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.

Ancestry of Edward Joseph Larschan.

Larschan family tree reaching back to 1815

Shtar Halitsah given by Edward and Henry Morrison

Digital image

The influence of school smoking policy and school prevention programs on the smoking behaviour of high school students in Prince Edward Island, Canada

The aim of the study was to examine the influence of school smoking policy and school smoking prevention programs on the smoking behaviour of students in high schools in Prince Edward Island using the School Health Action Planning Evaluation System (SHAPES). A total sample included 13,131 observations of students in grades 10-12 in ten high schools in Prince Edward Island over three waves of data collection (1999, 2000, and 2001). Changes in prevalence of smoking and factors influencing smoking behaviour were analyzed using descriptive statistics and Chi-Square tests. Multi-level logistic regression analyses were used to examine how both school and student characteristics were associated with smoking behaviour (I, II, III, IV). Since students were located within schools, a basic 2-level nested structure was used in which individual students (level 1) were nested within schools (level 2). For grade 12 students, the combination of both school policies and programs was not associated with the risk of smoking and the presence of the new policy was not associated with decreased risk of smoking, unless there were clear rules in place (I). For the grade 10 study, (II) schools with both policies and programs were not associated with decreased risk of smoking. However, the smoking behaviour of older students (grade 12) at a school was associated with younger students’ (grade 10) smoking behaviour. Students first enrolled in a high school in grade 9, rather than grade 10, were at increased risk of occasional smoking. For students who transitioned from grade 10 to 12 (III), close friends smoking had a substantial influence on smoking behaviour for both males and females (III). Having one or more close friends who smoke (Odds Ratio (OR) = 37.46; 95% CI = 19.39 to 72.36), one or more smokers in the home (OR = 2.35; 95% CI = 1.67 to 3.30) and seeing teachers and staff smoking on or near school property (OR=1.78; 95% CI = 1.13 to 2.80), were strongly associated with increased risk of smoking for grade 12 students. Smoking behaviour increased for both junior (Group 1) and senior (Group 2) students (IV). Group 1 students indicated a greater decrease in smoking behaviour and factors influencing smoking behaviour compared to those of Group 2. Students overestimating the percentage of youth their age who smoke was strongly associated with increased likelihood of smoking. Smoking rates showed a decreasing trend (1999, 2000, and 2001). However, policies and programs alone were not successful in influencing smoking behaviour of youth. Rather, factors within the students and schools contextual environment influenced smoking behaviour. Comprehensive approaches are required for school-based tobacco prevention interventions. Keywords: schools, policy, programs, smoking prevention, adolescents Subject Terms: school-based programming, public health, health promotion

Propiedades eclesiásticas en una ciudad aduanera: los jesuitas en Orduña, 1689-1767

[ES]El colegio de los jesuitas de Orduña, uno de los más tardíos de todo el País Vasco, sigue en su fundación un patrón característico en los casos de mecenazgo indiano: benefactor oriundo, capital consolidado sobre el comercio y el servicio de la Corona, y diseño dirigido desde el otro lado del Atlántico, en este caso desde el Perú. El presente artículo aporta algunas claves sobre esas cuestiones, y ahonda en la formación del patrimonio que la Compañía de Jesús logró reunir en esta ciudad aduanera del Señorío de Vizcaya hasta el momento de la expulsión decretada por el rey Carlos III.

O jogo de espelho das colonizações: nacionalismo e pós-colonialismo na obra de Edward W. Said

O objetivo desse trabalho é compreender a produção intelectual do autor palestino, Edward W. Said, cuja trajetória heterogênea representou em larga medida uma metáfora teórica dos seus maiores dilemas políticos e conceituais, alguns deles constitutivos do objeto dessa tese. Entendemos que Said define a Cultura como lócus privilegiado para compreender a dominação colonial e, posteriormente, incorpora um discurso político para a formação da chamada identidade nacional Palestina. Procuramos demarcar o paradoxo central da sua obra que diz respeito ao convívio teórico da abordagem pós-colonial com a busca da historicidade do ethos nacional palestino. Entendemos que o paradoxo do Nacionalismo, sua estreita vinculação com o debate pós-colonial e os percursos teóricos decorrentes do engajamento progressivo com a causa nacional Palestina subsidiam outras reflexões que possuem interrelação. São essas; a representação do intelectual na sociedade contemporânea, a relação entre texto e realidade histórica, entendida por meio do conceito de mundanidade, a categoria de exílio como condição ontológica e metáfora epistemológica e o problema da relação entre cultura e imperialismo. Esses percursos de análise orientam-se por um objetivo mais geral que é a análise da centralidade e respectiva atualidade da obra de Edward W. Said na Historiografia Pós-Colonial.

Escala macroscópica de maturaçāo e ciclo sexual das espécies Penaeus indicus H. Milne Edward e Metapenaeus monoceros (Fabricius)

The macroscopic scale used for determination of sexual maturity in shrimps was tested against objective parameters namely the gonad-somatic index and the size of oocytes. The two main species caught in Mozambique, Penaeus indicus and Metapenaeus monoceros, were the object of the work. In order to reduce the subjectivity in the macroscopic exam, a table with the colours representative of each stage is presented. Since this study was conducted over a period of 13 consecutive months and there were observations from previous years, the sexual cycle of the two species is also presented, as well as an estimate of the size at first maturity.

Technical report of frame and catch assessment surveys of Lakes Edward and George; and the Kazinga Channel conducted in January and July 2011- 2013

This study aimed at evaluating the production levels in terms of catch estimates of the artisanal fisheries of the Edward-George system in addition to providing information on the facilities and services at landing sites and the composition, magnitude and distribution of fishing effort to guide development and management of the fisheries resources of the Edward and George lakes and Kazinga channel. Specifically, the study was expected to come up with the following outputs:- a) Information on the number of fish landing sites on the basin lakes; b) Information on the facilities available at the fish landing sites to service the fisheries sector ; c) Information on the number of fishers; d) Information on the number and types of fishing crafts; e) Information on the modes of propulsion of the fishing crafts; f) Information on the number types and sizes of fishing gears including the number of illegal fishing gears in the fishery; and g) Recommendations on development and management of the fisheries of the Edward and George lakes and Kazinga channel. h) Beach values in terms of annual catches and annual revenue from the water bodies.

A baseline survey of water quality, invertebrates, fisheries and socioeconomics on Lake Edward for proposed seismic surveys in block 4B : Final report

The National Fisheries Resources Research Institute (NaFIRRI) on behalf of OPEP Consult Ltd undertook a baseline survey of the transition zone (basically along the shoreline) and near shore habitats of the Uganda apart of Lake Edward and Kazinga channel during December 2007 to January 2008. A major objective of the baseline survey was to generate baseline information on the aquatic ecosystem features related to the fisheries and socio-economics of the fish catch including issues raised by residents in the fish landing sites. Therefore, the baseline survey captured information on water quality, the aquatic invertebrate fauna, aspects of fish biology and ecology, the fish catch including facilities at fish landings, value in the catch and related fisheries socio-economic issues perceived by residents in the settled areas along the shores.

Fishery resources and some economic aspects of four fishing villages on Lakes George and Edward in the Queen Elizabeth National Park, Uganda

The fishery resources of Lake George and Ugandan waters of Lake Edward are described. The main fish species currently observed in the commercial catches were determined and the reasons of changes in species composition of the catches. that occurred in the recent years, are explained. The fishing activity and some economic and nutritional aspects of four fishing villages, selected among the ten present within the Queen Elizabeth National Park boundaries, are analyzed, In the end some suggestions are given for management of the fishery resources of these lakes.

Plankton identified in stomach contents of Oreochromis niloticus (Pisces, Cichlidae) and the water system of Lakes Edward, George, and Kazinga channel - Uganda

The samples were collected from Lake Edward at Rwenshama, Kisenyi and Katwe, and from Lake George at Mahyoro, Kashaka and Kasenyi and in Kazinga Channel at Katunguru. The organisms identified from the water samples obtained irrespective of station or depth were mainly the phytoplankton (diatoms, blue-green algae and green algae). Of the phytoplankton, blue green-algae were the most abundant both in quantity and number of species especially in L. George. In order of importance were Microcystis spp, Planktolyngbya spp and Anabaenopsis spp were the dominant blue greens. Diatoms and green algae were present but less abundant. The estimated proportions of different types of phytoplankton identified in O. niloticus stomach contents indicate that bluegreen algae were the most abundant followed by the diatoms and green algae.

High performance 1689-nm quantum well diode lasers

1689-nm diode lasers used in medical apparatus have been fabricated and characterized. The lasers had pnpn InP current confinement structure, and the active region consisted of 5 pairs of InGaAs quantum wells and InGaAsP barriers. Stripe width and cavity length of the laser were 1.8 and 300 pm, respectively. After being cavity coated. and transistor outline (TO) packaged, the lasers showed high performance in practice. The threshold current was about 13 +/- 4 mA, the operation current and the lasing spectrum were about 58 6 mA and 1689 +/- 6 nm at 6-mW output power, respectively. Moreover, the maximum output power of the lasers was above 20 mW.