Is the Rise in Reported Dementia Mortality Real? Analysis of Multiple-Cause-of-Death Data for Australia and the United States

Official statistics in Australia and the United States show large recent increases in dementia mortality rates. In this study, we assessed whether these trends are biased by an increasing tendency of medical certifiers (predominantly physicians) to report on the death certificate that dementia was a direct cause of death. Regression models of multiple-cause-of-death data in Australia (2006-2016) and the United States (2006-2017) were constructed to adjust dementia mortality rates for changes in death certification practices. Compared with official statistics, the recent increase in adjusted age-standardized dementia death rates was less than half as large in Australia and about two-thirds as large in the United States. Further adjustment for changes in reporting of dementia anywhere on the death certificate implied even lower increases in dementia mortality. Declines in reporting of cardiovascular diseases as comorbid conditions also contributed to rises in dementia mortality rates. The increasing likelihood of dementia's being reported as directly leading to death largely explains recent increases in dementia mortality rates in both countries. However, studies have found that reported dementia on death certificates remains low compared with clinical evaluations of its prevalence. Improved guidance and training for certifiers in reporting of dementia on death certificates will help standardize mortality statistics within and between countries

Higher resources decrease fluctuating selection during host-parasite coevolution

This is the final version of the article. Available from the publisher via the DOI in this record.We still know very little about how the environment influences coevolutionary dynamics. Here, we investigated both theoretically and empirically how nutrient availability affects the relative extent of escalation of resistance and infectivity (arms race dynamic; ARD) and fluctuating selection (fluctuating selection dynamic; FSD) in experimentally coevolving populations of bacteria and viruses. By comparing interactions between clones of bacteria and viruses both within- and between-time points, we show that increasing nutrient availability resulted in coevolution shifting from FSD, with fluctuations in average infectivity and resistance ranges over time, to ARD. Our model shows that range fluctuations with lower nutrient availability can be explained both by elevated costs of resistance (a direct effect of nutrient availability), and reduced benefits of resistance when population sizes of hosts and parasites are lower (an indirect effect). Nutrient availability can therefore predictably and generally affect qualitative coevolutionary dynamics by both direct and indirect (mediated through ecological feedbacks) effects on costs of resistance.This work was funded by NERC (UK). ABu was supported by the Royal Society and ABe by a the Leverhulme Trust Early Career Fellowship

The First Model-Based Geostatistical Map of Anaemia

Abdisalan Noor discusses new research in <i>PLoS Medicine<I> that used model-based geostatistics to investigate the risks of anemia among preschool-aged children in West Africa that were attributable to malnutrition, malaria, and helminth infections

Building capacity for public and population health research in Africa : the consortium for advanced research training in Africa (CARTA) model

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region’s socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA’s program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTA’s focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative’s goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems

Alpha-particle clustering in excited expanding self-conjugate nuclei

The fragmentation of quasi-projectiles from the nuclear reaction 40Ca + 12C at 25 MeV/nucleon was used to produce alpha-emission sources. From a careful selection of these sources provided by a complete detection and from comparisons with models of sequential and simultaneous decays, strong indications in favour of $\alpha$-particle clustering in excited 16O, 20Ne and 24}Mg are reported.Comment: 8 pages, 4 figures, 12th International Conference on Nucleus-Nucleus collisions (NN2015), 21-26 June 2015, Catania, Ital

Remembering the forgotten non-communicable diseases

The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicable diseases (NCDs). Some of these NCDs, such as neoplasms, COPD, cardiovascular diseases and diabetes, cause much health loss worldwide and are already widely recognised as doing so. However, 55% of the global NCD burden arises from other NCDs, which tend to be ignored in terms of premature mortality and quality of life reduction. Here, experts in some of these 'forgotten NCDs' review the clinical impact of these diseases along with the consequences of their ignoring their medical importance, and discuss ways in which they can be given higher global health priority in order to decrease the growing burden of disease and disability.MerckUniv Melbourne, Sch Populat & Global Hlth, Melbourne, Vic 3053, AustraliaUniv London Imperial Coll Sci Technol & Med, St Marys Hosp, Dept Med, London W2 1NY, EnglandKEMRI Wellcome Trust Res Programme, Kilifi, KenyaUniv British Columbia, St Pauls Hosp, Vancouver, BC V6Z 1Y8, CanadaVA Med Ctr, Med Serv, Birmingham, AL USAVA Med Ctr, Ctr Surg Med Acute Care Res & Transit, Birmingham, AL USAUniv Alabama Birmingham, Sch Med, Dept Med, Birmingham, AL 35294 USAUniv Alabama Birmingham, Sch Publ Hlth, Div Epidemiol, Birmingham, AL 35294 USAMayo Clin, Coll Med, Dept Orthoped Surg, Rochester, MN 55905 USAUniv London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London, EnglandCtr Addict & Mental Hlth, Toronto, ON, CanadaTech Univ Dresden, D-01062 Dresden, GermanyUniv Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, CanadaUniv Toronto, Dept Psychiat, Toronto, ON, CanadaUofT, Inst Med Sci, Toronto, ON, CanadaNIDA, NIH, Rockville, MD USANIAAA, NIH, Bethesda, MD 20892 USAHosp Alemao Oswaldo Cruz, Inst Educ & Hlth Sci, BR-01323903 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Psychobiol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Psychobiol, BR-04023062 São Paulo, BrazilWeb of Scienc

Constrained caloric curves and phase transition for hot nuclei

Simulations based on experimental data obtained from multifragmenting quasi-fused nuclei produced in central $^{129}$Xe + $^{nat}$Sn collisions have been used to deduce event by event freeze-out properties in the thermal excitation energy range 4-12 AMeV [Nucl. Phys. A809 (2008) 111]. From these properties and the temperatures deduced from proton transverse momentum fluctuations, constrained caloric curves have been built. At constant average volumes caloric curves exhibit a monotonic behaviour whereas for constrained pressures a backbending is observed. Such results support the existence of a first order phase transition for hot nuclei.Comment: 14 pages, 5 figures, accepted in Physics Letters

Aging, Transition, and Estimating the Global Burden of Disease

The World Health Organization's Global Burden of Disease (GBD) reports are an important tool for global health policy makers, however the accuracy of estimates for countries undergoing an epidemiologic transition is unclear. We attempted to validate the life table model used to generate estimates for all-cause mortality in developing countries.Data were obtained for males and females from the Human Mortality Database for all countries with available data every ten years from 1900 to 2000. These provided inputs for the GBD life table model and served as comparison observed data. Above age sixty model estimates of survival for both sexes differed substantially from those observed. Prior to the year 1960 for males and 1930 for females, estimated survival tended to be greater than observed; following 1960 for both males and females estimated survival tended to be less than observed. Viewing observed and estimated survival separately, observed survival past sixty increased over the years considered. For males, the increase was from a mean (sd) probability of 0.22 (0.06) to 0.46 (0.1). For females, the increase was from 0.26 (0.06) to 0.65 (0.08). By contrast, estimated survival past sixty decreased over the same period. Among males, estimated survival probability declined from 0.54 (0.2) to 0.09 (0.06). Among females, the decline was from 0.36 (0.12) to 0.15 (0.08).These results show that the GBD mortality model did not accurately estimate survival at older ages as developed countries transitioned in the twentieth century and may be similarly flawed in developing countries now undergoing transition. Estimates of the size of older-age populations and their attributable disease burden should be reconsidered