Measuring the global burden of disease and epidemiological transitions: 2002-2030

Any planning process for health development ought to be based on a thorough understanding of the health needs of the population. This should be sufficiently comprehensive to include the causes of premature death and of disability, as well as the major risk factors that underlie disease and injury. To be truly useful to inform health-policy debates, such an assessment is needed across a large number of diseases, injuries and risk factors, in order to guide prioritization. The results of the original Global Burden of Disease Study and, particularly, those of its 2000-2002 update provide a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability: the disability-adjusted life-year (DALY). Globally, it appears that about 5 6 million deaths occur each year, 10. 5 million (almost all in poor countries) in children. Of the child deaths, about one-fifth result from perinatal causes such as birth asphyxia and birth trauma, and only slightly less from lower respiratory infections. Annually, diarrhoeal diseases kill over 1.5 million children, and malaria, measles and HIV/AIDS each claim between 500,000 and 800,000 children. HIV/AIDS is the fourth leading cause of death world-wide (2.9 million deaths) and the leading cause in Africa. The top three causes of death globally are ischaemic heart disease (7.2 million deaths), stroke (5.5 million) and lower respiratory diseases (3.9 million). Chronic obstructive lung diseases (COPD) cause almost as many deaths as HIV/AIDS (2.7 million). The leading causes of DALY, on the other hand, include causes that are common at young ages [perinatal conditions (7. 1 % of global DALY), lower respiratory infections (6.7%), and diarrhoeal diseases (4.7%)] as well as depression (4.1%). Ischaemic heart disease and stroke rank sixth and seventh, retrospectively, as causes of global disease burden, followed by road traffic accidents, malaria and tuberculosis. Projections to 2030 indicate that, although these major vascular diseases will remain leading causes of global disease burden, with HIV/AIDS the leading cause, diarrhoeal diseases and lower respiratory infections will be outranked by COPD, in part reflecting the projected increases in death and disability from tobacco use.

Reliability and validity of arm volume measurements for assessment of lymphedema

Background and Purpose. Arm lymphedema following breast cancer In this study, we assessed the surgery is a continuing problem. reliability and validity of circumferential measurements and water displacement for measuring upper-limb volume. Subjects. Participants included subjects who had had breast cancer surgery, including axillary dissection-19 with and 22 without a diagnosis of arm lymphedema-and 25 control subjects. Methods. Two raters measured each subject by using circumferential tape measurements at specified distances from the fingertips and in relation to anatornic landmarks and by using water displacement. Interrater reliability was calculated by analysis of variance and multilevel modeling. Volumes from circumferential measurements were compared with those from water displacement by use of means and correlation coefficients, respectively. The standard error of measurement, minimum detectable change (MDC), and limits of agreement (LOA) for volumes also were calculated. Results. Arm volumes obtained with these methods had high reliability. Compared with volumes from water displacement, volumes from circumferential measurements had high validity, although these volumes were slightly larger. Expected differences between subjects with and without clinical lymphedema following breast cancer were found. The MDC of volumes or the error associated with a single measure for data based oil anatomic landmarks was lower than that based oil distance from fingertips. The mean LOA with water displacement were lower for data based on anatomic landmarks than for data based on distance from fingertips. Discussion and Conclusion. Volumes calculated from anatomic landmarks are reliable, valid, and more accurate than those obtained from circumferential measurements based on distance from fingertips.

Using context and preferences to implement self-adapting pervasive computing applications

Applications that exploit contextual information in order to adapt their behaviour to dynamically changing operating environments and user requirements are increasingly being explored as part of the vision of pervasive or ubiquitous computing. Despite recent advances in infrastructure to support these applications through the acquisition, interpretation and dissemination of context data from sensors, they remain prohibitively difficult to develop and have made little penetration beyond the laboratory. This situation persists largely due to a lack of appropriately high-level abstractions for describing, reasoning about and exploiting context information as a basis for adaptation. In this paper, we present our efforts to address this challenge, focusing on our novel approach involving the use of preference information as a basis for making flexible adaptation decisions. We also discuss our experiences in applying our conceptual and software frameworks for context and preference modelling to a case study involving the development of an adaptive communication application.

Danger zones and hot spots: Traversing Canadian and Australian narratives of urban multiculturalism

The ethnicity of urban space has long been an element in the burgeoning discourse of national multiculturalisms; so much so that spatial theorist Edward Soja uses the term “ethni-city” to speak of so-called postmodern or postcolonial urban geographies (239). In our focus on the urban, we point to both the conceptual and material thresholds of multiculturalism within the borders of the city, as well as the internal urban/suburban borders that delineate belonging. These are often as strongly patrolled as larger national borders. In taking up Sneja Gunew’s call in Haunted Nations for comparative and critical work on multiculturalisms, this paper offers preliminary and exploratory avenues and points of departure, and aims to particularise the multicultural as an encounter and experience that is regulated spatially and corporeally.

Climate and causation in the Swedish Iron Age : Learning from the present to understand the past

The paper reassesses the role of climate as a factor shaping changes in settlement and landscape in the Swedish Iron Age (500 BC to AD 1050). Two reasons motivate this re-evaluation. First, high-resolution data based on climate proxies from the natural sciences are now increasingly available. Second, the climate-related social sciences have yielded conceptual and theoretical developments regarding vulnerability and adaptability in the present and recent past, creating new ways to analyse the effects of climatic versus societal factors on societies in the more distant past. Recent research in this field is evaluated and the explicitly climate deterministic standpoint of many recent natural science texts is criticized. Learning from recent approaches to climate change in the social sciences is crucial for understanding society–climate relationships in the past. The paper concludes that we are not yet in a position to fully evaluate the role of the new evidence of abrupt climate change in 850 BC, at the beginning of the Iron Age. Regarding the crisis in the mid first millennium AD, however, new climate data indicate that a dust veil in AD 536–537 might have aggravated the economic and societal crisis known from previous research.

A risk-based model for inspection and maintenance of cross-country petroleum pipeline

The existing method of pipeline health monitoring, which requires an entire pipeline to be inspected periodically, is both time-wasting and expensive. A risk-based model that reduces the amount of time spent on inspection has been presented. This model not only reduces the cost of maintaining petroleum pipelines, but also suggests efficient design and operation philosophy, construction methodology and logical insurance plans. The risk-based model uses Analytic Hierarchy Process (AHP), a multiple attribute decision-making technique, to identify the factors that influence failure on specific segments and analyzes their effects by determining probability of risk factors. The severity of failure is determined through consequence analysis. From this, the effect of a failure caused by each risk factor can be established in terms of cost, and the cumulative effect of failure is determined through probability analysis. The technique does not totally eliminate subjectivity, but it is an improvement over the existing inspection method.

The spacing and timing of [a chic] critique

This rejoinder reflects an important step, for me, in a preoccupation with methodology that has provided me with many hours of enjoyable reading, not to mention anxiety. For me the ‘reality’ of the incommensurable nature of paradigms and acceptance of the legitimacy of a range of conceptual and philosophical traditions came late. As a constructionist I find myself on the ‘anything goes’ end of methodology choice. This paper and my main paper ought not to be read as a critique of ‘middle range’ theory, but as a critique of an important and necessary aspect of the way we all seek to inscribe facts and structure our writing. What follows is a reflection of the influence Bruno Latour’s writings have had on my ways of seeing and perhaps an unhealthy emphasis on the small things that combine to produce convincing arguments and ‘facts’.

Contextualising accounts of illness:Notions of responsibility and blame in white and South Asian respondents' accounts of diabetes causation

We undertook a secondary analysis of in-depth interviews with white (n = 32) and Pakistani and Indian (n = 32) respondents who had type 2 diabetes, which explored their perceptions and understandings of disease causation. We observed subtle, but important, differences in the ways in which these respondent groups attributed responsibility and blame for developing the disease. Whereas Pakistani and Indian respondents tended to externalise responsibility, highlighting their life circumstances in general and/or their experiences of migrating to Britain in accounting for their diabetes (or the behaviours they saw as giving rise to it), white respondents, by contrast, tended to emphasise the role of their own lifestyle 'choices' and 'personal failings'. In seeking to understand these differences, we argue for a conceptual and analytical approach which embraces both micro- (i.e. everyday) and macro- (i.e. cultural) contextual factors and experiences. In so doing, we provide a critique of social scientific studies of lay accounts/understandings of health and illness. We suggest that greater attention needs to be paid to the research encounter (that is, to who is looking at whom and in what circumstances) to understand the different kinds of contexts researchers have highlighted in presenting and interpreting their data. © 2007 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Undue influence and the family home

This book provides a comprehensive analysis of the doctrine of undue influence in the context of the family home and fully incorporates the recent House of Lords ruling in Royal Bank of Scotland v Etridge (No 2) (2001). It is aimed predominantly at the legal practitioner, but will also act as a useful source of reference for academics and students of contract, land law and equity and trusts. Emphasis is placed on claims brought by spouses (usually the wife) seeking to set aside a charge over the matrimonial home made in favour of a lending institution. The role of lenders in this context is also examined in depth, as is the part played by the solicitor acting on behalf of the parties. Apart from providing an exposition of the doctrine and its key elements, the book also gives a broader outlook by examining the Commonwealth experience (notably in Australia, Canada and New Zealand) and suggesting an underlying concept of unconscionability as governing undue influence claims. There is also a separate chapter on remedies, as well as an appendix containing a number of draft pleadings for use by the legal practitioner. In the foreword, the Honourable Mr Justice Neuberger writes: 'Pawlowski and Brown are to be congratulated for having produced a book ...as comprehensive and user-friendly as this volume. Not only have they considered the effect of the authorities in a clear and logical way, but they have also highlighted problems which have yet to be resolved and questions which have yet to be answered ...one of the hallmarks of a good legal book.'

The European Union and the racialization of immigration, 1985-2006

Over the past two decades, the European Union (EU) has played an increasingly influential role in the construction of a de facto common immigration and asylum policy, providing a forum for policy-formulation beyond the scrutiny of national parliaments. The guiding principles of this policy include linking the immigration portfolio to security rather than justice; reaffirming the importance of political, conceptual and organizational borders; and attempting to transfer policing and processing functions to non-EU countries. The most important element, I argue, is the structural racialization of immigration that occurs across the various processes and which escapes the focus of much academic scrutiny. Exploring this phenomenon through the concept of the “racial state,” I examine ways to understand the operations of immigration policy-making at the inter-governmental level, giving particular attention to the ways in which asylum-seekers emerge as a newly racialized group who are both stripped of their rights in the global context and deployed as Others in the construction of national narratives.

Switching and generation of ultrashort pulses using all-fibre devices

Serial and parallel interconnection of photonic devices is integral to the construction of any all-optical data processing system. This thesis presents results from a series of experiments centering on the use of the nonlinear-optical loop mirror (NOLM) switch in architectures for the manipulation and generation of ultrashort pulses. Detailed analysis of soliton switching in a single NOLM and cascade of two NOLM's is performed, centering on primary limitations to device operation, effect of cascading on amplitude response, and impact of switching on the characteristics of incident pulses. By using relatively long input pulses, device failure due to stimulated Raman generation is postponed to demonstrate multiple-peaked switching for the first time. It is found that while cascading leads to a sharpening of the overall switching characteristic, pulse spectral and temporal integrity is not significantly degraded, and emerging pulses retain their essential soliton character. In addition, by including an asymmetrically placed in-fibre Bragg reflector as a wavelength selective loss element in the basic NOLM configuration, both soliton self-switching and dual-wavelength control-pulse switching are spectrally quantised. Results are presented from a novel dual-wavelength laser configuration generating pulse trains with an ultra-low rms inter-pulse-stream timing jitter level of 630fs enabling application in ultrafast switching environments at data rates as high as 130GBits/s. In addition, the fibre NOLM is included in architectures for all-optical memory, demonstrating storage and logical inversion of a 0.5kByte random data sequence; and ultrafast phase-locking of a gain-switched distributed feedback laser at 1.062GHz, the fourteenth harmonic of the system baseband frequency. The stringent requirements for environmental robustness of these architectures highlight the primary weaknesses of the NOLM in its fibre form and recommendations to overcome its inherent drawbacks are presented.

Sales manager problem resolution styles:measure development and an examination of their salesperson-related consequences

Personal selling and sales management play a critical role in the short and long term success of the firm, and have thus received substantial academic interest since the 1970s. Sales research has examined the role of the sales manager in some depth, defining a number of key technical and interpersonal roles which sales managers have in influencing sales force effectiveness. However, one aspect of sales management which appears to remain unexplored is that of their resolution of salesperson-related problems. This study represents the first attempt to address this gap by reporting on the conceptual and empirical development of an instrument designed to measure sales managers' problem resolution styles. A comprehensive literature review and qualitative research study identified three key constructs relating to sales managers' problem resolution styles. The three constructs identified were termed; sales manager willingness to respond, sales manager caring, and sales manager aggressiveness. Building on this, existing literature was used to develop a conceptual model of salesperson-specific consequences of the three problem resolution style constructs. The quantitative phase of the study consisted of a mail survey of UK salespeople, achieving a total sample of 140 fully usable responses. Rigorous statistical assessment of the sales manager problem resolution style measures was undertaken, and construct validity examined. Following this, the conceptual model was tested using latent variable path analysis. The results for the model were encouraging overall, and also with regard to the individual hypotheses. Sales manager problem resolution styles were found individually to have significant impacts on the salesperson-specific variables of role ambiguity, emotional exhaustion, job satisfaction, organisational commitment and organisational citizenship behaviours. The findings, theoretical and managerial implications, limitations and directions for future research are discussed.

Leadership and the negotiation of order in small groups

This thesis is focussed on the role differentiationhypothesis as it relates to small groups (Bales, 1958). The hypothesis is systematically examined, both conceptually and empirically, in the light of the Equilibrium Hypothesis (Bales, 1953) and the Negotiated Order Theory of leadership (e.g. Hosking, 1988). Chapter 1 sketches in a context for the research,which was stimulated by attempts during the 60s and 70s to organise small groups without leaders (the leaderless group, based on isocratic principles). Chapter 2 gives a conceptual and developmental overview of Bales' work, concentrating on the Equilibrium Hypothesis. It is argued that Bales' conceptual approach, if developed, can potentially integrate the disparate small groups and leadership literatures. Chapters 3 and 4 examine the concepts `group', `leader' and `leadership' in terms of the Negotiated Order perspective. In chapter 3 it is argued that two aspects of the concept group need to be taken separately into account; physical attributes and social psychological aspects (the metaphysical glue). It is further argued that a collection of people becomes a group only when they begin to establish a shared sense of social order. In chapter 4 it is argued that leadership is best viewed as a process of negotiation between those who influence and those who are influenced, in the context of shared values about means and ends. It is further argued that leadership is the process by which a shared sense of social order is established and maintained, thus linking the concepts `leadership' and `group' in a single formulation. The correspondences with Bales' approach are discussed at the end of the chapter. Chapters 5 to 8 present a detailed critical description and evaluation of the empirical work which claims to show role differentiation or test the hypothesis, both Bales original work and subsequent studies. It is argued here, that the measurement and analytical procedures adopted by Bales and others, in particular the use of simple means as summaries of group structures, are fundamentally flawed, and that role differentiation in relation to particular identifiable groups has not been demonstrated clearly anywhere in the literature. Chapters 9 to 13 present the empirical work conducted for the thesis. 18 small groups are examined systematically for evidence of role differentiation using an approach based on early sociometry (Moreno, 1934). The results suggest that role differentiation, as described by Bales, does not occur as often as is implied in the literature, and not equivocally in any case. In particular structures derived from Liking are typically distributed or weak. This suggests that one of Bales' principal findings, that Liking varies independently of his other main dimensions, is the product of statistical artifact. Chapter 14 presents a general summary of results and presents some considerations about future research.

Consumer responses to really new products: examining the impacts of learning strategies and presentation formats on product comprehension and attitude formation

Mental simulations and analogies have been identified as powerful learning tools for RNPs. Furthermore, visuals in advertising have recently been conceptualized as meaningful sources of information as opposed to peripheral cues and thus may help consumers learn about RNPs. The study of visual attention may also contribute to understanding the links between conceptual and perceptual analyses when learning for a RNP. Two conceptual models are developed. the first model consists of causal relationships between the attributes of advertising stimuli for RNPs and consumer responses, as well as mediating influences. The second model focuses on the role of visual attention in product comprehension as a response to advertising stimuli. Two experiments are conducted: a Web-Experiment and an eye-tracking experiment. The first experiment (858 subjects) examines the effect of learning strategies (mental simulation vs. analogy vs. no analogy/no mental simulation) and presentation formats (words vs. pictures) on individual responses. The mediating role of emotions is assessed. The second experiment investigates the effect of learning strategies and presentation formats on product comprehension, along with the role of attention (17 subjects). The findings from experiment 1 indicate that learning strategies and presentation formats can either enhance or undermine the effect of advertising stimuli on individual responses. Moreover, the nature of the product (i.e. hedonic vs. utilitarian vs. hybrid) should be considered when designing communications for RNPs. The mediating role of emotions is verified. Experiment 2 suggests that an increase in attention to the message may either reflect enhanced comprehension or confusion.