduce the power of association between migraine and PRSH, while comorbidities related to the mental dimension reduce the power of association of migraine and other health conditions. The power of the association between migraine and PRSH is also independent of demographic/socioeconomic factors. We can also conclude that migraine seems to be a phenomenon that is in a bi-directional relationship with mental states (thus having an impact on PSRH) and is itself a stressor.     

Zarit burden interview among caregivers of community-dwelling older adults in a caribbean setting (Jamaica): Reliability and factor structure

The Zarit Burden Interview has been the most popularly used tool for measuring caregiver burden and with the 60 years and over population in Jamaica and developing countries expected to increase, caregiver burden and its assessment assume increased importance. Establishing the reliability and underlying factor structure of instruments such as the ZBI is critical. This study sought to determine the reliability of the Zarit Burden Interview and to assess its underlying factor structure. The ZBI was administered to 180 caregivers of community dwelling older persons in Jamaica in a nationally representative sample across four geographic health regions in 2016. The factor structure was identified using exploratory factor analysis (EFA) with Varimax rotation. Cronbach's alpha was used to assess internal consistency/reliability of the instrument. The internal consistency/reliability of the ZBI instrument was high (Cronbach's α = 0.859) and the corrected item-total correlations ranged from 0.134 to 0.730. The ZBI mean score was found to be 16.92 ± 12.04. EFA produced a six-factor model comprised of 19 items which explained 48.97% of total variance, and was subsequently reduced to four (37.27% of total variance) via the use of parallel analysis and scrutiny of confidence intervals. The four factors identified were ‘personal strain’, ‘social relations disruption’, ‘resource strain/imbalance’ and ‘role intensity’. The ZBI-22 tool is a reliable instrument for evaluating caregiver burden among community dwelling older persons in Jamaica. A four factor model has emerged providing greater insights on the underlying constructs of the ZBI, the most widely used caregiver burden assessment tool.     

失能调整生命年在煤矿职业性疾病负担分析中的应用

为估计煤矿外伤性截瘫疾病负担,采用横断面抽样调查,共抽样调查全国５ 个统配矿务局的２６ 个煤矿。以煤矿外伤性截瘫的患病和死亡资料为基础,用失能调整生命年（ＤＡＬＹ） 估计煤矿外伤性截瘫疾病负担。结果表明：煤矿外伤性截瘫疾病负担为每千人口３２２５ＤＡＬＹ。各矿务局比较：铜川矿务局外伤性截瘫疾病负担最重,每千人口５４４７ ＤＡＬＹ,高于５ 个矿务局的平均水平每千人口３２２５ＤＡＬＹ。其次为阳泉、峰峰矿务局、三路安矿务局和晋城矿务局,分别为每千人口２７ ．８５ 、２６ ．６０ 、１５１０ 和１１ ．７１ＤＡＬＹ。结果提示：ＤＡＬＹ 可用于煤矿职业性疾病负担分析。各统配矿务局外伤性截瘫的ＤＡＬＹ 差异较大     

吸毒人员相关信息访谈分析

目的深入了解吸毒者的吸毒原因、社会背景、心理状态及与艾滋病相关的知识、态度、行为现状,为开展有针对性的健康教育和减低毒品危害的干预措施提供信息。方法由经过培训的无身份标志的访谈员与100名吸毒者进行一对一的面对面访谈,用资料记录方法记录整理分析访谈内容。结果本市吸毒者以男性为主,占84%,17~35岁的青壮年占大多数,为70%;91%的吸毒者平时主要依靠静脉注射海洛因吸毒,在吸毒过程中有91%的吸毒者和他人一次或多次共用过注射器;男女吸毒者在商业性性行为中,安全套的使用率仅为35%;吸毒者对美沙酮替代或针具交换的看法表示欢迎与愿意接受,但存在安全忧虑的心理。结论吸毒者普遍存在着与艾滋病病毒感染和扩散相关的高危行为,但吸食毒品与预防艾滋病重要性相比吸毒者首先考虑需求的通常是前者,因此,需要全社会普遍关注吸毒传播艾滋病危险,主动采取干预对策和措施,才能在源头上有效遏制艾滋病经吸毒人群传播。     

Measures of initiation and progression to increased smoking among current menthol compared to non-menthol cigarette smokers based on data from four U.S. government surveys

There are no large-scale, carefully designed cohort studies that provide evidence on whether menthol cigarette use is associated with a differential risk of initiating and/or progressing to increased smoking. However, questions of whether current menthol cigarette smokers initiated smoking at a younger age or are more likely to have transitioned from non-daily to daily cigarette use compared to non-menthol smokers can be addressed using cross-sectional data from U.S. government surveys. Analyses of nationally representative samples of adult and youth smokers indicate that current menthol cigarette use is not associated with an earlier age of having initiated smoking or greater likelihood of being a daily versus non-daily smoker. Some surveys likewise provide information on cigarette type preference (menthol versus non-menthol) among youth at different stages or trajectories of smoking, based on number of days smoked during the past month and/or cigarettes smoked per day. Prevalence of menthol cigarette use does not appear to differ among new, less experienced youth smokers compared to established youth smokers. While there are limitations with regard to inferences that can be drawn from cross-sectional analyses, these data do not suggest any adverse effects for menthol cigarettes on measures of initiation and progression to increased smoking.