BackgroundPast research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.MethodsWe reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).FindingsIn 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).InterpretationInjuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.

BackgroundThe COVID-19 pandemic has disrupted routine childhood vaccinations worldwide with low- and middle-income countries (LMICs) most affected. This study aims to quantify levels of disruption to routine vaccinations in LMICs.MethodsA systematic review (PROSPERO CRD42021286386) was conducted of MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on the 11th of February 2022. Primary research studies published from January 2020 onwards were included if they reported levels of routine pediatrics vaccinations before and after March 2020. Study appraisal was performed using NHLBI tool for cross-sectional studies. Levels of disruption were summarized using medians and interquartile ranges.ResultsA total of 39 cross-sectional studies were identified. These showed an overall relative median decline of −10.8% [interquartile range (IQR) −27.6%, −1.4%] across all vaccines. Upper-middle-income countries (upper-MICs) (−14.3%; IQR −24.3%, −2.4%) and lower-MICs (−18.0%; IQR −48.6%, −4.1%) showed greater declines than low-income countries (−3.1%; IQR −12.8%, 2.9%), as did vaccines administered at birth (−11.8%; IQR −27.7%, −3.5%) compared to those given after birth (−8.0%; IQR −28.6%, −0.4%). Declines during the first 3 months of the pandemic (−8.1%; IQR −35.1%, −1.4%) were greater than during the remainder of 2020 (−3.9%; IQR −13.0%, 11.4%) compared to baseline.ConclusionThere has been a decline in routine pediatric vaccination, greatest in MICs and for vaccines administered at birth. Nations must prioritize catch-up programs alongside public health messaging to encourage vaccine uptake.Systematic review registrationIdentifier: CRD42021286386.

We identify ten public health challenges that need to be closely tracked in 2022. These challenges are COVID‐19, inadequate human resources for health, poor health systems financing, conflict and humanitarian crises, mental health, poverty, climate change, the health of children, reproductive health issues, and the infodemic. These global priorities, based on opinion of experts and current evidence and literature, need immediate attention and scaled‐up actions. This list of priorities does not discount the existence of other major public health challenges. We forecast and highlight those that may impact global public health in 2022 in order to progress and to achieve the United Nations’ Sustainable Development Goals (SDG). Thus, we advocate for stronger international cooperation, solidarity, and sustainable funding to address these challenges, and improve health across and within populations globally.

Introduction: Globally, there is a discrepancy between demand and availability of organs for transplantation. Transplantation is done from a living donor as well as a brain-dead/deceased donor. However, the World Health Organization (WHO) encourages deceased donor transplantation, since there is no risk to the donor. Although, the Transplant Act of Nepal 2016 opened the doors for deceased donor organ transplantation, the rate of transplantation from deceased donors is very low. Thus, this study assesses factors associated with willingness for deceased organ donation among post-graduate students of law, medicine, and mass communication streams. Methods: A total of 9 colleges, 3 from each specialty were selected via lottery method. The total sample size calculated was 440. Self- administered questionnaire was used to collect the data. 170, 140 and 130 forms were distributed in law, medicine and mass communication respectively via convenient sampling. Multivariate analysis among the variables that had p- value <0.05 in bivariate analysis was carried out to find out the strongest predictors of willingness to be deceased organ donors. Results: In all, 53.2% were willing to become deceased organ donors. Family permission in one’s wish to donate organs, having someone in family with chronic disease, having attended any conference or general talk on organ donation, knowing a live organ donor and knowing that body will not be left disfigured after organ extraction were found to be the strongest predictors for willingness to be deceased organ donors; while lack of awareness was reported as the main barrier for the same reason. Conclusion: There is a need for extensive awareness programs and new strategies to motivate individuals and family members for organ donation. Key words: • Deceased Organ Donation • Willingness • Kathmandu • Nepal • Organ Transplantation • Living Donor • Deceased Donor   Copyright © 2019 Paneru et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction Underrepresentation of disabled groups in clinical trials results in an inadequate evidence base for their clinical care, which drives health inequalities. This study aims to review and map the potential barriers and facilitators to the recruitment of disabled people in clinical trials to identify knowledge gaps and areas for further extensive research. The review addresses the question: ‘What are the barriers and facilitators to recruitment of disabled people to clinical trials?’. Methods The Joanna Briggs Institute (JBI) Scoping review guidelines were followed to complete the current scoping review. MEDLINE and EMBASE databases were searched via Ovid. The literature search was guided by a combination of four key concepts from the research question: (1) disabled populations, (2) patient recruitment, (3) barriers and facilitators, and (4) clinical trials. Papers discussing barriers and facilitators of all types were included. Papers that did not have at least one disabled group as their population were excluded. Data on study characteristics and identified barriers and facilitators were extracted. Identified barriers and facilitators were then synthesised according to common themes. Results The review included 56 eligible papers. The evidence on barriers and facilitators was largely sourced from Short Communications from Researcher Perspectives (N = 22) and Primary Quantitative Research (N = 17). Carer perspectives were rarely represented in articles. The most common disability types for the population of interest in the literature were neurological and psychiatric disabilities. A total of five emergent themes were determined across the barriers and facilitators. These were as follows: risk vs benefit assessment, design and management of recruitment protocol, balancing internal and external validity considerations, consent and ethics, and systemic factors. Conclusions Both barriers and facilitators were often highly specific to disability type and context. Assumptions should be minimised, and study design should prioritise principles of co-design and be informed by a data-driven assessment of needs for the study population. Person-centred approaches to consent that empower disabled people to exercise their right to choose should be adopted in inclusive practice. Implementing these recommendations stands to improve inclusive practices in clinical trial research, serving to produce a well-rounded and comprehensive evidence base.