Estimates of global and regional potential health gains from reducing multiple major risk factors

Background Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. Methods We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Results Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Interpretation Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions, The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.

Telehealth responses to bio-terrorism and emerging infections

Emerging infectious diseases, such as severe acute respiratory syndrome (SARS), are of huge economic importance. They are difficult to predict. The World Health Organization has a Global Outbreak Alert and Response Network, which was involved at an early stage in the SARS outbreak in 2003. Three major lessons were learned as a result of the SARS epidemic in 2003, involving communication, evidence-based action and global partnerships. It is proposed that a series of broadband global response networks should be developed. At a technical level the networks are essentially in place, such as the Internet2 global network. Suitable peripheral devices also exist. What has not yet been created is the appropriate software to allow the use of these networks, although a number of commercial products are in the process of development.

Modeling diffraction in free-space optical interconnects by the mode expansion method

Free-space optical interconnects (FSOIs), made up of dense arrays of vertical-cavity surface-emitting lasers, photodetectors and microlenses can be used for implementing high-speed and high-density communication links, and hence replace the inferior electrical interconnects. A major concern in the design of FSOIs is minimization of the optical channel cross talk arising from laser beam diffraction. In this article we introduce modifications to the mode expansion method of Tanaka et al. [IEEE Trans. Microwave Theory Tech. MTT-20, 749 (1972)] to make it an efficient tool for modelling and design of FSOIs in the presence of diffraction. We demonstrate that our modified mode expansion method has accuracy similar to the exact solution of the Huygens-Kirchhoff diffraction integral in cases of both weak and strong beam clipping, and that it is much more accurate than the existing approximations. The strength of the method is twofold: first, it is applicable in the region of pronounced diffraction (strong beam clipping) where all other approximations fail and, second, unlike the exact-solution method, it can be efficiently used for modelling diffraction on multiple apertures. These features make the mode expansion method useful for design and optimization of free-space architectures containing multiple optical elements inclusive of optical interconnects and optical clock distribution systems. (C) 2003 Optical Society of America.

Tool support for testing concurrent Java components

Concurrent programs are hard to test due to the inherent nondeterminism. This paper presents a method and tool support for testing concurrent Java components. Too[ support is offered through ConAn (Concurrency Analyser), a too] for generating drivers for unit testing Java classes that are used in a multithreaded context. To obtain adequate controllability over the interactions between Java threads, the generated driver contains threads that are synchronized by a clock. The driver automatically executes the calls in the test sequence in the prescribed order and compares the outputs against the expected outputs specified in the test sequence. The method and tool are illustrated in detail on an asymmetric producer-consumer monitor. Their application to testing over 20 concurrent components, a number of which are sourced from industry and were found to contain faults, is presented and discussed.

Document retrieval for e-mail search and discovery using Formal Concept Analysis

This paper discusses a document discovery tool based on Conceptual Clustering by Formal Concept Analysis. The program allows users to navigate e-mail using a visual lattice metaphor rather than a tree. It implements a virtual. le structure over e-mail where files and entire directories can appear in multiple positions. The content and shape of the lattice formed by the conceptual ontology can assist in e-mail discovery. The system described provides more flexibility in retrieving stored e-mails than what is normally available in e-mail clients. The paper discusses how conceptual ontologies can leverage traditional document retrieval systems and aid knowledge discovery in document collections.

Assessing forest fire as a potential PCDD/F source in Queensland, Australia

Forest fires are suggested as a potential and significant source of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs), even though no studies to date provide sufficient evidence to confirm forest fires as a source of PCDD/Fs. Recent investigations in Gueensland, Australia have identified a widespread contamination of PCDDs (in particular OND) in soils and sediments in the coastal region from an unknown source of PCDD/Fs. Queensland is predominately rural; it has few known anthropogenic sources of PCDD/Fs, whereas forest fires are a frequent occurrence. This study was conducted to assess forest fires as a potential source of the unknown PCDD/F contamination in Queensland. A combustion experiment was designed to assess the overall mass of PCDD/Fs before and after a simulated forest fire. The results from this study did not identify an increase in Sigma-PCDD/Fs or OCDD after the combustion process. However, specific non-2,3,7,8 substituted lower chlorinated PCDD/Fs were elevated after the combustion process, suggesting formation from a precursor. The results from this study indicate that forest fires are unlikely to be the source of the unknown PCDD contamination in Gueensland, rather they are a key mechanism for the redistribution of PCDD/Fs from existing sources and precursors.

Induction in the timed interval calculus

The Timed Interval Calculus, a timed-trace formalism based on set theory, is introduced. It is extended with an induction law and a unit for concatenation, which facilitates the proof of properties over trace histories. The effectiveness of the extended Timed Interval Calculus is demonstrated via a benchmark case study, the mine pump. Specifically, a safety property relating to the operation of a mine shaft is proved, based on an implementation of the mine pump and assumptions about the environment of the mine. (C) 2002 Elsevier Science B.V. All rights reserved.

Reliability of moderate-intensity and vigorous physical activity stage of change measures for young adults

Background. The purpose of this study was to examine the reliability of stage of change (SOC) measures for moderate-intensity and vigorous physical activity in two separate samples of young adults. Staging measures have focused on vigorous exercise, but current public health guidelines emphasize moderate-intensity activity. Method. For college students in the USA (n = 105) and in Australia (n = 123), SOC was assessed separately on two occasions for moderate-intensity activity and for vigorous activity. Test-retest repeatability was determined, using Cohen's kappa coefficient. Results. In both samples, the reliability scores for the moderate-intensity physical activity staging measure were lower than the scores for the vigorous exercise staging measure. Weighted kappa values for the moderate-intensity staging measure were in the fair to good range for both studies (0.50 and 0.45); for the vigorous staging measure kappa values were excellent and fair to good (0.76 and 0.72). Conclusions. There is a need to standardize and improve methods for staging moderate-intensity activity, given that such measures are used in public health interventions targeting HEPA (health-enhancing physical activity). (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.

A global health problem caused by arsenic from natural sources

Arsenic is a carcinogen to both humans and animals. Arsenicals have been associated with cancers of the skin, lung, and bladder. Clinical manifestations of chronic arsenic poisoning include non-cancer end point of hyper- and hypo-pigmentation, keratosis, hypertension, cardiovascular diseases and diabetes. Epidemiological evidence indicates that arsenic concentration exceeding 50 mug l(-1) in the drinking water is not public health protective. The current WHO recommended guideline value for arsenic in drinking water is 10 mug l(-1), whereas many developing countries are still having a value of 50 mug 1(-1). It has been estimated that tens of millions of people are. at risk exposing to excessive levels of arsenic from both contaminated water and arsenic-bearing coal from natural sources. The global health implication and possible intervention strategies were also discussed in this review article. (C) 2003 Elsevier Ltd. All rights reserved.