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'No Man is an Island' - Crossing Thresholds: Journeying with the recent poetry of Syd Harrex
No full textArticl
Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
No full textPublished by Elsevier Ltd. This is an Open Access article under the CC BY license.Background
Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development.
Methods
We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate.
Findings
Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs.
Interpretation
Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum
Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
No full textPublished by Elsevier Ltd. This is an Open Access article under the CC BY license.Background
In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015.
Methods
We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10–54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility.
Findings
Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance.
Interpretation
Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population
Visual Field Dependence Is Associated with Reduced Postural Sway, Dizziness and Falls in Older People Attending a Falls Clinic.
No full textMoving visual fields can have strong destabilising effects on balance, particularly when visually perceived motion does not correspond to postural movements. This study investigated relationships between visual field dependence (VFD), as assessed using the roll vection test, and reported dizziness, falls and sway under eyes open, eyes closed and optokinetic conditions. Ninety five falls clinic attendees undertook the roll vection test (i.e. attempted to align a rod to the vertical while exposed to a rotating visual field). Sway was assessed under different visual conditions by centre of pressure movement. Participants also completed questionnaires on space and motion discomfort, fear of falling, depression and anxiety. Thirty four (35.8%) participants exhibited VFD, i.e. had an error > 6.5º in the roll vection test. Compared to participants without VFD, participants with VFD demonstrated less movement of the centre of pressure across all visual conditions, were more likely to report space and motion discomfort and to have suffered more multiple falls in the past year. VFD was independent of fear of falling, anxiety and depression. VFD in a falls clinic population is associated with reduced sway possibly due to a stiffening strategy to maintain stance, dizziness symptoms and an increased risk of falls
Analysis of ASR Clogging Investigations at Three Australian ASR Sites in a Bayesian Context
No full text© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC-BY) license (http://creativecommons.org/licenses/by/4.0/).When evaluating uncertainties in developing an aquifer storage and recovery (ASR) system, under normal budgetary constraints, a systematic approach is needed to prioritise investigations. Three case studies where field trials have been undertaken, and clogging evaluated, reveal the changing perceptions of viability of ASR from a clogging perspective as a result of the progress of investigations. Two stormwater and one recycled water ASR investigations in siliceous aquifers are described that involved different strategies to evaluate the potential for clogging. This paper reviews these sites, as well as earlier case studies and information relating water quality, to clogging in column studies. Two novel theoretical concepts are introduced in the paper. Bayesian analysis is applied to demonstrate the increase in expected net benefit in developing a new ASR operation by undertaking clogging experiments (that have an assumed known reliability for predicting viability) for the injectant treatment options and aquifer material from the site. Results for an example situation demonstrate benefit cost ratios of experiments ranging from 1.5 to 6 and apply if decisions are based on experimental results whether success or failure are predicted. Additionally, a theoretical assessment of clogging rates characterised as acute and chronic is given, to explore their combined impact, for two operating parameters that define the onset of purging for recovery of reversible clogging and the onset of occasional advanced bore rehabilitation to address recovery of chronic clogging. These allow the assessment of net recharge and the proportion of water purged or redeveloped. Both analyses could inform economic decisions and help motivate an improved investigation methodology. It is expected that aquifer heterogeneity will result in differing injection rates among wells, so operational experience will ultimately be valuable in differentiating clogging behaviour under different aquifer conditions for the same water type. This paper was originally presented at ISMAR9, Mexico City 20–24 June 2016
Rapid protein immobilization for thin film continuous flow biocatalysis
No full textOpen Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.A versatile enzyme immobilization strategy for thin film continuous flow processing is reported. Here, non-covalent and glutaraldehyde bioconjugation are used to immobilize enzymes on the surfaces of borosilicate reactors. This approach requires only ng of protein per reactor tube, with the stock protein solution readily recycled to sequentially coat >10 reactors. Confining reagents to thin films during immobilization reduced the amount of protein, piranha-cleaning solution, and other reagents by ∼96%. Through this technique, there was no loss of catalytic activity over 10 h processing. The results reported here combines the benefits of thin film flow processing with the mild conditions of biocatalysis
Wool deconstruction using a benign eutectic melt
No full textOpen Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.Wool fibre is deconstructed in a facile ‘top down’ fabrication process into functional, nano-dimensional α-keratin chains using a benign choline chloride-urea deep eutectic solvent (DES) melt. After breakdown, the keratin can be easily isolated from the DES mixture through dialysis, and freeze-dried to form a protein powder ready for subsequent processing for applications such as wound healing or animal feedstock. The process is simple, efficient, and environmentally friendly. It can potentially utilise what would otherwise be a waste stream, stemming from wool that is deemed unsuitable for the clothing industry, and at the same time providing an additional revenue source
Biocompatible anti-microbial coatings for urinary catheters
No full textOpen Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.Using a simple dip-coating mechanism, urinary catheters have been coated with poly(2-methacryloyloxyethyl)trimethylammonium chloride (pMTAC) using activator regenerated by electron transfer (ARGET)–atom transfer radical polymerization (ATRP). A polydopamine-2-bromoisobutyryl bromide (pDA-BiBBr) initiator was initially grafted to the catheter surface to initiate polymerization resulting in a pDA-g-pMTAC coating. The pDA-g-pMTAC-coated catheters showed a significant reduction in bacterial adhesion, with respect to uncoated silicone catheters, as determined by analyzing microbiological assays as well as scanning electron microscopy images. At the same time, no evidence for cytotoxicity was observed, rather, the coating promoted cell adhesion and proliferation of human cells. This makes the coating attractive for temporary as well as permanently implanted medical devices
Dry shear aligning: a simple and versatile method to smooth and align the surfaces of carbon nanotube thin films
No full textOpen Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.We show that the application of lateral shear force on a randomly oriented thin film of carbon nanotubes, in the dry state, causes significant reordering of the nanotubes at the film surface. This new technique of dry shear aligning is applicable to carbon nanotube thin films produced by many of the established methods
Turner’s Paddock
No full textCopyright Flinders University.
This dataset is made available under a Creative Commons Attribution-ShareAlike 4.0 International license (CC BY-SA 4.0)Turner’s Paddock, known officially as Park 23, is located in the parklands on the western edge of Adelaide. It is fairly representative of refuse dumps around Adelaide from that period (Piddock 1992). The site is located adjacent to Burbridge Road and the West Terrace Cemetery. The site was used not long after the formation of the colony and continued into the early twentieth century. The name of Turner’s Paddock came from the 1920s when it was used by Turner’s Butchers for pasturing their horses (Piddock 1992)