The evolution of the Global Burden of Disease framework for disease, injury and risk factor quantification: Developing the evidence base for national, regional and global public health action

Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries and risk factors are generally incomplete, fragmented and of uncertain reliability and comparability. Lack of a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and failure to systematically evaluate data quality have impeded comparative analyses of the true public health importance of various conditions and risk factors. As a consequence the impact of major conditions and hazards on population health has been poorly appreciated, often leading to a lack of public health investment. Global disease and risk factor quantification improved dramatically in the early 1990s with the completion of the first Global Burden of Disease Study. For the first time, the comparative importance of over 100 diseases and injuries, and ten major risk factors, for global and regional health status could be assessed using a common metric (Disability-Adjusted Life Years) which simultaneously accounted for both premature mortality and the prevalence, duration and severity of the non-fatal consequences of disease and injury. As a consequence, mental health conditions and injuries, for which non-fatal outcomes are of particular significance, were identified as being among the leading causes of disease/injury burden worldwide, with clear implications for policy, particularly prevention. A major achievement of the Study was the complete global descriptive epidemiology, including incidence, prevalence and mortality, by age, sex and Region, of over 100 diseases and injuries. National applications, further methodological research and an increase in data availability have led to improved national, regional and global estimates for 2000, but substantial uncertainty around the disease burden caused by major conditions, including, HIV, remains. The rapid implementation of cost-effective data collection systems in developing countries is a key priority if global public policy to promote health is to be more effectively informed.

'Worldmarks': Web guidelines for socially and culturally responsive assessment in university classrooms

In the early 21st century, we need to prepare university students to navigate local and global cultures effectively and sensitively. These future professionals must develop comprehensive intercultural communication skills and understanding. Yet university assessment in Australia is often based on a western template of knowledge, which automatically places International, Indigenous, as well as certain groups of local students at a study disadvantage. It also ensures that Australian students from dominant groups are not given the opportunity to develop these vital intercultural skills. This paper explores the issues embedded in themes 1 and 4 of this conference and provides details of an innovative website developed at Queensland University of Technology in Brisbane, Australia, which encourages academic staff to investigate the hidden assumptions that can underpin their assessment practices. The website also suggests strategies academics can use to ensure that their assessment becomes more socially and culturally responsive.

Role of catecholaminergic inputs to the medial prefrontal cortex in local and subcortical expression of Fos after psychological stress

A wide variety of stressors elicit Fos expression in the medial prefrontal cortex (mPFC). No direct attempts, however, have been made to determine the role of the inputs that drive this response. We examined the effects of lesions of mPFC catecholamine terminals on local expression of Fos after exposure to air puff, a stimulus that in the rat acts as an acute psychological stressor. We also examined the effects of these lesions on Fos expression in a variety of subcortical neuronal populations implicated in the control of adrenocortical activation, one classic hallmark of the stress response. Lesions of the mPFC that were restricted to dopaminergic terminals significantly reduced numbers of Fos-immunoreactive (Fos-IR) cells seen in the mPFC after air puff, but had no significant effect on stress-induced Fos expression in the subcortical structures examined. Lesions of the mPFC that affected both dopaminergic and noradrenergic terminals also reduced numbers of Fos-IR cells observed in the mPFC after air puff. Additionally, these lesions resulted in a significant reduction in stress-induced Fos-IR in the ventral bed nucleus of the stria terminalis. These results demonstrate a role for catecholaminergic inputs to the mPFC, in the generation of both local and subcortical responses to psychological stress. (C) 2004 Wiley-Liss, Inc.

Antecedents of task-specific goal orientation: An investigation of task practice, personality and global goal orientation

Goal orientation, a mental framework for understanding how individuals approach learning and achievement situations, has emerged as an important topic in organisational psychology. This study investigated the effects of task practice, personality (openness to experience and neuroticism), and global goal orientation (predisposition to adopt a certain response pattern across all domains) on participants’ task-specific goal orientation (response pattern adopted for a specific task). One hundred and three participants performed an air traffic control task and their task-specific goal orientation was measured prior to each of a total of thirty trials. Results revealed an effect of task practice such that individuals’ task-specific learning orientation decreased over time while their task-specific prove orientation increased over time. The results also showed that individuals’ personality can influence their task-specific goal orientation and further, that this relationship can be mediated by global goal orientation. Specifically, the positive relationship between openness to experience and task-specific prove orientation was mediated by global prove orientation. Similarly, the positive relationship between neuroticism and task-specific avoid orientation was mediated by global avoid orientation. Theoretical and practical implications of these findings are considered.

Psilocybin impairs high-level but not low-level motion perception

The hallucinogenic serotonin(IA&2A) agonist psilocybin is known for its ability to induce illusions of motion in otherwise stationary objects or textured surfaces. This study investigated the effect of psilocybin on local and global motion processing in nine human volunteers. Using a forced choice direction of motion discrimination task we show that psilocybin selectively impairs coherence sensitivity for random dot patterns, likely mediated by high-level global motion detectors, but not contrast sensitivity for drifting gratings, believed to be mediated by low-level detectors. These results are in line with those observed within schizophrenic populations and are discussed in respect to the proposition that psilocybin may provide a model to investigate clinical psychosis and the pharmacological underpinnings of visual perception in normal populations.