Some considerations concerning the challenge of incorporating social variables into epidemiological models of infectious disease transmission

Incorporation of ‘social’ variables into epidemiological models remains a challenge. Too much detail and models cease to be useful; too little and the very notion of infection —a highly social process in human populations—may be considered with little reference to the social. The French sociologist Emile Durkheim proposed that the scientific study of society required identification and study of ‘social currents.’ Such ‘currents’ are what we might today describe as ‘emergent properties,’ specifiable variables appertaining to individuals and groups, which represent the perspectives of social actors as they experience the environment in which they live their lives. Here we review the ways in which one particular emergent property, hope, relevant to a range of epidemiological situations, might be used in epidemiological modelling of infectious diseases in human populations. We also indicate how such an approach might be extended to include a range of other potential emergent properties to repre

Diabetic kidney disease. new clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on "the natural history of diabetic kidney disease and treatment of hyperglycemia in patients with type 2 diabetes and impaired renal function"

Recent epidemiological studies have disclosed heterogeneity in diabetic kidney disease (DKD). In addition to the classical albuminuric phenotype, two new phenotypes have emerged, i.e., “nonalbuminuric renal impairment” and “progressive renal decline”, suggesting that DKD progression toward end-stage kidney disease in diabetic patients may occur through two distinct pathways heralded by a progressive increase in albuminuria and decline in renal function independent of albuminuria, respectively. Besides the natural history of DKD, also the management of hyperglycemia in patients with type 2 diabetes and reduced renal function has profoundly changed in the last two decades. New anti-hyperglycemic drugs have become available for treatment of these individuals and the lowest estimated glomerular filtration rate safety thresholds for some of the old agents have been reconsidered. This joint document of the Italian Diabetes Society (SID) and the Italian Society of Nephrology (SIN) reviews the natural history of DKD in the light of the recent epidemiological literature and provides updated recommendations on anti-hyperglycemic treatment with non-insulin agents in DKD patients

Get on the Cart! Wesleyan Discipleship in an Age of Endemic (Chapter 15 of Thinking Theologically About Mass Incarceration)

Excerpt: Fyodor Dostoyevsky once said that the so,ul of society can be measured by its prisons. 1 If that is true, then the soul of society in the United States is sick. The statistics on mass incarceration provided elsewhere in this volume illustrate the endemic nature of the problem much like epidemiological data shows the occurrence of a disease, but the stories from prisoners and their families-which the three of us have heard and told-show even more poignantly the depth of the wounds caused by the tragedy of incarceration that defies Christian virtues in this country. We pray this chapter will be one of many applications of healing b\u3c~Jlm to address this societal disease

Role of Epidemiological Studies in Disease Prevention

Today's society is full of disease that are of different natures including genetic, infectious and metabolic etc. Every disease has its own mechanisms of affecting humans and different prevention mechanisms as per disease nature. These factors are included in epidemiology of disease. Other factors include prevalence and incidence of diseases in different populations. Exactly knowing about disease epidemiology helps governing authorities to prevent the disease. Unfortunately, under-developed and developing nations are not focusing on diseases epidemiology. On the other hand, all developing nations developed best public health practices based on diseases epidemiology data. These studies may vary from basic epidemiological surveys to identification of microorganism strains etc

What makes or breaks a campaign to stop an invading plant pathogen?

Diseases in humans, animals and plants remain an important challenge in our society. Effective control of invasive pathogens often requires coordinated concerted action of a large group of stakeholders. Both epidemiological and human behavioural factors influence the outcome of a disease control campaign. In mathematical models that are frequently used to guide such campaigns, human behaviour is often ill-represented, if at all. Existing models of human, animal and plant disease that do incorporate participation or compliance are often driven by pay-offs or direct observations of the disease state. It is however very well known that opinion is an important driving factor of human decision making. Here we consider the case study of Citrus Huanglongbing disease (HLB), which is an acute bacterial disease that threatens the sustainability of citrus production across the world. We show how by coupling an epidemiological model of this invasive disease with an opinion dynamics model we are able to answer the question: What makes or breaks the effectiveness of a disease control campaign? Frequent contact between stakeholders and advisors is shown to increase the probability of successful control. More surprisingly, we show that informing stakeholders about the effectiveness of control methods is of much greater importance than prematurely increasing their perceptions of the risk of infection. We discuss the overarching consequences of this finding and the effect on human as well as plant disease epidemics

A Practical Guide to Integrating Reproductive Health and HIV/AIDS into Grant Proposals to the Global Fund

Integrating RH and HIV can greatly contribute to mitigating the AIDS pandemic by reducing unintended pregnancy; preventing perinatal transmission; expanding to more target groups; reducing gender based violence; meeting the needs of people living with HIV and providing our youth with the knowledge and services they need. Whether to integrate, how to integrate and exactly what to integrate will depend on a country's epidemiological profile, policies and program structures.Experience with implementation of integration initiatives in countries around the world shows that scale up and sustainability requires attention to policy and program operations issues. This document, with links to a range of resources, will help CCMs, civil society organizations and others developing proposals for the Global Fund that contribute to preventing HIV and mitigating the effects of the AIDS pandemic through programs that link and integrate RH and HIV/AIDS

The Role of Physical Activity in the Primary Prevention of Type 2 Diabetes via the Amelioration of Insulin Resistance.

Type 2 diabetes is the most common endocrine disease in our society, affecting around 5% of Western populations, whilst showing a steady rise in prevalence. The complications that arise from the disease are known to cause morbidity and mortality, and are associated with long-term damage, dysfunction, and failure of various organs. These complications include atherosclerosis in the micro and macro vasculature, kidney dysfunction, nerve problems, hypertension; and eye problems such as retinopathy. Epidemiological evidence suggests regular physical activity improves insulin sensitivity. This review presents the case for physical activity as a tool of primary prevention, in the population of non-diabetics and high risk individuals (IFG & IGT), in reference to obesity related insulin resistance. Cross-sectional, prospective cohort and randomised control trials clearly show that moderate-intensity physical activity can improve insulin sensitivity; this can be improved further by undertaking vigorous intensity physical activity

Taming troubled teens: The social production of mental morbidity amongst young mothers in Pelotas, Brazil

Copyright @ 2011 Elsevier Ltd. This is a post-print version of the article. The published version of the article can be viewed at the link below.Explanations for the association between teen-childbearing and subsequent mental morbidity vary considerably, from those based on neurological theories of development to those investigating underlying social and economic determinants. Based on longitudinal epidemiological and ethnographic sub-studies of the 1982 Pelotas birth cohort study, this paper explores the hypothesis that teen childbearing and subsequent mental morbidity have become associated through the interplay of culture, society, and biology in situations where teen pregnancy has become a stigmatised object of scientific and public health attention. Results show that the effect of teen childbearing on subsequent mental morbidity remained significant in the multivariate analysis. Ethnographic analysis, together with epidemiological effect modification analyses, suggest that this association is partially accounted for by the fact that it is more pronounced amongst a specific subgroup of women of low socio-economic status who, being more politicised about societal injustice, were also more critically engaged with – and thus troubled by – the inequitable institutionalisation of life-cycle transitions. With time, these women became highly critical of the institutionalised identification of early childbearing as a key violation of life-cycle norms and the differential class-based application of scientific knowledge on its causes and consequences. Public health campaigns should consider how the age-based institutionalisation of developmental norms has enabled the stigmatisation of those identified as transgressors.The 1982 cohort study has been funded by The Wellcome Trust, the World Health Organisation, the PanAmerican Health Organisation, the European Union, the Programa Nacional para Centros de Excelência (PRONEX), the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), the Brazilian Ministry of Health, and the Fundação de Amparo à Pesquisa do Rio Grande do Sul (Fapergs). D Béhague received support from a US National Science Foundation Doctoral Fellowship and a Postdoctoral Training Fellowship from The Wellcome Trust (Grant no. GR077175MA)