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Die Themen in den Wissensnachrichten: +++ Mammutfell-Mäuse gezüchtet +++ Klimawandel bedroht Ernteerträge +++ Frauen bei Weiterbildung benachteiligt +++**********Weiterführende Quellen zu dieser Folge:Multiplex-edited mice recapitulate woolly mammoth hair phenotypes. BioRxiv. 04.03.2025Climate change threatens crop diversity at low latitudes, Nature Food, 04.03.2025UND ES GIBT IHN DOCH! Der Gender Training Gap bei betrieblichen Weiterbildungen, WSI Report, März 2025Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021, The Lancet 3.3.25Überraschender Strandfund: Historische Driftkarte von 1961 auf Juist entdeckt, Bundesamt für Seeschifffahrt und Hydrographie, 03.03.2025**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok auf&ab , TikTok wie_geht und Instagram .
Valery Feigin speaks to Pierre Nauleau about the Global Burden of Disease study on epilepsy.Read the full article, Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021, at https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00302-5/fulltext?dgcid=buzzsprout_icw_podcast_lanpubContinue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv
Being overweight or obese has overtaken smoking as the top risk factor contributing to health problems in 2024, new data shows. The Australian Burden of Disease Study 2024 estimates that Australians lost 5.8m years of healthy life due to living with illness and injury - or premature death. While smoking has previously been the lead factor contributing to poor health later on in life - being overweight has since beaten it out. Australian correspondent Murray Olds says experts are calling for sugar taxes and less marketing of junk food to children. LISTEN ABOVESee omnystudio.com/listener for privacy information.
In this episode, we discuss the plight of mental illness and unique risk factors for mental illness in developing countries, the poverty trap and much more... Chapters 0:00 Show Intro 1:54 Is MI a Western Problem Only? 3:10 Risk Factors in Developing Countries 8:30 Mental Health Stigma 11:30 The Poverty Trap 16:48 Possible Solutions Show Notes "The Lancet Commission on global mental health and sustainable development" by Patel et al., 2018 "Mental Health Service Provision in Low- and Middle-Income Countries" by Rathod et al., 2017 "World mental health report: Transforming mental health for all" by WHO, 2022 "Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017" "Brain drain among Sri Lankan psychiatrists" by Chandradasa and Kuruppuarachchi (2023) "Why are we still living in the past? Sri Lanka needs urgent and timely reforms of its archaic mental health laws" by Hapangama et al., 2023
In a new format for the “Free Associations” podcast, we split our usual podcast into two bite-sized morsels. In the first segment, Jess, Matt and guest host Salma discuss an article that examines the effect of nighttime ambient light on risk of Alzheimer's disease. Journal club article: Alzheimer's Disease Study In the […]
The Grains & Legumes Nutrition Council's Whole Grain Week is coming soon (next week!). We're bringing you Elissa Price, PhD Candidate at the University of New South Wales to discuss her research findings on ultra-processed foods (UPF) and whole grains. We cover: What is food processing? Why are foods processed? Is it always bad? What is an UPF? The latest evidence on UPFs and healthRegardless of how whole grains are processed, what does the research tell us about whole grains and health? Can UPFs be part of a healthy diet? Elissa's three key takeaways on UPFs and whole grainsOne-liners you don't want to miss:“They categorise foods based on the level of processing and that UPF is that more extreme group of processing. They define an UPF based on the nature, extent and purpose of the food processing and are identified foods that have gone through more extensive processing.”“Higher ultra-processed food intake and worse health outcomes. Some of those being obesity, cancer, type 2 diabetes, cardiovascular disease, irritable bowel syndrome, depression and all-cause mortality. There is a lot of research happening in this space and a lot of links being made.”References Whole-grain health benefits Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019. 393(10184): p. 1958-1972.UPF health associations Taneri, P.E., et al., Association Between Ultra-Processed Food İntake and All-Cause Mortality: A Systematic Review and Meta-Analysis. Am J Epidemiol, 2022.Martínez Steele, E., et al., Dietary share of ultra-processed foods and metabolic syndrome in the US adult population. Preventive Medicine, 2019. 125: p. 40-48.Lane, M.M., et al., Higher Ultra-Processed Food Consumption Is Associated with Greater High-Sensitivity C-Reactive Protein Concentration in Adults: Cross-Sectional Results from the Melbourne Collaborative Cohort Study. Nutrients, 2022. 14(16): p. 3309.Beslay, M., et al., Ultra-processed food intake in association with BMI change and risk of overweight and obesity: A prospective analysis of the French NutriNet-Santé cohort. PLOS Medicine, 2020. 17(8): p. e1003256.Nova UPF subgroup associations Mendoza, K., et al., Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies. The Lancet Regional Health – Americas, 2024. 37.Chen, Z., et al., Ultra-Processed Food Consumption and Risk of Type 2 Diabetes: Three Large Prospective U.S. Cohort Studies. Diabetes Care, 2023. 46(7): p. 1335-1344.Cordova, R., et al., Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. The Lancet Regional Health – Europe.Nova UPF whole-grain exclusion Price, E.J., et al., Excluding whole grain-containing foods from the Nova ultraprocessed food category: a cross-sectional analysis of the impact on associations with cardiometabolic risk measures. Am J Clin Nutr, 2024.Nova and ADG discordance Nguyen, H., et al., Extent of alignment between the Australian Dietary Guidelines and the NOVA classification system across the Australian packaged food supply. Nutr Diet, 2024.
The November 2024 replay features four episodes dedicated to brain health. It kicks off with an interview with Dr. Nicoline Schiess, who discusses the World Health Organization (WHO) Brain Health Unit. Next, Dr. Katrin Seeher delves into the global burden of neurological conditions and the WHO's strategies to enhance care and awareness. The third segment features Dr. Natalia Rost who introduces and highlights the American Academy of Neurology's (AAN) groundbreaking brain health initiative. The episode wraps up with Dr. Rost again, who returns to give an update and emphasize the urgency of addressing brain health amidst public health challenges. Podcast Links: WHO Brain Health Unit Global Burden of Neurologic Conditions Brain Health Initiative with Dr. Natalia Rost Update on Brain Health with Dr. Natalia Rost Article Links: Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 The Brain Health Imperative in the 21st Century—A Call to Action AAN Brain Health Initiative Disclosures can be found at Neurology.org.
Lifestyle Behaviours in Mental Illness: 10min Lifestyle Psych Welcome to this 10 Minute Lifestyle Psychiatry episode. I discuss the mortality gap in people with serious mental illness, the underlying factors driving this and some of the solutions to this. Chapters 0:00 Show Intro 1:25 What Is the Mortality Gap Scandal? 3:20 Lifestyle Behaviours 7:55 Social Determinants of Mental Health 10:25 Diagnostic Overshadowing My name is Indi Dissanayake and I am a PhD Candidate investigating the implementation of exercise-based psychotherapy into mental healthcare, and a Provisional Psychologist. Check out the channel for deep dives into all things Lifestyle Psychiatry. I hope you find our content valuable. Show Notes -Physical health disparities and mental illness: the scandal of premature mortality (Thornicroft et al., 2011) -Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms--a qualitative study (Schefer et al., 2014) -Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders (Galletly et al., 2016) -Smoking and Mental Illness. A Population-Based Prevalence Study (Lasser et al., 2000) -Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis (Walker et al., 2015) -Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016 (Charlson et al., 2018)
Host: Jennifer Caudle, DO Guest: Samuel R. Wilson, MD Sickle cell disease is among the most common inherited conditions globally, affecting more than seven million individuals worldwide.1-3 Given its prevalence, it is important to understand all of the complexities surrounding this disease. Joining Dr. Jennifer Caudle to discuss the pathophysiology, clinical presentation, burden, and unmet needs of sickle cell disease is Dr. Samuel R. Wilson, Assistant Professor of Medicine in the Division of Hematology at the University of North Carolina School of Medicine. References: Sedrak A, Kondamudi NP. Sickle cell disease. StatPearls Publishing; 2023. Updated August 12, 2023. Accessed April 16, 2024. https://www.ncbi.nlm.nih.gov/books/NBK482384/. Thomson AM, McHugh TA, Oron AP, et al. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(8):e585-e599. doi:10.1016/S2352-3026(23)00118-7. CDC. Data & statistics on sickle cell disease. Centers for Disease Control and Prevention. Published May 2, 2022. Accessed April 16, 2024. https://www.cdc.gov/ncbddd/sicklecell/data.html/. Agios Pharmaceuticals, Inc. © 2024 All right reserved.SCD-US-0095 / June 2024
Host: Jennifer Caudle, DO Guest: Samuel R. Wilson, MD Sickle cell disease is among the most common inherited conditions globally, affecting more than seven million individuals worldwide.1-3 Given its prevalence, it is important to understand all of the complexities surrounding this disease. Joining Dr. Jennifer Caudle to discuss the pathophysiology, clinical presentation, burden, and unmet needs of sickle cell disease is Dr. Samuel R. Wilson, Assistant Professor of Medicine in the Division of Hematology at the University of North Carolina School of Medicine. References: Sedrak A, Kondamudi NP. Sickle cell disease. StatPearls Publishing; 2023. Updated August 12, 2023. Accessed April 16, 2024. https://www.ncbi.nlm.nih.gov/books/NBK482384/. Thomson AM, McHugh TA, Oron AP, et al. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(8):e585-e599. doi:10.1016/S2352-3026(23)00118-7. CDC. Data & statistics on sickle cell disease. Centers for Disease Control and Prevention. Published May 2, 2022. Accessed April 16, 2024. https://www.cdc.gov/ncbddd/sicklecell/data.html/. Agios Pharmaceuticals, Inc. © 2024 All right reserved.SCD-US-0095 / June 2024
19 Aug 2024 - Immutep Limited (ASX:IMM) CEO and Executive Director Marc Voigt discusses progress with the company's IMP761 drug, which is potentially active in more than 90% of autoimmune diseases.
Das zeigt eindrucksvoll eine neue Studie. In dieser Folge sprechen wir über die größten gefundenen Ernährungsfaktoren und wie du durch bessere Ernährungsgewohnheiten das Risiko senken kannst. Viel Freude beim Hören! - Theresa Pörschmann, Toni Meier, Stefan Lorkowski, Cardiovascular mortality attributable to dietary risk factors in 54 countries in the WHO European Region from 1990 to 2019: an updated systematic analysis of the Global Burden of Disease Study, European Journal of Preventive Cardiology, 2024;, zwae136, Cardiovascular mortality attributable to dietary risk factors in 54 countries in the WHO European Region from 1990 to 2019: an updated systematic analysis of the Global Burden of Disease Study Du möchtest raus aus der Zuckerfalle und ein Bewusstsein für deinen eigenen Zuckerkonsum entwickeln? Hier kannst du dir meinen 0€ Zuckerdetektiv herunterladen: https://vollundwertig.de/zuckerdetektiv/ Wenn dir die Folge gefallen hat, hinterlasse mir eine kurze Bewertung bei Spotify oder Apple Podcasts. Damit unterstützt du mich sehr. Für mehr fundiertes Ernährungs- und Einkaufswissen und alles rund um eine vollwertig, pflanzliche(re) Ernährung folge mir bei Instagram: https://www.instagram.com/vollundwertig/
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Life expectancy is expected to increase by almost five years around the world by 2050, according to new research. The Global Burden of Disease Study says countries with lower life expectancy are expected to see the biggest increases.Claudia Hammond is joined by BBC Africa health correspondent Dorcas Wangira to hear how public health measures are behind the predicted increases.We also hear about how negotiations at this week's World Health Assembly to secure a global deal for countries to prepare for pandemics have fallen through.Claudia and Dorcas discuss new research in Kenya into the time of day mosquitoes are biting children in school, and what it tells us about whether the insects are getting smarter.We also hear about the project twinning hospitals in Mexico and the US to try to improve the survival chances of children with leukaemia.And new research from Australia suggests having a baby takes much more metabolic energy than previously thought. Presenter: Claudia Hammond Producer: Dan Welsh Editor: Holly Squire
Le nombre de diabétiques a quadruplé depuis les 30 derrières années... mais ça vient d'où le diabète ? Adhérez à cette chaîne pour obtenir des avantages : https://www.youtube.com/channel/UCN4TCCaX-gqBNkrUqXdgGRA/join Video tournée avec le Dr Gilbert Bou Jaoudé, médecin sexologue et andrologue. Consultez son site sur Youtube: https://www.youtube.com/@Charlesco Script: Françoise Dulong et équipe Charles.co Montage: Charles.co Pour soutenir la chaîne, au choix: 1. Cliquez sur le bouton « Adhérer » sous la vidéo. 2. Patreon: https://www.patreon.com/hndl Musique issue du site : epidemicsound.com Images provenant de https://www.storyblocks.com Abonnez-vous à la chaine: https://www.youtube.com/c/LHistoirenousledira Les vidéos sont utilisées à des fins éducatives selon l'article 107 du Copyright Act de 1976 sur le Fair-Use. Sources et pour aller plus loin: Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021” GBD 2021 Diabetes Collaborators, June 22, 2023 Dictionnaire Larousse https://www.larousse.fr/dictionnaires/francais/diabète/25108 Le texte médical du Papyrus Ebers Transcription hiéroglyphique, translittération, traduction, glossaire et index, Bernard Lalanne et Gérard Métra. 2017 Coll. Langues et cultures anciennes. Celse, traité de la médecine en 8 livres, (traduction par Charles des Etangs) Paris, Dubocher, Le Chevalier et cie., 1846. Livre IV, Ch XX, par 2, p118 RENAUD M.L. Traité des signes, des causes et de la cure des maladies aigües et chroniques; ouvrage d'Aréthée (traduit du grec) 1 volume in-80,XVIII-422IV pages. Paris, Lagny, 1834 DAREMBERG Ch. Œuvres anatomiques, physiologiques et médicales de Galien (traduction française) 2 volumes in-80, XVI-706 et 784 pages, Paris, Baillière, 1856 Histoire illustrée du diabète, de l'Antiquité à nos jours, J-J. Peumery, Les éditions Roger Dacosta, Paris, déc 1987 A Bouchardat , Diabète sucré, son traitement hygiénique , Paris, 1883 J.A. Leouffre, De la glycosurie ou diabète sucré, Paris, 1854, no 259, 55 pages Regimen sanitaris, Arnaldus de Villanova, Lyon, 1504 https://collections.nlm.nih.gov/catalog/nlm:nlmuid-2211085R-bk Dictionnaire de l'encyclopediae universalis, 2023 https://www.universalis.fr/atlas/ Histoire du diabète, Ph. Vague et B. Vialettes Hôpital du Petit-Arbois. Centre hospitalo-universitaire de Marseille. 13290 Les Milles. Nicolas, Pierre-François et Gueudeville Victor, Recherches et expériences médicales sur le diabète sucré et la phthisurie sucrée, 1 volume in-80, 99 pages, Paris, Méquignon, 1803 Le diabète dans le monde : classement par pays, 26 Oct 2022 https://www.dbl-diabete.fr/tout-sur-le-diabete/societe/classement-diabete-pays-monde Qu'est-ce que le diabète, Nov 2021 https://www.diabete.qc.ca/le-diabete/informations-sur-le-diabete/quest-ce-que-le-diabete/ Vins de Bourgogne, lexique https://www.vins-bourgogne.fr/glossaire/austere,2530,9410.html?&args=Y29tcF9pZD0xNTU5JmFjdGlvbj12aWV3R2xvc3NhaXJlJmlkPSZtb3Q9NzB8#_ La langue française, dictionnaire https://www.lalanguefrancaise.com/dictionnaire/definition/leucophlegmatie The Starvation Treatment of Diabetes par Lewis Webb Bill, M.D. et Rena S. Eckman, diététicienne. 1915. Le diabète sucré https://fr.wikipedia.org/wiki/Diabète_sucré Traité du diabète sucré, des affections gastriques et des maladies qui en dépendant, par John Rollo, traduit de l'anglais par Alyon, 1 volume in-80. Paris, Montardier-Cérioux, An VI (1797) Fédération française des diabétiques https://www.federationdesdiabetiques.org/information/recherche-innovations-diabete/decouverte-insuline#:~:text=Sur%20la%20piste%20de%20l%27insuline&text=L%27étudiant%20en%20médecine%20allemand,nom%20%3A%20les%20îlots%20de%20Langerhans Diabète Québec https://www.diabete.qc.ca/le-diabete/informations-sur-le-diabete/quest-ce-que-le-diabete/ HISTOIRE DU DIABÈTE AUX TEMPS ANCIENS: Diabète dans tous ses états, le 22/08/2022, Marc Gozlan https://www.le-diabete-dans-tous-ses-etats.precidiab.org/histoire-du-diabete/histoire-du-diabete-aux-temps-anciens/ Le taux mondial du diabète augmenteront de 529 millions cas à 1,3 milliard cas par 2050 On s'attend que chaque pays du monde verra une augmentation des taux. SEATTLE, Wash. 22 juin 2023 https://www.healthdata.org/sites/default/files/files/images/news_release/2023/French_GBD%202021%20Diabetes%20News%20Release.pdf Événement historique national de la découverte de l'insuline, 2022-12-01 https://parcs.canada.ca/culture/designation/evenement-event/decouverte-insuline-insulin-discovery# Diabète https://www.paho.org/fr/sujets/diabete#:~:text=Le%20nombre%20des%20personnes%20atteintes,%25%20en%202014%20(1) Un portrait complet du diabète de type 1 dans le monde, 2022 https://ici.radio-canada.ca/nouvelle/1923169/diabete-de-type-1-portrait-complet-planete Autres références disponibles sur demande.
Is there a vaccine for bird flu? Can pets get bird flu? Is America prepared for another pandemic? What is an example of a DALY? Why is global health security important? Our guest is AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH. American Medical Association CXO Todd Unger hosts.
Die Themen in den Wissensnachrichten: +++ Lebenserwartung hat weltweit zugenommen +++ Top Ten der Vergessenen Nachrichten +++ Kakerlaken-Drohne hilft bei Forschung in Wäldern +++**********Weiterführende Quellen zu dieser Folge:Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021, The Lancet, 03.04.2024Was in den Medien fehlt. Die „Vergessenen Nachrichten“ des Jahres, Deutschlandfunk, 04.04.2024Inequality Trends in the Context of Changes in Labor Market Outcomes, Composition and Redistribution in Germany, EconPol Forum 02/2024Synergistic morphology and feedback control for traversal of unknown compliant obstacles with aerial robots, Nature Communications, 26.03.2024Threat of mining to African great apes, Science Advances, 03.04.2024Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: Tiktok und Instagram.
Die Themen in den Wissensnachrichten: +++ Pythons sind effiziente Nahrungsquelle +++ Mehr Methanlecks durch Erdgas-Förderung +++ Warum Elefanten eher langsam sind +++**********Weiterführende Quellen zu dieser Folge:Python farming as a flexible and efficient form of agricultural food security, Scientific Reports, 14.3. 2024US oil and gas system emissions from nearly one million aerial site measurements, Nature, 13.03. 2024Dynamic similarity and the peculiar allometry of maximum running speed, Nature, 11.03. 2024Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021, THE LANCCET Neurology, 14.03. 2024Wandering outside of the Styx: Surface activity of an iconic subterranean vertebrate, the olm (Proteus anguinus), Ecology, 08.02. 2024Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: Tiktok und Instagram.
You may have heard that high blood pressure, or hypertension, is a “silent killer.” Today, Rip unpacks what that means and how ingesting too much sodium leads to serious problems. High blood pressure, also called hypertension, is known as a “silent killer” because in most cases it has no symptoms. People with elevated blood pressure are straining their hearts by making them work harder to move blood around. Their hearts sweat and pound and gasp away, but they're none the wiser. For this reason, the Global Burden of Disease Study, which involved more than 300 institutions in 50 countries, concluded that high blood pressure is the number-one world-wide risk factor for death, resulting in fatal heart attacks, strokes, and other catastrophic organ failures.Learn why in this short minisode. Join the FREE PLANTSTRONG 7-Day Challenge: https://plantstrongfoods.com/pages/plantstrong-seven-day-challengeUpcoming Events:Black Mountain Retreat - April 14th-19th, 2024 - Save $200 with code: RIP200https://plantstrongfoods.com/pages/2024-black-mountain-retreat Sedona Retreat - October 8th-13th, 2024 - Save $200 with code: RIP200https://plantstrongfoods.com/pages/2024-sedona-retreat Follow PLANTSTRONG and Rip Esselstynhttps://plantstrongfoods.com/ https://www.facebook.com/GoPlantstrong https://www.instagram.com/goplantstrong/https://www.instagram.com/ripesselstyn/ Leave Us a Voicemail Question or StoryLeave us a voicemail: https://www.speakpipe.com/plantstrong Let Us Help Your PLANTSTRONG Journeyhttps://home.mealplanner.plantstrong.com/ https://myplantstrong.com/b/trailblazer Follow the PLANTSTRONG Podcast and Give the Show a 5-star RatingApple PodcastsSpotifyTheme Music for Episodehttps://app.soundstripe.com/songs/10845
KGMI's Dianna Hawryluk and Adam Smith chat about a new study on cardiovascular disease among marijuana smokers and the rise of kids' gun accidents during the pandemic.
In 2005, German gynaecologist Dr Frank Hoffmann, started his quest for a suitable medical assistant to conduct clinical breast exams for his clinic in Duisburg in Germany. By 2010, he had set up a social enterprise called Discovering Hands that trains blind and visually impaired women to conduct specialised routine breast examinations called tactile breast examinations. Today, Discovering Hands is spread across Germany, Switzerland, Austria and India, training blind and visually impaired women for the role of Medical Tactile Examiners (MTEs) who can offer accurate breast cancer screening with their highly sensitive and trained touch. The first episode in this two-part podcast series is about the problems associated with breast cancer in India and the solution MTEs offer. In the episode, hear from Dr. Frank Hoffmann, Meenakshi Gupta, Sonal Prakash, Dr. Mandeep Malhotra, Dr. Kanchan Kaur, Dr. Lily Gutnik, Dr Poovamma CU, Shanti Raghavan, Dr. Vrutika Patel, Asha Sharma and Shashi Menon. This mini-serires has been reported by Priti Salian and the project was funded by the European Journalism Centre, through the Global Health Security Call. This programme is supported by the Bill & Melinda Gates Foundation. Transcript: Blind and visually impaired women are emerging as a workforce in early breast cancer detection part 1.pdf References NAB India Centre for Blind Women & Disability Studies The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016 - The Lancet Oncology Breast cancer in India: Present scenario and the challenges ahead - PMC https://journals.lww.com/jfmpc/Fulltext/2022/11000/Status_of_cancer_screening_in_India__An_alarm.106.aspx Survival Analysis of Breast Cancer Patients Treated at a Tertiary Care Centre in Southern India - ScienceDirect Breast cancer in India: Present scenario and the challenges ahead - PMC Status of cancer screening in India: An alarm signal from the National Family Health Survey (NFHS-5) See sunoindia.in/privacy-policy for privacy information.
In this episode Sal, Adam & Justin speak with Shawn Stevenson, author of Sleep Smarter, Eat Smarter, and the new Eat Smarter Family Cookbook. Learning along the way as a parent. (2:29) “Life doesn't call the qualified. Life qualifies the called.” (5:50) We are a product of our environment but also CREATORS of it. (11:17) Fighting his way through life. (19:39) “What can I do to feel better?” His transformation moment with his health. (28:11) The three things he did to change his health. (36:31) Taking his education into his own hands. (41:31) Tackling the seed oil debate. (50:26) Looking at alternative forms of medicine for clues or hints that science hasn't looked at yet. (58:49) Why an individual approach is the best. (1:05:56) How your culture controls your choices. (1:09:36) Steps to create a healthier micro-culture in your household. (1:22:16) The impetus behind his new book and what makes it different. (1:36:24) Challenging your children through ‘safe stressors'. (1:47:12) Exposing your children to different environments so they can learn from other voices. (1:54:32) Related Links/Products Mentioned Eat Smarter Family Cookbook: 100 Delicious Recipes to Transform Your Health, Happiness, and Connection – Book by Shawn Stevenson Limited time offer exclusively for Mind Pump Listeners ONLY: 50% off the Stress, Mood & Metabolism At-Home Lab Test + Health Coaching Call – Reserve yours today here October Promotion: MAPS Bands | The Skinny Guy ‘hardgainer' Bundle 50% off! **Code OCTOBER50 at checkout** What Effect Do Questions Have On Our Brain? - Medium Racehorse Bone Health: From a Nutritional Perspective Chronic Diseases in America | CDC Importance of EPA and DHA Blood Levels in Brain Structure and Function Consumption of ultra-processed foods and associated ... - BMJ Open Trends in Consumption of Ultraprocessed Foods Among US Youths Aged 2-19 Years, 1999-2018 Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis In vivo respiratory toxicology of cooking oil fumes: Evidence, mechanisms and prevention Adult Obesity Facts | Overweight & Obesity | CDC The Past 200 Years in Diabetes | NEJM Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 Sleep Smarter – Book by Shawn Stevenson The Benefit of Family Dinner | Harvard Graduate School of Education Is Frequency of Shared Family Meals Related to the Nutritional Health of Children and Adolescents? We Need a New Approach to Prevent Obesity in Low-Income Minority Populations Mind Pump Podcast – YouTube Mind Pump Free Resources Featured Guest/People Mentioned Shawn Stevenson (@shawnmodel) Instagram Website Bedros Keuilian (@bedroskeuilian) Instagram Bruce H. Lipton, PhD Layne Norton, Ph.D. (@biolayne) Instagram Paul Saladino, MD (@paulsaladinomd) Instagram Arthur Brooks (@arthurcbrooks) Instagram Jim Kwik (@jimkwik) Instagram Mark Bell (@marksmellybell) Instagram
Hoy viene mi querido Alex Asz a hablarnos sobre los problemas de encías y cómo es que muchos ni en cuanta que los tienen. Según el Global Burden of Disease Study, 2019, las enfermedades bucodentales, afectan a cerca de 3,500 millones de personas en todo el mundo y muchos no tienen idea, incluso empiezan con problemas de encías y terminan con pérdidas dentales.
In this podcast, an experienced conference and webinar moderator is joined by two doctors in the field of paediatric infectious diseases: David Greenberg and Maria Hemming-Harlo. In this podcast, our guest experts provide information and their perspectives on the following topics: The disease burden of rotavirus The related morbidity and mortality of rotavirus How rotavirus is transmitted The clinical picture of rotavirus infection The evidence supporting routine vaccination with RotaTeq (Rotavirus Vaccine, Live, Oral, Pentavalent) This podcast was funded by Merck Sharp & Dohme LLC. Below please find the reference list for Vax Voices, Podcast 1: The Global Burden of Rotavirus Disease and Evidence Supporting Routine Vaccination With RotaTeq to ensure listeners can further explore the content discussed. View the product information and indication for RotaTeq here. View the Select Safety Information from MSD below. Select Safety Information RotaTeq should not be administered to infants with a demonstrated history of hypersensitivity to the vaccine or any component of the vaccine. Infants with a history of intussusception or who have congenital malformation of the gastrointestinal tract that could predispose infants to intussusception should not receive RotaTeq. Infants with Severe Combined Immunodeficiency Disease or SCID should not receive RotaTeq. Administration of RotaTeq should be postponed in infants suffering from acute severe febrile illness. The presence of a minor infection is not a contraindication for immunisation. The administration of RotaTeq should be postponed in subjects suffering from acute diarrhoea or vomiting. No safety or efficacy data are available from clinical trials regarding the administration of RotaTeq to infants who are potentially immunocompromised. Cases of gastroenteritis associated with vaccine virus have been reported post marketing in infants with severe combined immunodeficiency. Vaccine virus transmission from vaccine recipient to nonvaccinated contacts has been reported. Caution is advised when considering whether to administer RotaTeq to individuals with immunodeficient contacts. In post-marketing experience, intussusception (including death) and Kawasaki disease have been reported in infants who have received RotaTeq. As a precaution, healthcare professionals should follow-up on any symptoms indicative of intussusception (severe abdominal pain, persistent vomiting, bloody stools, abdominal bloating and/or high fever) since data from observational studies indicate an increased risk of intussusception, mostly within 7 days after rotavirus vaccination. Parents/guardians should be advised to promptly report such symptoms to their healthcare provider. The level of protection provided by RotaTeq is based on the completion of all 3 doses. As with any vaccine, vaccination with RotaTeq may not result in complete protection in all recipients. HQ-ROT-00133 | 02/23 Podcast References: 1.Nelson R. COVID-19 disrupts vaccine delivery. Lancet Infect Dis. 2020;20(5):546. 2.Centers for Disease Control and Prevention (CDC). Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Chapter 19: Rotavirus. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/rota.html. Last accessed: 6 March 2023. 3.Dormitzer PR. "Rotaviruses," Mandell GL, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier Saunders; 2019:1983-96. 4.Centers for Disease Control and Prevention (CDC). Rotavirus. Clinical information. 2021. Available at: https://www.cdc.gov/rotavirus/clinical.html. Last accessed: 13 October 2022. 5.Troeger C et al. Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years. JAMA Pediatr. 2018;172(10):958-965. Erratum in: JAMA Pediatr. 2022;176(2):208. 6.GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(9):909-948. Erratum in: Lancet Infect Dis. 2017 Sep;17(9):897. 7.Van Damme P et al. Rotavirus vaccines: considerations for successful implementation in Europe. Lancet Infect Dis. 2006;6(12):805-12. 8.Paul MO, Erinle EA. Influence of humidity on rotavirus prevalence among Nigerian infants and young children with gastroenteritis. J Clin Microbiol. 1982;15(2):212-5. 9.Finnish Institute for Health and Welfare. Infectious diseases and vaccines: rotavirus vaccine. 2020. Available at: https://thl.fi/en/web/infectious-diseases-and-vaccinations/vaccines-a-to-z/rotavirus-vaccine. Last accessed: 16 September 2022. 10.GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. 11.Franco MA et al. Immunity and correlates of protection for rotavirus vaccines. Vaccine. 2006;24(15):2718-31. 12.Gentsch JR et al. Serotype diversity and reassortment between human and animal rotavirus strains: implications for rotavirus vaccine programs. J Infect Dis. 2005;192(Suppl 1):S146-59. 13.Merck & Co. RotaTeq®. Prescribing information. 2022. Available at: https://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_pi.pdf. Last accessed: 4 January 2023. 14.European Medicine Agency (EMA). RotaTeq. Summary of product characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/rotateq-epar-product-information_en.pdf. Last accessed: 4 January 2023. 15.Velasquez-Portocarrero DE et al. Head-to-head comparison of the immunogenicity of RotaTeq and Rotarix rotavirus vaccines and factors associated with seroresponse in infants in Bangladesh: a randomised, controlled, open-label, parallel, phase 4 trial. Lancet Infect Dis. 2022;22(11):1606-16. 16.Cortese MM, Parashar UD; Centers for Disease Control and Prevention (CDC). Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009;58(RR-2):1-25. 17.Vesikari T et al.; Rotavirus Efficacy and Safety Trial (REST) Study Team. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354(1):23-33. 18.Vesikari T et al. Efficacy of a pentavalent rotavirus vaccine in reducing rotavirus-associated health care utilization across three regions (11 countries). Int J Infect Dis. 2007;11(Suppl 2):S29-35. 19.Heyse JF; REST Study Team. Evaluating the safety of a rotavirus vaccine: the REST of the story. Clin Trials. 2008;5(2):131-9. 20.World Health Organization (WHO). Rotavirus vaccines: WHO position paper. Wkly Epidemiol Rec. 2021;96(28):301-20.
This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!In part 1 we talked about a request that has been submitted for the World Health Organization (WHO) to add diet drugs to their list of “essential medicines.” We discussed who was making this request and the justification that they were using. Today we're going to take a deeper dive into the research that they used to try to support this request, and in part three will look at the research around harm and “efficacy,” as well as “cost effectiveness.” (I was originally going to write this in two parts, but I realized that it was just ridiculously long, and there is time before the WHO meets about this, so I've decided to break it into three parts.)Just a reminder that I don't hyperlink to studies or articles that come from a place of weight stigma, though I do provide enough information that someone could google them.In their ”Summary statement of the proposal for inclusion” they say“The use of GLP-1 RAs in the treatment of ob*sity has been well studied and meta-analyses of various GLP-1 RAs have demonstrated that this class of medications can lead to clinically significant weight loss. Compared to control groups, GLP-1 RAs were found to lead to more significant weight loss with a mean difference of approximately 7.1 kg as well as an improvement in glycemic control, with low concern for hypoglycemia[3].”The single paper they cite to back this up (Iqbal et al. Effect of glucagon-like peptide-1 receptor agonists on body weight in adults with ob*sity without diabetes mellitus-a systematic review and meta-analysis of randomized control trials, 2022) looked at weight loss on these drugs among “ob*se” adults without type 2 diabetes (so hypoglycemia would have been unlikely anyway.) It included 12 trials with a total of 11,459 participants. 80% of the participants were white, 10% were Black or African Americans and 5% were Asians. It is concerning that they are making a global recommendation based on a study population that is overwhelmingly white. There is also the issue of follow-up. Some of the trials were as short as 14 weeks and the longest trial included was only 3 years. The average weight loss was 15.6 lbs more in the group taking the drugs than in control, but some subjects on the drugs lost as little as 5.5 lbs. Those on the drugs also experienced vomiting, nausea, dyspepsia (indigestion,) diarrhea, constipation and abdominal pain as common side effects. There is no way to know how much of this (short-term) weight loss is due to experiencing these common side effects. These drugs also have significant (possibly life-threatening) side effects and the short-term follow-up included here is not likely long enough to capture those. Also, remember that the recommendation is for people to take these drugs for the rest of their lives (since, if they don't, their weight shoots right back up and they lose cardiometabolic benefits,) and they are making that recommendation (globally) on just 14 weeks to 3 years of data.The authors of this study cite no conflicts of interest. Per LinkedIn, someone with the same name as the lead author is a product specialist at Novo Nordisk but I imagine that must be a coincidence or surely it would have been listed as a COI. The article was published in “Ob*sity Reviews” which is an official journal of the “World Ob*sity Federation” (WOF). The WOF took over $5.3 Million dollars from Novo Nordisk (whose weight loss drugs are covered by this recommendation) over three years. Their “members” include the Ob*sity Action Coalition (whose chief funder is Novo Nordisk.) Their current President has taken money to speak on behalf of Novo Nordisk and their past president is John Wilding who was implicated in the recent Novo Nordisk scandal for not disclosing his financial ties to Novo Nordisk while praising their weight loss drugs in the media.There are more issues with this meta-analysis but I'll just stop there and say that I don't think there is any way that 14 weeks to 3 years of data on 11,459 people who are mostly white justifies a global recommendation of these drugs as “essential.”Under “Treatment details (requirements for diagnosis, treatment and monitoring)”Here again they say “Ob*sity, a preventable disease” but offer no citation or support for this narrative that has been largely architected and marketed by the weight loss industry. They continue:“When used in supplement to life style modifications, including a decrease in caloric intake and an increase in exercise, liraglutide is indicated for adults with ob*sity (BMI >30.00) or overweight (BMI >27.00) with a weight-related comorbidity”I just want to note here that this indication (which wasn't created by those who wrote the recommendation to the WHO) predicates risk on body size and simple correlation. These drugs have very unpleasant common side effects and other, possibly life-threatening, side effects. So the fact that those who are “overw*ight” have to have at least one condition that is correlated with being higher weight (with no proof of causation, by the way) but those who are “ob*se” are recommended to risk these side effects based on size alone, with no required symptomology, is pure weight stigma.Next is a table “Excerpts from national and international guidelines on the pharmacological treatment of ob*sity”It is a list of organizations with quotes pulled from various publications that are intended to show support for the drugs. Almost every one of the organizations has financial ties to Novo Nordisk and/or Eli Lilly which doesn't prove that there is anything shady going on, but would be worth disclosing given their use to back up the request that these companies' drugs be considered “essential.” Let's take a deeper look:The American College of Cardiology (ACC)The recommendation that is cited is for the use of these drugs for Type 2 diabetes (T2D), and they mention weight loss as an ancillary effect. This will be a pattern in these recommendations and it matters because the risk/benefit analysis is different for people who have an actual health condition (Type 2 diabetes) rather than those who are simply living in a higher-weight body. Also, one might be misled by the title of the section to believe that these recommendations are specifically for the use of the drugs in the treatment of “ob*sity” which is not the case.The ACC has a partnership with Novo NordiskThey have also partnered with Eli LillySouth Asian Task ForceAgain, this is a recommendation for these medications for the treatment of T2D, not for weight loss.The paper's lead author, Sanjay Kalra has received honoraria for lectures and advisory boards from Eli Lilly and Novo Nordisk.International Diabetes FederationThis, again, is a recommendation of these drugs for the treatment of T2D.Novo Nordisk is a “platinum partner” and Eli Lilly is a “gold partner” (the website isn't clear about how much money they donate, and an email I sent has gone unanswered so far.)National Institute for Health and Care Excellence (NICE)This one actually is a recommendation for these drugs for weight loss, however, NICE was implicated in the recent scandal which found that “Novo Nordisk had paid millions to prominent ob*sity “charities,” NHS trusts, universities and other bodies as well healthcare professionals who publicly praised the drug (typically without disclosure of their funding) and who advised NICE (The National Institute for Health and Care Excellence) on their reviewing of Novo's weight loss drug to decide whether or not it should be made available.”Position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM)This is a statement of recommendations for prevention of cardiovascular disease in patients with diabetes.Here is a selection of the authors “competing interests” (I've only included Novo Nordisk and Eli Lilly, the two main companies trying to sell this class of drugs for weight loss.) ROM has received speaker honorarium from: Novo Nordisk and Eli Lilly.CMV has received honoraria as speaker from Novo Nordisk.SV over the last 5 years, has received honoraria for clinical research from Novo Nordisk; Advisory Board to Novo Nordisk; has received honoraria as speaker from Novo NordiskFT has received honoraria for medical lectures from: Lilly, Novo NordiskRDS over the last 3 years has received honoraria for consulting, research and speaker activities from Eli LillyThe Brazilian Diabetes Society (SBD) has collaborated with Novo NordiskThe Brazilian Cardiology Society (SBC) holds an annual congress that is sponsored by Novo Nordisk and Eli Lilly. The Brazilian Endocrinology and Metabolism Society (SBEM) has partnered with Novo Nordisk on multiple occasions.Korean Society for the Study of Ob*sity Guidelines for the Management of Ob*sity in KoreaThis is not a study but guidelines put out by an organization that appears to represent those with a profit interest in “ob*sity treatment” (similar to the Ob*sity Action Coalition.) Their “recommendation” includes every drug that is approved for long-term use, fails to cite any evidence of efficacy (short or long-term) and they mention that “Not all ob*se people respond to ob*sity drugs, and there are a significant number of non-responders.”Novo Nordisk is a platinum sponsor for their conference. They are also a member of the World Ob*sity Federation which took over $5M from Novo Nordisk.European Medical Association[sic]Here they are citing a press release stating that the European Medicines Association (EMA) (the recommendation authors appear to have been mistaken on the name) has “recommended granting a marketing authorisation for Saxenda (liraglutide) for weight management in overweight or ob*se adults.” Per the EMA's website they are “a scientific body with the expertise required to assess the benefits and risks of medicines. However, under EU law it has no authority to actually permit marketing in the different EU countries. The role of EMA is to make a recommendation to the European Commission which then takes a final legally binding decision on whether the medicine can be marketed in the EU.”I could not find information about the panel that made the decision, or any conflicts of interest they may have had.Australia: NPS Medicine WiseThe citation they offer here is not to Australia: NPS Medicine Wise, but to a paper by a single author - Joseph Proietto who “has been on the medical advisory boards for liraglutide, semaglutide 2.4 mg and bupropion/naltrexone. He has been involved in educational sessions for ob*sity management for both Novo Nordisk (liraglutide, semaglutide) and iNova (phentermine and bupropion/ naltrexone) for which he has received honoraria.” In other disclosures it mentions that he was, in fact, chair of the medical advisory board for Saxenda (Novo Nordisk's brand name for liraglutide, the drug being recommended here.)In the paper he recommends all of the above weight loss drugs in general, but does not recommend the GLP-1 class of drugs over any of the others. The study he uses to recommend these drugs only follows participants for 68 weeks.Singapore HPB-MOH Clinical Practice GuidelinesIn the section on liraglutide they offer information for 56 weeks of follow up and conclude “The long-term safety of high dose liraglutide therapy is, however, unclear.”Canadian Medical Association Journal- Ob*sity in adults: a clinical practice guidelineFunding for these guidelines was provided by Ob*sity Canada, an organization that lobbies for the priorities of those who profit from “ob*sity treatment.” Specifically, the funds came from “Ob*sity Canada's Fund for Ob*sity Collaboration and Unified Strategies (FOCUS) initiative” Novo Nordisk is a supporter of this fund, as well as a sponsor for their annual summit.Here are excerpts from the 1,293 word competing interests statement for the authors (I've only included Novo Nordisk and Eli Lilly, the two main companies trying to sell this class of drugs for weight loss.) Sean Wharton reports receiving honoraria and travel expenses and has participated in academic advisory boards for Novo Nordisk, Eli Lilly. Sean Wharton is also the medical director of a medical clinic specializing in weight management and diabetes. David Lau reports receiving grants and research support from Novo Nordisk, speaker bureau fees from Eli Lilly and Novo Nordisk; and consulting fees from Eli Lilly and Novo Nordisk. Michael Vallis is a member of advisory boards for Novo Nordisk. Michael Vallis has also received consulting fees from Novo Nordisk and speaking fees from Novo Nordisk. Arya Sharma reports receiving speaker's bureau and consulting fees from Novo Nordisk. Laurent Biertho is a member of advisory boards for Novo Nordisk. Denise Campbell-Scherer reports receiving research funding from Novo Nordisk. She also reports receiving an unrestricted education grant from Ob*sity Canada, funded by Novo Nordisk Global. Jennifer Brown reports receiving nonfinancial support from Novo Nordisk, and personal fees Yoni Freedhoff is the co-owner of the Bariatric Medical Institute and Constant Health, which provide weight management services; Constant Health has received a grant from Novo Nordisk. Yoni Freedhoff also regularly speaks on topics related to ob*sity and receives honoraria and travel costs and expenses for same. Michel Gagner reports receiving consulting fees from Novo Nordisk. Marie-France Langlois reports receiving personal fees from Novo Nordisk, Eli Lilly. David Macklin reports receiving personal fees from Novo Nordisk. Priya Manjoo reports receiving personal fees from Novo Nordisk. Marie-Philippe Morin reports receiving speaker honoraria from Novo Nordisk, Eli Lilly and research subvention from Novo Nordisk, and consultation honoraria from Novo Nordisk, Eli Lilly. Sue Pedersen reports receiving personal fees from Novo Nordisk, Eli Lilly and grants from Eli Lilly, and nonfinancial support from Novo Nordisk and Eli Lilly.Megha Poddar reports receiving honoraria for continuing medical education (CME) from Novo Nordisk, Eli Lilly, education grants from Novo Nordisk, fees for mentorship from Novo Nordisk; fees for membership of advisory boards from Novo Nordisk. Paul Poirier reports receiving fees for consulting and continuing medical education from Eli Lilly, Novo Nordisk. Judy Shiau reports receiving personal fees from Novo Nordisk. Diana Sherifali reports receiving a grant from Ob*sity Canada to support the literature review process, during the conduct of the study. Shahebina Walji reports receiving consulting or advisory board fees from Novo Nordisk and speaker's bureau fees from Novo Nordisk.All of their recommendations around liraglutide are level 2a (Evidence from at least 1 controlled study without randomization) and Grade B ( Directly based on level 2 evidence or extrapolated recommendation from category 1 evidence) they suggest that these recommendations should use the terms “may” or “can” (as opposed to “should.”) The studies that they cite offer, at most, only 56 weeks of follow-up.Information supporting the public health relevanceIn this section they claim that “not only is the prevalence of ob*sity increasing, but the number of global deaths attributed to BMI has substantially increased from 1990 to 2017 (Figure 1) [23]. The global burden of disease of ob*sity study also found that though the age-standardized rate of high BMI related disability adjusted life years (DALY) increased by 12.7% for females and 26.8% for males, the actual global number of high BMI DALYs has doubled, despite sex”The study that they cite to support this (The global burden of disease attributable to high body mass index in 195 countries and territories, 1990-2017: An analysis of the Global Burden of Disease Study, Dai et al., 2020) calculates these numbers based on the assumption that the health problems higher-weight people have are due to their weight (even though people of all sizes experience them). They also fail to control for the health impacts of weight stigma, weight cycling, or healthcare inequalities, despite the research that shows that they are confounding variables. The assumption that higher-weight people's health issues are caused by their weight coupled with the failure to account for (or even discuss) confounding variables suggests to me either near-complete incompetence of the study authors around basic research methods, or a desire for specific conclusions.The study is at least honest that they don't know if weight loss would change this, stating “Successful population-wide initiatives targeting high BMI may mitigate the burden of a wide range of diseases” [emphasis mine].Thus, this doesn't actually support the recommendation to the WHO. Without proof that these medications would reduce disease or increase life years long-term, there is no reason to consider them “essential,” and no such evidence exists.Next they claim that “Ob*sity also plays a role in health care related costs; for patients and families, total healthcare costs for patients with ob*sity were higher than that of patients who are overweight.”First of all, this begins to wade into the idea that higher-weight people should be eradicated because they are “too expensive,” which is heading down a bad road when it comes to ethics. Further, the study they use to support this is based on 97 Dutch people who filled out a survey. The study included costs such as “expenditures related to the respondent's weight, such as adapted clothing, gym subscription, diet books, parking permit, food, etc.” First of all, thin people also have gym subscriptions and parking permits, but, moreover, telling fat people that they should buy diet books and pay for various weight loss foods and methods (despite the near-total failure rate,) then blaming them for the cost of following those dubious recommendations (as well as the additional costs of living in a world where structural weight stigma creates a lack of accommodation in clothing etc.) as a justification for more expensive, more dangerous “interventions” is a long way from being ethical science and is a particularly craven marketing tactic. I'm just going to stop there, but to say that I've seen elementary school science fair projects with more rigorous methodology and I would be beyond embarrassed to cite this for any reason ever, other than as an example of the piss-poor state of weight science.They finish up the section with “Given the global burden of ob*sity and the goal of reducing preventable disease related deaths, it is evident that affordable and available pharmacotherapy for ob*sity is needed on a global level.”Let's rephrase this to reflect the evidence they provided: “Based on a survey taken by 97 people, a study that failed to control for any confounding variables and made wild assumptions about causality based on simple correlation, and their own research's acknowledgment that changing body size may not change health outcomes, it is evident that affordable and available pharmacotherapy for ob*sity is needed on a global level.”Which is to say, what they provided here does not come close to justifying their request.In part three we'll wrap this up with a look at the evidence they use to discuss harm, effectiveness, and cost-effectiveness.Did you find this post helpful? You can subscribe for free to get future posts delivered direct to your inbox, or choose a paid subscription to support the newsletter and get special benefits! Click the Subscribe button below for details:Liked this piece? Share this piece:More research and resources:https://haeshealthsheets.com/resources/*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings' Fearing the Black Body – the Racial Origins of Fat Phobia and Da'Shaun Harrison's Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe
Die ewige Fragestellung: Alkoholkonsum – gesund oder ungesund? Einige von euch mögen bei dieser Frage die Augen verdrehen. Ich verstehe, dass es bereits zahlreiche Diskussionen zu diesem Thema gab. Allerdings bin ich der Meinung, dass die bisherigen Ergebnisse unbefriedigend waren. Die Debatte kam erst vor Kurzem wieder auf, als unser Gesundheitsminister Karl Lauterbach kürzlich wegen seiner Aussage, dass ein Glas Wein gesund sein kann, in die Kritik geraten ist. Aus diesem Grund möchte ich in meinem Podcast diese Frage aufgreifen und meinen Beitrag zu dieser Diskussion leisten. Eins vorweg: Eine einfache Antwort gibt es nicht. In dieser Episode werden wir uns mit einer interessanten Studie auseinandersetzen, die du kostenlos unter folgendem Link finden: Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020 - The Lancet Die wichtigsten Ergebnisse haben ich für dich zusammengefasst. Viel Vergnügen beim Zuhören! ____________________________________ Werbung: Hier findest du alle Infos und Rabatte! Danke an meine Werbepartner:innen, die diesen Podcast möglich machen
This week on the podcast I'm joined by friend of the podcast, Monica Reinagel. We're discussing a recent episode of the Nutrition Diva that Monica recorded based on a listener question. The question spurred Monica to dive into a 2022 article analyzing the 2020 Global Burden of Disease Study. We're talking about it all (and then some). To listen to the Nutrition Diva podcast: Nutrition Diva Podcast Meta-Analysis 2022 Canada's Guidance on Alcohol and Health: Final Report 2023 Alcohol Truths: How Much is Safe? Buy Breaking the Bottle Legacy: How to Change Your Drinking Habits and Create A Peaceful Relationship with Alcohol on Amazon or most online retailers. US Kindle US Paperback UK Kindle UK Paperback Apple Books Barnes & Noble Kobo Join my private FB group Alcohol Minimalists here: https://www.facebook.com/groups/changeyouralcoholhabit Has this podcast helped you? Please leave a review wherever you listen to podcasts! This week on the podcast I'm talking about what causes your drinking...and why alcohol isn't the problem. Follow me on Instagram: @AlcoholMinimalist Have you grabbed your free e-book, "Alcohol Truths: How Much is Safe?" Get it here. Low risk drinking guidelines from the NIAAA: Healthy men under 65: No more than 4 drinks in one day and no more than 14 drinks per week. Healthy women (all ages) and healthy men 65 and older: No more than 3 drinks in one day and no more than 7 drinks per week. One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. So remember that a mixed drink or full glass of wine are probably more than one drink. Abstinence from alcohol Abstinence from alcohol is the best choice for people who take medication(s) that interact with alcohol, have health conditions that could be exacerbated by alcohol (e.g. liver disease), are pregnant or may become pregnant or have had a problem with alcohol or another substance in the past. Benefits of “low-risk” drinking Following these guidelines reduces the risk of health problems such as cancer, liver disease, reduced immunity, ulcers, sleep problems, complications of existing conditions, and more. It also reduces the risk of depression, social problems, and difficulties at school or work. If you' are unsure about whether or not you have alcohol use disorder, please visit the NIAAA for more information.
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
The Global Burden of Disease Study (GBD) began in 1991 sponsored by the World Bank and the World Health Organization to fill a critical gap in global health information. It has grown steadily to become an active collaboration of more than 8,000 scientists, researchers and policy-makers from 156 countries working together to quantify health at the national and subnational level. In this program, Christopher J.L. Murray, Professor and Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME), discusses what we've learned over the last 30 years studying global health. Series: "UC Berkeley Graduate Lectures" [Public Affairs] [Health and Medicine] [Show ID: 38270]
When many people started messaging me with questions and asking for my thoughts on the 23 and Me Research Study on ANCA Vasculitis, I of course took a look. I read everything on their website and had questions. So I emailed them and asked those questions and promised to share them with you. I want to point out these are basics for ANY rare disease research study they will do and in the literature they provided they have worked on a handful of studies with the pharma company GSK that has developed 40 potential therapies. So whatever rare disease you have, this information may apply to you as well. Join us on Instagram: https://www.instagram.com/teamvasculitis Join the Email List: https://teamvasculitis.com/team-vasculitis-email Links From 23 and Me: 23 and Me Rare Disease Research Study: Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis: https://www.23andme.com/rare-disease-research-study/anca-associated-vasculitis/ To learn more about Rare Disease Research Study funding, please visit: https://www.23andme.com/therapeutics/ GSK partnership for therapeutic research. https://investors.23andme.com/news-releases/news-release-details/23andme-announces-extension-gsk-collaboration-and-update-joint Research Consent Document: https://www.23andme.com/about/consent/
Listen: We've all done it. Everyone has, at one point or another, stayed up…
Listen: We've all done it. Everyone has, at one point or another, stayed up too late or pulled an all-nighter. The next day's bleary consequences are usually enough to dissuade...
In this podcast, Dr. Eeks chats with Dr. Christopher Murray about his recent article published in The Lancet (2022) titled The Global Burden of Cancer Attributable to Risk Factors, 2010-2019, a Systematic Analysis for the Global Burden of Disease Study 2019. This is the largest effort to date to determine the gobal burden of cancer due to risk factors. He will discuss what the global burden of disease study is, how he and his team estimated the burden of cancer, the risk factors and the assessment framework used to link specific cancers to specific risks, what percentage of cancer is attributed to risk factors, what the greatest risks are, differences in high income vs low income countries and public health implications. Dr. Murray is Chair of Health Metrics Sciences at the University of Washington and Director of the Institute for Health Metrics and Evaluation (IHME). He also leads the Global Burden of Disease collaboration ( a systemic effort to quantify the comparitive magnitude of health loss due to diseases, injuries and risk factors.)He is both a physician and a health economist and his work has led to innovative methods for strengthening health measurements, analyzing the performance of health systems and producing forecasts for the future state of health. During the COVID-19 pandemic, the White House, European Commission, WHO EURO and Africa CDC have used IHME forecasts and policy scenarios as sources of evidence. You can contact Dr. Eeks at bloomingwellness.com.Follow Dr. Eeks on Instagram here.Or Facebook here.Or Twitter.Subcribe to her newsletter here!Support the show
Dr. Alice Stanton is on a mission to get to the bottom of the questionable conclusions made by the 2019 Global Burden of Disease Risk Factor Study. She is on the podcast today to talk about her and her group's progress and how we can help. Episode Credits: Thank you to all who've made this show possible. Our hosts are Diana Rodgers and James Connelly. Our producer is Emily Soape. And, of course, we are grateful for our sponsors, Patreon supporters, and listeners. Patrons get access to ad-free podcasts, exclusive videos, a discussion community, and much more. Go to sustainabledish.com/join to support my work. It's officially Sustainavore September! We're launching the biggest Sustainavore community yet, and I'd love for you to be a part of it. Check it out at sustainavore.com. Episode resources and transcripts are available at www.sustainabledish.com.
Welcome to this episode of Physician's Weekly podcast. I am your host, Dr. Rachel Giles, from Medicom Medical Publishers, in collaboration with Physician's Weekly. Earlier this week I was listening to National Public Radio's This American Life podcast, which featured blind comedian Darryl Lenox, who talked about how his trust in strangers dramatically shifted after he lost his sight. It got me thinking about how being visually impaired is truly an obstacle to care in some circumstances and brought me to the idea of this inDEPTH episode. Today's episode features two interviews. We start off by exploring the association of vision loss on health care utilization, functional implications of vision loss, ethical and communication issues in patient-centered care delivery, patient engagement, and adherence. In our second interview, we go for a more optimistic ending, in which Physician's Weekly's Chris Cole interviews Dr. Andrea Lora Kossler, a plastic and reconstructive surgeon at the Byers Eye Institute Stanford University School of Medicine, in California, about her study published this month Aug 2022, about teprotumumab in retaining functional vision. But first I interview Professor Alan R. Morse from the Department of Ophthalmology, Columbia University. Enjoy listening! Additional readingMorse AR, Seiple W, Talwar N, Lee PP, Stein JD. Association of Vision Loss With Hospital Use and Costs Among Older Adults. JAMA Ophthalmol. 2019 Jun 1;137(6):634-640. GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021 Feb;9(2):e144-e160.Ugradar S, Kang J, Kossler AL, Zimmerman E, Braun J, Harrison AR, Bose S, Cockerham K, Douglas RS. Teprotumumab for the treatment of chronic thyroid eye disease. Eye (Lond). 2022 Aug;36(8):1553-1559Lu TJ, Amarikwa L, Sears CM, Kossler AL. Advances in the Treatment of Thyroid Eye Disease Associated Extraocular Muscle Myopathy and Optic Neuropathy. Curr Neurol Neurosci Rep. 2022 Jun;22(6):313-325.
Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Launching a donor circle for mental health, published by Joey on June 24, 2022 on The Effective Altruism Forum. TLDR: The cause area of mental health is growing in popularity in the EA movement but it is also often limited by funding. As such, it seemed like a uniquely promising area to start a funding circle. This circle is roughly modeled on Farmed Animal Funders, and aims to connect funders to support projects in the space. If you would like to apply for funding or join the circle, you can connect via our website. Why the area of mental health? Mental health disorders are an important problem in the world. According to the Global Burden of Disease Study, mental disorders were the seventh leading cause of health burdens in the world in 2019; causing about 5% of all disability adjusted life years, and 14% of years of life lived with a disability. According to the WHO, mental health is the most neglected health issue and should urgently receive more global investment. The Happier Lives Institute also argues that mental health disorders are particularly neglected, especially considering that they have some of the greatest impact on life satisfaction. Additionally, some initial estimates suggest a high cost-effectiveness and there seems to be shovel-ready charities with important gaps that we can fill. What is a funding circle? A funding circle is a collaboration between a number of funders who typically target a certain cause area. For example, Farmed Animal Funders (FAF) is a group of funders who are all keen to support the end of factory farming. Many of these funders have varying interests and they range fairly dramatically in size. FAF has a couple of staff who help the members of the network research and find opportunities, as well as generally coordinate between them. This reduces the risk of double-funding, or missing promising opportunities. Another example is Big Bang Philanthropy. Funding circles can be a powerful way to leverage and coordinate multiple funders that share a common interest. Often a cause area will have a number of funders; but between closed application rounds, unclear standards, and disjointed networks, the funding is not organized as well as it could be. Having different funder views is really important for a good funding ecosystem, but a funding circle has the added, massive benefit of having a centralized point of contact. This means organizations can apply as if applying to a single large funder, but gain exposure to several potential funders. The structure also means that if one member of the network discovers a promising opportunity, but it falls outside of their scope, communication channels are open and ready for them to pass the project on to a grantmaker who is a better fit. Testing the circle If this funding circle works well, there may be similar groups set up in the future for other cause areas. Thanks for listening. To help us out with The Nonlinear Library or to learn more, please visit nonlinear.org.
Do you know all the signs and what to look for in yourself and others when it comes to Major Depressive Disorder (MDD)? In this episode, Enoch and Austin give a quick rundown of Major Depressive Disorder to give you a better understanding of it in helping you navigate this complex and busy thing we call life! References: GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (10 November 2018). "Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017". Lancet. 392 (10159): 1789–1858. doi:10.1016/S0140-6736(18)32279-7. PMC 6227754. PMID 30496104. Retrieved 23 June 2020. American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 160–68, ISBN 978-0-89042-555-8, retrieved 22 July 2016 Mood Disorders. Authored by: OpenStax College. Located at: https://cnx.org/contents/Sr8Ev5Og@5.52:e4xKX_VU@5/Mood-Disorders. License: CC BY: Attribution. License Terms: Download for free at http://cnx.org/contents/4abf04bf-93a0-45c3-9cbc-2cefd46e68cc@5.48 Major Depressive Disorder. Provided by: Wikipedia. Located at: https://en.wikipedia.org/wiki/Major_depressive_disorder. License: CC BY-SA: Attribution-ShareAlike Depressive Disorders: Presentation & Treatment. Provided by: Psych Hub Education. Located at: https://www.youtube.com/watch?v=cxdalJP7xSA. License: Other. License Terms: Standard YouTube License Why Depression Isn't Just a Chemical Imbalance. Provided by: CrashCourse. Located at: https://www.youtube.com/watch?v=GAC9ODvSxh0. License: Other. License Terms: Standard YouTube License
Theresa Marteau is a British health psychologist, professor, and director of the Behaviour and Health Research Unit at the University of Cambridge. Her initial research concerned communicating risk information and found out that people usually don't change their behaviours despite receiving any form of information about preventable diseases like type 2 diabetes or certain types of cancer. Hence, she decided to redirect her focus on the non-conscious rather than conscious processes that could improve people's health behaviours e.g. reducing glass size to reduce alcohol consumption. Through that research, she's demonstrated that it is the change in government policies or population-level interventions - putting nudge theory into practice - that present a potential for the improvement in our population's health. For these notable findings and contributions she was appointed Dame Commander of the Order of the British Empire in the 2017 Queen's Birthday Honours List. Nudge theory Social psychology Milgram experiment Obedience to Authority: An Experimental View by Stanley Milgram Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 Impact of bottle size on in-home consumption of wine: feasibility and acceptability randomised cross-over study Shopper lab Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses ★ Support this podcast ★
In today's episodes the guys discuss the Academy Award Winning movie “Another Round” (4:11). Ali starts out first by discussing his (tenuous) connection to star Mads Mikkelsen. He then discussed the development of the movie by director Thomas Vinterberg and the influence of his late daughter Ida on the film. They also talk about the influence of the Dogme ‘95 movement on the film and the announcement of a remake by Leonardo DeCaprio's production company. Then Asif discusses the issue of increased alcohol use during the pandemic, particularly amongst women (24:25). After Asif calls Ali out on his “man-to mansplaining”, they talk about how joking with memes about drinking has become common. Asif then discusses whether alcohol is actually good for you, and how this needs to be balanced with the costs to society. The opinions expressed are those of the hosts, and do not reflect those of any other organizations. This podcast and website represents the opinions of the hosts. The content here should not be taken as medical advice. The content here is for entertainment and informational purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions. Music courtesy of Wataboi and 8er41 from Pixabay Contact us at doctorvcomedian@gmail.com Follow us on Social media: Twitter: @doctorvcomedian Instagram: doctorvcomedian Show Notes The Year of Magical Drinking: Mads Mikkelsen and Thomas Vinterberg on ‘Another Round': https://www.rollingstone.com/movies/movie-features/another-round-interview-mads-mikkelsen-thomas-vinterberg-1156357/ 'Another Round': How a film about a drinking experiment became a life-affirming Oscars hit: https://www.cnn.com/style/article/thomas-vinterberg-interview-another-round-spc-intl/index.html Thomas Vinterberg on Another Round and convincing Mads Mikkelsen to dance: https://ew.com/awards/oscars/thomas-vinterberg-another-round-interview/ Functional Benefits of (Modest) Alcohol Consumption: https://link.springer.com/article/10.1007/s40750-016-0058-4# https://www.harpercollins.com/products/drink-ann-dowsett-johnston?variant=32208103505954citeas Alcohol and COVID-19: How Do We Respond to This Growing Public Health Crisis? https://link.springer.com/article/10.1007/s11606-020-06321-z Alcohol and cannabis use during the pandemic: Canadian Perspectives Survey Series 6: https://www150.statcan.gc.ca/n1/daily-quotidien/210304/dq210304a-eng.htm Why I'm Tired of All the Wine Mom Memes: https://albuquerque.momcollective.com/parenting-wisdom/wine-mom-memes/ https://www.canada.ca/content/dam/phac-aspc/documents/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/2018-preventing-problematic-substance-use-youth/2018-preventing-problematic-substance-use-youth.pdf Why some women are pushing back against alcohol and the wine-to-unwind culture: https://www.cbc.ca/news/health/women-alcohol-consumption-risks-pandemic-1.5973004 You Might Have a Drinking Problem—And Not Even Know It: https://www.chatelaine.com/health/women-alcohol-consumption-drinking-wine/ Drink - The Intimate Relationship Between Women and Alcohol: https://www.harpercollins.com/products/drink-ann-dowsett-johnston?variant=32208103505954 https://www.ccsa.ca/alcohol-canadian-drug-summary Rates of emergency department visits attributable to alcohol use in Ontario from 2003 to 2016: a retrospective population-level study: https://www.cmaj.ca/content/191/29/E804 Excessive Drinking is Draining the U.S. Economy: https://www.cdc.gov/alcohol/features/excessive-drinking.html Alcohol: Balancing Risks and Benefits: https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/ Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis: https://www.bmj.com/content/342/bmj.d671 Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext No level of alcohol consumption improves health: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31571-X/fulltext