An overview of the current challenges and opportunities for surveillance

This keynote address opens the Joint 9th WARFS Global Conference and 12th AMNET Conference 2015. Initially a brief history of the WARFS conference, which began in 1999 in Atlanta, is given. Much ground has been covered since that initial conference. There have been many developments and expansion, but at the same time many challenges were unmet and remain as challenges to risk factor surveillance globally. Historically we have focused on the many technical challenges facing surveillance. This presentation will address the structural and theoretical challenges facing risk factor surveillance. The major challenges are: incorporating the social determinants of health perspective into risk factor surveillance; moving away from continuing to collect data on what we already know; and creating the evidence base to evaluate health policies and interventions designed to improve population health. Above all, the underlying assumption of what we do remains important: continuous data collection, analysis and use of surveillance data provides an evidence base for public health interventions

Explanation for Anomalous Shock Temperatures Measured by Neutron Resonance Spectroscopy

Neutron resonance spectrometry (NRS) has been used to measure the temperature inside Mo samples during shock loading. The temperatures obtained were significantly higher than predicted assuming ideal hydrodynamic loading. The effect of plastic flow and non-ideal projectile behavior were assessed. Plastic flow was calculated self-consistently with the shock jump conditions: this is necessary for a rigorous estimate of the locus of shock states accessible. Plastic flow was estimated to contribute a temperature rise of 53K compared with hydrodynamic flow. Simulations were performed of the operation of the explosively-driven projectile system used to induce the shock in the Mo sample. The simulations predicted that the projectile was significantly curved on impact, and still accelerating. The resulting spatial variations in load, including radial components of velocity, were predicted to increase the apparent temperature that would be deduced from the width of the neutron resonance by 160K. These corrections are sufficient to reconcile the apparent temperatures deduced using NRS with the accepted properties of Mo, in particular its equation of state.Comment: near-final version, waiting for final consent from an autho

A preface to the keynote and accepted abstracts of the Joint 9th World Alliance for Risk Factor Surveillance (WARFS) and 12th Americas' Network for Chronic Disease Surveillance (AMNET) 2015 Conference, November 18th-20th, 2015, St. John's, Antigua

It is a pleasure to introduce the abstracts arising from the Joint World Alliance for Risk Factor Surveillance (WARFS) and Americas' Network for Chronic Disease Surveillance (AMNET) conference held in Antigua during November 18th-20th, 2015. This was a global conference on risk factor surveillance for public health. This conference was particularly notable because it combined three organizations concerned with public health. First, the host of the conference, the American University of Antigua College of Medicine; second, the World Alliance of Risk Factor Surveillance, a group affiliated with the Paris-based International Union for Health Promotion and Education (IUHPE); and third, Americas' Network for Chronic Disease Surveillance. Thus it was subtitled the Joint 9th WARFS Global Conference and 12th AMNET Conference 2015. Both surveillance groups WARFS and AMNET had their historical origins at the U.S. Centers for Disease Control and Prevention (CDC). Over the yeas, since the first global meeting on behavioral risk-factor surveillance held in the Atlanta, GA USA area, these two institutions have developed and held meetings focusing on issues in risk factorsurveillance. Historically there have been keen discussions, keynotes, presentations, and posters on such topics as the theory of surveillance, the incorporation of social factors into the surveillance, the ever arising methodological and technical challenges, and the global importance of good data to inform decision making and policy taking with regard to major public health issues. The Antigua conference touched on all these issues and the abstracts within this volume represent this diversity of topics. Of particular note was the chance for a small Caribbean country to be a part of this global discussion and it illustrates that the importance of risk factor surveillance is not confined just to larger economically highly developed nations. It is also notable because the previous WARFS-IUHPE Conference in 2013 was held in Beijing, China. Nonetheless, despite the obvious difference in venue and country size, the discussions were just as globally relevant and pertinent to today's global concerns. Therefore, as the editors of this special issue, we are pleased to present the abstracts that represent the 2015 Antigua Conference

The Social Determinants of Health:Time to Re-Think?

Twelve years have now passed since the influential WHO Report on the Social Determinants of Health (SDoH) in 2008. A group of senior international public health scholars and decision-makers met in Italy in mid-2019 to review the legacy of the SDoH conceptual framework and its adequacy for the many challenges facing our field as we enter the 2020s. Four major categories of challenges were identified: emerging "exogenous" challenges to global health equity, challenges related to weak policy and practice implementation, more fundamental challenges related to SDoH theory and research, and broader issues around modern research in general. Each of these categories is discussed, and potential solutions offered. We conclude that although the SDoH framework is still a worthy core platform for public health research, policy, and practice, the time is ripe for significant evolution

Cost-Effectiveness of Asthma Step-Up Therapy as an Increased Dose of Extrafine-Particle Inhaled Corticosteroid or Add-On Long-Acting Beta2-Agonist

The analyses were funded by an unrestricted grant from Teva Pharmaceuticals Limited of Petach Tikva, Israel. Access to data from the Optimum Patient Care Research Database was co-funded by Research in Real-Life Ltd (RiRL), Cambridge, UK. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. The authors thank Julie von Ziegenweidt for assistance with data extraction.Peer reviewedPublisher PD

LSST: from Science Drivers to Reference Design and Anticipated Data Products

(Abridged) We describe here the most ambitious survey currently planned in the optical, the Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST will have unique survey capability in the faint time domain. The LSST design is driven by four main science themes: probing dark energy and dark matter, taking an inventory of the Solar System, exploring the transient optical sky, and mapping the Milky Way. LSST will be a wide-field ground-based system sited at Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m effective) primary mirror, a 9.6 deg$^2$ field of view, and a 3.2 Gigapixel camera. The standard observing sequence will consist of pairs of 15-second exposures in a given field, with two such visits in each pointing in a given night. With these repeats, the LSST system is capable of imaging about 10,000 square degrees of sky in a single filter in three nights. The typical 5$\sigma$ point-source depth in a single visit in $r$ will be $\sim 24.5$ (AB). The project is in the construction phase and will begin regular survey operations by 2022. The survey area will be contained within 30,000 deg$^2$ with $\delta<+34.5^\circ$, and will be imaged multiple times in six bands, $ugrizy$, covering the wavelength range 320--1050 nm. About 90\% of the observing time will be devoted to a deep-wide-fast survey mode which will uniformly observe a 18,000 deg$^2$ region about 800 times (summed over all six bands) during the anticipated 10 years of operations, and yield a coadded map to $r\sim27.5$. The remaining 10\% of the observing time will be allocated to projects such as a Very Deep and Fast time domain survey. The goal is to make LSST data products, including a relational database of about 32 trillion observations of 40 billion objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures available from https://www.lsst.org/overvie

Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) protocol : a pragmatic multi-centre randomised controlled trial of cast treatment versus surgical fixation for the treatment of bi-cortical, minimally displaced fractures of the scaphoid waist in adults

BACKGROUND: A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. METHODS/DESIGN: We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation. The plaster cast treatment will be immobilisation in a below elbow cast for 6 to 10 weeks followed by mobilisation. If non-union is confirmed on plain radiographs and/or Computerised Tomogram at 6 to 12 weeks, then urgent surgical fixation will be performed. This is being compared with immediate surgical fixation with surgeons using their preferred technique and implant. These treatments will be undertaken in trauma units across the United Kingdom. The primary outcome and end-point will be the Patient Rated Wrist Evaluation (a patient self-reported assessment of wrist pain and function) at 52 weeks and also measured at 6, 12, 26 weeks and 5 years. Secondary outcomes include an assessment of radiological union of the fracture; quality of life; recovery of wrist range and strength; and complications. We will also qualitatively investigate patient experiences of their treatment. DISCUSSION: Scaphoid fractures are an important public health problem as they predominantly affect young active individuals in the more productive working years of their lives. Non-union, if untreated, can lead to arthritis which can disable patients at a very young age. There is a rapidly increasing trend for immediate surgical fixation of these fractures but there is insufficient evidence from existing RCTs to support this. The SWIFFT Trial is a rigorously designed and adequately powered study which aims to contribute to the evidence-base to inform clinical decisions for the treatment of this common fracture in adults. TRIAL REGISTRATION: The trial is registered with the International Standard Randomised Controlled Trial Register ( ISRCTN67901257 ). Date registration assigned was 13/02/2013

Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use

Tobacco and alcohol use are leading causes of mortality that influence risk for many complex diseases and disorders 1 . They are heritable 2,3 and etiologically related 4,5 behaviors that have been resistant to gene discovery efforts 6–11 . In sample sizes up to 1.2 million individuals, we discovered 566 genetic variants in 406 loci associated with multiple stages of tobacco use (initiation, cessation, and heaviness) as well as alcohol use, with 150 loci evidencing pleiotropic association. Smoking phenotypes were positively genetically correlated with many health conditions, whereas alcohol use was negatively correlated with these conditions, such that increased genetic risk for alcohol use is associated with lower disease risk. We report evidence for the involvement of many systems in tobacco and alcohol use, including genes involved in nicotinic, dopaminergic, and glutamatergic neurotransmission. The results provide a solid starting point to evaluate the effects of these loci in model organisms and more precise substance use measures