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The author considers the U.S. presidential election of 2024 as a public health issue. He discusses an editorial on the Web site of the American Civil Liberties Union which calls for public health because the authoritarian plans proposed by the former president and current presidential candidates are serious, the integrity of elections, and domains in which a victory by chauvinist, racist, religiously fanatic, and xenophobic far-right forces would have disastrous public health consequences.

Carcinoma of the head, neck and face is a challenge faced by surgeons worldwide. This case report presents a complicated surgical approach utilised in a patient diagnosed with right lower lip and gingivobuccal sulcus carcinoma, with a fixed neck flexion deformity due to ankylosing spondylitis. The patient, a 55-year-old man with cervical kyphosis, was declared inoperable due to his complex anaesthetic and surgical requirements. We performed a successful wide local excision of the tumour with a right marginal mandibulectomy, and later reconstructed the defect using a left free radial forearm flap. [ABSTRACT FROM AUTHOR]

The article offers information on Notes From the Field (NFTF), a popular format for article submissions to the journal.

The authors discuss an article published in the October 2023 issue wherein Kassler and Bowman outlined why the term "surveillance" has proven to be an unfortunate choice within the realm of public health. Topics include reasons cited why it has been an unfortunate choice, criticism against syndromic surveillance, and the need for public health monitoring systems in the U.S. of a significant overhaul.

Copyright comment Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Olli Miettinen was an MD (1962) and MPH (1964) but had earned an MS in mathematical statistics (1965) and then completed a PhD in "biometry and epidemiology" (1968) after he had already joined the department of epidemiology at Harvard (1966). In 1981 Olli Miettinen and E Francis Cook explained that matching had different methodological implications when used in a cohort study or a case-control study. [Extracted from the article]

The article discusses community-engaged research and interventions that are considered important achievements of public health during the pandemic. Topics include supplements that form a catalogue, a repository, and a bank of best community-engaged practices, the launch of the Rapid Acceleration of Diagnostics-Underserved Populations in 2020 to support community-engaged research, and members of the Community Engagement Alliance (CEAL).

The article discusses the April 2020 Food and Drug Administration (FDA) guidance document on flavors in electronic cigarettes. Topics include broad classes of vaping devices in the U.S., smoking trends among youths, and concerns on the availability of unregulated flavor pods. Loopholes stemming from FDA regulations are also mentioned.

An interview with former Ohio governor John Kasich is presented in which he discusses public health in the U.S. He answers questions about his definition of public health, the public's perception of, and interpretation of, public health and policy, and the preventive nature of public health. He also discusses public health initiatives in his native Pittsburgh, Pennsylvania, health equity and inclusion, and interest in public health.

In 1931, Edgar Sydenstricker, the former statistician of the US Public Health Service, challenged the common belief that the 1918 influenza outbreak had affected "the rich and the poor alike." Using data from 112,317 participants in a 1918 US national survey, he observed that, on the contrary, both morbidity and mortality from the flu had been higher among the poor than among the rich. To explain these differences, Sydenstricker stratified the analyses by 2 measures of affluence collected in the survey: "economic status" (from "very poor" to "well-to-do") and household crowding (i.e. number of people per household room). Economic status was associated with influenza attack rates within categories of crowding, but not the opposite, suggesting that characteristics of poverty other than "household congestion" were the culprit of the poor's higher influenza burden. Attack rate ratios for influenza in infants and older adults were greater for the poor or very poor. Sydenstricker reanalyzed an already 12-year-old data set in the context of the Great Depression to build the evidence base relating poverty to ill health. For this purpose he used a stratification approach to assess confounding, mediation, and interaction before the concepts were formally named. [ABSTRACT FROM AUTHOR]

Between November 20, 1918, and March 12, 1919, the US Public Health Service carried out a vast population-based survey to assess the incidence rate and mortality of the influenza pandemic among 146 203 persons in 18 localities across the United States. The survey attempted to retrospectively assess all self-reported or diagnosed cases of influenza since August 1, 1918. It indicated that the cumulative incidence of symptomatic influenza over 6 months had been 29.4% (range = 15% in Louisville, KY, to 53.3% in San Antonio, TX). The overall case fatality rate (CFR) was 1.70%, and it ranged from 0.78% in San Antonio to 3.14% in New London, Connecticut. Localities with high cumulative incidence were not necessarily those with high CFR. Overall, assuming the survey missed asymptomatic cases, between August 1, 1918, and February 21, 1919, maybe more than 50% of the population was infected, and about 1% of the infected died. Eight months into the COVID-19 pandemic, the United States has not yet launched a survey that would provide population-based estimates of incidence and CFRs analogous to those generated by the 1918 US Public Health Service house-to-house canvass survey of influenza. [ABSTRACT FROM AUTHOR]

Over the past century, the field of epidemiology has evolved and adapted to changing public health needs. Challenges include newly emerging public health concerns across broad and diverse content areas, new methods, and vast data sources. We recognize the need to engage and educate the next generation of epidemiologists and prepare them to tackle these issues of the 21st century. In this commentary, we suggest a skeleton framework upon which departments of epidemiology should build their curriculum. We propose domains that include applied epidemiology, biological and social determinants of health, communication, creativity and ability to collaborate and lead, statistical methods, and study design. We believe all students should gain skills across these domains to tackle the challenges posed to us. The aim is to train smart thinkers, not technicians, to embrace challenges and move the expanding field of epidemiology forward. [ABSTRACT FROM AUTHOR]

The author reassesses the National Institutes of Health Multiple Risk Factor Intervention Trial and the National Cooperative Trial on Multifactorial Prevention of First Heart Attacks and Coronary Mortality in Free-Living, High-Risk, Middle-Aged American Men. Highlights include an increase in coronary heart disease deaths among middle-aged White men in the 1960s, the Seven Countries Study in 1958, and trends of men quitting smoking and being treated for hypertension.

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses articles presented in the "American Journal of Public Health" in 2020, most of which were focused upon the COVID-19 pandemic.

An introduction is presented in which the editor discusses articles in the issue on topics including the impact of abortion restrictions on the gynecologic profession, codifying abortion rights and access, and the consequences of abortion restrictions on maternal and infant health.

Objective: Rare disease. Background: Adrenal hemorrhage is an uncommon and under-recognized disorder with a wide array of etiologies ranging from pregnancy to septic shock. It is one of the complications of anticoagulation therapy, including direct anticoagulant medications. Case Report: Here, we present a case of a 68-year-old female with recent right knee arthroplasty who was on rivaroxaban for deep vein thrombosis (DVT) prophylaxis presented to the emergency department (ED) for severe acute onset abdominal pain, computed tomography (CT) of abdomen and pelvis revealed possible left adrenal hemorrhage that was confirmed with magnetic resonance imaging (MRI). On repeat CT, her unilateral adrenal hemorrhage converted to a bilateral adrenal hemorrhage (BAH) and, as a result, the patient developed adrenal insufficiency. Conclusions: An undiagnosed and untreated adrenal hemorrhage can have catastrophic consequences, leading to adrenal insufficiency with potential shock and death. Therefore, it is important for clinicians to have an increased awareness and knowledge about adrenal hemorrhage. [ABSTRACT FROM AUTHOR]

The author discusses the theme of the special section "Building Common Ground," which was curated by associate editor Tanya Telfair LeBlanc and guest editors William Kassler and Michael Fine. He discusses the idea behind the theme, the start of the promotion of public health dialogue in 2018, and a collection of evidence brought by the public health response to COVID-19.

The article discusses the role of pandemics, like the 17th century plague, 19th century cholera, and influenza of 1918, in stimulating the development of new methods in epidemiology in the wake of Covid-19 pandemic. Topics include a population-based comparative study by epidemiologist John Snow during London cholera; emergence of academic studies and public service dedicated to public health and epidemiology after influenza of 1918; and concept of group immunity during Covid-19.

Copyright of Hungarian Studies (02366568) is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the absurdities about the coronavirus pandemic and public health, particularly in the U.S., like the attempts to disparage the role of public health. Also cited are how the deployment of vaccines in high numbers to control the pandemic is a key achievement in the history of American public health and the book "Vaccinating America: The Inside Story Behind the Race to Save Lives, and End a Pandemic" by Michael Fraser and Brent Ewig.

The author reviews some of the articles published since 2018 and presents new articles from the issue about the importance of jobs, occupations, and work in people's health. Topics include the methodological challenges associated with incorporating work in the study of health inequities, the 50th anniversary of the passage of the 1970 Occupational Safety and Health Act (OSHA), and strengths and limitations of the National Health Service (NHS) data to assess the inequitable impact of COVID-19.

The article provides an overview of various topics explored in different issues of the journal including state of the health monitoring system, state of city dashboards, and the Spanish and British surveys on the national health systems.

The author argues the need to care about the death of more Republicans because of the COVID-19 pandemic as public health is all-inclusive. It offers an overview of the September 2022 research from the National Bureau of Economic Research that compared excess deaths among Republicans and Democrats. It points out that public health emergency response should be collective to make it successful, otherwise it is a failure.

The article shares tips for publishing in the journal to avoid desk rejections and unwarranted frustration. Information on the review process for article submissions by prospective authors is provided. Common causes of desk rejections include outdated data and low priority in terms of novelty or mainly of local interest. It advises prospective authors to read the journal's Instructions for Authors and familiarize themselves with its mission to reduce desk rejections.

In an attempt to reproduce the results of an inconclusive 1927 report by the British Medical Research Council on the hereditary versus social origins of rheumatic fever, Read, Ciocco, and Taussig, from Johns Hopkins University, with the support of Frost, conducted a case-control study in 1935 and 1936. Their study, which appeared in the American Journal of Hygiene in 1938, was outstanding for its clear and tidy rational for separating hereditary from environmental causes. The authors compared the prevalence of rheumatic fever among the relatives of 33 children admitted for "incident" rheumatic fever and 33 control children admitted in a tuberculosis clinic for reasons other than rheumatic fever. Both rheumatic fever (cases) and tuberculosis (controls) were diseases of the poor. All family members of both cases and controls, including uncles, aunts, and grandparents, were eligible for interview and physical examination. The results were compatible with the presence of an "inherited predisposition" to rheumatic fever because the disease was more prevalent among the uncles, aunts, and grandparents of case patients than among those of control patients. Methodologically, the paper by Read, Ciocco, and Taussig is an important but almost completely forgotten milestone in the evolution of case-control studies and of genetic epidemiology. [ABSTRACT FROM AUTHOR]

The article cites several studies in the present and previous issues which examined the state of the U.S. surveillance system. It includes one which reviewed the system along with ways to prepare for and respond to COVID-19 pandemic and future emergencies, another which examined the state of city dashboards designed to remediate or complement the gaps in existing federal surveillance, and one which documented the gaps in the surveillance systems that are hiding the pandemic's inequities.

The author offers observation on fascist threat to reproductive rights. Topics discussed include example of countries in Latin America where abortion was legalized, reactionary opinion holding released by the U.S. Supreme Court about federal constitutional right to abortion, and immediate consequences of the overruling of Roe v. Wade.

Before World War II, epidemiology was a small discipline, practiced by a handful of people working mostly in the United Kingdom and in the United States. Today it is practiced by tens of thousands of people on all continents. Between 1945 and 1965, during what is known as its 'classical' phase, epidemiology became recognized as a major academic discipline in medicine and public health. On the basis of a review of the historical evidence, this article examines to which extent classical epidemiology has been a golden age of an action-driven, problem-solving science, in which epidemiologists were less concerned with the sophistication of their methods than with the societal consequences of their work. It also discusses whether the paucity of methods stymied or boosted classical epidemiology's ability to convince political and financial agencies about the need to intervene in order to improve the health of the people. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "A Tutorial on Interaction" by Tyler VanderWeele and Mirjam Knol that was published in the previous issue.

Objective: To determine whether decision analysis is applicable to routine management of suspected pulmonary embolism in an emergency care setting.Design: Controlled feasibility trial.Setting: Emergency center of a university hospital.Patients: Outpatients (n = 84) admitted with clinical and scintigraphic evidence of pulmonary embolism.Interventions: Patients were treated either with the usual clinical work-up for pulmonary embolism (control group) or using a decision analysis model with three options: no action: angiography followed by treatment if positive; treatment without angiography.Results: All six senior residents in the decision analysis group agreed to fully participate for the 16 months of the study. Summarizing the decision analysis model in a graph was critical to obtain acceptance from all the physicians. Decision analysis (n = 43) and control (n = 41) patients underwent similar numbers of angiographies. However, angiographies for patients who had intermediate clinical probabilities of pulmonary embolism, between 25 and 75%, were more frequent in the decision analysis group (9/13 = 69%) than in the control group (7/20 = 35%). Agreement between clinical probability and lung-scan result was stronger in the decision analysis group.Conclusions: Decision analysis was successfully used to manage all patients suspected of having pulmonary embolism admitted to an emergency center during the 16-month trial. There was no insuperable obstacle to acceptance of clinical decision analysis by the physicians. Decision analysis may have resulted in a better discrimination between low and intermediate clinical probabilities of pulmonary embolism. [ABSTRACT FROM AUTHOR]

A study was conducted with transmission electron microscopy to find whether bronchoalveolar lavage could be used to identify subjects with occupational exposure to mineral particles. Non-fibrous mineral particles in bronchoalveolar lavage (BAL) fluid from 46 dental technicians and 41 white collar controls with lung diseases but free from occupational exposure to dusts were analysed. The total particle concentration in BAL fluid was significantly higher in dental technicians than in controls (12.18 x 10(5) particles/ml of BAL fluid, v 2.03 x 10(5) particles/ml, p < 0.001). Dental technicians had significantly more crystalline silica, aluminium, and alloys containing nickel and chromium. There was a non-significant twofold increase of total particle concentration in the lungs of dental technicians who were smokers compared with non-smokers. The results strongly support the use of BAL fluid analysis to assess dust accumulation in workers in heavily exposed occupations such as dental technicians. This is a valid method to evaluate occupational exposure to non-fibrous mineral particles, and may be useful to determine the occupational aetiology of some respiratory diseases. [ABSTRACT FROM AUTHOR]

Epidemiological studies have consistently demonstrated that either occupational or recreational physical activity is pro tective against colon cancer. However, it is unclear whether recreational activity is similarly protective among those who engage in high or low occupational activity. We therefore compared 440 male cases of colorectal cancer with 1164 male hospital patients. Occupational activity was defined according to job title, while recreational activity was assessed by questionnaire for three different periods of life. Occupational activity was protective with respect to colorectal cancer irrespective of whether one engaged in recreational activity at any different period of life. In contrast, recrea tional activity, performed at 20–44 years of age appeared to decrease colon cancer risk by 10–25% irrespective of the in tensity of job activity. The present results suggest that, although we observed a larger effect with occupational activity than with recreational activity, middle-aged men may reduce their risk of colorectal cancer if they exercise when they are not working. These findings need to be confirmed in other populations. [ABSTRACT FROM PUBLISHER]

It is often assumed, but has not been consistently observed, that some characteristics of reproductive history are specifically related to breast cancer of pre- or postmenopausal onset. To determine whether inconsistent reports may be due to differences in definition of menopause, we computed the relative odds (RO) of breast cancer for nulliparity, age at first live birth, family history of breast cancer and prior history of benign breast disease, separately in pre- and postmenopausal women, using seven different definitions of menopause. Results show that (i) relative odds of breast cancer and their confidence intervals may vary according to definitions of menopause; (ii) age-based definitions of menopause are associated with moderate differential misclassification bias between cases and controls; (iii) nulliparity, late age at first birth and family history of breast cancer seem to be specific risk factors for pre- but not postmenopausal breast cancer when cutoff for menopausal status is 10 years or more after last menses; and (iv) when information on menstrual history is not available, 50 years of age may be the best proxy for all menses-based definitions of menopause. We conclude that inconsistent findings on the effect of menopausal status in the association of breast cancer with some reproductive factors are partly due to statistical imprecision and differential misclassification bias associated with different age-based or menses-based definitions of menopause. Researchers should either test whether their conclusions hold using several definitions of menopause or give a biological rationale for the choice of a given definition of menopause. [ABSTRACT FROM AUTHOR]

The editor presents an overview of Notes From the Field (NFTF) articles made to share the experiences that may improve the practice of public health.

The article discusses a guidance for the industry released by the U.S. Food and Drug Administration (FDA) in January 2020 about marketing flavors for e-cigarettes. Topics include purpose of the guidance, the invitation made by the journal for scholars to give opinion about the expected impact of the guidance, and the policy of the journal on publishing industry-funded opinions.

An introduction is presented for an article in the issue on antitobacco campaigns in the Soviet Union during the 1920s.

In this issue of the Journal, Keyes and Galea (Am J Epidemiol. 2014;180(7):661–668) propose “7 foundational steps” for introducing epidemiologic methods and concepts to beginners. Keyes and Galea's credo is that the methododological and conceptual components that comprise epidemiology, today scattered in textbook chapters, come together as an integrated and coherent methodological corpus in the process of designing studies. Thus, they expound, the process of designing studies should be the core of teaching epidemiology. Two aspects of their 7-steps-to-epidemiology, do-it-yourself user manual stand out as novel: 1) the approach, because of its emphasis on modern epidemiology's causal framework of a dynamic population in a steady state evolving across time, and 2) the ambition to teach modern epidemiology in introductory courses, instead of the popular mix of classical and modern epidemiology that is often used today to keep introductory courses simple. Both aspects are of potentially great significance for our discipline. [ABSTRACT FROM PUBLISHER]

As pellagra reached epidemic proportions in the United States in the early 20th century, 2 teams of investigators assessed its incidence in cotton mill villages in South Carolina. The first, the Thompson-McFadden Commission, concluded that pellagra was likely infectious. The second, a Public Health Service investigation led by Joseph Goldberger, concluded that pellagra was caused by a dietary deficiency. In this paper, we recount the history of the 2 investigations and consider how the differences between the 2 studies' designs, measurements, analyses, and interpretations led to different conclusions. Because the novel dietary assessment strategy was a key feature of the Public Health Service's study design, we incorporated simulated measurement error in a reanalysis of the Public Health Service's data to assess whether this specific difference affected the divergent conclusions. [ABSTRACT FROM PUBLISHER]

For almost a century, epidemiologists have stratified age-specific disease rates by year of birth to better understand the distribution of a disease in a population and its evolution across time. In the present article, I review the contributions of John Brownlee, Kristian Feyer Andvord, and Wade Hampton Frost and, to accentuate the similarities of their approaches, redraw their original graphs of age-specific death rates of tuberculosis organized either by year of death or year of birth. In addition, this article reports on an apparently universally forgotten publication in the American Journal of Hygiene published in 1929, which both upsets the conventional history of the earliest reports of disease rates stratified by birth cohorts and challenges the theory that Frost discovered cohort analysis independently and gave it its name. [ABSTRACT FROM PUBLISHER]