Mario Preti, Amanda Selk, Colleen Stockdale, Federica Bevilacqua, Pedro Vieira-Baptista, Fulvio Borella, Niccolò Gallio, Stefano Cosma, Catarina Melo, Leonardo Micheletti, Chiara Benedetto
Knowledge of Vulvar Anatomy and Self-examination in a Sample of Italian Women
Journal of lower genital tract disease
understanding health consequences associated exposure risk factors necessary inform public health policy practice systematically quantify contributions risk factor exposures specific health outcomes global burden diseases injuries risk factors study gbd 2021 aims provide comprehensive estimates exposure levels relative health risks attributable burden disease 88 risk factors 204 countries territories 811 subnational locations 1990 2021 gbd 2021 risk factor analysis used data 54 561 total distinct sources produce epidemiological estimates 88 risk factors associated health outcomes total 631 riskoutcome pairs pairs included basis datadriven determination riskoutcome association agesexlocationyearspecific estimates generated global regional national levels approach followed comparative risk assessment framework predicated causal web hierarchically organised potentially combinative modifiable risks relative risks rrs given outcome occurring function risk factor exposure estimated separately riskoutcome pair summary exposure values sevs representing riskweighted exposure prevalence theoretical minimum risk exposure levels tmrels estimated risk factor estimates used calculate population attributable fraction paf ie proportional change health risk would occur exposure risk factor reduced tmrel product pafs disease burden associated given outcome measured disabilityadjusted lifeyears dalys yielded measures attributable burden ie proportion total disease burden attributable particular risk factor combination risk factors adjustments mediation applied account relationships involving risk factors act indirectly outcomes via intermediate risks attributable burden estimates stratified sociodemographic index sdi quintile presented counts agestandardised rates rankings complement estimates rr attributable burden newly developed burden proof risk function bprf methods applied yield supplementary conservative interpretations riskoutcome associations based consistency underlying evidence accounting unexplained heterogeneity input data different studies estimates reported represent mean value across 500 draws estimates distribution 95 uncertainty intervals uis calculated 25th 975th percentile values across draws among specific risk factors analysed study particulate matter air pollution leading contributor global disease burden 2021 contributing 80 95 ui 6794 total dalys followed high systolic blood pressure sbp 78 6492 smoking 57 4768 low birthweight short gestation 56 4863 high fasting plasma glucose fpg 54 4860 younger demographics ie aged 04 years 514 years risks low birthweight short gestation unsafe water sanitation handwashing wash among leading risk factors older age groups metabolic risks high sbp high bodymass index bmi high fpg high ldl cholesterol greater impact 2000 2021 observable shift global health challenges marked decline number allage dalys broadly attributable behavioural risks decrease 207 139277 environmental occupational risks decrease 220 155288 coupled 494 423569 increase dalys attributable metabolic risks reflecting ageing populations changing lifestyles global scale agestandardised global daly rates attributable high bmi high fpg rose considerably 157 99217 high bmi 79 33129 high fpg period exposure risks increasing annually rates 18 1619 high bmi 13 1115 high fpg contrast global riskattributable burden exposure many risk factors declined notably risks child growth failure unsafe water source agestandardised attributable dalys decreasing 715 644788 child growth failure 663 602720 unsafe water source separated risk factors three groups according trajectory time decreasing attributable burden due largely declining risk exposure eg diet high transfat household air pollution also proportionally smaller child youth populations eg child maternal malnutrition burden increased moderately spite declining risk exposure due largely population ageing eg smoking burden increased considerably due increasing risk exposure population ageing eg ambient particulate matter air pollution high bmi high fpg high sbp substantial progress made reducing global disease burden attributable range risk factors particularly related maternal child health wash household air pollution maintaining efforts minimise impact risk factors especially low sdi locations necessary sustain progress successes moderating smokingrelated burden reducing risk exposure highlight need advance policies reduce exposure leading risk factors ambient particulate matter air pollution high sbp troubling increases high fpg high bmi risk factors related obesity metabolic syndrome indicate urgent need identify implement interventions bill melinda gates foundation