Stable population structure in Europe since the Iron Age, despite high mobility

Ancient DNA research in the past decade has revealed that European population structure changed dramatically in the prehistoric period (14,000–3000 years before present, YBP), reflecting the widespread introduction of Neolithic farmer and Bronze Age Steppe ancestries. However, little is known about how population structure changed from the historical period onward (3000 YBP - present). To address this, we collected whole genomes from 204 individuals from Europe and the Mediterranean, many of which are the first historical period genomes from their region (e.g. Armenia and France). We found that most regions show remarkable inter-individual heterogeneity. At least 7% of historical individuals carry ancestry uncommon in the region where they were sampled, some indicating cross-Mediterranean contacts. Despite this high level of mobility, overall population structure across western Eurasia is relatively stable through the historical period up to the present, mirroring geography. We show that, under standard population genetics models with local panmixia, the observed level of dispersal would lead to a collapse of population structure. Persistent population structure thus suggests a lower effective migration rate than indicated by the observed dispersal. We hypothesize that this phenomenon can be explained by extensive transient dispersal arising from drastically improved transportation networks and the Roman Empire’s mobilization of people for trade, labor, and military. This work highlights the utility of ancient DNA in elucidating finer scale human population dynamics in recent history

Organization or Community-Based Outbreak? Responding to Cases of Meningitis Under Epidemiologic Uncertainty.

Six cases of serogroup C invasive meningococcal disease were identified in Treviso district, Veneto region, Italy between December 13 and 15, 2007. The afflicted patients were found to have attended the same Latin-dance clubs on the same nights, and chemoprophylaxis was provided to potentially exposed individuals. Despite these efforts, 2 cases caused by the same meningococcal strain subsequently occurred in the same area, without any apparent epidemiological correlation to the initial cases. This may have resulted from a failure to neutralize the meningococcal carrier/s. The root cause analysis method applied to public health emergency preparedness was used to analyze the response to this critical incident. The root cause analysis revealed a need to develop regional guidelines for the classification and management of a meningococcal outbreak and for developing risk-communication strategies that include the identification of appropriate channels of communication for differing segments of the population. (Disaster Med Public Health Preparedness. 2018;page 1 of 4)

Management of meningococcal outbreaks: are we using the same language? Comparison of the public health policies between high-income countries with low incidence of meningococcal disease

Background: Invasive meningococcal disease (IMD) in high-income countries usually occurs sporadically with low incidence and occasionally as small clusters or outbreaks. The WHO guidelines (GLs) for IMD outbreak applies only to African countries with high endemic incidence. Several high-income countries developed their own GLs on IMD outbreak, and we compare their terminology, classification, definitions, and public health interventions. Methods: National IMD outbreak GLs of the European Union and the Organisation for Economic Co-operation and Development member states were compared. Due to linguistic barriers, 17 out of forty-one countries were selected, and the GLs on the websites of the national health authorities were independently screened by two researchers. Results: National GLs on IMD outbreak were available for 12 countries. All GLs classify IMD outbreak into organization and community based using different terminology (cluster, epidemic, etc.). Two GLs introduce also a third condition of hyperendemic. Definitions, thresholds, and countermeasures vary among countries. Conclusions: Different definitions of organization and community-based outbreaks and countermeasures are expected because of uncertainties about their effectiveness, and differences between countries in health-care systems and public health policy approaches. Nevertheless, variations in terminology, definitions and countermeasures are confusing and reflect the need for an international standardization

Progetto multicentrico nazionale di coorti di nascita con informazioni da archivi CEDAP e record linkage di flussi amministrativi correnti

Introduzione I dati del Certificato di assistenza al parto (CEDAP) presentano informazioni individuali sui nuovi nati, sul livello socio-economico dei genitori, assistenza in gravidanza, modalità di travaglio e parto, di rilevanza per costituire coorti di nati da seguire nel tempo ed identificare possibili fattori di rischio perinatali o nei primi anni di vita. Sono già in corso esperienze locali di utilizzo delle schede CEDAP linkate a flussi sanitari per diverse finalità. Obiettivo L’obiettivo generale del progetto è quello di costituire una base dati multicentrica di coorti di nati con informazioni da archivi CEDAP standardizzata per alcune variabili di interesse e linkata a fonti informative correnti per valutare possibili fattori di rischio alla nascita o nei primi anni di vita. Rispetto ad analisi precedentemente condotte in alcune aree, questo progetto avrà il vantaggio di poter confrontare in modo standardizzato diverse realtà a livello nazionale, aumentare la potenza statistica dello studio e valutare alcuni outcome di salute utilizzando flussi correnti non precedentemente esaminati. All’interno di questo ampio obiettivo andranno definiti obiettivi specifici secondo gli interessi del gruppo e la rilevanza scientifica. Metodi È stata valutata la fattibilità del progetto in alcuni centri che avevano già lavorato con archivi CEDAP o mostrato un interesse al progetto e con disponibilità di tali dati. Sono state richieste alcune informazioni sulla popolazione di nati residenti, disponibilità temporale dell’archivio CEDAP (assieme a informazioni sul tracciato record) e di altri flussi informativi correnti, e la possibilità di record linkage (RL) dei principali flussi informativi con l’archivio CEDAP. Risultati I centri che hanno mostrato un interesse al progetto sono: Venezia, Rovigo, Trento, Torino, Firenze, Roma, Regione Umbria, Regione Emilia-Romagna, Regione FVG (in fase di valutazione Pisa, Brindisi) per una popolazione di circa 102,000 nuovi nati residenti nel 2009 (periodo 2002-2012 ~1 milione di nati). I dati CEDAP sono disponibili dall’anno 1989 in FVG mentre dal 2005 per Venezia e Umbria. La disponibilità di flussi sanitari correnti (ricoveri (SDO), certificati di morte (CM), farmaceutica (F), specialistica ambulatoriale (SA), pronto soccorso, esenzioni ticket, registro tumori, anatomia patologica, registro vaccinale) è risultata eterogenea nei diversi centri, ma le fonti principali (SDO, CM, F, SA) sono disponibili in tutti i centri almeno dai primi anni 2000. Il RL tra CEDAP e altri flussi è già stato effettuato a Torino, Venezia, Roma e Regioni Umbria, Emilia- Romagna e FVG anche se con modalità diverse. Sono state individuate variabili comuni nelle sezioni relative a madre, padre, gravidanza,travaglio, parto e neonato e relative codifiche per ogni centro. Conclusioni Si sta costituendo una rete multicentrica nazionale di coorte di nuovi nati. L’inclusione nel progetto di altri centri in possesso di dati CEDAP è possibile e auspicabil

Avaliação da aplicação da estratégia da Atenção Integrada às Doenças Prevalentes da Infância (AIDPI) por Agentes Comunitários de Saúde Evaluation of the Integrated Management Childhood Illness (IMCI) strategy application by Community Health Agents

OBJETIVOS: avaliar a utilização da estratégia da Atenção Integrada às Doenças Prevalentes da Infância por Agentes Comunitários de Saúde. MÉTODOS: estudo do tipo avaliativo realizado nas cidades de Recife e Olinda, Nordeste do Brasil. Foram aplicados 195 questionários estruturados durante as visitas domiciliares realizadas por 106 agentes comunitários de saúde às crianças menores de cinco anos, no período de outubro a novembro de 2002. RESULTADOS: observou-se que 91,7% dos menores de dois meses foram avaliados corretamente quanto aos sinais de perigo e 83,3% quanto aos sinais de alerta. A avaliação das seções sobre "alimentação", "crescimento" e "vacina" demonstrou que o método foi bem aplicado em 96,9%, 99% e 99% dos casos, respectivamente. Em 73,1% das visitas às crianças na faixa etária entre dois meses e cinco anos, os agentes de saúde seguiram corretamente a padronização para verificação dos sinais de perigo e em 80,8% para os sinais de alerta. CONCLUSÕES: verificou-se que os agentes comunitários foram capazes de apreender o conteúdo e aplicar corretamente a estratégia. O "Manual de condutas" demonstrou ser um adequado instrumento à correta abordagem dos problemas de saúde dos menores de cinco anos na comunidade.<br>OBJECTIVES: to assess the strategy for Integrated Management Childhood Illness by Community Health Agents. METHODS: assessment study accomplished in the cities of Recife and Olinda, Northeast Brazil. One hundred and ninety five structured questionnaires were applied by 106 community health agents during home visits to children under five years old in the period of October to November, 2002. RESULTS: 91,7% of the children under two months old were correctly assessed for signs of danger and 83,3% for signs of alert. The assessment of conditions such as "nutrition", "growth" and "vaccination" indicated that the method was well performed in 96,9%, 99% and 99% of the cases, respectively. In 73,1% of visits to children in the age group between two and five years old, the community health agents followed the protocol for danger signs correctly; as for alert signs the performance reached was of 80.8%. CONCLUSIONS: Community agents demonstrated they had the capability of learning and applying the strategy correctly. The "Procedure manual" demonstrated to be an adequate tool to address the health conditions of children under five years old in the community

The genomic history of southeastern Europe

Farming was first introduced to Europe in the mid-seventh millennium bc, and was associated with migrants from Anatolia who settled in the southeast before spreading throughout Europe. Here, to understand the dynamics of this process, we analysed genome-wide ancient DNA data from 225 individuals who lived in southeastern Europe and surrounding regions between 12000 and 500 bc. We document a west-east cline of ancestry in indigenous hunter-gatherers and, in eastern Europe, the early stages in the formation of Bronze Age steppe ancestry. We show that the first farmers of northern and western Europe dispersed through southeastern Europe with limited hunter-gatherer admixture, but that some early groups in the southeast mixed extensively with hunter-gatherers without the sex-biased admixture that prevailed later in the north and west. We also show that southeastern Europe continued to be a nexus between east and west after the arrival of farmers, with intermittent genetic contact with steppe populations occurring up to 2,000 years earlier than the migrations from the steppe that ultimately replaced much of the population of northern Europe.Iain Mathieson … Wolfgang Haak … David Reic

Large-scale migration into Britain during the Middle to Late Bronze Age

Present-day people from England and Wales harbour more ancestry derived from Early European Farmers (EEF) than people of the Early Bronze Age . To understand this, we generated genome-wide data from 793 individuals, increasing data from the Middle to Late Bronze and Iron Age in Britain by 12-fold, and Western and Central Europe by 3.5-fold. Between 1000 and 875 BC, EEF ancestry increased in southern Britain (England and Wales) but not northern Britain (Scotland) due to incorporation of migrants who arrived at this time and over previous centuries, and who were genetically most similar to ancient individuals from France. These migrants contributed about half the ancestry of Iron Age people of England and Wales, thereby creating a plausible vector for the spread of early Celtic languages into Britain. These patterns are part of a broader trend of EEF ancestry becoming more similar across central and western Europe in the Middle to Late Bronze Age, coincident with archaeological evidence of intensified cultural exchange . There was comparatively less gene flow from continental Europe during the Iron Age, and Britain's independent genetic trajectory is also reflected in the rise of the allele conferring lactase persistence to ~50% by this time compared to ~7% in central Europe where it rose rapidly in frequency only a millennium later. This suggests that dairy products were used in qualitatively different ways in Britain and in central Europe over this period. [Abstract copyright: © 2021. The Author(s), under exclusive licence to Springer Nature Limited.