Public Health burden of exposure to microbes and parasites originating from pigs and pork

The production and consumption of pork still is an important source of human illness. Quantifying the burden of illness requires the integration of data from a wide variety of sources. First, relevant hazards need to be identified, based on sources such as outbreaks of human illness, and the occurrence of pathogens in pigs, pork and pork products. Then, the incidence of disease due to these pathogens in the population must be assessed. Reported cases only reflect a minor part of all illness and there are different approaches to estimating underreporting factors. The health impact of different pathogens varies widely in severity, duration and associated fatalities

Unravelling the reservoirs for colonisation of infants with Campylobacter spp. in rural Ethiopia: Protocol for a longitudinal study during a global pandemic and political tensions

INTRODUCTION: Undernutrition is an underlying cause of mortality in children under five (CU5) years of age. Animal-source foods have been shown to decrease malnutrition in CU5. Livestock are important reservoirs for METHODS AND ANALYSIS: This longitudinal study involves 115 infants who are followed from birth to 12 months of age and are selected randomly from 10 kebeles of Haramaya woreda, East Hararghe zone, Oromia region, Ethiopia. Questionnaire-based information is obtained on demographics, livelihoods, wealth, health, nutrition and women empowerment; animal ownership/management and diseases; and water, sanitation and hygiene. Faecal samples are collected from infants, mothers, siblings and livestock, drinking water and soil. These samples are analysed by a range of phenotypic and genotypic microbiological methods to characterise the genetic structure of the ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of Florida Internal Review Board (IRB201903141), the Haramaya University Institutional Health Research Ethics Committee (COHMS/1010/3796/20) and the Ethiopia National Research Ethics Review Committee (SM/14.1/1059/20). Written informed consent is obtained from all participating households. Research findings will be disseminated to stakeholders through conferences and peer-reviewed journals and through the Feed the Future Innovation Lab for Livestock Systems

Estimating the Costs and the Disease Burden Associated With Campylobacter Infections and Sequelae in the Netherlands

Campylobacter infections pose an important public health problem in the Netherlands. Approximately 79,000 persons per year are estimated to experience symptoms of acute gastroenteritis. Further annually some 1400 ReA cases, 60 GBS cases and 11 IBD cases are associated with a previous Campylobacter infection. Using a stochastic simulation model the disease burden and the cost-of-illness of Campylobacter infections and its sequelae were estimated. Estimates of the Campylobacter-associated disease burden and costs-of-illness were 1185 DALYs (90% C.I. 693 - 1845 DALYs) per year and some 21 million E (90% C.I. 10 - 38 million E) per year respectively.Campylobacter, sequelae, cost-of-illness, disease burden, Netherlands, Food Consumption/Nutrition/Food Safety,

Evaluation of a Performance-Based Expert Elicitation:WHO Global Attribution of Foodborne Diseases

For many societally important science-based decisions, data are inadequate, unreliable or non-existent, and expert advice is sought. In such cases, procedures for eliciting structured expert judgments (SEJ) are increasingly used. This raises questions regarding validity and reproducibility. This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert's statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values. Equal weights combinations were also calculated. The main conclusions on expert performance are: (1) SEJ does provide a science-based method for attribution of the global burden of foodborne diseases; (2) equal weighting of experts per panel increased statistical accuracy to acceptable levels, but at the cost of informativeness; (3) performance-based weighting increased informativeness, while retaining accuracy; (4) due to study constraints individual experts' accuracies were generally lower than in other SEJ studies, and (5) there was a negative correlation between experts' informativeness and statistical accuracy which attenuated as accuracy improved, revealing that the least accurate experts drive the negative correlation. It is shown, however, that performance-based weighting has the ability to yield statistically accurate and informative combinations of experts' judgments, thereby offsetting this contrary influence. The present findings suggest that application of SEJ on a large scale is feasible, and motivate the development of enhanced training and tools for remote elicitation of multiple, internationally-dispersed panels

Systematic review of foodborne burden of disease studies: Quality assessment of data and methodology

Burden of disease (BoD) studies aim to identify the public health impact of different health problems and risk factors. To assess BoD, detailed knowledge is needed on epidemiology, disability and mortality in the population under study. This is particularly challenging for foodborne disease, because of the multitude of causative agents and their health effects. The purpose of this study is to systematically review the methodology of foodborne BoD studies. Three key questions were addressed: 1) which data sources and approaches were used to assess mortality, morbidity and disability?, 2) which methodological choices were made to calculate Disability Adjusted Life Years (DALY), and 3) were uncertainty analyses performed and if so, how? Studies (1990-June 2012) in international peer-reviewed journals and grey literature were identified with main inclusion criteria being that the study assessed disability adjusted life years related to foodborne disease. Twenty-four studies met our inclusion criteria. To assess incidence or prevalence of foodborne disease in the population, four approaches could be distinguished, each using a different data source as a starting point, namely 1) laboratory-confirmed cases, 2) cohort or cross-sectional data, 3) syndrome surveillance data and 4) exposure data. Considerable variation existed in BoD methodology (e.g. disability weights, discounting, age-weighting). Almost all studies analyzed the effect of uncertainty as a result of possible imprecision in the parameter values. Awareness of epidemiological and methodological rigor between foodborne BoD studies using the DALY approach is a critical priority for advancing burden of disease studies. Harmonization of methodology that is used and of modeling techniques and high quality data can enlarge the detection of real variation in DALY outcomes between pathogens, between populations or over time. This harmonization can be achieved by identifying substantial data gaps and uncertainty and establish which sequelae of foodborne disease agents should be included in BoD calculations

Disability Adjusted Life Years and minimal disease: application of a preference-based relevance criterion to rank enteric pathogens

Background: Burden of disease estimates, which combine mortality and morbidity into a single measure, are used increasingly for priority setting in disease control, prevention and surveillance. However, because there is no clear exclusion criterion for highly prevalent minimal disease in burden of disease studies its application may be restricted. The aim of this study was to apply a newly developed relevance criterion based on preferences of a population panel, and to compare burden of disease estimates of five foodborne pathogens calculated with and without application of this criterion. Methods: Preferences for twenty health states associated with foodborne disease were obtained from a population panel (n = 107) with the Visual Analogue Scale and the Time Trade-off (TTO) technique. The TTO preferences were used to derive the relevance criterion: if at least 50% of a panel of judges is willing to trade-off time in order to be restored to full health the health state is regarded as relevant, i.e. TTO median is greater than 0. Subsequently, the burden of disease of each of the five foodborne pathogens was calculated both with and without the relevance criterion. Results: The panel ranked the health states consistently. Of the twenty health states, three did not meet the preference-based relevance criterion. Application of the relevance criterion reduced the burden of disease estimate of all five foodborne pathogens. The reduction was especially significant for norovirus and rotavirus, decreasing with 94% and 78% respectively. Conclusion: Individual preferences elicited with the T

Bizneset e vogla familjare garant i zhvillimit ekonomik e social

Integrimi global ekonomik si proces gjithnjë e më shumë po ka ndikim edhe në politikat nacionale të zhvillimit, ndaj si i tillë është jashtëzakonisht vështir që të kontrollohet me aplikimin e metodave dhe instrumenteve tradicionale të zhvillimit ekonomik. Kjo mbase vështirëson që në vitet në vijim, të planifikohen qëllime të caktuara ekonomike në nivel shteti. Të gjitha ndërmarrjet në botë, të mëdha apo të vogla, familjare dhe jo familjare, publike apo jo publike, të zhvilluara dhe të pa zhvilluara, po përballen me një sërë pyetjesh të cilat kanë të bëjnë me ardhmërinë dhe perspektivën e tyre, respektivisht vije në pikëpyetje ekzistenca e tyre në situata të paparapara turbulente për rrethinën. Çfarë do të jenë nevojat e tregut, çfarë synon konkurrenca, a po lëkunden qëndrimet e blerësve, kah pretendon përparimi i teknikës dhe teknologjisë, çfarë me zhvillimin e prodhimeve të reja, a ka mundësi të sigurimit të resurseve të nevojshme, kah udhëzon globalizimi i biznesit,cilat nevoja duhet përdorur për arritjen e efikasitetit, efektiviteti dhe inovacionet, etj… të gjitha këto pyetje u adresohen çdo ditë ndërmarrjeve – pa marrë parasysh nëse ato janë në pronësi të familjes apo nuk janë të tilla. Ajo çka ndërmarrjet familjare i bënë të veçanta dhe që i dallon nga ndërmarrjet e tjera që nuk janë në pronësi apo kontroll të familjes, paraqet diversitetin e interesit familjar dhe interesit të ndërmarrjes në sistemin e unik të biznesit familjar. Pronarët e kompanive familjare në të gjithë botën ndajnë filozofinë dhe vlerat e njëjta, ata mendojnë në perspektivë, kapitali i tyre është durimi dhe zelli, interesohen për bashkësinë ku veprojnë dhe punojnë ashtu që kompaninë në gjendjen më të mirë të mundshme t’ua lënë trashëgimtarëve të tyre. Modeli i biznesit të kompanive familjare është tejet inovativ dhe largpamës, kërkon në realizim më të mirë, krijon më shumë vlera, ruan vendet e punës, përkundër rënieve dhe recesioneve ciklike. Zhvillimi i ndërmarrjeve të vogla dhe të mesme familjare, paraqet rrugën më të shpejtë dhe më të lirë të zhvillimit të ekonomive kombëtare. NVM janë shtyllat kurrizore të zhvillimit ekonomik të shteteve në tranzicion dhe përkrah rolit të madh që kanë në punësim ato janë mjaft domethënëse për demokratizimin e shoqërisë

Programs for special classes for children with complex violations of the development of special educational institutions for visually impaired children. Labor training. Preparatory, grades 1-4

Метою трудового навчання є розвиток особистості зі складними вадами розвитку через залучення до різних видів доступної праці, засвоєння знань про властивості оброблюваних матеріалів, вивчення засобів праці, формування відповідального ставлення до вирішення трудових завдань і навчання безпеки праці. У процесі трудової діяльності з різноманітними предметами та матеріалами, змінюючи під час обробки їх форму, конфігурацію, розміри, величину, об’єм, вагу, поверхню, учні оволодівають прийомами і способами проведення обстежувальних дій, предметної і просторової орієнтації, збагачують власні уявлення про навколишню дійсність, знаходять особисто значущі для них об’єкти праці, тобто такі, що найкраще забезпечують реалізацію їхніх творчих можливостей. Мета і завдання предмета реалізуються на основі змісту кількох основних напрямків життєдіяльності: природа, людина, техніка, естетичне довкілля. За структурою програма складається з трьох колонок: зміст навчального матеріалу; навчальні досягнення учнів; спрямованість корекційно-розвивальної роботи.Целью трудового обучения является развитие личности со сложными нарушениями в развитии путем привлечения к различным видам доступного труда, усвоение знаний о свойствах обрабатываемых материалов, изучение средств труда, формирование ответственного отношения к решению трудовых задач и обучения безопасности труда. В процессе трудовой деятельности с различными предметами и материалами, изменяя при обработке их форму, конфигурацию, размеры, величину, объем, вес, поверхность, учащиеся овладевают приемами и способами проведения обследовательских действий, предметной и пространственной ориентации, обогащают собственные представления об окружающей действительности, находят лично значимые для них объекты труда, то есть такие, которые лучше всего обеспечивают реализацию их творческих возможностей. Цель и задачи предмета реализуются на основе содержания нескольких направлений жизнедеятельности: природа, человек, техника, эстетика окружающей среды. По структуре программа состоит из трех колонок: содержание учебного материала; учебные достижения учащихся; направленность коррекционно-развивающей работы.The purpose of labor training is the development of a person with complex defects through the involvement in various types of accessible labor, the acquisition of knowledge about the properties of processed materials, the study of means of labor, the formation of responsible attitude to solving labor problems and training in labor safety. In the process of work with various objects and materials, changing their shape, configuration, size, size, volume, weight, surface, and size, size, size, volume, weight, surface, students acquire techniques and methods of conducting exploratory actions, subject and spatial orientation, enriching their own ideas about the surrounding reality, find objects of labor that are personally meaningful to them, that is, those that best ensure the realization of their creative abilities. The purpose and tasks of the subject are realized on the basis of the content of several key areas of life: nature, man, technique, aesthetic environment. The structure of the program consists of three columns: the content of the training material; educational achievements of students; the direction of correction and development work

Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013.

Background and aimsThe Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25-1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control