Mathers CD, Loncar DProjections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11): 2011-2030

Evidence and Information for Policy Cluster, World Health Organization, Geneva, Switzerland.
PLoS Medicine (Impact Factor: 14.43). 12/2006; 3(11):e442. DOI: 10.1371/journal.pmed.0030442
Source: PubMed


Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results.
Relatively simple models were used to project future health trends under three scenarios-baseline, optimistic, and pessimistic-based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015.
These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries.

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    • "Its prevalence varies largely by country, ranging from 3% of adult population in Japan to 17% in the US [1]. Overall, incidence of depressive disorders is progressively increasing, ranking among the leading conditions contributing to the global burden of disease [2]. Recent epidemiological evidence suggests that dietary factors may play an important role in the development of depression. "
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    ABSTRACT: Scope: The aim of the study was to systematically review and analyze results from observational studies on coffee, caffeine, and tea consumption and association or risk of depression. Methods and results: Embase and Pubmed databases were searched from inception to June 2015 for observational studies reporting the odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CI) of depression by coffee/tea/caffeine consumption. Random-effects models, subgroup and dose-response analyses were performed. Twelve studies with 23 datasets were included in the meta-analysis, accounting for a total of 346,913 individuals and 8146 cases of depression. Compared to individuals with lower coffee consumption, those with higher intakes had pooled RR of depression of 0.76 (95% CI: 0.64, 0.91). Dose-response effect suggests a non-linear J-shaped relation between coffee consumption and risk of depression with a peak of protective effect for 400 ml/d. A borderline non-significant association between tea consumption and risk of depression was found (RR 0.70, 95% CI: 0.48, 1.01) while significant results were found only for analysis of prospective studies regarding caffeine consumption (RR = 0.84, 95% CI: 0.75, 0.93). Conclusions: This study suggests a protective effect of coffee and, partially, of tea and caffeine on risk of depression. This article is protected by copyright. All rights reserved.
    Molecular Nutrition & Food Research 10/2015; DOI:10.1002/mnfr.201500620 · 4.60 Impact Factor
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    • "(4) Unipolar depressive disorder is currently one of the most prevalent mental disorders worldwide and is predicted to be the number one overall cause of disability by 2030 for citizens of higher income countries (World Health Organization 2008; Mathers & Loncar 2006). Depressive disorders can lead to reduced quality of life, impaired social and personal relationships and disturbed professional life. "
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    ABSTRACT: ackground Depressive disorder is a major societal challenge. Despite the availability of clinically and cost-effective treatments including Internet interventions, the number of patients receiving treatment is limited. Evidence-based Internet interventions promise wide availability and high efficiency of treatments. However, these interventions often do not enter routine mental healthcare delivery at a large scale. The MasterMind project aims to provide insight into the factors that promote or hinder the uptake and implementation of evidence-based Internet interventions by mental healthcare practice. Internet-based Cognitive Behaviour Therapy (iCBT) and videoconferencing facilitating collaborative care (ccVC) will be implemented in routine mental healthcare. The services will be offered to 5230 depressed adults in 15 European regions. The current paper describes the evaluation protocol for this large-scale implementation project. Design Current summative evaluation study follows a naturalistic one-group pretest–posttest design and assesses three distinct stakeholders: patients, mental healthcare professionals, and mental healthcare organisations. The Model for Assessment of Telemedicine applications (MAST) will be employed to structure the implementation and evaluation study. The primary focal points of interest are reach, clinical effect, acceptability, appropriateness, implementation costs, and sustainability of the interventions in practice. Mixed-methods are used to provide an understanding of what (quantitative) the implementation projects have achieved and their meaning to various stakeholders (qualitative). Discussion The use of Internet interventions in routine practice is limited. MasterMind attempts to bridge the gap between routine practice and effectiveness research by evaluating the implementation of evidence-based Internet interventions for depressive disorders in routine mental healthcare settings in Europe.
    Internet Interventions 10/2015; 2(4). DOI:10.1016/j.invent.2015.10.002
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    • "Furthermore, this disease tends to be more common in white than black men [1]. The magnitude of this problem is deep, because atherosclerosis claims more lives than all types of combined cancer and economic costs are considerably high[2]. Currently, the idea that atherosclerosis constitutes a state of high levels of oxidative stress is widely accepted and this phenomenon is associated with lipid and protein oxidation in the vascular wall[3] [4]. "

    Edited by Sekar Ashok Kumar, 09/2015; InTech., ISBN: ISBN 978-953-51-2169-5
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