The global impact of non-communicable diseases on macro-economic productivity: a systematic review

© 2015, The Author(s). Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)] on macro-economic productivity. Systematic search, up to November 6th 2014, of medical databases (Medline, Embase and Google Scholar) without language restrictions. To identify additional publications, we searched the reference lists of retrieved studies and contacted authors in the field. Randomized controlled trials, cohort, case–control, cross-sectional, ecological studies and modelling studies carried out in adults (>18 years old) were included. Two independent reviewers performed all abstract and full text selection. Disagreements were resolved through consensus or consulting a third reviewer. Two independent reviewers extracted data using a predesigned data collection form. Main outcome measure was the impact of the selected NCDs on productivity, measured in DALYs, productivity costs, and labor market participation, including unemployment, return to work and sick leave. From 4542 references, 126 studies met the inclusion criteria, many of which focused on the impact of more than one NCD on productivity. Breast cancer was the most common (n = 45), followed by stroke (n = 31), COPD (n = 24), colon cancer (n = 24), DM (n = 22), lung cancer (n = 16), CVD (n = 15), cervical cancer (n = 7) and CKD (n = 2). Four studies were from the WHO African Region, 52 from the European Region, 53 from the Region of the Americas and 16 from the Western Pacific Region, one from the Eastern Mediterranean Region and none from South East Asia. We found large regional differences in DALYs attributable to NCDs but especially for cervical and lung cancer. Productivity losses in the USA ranged from 88 million US dollars (USD) for COPD to 20.9 billion USD for colon cancer. CHD costs the Australian economy 13.2 billion USD per year. People with DM, COPD and survivors of breast and especially lung cancer are at a higher risk of reduced labor market participation. Overall NCDs generate a large impact on macro-economic productivity in most WHO regions irrespective of continent and income. The absolute global impact in terms of dollars and DALYs remains an elusive challenge due to the wide heterogeneity in the included studies as well as limited information from low- and middle-income countries.WHO; Nestle´ Nutrition (Nestec Ltd.); Metagenics Inc.; and AX

The V471A polymorphism in autophagy-related gene ATG7 modifies age at onset specifically in Italian Huntington disease patients

The cause of Huntington disease (HD) is a polyglutamine repeat expansion of more than 36 units in the huntingtin protein, which is inversely correlated with the age at onset of the disease. However, additional genetic factors are believed to modify the course and the age at onset of HD. Recently, we identified the V471A polymorphism in the autophagy-related gene ATG7, a key component of the autophagy pathway that plays an important role in HD pathogenesis, to be associated with the age at onset in a large group of European Huntington disease patients. To confirm this association in a second independent patient cohort, we analysed the ATG7 V471A polymorphism in additional 1,464 European HD patients of the “REGISTRY” cohort from the European Huntington Disease Network (EHDN). In the entire REGISTRY cohort we could not confirm a modifying effect of the ATG7 V471A polymorphism. However, analysing a modifying effect of ATG7 in these REGISTRY patients and in patients of our previous HD cohort according to their ethnic origin, we identified a significant effect of the ATG7 V471A polymorphism on the HD age at onset only in the Italian population (327 patients). In these Italian patients, the polymorphism is associated with a 6-years earlier disease onset and thus seems to have an aggravating effect. We could specify the role of ATG7 as a genetic modifier for HD particularly in the Italian population. This result affirms the modifying influence of the autophagic pathway on the course of HD, but also suggests population-specific modifying mechanisms in HD pathogenesis

Population structure, growth and production of the yellow clam Mesodesma mactroides (Bivalvia: Mesodesmatidae) from a high-energy, temperate beach in northern Argentina

The yellow clam Mesodesma mactroides (Bivalvia: Mesodesmatidae) was once the most abundant intertidal species on the Atlantic coast of northern Argentina and an important commercial resource in South America. This study of a population inhabiting the intertidal zone of the sheltered-dissipative sandy beach Santa Teresita documents the species' population biology, including demographic structure, growth and production during December 2004 and December 2006, and adumbrates the critical state of M. mactroides at present. A total of 3,015 M. mactroides were collected and measured, whereas individuals were found with an anterior-posterior shell length between 2 and 64 mm. A von Bertalanffy growth function with an asymptotic length (L∞) of 85 mm and a growth constant (K) of 0.47 year-1 was established from length-frequency distributions. The longevity of the species is estimated at approximately 6 years, and instantaneous mortality rate was about three times higher than 40 years ago. Besides, this study confirmed that the overall growth performance index (OGP) is habitat-specific and can be used to group M. mactroides and M. donacium from different areas into temperate and upwelling species. Furthermore, OGP is inversely correlated with the latitudinal distribution of Mesodesma populations. The intertidal biomass ranged between 0.06 and 0.07 g AFDM m-2 year-1. Individual production was observed to be highest at 47 mm length (0.35 g AFDM m-2 year-1), and annual production ranged between 0.12 and 0.19 g AFDM m-2 year-1, resulting in productivity values (P/B) between 1.84 and 2.93. The comparison of the results of the present study with those of growth studies conducted on M. mactroides 40 years ago revealed the following considerable differences in the population structure of M. mactroides, indicating the conservation status of this intertidal bivalve as endangered: (1) present growth rates are faster, but that the maximum length attained has decreased, (2) the numbers of individuals per square metre were many times higher in the past than in the present, (3) bivalves from the present work never reached the 'commercial size' of 60 mm and (4) 40 years ago, the population of M. mactroides was composed of up to three cohorts, whereas in this study, there was only one single cohort visible.Fil: Herrmann, Marko. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; Argentina. Johann Heinrich von Thünen Institute; AlemaniaFil: Fernandez Alfaya, Jose Elias. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Lepore, Mauro L.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Penchaszadeh, Pablo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Arntz, Wolf E.. Institute for Polar and Marine Research; Alemani