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Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity. No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels. Bill & Melinda Gates Foundation.

Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5–14 years, typically in school and cared for by child health services) and older adolescents (aged 15–24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990–2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6–96·6) individuals aged 5–14 years and 80·6 million (78·2–83·3) aged 15–24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15–24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5–14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7–17·2) of those aged 5–14 years are forecasted to have obesity by 2050 (186 million [141–221]), compared with 14·2% (11·4–15·7) of those aged 15–24 years (175 million [136–203]). We forecasted that by 2050, there will be more young males (aged 5–14 years) living with obesity (16·5% [13·3–18·3]) than overweight (12·9% [12·2–13·6]); while for females (aged 5–24 years) and older males (aged 15–24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041–50: children and adolescents (males and females aged 5–24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5–14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5–14 years in Australasia; females aged 15–24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15–24 years in high-income North America. Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.

The growing number of people living with, through and beyond cancer poses a new challenge for sustainable survivorship care solutions. Digital health solutions which incorporate various information and communication technologies are reshaping healthcare; offering huge potential to facilitate health promotion, support healthcare efficiencies, improve access to healthcare and positively impact health outcomes. Digital health solutions include websites and mobile applications, health information technologies, telehealth solutions, wearable devices, AI-supported chatbots and other technologically assisted provision of health information, communication and services. The breadth and scope of digital health solutions necessitate a synthesis of evidence on their use in supportive care in cancer. This umbrella review will identify, synthesise, and compare systematic reviews which have evaluated the efficacy or effectiveness of digital solutions for adult cancer survivorship care with a particular focus on surveillance and management of physical effects, psychosocial effects, new cancer/ recurring cancers and supporting health promotion and disease prevention. An umbrella review of published systematic reviews will be undertaken to explore the types of digital health solutions used, their efficacy or effectiveness as a form of supportive care, and the barriers and enablers associated with their implementation. The umbrella review will be reported according to the Preferred Reporting Items for Overviews of Reviews (PRIOR) checklist. A search will be conducted across key databases. Records will be assessed independently by two review authors for eligibility against predefined criteria and will undergo two stage title, abstract and full text screening. All systematic reviews that meet the inclusion criteria will be assessed for quality using the AMSTAR 2 checklist with quality assessment and data extraction by two reviewers. The degree of publication overlap of primary studies across the included reviews will also be calculated and a mapping of the evidence will also be presented. As this research proposes using systematic reviews that are already published, ethical approval is not required. Results from this umbrella review will be published in a peer-reviewed journal where any significant deviations from the protocol will be justified.

The rapid digitalisation of workplaces presents both challenges and opportunities for older workers. This scoping review examines how digital technologies impact social support for older workers, focusing on emotional, informational, and instrumental support within professional environments. While social support is critical for well-being and productivity in ageing workforces, the effects of digitalisation on social support dynamics remain insufficiently understood. Following Joanna Briggs Institute and PRISMA-ScR guidelines, a comprehensive search strategy was conducted across databases like ERIH, Web of Science, Scopus, and PubMed from anytime to 2023 to identify peer-reviewed studies involving digital technologies used by older workers, generally considered as workers aged 50 years or older. Covidence software facilitated the screening of over 5000 scientific papers, study selection, and data extraction, and the Mixed Methods Appraisal Tool (MMAT) assessed quality. Findings were synthesized through descriptive statistics and narrative analysis. Forty-three studies met inclusion criteria. Digital technologies were found to enhance various forms of social support: remote work tools, messaging apps, and telemedicine platforms facilitated emotional connection and informational exchange. However, digitalisation also introduced barriers, some older workers reported isolation, reduced informal contact, and technostress, underscoring disparities in digital literacy and adaptation. Digitalisation exerts a dual impact on social support for older workers: it can strengthen professional connectedness yet also heighten vulnerability to stress and exclusion. Targeted digital literacy initiatives and sustained managerial engagement are crucial to ensure that technology enhances, rather than undermines, well-being and productivity among ageing employees.

Objectives Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. Results A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates. Registration The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/ ).

A corrosão das armaduras é a principal causa para a degradação, redução da fiabilidade e segurança das estruturas de betão armado. A corrosão ocorre devido à carbonatação do betão e à sua contaminação por iões de cloreto. No primeiro caso, a corrosão tende a ser generalizada, caracterizando-se por uma redução uniforme da secção transversal em todo o comprimento dos varões de aço. No segundo caso, a corrosão é sobretudo localizada, sendo que a redução de secção dos varões apresenta forte variabilidade espacial.Esta dissertação apresenta um estudo sobre a fiabilidade de vigas de betão armado sujeitas à flexão e a diferentes taxas de corrosão das armaduras, utilizando simulação de Monte Carlo. Comparam-se cenários de deterioração correspondentes a corrosão generalizada e corrosão localizada, considerando-se para este último fenómeno a variabilidade espacial da redução da secção das armaduras ao longo do seu comprimento de forma probabilística. Para ambos os cenários consideraram-se vigas com diversos comprimentos e pormenorizações (número e diâmetro dos varões) e um período de vida útil correspondente a 50 anos. A fiabilidade de vigas atacadas pela corrosão foi também comparada com a de vigas não corroídas, para o período de vida útil em causa.Os resultados obtidos demonstram que, a longo prazo e para taxas de ataque idênticas, a corrosão localizada provoca uma redução mais significativa da fiabilidade estrutural quando comparada com a corrosão generalizada, situação que se acentua para varões de reduzido diâmetro. Para curto prazo, a corrosão generalizada tende a ser mais gravosa, sobretudo para varões de maior diâmetro. A não consideração da variabilidade espacial associada à perda de secção localizada das armaduras pode levar a uma subavaliação da probabilidade de falha, tanto mais significativa quanto maior o vão da viga e mais reduzidos o número e diâmetro dos varões utilizados.

Introdução: A rotura do Tendão de Aquiles tem demonstrado, ao longo dos anos, ser umas das mais comuns lesões musculoesquelédcas a nível de atletas, dada a exigência e variação brusca de movimentos nas advidades despordvas, e adultos jovens, em especial os mais advos. Técnicas conservadoras ou cirúrgicas são as abordagens de eleição, atualmente, e com bons resultados na maioria dos casos, cujo principal propósito concerne na recuperação da função e minimização de tempo de recuperação. Com o objedvo de incrementar os resultados clínicos, para a maioria dos pacientes e de um modo mais personalizado, exploram-se novas e promissoras técnicas, que sejam mais eficientes e permitam um retorno mais célere à prádca despordva.ObjePvos: Revisão sistemádca da literatura respeitante às atuais e às novas abordagens, em termos de segurança e eficácia, assim como comparar resultados entre os diferentes métodos no tratamento da lesão é o objedvo primordial desta dissertação de mestrado.Método: Através da pesquisa de palavras-chave como “rotura do tendão de Aquiles”, “tratamento” e “novas abordagens terapêudcas”, em diferentes bases de dados médicas, como sejam PubMed, Web of science ou Scopus, foram selecionados estudos dos úldmos 6 anos até Dezembro de 2023 e os critérios de inclusão foram ardgos escritos em Inglês ou Português, respedvos níveis de evidência e relevância ciensficas além da avaliação da qualidade metodológica e que reportassem resultados clínicos respeitantes às opções terapêudcas no tratamento da rotura do TA.Resultados: Após idendficação de 120 ardgos, analisaram-se os 45 que respeitavam os anteriormente referidos critérios. A nível de abordagens destacam-se as minimamente invasivas e as regeneradoras e cujos resultados demonstraram diminuição do tempo de recuperação, das taxas de re-rotura ou mesmo de infeção, comparadvamente aos métodos tradicionalmente estabelecidos. De referir que limitações como diferenças ao nível protocolar de execução ou duração reduzida de acompanhamento pós-intervenção, em muitos deles, limitaram a generalização dos resultados.Conclusão: Embora as novas abordagenssejam promissoras ao nível de segurança e eficácia, são ainda necessários mais estudos e ensais clínicos randomizados permidndo confirmar a sua superioridade e padronizar os protocolos de tratamento. Assim, a sua udlização no âmbito do planeamento do tratamento desta rotura consdtuirá uma mais-valia e avanço para a ortopedia e medicina despordva.

Na actualidade, é possível encontrar uma grande discrepância entre as necessidades apresentadas pela sociedade e aquelas que são as soluções propostas pelo sector da construção civil para as satisfazer, uma falha que tem levado a uma grave quebra do sector ao longo dos últimos anos.No sentido de conseguir responder a estas necessidades a empresa CoolHavenapresenta um novo conceito de habitação sob a forma de casas modulares. Este baseia-se na assemblagem em local próprio de elementos estruturais base (módulos) previamente produzidos em ambiente fabril com o objectivo de criar um produto final mais barato, flexível a todos os estágios de vida do cliente e com baixos efeitos ambientais.No sentido de aumentar a sua capacidade de produção dos ditos módulos a CoolHaven subcontratou a SARKKISpara projectar uma linha de fabrico adequada, projecção essa que será abordada ao longo deste documento.Será então objectivo deste trabalho encontrar uma proposta de linha de montagem que melhor se adeque aos requerimentos da CoolHaven, em termos de velocidade de produção, flexibilidade de produção, custos de implementação e adaptação ao pavilhão disponível.Para tal será estudado um conjunto de propostas de layout, sendo consequentemente criados os respectivos modelos de simulação através dos softwares RobotStudioe SIMUL8 que consigam proporcionar mais elementos de decisão acerca da melhor alternativa encontrada.Finalmente a melhor alternativa encontrada será caracterizada em termos da sua capacidade de produção e outros indicadores de rendimento.

(1) Background: The repercussions of work environments were widely studied before the pandemic. However, there are still many difficulties to be discovered considering the impact generated by it. Thus, this study aimed to analyse the impact of COVID-19 on nursing practice environments and nurses’ job satisfaction. (2) Methods: A correlational study was conducted in a hospital in northern Portugal, with the participation of 416 registered nurses. Data were collected in June 2021 through questionnaires. The study was approved by the Institutional Ethics Committee. (3) Results: COVID-19 had a favourable impact on the structure component of the practice environments; the process component decreased compared to the pre-pandemic period; the outcome component remained moderately favourable to the quality of care. Nurses were not very satisfied or not at all satisfied with their valuation and remuneration; moderately satisfied with the leadership and staffing; and satisfied with the organisation and resources, co-workers and valuation by patients and families. In more favourable environments, nurses’ job satisfactions were higher. (4) Conclusions: Identifying the dimensions with the best and worst scores allowed the institution’s managers to concentrate efforts on where improvements were needed, thus preparing professional contexts for the recovery of care activities.

ObjectivesTo make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber–reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP).Materials and methodsEighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth.ResultsThe groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP.ConclusionsThe Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber–reinforced composite post (GT) improves the resistance and stress distribution of immature teeth.Clinical relevanceLongitudinal fracture is less frequent in teeth restored with GT and RP posts.