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Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). For these causes, the contribution of years lived with disability (YLD) – put simply, ill-health – is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease. [ABSTRACT FROM AUTHOR]

Objectives: Legal abortion based purely in maternal option without fetal/maternal pathology was liberalised in Portugal in 2007 and since then abortion rates have increased substantially. The aim of this paper was to study the impact of the liberalisation of abortion by maternal request on total legal abortion related hospitalisation trends., Study Design: We considered hospitalisations of legal abortion (ICD-9-CM codes 635.x) with discharges from 2000 to 2014. Data was obtained from a Portuguese administrative database, which contains all registered public hospitalisations in mainland Portugal. Performed legal abortions during the same period were obtained from INE (National Statistics Institute). Hospitalisations per abortion were calculated by dividing the number of legal abortions hospitalisations per the number of legal abortions, mean ages, number of hospitalisations per age group, complications, admission type and length of stay were also analysed, throughout the study period., Results: Hospitalisations rose during the study period, (from 618 episodes in 2000 to 1,259 in 2014, with a peak of 1,603 in 2010). Since the liberalisation law was passed there was a significant decrease in the number of hospitalisations per abortion: from 1.07 in 2000 to 0.11 in 2014 (p<0.001). Furthermore, the mean age maintained stable since liberalisation (30.8 years before 2007 and 31.0 after). Abortion related hospitalisations are more frequent in women aged 25-39. A significant decrease from the emergent to the scheduled type of admission occurred from 2000 to 2014 (from 83.5% to 56.7% of emergent admissions) (p<0.001). Complications remained stable between 2000 and 2014 and delayed or excessive haemorrhage was the most frequent (4.6%)., Conclusions: Since the liberalisation, hospitalisations per abortion have decreased, reflecting the major impact that the liberalisation of legal abortion by maternal request had on abortion trends nationwide. Before the liberalisation, each abortion led to approximately one hospitalisation while after the liberalisation this trend shifted to approximately 10% of the number of abortions. Legal abortion related hospitalisations are more frequent in women aged between 25 and 39 years old, an older age group when compared to the one registered in all cases of legal abortions, reflecting the differences between those hospitalised and those who are not. Our study shows the impact that legal abortion by maternal request liberalisation law can bring to abortion and to hospitalisation trends., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Objectives: Our study presents the results of a survey of physicians and/or researchers working in 21 European countries, on their opinion about the relevance of perinatal indicators, in order to compare it with the EURO-PERISTAT recommendations., Study Design: In this cross-sectional study, we selected 21 out of the initial set of 34 indicators of the national data supply on the European Perinatal Health Report, and added four other indicators based on expert opinion. The relative relevance of these 25 perinatal indicators was then rated by 134 respondents--expert physicians and/or researchers who have published in perinatal medicine--through a web-based survey. We summarized our data using descriptive statistics., Results: The top five perinatal indicators, according to the respondents' rating were: neonatal mortality rate by gestational age, birth weight and plurality; percentage of highly preterm babies delivered in units without a NICU; prevalence of severe maternal morbidity; severe neonatal morbidity among babies at high risk and prevalence of hypoxic-ischemic encephalopathy. Of these top five indicators, however, only neonatal mortality rate by gestational age, birth weight and plurality was considered a core indicator, in 2003. Moreover, severe neonatal morbidity among babies at high risk and prevalence of hypoxic-ischemic encephalopathy, that were considered in 2003 as requiring further development, were now considered by the respondents as highly relevant., Conclusions: Current views of European physicians and/or researchers working in the perinatal field may not be in agreement with the EURO-PERISTAT recommendations. A revision of the set of perinatal indicators is, therefore, mandatory if a more comprehensive view of health care systems performance across Europe is to be achieved., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

The present study proposes an analytical methodology that employs ion chromatography-conductivity detection for simultaneous quantification of inorganic (F(-), Cl(-), NO(3)(-), SO(4)(2-), and PO(3)(-)), monocarboxylate (HCOO(-), CH(3)COO(-), propionate, n-butyrate, lactate, and pyruvate), dicarboxylate (oxalate and succinate), and tricarboxylate anions (citrate), as well as crustal cations (Li(+), Na(+), K(+), NH(4)(+), Ca(2+), Mg(2+)) at low pgm(-3) range in airborne particle samples in one single run. The optimized conditions for anions were as follows: 0.6 mmol L(-1) KOH for 0-14 min, 0.6-15 mmol L(-1) KOH 14-20 min, 15-38 mmol L(-1) KOH during 20-32 min and finally returned to 0.6 mmol L(-1) for a period of 3 min, thereafter the eluent flow rate was 0.38 mL min(-1). Similarly, for cations, isocratic elution was adjusted to 0.36 mL min(-1) at 17.5 mmol L(-1) H(2)SO(4). LOD ranged 3.0-130 pgm(-3) and LOQ was within 10-400 pgm(-3) (Li(+) and PO(4)(3-), respectively) as well as recoveries ranged 89% (Ca(2+)) to 120% (Li(+)). Major ions were successfully determined in real PM1 and PM2.5 samples. The method used here was found to be a comprehensive, simple, cheap and reliable procedure for studying ions in particulate matter (PM) samples even those from remote areas or near ecosystem natural conditions., (Copyright © 2012 Elsevier B.V. All rights reserved.)