Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. MethodsWe applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FindingsIn 2019, there were 12•2 million (95% UI 11•0-13•6) incident cases of stroke, 101 million (93•2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6•55 million (6•00-7•02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11•6% [10•8-12•2] of total deaths) and the third-leading cause of death and disability combined (5•7% [5•1-6•2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70•0% (67•0-73•0), prevalent strokes increased by 85•0% (83•0-88•0), deaths from stroke increased by 43•0% (31•0-55•0), and DALYs due to stroke increased by 32•0% (22•0-42•0). During the same period, age-standardised rates of stroke incidence decreased by 17•0% (15•0-18•0), mortality decreased by 36•0% (31•0-42•0), prevalence decreased by 6•0% (5•0-7•0), and DALYs decreased by 36•0% (31•0-42•0). However, among people younger than 70 years, prevalence rates increased by 22•0% (21•0-24•0) and incidence rates increased by 15•0% (12•0-18•0). In 2019, the age-standardised stroke-related mortality rate was 3•6 (3•5-3•8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3•7 (3•5-3•9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62•4% of all incident strokes in 2019 (7•63 million [6•57-8•96]), while intracerebral haemorrhage constituted 27•9% (3•41 million [2•97-3•91]) and subarachnoid haemorrhage constituted 9•7% (1•18 million [1•01-1•39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79•6 million [67•7-90•8] DALYs or 55•5% [48•2-62•0] of total stroke DALYs), high bodymass index (34•9 million [22•3-48•6] DALYs or 24•3% [15•7-33•2]), high fasting plasma glucose (28•9 million [19•8-41•5] DALYs or 20•2% [13•8-29•1]), ambient particulate matter pollution (28•7 million [23•4-33•4] DALYs or 20•1% [16•6-23•0]), and smoking (25•3 million [22•6-28•2] DALYs or 17•6% [16•4-19•0]...

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2016): SHARP: integrating a traditional survey with participatory self-evaluation and learning for climate change resilience assessment, Climate and Development, Climate change, population growth and social conflict have left many farmers and pastoralists in sub-Saharan Africa at near constant crisis conditions. Participatory climate resilience assessments can help farmer and pastoralist communities to identify, measure and prioritize actions to improve the climate resilience of their agricultural systems. Self-evaluation and Holistic Assessment of climate change Resilience of farmers and Pastoralists (SHARP) has been developed as a dualpurpose tool, employing participatory methods to help farmers and pastoralists to discuss and understand threats and opportunities, and to prioritize individual and collective actions aimed at improving overall resilience. Additionally, SHARP provides government and programme management with qualitative and quantitative information on a wide variety of important economic and development factors. The development of SHARP faces many challenges inherent to assessing resilience in terms of the complex nature and wide-reaching impacts of climate change. SHARP presents a unique assessment that combines resilience literature and indicators with a participatory self-assessment from the farmers and pastoralists.

Objective: To investigate dietary health understandings; healthy foods access perceptions; and the main sources of nutritional knowledge of residents in three urban communities of varying socio-economic make-up. Design: An ethnographic approach to primary qualitative data collection, involving frequent visits to study areas over four months and in-depth interviews. Interviews were recorded, transcribed verbatim, and analysed through an iterative approach. Setting: Yogyakarta, Indonesia. Participants: A purposive sample of 45 participants divided equally among the three communities. Participants were mostly female (93%), aged between 27-75 years (mean 47.7), and largely identified as the person responsible for household food-related decisions (93%). Results: Three overarching themes emerged: i) dietary health understandings, ii) healthy foods access perceptions, and iii) sources of nutritional knowledge. Participants employed multi-faceted conceptualisation of dietary health. Most identified healthy foods with traditional plant-based foods, inexpensive and locally-available from multiple sources. Thus, all participants perceived healthy foods as highly available in the local environment and most (80%) as affordable. Reported affordability issues referred to specific foods (particularly animal-source products) and were independent of income levels. Participants acquired nutritional knowledge from multiple sources, including many community-based initiatives. These were overall perceived as useful, but also as presenting some limitations. Conclusions: The variety in dietary health understandings reported by study participants, and their high perceptions of healthy foods availability in the local environment reinforce the idea that individual- and food environment-level determinants of nutritional behaviours are highly contextual.