Examinando por Autor "Wang, Yang"

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  • Publicación
    Acceso abierto
    Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35–70 years in 17 countries : A cross-sectional analysis of the prospective urban rural Epidemiological (PURE) study
    (2016) Raina, Parminder; Sohel, Nazmul; Oremus, Mark; Shannon, Harry; Mony, Prem; Kumar, Rajesh; Li, Wei; Wang, Yang; Wang, Xingyu; Yusoff, Khalid; Yusuf, Rita; Iqbal, Romaina; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Kruger, Annamarie; Chifamba, Jephat; Mohammadifard, Noushin; Darwish, Ebtihal Ahmad; Dagenais, Gilles; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Seron, Pamela; Rangarajan, Sumathy; Teo, Koon; Yusuf, Salim; The PURE (Prospective Urban Rural Epidemiology) Study investigators
    Objectives To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Methods Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Results Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65–70 years was associated with fewer RTAs, but more falls; age 55–64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type. Conclusions This study of persons aged 35–70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI.
  • Publicación
    Restringido
    A novel method to evaluate the community built environment using photographs - Environmental profile of a community health (Epoch) Photo neighbourhood evaluation tool
    (2014-11-04) Chow, Clara K.; Corsi, Daniel J.; Lock, Karen; Madhavan, Manisha; Mackie, Pam; Li, Wei; Yi, Sun; Wang, Yang; Swaminathan, Sumathi; Lopez-Jaramillo, Patricio; Gómez Arbeláez, Diego; Avezum, Alvaro; Lear, Scott A.; Dagenais, Gilles; Teo, Koon; McKee, Martin; Yusuf, Salim
    Background: Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument. Methods/Principal Findings: A minimum of 5 photos were taken per community in 86 communities in 5 countries according to a standard set of instructions from a designated central point of each community by researchers at each site. A standard pro forma derived from reviewing existing instruments to assess the built environment was developed and used to score the characteristics of each community. Photo sets from each community were assessed independently by three observers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-class correlation (ICC). Overall 87% (53 of 60) items had an ICC of $0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3 of 60) items had an ICC #0.50. Conclusions/Significance: Analysis of photos using a standardized protocol as described in this study offers a means to obtain reliable and reproducible information on the built environment in communities in very diverse locations around the world. The collection of the photographic data required minimal training and the analysis demonstrated high reliability for the majority of items of interest.
  • Publicación
    Acceso abierto
    The household economic burden of non-communicable diseases in 18 countries
    (BMJ Global Health, 2020-02-11) Murphy, Adrianna; Palafox, Benjamin; Walli-Attaei, Marjan; Powell-Jackson, Timothy; Rangarajan, Sumathy; Alhabib, Khalid F.; Avezum, Alvaro; Tumerdem Calik, Kevser Burcu; Chifamba, Jephat; Choudhury, Tarzia; Dagenais, Gilles; Dans, Antonio; Gupta, Rajeev; Iqbal, Romaina; Kaur, Manmeet; Kelishadi, Roya; Khatib, Rasha; Kruger, Iolanthe Marike; Raman Kutty, Vellappillil; Lear, Scott A.; Li, Wei; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Mony, Prem K.; Orlandin, Andres; Rosengren, Annika; Rosnah, Ismail; Seron, Pamela; Teo, Koon; Tse, Lap Ah; Tsolekile, Lungiswa; Wang, Yang; Wielgosz, Andreas; Yan, Ruohua; Yeates, Karen; Yusoff, Khalid; Zatonska, Katarzyna; Hanson, Kara; Yusuf, Salim; McKee, Martin; Everest
    Abstract Background Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China. Results The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs. Conclusions Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs.