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To evaluate the quality of reporting in published randomized controlled trials (RTCs) in the field of fall injuries. The 188 RTCs published between 2001 and 2011, indexed in EMBASE and Medline databases were extracted through searching by appropriate keywords and EMTree classification terms. The evaluation trustworthiness was assured through parallel evaluations of two experts in epidemiology and biostatistics. About 40%-75% of papers had problems in reporting random allocation method, allocation concealment, random allocation implementation, blinding and similarity among groups, intention to treat and balancing benefits and harms. Moreover, at least 10% of papers inappropriately/not reported the design, protocol violations, sample size justification, subgroup/adjusted analyses, presenting flow diagram, drop outs, recruitment time, baseline data, suitable effect size on outcome, ancillary analyses, limitations and generalizability. Considering the shortcomings found and due to the importance of the RCTs for fall injury prevention programmes, their reporting quality should be improved. [ABSTRACT FROM AUTHOR]

The National Health and Medical Research Council recently reported that there were not enough high-quality studies to conclude that associations between health effects and blood lead levels <10 μg/dL were caused by lead. It identified uncontrolled confounding, measurement error and other potential causal factors as common weaknesses. This paper supports those findings with evidence of uncontrolled confounding by parental education, intelligence or household management from several papers. It suggests that inappropriate statistical tests and aggregation of data representing different exposure routes partly explain why confounding has been overlooked. Inadequate correction of confounding has contributed to incorrect conclusions regarding causality at low levels of lead. Linear or log-linear regression models have tended to mask any threshold. While the effects of higher levels of lead exposure are not disputed, overestimation of health effects at low lead exposures has significant implications for policy-makers endeavouring to protect public health through cost-effective regulations. [ABSTRACT FROM PUBLISHER]

The outbreak of COVID-19 has attracted attention from all around the world. Governments and institutions have adopted ways to fight COVID-19, but its prevalence is still strong. The SIR model has important reference value for the novel coronavirus epidemic, offering both preventive measures and the ability to predict future trends. Based on an analysis of the classical epidemiological SIR model along with key parameters, this paper aims to analyze the patterns of COVID-19, to discuss potential anti-COVID-19 measures, and to explain why we need to conduct appropriate measures against COVID-19. The use of the SIR model can play an important role in public health emergencies. Among the parameters of the SIR model, the contact ratio and the reproduction ratio are the factors that have the potential to mitigate the consequences of COVID-19. Anti-COVID-19 measures include wearing a mask, washing one's hands, keeping social distance, and staying at home if possible. [ABSTRACT FROM AUTHOR]

Major approaches of the Russian Federation in setting of exposure guidelines to electromagnetic fields (EMF) in occupational and public environments are discussed in this paper. EMF exposure guidelines in Russia are based on the results of hygienic, clinical, physiological, epidemiological and experimental studies and are frequency-dependent. The concept of a threshold principle of occupational and environmental factors due to hazardous exposure effects has been used to set permissible exposure levels of different EMF frequency ranges. The data of experimental studies showed hazardous threshold levels of EMF effects. The main criteria of EMF hazardous exposure evaluated in the experimental study concerned both estimation of threshold levels of chronic (long-term) and acute exposure. Also, this paper contains some recent experimental study data on correlation of long-term radiofrequency and power-frequency EMF exposure effects with regard to time duration, the so-called time-dependence approach. It enables identification of the value of permissible EMF exposure levels depending on exposure duration. This approach is used in occupational exposure guideline setting and requires the introduction of “power exposition” (PE) and “maximal permissible level” (MPL). In general, EMF exposure guidelines are established with regard to possible duration of exposure per day. [ABSTRACT FROM AUTHOR]

Public health lessons from one pandemic become the planning assumptions for the next one. Aotearoa New Zealand's 2017 pandemic plan was derived from past experience of influenza. When Covid-19 emerged as a major global health threat, it took time for the realisation to crystallise that this infection was so different from influenza that it required a completely new pandemic response strategy. In this paper we describe how early evidence about SARS-CoV-2 transmission from China led to the adoption of an elimination strategy in Aotearoa New Zealand, making it the first country to choose elimination as a specific policy response. We discuss how further evidence has shaped the selection and design of Covid-19 pandemic control measures such as border restrictions, case and contact management, hygiene practices and use of face masks, physical distancing, and vaccines. This experience demonstrates the need for a different approach to the design of the next national pandemic plan. We identify key early evidence that will be required to develop a flexible and appropriate public health response to a new pandemic threat. We present a framework for a new pandemic plan that aims to learn from the Covid-19 experience by making as few limiting assumptions as possible. [ABSTRACT FROM AUTHOR]

This paper presents air pollution as a ‘post-human’ public health phenomenon. It draws on an ethnography of a multidisciplinary research project called Weather Health and Air Pollution to explore the material ways in which air pollution challenged scientists’ conceptualisations of harm and health. The epidemiologists on WHAP used statistical techniques to correlate data of air pollution concentrations with mortality and morbidity data collected by hospitals in order to establish a quantified measure of the health effects of exposure to air pollution. Initially, these correlations were problematic: plotted data points failed to map over temporal patterns. A series of negotiations followed. As a result of these, the concept of ‘season’ emerged as a temporal figure through which the very existence and meaning of air pollution was put to the test. Indeed, attempts by researchers to hold stable the notion of toxicity signalled the problem of trying to assess the bodily response to a polluted environment that has supposedly ‘already been’. The paper concludes by arguing how contemplating health through the lens of the material dimensions of time allows public health to: first, view health problems as constituted through bodies and environments, rather than as a relation separating the two; and second, open up indeterminacies and uncertainties as a generative condition of air pollution, and perhaps public health more generally. [ABSTRACT FROM PUBLISHER]

Acute poisoning is a significant international public health issue and one of the leading causes of death in the emergency department (ED). In the absence of any previous reports describing the poisoning profile in Syria, we present this study to assess the epidemiological and clinical characteristics of poisoning over 21 years. We collected the data retrospectively from the Syrian Poisons Information Centre (SPIC) from January 1999 until December 2020. The data included patients who had accidental or non-accidental exposure to poisons, either by drugs, medicaments, and biological substances or substances chiefly nonmedicinal sources such as soaps and detergents, corrosive substances, pesticides, and other miscellaneous products. We collected the data of 120,972 poisoned patients, of whom 52.6% were females, and 47.4% were males. Aleppo governorate reported the highest number of poisoned cases (28.6%), followed by Damascus governorate (19.9%). The highest poisoning rates were recorded in 2020, 2014, and 2010. Pharmaceutical (37.0%) and animal (33.8%) sources were the most common causative agents. The oral route was the route of poisoning in 58.3% of patients, and 33.4% through the skin. The most common poison was scorpion stings 19.5% while the most common cause of death was organophosphates 15.7%. The differences in socioeconomic status, cultural habits, and agricultural and industrial activities between countries have led to a state of fluctuation regarding the most common poisoning agents. Damascus and Aleppo, the two major governorates in Syria, had the highest poisoning cases. Oral administration of pharmaceutical agents was responsible for most of the poisoning cases. The most common individual poison was the scorpion poison, while the top killer was organophosphates. [ABSTRACT FROM AUTHOR]

Brooker et al. (2002) conducted a systematic review of research into the mental health of prisoners. Their final report included a review of the epidemiology of the prison population, an overview of the interventions used to treat the major mental health disorders in both the general and prison populations, and a review of service delivery and organisation for prisoners with mental health disorders. The review found a high prevalence of mental health disorders in prison populations, with up to 15% of prisoners having four or five co-existing mental disorders. This review has been updated, using the same methodology, to include literature dated from 2002 to August 2006. This paper presents findings from the epidemiology section of the updated review, which includes 18 new studies. The recent studies largely reflect the findings of earlier research. However, some studies in the updated review focus on countries where little of this type of research has previously been conducted. The prevalence of mental health disorders, suicide, and substance misuse remains high in prison populations around the world - demonstrating the need for suitable evidence-based interventions to address these issues. Future research should concentrate on mapping interventions available to prisoners and evaluating their effectiveness. [ABSTRACT FROM AUTHOR]

This paper situates the ethnography of avian flu within the geo-political context of a new epidemiologic transition. Drawing on anthropological experience and insight, this paper examines areas of enquiry in which an ethnographic approach could contribute to a better implementation of prevention and control measures. Within the context of newly emerging diseases and accelerated globalization, the task of ethnography needs to extend far beyond the local. This paper reveals two major global issues that the ethnography of epidemiologic transition must take into consideration: (1) Global agro-industrial capitalism, and (2) global politics in the context of international health organizations and multi-national drug companies. The case of Thailand poses a question of how the strength of ethnographic practice could be deployed to account for the reality of the global-local interface of the new epidemiologic transition. [ABSTRACT FROM AUTHOR]

This paper concerns the difficulty of taking long-term effects on health into account in an economic valuation. Indeed, public decision makers should incorporate the cessation lag between implementation of an abatement policy and achievement of all of the expected mortality-related benefits for any projects involving health impacts. This paper shows how this time lag problem can be handled by proposing two approaches—either in terms of deaths avoided or of life years saved—within a dynamic perspective. The main findings are that long-term health benefits calculated by standard methods and widely applied to adverse health effects should be corrected downwards when incorporated into an economic analysis. The magnitude of correction depends on the discount rate, on technical choices dealing with epidemiology and on the method chosen to assess mortality benefits. [ABSTRACT FROM AUTHOR]

In the context of rolling out antiretroviral treatment programmes in resource-constrained settings, 'expert patients' are hailed as an important step towards greater involvement of people living with HIV (PLHIV) in HIV care, and in addressing the human resources crisis. The rise of the 'expert patient' in HIV care partly echoes the move towards greater patient agency and self-management that informs health services delivery in industrialised countries. However, the 'expert patient' also represents a particular moment in the trajectory of PLHIVs' quest for greater access to treatment and health care. In this paper, we examine the unique evolution and 'instrumentalisation' of PLHIV in public health in relation to shifts in the epidemiology, interventions and socio-political response related to HIV since the 1980s. Synthesised broadly as 'risk-based', 'empowerment', 'structural' and 'activist' approaches, four key paradigms are identified that attribute different levels of citizenship for PLHIV, that is the motivation, agency and responsibility to act not only on their own interests, but also on behalf of collective interests in HIV prevention and care. We problematise the concept of the patient-citizen by drawing attention to the context-specificity of such notions as patient identity, capacity and rights as well as the structural realities of access to treatment, and broader engagement with the health system. We conclude by offering some thoughts on the applicability of 'expert patient' approaches across a broad range of settings. [ABSTRACT FROM AUTHOR]

There is significant current interest in the application of game theory to problems in epidemiology. Most mathematical analyses of epidemiology games have studied populations where all individuals have the same risks and interests. This paper analyses the rational-expectation equilibria in an epidemiology game with two interacting subpopulations of equal size where decisions change the prevalence and transmission patterns of an infectious disease. The transmission dynamics are described by an SIS model and individuals are only allowed to invest in daily prevention measures like hygiene. The analysis shows that disassortative mixing may lead to multiple Nash equilibria when there are two interacting subpopulations affecting disease prevalence. The dynamic stability of these equilibria is analysed under the assumption that strategies change slowly in the direction of self-interest. When mixing is disassortative, interior Nash equilibria are always unstable. When mixing is positively assortative, there is a unique Nash equilibrium that is globally stable. [ABSTRACT FROM AUTHOR]

Objectives. This is the second of 2 papers reporting on the result of the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland. Methods. Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries. Results. Cancer in general is increasing among Inuit, in all regions, and among both men and women. Inuit continue to be at extreme high risk, relative to non-Inuit and to comparisons of global populations, for the historically recognized so-called traditional cancers (such as cancer of the nasopharynx and salivary glands). Among the so-called modern cancers prevalent in developed societies, lung cancer is rapidly increasing in incidence (especially in Canada), such that the rate in both Inuit men and women is the highest in the world; other cancers, such as colorectal cancer, are also on the rise (especially in Alaska), while breast and prostate cancer remain low relative to the non-Inuit population. The decline in cervical cancer is a positive development; in the 3 regions, the rate in Greenland is the highest. Conclusions. Data such as these can form the basis of interventions directed towards known risk factors such as smoking, diet, obesity, viral and bacterial infections, and low screening prevalence. Cancer surveillance is a basic task of the public health system; in the Arctic, it is particularly important as Inuit continue to undergo further changes in their life-styles and social environments. [ABSTRACT FROM AUTHOR]

Due to the availability of a huge amount of epidemiological and public health data that require analysis and interpretation by using appropriate mathematical tools to support the existing method to control the mosquito and mosquito-borne diseases in a more effective way, data-mining tools are used to make sense from the chaos. Using data-mining tools, one can develop predictive models, patterns, association rules, and clusters of diseases, which can help the decision-makers in controlling the diseases. This paper mainly focuses on the applications of data-mining tools that have been used for the first time to prioritize the malaria endemic regions in Manipur state by using Self Organizing Maps (SOM). The SOM results (in two-dimensional images called Kohonen maps) clearly show the visual classification of malaria endemic zones into high, medium and low in the different districts of Manipur, and will be discussed in the paper. [ABSTRACT FROM AUTHOR]

The outbreak of severe acute respiratory syndrome (SARS) in Toronto and other cities in 2003 showed a heightened sensitivity of places in the global economy to rapid changes brought on by the acceleration of social and ecological relationships. The spread of the SARS virus may be a predictable consequence of these processes. The paper investigates how processes of globalisation have affected the transmission and response to SARS within the context of the global cities network. Little work has been done on the relationship of global city formation and the spread of infectious disease. Arguing that this relationship may be central to understanding the intricate capillary structures of the globalised network, the paper focuses on how pathogens interact with economic, political and social factors. These relationships exist both in the network and in global cities themselves, thereby posing new issues for public health and epidemiological efforts at disease containment and tracking. [ABSTRACT FROM AUTHOR]

Applying the Precautionary Principle to public health requires a re-evaluation of the methods of inference currently used to make claims about disease causation from epidemiologic and other forms of scientific evidence. In current thinking, a well-established, near-certain causal relationship implies highly consistent statistically significant results across many different studies, large relative risk estimates, extensive understanding of biological mechanisms and dose-response relationships, positive prevention trial results, a clear temporal relationship between cause and effect, and other conditions spelled out in terms of the widely-used causal criteria. The Precautionary Principle, however, states that preventive measures are to be taken when cause and effect relationships are not fully established scientifically. What evidentiary conditions, as reflected in the causal criteria, will be certain enough to warrant precautionary preventive action? This paper argues that minimum evidentiary requirements for causation need to be articulated if the Precautionary Principle is to be successfully incorporated into public health practice. Two precautionary changes to criteria-based methods of causal inference are examined: reducing the number of criteria and weakening the rules of inference accompanying the criteria. Such changes point in the direction of identifying minimum evidentiary conditions, but would be premature without better understanding how well current methods of causal inference work. [ABSTRACT FROM AUTHOR]

This paper analyses the situation in countries comprising the WHO South-East Asia Region with respect to water supply and sanitation services, hygiene and the epidemiology of related infectious diseases. Recently, published data from the WHO/UNICEF Global Water Supply and Sanitation Assessment 2000 report was reviewed to depict the situation with respect to consumers' access to improved water supply and sanitation services. It was shown that access to improved drinking water supplies is among the lowest in the world, and that sanitation coverage in this region is below all others. The paper also reviews selected surveys of hygiene behaviours in several countries of the region. Associations are suggested between access to services, hygienic practices and specific infectious diseases. The need is acknowledged to improve the evidence base on linkages between infectious diseases and water, sanitation and hygiene, and specific recommendations are made in this regard. There is a need now and for the foreseeable future to promote low-cost household-level interventions, including behaviour change strategies, that mitigate the health consequences of the current situation with respect to water supply, sanitation and hygiene. The role of health authorities in meeting this challenge, and as advocates for accelerating development of the water and sanitation sector, is highlighted. [ABSTRACT FROM AUTHOR]

This paper estimates the incidence and severity of experienced stress among several convenience populations in healthcare settings, with total N surpassing 7,500. An 8-phase model of burnout places many healthcare providers in the most-advanced phases--approximately 47 percent. This is substantially higher than the record in 25 organizational populations, N = 5,310, which are largely managerial and white-collar in composition. Selected missing populations approximate the distribution in these 25 populations. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to consider a very simple model of the AIDS epidemic. This model illustrates how the spread of AIDS can be affected by parameters whose values, at the present time, are very imprecise or unknown. Of particular interest are the data related to sexual encounters and practices, data which are often unreliable or ambiguous. In this regard, the present model also suggests that the epidemiology of AIDS is particularly sensitive to the limitations in the assessment of sexuality/drug-related behavior. Using a system of elementary differential equations, the present paper illustrates (using 3 examples) that depending upon the value of critical parameters, one could predict either very rapid increases of seropositivity or a decreasing rate of seropositivity. Thus, in order to diminish the ambiguity, it becomes crucial to make careful estimates of the sexual "interaction" coefficients, along with all other parameters, to insure that reasonable predictions can be made. [ABSTRACT FROM AUTHOR]

What makes beliefs thrive? In this paper, we model the dissemination of bona fide science versus pseudoscience, making use of Dan Sperber's epidemiological model of representations. Drawing on cognitive research on the roots of irrational beliefs and the institutional arrangement of science, we explain the dissemination of beliefs in terms of their salience to human cognition and their ability to adapt to specific cultural ecologies. By contrasting the cultural development of science and pseudoscience along a number of dimensions (selective pressure, cumulative change, sources of stabilization, and types of attraction), we gain a better understanding of their underlying epistemic differences. Pseudoscience can achieve widespread acceptance by tapping into evolved cognitive mechanisms, thus sacrificing intellectual integrity for intuitive appeal. Science, by contrast, defies those deeply held intuitions precisely because it is institutionally arranged to track objective patterns in the world, and the world does not care much about our intuitions. In light of these differences, we discuss the degree of openness or resilience to conceptual change (evidence and reason), and the divergent ways in which science and pseudoscience can achieve cultural "success". [ABSTRACT FROM AUTHOR]

Abstract: Obesity (BMI greater than 30.0 kg/m2) is always a trending public health problem and different studies have linked it to the development of heart diseases. However, overweight (BMI between 25.0 kg/m2 and less than 30.0 kg/m2) has very few studies linking it to the development of heart diseases, coupled with the overweight/obesity paradox phenomena which still causes controversy. Therefore, the purpose of this paper is to determine the relationship between overweight and congestive heart failure/coronary heart diseases in the United States. To determine this relationship, the 2011–2012 National Health and Nutrition Examination Survey (NHANES) dataset, which surveyed 9756 individuals in the United States was utilized. The dataset was analyzed using Software for Statistics and Data Software (STATA) and Pearson's chi-squared test. The p-value using the t-test command in STATA for all these variables was <0.001, which indicated that there is a significant relationship between overweight and congestive heart failure/coronary heart disease across gender, ethnicity, and socioeconomic status. Although the development of congestive heart failure/coronary heart disease in overweight individuals was confirmed with this study, it is surprising to realize that the socioeconomic status of an individual also plays a role. Further research is necessary to determine how a lower or higher socioeconomic status causes overweight leading to heart diseases. [ABSTRACT FROM AUTHOR]

This article explores the first field epidemiology training programme (FETP) through a case study to understand its approach to learning and education. Field epidemiologists deploy to outbreaks to investigate, control, and prevent future epidemics and pandemics. Since the 1950s, they have learned their trade through FETP. FETP arose at a paradigmatic crossroads, has endured for seventy years, and is now delivered in over ninety countries. COVID-19 has highlighted the urgency for re-thinking learning in the health sector, hence the analysis of this case can inform FETP, public health, and the adult education field. Inductive content analysis of this case using published accounts from the programme designer-leader and participants suggests the programme's approach to learning reflected Knowles's andragogical assumptions, Kolb's experiential learning cycle, and Lave and Wenger's legitimate peripheral participation in communities of practice. Alignment with such influential contributors to the field of adult learning clarifies the programme's paradigm and explains its endurance. Now, given the lessons of COVID-19, critical learning approaches are needed to enable field epidemiologists to engage issues of culture and power as they investigate epidemics. Recent adult learning theories offer opportunities for adult educators to collaborate with public health programmes. COVID-19 urges that we do not hesitate. [ABSTRACT FROM AUTHOR]

The phytochemicals present in fruits and vegetables may play an important role in deceasing chronic disease risk. Grapes, one of the most popular and widely cultivated and consumed fruits in the world, are rich in phytochemicals. Epidemiological evidence has linked the consumption of grapes with reduced risk of chronic diseases, including certain types of cancer and cardiovascular disease. In vitro and in vivo studies have shown that grapes have strong antioxidant activity, inhibiting cancer cell proliferation and suppressing platelet aggregation, while also lowering cholesterol. Grapes contain a variety of phytochemicals, like phenolic acids, stilbenes, anthocyanins, and proanthocyanidins, all of which are strong antioxidants. The phytochemical composition of grapes, however, varies greatly among different varieties. While extensive research exists, a literature review of the health benefits of grapes and their phytochemicals has not been compiled to summarize this work. The aim of this paper is to critically review the most recent literature regarding the concentrations, biological activities, and mechanisms of grape phytochemicals. [ABSTRACT FROM AUTHOR]

The Nouna Health and Demographic Surveillance System (HDSS) is located in rural Burkina Faso and has existed since 1992. Currently, it has about 78,000 inhabitants. It is a member of the International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), a global network of members who conducts longitudinal health and demographic evaluation of populations in low- and middle-income countries. The health facilities consist of one hospital and 13 basic health centres (locally known as CSPS). The Nouna HDSS has been used as a sampling frame for numerous studies in the fields of clinical research, epidemiology, health economics, and health systems research. In this paper we review some of the main findings, and we describe the effects that almost 20 years of health research activities have shown in the population in general and in terms of the perception, economic implications, and other indicators. Longitudinal data analyses show that childhood, as well as overall mortality, has significantly decreased over the observation period 1993-2007. The under-five mortality rate dropped from about 40 per 1,000 person-years in the mid-1990s to below 30 per 1,000 in 2007. Further efforts are needed to meet goal four of the Millennium Development Goals, which is to reduce the under-five mortality rate by two-thirds between 1990 and 2015. [ABSTRACT FROM AUTHOR]

This is a scholarly analysis of the epidemiological criminology measures applied by South Africa to combat human trafficking of women and girls for involuntary prostitution. It comprises a description of the range of services provided by South African and international organizations and institutions responding to human trafficking of women and girls for involuntary prostitution. Firstly, the sources of information collected to assemble this paper are described. Secondly, the theoretical framework of epi-criminology and the conceptual framework of human trafficking for involuntary prostitution are explained. Thirdly, criminological and public health challenges facing South Africa are discussed briefly as factors giving rise to human trafficking of young women and girls for involuntary prostitution. The fourth aspects discussed are epi-criminological responses, and challenges facing South Africa when responding to human trafficking of women and girls are described. Although victims of human trafficking would still remain hidden with legislation, in the absence of the Human Trafficking Law South Africa cannot determine the extent of the crime. In addition, an ambiguous approach to prostitution prevails in communities and among South African Police Service (SAPS) officers. Furthermore, it is possible that poverty alleviation programmes aimed at mediating poverty and unemployment challenges may not be reaching the targeted populations. To conclude, an emphasis on a multi-faceted approach to address human trafficking of women and girls is advised. South Africa is currently applying a prevention, protection of victims, and prosecution of traffickers approach to respond to human trafficking of girls for involuntary prostitution. [ABSTRACT FROM AUTHOR]

Non-interventional or observational research is often based on existing data, which has been collected over an extended period of time. When the nature of the research requires the examination of a large number of variables, the increased volume of data renders its exploration and understanding a more difficult task. More important, the quality of any analysis is dependent upon the availability of data over time. The aims of this paper are: to communicate the need for a graphical approach when evaluating the completeness of longitudinal data; to demonstrate how we arrived at a SAS/GRAPH® based solution to addressing this need in our project – the patient profile plots (PPPs) and centre profile plots (CPPs); to demonstrate the application of our approach in other settings; to explain the programming principles behind the PPPs and CPPs; and finally, to place PPPs and CPPs in the context of other graphical approaches and discuss their strengths and limitations. PPPs and CPPs are novel SAS based graphical tools that allow the investigator to evaluate the completeness of longitudinal data in a simple, easy to use graphical approach. [ABSTRACT FROM AUTHOR]

Forty years after the World Health Organization abandoned its eradication campaign, malaria remains a public health problem of the first magnitude with worldwide infection rates on the order of 300 million souls. The present paper reviews potential control strategies from the viewpoint of mathematical epidemiology. Following MacDonald and others, we argue in Section 1 that the use of imagicides, i.e., killing, or at least repelling, adult mosquitoes, is inherently the most effective way of combating the pandemic. In Section 2, we model competition between wild-type (WT) and plasmodium-resistant, genetically modified (GM) mosquitoes. Under the assumptions of inherent cost and prevalence-dependant benefit to transgenics, GM introduction can never eradicate malaria save by stochastic extinction of WTs. Moreover, alternative interventions that reduce prevalence have the undesirable consequence of reducing the likelihood of successful GM introduction. Section 3 considers the possibility of using seasonal fluctuations in mosquito abundance and disease prevalence to 'slingshot' GM mosquitoes into natural populations. By introducing GM mosquitoes when natural populations are about to expand, one can 'piggyback' on the yearly cycle. Importantly, this effect is only significant when transgene cost is small, in which case the non-trivial equilibrium is a focus (damped oscillations), and piggybacking is amplified by the system's inherent tendency to oscillate. By way of contrast, when transgene cost is large, the equilibrium is a node and no such amplification is obtained. [ABSTRACT FROM AUTHOR]

This paper presents epidemiological data from ongoing HIV-prevalence surveillance in a large South African manufacturing company located in various provinces, as well as one location in Swaziland. A survey of the workforce in 12 of the manufacturer's business units (BUs) throughout these locations was carried out in 2001-2003, and each was repeated three years later, in 2004-2006. The company is typical of manufacturing in South Africa, in that it is labour-intensive, male-dominated, and has high proportions of semi-skilled and unskilled employees. The surveys were anonymous, cross-sectional and unlinked. The workforce was stratified at the level of analysis by workplace, geographical location, job status (permanent or contract), job skill level, and age group. In 2001/3 a total of 5 177 permanent employees, representing 76% of those on duty at the time, plus 1 966 contract employees were surveyed. In 2004/6, 5 445 permanent employees, representing 81% of those on duty, and 2 688 contract employees were surveyed. HIV prevalence in the 2004/6 survey ranged from 0.9-30.7% throughout the 12 BUs, with a mean of 15.4%, showing an increase from the previous mean of 13% prevalence in the 2001/3 survey of the same locations (p = 0.0001). Differences in HIV prevalence across the BUs were determined by geographical location and the profile of the workforce. Similar proportions of contract employees were found to be HIV-positive in the initial survey and repeat survey (23% and 24.5%, respectively). HIV prevalence was inversely proportionate to permanent employees' job skill level. The 2004/6 data show lowest HIV prevalence in the upper-management category (3.6%) and highest prevalence in the unskilled category (22.6%). HIV prevalence did not increase in the upper- and middle-management categories but increased significantly in the skilled (p = 0.02), semi-skilled (p < 0.001) and unskilled (p < 0.001) job categories. HIV prevalence was similar among contract employees and unskilled permanent employees. Race (not considered in the study) may in part confound these findings. In both surveys, HIV prevalence was highest in the age group 30-39. Prevalence did not increase between surveys in the age group 18-29; however, significant increases occurred in the age groups 30-39 and 40-49 (p < 0.001), and possibly also in the age 50+ category (p = 0.09). [ABSTRACT FROM AUTHOR]

Objectives. This is the second of 2 papers reporting on the result of the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland. Methods. Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries. Results. Cancer in general is increasing among Inuit, in all regions, and among both men and women. Inuit continue to be at extreme high risk, relative to non-Inuit and to comparisons of global populations, for the historically recognized so-called traditional cancers (such as cancer of the nasopharynx and salivary glands). Among the so-called modern cancers prevalent in developed societies, lung cancer is rapidly increasing in incidence (especially in Canada), such that the rate in both Inuit men and women is the highest in the world; other cancers, such as colorectal cancer, are also on the rise (especially in Alaska), while breast and prostate cancer remain low relative to the non-Inuit population. The decline in cervical cancer is a positive development; in the 3 regions, the rate in Greenland is the highest. Conclusions. Data such as these can form the basis of interventions directed towards known risk factors such as smoking, diet, obesity, viral and bacterial infections, and low screening prevalence. Cancer surveillance is a basic task of the public health system; in the Arctic, it is particularly important as Inuit continue to undergo further changes in their life-styles and social environments. [ABSTRACT FROM AUTHOR]

Prominent British and American sources now seek to structure public understanding of climate change by issuing “tipping point” forewarnings of danger with increasing frequency. This emerging trend announces a shift in the way we are likely to perceive and respond to climate change dangers. This paper reviews key statements to suggest a significant dimension of this trend is its enrollment of epidemiological terminology to communicate urgent and uncertain threats. First, key events in the popular employment of epidemiological and public health models of explanation are reviewed. Second, the author discusses the climate change “debate” to illuminate the limitations involved in treating climate change as a public issue detached from other problems involving atmospheric science. Third, the author reconstructs the tipping point tendency in this context. The essay concludes that the use of this concept signals a broader trend toward epidemiological models of explanation likely to activate public health styles of intervention for addressing climate change impacts. Some implications are briefly discussed. [ABSTRACT FROM AUTHOR]

Background: Traditionally, studies in human biodiversity, disease risk, and health disparities have defined populations in the context of typological racial models. However, such racial models are often imprecise generalizations that fail to capture important local patterns of human biodiversity. Aim: More explicit, detailed, and integrated information on relevant geographic, environmental, cultural, genetic, historical, and demographic variables are needed to understand local group expressions of disease inequities. This paper details the methods used in ethnogenetic layering (EL), a non-typological alternative to the current reliance of the biological racial paradigm in public health, epidemiology, and biomedicine. Subjects and methods: EL is focused on geographically identified microethnic groups or MEGs, a more nuanced and sensitive level of analysis than race. Using the MEG level of analysis, EL reveals clinical variations, details the causes of health disparities, and provides a foundation for bioculturally effective intervention strategies. EL relies on computational approaches by using GIS-facilitated maps to produce horizontally stratified geographical regional profiles which are then stacked and evaluated vertically. Each horizontal digital map details local geographic variation in the attributes of a particular database; usually this includes data on local historical demography, genetic diversity, cultural patterns, and specific chronic disease risks (e.g. dietary and toxicological exposures). Horizontal visual display of these layered maps permits vertical analysis at various geographic hot spots. Results and conclusions: From these analyses, geographical areas and their associated MEGs with highly correlated chronic disease risk factors can be identified and targeted for further study. [ABSTRACT FROM AUTHOR]

The primary objective was to present a cross-country comparison of injury rates, contexts and consequences. The research design was the analysis of data from the 1998 cross-national Health Behaviour in School-aged Children survey and 52 955 schoolchildren from 11 countries, aged 11, 13 and 15 years, completed a self-administrated questionnaire. A total of 41.3% of all children were injured and needed medical treatment in the past 12 months. Injury rates among boys were higher than among girls, 13.3% reported activity loss due to injury and 6.9% reported severe injury consequences. Most injuries occurred at home and at a sport facility, mainly during sport activity. Fighting accounted for 4.1% of injuries. This paper presents the first cross-national comparison of injury rates and patterns by external cause and context. Findings present cross-country similarities in injury distribution by setting and activity. These findings emphasize the importance of the development of global prevention programmes designed to address injuries among youth. [ABSTRACT FROM AUTHOR]

The literature on borderline personality disorder (BPD), including its epidemiology, biology, phenomenology, causes, correlates, consequences, costs, treatments, and outcomes is vast. Thousands of articles and books have been published. Because the true prevalence of BPD by sex (gender) in the general population is still unknown, the important question of why women, rather than men, are more frequently diagnosed with BPD remains largely unanswered—despite current evidence for the origin of personality disorder in genetics and neurobiology, and despite recent suggestions that biased sampling is the most likely explanation for gender bias in the diagnosis of BPD. This paper reviews selected literature on (a) the epidemiology of BPD, (b) gender bias in the diagnosis of BPD, and (c) the social construction of diagnosis, particularly the diagnostic entity labeled “Borderline Personality Disorder.” It attempts a synthesis of diverse, multidisciplinary literature to address the question of why women outnumber men by a ratio of 3:1 in the diagnosis of BPD. It rests on assumptions that (a) to varying degrees sociocultural factors inevitably play a role in the expression of disease conditions, and that (b) personality disorders, including BPD, have cultural histories. It also rests on the belief, for which there is considerable scholarly support, that the phenomenon called BPD has multiple, complex, interactive, biological, psychological, and constructed sociocultural determinants. Nurses must understand the phenomenon at this level of complexity to provide appropriate care. [ABSTRACT FROM AUTHOR]

In this paper the epidemiology of club drug use in Germany, including the use of 3,4-methylendioxy-N-methamphetamine (MDMA) known as ‘ecstasy’ and related substances such as speed, amphetamines, hallucinogens, and cannabis is described on the basis of five different surveys. Two of them are representative household surveys to monitor the licit and illicit drug use behavior of the German population. The third one is a longitudinal study aimed at exploring comorbidity and posited risk and protective factors in adolescents and young adults with specific emphasis on substance use-related disorders. Since ecstasy seemed to be associated with a new music culture of the ‘90s called “techno,” two studies investigating the relationship of using ecstasy and related substances in the techno party scene are additionally presented. The question of the clinical impact of using ecstasy and related substances is raised in terms of substance use-related and mental disorders associated with the use of ecstasy. Finally, the motivation for using and stopping the use of ecstasy is addressed. It is shown that ecstasy has reached the second place (after cannabis) in illegal drug preferences of adolescents and young adults in Germany. Evidence is found that ecstasy use as well as ecstasy use-related disorders such as “abuse” and “dependence” are of a transient, “youth-limited” nature. [ABSTRACT FROM AUTHOR]

Despite the demands it places on individuals, families and the community, intellectual disability (ID) is a neglected area of public health. Accurate estimates of prevalence are sparse and range from 0.5 to 3.0%. The cause of the condition is unknown in at least 50% of cases. This paper describes the Intellectual Disability Exploring Answers (IDEA) database set up in Western Australia to provide an infrastructure for research and to facilitate the planning of service provision for people with ID. Since 1953 a database for ID has been maintained in Western Australia, a state with a population of 1.95 million in an area of 2.52 million km 2 . The current IDEA database aims to obtain ongoing population-based ascertainment of ID from providers of clinical and educational services, with the potential for linkage to a network of other state databases. The average prevalence of ID for children born in Western Australia over the years 1983–1996 was 15.2 per 1000 live births, with 50% ascertained only through the education system. During this time period 60% of cases were male. Of children with an ID born in Western Australia in 1980–1999 and surviving to 1 year, 30.1% had a birth defect, and the prevalence ratio of birth defects in this group compared to the population with no birth defects was 6.5 (CI 6.3–6.8). [ABSTRACT FROM AUTHOR]

As technology advances rapidly, so do applications with potential adverse implications on human health. The possible threats include risks that can be substantial, far-reaching and irreversible, and currently available methods of investigation, designed to deal with direct exposure-disease associations, are not always suitable. Growing interest is being paid to health effects that may be the consequence of distal, “upstream” determinants. Considering the complex chain of events that links such determinants with health can be extremely difficult, and exposes severe limitations in science. Thus, there is often a mismatch between what is known and what would be required to inform rational, evidence-based decision making, which is increasingly called for. It has become apparent how production and use of scientific evidence in decision making must be accompanied by precaution, especially in those circumstances, more and more common in recent times, where there is an uncertain possibility that serious health consequences might take place. Several cautionary approaches have been proposed, but the Precautionary Principle (PP) has been the object of especially intense debate in recent years. Developed in the field of environmental health, the PP has been clarified, and has been applied or called for in several instances in public health. Although a unique definition is not available, the principle has been characterised, and criteria for its application have been proposed. However, many questions remain open on general as well as specific issues. In this paper, we address some of the questions that are relevant for the PP to support rational decision making in environment and health and more in general to strengthen its contribution towards human health protection. [ABSTRACT FROM AUTHOR]

The dominant discourses of breast cancer risk are individualistic and biological, tending to emphasize personal life history, genetic predisposition and 'lifestyle' factors. Statutory programmes to reduce risk are correspondingly concerned primarily with early detection, and not with primary prevention of a disease whose incidence rate continues to rise in the UK and the USA. Against this, the breast cancer movement is working to emphasize the collective narrative of breast cancer aetiology, applying an ecological approach to public health protection, and basing its demands on a precautionary approach to environmental hazards. This paper considers how the breast cancer/environment movement in the US and UK asserts the legitimacy of activists' alternative expertise, and challenges the biomedical foundation of traditional epidemiological practices. Activists' knowledge claims are, additionally, understood as embodied, lay expertise, predicated in feminist epistemology which has argued that the personal, the subjective and the partial count, and that such situated knowledge makes for stronger science. These dimensions of the breast cancer/environment movement shape what is here termed 'citizen expertise', as activists present a 'transformational vision' of the physical, political, social and economic environments that currently contribute to breast cancer. [ABSTRACT FROM AUTHOR]

A review of the epidemiological literature on the health of UK-born Black Caribbeans was undertaken. Forty-three papers were found; around half of these were on the incidence of schizophrenia and psychotic conditions in this population. A small number were on autoimmune disorders, sexual health, diet and alcohol intake and children's health. Although there are many methodological limitations with the research on schizophrenia and psychotic conditions, the findings are consistent in that UK-born Black Caribbeans are more likely to be diagnosed with these conditions than Whites, and possibly more so than migrant Black Caribbeans. Poorer sexual health and the high prevalence of some specific autoimmune conditions, such as human T-cell lymphoma/leukaemia (HTLV-1), were also consistent features in the research evidence. The findings from these studies suggest a transmission of risk of these conditions across generations, and that environmental factors, rather than genetic susceptibility, play a major role in outcomes. There was a lack of research investigating generational shifts in risks for major conditions, such as coronary heart disease, lung or breast cancer. [ABSTRACT FROM AUTHOR]

This paper examines the impact of the National Research Council's report Risk Assessment in the Federal Government: Managing the Process, known as the "Red Book," on the practice of risk assessment, risk management, and the education of public health and risk professionals. The four-step approach to risk assessment was broadly adopted by the regulatory community and has a profound impact on science, research, public health, and regulatory decision-making. Early limitations and unintended negative consequences of the approach are also examined, including the isolation of public health agencies from regulatory decision-making and the de-emphasis of epidemiology and public health surveillance. Recent progress to address the gap between public health and risk assessment is described and a list of future challenges is presented to assure continued building upon the foundation provided by the first 20 years of the Red book. Among the greatest of these challenges is the continued effort to improve the interface between science and policy in risk decision-making. Key Words: risk assessment; risk management; Red Book; National Research Council; public health; health surveillance. [ABSTRACT FROM AUTHOR]

In order to prepare social workers better to intervene in the complex social problems affecting the health and social functioning of all populations, we propose the integration of appropriate public health content into the social work curriculum. In this paper we discuss the relationship between social work and public health, how public health content (i.e., epidemiology, prevention, community and population level interventions) fits in the social work curriculum, existing curriculum resources, and potential barriers to implementation of the proposal. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the association between sugar-sweetened beverages (SSB) consumption (including individual SSB) and cognitive function from the National Health and Nutrition Examination Survey (NHANES) and Food Patterns Equivalents Database (FPED) and whether it is age-dependent. Methods: Older adults aged 60 years old and over were included during the NHANES 2011–2014. SSB consumption was defined as the amount of added sugar obtained by connecting the NHANES and FPED. Cognitive function tests included the consortium to establish a registry for Alzheimer's disease test, Animal Fluency Test and Digit Symbol Substitution Test. We calculated z-score using the average of the total standardized scores on three cognitive tests to estimate the level of whole cognition. Multi-variable linear regression models and interaction analysis were conducted in this study. Results: For individual SSB types, increased carbonated soft drinks, sweetened tea, fruit drinks, energy drinks, and sport drinks were all significantly linked to declined cognitive function (P < 0.05), respectively. Nevertheless, interaction effects by age groups were not significant (P for interaction > 0.05). Discussion: SSB consumption (including individual SSB) was negatively associated with cognitive function, which was not age-dependent. Future studies may advance the knowledge in the field considering the association between SSB consumption and cognitive function. [ABSTRACT FROM AUTHOR]

FLA-related conditions are a rare medical occurrence. Despite their rarity, they are considered a public health concern for two reasons: the absence of a regular treatment regimen in the case of central nervous system infections and the fast progression of the symptoms leading to fatal outcomes. A total of 358 articles were retrieved from different databases (91 from PubMed, 26 from NCBI, 138 from Academia, 102 from Science Direct, and one from IJMED). 7 (46.6%) clinical cases came from Egypt, 2 (13.3%) cases of FLA infection came from Nigeria, 3 (20%) cases came from the Gambia, and 1 (6.6%) case was reported from African countries like Algeria, Tunisia, South Africa, and Zambia. Medical conditions caused by free-living amoeba are considered significant public health concerns. These ubiquitous organisms can cause both fatal and debilitating health conditions. Immediate diagnosis of cases and proper hygienic practices are necessary to provide direct medical intervention. They may be the key to reducing the morbidity and mortality rates from FLA-acquired infections. Although several government-led initiatives have been implemented to mitigate a plethora of parasitic diseases, the case of FLA-related conditions in African countries has yet to be realized. [ABSTRACT FROM AUTHOR]

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault's power-knowledge concepts—"objects", "ritual", and "the privileged"—and guided by Black feminist philosopher Kristie Dotson's conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology's affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never stepped foot inside the communities they aver to model. It also expressly names the structurally racist reality of a "colorblind" knowledge production/curation system controlled by White scholars working from/for an invisibilized White scientific gaze. In this spirit, this commentary engages the public health critical race praxis principle of "disciplinary self-critique", illuminating the inherent contradictions of a racial health equity discourse that fails to interrogate the racialized power dynamics underlying its knowledge production enterprise. In doing so, this commentary seeks to (re)frame and invite discourse regarding matters of epistemic violence and (re)colonization as manifest/legible within epidemiology research, suggesting that the structural racism embedded within – and perpetuated through – our collective work must be addressed to advance antiracist and decolonial public health futures. In this regard, I suggest the value of engaging poetry as praxis—as mode of knowledge production/expression to "center the margins" and offer counternarratives to epidemiology's epistemic violence. [ABSTRACT FROM AUTHOR]

A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence, crude, age-specific and age-adjustment rates into the gerontology classroom. Background information and formulas for each rate, as well as examples of how they can be applied are provided. A recent change, encouraged by the U.S. Department of Health and Human Services, from a 1940 to a 2000 “standard million population” for ageadjusted rates, is reviewed. Finally, a teaching module with answers is provided for use in the gerontology classroom. [ABSTRACT FROM PUBLISHER]

The article presents the discussion on impeding governments' ability for implementing public health measures effectively. Topics include individuals increasingly relying on the social media networks, messaging apps, and streaming platforms for news stories; and engaging experts, agencies and authorities from fields ranging from epidemiology and public health to social and behavioral sciences.

Beer remains the greatest source of per capita alcohol consumption in the United States, and increasing market availability and consumer demand for higher alcohol has meaningful public health consequences. Objectives: To determine whether apparent alcohol intake from beer changed among households over time, we used nationally-representative US Nielsen Consumer Panel purchasing data from 2004 to 2014, and incorporated information on percent alcohol by volume (ABV) to compute the number of standard drinks of alcohol consumed from beer as a result. Methods: We queried external data sources (e.g. official manufacture, consumer beer-related websites) to obtain beer-specific ABVs, merged this information with Nielsen consumer-level data, and calculated the average rate of beer and standard drink consumption per household per year. We used joinpoint regression to estimate annual percentage changes and annual absolute changes in intake over time, with separate piecewise linear segments fit between years if a significant deviation in trend was detected. Results: Higher alcohol content beer consumption increased steadily across the decade, accounting for 9.6% of total intake in 2004 compared to 21.6% of total intake by 2014. Standard drink intake from beer declined sharply post-2011 by 3.04% annually (95% CI: −5.93, −0.06) or by 4.52 standard drinks (95% CI: −8.69, −0.35) yearly – coinciding with several beer industry transitions, market share fluctuations, and consumer preference changes for beer occurring around that time. Conclusions: Despite consistent increases in higher alcohol content beer intake across the decade, households do not appear to be consuming more standard drinks of alcohol from beer as a result. Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1928208. [ABSTRACT FROM AUTHOR]

Essential health, education and other service disruptions arising from the COVID-19 pandemic risk reversing some of the hard-won gains in improving child survival over the past 40 years. Although children have milder symptoms of COVID-19 disease than adults, pandemic control measures in many countries have disrupted health, education and other services for children, often leaving them without access to birth and postnatal care, vaccinations and early childhood preventive and treatment services. These disruptions mean that the SARS-CoV-2 virus, along with climate change and shifting epidemiological and demographic patterns, are challenging the survival gains that we have seen over the past 40 years. We revisit the initiatives and actions of the past that catalyzed survival improvements in an effort to learn how to maintain these gains even in the face of today's global challenges. [ABSTRACT FROM AUTHOR]

Background: Betel quid chewing is a deep-rooted practice in India and neighboring countries, which has migrated to other parts of the world. Betel leaf acts as a carrier for areca nut and most often, smokeless tobacco, both of which are carcinogenic, making betel quid a harmful product. Objectives: The first objective was to compare the prevalence of "use of betel quid with tobacco" from GATS-1 to GATS-2. The second was to study the association of "use of betel quid with and without tobacco" with different socio-economic groups (wealth quintiles) according to select background characteristics. Methods: This study used data from the Global Adult Tobacco Surveys (GATS), 2009–10 and 2016–17. Logistic regression with adjustment of co-variates (age, gender, residence and education) was used to study association of use of betel quid with different socio-economic groups. Results: Highest reduction (40 percent) was seen in "use of betel quid with tobacco" among male youth (15–24 years) over the two rounds of GATS. No change was seen in this form of use among females. The odds of "use of betel quid with tobacco" had a positive gradient with decreasing wealth quintiles. "Use of betel quid without tobacco" showed highest odds among participants with moderate levels of education. Conclusion: Health promotion interventions around harmful effects of "betel quid with and without tobacco" are needed for all genders from poorer populations with low education. Stress needs to be laid on universal population-level public health awareness campaigns about the carcinogenic properties of areca nut in betel quid. [ABSTRACT FROM AUTHOR]

Background: Betel nut use is a public health issue in the Asia-Pacific region that is often neglected. To control betel nut use, understanding of the adverse effects of betel nut use and evidence-based policies and strategies is necessary. Objectives: This narrative review aims to characterize the current situation on betel nut use at a global level regarding the epidemiology, pharmacology and toxicology, health effects, treatment options, policies and strategies. Methods: We found 139 existing literature published between 1970–2019 on the Web of Science database and other technical documents to collate the most relevant information on betel nut use. Data were categorized into appropriate themes. Results: The literature demonstrates that there is a lack of up to date statistics on betel nut use. There is limited research on the effect of policies and strategies to control betel nut use. Conclusion: Betel nut-chewing countries should focus on understanding which populations chew betel nut and implement appropriate policies, educational and cessation programs to help control betel nut use. [ABSTRACT FROM AUTHOR]