Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.

The ship as symbol in the prehistory of Scandinavia and south-east Asia

The ship is the dominant element in the visual culture of the South Scandinavian Bronze Age, appearing in several different media, including rock carvings, decorated metalwork and above-ground monuments. Discussion has divided between those scholars who interpret this imagery in terms of long-distance exchange networks and those who emphasize its more local significance, including its deployment in mortuary ritual. A strikingly similar system is identified in Southeast Asia and part of Melanesia and can be interpreted through archaeological and ethnographic sources, but in this case there is no need to distinguish between 'practical' and 'symbolic' interpretations of the depictions of ships. This paper summarizes the evidence from this region and suggests that it can offer a fruitful source of comparison for archaeologists working in northern Europe.

Crops and cultures in the Pacific: new data and new techniques for the investigation of old questions

Fifty years ago Carl Sauer suggested, controversially and on the basis of theory rather than evidence, that Southeast Asia was the source area for agriculture throughout the Old World, including the Pacific. Since then, the archaeobotanical record (macroscopic and microscopic) from the Pacific islands has increased, leading to suggestions, also still controversial, that Melanesia was a center of origin of agriculture independent of South-east Asia, based on tree fruits and nuts and vegetatively propagated starchy staples. Such crops generally lack morphological markers of domestication, so exploitation, cultivation and domestication cannot easily be distinguished in the archaeological record. Molecular studies involving techniques such as chromosome painting, DNA fingerprinting and DNA sequencing, can potentially complement the archaeological record by suggesting where species which were spread through the Pacific by man originated and by what routes they attained their present distributions. A combination of archaeobotanical and molecular studies should therefore eventually enable the rival claims of Melanesia versus South-east Asia as independent centers of invention of agriculture to be assessed.

Are the earliest field monuments of the pacific landscape serial sites?

Explanations of the origin and genesis of Pacific field monuments commonly assume they reflect local social change in islands or island groups which were increasingly isolated following colonization. A recent review of early West Polynesian archaeology suggests that the penecontemporaneous appearance of various kinds of field monuments from eastern Melanesia to Polynesia may be better explained as evidence of interaction and the movement of people and/or ideas, possibly associated with the colonization of East Polynesia.

Solar thermal drying of canarium indicum nuts

Many situations exist in rural areas of developing countries where the help of simple technology can make substantial positive impacts on living conditions, finance, and in this case; sustainability. In the Melanesia region, there are numerous areas identified as needing improvement, including indigenous food preservation which will be addressed with a proposed solar thermal solution utilizing locally available materials as much as possible for low cost local construction. The current knowledge of the drying requirements for the product chosen in this study is quite limited. However, it is believed that solar thermal drying might be feasible for the remote sunny regions as in Melanesia. This paper describes the processes involved in determining the drying parameters of the Canarium indicum nut, and the proposed solar dryer designs that have been considered for the particular environmental conditions and product specifications. Through the selection process, a mixed mode, low-tunnel solar dryer was chosen as the best match to satisfy the different parameters.

Defending friends : Robert Codrington, George Sarawia and Edward Wogale

Friendship between nineteenth century missionary anthropologists and their converted cultural mentors was central to the gathering of cultural and linguistic information. This chapter traces the friendship between Anglican missionary/anthropologist, Robert Codrington, and brothers George Sarawia - first Melanesian priest - and Edward Wogale - deacon. Codrington's theological perspective on Melanesians and his close friendships with the pupils of the Melanesian Mission School at Norfolk Island allowed him to resist the increasing racialism of Atlantic science in the late nineteenth century and to challenge the evolutionist anthropology of the 1870s and 1880s. The chapter is based, in part, on a cache of letters from Wogale and Sarawia to Codrington written in Mota, the lingua franca of the Anglican Mission.

'Against the tide': Australian government attitudes to decolonisation in the South Pacific, 1962-1972

This article is a study of the attitudes of Australian government ministers and officials towards the decolonisation of the Pacific island colonial territories in the decade from 1962 to 1972. It argues that the Australian state was very slow to recognise and understand that the winds of change would also sweep through the South Pacific and see the emergence of many new island nations by 1980.

iSeru : Meleponi Pasifika Exhibition

Mixed-media, Fijian barkcloth (masi), screenprint, digital photographic prints, Fijian wooden comb all exhibited in the exhibition Meleponi Pasifika.

The rise of the Anglican orthodox church in Solomon Islands

 This research examines an Anglican schism in Melanesia which led to the rise of a new church and argues that the new church was a response to the fundamental importance of territory. The result is a new social formation called the segmentary church society.

Innovative delivery mechanisms: Australian aid partnership with churches in Papua New Guinea

The Australian Aid programme is currently valued at AUD5 billion. The majority of this aid flows to the Asia Pacific region with Papua New Guinea and Indonesia being the largest recipients. In addition to traditional delivery mechanisms-bilateral and multilateral-the Australian Government has piloted a small partnership activity with Churches in Papua New Guinea. This paper will consider this model and the benefit it brings. Possible extension of this partnership model to non-Christian religious faiths in other countries, such as Islamic nationwide organisations in Indonesia, is also discussed.

Immigrants in the Czech Republic (With Special Reference to Ukrainian Workers and "Western" Firms Operating in Prague)

International migration has increased rapidly in the Czech Republic, with more than 150,000 legally registered foreign residents at the end of 1996. A large proportion of these are in Prague - 35% of the total in December 1996. The aim of this project was to enrich the fund of information concerning the "environment", reasons and "mechanisms" behind immigration to the Czech Republic. Mr. Drbohlav looked first at the empirical situation and on this basis set out to test certain well-known migration theories. He focused on four main areas: 1) a detailed description and explanation of the stock of foreign citizens legally settled in Czech territory, concentrating particularly on "economic" migrants; 2) a questionnaire survey targeting a total of 192 Ukrainian workers (98 in the fall 1995 and 94 in the fall 1996) working in Prague or its vicinity; 3) a second questionnaire survey of 40 "western" firms (20 in 1996 and 20 in 1997) operating out of Prague; 4) an opinion poll on how the Czech population reacts to foreign workers in the CR. Over 80% of economic immigrants at the end of 1996 were from European countries, 16% from Asia and under 2% from North America. The largest single nationalities were Ukrainians, Slovaks, Vietnamese and Poles. There has been a huge increase in the Ukrainian immigrant community over both space (by region) and time (a ten-fold increase since 1993), and at 40,000 persons this represents one third of all legal immigrants. Indications are that many more live and work there illegally. Young males with low educational/skills levels predominate, in contrast with the more heterogeneous immigration from the "West". The primary reason for this migration is the higher wages in the Czech Republic. In 1994 the relative figures of GDP adjusted for parity of purchasing power were US$ 8,095 for the Czech Republic versus US$ 3,330 for the Ukraine as a whole and US$ 1,600 for the Zakarpatye region from which 49% of the respondents in the survey came. On an individual level, the average Czech wage is about US$ 330 per month, while 50% of the Ukrainian respondents put their last monthly wage before leaving for the Czech Republic at under US$ 27. The very low level of unemployment in the latter country (fluctuating around 4%) was also mentioned as an important factor. Migration was seen as a way of diversifying the family's source of income and 49% of the respondents had made their plans together with partners or close relatives, while 45% regularly send remittances to Ukraine (94% do so through friends or relatives). Looking at Ukrainian migration from the point of view of the dual market theory, these migrants' type and conditions of work, work load and earnings were all significantly worse than in the primary sector, which employs well educated people and offers them good earnings, job security and benefits. 53% of respondents were working and/or staying in the Czech Republic illegally at the time of the research, 73% worked as unqualified, unskilled workers or auxiliary workers, 62% worked more than 12 hours a day, and 40% evaluated their working conditions as hard. 51% had no days off, earnings were low in relation to the number of hours worked. and 85% said that their earnings did not increase over time. Nearly half the workers were recruited in Ukraine and only 4% expressed a desire to stay in the Czech Republic. Network theories were also borne out to some extent as 33% of immigrants came together with friends from the same village, town or region in Ukraine. The number who have relatives working in the Czech Republic is rising, and many wish to invite relatives or children to visit them. The presence of organisations which organised cross-border migration, including some which resort to organising illegal documents, also gives some support for the institutional theory. Mr. Drbohlav found that all the migration theories considered offered some insights on the situation, but that none was sufficient to explain it all. He also points out parallels with many other regions of the world, including Central America, South and North America, Melanesia, Indonesia, East Africa, India, the Middle East and Russia. For the survey of foreign and international firms, those chosen were largely from countries represented by more than one company and were mainly active in market services such as financial and trade services, marketing and consulting. While 48% of the firms had more than 10,000 employees spread through many countries, more than two thirds had fewer than 50 employees in the Czech Republic. Czechs formed 80% plus of general staff in these firms although not more than 50% of senior management, and very few other "easterners" were employed. All companies absolutely denied employing people illegally. The average monthly wage of Czech staff was US$ 850, with that of top managers from the firm's "mother country" being US$ 6,350 and that of other western managers US$ 3,410. The foreign staff were generally highly mobile and were rarely accompanied by their families. Most saw their time in the Czech Republic as positive for their careers but very few had any intention of remaining there. Factors in the local situation which were evaluated positively included market opportunities, the economic and political environment, the quality of technical and managerial staff, and cheap labour and low production costs. In contrast, the level of appropriate business ethics and conduct, the attitude of local and regional authorities, environmental production conditions, the legal environment and financial markets and fiscal policy were rated very low. In the final section of his work Mr. Drbohlav looked at the opinions expressed by the local Czech population in a poll carried out at the beginning of 1997. This confirmed that international labour migration has become visible in this country, with 43% of respondents knowing at least one foreigner employed by a Czech firm in this country. Perception differ according to the region from which the workers come and those from "the West" are preferred to those coming from further east. 49% saw their attitude towards the former as friendly but only 20% felt thus towards the latter. Overall, attitudes towards migrant workers is neutral, although 38% said that such workers should not have the same rights as Czech citizens. Sympathy towards foreign workers tends to increase with education and the standard of living, and the relatively positive attitudes towards foreigners in the South Bohemia region contradicted the frequent belief that a lack of experience of international migration lowers positive perceptions of it.