Author
Lukasz Aleksandrowicz
Other affiliations: St. Michael's Hospital, Wellcome Trust, University of Toronto
Bio: Lukasz Aleksandrowicz is an academic researcher from University of London. The author has contributed to research in topics: Population & Verbal autopsy. The author has an hindex of 13, co-authored 27 publications receiving 1850 citations. Previous affiliations of Lukasz Aleksandrowicz include St. Michael's Hospital & Wellcome Trust.
Papers
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TL;DR: This work aimed to quantify suicide mortality in India in 2010 by applying the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India.
780 citations
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TL;DR: It is revealed that environmental and health benefits are possible by shifting current Western diets to a variety of more sustainable dietary patterns, with reductions as high as 70–80% of GHG emissions and land use, and 50% of water use possible by adoptingustainable dietary patterns.
Abstract: Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the environment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them. We systematically review the evidence on changes in GHG emissions, land use, and water use, from shifting current dietary intakes to environmentally sustainable dietary patterns. We find 14 common sustainable dietary patterns across reviewed studies, with reductions as high as 70-80% of GHG emissions and land use, and 50% of water use (with medians of about 20-30% for these indicators across all studies) possible by adopting sustainable dietary patterns. Reductions in environmental footprints were generally proportional to the magnitude of animal-based food restriction. Dietary shifts also yielded modest benefits in all-cause mortality risk. Our review reveals that environmental and health benefits are possible by shifting current Western diets to a variety of more sustainable dietary patterns.
572 citations
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TL;DR: For instance, the authors found that the conditional sex ratio for second-order births when the firstborn was a girl fell from 906 per 1000 boys (99% CI 798-1013) in 1990 to 836 (733-939) in 2005; an annual decline of 0·52% (p for trend=0·002).
231 citations
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TL;DR: Highlights • Highest GHG emissions from food production are from rice and ruminant products, while highest GHGs emissions from consumption are from Rice and livestock products.
152 citations
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TL;DR: There is no single best-performing coding method for verbal autopsies across various studies and metrics and there is little current justification for CCVA to replace PCVA, particularly as physician diagnosis remains the worldwide standard for clinical diagnosis on live patients.
Abstract: Computer-coded verbal autopsy (CCVA) methods to assign causes of death (CODs) for medically unattended deaths have been proposed as an alternative to physician-certified verbal autopsy (PCVA). We conducted a systematic review of 19 published comparison studies (from 684 evaluated), most of which used hospital-based deaths as the reference standard. We assessed the performance of PCVA and five CCVA methods: Random Forest, Tariff, InterVA, King-Lu, and Simplified Symptom Pattern. The reviewed studies assessed methods’ performance through various metrics: sensitivity, specificity, and chance-corrected concordance for coding individual deaths, and cause-specific mortality fraction (CSMF) error and CSMF accuracy at the population level. These results were summarized into means, medians, and ranges. The 19 studies ranged from 200 to 50,000 deaths per study (total over 116,000 deaths). Sensitivity of PCVA versus hospital-assigned COD varied widely by cause, but showed consistently high specificity. PCVA and CCVA methods had an overall chance-corrected concordance of about 50% or lower, across all ages and CODs. At the population level, the relative CSMF error between PCVA and hospital-based deaths indicated good performance for most CODs. Random Forest had the best CSMF accuracy performance, followed closely by PCVA and the other CCVA methods, but with lower values for InterVA-3. There is no single best-performing coding method for verbal autopsies across various studies and metrics. There is little current justification for CCVA to replace PCVA, particularly as physician diagnosis remains the worldwide standard for clinical diagnosis on live patients. Further assessments and large accessible datasets on which to train and test combinations of methods are required, particularly for rural deaths without medical attention.
87 citations
Cited by
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Harvard University1, Potsdam Institute for Climate Impact Research2, Stockholm Resilience Centre3, University of Oxford4, City University London5, Chatham House6, World Wide Fund for Nature7, Environmental Change Institute8, University of Minnesota9, University of California, Santa Barbara10, CGIAR11, Johns Hopkins University12, American University of Beirut13, Wageningen University and Research Centre14, Institute for Health Metrics and Evaluation15, ETH Zurich16, Indian Institute of Technology Kanpur17, Commonwealth Scientific and Industrial Research Organisation18, University of Indonesia19, World Health Organization20, Food and Agriculture Organization21, International Food Policy Research Institute22, Royal Swedish Academy of Sciences23, University of Auckland24, Public Health Foundation of India25, Centre for Science and Environment26
TL;DR: Food in the Anthropocene : the EAT-Lancet Commission on healthy diets from sustainable food systems focuses on meat, fish, vegetables and fruit as sources of protein.
4,710 citations
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Boston Children's Hospital1, Harvard University2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Brigham and Women's Hospital9, Partners In Health10, Royal North Shore Hospital11, Medical College of Wisconsin12, Monash University13, Nanyang Technological University14, University of Sierra Leone15, University of Oxford16, Mongolian National University17, Flinders University18, University of Malawi19, Beth Israel Deaconess Medical Center20, Bhabha Atomic Research Centre21, Royal Australasian College of Surgeons22, Stanford University23, University of California, San Francisco24
TL;DR: The need for surgical services in low- and middleincome countries will continue to rise substantially from now until 2030, with a large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs.
2,209 citations
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University of Melbourne1, Royal Children's Hospital2, Columbia University3, World Health Organization4, University of London5, American University of Beirut6, University of Oregon7, Public Health Foundation of India8, University College London9, Burnet Institute10, United Nations Population Fund11, University of Toronto12, Aga Khan University13, Obafemi Awolowo University14, Jawaharlal Nehru University15, UNICEF16, Kunming Medical University17
TL;DR: This Commission outlines the opportunities and challenges for investment in adolescent health and wellbeing at both country and global levels (panel 1).
1,976 citations
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TL;DR: The findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors.
Abstract: Summary Background Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. We aimed to assess the changing patterns of cancer according to varying levels of human development. Methods We used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988–2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites. Findings In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be offset by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12·7 million new cases in 2008 to 22·2 million by 2030. Interpretation Our findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes. Funding None.
1,792 citations