Browsing by Subject "PROGRESS"

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  • Coviello, Andrea D.; Haring, Robin; Wellons, Melissa; Vaidya, Dhananjay; Lehtimaki, Terho; Keildson, Sarah; Lunetta, Kathryn L.; He, Chunyan; Fornage, Myriam; Lagou, Vasiliki; Mangino, Massimo; Onland-Moret, N. Charlotte; Chen, Brian; Eriksson, Joel; Garcia, Melissa; Mei, Yong; Koster, Annemarie; Lohman, Kurt; Lyytikainen, Leo-Pekka; Petersen, Ann-Kristin; Prescott, Jennifer; Stolk, Lisette; Vandenput, Liesbeth; Wood, Andrew R.; Zhuang, Wei Vivian; Ruokonen, Aimo; Hartikainen, Anna-Liisa; Pouta, Anneli; Bandinelli, Stefania; Biffar, Reiner; Brabant, Georg; Cox, David G.; Chen, Yuhui; Cummings, Steven; Ferrucci, Luigi; Gunter, Marc J.; Hankinson, Susan E.; Martikainen, Hannu; Hofman, Albert; Homuth, Georg; Illig, Thomas; Jansson, John-Olov; Johnson, Andrew D.; Karasik, David; Karlsson, Magnus; Kettunen, Johannes; Kiel, Douglas P.; Kraft, Peter; Liu, Jingmin; Ljunggren, Osten; Lorentzon, Mattias; Maggio, Marcello; Markus, Marcello R. P.; Mellstrom, Dan; Miljkovic, Iva; Mirel, Daniel; Nelson, Sarah; Papunen, Laure Morin; Peeters, Petra H. M.; Prokopenko, Inga; Raffel, Leslie; Reincke, Martin; Reiner, Alex P.; Rexrode, Kathryn; Rivadeneira, Fernando; Schwartz, Stephen M.; Siscovick, David; Soranzo, Nicole; Stockl, Doris; Tworoger, Shelley; Uitterlinden, Andre G.; van Gils, Carla H.; Vasan, Ramachandran S.; Wichmann, H. -Erich; Zhai, Guangju; Bhasin, Shalender; Bidlingmaier, Martin; Chanock, Stephen J.; De Vivo, Immaculata; Harris, Tamara B.; Hunter, David J.; Kahonen, Mika; Liu, Simin; Ouyang, Pamela; Spector, Tim D.; van der Schouw, Yvonne T.; Viikari, Jorma; Wallaschofski, Henri; McCarthy, Mark I.; Frayling, Timothy M.; Murray, Anna; Franks, Steve; Jarvelin, Marjo-Riitta; de Jong, Frank H.; Raitakari, Olli; Teumer, Alexander; Ohlsson, Claes; Murabito, Joanne M.; Perry, John R. B. (2012)
  • Fraixedas, Sara; Linden, Andreas; Piha, Markus; Cabeza, Mar; Gregory, Richard; Lehikoinen, Aleksi (2020)
    The current loss of biodiversity has been broadly acknowledged as the main cause of ecosystem change. To halt this trend, several international agreements have been made, and various biodiversity metrics have been developed to evaluate whether the targets of these agreements are being met. The process of developing good indicators is not trivial. Indicators should be able to synthesize and communicate our current knowledge, but they also need to meet both scientific and practical criteria. Since it would not be practical to monitor all species, indicators are mainly built on the monitoring of some well-known taxa, such as birds. Here we systematically review the wide spectrum of bird biodiversity indicators (hereafter indicators) available to: i) evaluate recent methodological advances; ii) identify current knowledge gaps jeopardizing indicator interpretation and use in guiding decision-making; and iii) examine challenges in their applicability across different spatial and temporal contexts. We pay particular attention to indicator characteristics such as site and species selection, spatial, seasonal and habitat coverage, and statistical issues in developing indicators and tools to tackle them, to provide specific recommendations for the future construction of indicators. Several methodological advances have recently been made to enhance the process of indicator development, including multiple ways to select sites and species to increase their robustness. However, we found that there are strong spatial, seasonal and habitat biases among the selected indicators. Most of them are from Europe, using mainly census data from the breeding season and typically covering farmland and forest habitats. The major challenges that we detected in their applicability were related to the modelling of the statistical uncertainty associated to the indicator. We recommend the use of quantitative methods in site and species selection procedures whenever possible. Current indicators should be expanded to areas outside Europe and to less studied habitats and should not neglect monitoring work outside the breeding season. Time-series analyses studying temporal trends and using multi-species data should in general account for temporal autocorrelation as well as for phylogenetic correlation. Multi-species hierarchical models are a good alternative for analysing and constructing indicators, but they need to include annual random effects allowing for unexplained annual variation in the average status of the community, i.e. the indicator target. Despite methodological and context-specific differences in the indicators reviewed, most of them seem to highlight the urgent need of devising strategic climate and conservation policies to improve the status and trends of biodiversity.
  • Henriques, Sérgio; Böhm, Monika; Collen, Ben; Luedtke, Jennifer; Hoffmann, Michael; Hilton-Taylor, Craig; Cardoso, Pedro; Butchart, Stuart H. M.; Freeman, Robin (2020)
    Abstract Given the current biodiversity crisis, pragmatic approaches to detect global conservation trends across a broad range of taxa are critical. A sampled approach to the Red List Index (RLI) was proposed, as many groups are highly speciose. However, a decade after its conception, the recommended 900 species sample has only been implemented in six groups and trend data are available for none, potentially because this sample is unfeasibly high. Using a broader set of all available data we show that when re-assessments are conducted every 10 years, 200 species (400 in some cases) should be sufficient to detect a RLI trend. Correctly detecting changes in slope still requires samples of 900 species (11,000 in some cases). Sampled assessments can accelerate biodiversity monitoring and complement current metrics, but the time-period between assessments and the approaches? purpose should be carefully considered, as there is a trade-off between sample size and the resulting indices.
  • Gädda, Akiko; Ott, Jennifer; Karadzhinova-Ferrer, Aneliya; Golovleva, Maria; Kalliokoski, Matti; Winkler, Alexander; Luukka, Panja; Härkönen, Jaakko (2019)
    The suitability of two low-temperature dielectric passivation layer processes for the fabrication of Cadmium Telluride (CdTe) X-ray detectors has been investigated. The CdTe crystals with a size of (10 10 1) mm were coated with sputtered aluminum nitride (AlN) or with aluminum oxide (AlO) grown by the atomic layer deposition (ALD) method. The metallization contacts of the detectors were made by titanium tungsten (TiW) and gold (Au) metal sputtering depositions. The pad detector structures were patterned with proximity-contactless photolithography techniques followed by lift-off patterning of the electrodes. The detector properties were characterized at room temperature by Transient Current Technique (TCT) measurements. The obtained results were compared and verified by numerical TCAD simulations of the detector response. Our results indicate that higher signal charge was collected from samples with AlO. Furthermore, no significant laser light induced signal decay by CdTe material polarization was observed within order of 30 min of continuous illumination.
  • Vaden, T.; Lähde, Ville; Majava, A.; Jarvensivu, P.; Toivanen, T.; Hakala, Emma; Eronen, J. T. (2020)
    The idea of decoupling "environmental bads" from "economic goods" has been proposed as a path towards sustainability by organizations such as the OECD and UN. Scientific consensus reports on environmental impacts (e.g., greenhouse gas emissions) and resource use give an indication of the kind of decoupling needed for ecological sustainability: global, absolute, fast-enough and long-enough. This goal gives grounds for a categorisation of the different kinds of decoupling, with regard to their relevance. We conducted a survey of recent (1990-2019) research on decoupling on Web of Science and reviewed the results in the research according to the categorisation. The reviewed 179 articles contain evidence of absolute impact decoupling, especially between CO2 (and SOX) emissions and evidence on geographically limited (national level) cases of absolute decoupling of land and blue water use from GDP, but not of economy-wide resource decoupling, neither on national nor international scales. Evidence of the needed absolute global fast-enough decoupling is missing.
  • Vaden, T.; Lähde, Ville; Majava, A.; Jarvensivu, P.; Toivanen, T.; Hakala, Emma; Eronen, J. T. (2020)
    The idea of decoupling "environmental bads" from "economic goods" has been proposed as a path towards sustainability by organizations such as the OECD and UN. Scientific consensus reports on environmental impacts (e.g., greenhouse gas emissions) and resource use give an indication of the kind of decoupling needed for ecological sustainability: global, absolute, fast-enough and long-enough. This goal gives grounds for a categorisation of the different kinds of decoupling, with regard to their relevance. We conducted a survey of recent (1990-2019) research on decoupling on Web of Science and reviewed the results in the research according to the categorisation. The reviewed 179 articles contain evidence of absolute impact decoupling, especially between CO2 (and SOX) emissions and evidence on geographically limited (national level) cases of absolute decoupling of land and blue water use from GDP, but not of economy-wide resource decoupling, neither on national nor international scales. Evidence of the needed absolute global fast-enough decoupling is missing.
  • Vaden, T.; Lähde, Ville; Majava, A.; Jarvensivu, P.; Toivanen, T.; Hakala, Emma; Eronen, J. T. (2020)
    The idea of decoupling "environmental bads" from "economic goods" has been proposed as a path towards sustainability by organizations such as the OECD and UN. Scientific consensus reports on environmental impacts (e.g., greenhouse gas emissions) and resource use give an indication of the kind of decoupling needed for ecological sustainability: global, absolute, fast-enough and long-enough. This goal gives grounds for a categorisation of the different kinds of decoupling, with regard to their relevance. We conducted a survey of recent (1990-2019) research on decoupling on Web of Science and reviewed the results in the research according to the categorisation. The reviewed 179 articles contain evidence of absolute impact decoupling, especially between CO2 (and SOX) emissions and evidence on geographically limited (national level) cases of absolute decoupling of land and blue water use from GDP, but not of economy-wide resource decoupling, neither on national nor international scales. Evidence of the needed absolute global fast-enough decoupling is missing.
  • Rochette, Anne-Julie; Akpona, Jean Didier T.; Akpona, Hugues Adeloui; Akouehou, Gaston S.; Kwezi, Blanchard Mayundo; Djagoun, Chabi A. M. S.; Habonimana, Bernadette; Idohou, Rodrigue; Legba, Ingride S.; Nzigidahera, Benoit; Matilo, Augustin Orou; Taleb, Mohammed Sghir; Bamoninga, Benjamin Toirambe; Ivory, Sarah; de Bisthoven, Luc Janssens; Vanhove, Maarten P. M. (2019)
    There is an increasing need for monitoring schemes that help understand the evolution of the global biodiversity crisis and propose solutions for the future. Indicators, including temporal baselines, are crucial to measure the change in biodiversity over time, to evaluate progress towards its conservation and sustainable use and to set conservation priorities. They help design and monitor national and regional policies on biodiversity; they also feed into national reporting on international agreements such as the Convention on Biological Diversity and the Sustainable Development Goals. We analyse the methodological approach of five small African projects resulting from a call to promote indicator development, improve monitoring capacity and strengthen the science-policy interface in the field of biodiversity. We compared their approach to existing guidance provided by the international community, specifically the Biodiversity Indicators Partnership. To this end, we assess whether internationally recommended steps are effectively applied to national/local biodiversity monitoring in selected developing countries. We also present lessons learnt from workshop interactions between partners involved in these projects. Through our pilot projects we identified data availability and data accessibility, together with the involvement of stakeholders, as critical steps in indicator development. Moreover, there is a need for a better awareness and a wider application of the indicator concept itself. Hence, training of key actors both in the policy and science spheres is needed to operationalize indicators and ensure their continuity and sustainability. We hope that these case studies and lessons learnt can stimulate and support countries in the Global South to formulate policy-relevant biodiversity indicators.
  • Lohela, Terhi; Campbell, Oona M. R.; Gabrysch, Sabine (2012)
  • Hiilamo, Heikki; Glantz, Stanton (2022)
    Introduction The world’s first global health treaty, WHO Framework Convention on Tobacco Control (FCTC) aims to reduce tobacco product demand by focusing on tobacco taxes, smoking bans, health warning labels, and tobacco advertising bans. Previous studies almost unanimously suggest that FCTC has prompted countries to implement more effective tobacco demand reduction policies. Aims and Methods By taking into account the pre-FCTC status, country income level, and state capacity we studied if ratifying FCTC was associated with tobacco demand reduction measures in 2018/2019. We used logistic regression to assess the association of FCTC ratification with adoption demand reduction measures, accounting for years since ratification, baseline status, and other covariates. Results Except for taxes, state of tobacco policy implementation before FCTC ratification did not predict adoption of FCTC policies. Time since FCTC ratification was associated with implementing smoking bans and pictorial HWLs. In contrast, while the tax rate prior to FCTC ratification was positively associated with increased taxes after FCTC ratification, time since FCTC ratification was marginally negatively associated with increases in tobacco taxes. Conclusions While the FCTC was followed by implementation of compliant demand reduction policies, there are still many parties that have not implemented the FCTC, particularly increasing taxes and ending tobacco advertising and promotions. Implications We assessed changes in tobacco demand reductions measures over 22 years in 193 countries. By using internal tobacco industry documents, we were able establish a baseline before the FCTC negotiations. Unlike previous studies, we included four tobacco demand reductions measures: tobacco taxes, smoking bans, health warning labels, and tobacco advertising ban. The limitation of the study is that we do not have data to describe if demand reduction measures are actually enforced or what their effect on tobacco consumption is.
  • Local Burden Dis Educ Attainment C; Graetz, Nicholas; Woyczynski, Lauren; Wilson, Katherine F.; Meretoja, Tuomo J. (2021)
    The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)(1-4). Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)(5-8). Here we generated annual estimates of routine childhood MCV1 coverage at 5 x 5-km(2) pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
  • GBD 2020 Release 1 Vaccine Coverag; Galles, Natalie C.; Liu, Patrick Y.; Updike, Rachel L.; Meretoja, Tuomo J. (2021)
    Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
  • Lim, Stephen S.; Allen, Kate; Bhutta, Zulficiar A.; Dandona, Lalit; Forouzanfar, Mohammad H.; Fullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Hay, Simon I.; Holmberg, Mollie; Kinfu, Yohannes; Kutz, Michael J.; Larson, Heidi J.; Liang, Xiaofeng; Lopez, Alan D.; Lozano, Rafael; McNellan, Claire R.; Mokdad, Ali H.; Mooney, Meghan D.; Naghavi, Mohsen; Olsen, Helen E.; Pigott, David M.; Salomon, Joshua A.; Vos, Theo; Wang, Haidong; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Achoki, Tom; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Ahmed, Kedir Yimam; Akanda, Ali Shafqat; Meretoja, Atte; Meretoja, Tuomo J.; Weiderpass, Elisabete; GBD 2015 SDG Collaborators (2016)
    Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59.3 (95% uncertainty interval 56.8-61.8) and varied widely by country, ranging from 85.5 (84.2-86.5) in Iceland to 20.4 (15.4-24.9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r(2) = 0.88) and the MDG index (r(2) = 0.2), whereas the non-MDG index had a weaker relation with SDI (r(2) = 0.79). Between 2000 and 2015, the health-related SDG index improved by a median of 7.9 (IQR 5.0-10.4), and gains on the MDG index (a median change of 10.0 [6.7-13.1]) exceeded that of the non-MDG index (a median change of 5.5 [2.1-8.9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.
  • Gbd Universal Hlth Coverage; Lozano, Rafael; Fullman, Nancy; Mumford, John Everett; Kivimäki, Mika; Meretoja, Atte; Meretoja, Tuomo J.; Shiri, Rahman (2020)
    Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
  • Choque-Velasquez, Joham; Colasanti, Roberto; Kozyrev, Danil A.; Hernesniemi, Juha; Kawashima, Akitsugu (2017)
    BACKGROUND: Pediatric moyamoya cases may be very arduous, even more so in a developing country, where access to specialized centers may be prevented by different factors. CASE DESCRIPTION: Herein we report a challenging case, which was managed in the new Neurosurgical Center of Trujillo, regarding the direct anastomosis between the left superficial temporal artery and a cortical branch of the left middle cerebral artery in a 8-year-old Peruvian boy with moyamoya disease. Postoperatively, the patient's motor deficits and aphasia improved. To the best of our knowledge, this is the first performance of a direct revascularization for a pediatric moyamoya case in Peru. CONCLUSIONS: The creation of highly specialized neurosurgical centers in the main strategic places of developing countries may allow optimal treatment of neurosurgical patients with complex diseases.
  • GBD 2015 Eastern Mediterranean Reg; Mokdad, Ali H.; Weiderpass, Elisabete; Shiri, Rahman (2018)
    Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. In 2015, 755,844 (95% uncertainty interval (UI) 712,064-801,565) children under 5 died in the EMR. In the early neonatal category, deaths in the EMR decreased by 22.4%, compared to 42.4% globally. The rate of years of life lost per 100,000 population under 5 decreased 54.38% from 177,537 (173,812-181,463) in 1990 to 80,985 (76,308-85,876) in 2015; the rate of years lived with disability decreased by 0.57% in the EMR compared to 9.97% globally. Our findings call for accelerated action to decrease child morbidity and mortality in the EMR. Governments and organizations should coordinate efforts to address this burden. Political commitment is needed to ensure that child health receives the resources needed to end preventable deaths.
  • Sadiek, Ibrahim; Mikkonen, Tommi; Vainio, Markku; Toivonen, Juha; Foltynowicz, Aleksandra (2018)
    We report the first photoacoustic detection scheme using an optical frequency comboptical frequency comb photoacoustic spectroscopy (OFC-PAS). OFC-PAS combines the broad spectral coverage and the high resolution of OFCs with the small sample volume of cantilever-enhanced PA detection. In OFC-PAS, a Fourier transform spectrometer (FTS) is used to modulate the intensity of the exciting comb source at a frequency determined by its scanning speed. One of the FTS outputs is directed to the PA cell and the other is measured simultaneously with a photodiode and used to normalize the PA signal. The cantilever-enhanced PA detector operates in a non-resonant mode, enabling detection of a broadband frequency response. The broadband and the high-resolution capabilities of OFC-PAS are demonstrated by measuring the rovibrational spectra of the fundamental C-H stretch band of CH4, with no instrumental line shape distortions, at total pressures of 1000 mbar, 650 mbar, and 400 mbar. In this first demonstration, a spectral resolution two orders of magnitude better than previously reported with broadband PAS is obtained, limited by the pressure broadening. A limit of detection of 0.8 ppm of methane in N-2 is accomplished in a single interferogram measurement (200 s measurement time, 1000 MHz spectral resolution, 1000 mbar total pressure) for an exciting power spectral density of 42 W/cm(-1). A normalized noise equivalent absorption of 8 x 10(-10) W cm(-1) Hz(-1/2) is obtained, which is only a factor of three higher than the best reported with PAS based on continuous wave lasers. A wide dynamic range of up to four orders of magnitude and a very good linearity (limited by the Beer-Lambert law) over two orders of magnitude are realized. OFC-PAS extends the capability of optical sensors for multispecies trace gas analysis in small sample volumes with high resolution and selectivity.
  • Nagatsu, Michiru; Davis, Taylor; DesRoches, C. Tyler; Koskinen, Inkeri; MacLeod, Miles; Stojanovic, Milutin; Thoren, Henrik (2020)
    Sustainability science seeks to extend scientific investigation into domains characterized by a distinct problem-solving agenda, physical and social complexity, and complex moral and ethical landscapes. In this endeavor, it arguably pushes scientific investigation beyond its usual comfort zones, raising fundamental issues about how best to structure such investigation. Philosophers of science have long scrutinized the structure of science and scientific practices, and the conditions under which they operate effectively. We propose a critical engagement between sustainability scientists and philosophers of science with respect to how to engage in scientific activity in these complex domains. We identify specific issues philosophers of science raise concerning current sustainability science and the contributions philosophers can make to resolving them. In conclusion, we reflect on the steps philosophers of science could take to advance sustainability science.
  • Cui, Jin; Mackenzie, Kathryn; Eeckhaut, Tom; Müller, Renate; Lütken, Henrik (2019)
    A high yield of isolated protoplasts and efficient regeneration protocols are prerequisites for successful development of somatic hybrids. In the present study, protoplast isolation and regeneration were evaluated in 12 Kalanchoe accessions belonging to nine species. The highest protoplast yield was obtained from K. blossfeldiana Charming Red Meadow' with 10.780.51x10(5) protoplasts per gram fresh weight. We observed significant differences of protoplast yield while there was no distinct difference in viability among the accessions. Seven accessions reached the microcolony stage and four developed microcalli in medium supplemented with 1.0mg/l 1-naphthaleneacetic acid (NAA), 0.5mg/l 6-benzylaminopurine (BAP) and 0.5mg/l 2,4-dichlorophenoxy acetic acid (2,4-D). Using five selected accessions we optimized the PGR (plant growth regulators) concentrations using combinations of NAA, BAP and 2,4-D. K. blossfeldiana cultivars Charming Red Meadow' and Paris' produced significantly different numbers of calli depending on the PGR concentrations. For plant regeneration, the medium was supplemented with 1mg/l NAA and 2mg/l BAP or 2mg/l zeatin. Shoots were regenerated on medium supplemented with NAA and BAP for K. blossfeldiana Charming Red Meadow' and K. blossfeldiana Paris'. The plants successfully developed roots on the medium supplemented with IAA. The medium containing zeatin induced root formation directly from callus in K. blossfeldiana Charming Red Meadow'. Our findings have the potential to facilitate the use of Kalanchoe species in somatic hybridization breeding programs. Key Message The study revealed a strong genotype-dependent efficiency of colony and microcallus formation. Plants were regenerated from two Kalanchoe blossfeldiana cultivars on medium supplemented with NAA and BAP.
  • Hankonen, Nelli; Heino, Matti T. J.; Hynynen, Sini-Tuuli; Laine, Hanna; Araujo-Soares, Vera; Sniehotta, Falko F.; Vasankari, Tommi; Sund, Reijo; Haukkala, Ari (2017)
    Background: No school-based physical activity (PA) interventions among older adolescents have demonstrated long-term effectiveness, and few of them so far have addressed sedentary behaviour (SB). Based on behavioural theories and evidence, we designed a multi-level intervention to increase PA and decrease SB among vocational school students. This study investigates feasibility and acceptability of two main intervention components and research procedures. We also examine uptake of behaviour change techniques (BCTs) by the participants. Methods: Design was an outcome assessor blinded, cluster-randomised controlled trial. Four classes of students (matched pairs) were randomised into one intervention and one control arm. The intervention consisted of (1) a 6-h group-based intervention for students, (2) two 2-h training workshops to reduce their students' sitting in class for teachers, and (3) provision of light PA equipment in classrooms. At baseline (T1), mid-intervention (T2) at 3 weeks, post-intervention (T3) and 6 months after baseline (T4) we measured hypothesised psychosocial mediators and self-reported PA and sitting. Objective assessment of PA and SB (7-day accelerometry) was conducted at T1, T3 and T4. Body composition (bioimpedance) was measured at T1 and T4. Students and teachers in the intervention arm filled in acceptability questionnaires at T3. Results: Recruitment rate was 64% (students) and 88.9% (teachers), and at T3, all post-intervention measurements were completed by 33 students (retention 76.7%) and 15 teachers (retention 93.8%). Acceptability ratings of sessions were high (students M = 6.29, scale 1-7), and data collection procedures were feasible. Intervention arm students reported increased use of BCTs, but uptake of some key BCTs was suboptimal. BCT use correlated highly with objective measures of PA. Based on both self-report and student evaluation, teachers in the intervention arm increased the use of sitting reduction strategies at post-intervention and T4 follow-up (p <.05). Conclusions: We detected willingness of the target groups to participate, good response rates to questionnaires, adequate retention, as well as acceptability of the trial protocol. Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use. After making necessary modifications identified, intervention effectiveness can next be tested in a definitive trial.