Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. METHODS We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. FINDINGS Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. INTERPRETATION Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.

Dynamics of contour, object and face processing in the human visual cortex

The neural basis of visual perception can be understood only when the sequence of cortical activity underlying successful recognition is known. The early steps in this processing chain, from retina to the primary visual cortex, are highly local, and the perception of more complex shapes requires integration of the local information. In Study I of this thesis, the progression from local to global visual analysis was assessed by recording cortical magnetoencephalographic (MEG) responses to arrays of elements that either did or did not form global contours. The results demonstrated two spatially and temporally distinct stages of processing: The first, emerging 70 ms after stimulus onset around the calcarine sulcus, was sensitive to local features only, whereas the second, starting at 130 ms across the occipital and posterior parietal cortices, reflected the global configuration. To explore the links between cortical activity and visual recognition, Studies II III presented subjects with recognition tasks of varying levels of difficulty. The occipito-temporal responses from 150 ms onwards were closely linked to recognition performance, in contrast to the 100-ms mid-occipital responses. The averaged responses increased gradually as a function of recognition performance, and further analysis (Study III) showed the single response strengths to be graded as well. Study IV addressed the attention dependence of the different processing stages: Occipito-temporal responses peaking around 150 ms depended on the content of the visual field (faces vs. houses), whereas the later and more sustained activity was strongly modulated by the observers attention. Hemodynamic responses paralleled the pattern of the more sustained electrophysiological responses. Study V assessed the temporal processing capacity of the human object recognition system. Above sufficient luminance, contrast and size of the object, the processing speed was not limited by such low-level factors. Taken together, these studies demonstrate several distinct stages in the cortical activation sequence underlying the object recognition chain, reflecting the level of feature integration, difficulty of recognition, and direction of attention.

Global banana disease management - getting serious with sustainability and food security

Much research in understanding plant diseases has been undertaken, but there has been insufficient attention given to dealing with coordinated approaches to preventing and managing diseases. A global management approach is essential to the long-term sustainability of banana production. This approach would involve coordinated surveys, capacity building in developing countries, development of disease outbreak contingency plans and coordinated quarantine awareness, including on-line training in impact risk assessment and web-based diagnostic software. Free movement of banana plants and products between some banana-producing countries is causing significant pressure on the ability to manage diseases in banana. The rapid spread of Fusarium oxysporum f. sp. cubense 'tropical race 4' in Asia, bacterial wilts in Africa and Asia and black leaf streak [Mycosphaerella fijiensis] in Brazil and elsewhere are cases in point. The impact of these diseases is devastating, severely cutting family incomes and jeopardising food security around the globe. Agreements urgently need to be reached between governments to halt the movement of banana plants and products between banana-producing countries before it is too late and global food security is irreparably harmed. Black leaf streak, arguably the most serious banana disease, has become extremely difficult to control in commercial plantations in various parts of the world. Sometimes in excess of 50 fungicide sprays have to be applied each year. Disease eradication and effective disease control is not possible because there is no control of disease inoculum in non-commercial plantings in these locations. Additionally, there have been enormous sums of money invested in international banana breeding programmes over many years only to see the value of hybrid products lost too soon. 'Goldfinger' (AAAB, syn. 'FHIA-01'), for example, has recently been observed severely affected by black leaf streak in Samoa. Resistant cultivars alone cannot be relied upon in the fight against this disease. Real progress in control may only come when the local communities are engaged and become actively involved in regional programmes. Global recommendations are long overdue and urgently needed to help ensure the long-term sustainable utilisation of the products of the breeding programmes.

Porn, censorship, classification and free speech: Global paradoxes in the governance of media content

In this presentation, I reflect upon the global landscape surrounding the governance and classification of media content, at a time of rapid change in media platforms and services for content production and distribution, and contested cultural and social norms. I discuss the tensions and contradictions arising in the relationship between national, regional and global dimensions of media content distribution, as well as the changing relationships between state and non-state actors. These issues will be explored through consideration of issues such as: recent debates over film censorship; the review of the National Classification Scheme conducted by the Australian Law Reform Commission; online controversies such as the future of the Reddit social media site; and videos posted online by the militant group ISIS.

Climate change, sustainable development and India: Global and national concerns

Climate change is one of the most important global environmental challenges, with implications for food production, water supply, health, energy, etc. Addressing climate change requires a good scientific understanding as well as coordinated action at national and global level. This paper addresses these challenges. Historically, the responsibility for greenhouse gas emissions' increase lies largely with the industrialized world, though the developing countries are likely to be the source of an increasing proportion of future emissions. The projected climate change under various scenarios is likely to have implications on food production, water supply, coastal settlements, forest ecosystems, health, energy security, etc. The adaptive capacity of communities likely to be impacted by climate change is low in developing countries. The efforts made by the UNFCCC and the Kyoto Protocol provisions are clearly inadequate to address the climate change challenge. The most effective way to address climate change is to adopt a sustainable development pathway by shifting to environmentally sustainable technologies and promotion of energy efficiency, renewable energy, forest conservation, reforestation, water conservation, etc. The issue of highest importance to developing countries is reducing the vulnerability of their natural and socio-economic systems to the projected climate change. India and other developing countries will face the challenge of promoting mitigation and adaptation strategies, bearing the cost of such an effort, and its implications for economic development.

Voltage and Temperature Scalable Gate Delay and Slew Models Including Intra-Gate Variations

We investigate the feasibility of developing a comprehensive gate delay and slew models which incorporates output load, input edge slew, supply voltage, temperature, global process variations and local process variations all in the same model. We find that the standard polynomial models cannot handle such a large heterogeneous set of input variables. We instead use neural networks, which are well known for their ability to approximate any arbitrary continuous function. Our initial experiments with a small subset of standard cell gates of an industrial 65 nm library show promising results with error in mean less than 1%, error in standard deviation less than 3% and maximum error less than 11% as compared to SPICE for models covering 0.9- 1.1 V of supply, -40degC to 125degC of temperature, load, slew and global and local process parameters. Enhancing the conventional libraries to be voltage and temperature scalable with similar accuracy requires on an average 4x more SPICE characterization runs.

Voltage and Temperature Scalable Gate Delay and Slew Models Including Intra-Gate Variations

We investigate the feasibility of developing a comprehensive gate delay and slew models which incorporates output load, input edge slew, supply voltage, temperature, global process variations and local process variations all in the same model. We find that the standard polynomial models cannot handle such a large heterogeneous set of input variables. We instead use neural networks, which are well known for their ability to approximate any arbitrary continuous function. Our initial experiments with a small subset of standard cell gates of an industrial 65 nm library show promising results with error in mean less than 1%, error in standard deviation less than 3% and maximum error less than 11% as compared to SPICE for models covering 0.9- 1.1 V of supply, -40degC to 125degC of temperature, load, slew and global and local process parameters. Enhancing the conventional libraries to be voltage and temperature scalable with similar accuracy requires on an average 4x more SPICE characterization runs.

Collaborative training program in coastal management in the Philippines: a local initiative with a global perspective

A collaborative project in developing a broad-based coastal management training program in the Philippines is being undertaken by a group of government and nongovernment agencies. It addresses the lack of expertise in planning an implementation for coastal management in the country. The process will be documented to serve as a guide in starting and maintaining the process of collaborative training in coastal management in the region. Other training initiatives are outlined including regional and global efforts.

Monitoring well-being and changing environmental conditions in coastal communities: development of an assessment method

The intersection of social and environmental forces is complex in coastal communities. The well-being of a coastal community is caught up in the health of its environment, the stability of its economy, the provision of services to its residents, and a multitude of other factors. With this in mind, the project investigators sought to develop an approach that would enable researchers to measure these social and environmental interactions. The concept of well-being proved extremely useful for this purpose. Using the Gulf of Mexico as a regional case study, the research team developed a set of composite indicators to be used for monitoring well-being at the county-level. The indicators selected for the study were: Social Connectedness, Economic Security, Basic Needs, Health, Access to Social Services, Education, Safety, Governance, and Environmental Condition. For each of the 37 sample counties included in the study region, investigators collected and consolidated existing, secondary data representing multiple aspects of objective well-being. To conduct a longitudinal assessment of changing wellbeing and environmental conditions, data were collected for the period of 2000 to 2010. The team focused on the Gulf of Mexico because the development of a baseline of well-being would allow NOAA and other agencies to better understand progress made toward recovery in communities affected by the Deepwater Horizon oil spill. However, the broader purpose of the project was to conceptualize and develop an approach that could be adapted to monitor how coastal communities are doing in relation to a variety of ecosystem disruptions and associated interventions across all coastal regions in the U.S. and its Territories. The method and models developed provide substantial insight into the structure and significance of relationships between community well-being and environmental conditions. Further, this project has laid the groundwork for future investigation, providing a clear path forward for integrated monitoring of our nation’s coasts. The research and monitoring capability described in this document will substantially help counties, local organizations, as well state and federal agencies that are striving to improve all facets of community well-being.

Synchronization in climate dynamics and other extended systems

Synchronization is now well established as representing coherent behaviour between two or more otherwise autonomous nonlinear systems subject to some degree of coupling. Such behaviour has mainly been studied to date, however, in relatively low-dimensional discrete systems or networks. But the possibility of similar kinds of behaviour in continuous or extended spatiotemporal systems has many potential practical implications, especially in various areas of geophysics. We review here a range of cyclically varying phenomena within the Earth's climate system for which there may be some evidence or indication of the possibility of synchronized behaviour, albeit perhaps imperfect or highly intermittent. The exploitation of this approach is still at a relatively early stage within climate science and dynamics, in which the climate system is regarded as a hierarchy of many coupled sub-systems with complex nonlinear feedbacks and forcings. The possibility of synchronization between climate oscillations (global or local) and a predictable external forcing raises important questions of how models of such phenomena can be validated and verified, since the resulting response may be relatively insensitive to the details of the model being synchronized. The use of laboratory analogues may therefore have an important role to play in the study of natural systems that can only be observed and for which controlled experiments are impossible. We go on to demonstrate that synchronization can be observed in the laboratory, even in weakly coupled fluid dynamical systems that may serve as direct analogues of the behaviour of major components of the Earth's climate system. The potential implications and observability of these effects in the long-term climate variability of the Earth is further discussed. © 2010 Springer-Verlag Berlin Heidelberg.

Analysis of Differential and Matching Methods for Optical Flow

Several algorithms for optical flow are studied theoretically and experimentally. Differential and matching methods are examined; these two methods have differing domains of application- differential methods are best when displacements in the image are small (<2 pixels) while matching methods work well for moderate displacements but do not handle sub-pixel motions. Both types of optical flow algorithm can use either local or global constraints, such as spatial smoothness. Local matching and differential techniques and global differential techniques will be examined. Most algorithms for optical flow utilize weak assumptions on the local variation of the flow and on the variation of image brightness. Strengthening these assumptions improves the flow computation. The computational consequence of this is a need for larger spatial and temporal support. Global differential approaches can be extended to local (patchwise) differential methods and local differential methods using higher derivatives. Using larger support is valid when constraint on the local shape of the flow are satisfied. We show that a simple constraint on the local shape of the optical flow, that there is slow spatial variation in the image plane, is often satisfied. We show how local differential methods imply the constraints for related methods using higher derivatives. Experiments show the behavior of these optical flow methods on velocity fields which so not obey the assumptions. Implementation of these methods highlights the importance of numerical differentiation. Numerical approximation of derivatives require care, in two respects: first, it is important that the temporal and spatial derivatives be matched, because of the significant scale differences in space and time, and, second, the derivative estimates improve with larger support.

The protection and security of vulnerable populations in complex emergencies using the Dadaab refugee camps in the north eastern province of Kenya as a case study

The past two decades has seen a dramatic upheaval in the international world order: the end of the Cold War, the 9/11 attacks and the subsequent 'War on Terror', increased Jihadist activities, the accelerated pace of globalization, climate change and the 2008 global financial crisis have contributed to fear, uncertainty, poverty, conflict, massive displacements of populations of asylum seekers and refugees globally and a proliferation of Protracted Refugee Situations (PRS), defined as situations in which refugees have been in exile 'for 5 years or more after their initial displacement, without immediate prospects for implementation of durable solutions. In the past two decades there has been a huge proliferation of these with more than 7.2 million refugees now trapped in these PRS, with a further 16 million internally displaced persons (IDPs) trapped in camps within their own countries. The Dadaab refugee complex in Kenya, which of as March 2012, holds over 463,000 refugees, is the most significant and extreme example in recent times of a PRS. It was established in 1991 following the collapse of the Somali Government of Dictator Siad Barre, and the disintegration of Somalia into the chaos that still exists today. PRS such as Dadaab raise particular issues about humanitarianism in terms of aid, protection, security, human rights and the actions (or inaction) of the various stakeholders on an international, national and local level. This thesis investigates these issues by the use of a case study methodology on Dadaab as a PRS, framed in the context of humanitarianism and in particular the issues that arise in terms of how the international community, the UN system and individual states provide assistance and protection to vulnerable populations. Although the refugee camps have been in existence (as of 2012) for over 20 years, there has never been such a detailed study of Dadaab (or any other PRS) undertaken to date and would be of interest to academics in the areas of international relations, refugee/migration studies and global Governance as well as practitioners in both humanitarian response and development

Evaluation of distortions in laser welded shipbuilding parts using local-global finite element approach

In recognition of the differences of scale between the welding pool and the heat affected zone along the welding line on one hand, and the overall size of the components being welded on the other, a local-global finite element approach was developed for the evaluation of distortions in laser welded shipbuilding parts. The approach involves the tandem use of a 'local' and a 'global' step. The local step involves a three-dimensional finite element model for the simulation of the laser welding process using the Sysweld finite element code, which takes into account thermal, metallurgical, and mechanical aspects. The simulation of the laser welding process was performed using a non-linear heat transfer analysis, based on a keyhole formation model, and a coupled transient thermomechanical analysis, which takes into account metallurgical transformations using the temperature dependent material properties and the continuous cooling transformation diagram. The size and shape of the keyhole used in the local finite element analysis was evaluated using a keyhole formation model and the Physica finite volume code. The global step involves the transfer of residual plastic strains and the stiffness of the weld obtained from the local model to the global analysis, which then provides the predicted distortions for the whole part. This newly developed methodology was applied to the evaluation of global distortions due to laser welding of stiffeners on a shipbuilding part. The approach has been proved reliable in comparison with experiments and of practical industrial use in terms of computing time and storage.

Influences of the Oceans on Human Health and Well-Being

Human health and well-being are tied to the vitality of the global ocean and coastal systems on which so many live and rely. We engage with these extraordinary environments to enhance both our health and our well-being. But, we need to recognize that introducing contaminants and otherwise altering these ocean systems can harm human health and well-being in significant and substantial ways. These are complex, challenging, and critically important themes. How the human relationship to the oceans evolves in coming decades may be one of the most important connections in understanding our personal and social well-being. Yet, our understanding of this relationship is far too limited. This remarkable volume brings experts from diverse disciplines and builds a workable understanding of breadth and depth of the processes – both social and environmental – that will help us to limit future costs and enhance the benefits of sustainable marine systems. In particular, the authors have developed a shared view that the global coastal environment is under threat through intensified natural resource utilization, as well as changes to global climate and other environmental systems. All these changes contribute individually, but more importantly cumulatively, to higher risks for public health and to the global burden of disease. This pioneering book will be of value to advanced undergraduate and postgraduate students taking courses in public health, environmental, economic, and policy fields. Additionally, the treatment of these complex systems is of essential value to the policy community responsible for these questions and to the broader audience for whom these issues are more directly connected to their own health and well-being.