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3 - Chronic Disease
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- By Prabhat Jha, University of Toronto, Rachel Nugent, University of Washington, Stéphane Verguet, University of Washington, David Bloom, Harvard University, Ryan Hum, University of Toronto
- Edited by Bjørn Lomborg
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- Book:
- Global Problems, Smart Solutions
- Published online:
- 05 June 2014
- Print publication:
- 14 November 2013, pp 137-185
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Summary
Eighty percent of global deaths from heart disease, stroke, cancer, and other chronic diseases occur in low- and middle-income countries. This chapter discusses priorities for control of these chronic diseases as an input into the 2012 Copenhagen Consensus. This chapter and the accompanying Chapter 7 on infectious disease control build on the results of the 2008 Copenhagen Consensus chapter on disease control (Jamison et al., 2008), and is best read as an extension of the latter chapter.
This chapter also draws on the framework and findings of the Disease Control Priorities Project (DCP2). The DCP2 engaged over 350 authors and among its outputs were estimates of the cost-effectiveness of 315 interventions, including about 100 interventions for chronic diseases. These estimates vary a good deal in their thoroughness and in the extent to which they provide regionally-specific estimates of both cost and effectiveness. Taken as a whole, however, they represent a comprehensive canvas of chronic disease control opportunities. This chapter identifies five key priority interventions for chronic disease in developing countries which chiefly address heart attacks, strokes, cancer, and tobacco-related respiratory disease. These interventions are chosen from among many because of their cost-effectiveness, the size of the disease burden they address, their implementation ease, and other criteria. Separate but related 2008 Copenhagen Consensus chapters dealt with other major determinants of chronic diseases such as nutrition, (Behrman et al., 2007), air pollution (Larsen et al., 2008) and education (Orazem et al., 2008). The health-related chapters for the 2012 Copenhagen Consensus focus on infectious diseases (Jamison et al., 2012), sanitation and water (Rijsberman and Zwane, 2012), education (Orazem, 2012), hunger and undernutrition (Hoddinott et al., 2012) and population growth (Kohler, 2012).
Chapter 7 - Human Health: The Twentieth-Century Transformation of Human Health – Its Magnitude and Value
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- By Dean T. Jamison, University of Washington, Prabhat Jha, University of Toronto, Varun Malhotra, University of Toronto, Stéphane Verguet, University of Washington
- Edited by Bjørn Lomborg, Copenhagen Business School
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- Book:
- How Much Have Global Problems Cost the World?
- Published online:
- 05 June 2014
- Print publication:
- 10 October 2013, pp 207-246
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Summary
I have tried always to remember a simple truth about the past that the historically inexperienced are prone to forget. Most people in the past either died young or expected to die young, and those who did not were repeatedly bereft of those they loved . . . the power of death cut people off in their prime and made life seem precarious and filled with grief. It also meant that most of the people who built civilizations of the past were young when they made their contributions.
– Niall Ferguson, Civilization: The West and the Rest (2011, pp. xxii–xxiii)Ferguson refers to a past with mortality far higher than today, a past in which people not only died young but lived with frequent illness, undernutrition and (for women) the often debilitating consequences of high fertility. This past was not so very long ago. Section 1 will present long trends in life expectancy in the country where it is highest. From a period of virtually no change in mortality prior to 1790, improvements became rapid in the nineteenth century and extremely rapid in the period 1880–1960. During this latter period life expectancy in the leading country increased by 3.2 years per decade. And, as this chapter will document, not only did the leading country rapidly improve but much of the rest of the world converged toward the leader.
Mechanics of liquid–liquid interfaces and mixing enhancement in microscale flows
- STÉPHANE VERGUET, CHUANHUA DUAN, ALBERT LIAU, VEYSEL BERK, JAMIE H. D. CATE, ARUN MAJUMDAR, ANDREW J. SZERI
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- Journal:
- Journal of Fluid Mechanics / Volume 652 / 10 June 2010
- Published online by Cambridge University Press:
- 19 May 2010, pp. 207-240
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Experimental work on mixing in microfluidic devices has been of growing importance in recent years. Interest in probing reaction kinetics faster than the minute or hour time scale has intensified research in designing microchannel devices that would allow the reactants to be mixed on a time scale faster than that of the reaction. Particular attention has been paid to the design of microchannels in order to enhance the advection phenomena in these devices. Ultimately, in vitro studies of biological reactions can now be performed in conditions that reflect their native intracellular environments. Liau et al. (Anal. Chem., vol. 77, 2005, p. 7618) have demonstrated a droplet-based microfluidic mixer that induces improved chaotic mixing of crowded solutions in milliseconds due to protrusions (‘bumps’) on the microchannel walls. Liau et al. (2005) have shown it to be possible to mix rapidly plugs of highly concentrated protein solutions such as bovine hemoglobin and bovine serum albumin. The present work concerns an analysis of the underlying mechanisms of shear stress transfer at liquid–liquid interfaces and associated enhanced mixing arising from the protrusions along the channel walls. The role of non-Newtonian rheology and surfactants is also considered within the mixing framework developed by Aref, Ottino and Wiggins in several publications. Specifically, we show that proportional thinning of the carrier fluid lubrication layer at the bumps leads to greater advection velocities within the plugs, which enhances mixing. When the fluid within the plugs is Newtonian, mixing will be enhanced by the bumps if they are sufficiently close to one another. Changing either the rheology of the fluid within the plugs (from Newtonian to non-Newtonian) or modifying the mechanics of the carrier fluid-plug interface (by populating it with insoluble surfactants) alters the mixing enhancement.