Haemophilus influenzae type b reemergence after combination immunization

An increase in Haemophilus influenzae type b (Hib) in British children has been linked to the widespread use of a diphtheria/tetanus/acellular pertussis combination vaccine (DTaP-Hib). We measured anti-polyribosyl-ribitol phos- phate antibody concentration and avidity before and after a Hib booster in 176 children 2–4 years of age who had received 3 doses of DTP-Hib (either DT whole cell pertus- sis-Hib or DTaP-Hib) combination vaccine in infancy. We also measured pharyngeal carriage of Hib. Antibody con- centrations before and avidity indices after vaccination were low (geometric mean concentration 0.46μg/mL, 95% confidence interval [CI] 0.36–0.58; geometric mean avidity index 0.16, 95% CI 0.14–0.18) and inversely related to the number of previous doses of DTaP-Hib (p = 0.02 and p<0.001, respectively). Hib was found in 2.1% (95% CI 0.7%–6.0%) of study participants. Our data support an association between DTaP-Hib vaccine combinations and clinical Hib disease through an effect on antibody concen- tration and avidit

From Understanding to Impactful Action: Systems Thinking for Systems Change in Chronic Disease Prevention Research

Within the field of chronic disease prevention, research efforts have moved to better understand, describe, and address the complex drivers of various health conditions. Change-making is prominent in this paper, and systems thinking and systems change are prioritised as core elements of prevention research. We report how the process of developing a theory of systems change can assist prevention research to progress from understanding systems, towards impactful action within those systems. Based on Foster-Fishman and Watson’s ABLe change framework, a Prevention Systems Change Framework (PSCF) was adapted and applied to an Australian case study of the drivers of healthy and equitable eating as a structured reflective practice. The PSCF comprises four components: building a systemic lens on prevention, holding a continual implementation focus, integrating the systemic lens and implementation focus, and developing a theory of change. Application of the framework as part of a systemic evaluation process enabled a detailed and critical assessment of the healthy and equitable eating project goals and culminated in the development of a theory of prevention systems change specific to that project, to guide future research and action. Arguably, if prevention research is to support improved health outcomes, it must be more explicitly linked to creating systems change

Addressing complexity in chronic disease prevention research

There is wide agreement on the need for systems thinking to address complexity in chronic disease prevention but there is insufficient understanding of how such approaches are operationalised in prevention research. Ison and Straw propose that to address complexity, the right balance must be struck between ‘systemic’ and ‘systematic’ paradigms. We examined the nature and characteristics of this relationship in a series of six qualitative case studies of prevention research. Data comprised 29 semi-structured interviews with 16 participants, and online documents. The analysis combined inductive methods from grounded theory with a theoretically-informed framework analysis. Sys-temic and systematic ways of working varied across each case as a whole, and within the dimensions of each case. Further, the interplay of systemic and systematic approaches was described along a dynamic continuum of variable proportions; with greater emphasis on systemic aspects balanced by lesser focus on the systematic, and vice versa. By expanding the boundaries for exploring prevention research, we gained empirical understanding of the potential and scope of systemic and systematic paradigms for addressing complexity in prevention research. There is inherent value in being more explicitly conscious and bilingual in both systemic and systematic paradigms, so that their respective value and strengths may be utilised. Our findings propose a coherent theoretical frame to better understand existing approaches for addressing complexity in prevention research

Cutaneous effects of exposure to polybrominated biphenyls (PBBs): The Michigan PBB incident

In 1973 an environmental accident occurred in northern Michigan in which 1000-2000 pounds of the toxic fire retardant polybrominated biphenyl (PBB) was added to the livestock food supply of much of northern Michigan. PBB is highly lipophilic, poorly metabolized, and biocumulative. It subsequently entered the human food chain of the entire state of Michigan. Health effects were noted in contaminated animals and among exposed farmers some months after the contamination; these often included cutaneous problems. Three years later a multidisciplinary study of the farming population was undertaken. Detected cutaneous abnormalities included halogen acne, hair loss, skin redness, skin peeling, and scaling, itching, increased sweating, and increased growth of fingernails and toenails. The mechanisms underlying these effects are unknown. PBBs appear to be etiologically implicated for significant cutaneous toxicity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23843/1/0000082.pd

Expressions 1982

This fifth edition of EXPRESSIONS is the culmination of student efforts in the 1982 Creative Writing Contest, Campus Chronicle Photography Contest, Art and Commercial Art courses at Des Moines Area Community College. Journalism students did the design, typography and lay-out work necessary to bring these efforts together in this 1982 edition of EXPRESSIONS.https://openspace.dmacc.edu/expressions/1004/thumbnail.jp