The contribution of major depression to the global burden of ischemic heart disease : a comparative risk assessment

Background Cardiovascular disease and mental health both hold enormous public health importance, both ranking highly in results of the recent Global Burden of Disease Study 2010 (GBD 2010). For the first time, the GBD 2010 has systematically and quantitatively assessed major depression as an independent risk factor for the development of ischemic heart disease (IHD) using comparative risk assessment methodology. Methods A pooled relative risk (RR) was calculated from studies identified through a systematic review with strict inclusion criteria designed to provide evidence of independent risk factor status. Accepted case definitions of depression include diagnosis by a clinician or by non-clinician raters adhering to Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) classifications. We therefore refer to the exposure in this paper as major depression as opposed to the DSM-IV category of major depressive disorder (MDD). The population attributable fraction (PAF) was calculated using the pooled RR estimate. Attributable burden was calculated by multiplying the PAF by the underlying burden of IHD estimated as part of GBD 2010. Results The pooled relative risk of developing IHD in those with major depression was 1.56 (95% CI 1.30 to 1.87). Globally there were almost 4 million estimated IHD disability-adjusted life years (DALYs), which can be attributed to major depression in 2010; 3.5 million years of life lost and 250,000 years of life lived with a disability. These findings highlight a previously underestimated mortality component of the burden of major depression. As a proportion of overall IHD burden, 2.95% (95% CI 1.48 to 4.46%) of IHD DALYs were estimated to be attributable to MDD in 2010. Eastern Europe and North Africa/Middle East demonstrate the highest proportion with Asia Pacific, high income representing the lowest. Conclusions The present work comprises the most robust systematic review of its kind to date. The key finding that major depression may be responsible for approximately 3% of global IHD DALYs warrants assessment for depression in patients at high risk of developing IHD or at risk of a repeat IHD event.

“Back to the future” – a retrospective analysis of university business models

Using established strategic management and business model frameworks we map the evolution of universities in the context of their value proposition to students as consumers of their products. We argue that in the main universities over time have transitioned from a value-based business model through to an efficiency-based business model that for numerous reasons, is becoming rapidly unsustainable. We further argue that the future university business models would benefit with a reconfiguration towards a network value based model. This approach requires a revised set of perceived benefits, better aligned to the current and future expectations and an alternate approach to the delivery of those benefits to learner / consumers.

Environmental contributions to the leading causes of disease burden among Australian children

Although the effect of adverse environments on the well-being of children is an important global health issue, it remains underrecognized in health care and underconsidered in terms of both research and public policy. Children have developmentally distinct patterns of environmental exposure and susceptibilities that increase their risk of disease. Young children, especially those who are impoverished, have disproportionately heavier exposures to environmental threats in a given environment. They also have decreased metabolic capacity to detoxify and eliminate contaminants. Furthermore, rapid growth and development before and after birth and the continuing growth and postnatal maturation of the respiratory, immune, and neurological systems, in particular, make them increasingly vulnerable to environmental threats...

Veracity of the archive : a research approach to the collection and verification of urban morphological records using qualitative data analysis software

Critical to the research of urban morphologists is the availability of historical records that document the urban transformation of the study area. However, thus far little work has been done towards an empirical approach to the validation of archival data in this field. Outlined in this paper, therefore, is a new methodology for validating the accuracy of archival records and mapping data, accrued through the process of urban morphological research, so as to establish a reliable platform from which analysis can proceed. The paper particularly addresses the problems of inaccuracies in existing curated historical information, as well as errors in archival research by student assistants, which together give rise to unacceptable levels of uncertainty in the documentation. The paper discusses the problems relating to the reliability of historical information, demonstrates the importance of data verification in urban morphological research, and proposes a rigorous method for objective testing of collected archival data through the use of qualitative data analysis software.

From the bush to the burbs : a comparison of driver situation awareness at rural and urban railway level crossings

The problem of collisions between road users and trains at rail level crossings (RLXs) remains resistant to current countermeasures. One factor underpinning these collisions is poor Situation Awareness (SA) on behalf of the road user involved (i.e. not being aware of an approaching train). Although this is a potential threat at any RLX, the factors influencing SA may differ depending on whether the RLX is located in a rural or urban road environment. Despite this, there has been no empirical investigation regarding how road user SA might differ across distinct RLX environments. This knowledge is needed to establish the extent to which a uniform approach to RLX design and safety is acceptable. The aim of this paper is to investigate the differences in driver SA at rural versus urban RLXs. We present analyses of driver SA in both rural and urban RLX environments based on two recent on-road studies undertaken in Victoria, Melbourne. The findings demonstrate that driver SA is markedly different at rural and urban RLXs, and also that poor SA regarding approaching trains may be caused by different factors. The implications for RLX design and safety are discussed.

Protecting World Heritage sites from the adverse impacts of climate change : obligations for States Parties to the World Heritage Convention

Through its mandate to protect and preserve places of ‘outstanding universal value’, the World Heritage Convention provides an unlikely yet effective tool in global efforts to mitigate climate change. The practical efficacy of the Strategy to Assist States Parties to Implement Appropriate Management Responses (‘the Strategy’), which represents the World Heritage Committee’s primary response to the threats posed by climate change to World Heritage sites, is undermined by its weak stance on mitigation. This paper argues that the World Heritage Convention imposes stronger obligations on States Parties than those contained in the Strategy, including a duty on States Parties to commit to ‘deep cuts’ in greenhouse gas emissions. In order to ensure the continuing success of the World Heritage Convention States Parties must engage in extensive mitigation strategies without delay.

Flying robots to the rescue

UAVs could one day save the lives of lost civilians and those sent to find them, and a competition in outback Australia is proving how soon that day might come. We have all seen news stories of people who ventured beyond the day-to-day reach of the community and got lost: search parties are formed, aircraft drafted in, and often large sums of money expended in the quest to find them.

Comprehensive contribution of filament thickness and crosslinker failure to the rheological property of F-actin cytoskeleton

Rheological property of F-actin cytoskeleton is significant to the restructuring of cytoskeleton under a variety of cell activities. This study numerically validates the rheological property of F-actin cytoskeleton is not only a result of kinetic energy dissipation of F-actin, but also greatly depends on the configuration remodeling of networks structure. Both filament geometry and crosslinker properties can affect the remodeling of F-actin cytoskeleton. The crosslinker unbinding is found to dissipate energy and induce prominent stress relaxation in the F-actin adjacent to cross-linkages. Coupled with F-actin elasticity, the energy dissipation and stress relaxation are more significant in bundled F-actin networks than in single F-actin networks.

Temporal characteristics of melanopsin inputs to the human pupil light reflex

Rods, cones and melanopsin containing intrinsically photosensitive retinal ganglion cells (ipRGCs) operate in concert to regulate pupil diameter. The temporal properties of intrinsic ipRGC signalling are distinct to those of rods and cones, including longer latencies and sustained signalling after light offset. We examined whether the melanopsin mediated post-illumination pupil response (PIPR) and pupil constriction were dependent upon the inter-stimulus interval (ISI) between successive light pulses and the temporal frequency of sinusoidal light stimuli. Melanopsin excitation was altered by variation of stimulus wavelength (464 nm and 638 nm lights) and irradiance (11.4 and 15.2 log photons cm(-2) s(-1)). We found that 6s PIPR amplitude was independent of ISI and temporal frequency for all melanopsin excitation levels, indicating complete summation. In contrast to the PIPR, the maximum pupil constriction increased with increasing ISI with high and low melanopsin excitation, but time to minimum diameter was slower with high melanopsin excitation only. This melanopsin response to briefly presented pulses (16 and 100 ms) slows the temporal response of the maximum pupil constriction. We also demonstrate that high melanopsin excitation attenuates the phasic peak-trough pupil amplitude compared to conditions with low melanopsin excitation, indicating an interaction between inner and outer retinal inputs to the pupil light reflex. We infer that outer retina summation is important for rapidly controlling pupil diameter in response to short timescale fluctuations in illumination and may occur at two potential sites, one that is presynaptic to extrinsic photoreceptor input to ipRGCs, or another within the pupil control pathway if ipRGCs have differential temporal tuning to extrinsic and intrinsic signalling.