Global public health training in the UK: preparing for the future.

BACKGROUND: Many major public health issues today are not confined by national boundaries. However, the global public health workforce appears unprepared to confront the challenges posed by globalization. We therefore sought to investigate whether the current UK public health training programme adequately prepares its graduates to operate in a globalized world. METHODS: We used mixed methods involving an online cross-sectional survey of UK public health trainees on the international content of the Faculty of Public Health's written examination, a qualitative review of the Faculty's 2007 training curriculum and a questionnaire survey of all training deaneries in the UK. RESULTS: We found that global health issues are not addressed by the current training curriculum or in the written examination despite trainee interest for this. Many of the deaneries were also unreceptive to international placements. CONCLUSIONS: Despite the recognized educational legitimacy of global health placements and the favourable UK policy context, the opportunities and international content of public health training remain limited. In order to retain its position as a leader in the field of public health, the UK needs to adapt its training programme to better reflect today's challenges

COMPETITIVENESS IN THE LIGHT OF SPORTS HABITS

Munkám során arra voltam kíváncsi, hogy régiónk lakosainak fittségi állapota hogyan viszonyul a magyarországi átlagos értékhez, illetve egy másik, kulturális és történelmi hagyományait tekintve eltérő hazai régióhoz. Annak megértése érdekében, hogy ezen fittségi állapot milyen okok miatt alakul ki, illetve annak milyen felnőtt és időskori következményei lesznek az adott populáció sportolási szokásainak szempontjából, kérdőíves felmérésekben vizsgáltam az Észak-alföldi régió lakosainak ilyen irányú szokásait. Arra kerestem választ, hogy melyek azok a tényezők, amik a sportolás iránti igényt meghatározzák, illetve melyek azok a visszatartó okok, amelyek miatt egyesek keveset, vagy egyáltalán nem sportolnak. Munkám további részében, annak felderítésére, hogy a fiatalkori szervezett sportolás milyen infrastrukturális és anyagi támogatottsággal rendelkezik, Magyarország sportiskolai rendszerét vizsgáltam. Megállapítottam, hogy a fiatalok egészségmagatartásának fejlesztése egyrészt elengedhetetlen a jövő egészséges generációjának felneveléséhez, másrészt, hogy ennek szükséges az országos méretű intézményi kereteit kialakítani.During my research work, I wanted to learn how the fitness status of the inhabitants of the region I live in correlates with the average Hungarian values and also with those of another Hungarian region which is different in terms of cultural and historical traditions. In order to understand the causes of the given fitness status, as well as the resulting consequences in adult and old age from the aspect of the sports habits of the given population, I carried out questionnaire surveys focusing on the respective habits of the inhabitants of the North Great Plain region. I was looking for the factors which determine people’s need to do sports and also the causes which keep certain people from doing enough or any sports. In the rest of my work, I examined the sports school system of Hungary in order to explore the infrastructural and financial background of organised sports at young age. I concluded that the development of the health behaviour of youngsters is indispensable from the aspect of raising a healthy future generation and that it is needed to develop the necessary country-wide institutional framework.d

ISM In-Space Manufacturing

Develop and enable the technologies, materials, and processes required to provide affordable, sustainable on-demand manufacturing, recycling, and repair during Exploration Missions

An economic analysis of a pneumococcal vaccine programme in people aged over 64 years in a developed country setting.

BACKGROUND: Polysaccharide pneumococcal vaccination for older adults is being introduced in developed country settings. Evidence of protection by this vaccine against pneumococcal pneumonia, or confirmation that illness and death from bacteraemia are prevented, is currently limited. Decisions are often made based on partial information. We examined the policy implications by exploring the potential economic benefit to society and the health sector of pneumococcal vaccination in older adults. METHODS: A model to estimate the potential cost savings and cost-effectiveness of a polysaccharide pneumococcal vaccine programme was based on costs collected from patients, the literature, and routine health-services data. The effect of a pneumococcal vaccine (compared with no vaccination) was examined in a hypothetical cohort aged over 64 years. The duration of protection was assumed to be 10 years, with or without a booster at 5 years. RESULTS: If it were effective against morbidity from pneumococcal pneumonia, the main burden from pneumococcal disease, the vaccine could be cost-neutral to society or the health sector at low efficacy (28 and 37.5%, respectively, without boosting and with 70% coverage). If it were effective against morbidity from bacteraemia only, the vaccine's efficacy would need to be 75 and 89%, respectively. If protection against both morbidity and mortality from pneumococcal bacteraemia was 50%, the net cost to society would be 2500 pounds per year of life saved ( 3365 pounds from the health-sector perspective). Results were sensitive to incidence, case-fatality rates, and costs of illness. CONCLUSIONS: A vaccine with moderate efficacy against bacteraemic illness and death would be cost-effective. If it also protected against pneumonia, it would be cost-effective even if its efficacy were low

Trends and characteristics of accidental and intentional codeine overdose deaths in Australia

Examines trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths. Abstract Objectives: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths. Design and setting: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000–2013. Main outcome measures: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator). Results: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity. Conclusions: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy

Are Consumers Willing to Pay More for Biodegradable Containers Than for Plastic Ones? Evidence from Hypothetical Conjoint Analysis and Nonhypothetical Experimental Auctions

This study used and compared hypothetical conjoint analysis and nonhypothetical experimental auctions to elicit floral customers’ willingness to pay for biodegradable plant containers. The results of the study show that participants were willing to pay a price premium for biodegradable containers, but the premium is not the same for different types of containers. This article also shows the mixed ordered probit model generates more accurate results when analyzing the conjoint analysis Internet survey data than the ordered probit model.biodegradable, willingness to pay, marketing, carbon footprint, waste composition, green industry, nursery crops, floriculture crops, Agribusiness, Agricultural and Food Policy, Environmental Economics and Policy, Financial Economics, Food Consumption/Nutrition/Food Safety, Marketing, Public Economics, Research and Development/Tech Change/Emerging Technologies, D12, Q13,

A cohort study of the effectiveness of influenza vaccine in older people, performed using the United Kingdom general practice research database.

BACKGROUND: The effectiveness of influenza vaccination against hospitalization and death can only ethically be assessed in observational studies. A concern is that individuals who are vaccinated are healthier than individuals who are not vaccinated, potentially biasing estimates of effectiveness upward. METHODS: We conducted a historical cohort study of individuals >64 years of age, for whom there were data available in the General Practice Research Database for 1989 to 1999 in England and Wales. Rates of admissions for acute respiratory diseases and rates of death due to respiratory disease were compared over 692,819 person-years in vaccine recipients and 1,534,280 person-years in vaccine nonrecipients. RESULTS: The pooled effectiveness of vaccine against hospitalizations for acute respiratory disease was 21% (95% confidence interval [CI], 17%-26%). The rate reduction attributable to vaccination was 4.15 hospitalizations/100,000 person-weeks in the influenza season. Among vaccine recipients, no important reduction in the number of admissions to the hospital was seen outside influenza seasons. The pooled effectiveness of vaccine against deaths due to respiratory disease was 12% (95% CI, 8%-16%). A greater proportionate reduction was seen among people without medical disorders, but absolute rate reduction was higher in individuals with medical disorders, compared with individuals without such disorders (6.14 deaths due to respiratory disease/100,000 person-weeks vs. 3.12 deaths due to respiratory disease/100,000 person-weeks). Clear protection against death due to all causes was not seen. CONCLUSIONS: Influenza vaccination reduces the number of hospitalizations and deaths due to respiratory disease, after correction for confounding in individuals >64 years of age who had a high risk or a low risk for influenza. For elderly people, untargeted influenza vaccination is of confirmed benefit against serious outcomes