Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: Quantifying the epidemiological transition

Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6–6·6), from 65·3 years (65·0–65·6) in 1990 to 71·5 years (71·0–71·9) in 2013, HALE at birth rose by 5·4 years (4·9–5·8), from 56·9 years (54·5–59·1) to 62·3 years (59·7–64·8), total DALYs fell by 3·6% (0·3–7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6–29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non–communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Interpretation Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition—in which increasing sociodemographic status brings structured change in disease burden—is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5–89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

Meeting of the Joint Distribution Committee and the Executive Committee of the American Jewish Relief Committee 1918 in New York

Reproduction of a painting of a meeting of the Joint Distribution Committee (representing the American Jewish Relief Committee, the Central Rellief Committee and the People's Relief Committee) and the Executive Committee of the American Jewish Relief Committee, with chairman Felix Warburg, secretary Albert Lucas, stenographer Mrs. F. Friedman, executive director Boris Bogen, comptroller Harriet Lowenstein, associate treasurer Paul Baerwald and treasurer Arthur Lehman; Office of Mr. Felix M. Warburg, 52 William Street, New York

The File Marked "Rita". Selections from the Letters of Herbert Mueller and Rita Klein (1939-1945) 1939-1946

Exchange of letters between Herbert Mueller and Rita Klein after Mueller's emigration to England in 1939; Rita Klein's attempt to obtain divorce; suicide attempt by her husband Leo Klein; correspondence through intermediaries after outbreak of World War II; notice of Rita Klein's deportation to Auschwitz; (translation from original German)

David Frischmann (1859-1922) and Chaim Nachman Bialik(1873-1934) in conversation.

( 1862-1945 ) b. Odessa. Pasternak was a prominent Moscow artist, who emigrated to Berlin in 1921, the same year as the Hebrew poet Bialik.

Lucien Wolf and David Mowshowitch papers, [ca. 1869-1959]

Correspondence, reports, minutes, manuscripts, and clippings relating to the activities of Wolf, Mowshowitch, and the Joint Foreign Committee, as well as to the political situation of Jews in various countries and to the Paris Peace Conference. Papers of Lucien Wolf include his diary, lectures on English-German relations and English-Russian relations; bibliography of Wolf's works on Jewish themes; clippings of Wolf's articles; congratulations on his seventieth birthday; article on his last interview with Chamberlain; and correspondence with parents, 1869-1882, A. Abrahams, 1914-1925, Chief Rabbi Dr. J.H. Hertz, 1892-1923, Clara Melchior, 1913-1929, Jacob Schiff, 1910, Maxim Vinawer, 1917, Mark Wischnitzer, 1926-1928, Lord Robert Cecil, 1916-1919, Lord Rothschild, 1906, Cyrus Adler, Count J. Bernstorff, Szymon Ashkenazy, Solomon Dingol, Louis Marshall, Claude G. Montefiore, Sir Edward Sassoon, Jacob Schiff, Lord William Selborne, Nakhum Sokolow, Oscar Straus, Chaim Weizmann, the American Jewish Congress, 1916-1923, Hilfsverein der Deutschen Juden, 1913, and Jewish Historical Society of England.

Cyrus Adler papers, undated, 1883-1937.

Primarily correspondence relating to the Dropsie College for Hebrew and Cognate Learning, the Jewish encyclopedia, the Jewish Theological Seminary of America, the Smithsonian Institution and the American Jewish Historical Society. Contains also correspondence arranged alphabetically including letters from the staff of the American Hebrew, the American Jewish Committee, Theodor Herzl, the Jewish Agricultural and Industrial Aid Society, the Jewish Publication Society of America, Max J. Kohler, Louis Marshall, Jacob H. Schiff, Oscar S. Straus, Henrietta Szold, Stephen S. Wise and Israel Zangwill. Contains also material on the structure of the Jewish calendar, correspondence relating to the publication of the Jefferson Bible, correspondence and research material concerning Jewish servicemen in the Spanish-American War (published in the American Jewish year book, 1900-1901), a list of ... of the U.S. Congress, material ... immigration, the Jews in Rus ... cript proof articles from the Jewish quarterly review, numerous published articles by and ... Adler, and a large quantity of manuscript notes and material on Jewish history in general and American Jewish history in particular. Includes also David Sulzberger's collected data pertaining to the Jewish population in the United States-1900.

Elihu Stone collection undated, 1913-1962.

Collection contains materials pertaining to the life and work of Stone.

Políticas imigratórias e as instituições burocráticas no governo Vargas (1930-1945)

O respectivo trabalho tem como objetivo destacar o desenvolvimento das políticas imigratórias e a sua repercussão no cotidiano do imigrante, entre os anos de 1930 e 1945. Nesse período, salientamos as políticas de Estado e suas respectivas mudanças, alinhadas ao contexto histórico, no tocante a seleção dos imigrantes desejáveis e indesejáveis. A evolução do aparelhamento estatal, com a criação e adaptação de instituições repressivas, jurídicas e burocráticas, é ponto fundamental para compreender a relação do Estado com o imigrante. Além disso, vale destacar que a imagem do estrangeiro como um problema de segurança nacional era constantemente reforçada pela retórica oficial do Estado. Assim, a própria sofisticação das estruturas organizacionais confluíam para certo afastamento das instituições do poder central, resultando em maior autonomia nas decisões e conseqüente descenso no rigor do julgamento sobre os imigrantes. Dessa forma, se faz necessária uma análise crítica sobre o contexto histórico, captando o sistema estatal como algo heterogêneo, a fim de compreender as nuanças nas políticas e ações do Estado, bem como o papel do imigrante nesse processo.

Dodd [George], Winslow [Charles] [joueurs de tennis participant au championnat du monde à Saint-Cloud] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59419

Dodd [George], Winslow [Charles] [joueurs de tennis participant au championnat du monde à Saint-Cloud] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59424

[Charles George] Dandrow [lanceur de poids] (C.N. New York) : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59328

Mr Redmond-Howard [Louis George] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 60795