Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: Quantifying the epidemiological transition

Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6–6·6), from 65·3 years (65·0–65·6) in 1990 to 71·5 years (71·0–71·9) in 2013, HALE at birth rose by 5·4 years (4·9–5·8), from 56·9 years (54·5–59·1) to 62·3 years (59·7–64·8), total DALYs fell by 3·6% (0·3–7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6–29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non–communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Interpretation Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition—in which increasing sociodemographic status brings structured change in disease burden—is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.

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.

Gene patent practice across plant and human genomes

The uses of genetic sequences to inform, enable or create products or services for human biomedicine are substantially different from their uses in crop-based agriculture. Here, we explore what similarities and differences may emerge in patent use and strategies, and map patent-disclosed sequences onto three important plant genomes: maize (corn), rice and soybean. We focus on those referenced in the granted patent claims to compare their uses to the approach used in human gene patenting.

Public disclosure of biological sequences in global patent practice

Biological sequences are an important part of global patenting, with unique challenges for their effective and equitable use in practice and in policy. Because their function can only be determined with computer-aided technology, the form in which sequences are disclosed matters greatly. Similarly, the scope of patent rights sought and granted requires computer readable data and tools for comparison. Critically, the primary data provided to the national patent offices and thence to the public, must be comprehensive, standardized, timely and meaningful. It is not yet. The proposed global Patent Sequence (PatSeq) Data platform can enable national and regional jurisdictions meet the desired standards.

The ownership question of plant gene and genome intellectual properties

The restructuring of the crop agriculture industry over the past two decades has enabled patent holders to exclude, prevent and deter others from using certain research tools and delay or block further follow-on inventions

SU-8-Based Microchips for Capillary Electrophoresis and Electrospray Ionization Mass Spectrometry

Miniaturization of analytical instrumentation is attracting growing interest in response to the explosive demand for rapid, yet sensitive analytical methods and low-cost, highly automated instruments for pharmaceutical and bioanalyses and environmental monitoring. Microfabrication technology in particular, has enabled fabrication of low-cost microdevices with a high degree of integrated functions, such as sample preparation, chemical reaction, separation, and detection, on a single microchip. These miniaturized total chemical analysis systems (microTAS or lab-on-a-chip) can also be arrayed for parallel analyses in order to accelerate the sample throughput. Other motivations include reduced sample consumption and waste production as well as increased speed of analysis. One of the most promising hyphenated techniques in analytical chemistry is the combination of a microfluidic separation chip and mass spectrometer (MS). In this work, the emerging polymer microfabrication techniques, ultraviolet lithography in particular, were exploited to develop a capillary electrophoresis (CE) separation chip which incorporates a monolithically integrated electrospray ionization (ESI) emitter for efficient coupling with MS. An epoxy photoresist SU-8 was adopted as structural material and characterized with respect to its physicochemical properties relevant to chip-based CE and ESI/MS, namely surface charge, surface interactions, heat transfer, and solvent compatibility. As a result, SU-8 was found to be a favorable material to substitute for the more commonly used glass and silicon in microfluidic applications. In addition, an infrared (IR) thermography was introduced as direct, non-intrusive method to examine the heat transfer and thermal gradients during microchip-CE. The IR data was validated through numerical modeling. The analytical performance of SU-8-based microchips was established for qualitative and quantitative CE-ESI/MS analysis of small drug compounds, peptides, and proteins. The CE separation efficiency was found to be similar to that of commercial glass microchips and conventional CE systems. Typical analysis times were only 30-90 s per sample indicating feasibility for high-throughput analysis. Moreover, a mass detection limit at the low-attomole level, as low as 10E+5 molecules, was achieved utilizing MS detection. The SU-8 microchips developed in this work could also be mass produced at low cost and with nearly identical performance from chip to chip. Until this work, the attempts to combine CE separation with ESI in a chip-based system, amenable to batch fabrication and capable of high, reproducible analytical performance, have not been successful. Thus, the CE-ESI chip developed in this work is a substantial step toward lab-on-a-chip technology.

Bismuth tungsten-oxide bronzes - a study of intergrowth phases and related aspects

Reaction of bismuth metal with WO$_3$ in the absence of oxygen yields interesting bronze-like phases. From analytical electron microscopy and X-ray photoelectron spectroscopy, the product phases are found to have the general composition Bi$_x$ WO$_3$ with bismuth in the 3+ state. Structural investigations made with high resolution electron micrscopy and cognate techniques reveal that when x < 0.02, a perovskite bronze is formed. When x $\geqslant$ 0.02, however, intergrowth tungsten bronzes (i.t.b.) containing varying widths of the WO$_3$ slab are formed, the lattice periodicity being in the range 2.3-5.1 nm in a direction perpendicular to the WO$_3$ slabs. Image-matching studies indicate that the bismuth atoms are in the tunnels of the hexagonal tungsten bronze (h.t.b.) strips and the h.t.b. strips always remain one-tunnel wide. Annealed samples show a satellite structure around the superlattice spots in the electron diffraction patterns, possibly owing to ordering of the bismuth atoms in the tunnels. The i.t.b. phases show recurrent intergrowths extending up to 100 nm in several crystals. The periodicity varies considerably within the same crystal wherever there is disordered intergrowth, but unit cell dimensions can be assigned from X-ray and electron diffraction patterns. The maximum value of x in the i.t.b. phases is ca. 0.07 and there is no evidence for the i.t.b. phase progressively giving way to the h.t.b. phase with increase in x. Hexagonal tungsten bronzes that contain bismuth with x up to 0.02 can be formed by starting from hexagonal WO$_3$, but the h.t.b. phase seems to be metastable. Optical, magnetic and electron transport properties of the i.t.b. phases have been measured and it appears that the electrons become itinerant when x > 0.05.

What is racism? Othering, prejudice and hate-motivated violence

The paper’s concern is the current difficulty, in journalism, the academy and politics, of discussing questions to do with race, ethnicity, difference and immigration because of the fear of being called a racist. It starts with an analysis of biographical interview data drawn from fifteen people who had variously acquired the label racist and who were part of a small-scale study into racism in the Midlands city of Stoke-on-Trent, UK conducted between 2003 and 2005. The interviews used the free association narrative interview method. This analysis revealed that most people do not consider themselves racist and that having a conviction for a racially aggravated offence or being a member of a far right organisation was not able to differentiate racists from non-racists. It also revealed a spectrum of attitudes towards immigrants or particular ethnic groups: strong expressions of hatred at one end of the spectrum; strong prejudicial feelings in the middle; and a feeling that ‘outsider’ groups should not benefit at the expense of ‘insiders’ (called ‘othering’) at the other end. The turn to theory for assistance revealed that, although hatred, prejudice and ‘othering’ are not the same thing, and do not have the same origins, they have become elided. This is primarily because cognitive psychology’s hostility to psychoanalysis marginalised hatred whilst its exclusive preoccupation with prejudice came effectively to define racism at the individual level. Progress in thinking about racism might consist of abolishing the term and returning to thinking about hatred, prejudice and ‘othering’ separately.

A subculture of mental toughness in an Australian Football League club

Objective The current study aimed to provide a subcultural analysis of mental toughness in a high-performance context in sport. Design Using Schein's (1990) framework of organisational culture, an exploratory qualitative analysis, employing focus group and individual interviews, was used to investigate mental toughness in an Australian Football League club. Method Nine senior coaches and players participated in focus group and individual interviews. Photo elicitation was used as a method to capture mental toughness through the identification of prominent club artefacts. Participants were considered to have significant subcultural knowledge of their football club and were willing to describe personal experiences and perceptions of mental toughness through this cultural lens. Deductive and inductive analyses were conducted to capture the core themes of mental toughness across the disparate levels of Schein's organisational framework. Results Mental toughness was found to be a socially derived term marked by unrelenting standards and sacrificial displays. These acts were underpinned by subcultural values emphasising a desire for constant improvement, a team first ethos, relentless effort, and the maintenance of an infallible image. At its core, mental toughness was assumed to be an internal concept, epitomised an idealised form of masculinity, elitist values, and was rhetorically depicted through metaphors of war. Conclusions It may be difficult to understand mental toughness without giving attention to the contextual norms related to the term. Appreciating how people promote, instil, and internalise prized ideals coveted as mental toughness could be intriguing for future research in sport psychology.

Spontaneous fermentation of traditional sago starch in Papua New Guinea

Sago starch is an important dietary carbohydrate in lowland Papua New Guinea (PNG). An investigation was conducted to determine whether microbes play a role in its preservation using traditional methods. In 12 stored sago samples collected from PNG villages, lactic acid bacteria (LAB) were present (>= 3.6 x 10(4) cfu/g) and pH ranged from 6.8 to 4.2. Acetic and propionic acids were detected in all samples, while butyric, lactic and valeric acids were present in six or more. In freshly prepared sago, held in sealed containers in the laboratory at 30 degrees C, spontaneous fermentation by endogenous microflora of sago starch was observed. This was evident by increasing concentrations of acetic, butyric and lactic acids over 4 weeks, and pH reducing from 4.9 to 3.1: both LAB and yeasts were involved. Survival of potential bacterial pathogens was monitored by seeding sago starch with similar to 10(4)/g of selected organisms. Numbers of Bacillus cereus, Listeria monocytogenes and Staphylococcus aureus fell to <30/g within 7 days. Salmonella sp. was present only in low numbers after 7 days (<36/g), but Escherichia coli was still detectable after three weeks (>10(2)/g). Fermentation appeared to increase the storability and safety of the product.

Kehittäjä-interventionistien peiliaineistokäytännöt muutoslaboratoriohankkeissa : Narratiivit käyttäjätiedon välittäjänä

This research has its background on Knowledge Practices Laboratory (KP-Lab) research project. One of the aims of KP-Lab is to create virtual and technological tools to support the interventionist who use the Change Laboratory method as a developmental tool. In this research I studied the interventionists' mirror material practices which are context and theory bound and for that reason they pose challenges on the development of new tools. I focused on the gathering and working on the mirror material. The purpose of this study was to find out what kind of user knowledge does the research on narratives of mirror material practices in Change Laboratory provide to the developers of virtual tools? I answered this question by three sub questions: 1. What kind of mirror material the interventionists gather and analyze in different phases of developmental cycle of Change Laboratory project? 2. What kind of knowledge the different mirror materials contain and how is the knowledge transformed when the mirror material is analyzed and worked on? 3. What kind of tools the interventionists use and create when gathering and working on the mirror material? What wishes do the interventionists have on tools? I interviewed five interventionists in four different projects. I created narratives from the document supported interviews. Then I analyzed the narratives in three steps: first I placed the mirror materials in the developmental cycle. Secondly, I analyzed the mirror materials by placing them in a table by the form of the knowledge. Thirdly, I examined the tools the interventionists had used and created and what wishes they had on virtual tools. This research showed that different user groups of Change Laboratory method have different needs. All interventionists transform knowledge from one form to another so they seem to need especially tools by which they can analyze and transform knowledge. It seems that standardized model of gathering and analysing mirror material is not meaningful because mirror material is constructed in accordance with the object developed. This research also shows that the mirror material has a social function. This finding should be also noted when developing virtual tools together with actual users.

Personality in sport and exercise psychology: Integrating a whole person perspective

This paper draws on contemporary views in personality psychology as a means for understanding people participating in sport and physical activity. Specifically, we focus on McAdams’ integrative framework [McAdams (2013). The psychological self as actor, agent, and author. Perspectives on Psychological Science, 8, 272–295; McAdams & Pals (2006). A new big five: Fundamental principles for an integrative science of personality. American Psychologist, 61, 204–217] and suggest this framework as potentially generative in the field of sport and exercise psychology. McAdams indicates that people can be defined through three layers of understanding, incorporating (a) dispositional traits, (b) characteristic adaptations, and (c) narrative identities. Together these layers provide a vision of the whole person – a perspective of personality rarely adopted by the sport and exercise community. The aim of this paper is to introduce scholars and practitioners to the potential benefits of embracing this whole person outlook, and to discuss the opportunities and challenges McAdams’ framework may have for advancing scholarship in sport and exercise psychology.

Superstructures exhibited by oxides of the aurivillius family, (Bi2O2)2+ (Anâ 1BnO3n+1)2â

Bi5Ti3FeO15 and Bi7Ti3Fe3O21 which are n=4 and n=6 members of the family of oxides of the general formula (Bi2O2)2+(An−1BnO3n+1)2− show unusual superstructures, possibly due to cation ordering. Bi5Ti3FeO15; Bi7Ti3Fe3O21; oxides.

Great Barrier Reef Fish Biological Data

Biological measurements on fish sampled during the course of FRDC funded project Growth, Reproduction and Recruitment of Great Barrier Reef Food Fish Stocks (FRDC 90/18). The comma-delimited ascii file comprises the following fields: 1. Cruise number 2. Date (d-m-y) 3, Region (descriptor of part of Queensland coast or Great Barrier Reef system) 4. Reef (name or number) 5. Data source (Res=research, Rec=recreational fisher, Com=commercial fisher) 6. Capture method 7. Trap number (where appropriate) 8. Species name 9. LthStd (standard length, cm) 10. LthFrk (fork length, cm) 11. LthTot (total length, cm) 12. WtTot (approx total weight, g; weighed at sea) 13. FrameWt (weight of frame [after filleting, with viscera], g; weighed in lab) 14. Sex (macroscopic examination only) 15. GonadWt (g) Data obtained by the Department Employment, Economic Development and Innovation (formerly Primary Industries and Fisheries) between 1988 and 1993, primarily in the southern Great Barrier Reef (Capricorn-Bunker and Swain Groups), with fish traps and handlining.