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.

Variability in Voluntary Intake of Loose Mineral Mix Supplements by Grazing Heifers

Loose mineral mix (LMM) supplements are often fed to ruminants in extensive grazing situations to provide minerals and nitrogen likely to be deficient in pasture. However a large proportion of animals offered such supplements may not consume any supplement, while among consumer animals the variability in supplement intake may be high (Wheeler et al., 1980; Dixon et al., 1996). Two experiments examined the distribution of intake of LMM supplements offered to heifers grazing in mob and paddock sizes representative of commercial cattle properties.

Optimal advertisement-innovation mix for maximizing the discounted flow of profit

Due to boom in telecommunications market, there is hectic competition among the cellular handset manufacturers. As cellular manufacturing industry operates in an oligopoly framework, often price-rigidity leads to non-price wars. The handset manufacturing firms indulge in product innovation and also advertise their products in order to achieve their objective of maximizing discounted flow of profit. It is of interest to see what would be the optimal advertisement-innovation mix that would maximize the discounted How of profit for the firms. We used differential game theory to solve this problem. We adopted the open-loop solution methodology. We experimented for various scenarios over a 30 period horizon and derived interesting managerial insights.

Efecto del período de maduración del estiércol bovino sobre el comportamiento productivo de lombrices rojas en la zona de Camoapa

El presente trabajo se realizó en la finca de la Universidad Nacional Agraria sede Camoapa, ubicada en el municipio de Camoapa del departamento de Boaco, en el período comprendido de abril a agosto del 2003. La explotación de lombrices representa un gran potencial para nuestro país, genera ingresos adicionales por la comercialización de lombrices y lombrihumus que pueden ser utilizados como alimentación animal, humana y como una valiosa fuente de fertilización. El objetivo principal de este trabajo investigativo fue valorar el comportamiento productivo de lombrices rojas (Eisenia foetida y Eudrillus eugeniae) bajo diferentes tiempos de maduración del sustrato bovino. Actualmente hay desconocimiento sobre el tiempo de maduración necesario del estiércol para usarse como sustrato en lombricultura y con frecuencia se utiliza sustrato muy fresco o muy avanzado que conlleva a la liberación de sustancias tóxicas en el primer caso, y el desarrollo de la planaria (Dugesia sp.) en ambos casos se ve afectada la calidad del producto final. Para realizar el estudio se utilizó un Diseño Completamente Aleatorio con cuatro tratamientos y ocho repeticiones. Los tratamientos consistieron en los períodos 9, 13, 17 y 21 días de maduración respectivamente. Los datos fueron sometidos a un análisis estadístico en Statistical Análisis System consistente en la realización de un modelo aditivo lineal (M.A.L.) que permitiera la determinación de diferencias o no entre los tratamientos. Los datos que presentaron diferencias significativas en el Modelo Aditivo Lineal, fueron sometidos a un análisis de regresión para determinar la relación de los períodos de maduración del estiércol con las variables evaluadas y de esa manera pronosticar el período de maduración de mayor relevancia en la producción de humus y lombrices. Como resultado del presente estudio se obtuvo que no hay efecto del período de maduración sobre la producción de lombrices pero si sobre el peso total de humus producido (P < 0.0112) y se puede predecir a partir del análisis de regresión que el aumento en el tiempo de maduración provoca un aumento significativo (P > 0.0545) en la producción de humus siguiendo el modelo lineal y =19.1+1.26X; R-Sq = 89.4%.

Carlos Vega, creador de música escénica para La Salamanca de Ricardo Rojas

Resumen: La finalidad de este trabajo es analizar la tarea que desarrolló Carlos Vega al componer música escénica para el drama La Salamanca de Ricardo Rojas y como aplicó, en función de un espectáculo teatral, los conocimientos adquiridos a través de la labor de investigación etnomusicológica que desarrolló.

Reproducción de documentación perteneciente a Miguel José Garmendia Aldaz, Asesor Jurídico y Secretario Particular del Consejero de Gobernación del Gobierno Vasco durante la Guerra en el Norte, y Mayor Jefe de la Demarcación de Fronteras en Cataluña a partir de octubre de 1938, y en enero de 1939 Delegado de Orden Público adscrito a la Comandancia Militar de Figueras.

Fecha: 10-10-1936/31-1-1939 / Unidad de instalación: Carpeta 25 - Expediente 21 / Nº de pág.: 33 (28 mecanografiadas, 5 manuscritas)

Separatas de artículos de los que es autor Miguel Pelay Orozko, quien dedica alguno de ellos a Luis Ruiz de Aguirre.

Fecha: 1971-1972 / Unidad de instalación: Carpeta 48 - Expediente 7-17 / Nº de pág.: 8 (mecanografiadas)

Emergency dam at Pedro Miguel, Panama Canal (ca. 1914)

Leonard Carpenter Panama Canal Collection. Photographs: Dredging, Soldiers, and Ships. [Box 1] from the Special Collections & Area Studies Department, George A. Smathers Libraries, University of Florida.