Misinformation

The digital age and the birth of social media have changed how people receive news. New technologies make communicating events an instantaneous process. Generating information is far easier than ever, and the amount of information in the world has grown exponentially since the turn of the millennium. Information constantly generates, making it impossible to process and verify it as it appears. Social media allows people to instantly share information, exposing it to anybody on the same platform. Despite the benefits of sharing information instantly, not all information is truthful. Though they are hardly new concepts, misinformation, disinformation, and “fake news” have become lasting by-products of the current media climate

Is the Framingham Coronary Heart Disease Absolute Risk Function Applicable to Aboriginal People?

Objective: To determine the extent to which the Framingham function predicts the risk of coronary heart disease (CHD) in Aboriginal people. Design and setting: Cohort study in an Aboriginal community in the Northern Territory. Participants: 687 Aboriginal people aged 20-74 years were followed up from a baseline examination in 1992-1995 through to 31 December 2003. Main outcome measure: First CHD events were identified through hospital and death records during the follow-up period. Methods: An original Framingham function was used to predict CHD risk according to the duration of follow-up and the values of traditional risk factors, which included age, sex, total cholesterol level, high-density lipoprotein (HDL) cholesterol level, blood pressure, the presence of diabetes, and smoking status. The predicted CHD incidence using the Framingham function was 4.4 per 1000 person-years, while the observed incidence was 11.0 (95% CI, 8.7-13.9) per 1000 person-years. The observed number of CHD events (68) was 2.5 times the number predicted (27) using the Framingham function. The observed incidence was about four and three times the predicted incidence for age groups < 35 and 35-44 years, respectively, and about twice the predicted incidence for those over 45 years of age. The Framingham function was a particularly unreliable predictor for women, especially younger women, in whom the observed CHD rate was 30 times the predicted rate. Conclusions: The Framingham function substantially underestimates the actual risk of CHD observed in Aboriginal people in a remote community, especially for women and younger adults. This implies that traditional risk factors have different degrees of impact and/or that other factors are contributing to risk. A population-specific risk function is needed

Acute flaccid paralysis with anterior myelitis - California, June 2012-June 2014.

In August 2012, the California Department of Public Health (CDPH) was contacted by a San Francisco Bay area clinician who requested poliovirus testing for an unvaccinated man aged 29 years with acute flaccid paralysis (AFP) associated with anterior myelitis (i.e., evidence of inflammation of the spinal cord involving the grey matter including anterior horn cell bodies) and no history of international travel during the month before symptom onset. Within 2 weeks, CDPH had received reports of two additional cases of AFP with anterior myelitis of unknown etiology. Testing at CDPH's Viral and Rickettsial Disease Laboratory for stool, nasopharyngeal swab, and cerebrospinal fluid (CSF) did not detect the presence of an enterovirus (EV), the genus of the family Picornaviridae that includes poliovirus. Additional laboratory testing for infectious diseases conducted at the CDPH Viral and Rickettsial Disease Laboratory did not identify a causative agent to explain the observed clinical syndrome reported among the patients. To identify other cases of AFP with anterior myelitis and elucidate possible common etiologies, CDPH posted alerts in official communications for California local health departments during December 2012, July 2013, and February 2014. Reports of cases of neurologic illness received by CDPH were investigated throughout this period, and clinicians were encouraged to submit clinical samples for testing. A total of 23 cases of AFP with anterior myelitis of unknown etiology were identified. Epidemiologic and laboratory investigation did not identify poliovirus infection as a possible cause for the observed cases. No common etiology was identified to explain the reported cases, although EV-D68 was identified in upper respiratory tract specimens of two patients. EV infection, including poliovirus infection, should be considered in the differential diagnosis in cases of AFP with anterior myelitis and testing performed per CDC guidelines

Enhancing West Nile Virus Surveillance, United States

We provide a method for constructing a county-level West Nile virus risk map to serve as an early warning system for human cases. We also demonstrate that mosquito surveillance is a more accurate predictor of human risk than monitoring dead and infected wild birds

Influenza surveillance among children with pneumonia admitted to a district hospital in coastal Kenya, 2007-2010

Background: Influenza data gaps in sub-Saharan Africa include incidence, case fatality, seasonal patterns, and associations with prevalent disorders. Methods: Nasopharyngeal samples from children aged <12 years who were admitted to Kilifi District Hospital during 2007–2010 with severe or very severe pneumonia and resided in the local demographic surveillance system were screened for influenza A, B, and C viruses by molecular methods. Outpatient children provided comparative data. Results: Of 2002 admissions, influenza A virus infection was diagnosed in 3.5% (71), influenza B virus infection, in 0.9% (19); and influenza C virus infection, in 0.8% (11 of 1404 tested). Four patients with influenza died. Among outpatients, 13 of 331 (3.9%) with acute respiratory infection and 1 of 196 without acute respiratory infection were influenza positive. The annual incidence of severe or very severe pneumonia, of influenza (any type), and of influenza A, was 1321, 60, and 43 cases per 100 000 <5 years of age, respectively. Peak occurrence was in quarters 3–4 each year, and approximately 50% of cases involved infants: temporal association with bacteremia was absent. Hypoxia was more frequent among pneumonia cases involving influenza (odds ratio, 1.78; 95% confidence interval, 1.04–1.96). Influenza A virus subtypes were seasonal H3N2 (57%), seasonal H1N1 (12%), and 2009 pandemic H1N1 (7%). Conclusions: The burden of influenza was small during 2007–2010 in this pediatric hospital in Kenya. Influenza A virus subtype H3N2 predominated, and 2009 pandemic influenza A virus subtype H1N1 had little impact

Antiparasite defenses of fathead minnows exposed to trematode cercariae

105 leaves : ill. ; 29 cm.Parasites exert substantial costs on their hosts. Thus, natural selection should favour behavioural defenses that reduce hosts’ exposure to parasites. This prediction has rarely been tested for aquatic hosts exposed to parasites. I designed experiments to test if fathead minnows could detect cercariae of the trematode, Ornithodiplostomum sp. and engage in antiparasite behaviours to avoid them. Minnows exposed to cercariae formed 20.1% tighter shoals compared to water controls. Further, minnows greatly reduced their overall activity, but only when they were exposed for a second time. The latter result is important because it provides the first indication that hosts can learn to avoid parasites. Lastly, I tested if epidermal club cells play a defensive role against cercariae. Club cells did not, but other components of the epidermis, probably mucus cells, decreased cercarial infectivity by 61-68%. My results show that fish can detect, learn, and ultimately avoid aquatic larval stages of parasites

Impact of call-to-balloon time on 30-day mortality in contemporary practice.

OBJECTIVE: Studies reporting an association between treatment delay and outcome for patients with ST segment elevation myocardial infarction (STEMI) have generally not included patients treated by a primary percutaneous coronary intervention (PPCI) service that systematically delivers reperfusion therapy to all eligible patients. We set out to determine the association of call-to-balloon (CTB) time with 30-day mortality after PPCI in a contemporary series of patients treated within a national reperfusion service. METHODS: We analysed data on 16 907 consecutive patients with STEMI treated by PPCI in England and Wales in 2011 with CTB time of ≤6 hours. RESULTS: The median CTB and door-to-balloon times were 111 and 41 min, respectively, with 80.9% of patients treated within 150 min of the call for help. An out-of-hours call time (58.2% of patients) was associated with a 10 min increase in CTB time, whereas inter-hospital transfer for PPCI (18.5% of patients) was associated with a 49 min increase in CTB time. CTB time was independently associated with 30-day mortality (p180-240 min compared with ≤90 min. The relationship between CTB time and 30-day mortality was influenced by patient risk profile with a greater absolute impact of increasing CTB time on mortality in high-risk patients. CONCLUSION: CTB time is a useful metric to assess the overall performance of a PPCI service. Delays to reperfusion remain important even in the era of organised national PPCI services with rapid treatment times and efforts should continue to minimise treatment delays

Visual Disamenity in the Queensland Wet Tropics: Estimating the Economic Impacts of Overhead Transmission Lines

This paperexamines procedures and findings in estimation of the 'visual disamenity cost' associated with installation of high-voltage overhead power lines in the Wet Tropics of Queensland. The study was performed within a short timeframe and small budget, hence the need to design a relatively simple and cost-effective approach, yet one which would yield acceptable information on environmental values. An extensive literature review and advice from a number of resource economists indicated that there was little information from previous studies to support benefit transfer methodology. It was found possible to estimate disamenity costs to ecotourism operation (using a simplified travel cost approach), agricultural operations (based on compensation payments) and residential property values (through a simplified hedonic price approach). A planned contingent valuation of the intrusive effect of the transmission lines through rainforest areas did not proceed, due at least in part to the political sensitivity of this issue

Imprisoned and imperiled: access to HIV and TB prevention and treatment, and denial of human rights, in Zambian prisons

<p>Abstract</p> <p>Background</p> <p>Although HIV and tuberculosis (TB) prevalence are high in prisons throughout sub-Saharan Africa, little research has been conducted on factors related to prevention, testing and treatment services.</p> <p>Methods</p> <p>To better understand the relationship between prison conditions, the criminal justice system, and HIV and TB in Zambian prisons, we conducted a mixed-method study, including: facility assessments and in-depth interviews with 246 prisoners and 30 prison officers at six Zambian prisons; a review of Zambian legislation and policy governing prisons and the criminal justice system; and 46 key informant interviews with government and non-governmental organization officials and representatives of international agencies and donors.</p> <p>Results</p> <p>The facility assessments, in-depth interviews and key informant interviews found serious barriers to HIV and TB prevention and treatment, and extended pre-trial detention that contributed to overcrowded conditions. Disparities both between prisons and among different categories of prisoners within prisons were noted, with juveniles, women, pre-trial detainees and immigration detainees significantly less likely to access health services.</p> <p>Conclusions</p> <p>Current conditions and the lack of available medical care in Zambia's prisons violate human rights protections and threaten prisoners' health. In order to protect the health of prisoners, prison-based health services, linkages to community-based health care, general prison conditions and failures of the criminal justice system that exacerbate overcrowding must be immediately improved. International donors should work with the Zambian government to support prison and justice system reform and ensure that their provision of funding in such areas as health services respect human rights standards, including non-discrimination. Human rights protections against torture and cruel, inhuman or degrading treatment, and criminal justice system rights, are essential to curbing the spread of HIV and TB in Zambian prisons, and to achieving broader goals to reduce HIV and TB in Zambia.</p

School Centres for Teaching Excellence (SCTE): understanding new directions for schools and universities in Health and Physical Education

This paper critically analyzes a community collaborative approach for implementing Health and Physical Education (HPE) lessons within Gippsland primary schools (Victoria, Australia). The rural community collaborations reflected upon are embedded within the Victorian Department of Education and Early Childhood Development (DEECD) ‘School Centres for Teaching Excellence’ (SCTE) initiative and are timely with the current curriculum reform in Health and Physical Education. The purpose of this paper is to reflect on and share the experiential learning offered where the curriculum is relevant, engaging, contemporary, physically active, enjoyable and developmentally appropriate for all stakeholders; namely university pre-service teachers, primary school children and primary teachers. It is envisaged that through sharing the various dynamics involved in a SCTE program, educators may benefit and subsequently consider the suitability and possibility of establishing similar collaborations within their context