A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children.

A preliminary OSL chronology for coastal dunes on Moreton island, Queensland, Australia – Marginal deposits of A large-scale quaternary shelf sediment system

Moreton Island and several other large siliceous sand dune islands and mainland barrier deposits in SE Queensland represent the distal, onshore component of an extensive Quaternary continental shelf sediment system. This sediment has been transported up to 1000 km along the coast and shelf of SE Australia over multiple glacioeustatic sea-level cycles. Stratigraphic relationships and a preliminary Optically Stimulated Luminance (OSL) chronology for Moreton Island indicate a middle Pleistocene age for the large majority of the deposit. Dune units exposed in the centre of the island and on the east coast have OSL ages that indicate deposition occurred between approximately 540 ka and 350 ka BP, and at around 96±10 ka BP. Much of the southern half of the island has a veneer of much younger sediment, with OSL ages of 0.90±0.11 ka, 1.28±0.16 ka, 5.75±0.53 ka and <0.45 ka BP. The younger deposits were partially derived from the reworking of the upper leached zone of the much older dunes. A large parabolic dune at the northern end of the island, OSL age of 9.90±1.0 ka BP, and palaeosol exposures that extend below present sea level suggest the Pleistocene dunes were sourced from shorelines positioned several to tens of metres lower than, and up to few kilometres seaward of the present shoreline. Given the lower gradient of the inner shelf a few km seaward of the island, it seems likely that periods of intermediate sea level (e.g. ~20 m below present) produced strongly positive onshore sediment budgets and the mobilisation of dunes inland to form much of what now comprises Moreton Island. The new OSL ages and comprehensive OSL chronology for the Cooloola deposit, 100 km north of Moreton Island, indicate that the bulk of the coastal dune deposits in SE Queensland were emplaced between approximately 540 ka BP and prior to the Last Interglacial. This chronostratigraphic information improves our fundamental understanding of long-term sediment transport and accumulation on large-scale continental shelf sediment systems.

Dietary intake of children aged 12-16 months and associations with maternal feeding beliefs and practices

This thesis provides the first detailed data describing the dietary intake of first-born Australian children aged 12-16 months. Overall, quality of intake could improve, with toddlers being exposed to energy-dense, nutrient-poor foods which may adversely affect the development of long-term healthy food preferences and growth trajectory. The leaner, but healthy weight toddler who exhibited more frequent food refusal was described a fussy eater or prompted higher maternal concern. However these behaviours are consistent with typical child development during the second year of life. Mothers can be supported to understand food refusal as manifestation of children's ability to self-regulate energy intake.

A study of governance arrangements for land use and natural resource management planning in Cape York Peninsula

Complex intersecting social, economic and environmental dilemmas in Australia's Cape York Peninsula present a number of challenges for planners seeking to develop and implement land use and natural resource management (NRM) plans. There have been five different attempts at land use and NRM planning in Cape York Peninsula over the last 20 years. These processes have (to greater or lesser extents) failed to deliver community-owned and government-supported plans to guide development and/or the management of the region's natural resources. The region is remote, sparsely populated, and home to a significant Indigenous population. Much of the contestation within the region surrounds the access, use and ownership of the region's internationally valuable natural resources. This paper reviews, from the literature, the relevancy and applicability of criteria for best practice planning and governance. A range of identified best practice governance and planning principles are applied to assess the governance arrangements for planning in the Peninsula. The paper finds that decision-making arrangements for land use and NRM planning in the Peninsula are still in their infancy and are inadequate to support effective outcomes. The paper concludes that broader attention to best practice principles in governance for planning is needed to improve planning outcomes.

New England Youth Speeding Project: A pilot study of young drivers and risky driving: Effective strategies for preventing speeding amongst young Australians aged 16-25 years in the New England Region

Young Australian drivers aged 17 – 25 years are overwhelmingly represented in road fatalities where speed is a factor. In the combined LGAs of Armidale Dumaresq, Guyra, Uralla and Walcha in the 5 years 1999-2003 inclusive, 43% of speeding related casualty crashes involved a young driver aged less than 25 years. This is despite the fact that the 17-25 age group account for only 25% of the driving population in this area. Young male drivers account for the majority of these crashes and also tend to have a higher number of driving offences and accrue more penalties for road traffic offences, especially speeding. By analysing data from questionnaires by male and female participants this research project has been able to evaluate road safety advertisements to determine which ones are most effective to young drivers, what features of these advertisements are effective, how males differ from females in their receptiveness and preferences for road safety advertisements and specifically how to target young people especially young men in conveying road safety messages. Finally this research project has identified factors that are important in the production of media road safety advertisements and has made recommendations for how best to convey effective road safety messages to young Australian drivers in rural areas.

The role of environmental factors in the spatial distribution of Japanese encephalitis in mainland China

Japanese encephalitis (JE) is the most common cause of viral encephalitis and an important public health concern in the Asia-Pacific region, particularly in China where 50% of global cases are notified. To explore the association between environmental factors and human JE cases and identify the high risk areas for JE transmission in China, we used annual notified data on JE cases at the center of administrative township and environmental variables with a pixel resolution of 1 km×1 km from 2005 to 2011 to construct models using ecological niche modeling (ENM) approaches based on maximum entropy. These models were then validated by overlaying reported human JE case localities from 2006 to 2012 onto each prediction map. ENMs had good discriminatory ability with the area under the curve (AUC) of the receiver operating curve (ROC) of 0.82-0.91, and low extrinsic omission rate of 5.44-7.42%. Resulting maps showed JE being presented extensively throughout southwestern and central China, with local spatial variations in probability influenced by minimum temperatures, human population density, mean temperatures, and elevation, with contribution of 17.94%-38.37%, 15.47%-21.82%, 3.86%-21.22%, and 12.05%-16.02%, respectively. Approximately 60% of JE cases occurred in predicted high risk areas, which covered less than 6% of areas in mainland China. Our findings will help inform optimal geographical allocation of the limited resources available for JE prevention and control in China, find hidden high-risk areas, and increase the effectiveness of public health interventions against JE transmission.

Molecular and pathological insights into Chlamydia pecorum-associated sporadic bovine encephalomyelitis (SBE) in Western Australia

Background Despite its global recognition as a ruminant pathogen, cases of Chlamydia pecorum infection in Australian livestock are poorly documented. In this report, a C. pecorum specific Multi Locus Sequence Analysis scheme was used to characterise the C. pecorum strains implicated in two cases of sporadic bovine encephalomyelitis confirmed by necropsy, histopathology and immunohistochemistry. This report provides the first molecular evidence for the presence of mixed infections of C. pecorum strains in Australian cattle. Case presentation Affected animals were two markedly depressed, dehydrated and blind calves, 12 and 16 weeks old. The calves were euthanized and necropsied. In one calf, a severe fibrinous polyserositis was noted with excess joint fluid in all joints whereas in the other, no significant lesions were seen. No gross abnormalities were noted in the brain of either calf. Histopathological lesions seen in both calves included: multifocal, severe, subacute meningoencephalitis with vasculitis, fibrinocellular thrombosis and malacia; diffuse, mild, acute interstitial pneumonia; and diffuse, subacute epicarditis, severe in the calf with gross serositis. Immunohistochemical labelling of chlamydial antigen in brain, spleen and lung from the two affected calves and brain from two archived cases, localised the antigen to the cytoplasm of endothelium, mesothelium and macrophages. C. pecorum specific qPCR, showed dissemination of the pathogen to multiple organs. Phylogenetic comparisons with other C. pecorum bovine strains from Australia, Europe and the USA revealed the presence of two genetically distinct sequence types (ST). The predominant ST detected in the brain, heart, lung and liver of both calves was identical to the C. pecorum ST previously described in cases of SBE. A second ST detected in an ileal tissue sample from one of the calves, clustered with previously typed faecal bovine isolates. Conclusion This report provides the first data to suggest that identical C. pecorum STs may be associated with SBE in geographically separated countries and that these may be distinct from those found in the gastrointestinal tract. This report provides a platform for further investigations into SBE and for understanding the genetic relationships that exist between C. pecorum strains detected in association with other infectious diseases in livestock.

Postglacial Early Permian (late Sakmarian-early Artinskian) shallow-marine carbonate deposition along a 2000 km transect from Timor to west Australia

Late Sakmarian to early Artinskian (Early Permian) carbonate deposition was widespread in the marine intracratonic rift basins that extended into the interior of Eastern Gondwana from Timor in the north to the northern Perth Basin in the south. These basins spanned about 20° of paleolatitude (approximately 35°S to 55°S). This study describes the type section of the Maubisse Limestone in Timor-Leste, and compares this unit with carbonate sections in the Canning Basin (Nura Nura Member of the Poole Sandstone), the Southern Carnarvon Basin (Callytharra Formation) and the northern Perth Basin (Fossil Cliff Member of the Holmwood Shale). The carbonate units have no glacial influence and formed part of a major depositional cycle that, in the southern basins, overlies glacially influenced strata and lies a short distance below mudstone containing marine fossils and scattered dropstones (perhaps indicative of sea ice). In the south marine conditions became more restricted and were replaced by coal measures at the top of the depositional sequence. In the north, the carbonate deposits are possibly bryozoan–crinoidal mounds; whereas in the southern basins they form laterally continuous relatively thin beds, deposited on a very low-gradient seafloor, at the tops of shale–limestone parasequences that thicken upward in parasequence sets. All marine deposition within the sequence took place under very shallow (inner neritic) conditions, and the limestones have similar grain composition. Bryozoan and crinoidal debris dominate the grain assemblages and brachiopod shell fragments, foraminifera and ostracod valves are usually common. Tubiphytes ranged as far south as the Southern Carnarvon Basin, albeit rarely, but is more common to the north. Gastropod and bivalve shell debris, echinoid spines, solitary rugose corals and trilobite carapace elements are rare. The uniformity of the grain assemblage and the lack of tropical elements such as larger fusulinid foraminifera, colonial corals or dasycladacean algae indicate temperate marine conditions with only a small increase in temperature to the north. The depositional cycle containing the studied carbonate deposits represents a warmer phase than the preceding glacially influenced Asselian to early Sakmarian interval and the subsequent cool phase of the “mid” Artinskian that is followed by significant warming during the late Artinskian–early Kungurian. The timing of cooler and warmer intervals in the west Australian basins seems out-of-phase with the eastern Australian succession, but this may be a problem of chronostratigraphic miscorrelation due to endemic faunas and palynofloras.

Genome-wide association study of CNVs in 16,000 cases of eight common diseases and 3,000 shared controls

Copy number variants (CNVs) account for a major proportion of human genetic polymorphism and have been predicted to have an important role in genetic susceptibility to common disease. To address this we undertook a large, direct genome-wide study of association between CNVs and eight common human diseases. Using a purpose-designed array we typed 19,000 individuals into distinct copy-number classes at 3,432 polymorphic CNVs, including an estimated 50% of all common CNVs larger than 500 base pairs. We identified several biological artefacts that lead to false-positive associations, including systematic CNV differences between DNAs derived from blood and cell lines. Association testing and follow-up replication analyses confirmed three loci where CNVs were associated with diseaseIRGM for Crohns disease, HLA for Crohns disease, rheumatoid arthritis and type 1 diabetes, and TSPAN8 for type 2 diabetesalthough in each case the locus had previously been identified in single nucleotide polymorphism (SNP)-based studies, reflecting our observation that most common CNVs that are well-typed on our array are well tagged by SNPs and so have been indirectly explored through SNP studies. We conclude that common CNVs that can be typed on existing platforms are unlikely to contribute greatly to the genetic basis of common human diseases. © 2010 Macmillan Publishers Limited. All rights reserved.

Synthesis based on cyclohexadienes. Part 25. Total synthesis of (+/-)-allo-cedrol (khusiol)

The first stereoselective total synthesis of (+/-)-allo-cedrol 20, an enantiomer of khusiol and a complex sesquiterpene having a novel tricyclo[5.2.2.0(1,5)]undecane framework, is reported from 8-methoxytricyclo[6.2.2.0(1,6)]dodec-6-en-9-one 6c. The methodology involves preparation of 9-methoxytricyclo[7.2.1.0(1,6)]dodec-6-en-8-one 12 from 6c and its conversion through the compounds 8-benzyloxy-7,7-dimethyl-9-methoxytricyclo[7.2.1.0(1,6)]dodec-5-ene 38, 7-benzyloxy-8-methoxy-2,6,6-trimethyltricyclo[6.2.1.0(1,5)]undecane 48 into 8-methoxy-2,6,6-trimethyltricyclo[6.2.1.0(1,5)]undecan-7-one 49. Wittig reaction of 49 affords the olefin 50 which has been smoothly rearranged into khusione 51. Metal-ammonia reduction of khusione under specific conditions affords (+/-)-allo-cedrol. Thus, bridgehead substitution of a methoxy group by a methyl group is the key reaction in this synthesis. In an alternative strategy, attempted conversion of 8-methoxy-2-methyltricyclo[6.2.1.0(1,5)]undec-5-en-7-one 16 into khusione 37 results in an inseparable mixture of the isomers. A notable observation in this synthesis is the unusual formation of a gamma-alkylated product 27 during Woodward methylation of 16.

Transition from disc to rod-like shape of 16-3-16 dimeric micelles in aqueous solutions

Small-angle neutron scattering (SANS) measurements from bis-cationic C16H33N+(CH3)(2)-(CH2)(3)-N+ (CH3)(2)C16H33 2Br(-) dimeric surfactant, referred to as 16-3-16, at different concentrations and temperatures, are reported. It is seen that micelles are disc-like for concentrations C = 2.5 and 10 mM at temperature T = 30 degrees C. At low concentration C = 0.5 mM micelles are rod-like. Similarly, there is a disc to rod-like transition of micelles on increasing the temperature. For C = 2.5 mM, micelles are rod-like at T = 45 and 70 degrees C.

Regolith mass balance inferred from combined mineralogical, geochemical and geophysical studies: Mule Hole gneissic watershed, South India

The aim of this study is to propose a method to assess the long-term chemical weathering mass balance for a regolith developed on a heterogeneous silicate substratum at the small experimental watershed scale by adopting a combined approach of geophysics, geochemistry and mineralogy. We initiated in 2003 a study of the steep climatic gradient and associated geomorphologic features of the edge of the rifted continental passive margin of the Karnataka Plateau, Peninsular India. In the transition sub-humid zone of this climatic gradient we have studied the pristine forested small watershed of Mule Hole (4.3 km(2)) mainly developed on gneissic substratum. Mineralogical, geochemical and geophysical investigations were carried out (i) in characteristic red soil profiles and (ii) in boreholes up to 60 m deep in order to take into account the effect of the weathering mantle roots. In addition, 12 Electrical Resistivity Tomography profiles (ERT), with an investigation depth of 30 m, were generated at the watershed scale to spatially characterize the information gathered in boreholes and soil profiles. The location of the ERT profiles is based on a previous electromagnetic survey, with an investigation depth of about 6 m. The soil cover thickness was inferred from the electromagnetic survey combined with a geological/pedological survey. Taking into account the parent rock heterogeneity, the degree of weathering of each of the regolith samples has been defined using both the mineralogical composition and the geochemical indices (Loss on Ignition, Weathering Index of Parker, Chemical Index of Alteration). Comparing these indices with electrical resistivity logs, it has been found that a value of 400 Ohm m delineates clearly the parent rocks and the weathered materials, Then the 12 inverted ERT profiles were constrained with this value after verifying the uncertainty due to the inversion procedure. Synthetic models based on the field data were used for this purpose. The estimated average regolith thickness at the watershed scale is 17.2 m, including 15.2 m of saprolite and 2 m of soil cover. Finally, using these estimations of the thicknesses, the long-term mass balance is calculated for the average gneiss-derived saprolite and red soil. In the saprolite, the open-system mass-transport function T indicates that all the major elements except Ca are depleted. The chlorite and biotite crystals, the chief sources for Mg (95%), Fe (84%), Mn (86%) and K (57%, biotite only), are the first to undergo weathering and the oligoclase crystals are relatively intact within the saprolite with a loss of only 18%. The Ca accumulation can be attributed to the precipitation of CaCO3 from the percolating solution due to the current and/or the paleoclimatic conditions. Overall, the most important losses occur for Si, Mg and Na with -286 x 10(6) mol/ha (62% of the total mass loss), -67 x 10(6) mol/ha (15% of the total mass loss) and -39 x 10(6) mol/ha (9% of the total mass loss), respectively. Al, Fe and K account for 7%, 4% and 3% of the total mass loss, respectively. In the red soil profiles, the open-system mass-transport functions point out that all major elements except Mn are depleted. Most of the oligoclase crystals have broken down with a loss of 90%. The most important losses occur for Si, Na and Mg with -55 x 10(6) mol/ha (47% of the total mass loss), -22 x 10(6) mol/ha (19% of the total mass loss) and -16 x 10(6) mol/ha (14% of the total mass loss), respectively. Ca, Al, K and Fe account for 8%, 6%, 4% and 2% of the total mass loss, respectively. Overall these findings confirm the immaturity of the saprolite at the watershed scale. The soil profiles are more evolved than saprolite but still contain primary minerals that can further undergo weathering and hence consume atmospheric CO2.

International survey of bicycling exposure, crash involvement, behaviors, and attitudes: Preliminary results

This paper presents some results from preliminary analyses of the data of an international online survey of bicycle riders, who reported riding at least once a month. On 4 July 2015, data from 7528 participants from 17 countries was available in the survey, and were subsequently cleaned and checked for consistency. The median distance ridden ranged from 30 km/week in Israel to 150 km/week in Greece (overall median 54 km/week). City/hybrid bicycles were the most common type of bicycle ridden (44%), followed by mountain (20%) and road bikes (15%). Almost half (47%) of the respondents rode “nearly daily”. About a quarter rode daily to work or study (27%). Overall, 40% of respondents reported wearing a helmet ‘always’, varying from 2% in the Netherlands to 80% in Norway, while 25% reported ‘never’ wearing a helmet. Thus, individuals appeared to consistently either use or not use helmets. Helmet wearing rates were generally higher when riding for health/fitness than other purposes and appeared to be little affected by the type of riding location, but some divergences in these patterns were found among countries. Almost 29% of respondents reported being involved in at least one bicycle crash in the last year (ranging from 12% in Israel to 53% in Turkey). Among the most severe crashes for each respondent, about half of the crashes involved falling off a bicycle. Just under 10% of the most severe crashes for each respondent were reported to police. Among the bicycle-motor vehicle crashes, only a third were reported to police. Further analyses will address questions regarding the influence of factors such as demographic characteristics, type of bicycle ridden, and attitudes on both bi-cycle use and helmet wearing rates.

4,6,8,10,16-Penta- and 4,6,8,10,16,18-hexamethyldocosanes from the cane beetle Antitrogus parvulus - Cuticular hydrocarbons with unprecedented structure and stereochemistry

The major cuticular hydrocarbons from the cane beetle species Antitrogus parvulus were deduced to be 4,6,8,10,16,18-hexa- and 4,6,8,10,16- pentamethyldocosanes 2 and 3, respectively. Isomers of 2,4,6,8-tetramethylundecanal 27, 36, and 37, derived from 2,4,6-trimethylphenol, were coupled with the phosphoranes 28 and 29 to furnish alkenes and, by reduction, diastereomers of 2 and 3. Chromatographic and spectroscopic comparisons confirmed 2 as either 6a or 6b and 3 as either 34a or 34b.

Pronounced genetic population structure in a potentially vagile fish species (Pristipomoides multidens, Teleostei; Perciformes; Lutjanidae) from the East Indies triangle

The East Indies triangle, bordered by the Phillipines, Malay Peninsula and New Guinea, has a high level of tropical marine species biodiversity. Pristipomoides multidens is a large, long-lived, fecund snapper species that is distributed throughout the East Indies and Indo-Pacific. Samples were analysed from central and eastern Indonesia and northern Australia to test for genetic discontinuities in population structure. Fish (n = 377) were collected from the Indonesian islands of Bali, Sumbawa, Flores, West Timor, Tanimbar and Tual along with 131 fish from two northern Australian locations (Arafura and Timor Seas) from a previous study. Genetic variation in the control region of the mitochondrial genome was assayed using restriction fragment length polymorphism and direct sequencing. Haplotype diversity was high (0.67-0.82), as was intraspecific sequence divergence (range 0-5.8%). FST between pairs of populations ranged from 0 to 0.2753. Genetic subdivision was apparent on a small spatial scale; FST was 0.16 over 191 km (Bali/Sumbawa) and 0.17 over 491 km (Bali/Flores). Constraints to dispersal that contribute to, and maintain, the observed degree of genetic subdivision are experienced presumably by all life history stages of this tropical marine finfish. The constraints may include (1) little or no movement of eggs or larvae, (2) little or no home range or migratory movement of adults and (3) loss of larval cohorts due to transport of larvae away from suitable habitat by prevailing currents