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In the first half of the twentieth century, deaths from infectious disease, especially among the very young, fell dramatically in American cities. However, as infant mortality fell and life expectancy rose, racial inequality in urban infectious disease mortality grew. In this paper, we show that the fall in mortality and the rise in racial inequality in mortality reflected two countervailing processes. The dramatic decline in infant mortality from waterborne diseases drastically reduced the total urban infectious disease mortality rate of both Black and white Americans while having a comparatively small effect on the total racial disparity in urban infectious disease mortality. In contrast, the unequal fall in tuberculosis mortality, particularly in the prime of life, widened racial inequality in infectious disease mortality in US cities. [ABSTRACT FROM AUTHOR]

In this paper, we study a mathematical model for an infectious disease caused by a virus such as Cholera without lifetime immunity. Due to the different mobility for susceptible, infected human and recovered human hosts, the diffusion coefficients are assumed to be different. The resulting system is governed by a strongly coupled reaction–diffusion system with different diffusion coefficients. Global existence and uniqueness are established under certain assumptions on known data. Moreover, global asymptotic behaviour of the solution is obtained when some parameters satisfy certain conditions. These results extend the existing results in the literature. The main tool used in this paper comes from the delicate theory of elliptic and parabolic equations. Moreover, the energy method and Sobolev embedding are used in deriving a priori estimates. The analysis developed in this paper can be employed to study other epidemic models in biological, ecological and health sciences. [ABSTRACT FROM AUTHOR]

Vaccines have continued to play a crucial global role in preventing infectious diseases in the twenty-first century. The Covid-19 pandemic has underlined their importance, with vaccines seen as the best way to protect the public from coronavirus. A longstanding problem of governments has been the extent to which they should assume responsibility for the compensation of those injured by vaccines. This paper reappraises the vaccine damage schemes currently available in the US and UK in the light of the Covid-19 pandemic. It argues that any improvements to both US and UK schemes should be included in a revised national vaccine policy which takes into consideration their respective long-term national vaccine strategies to prepare for future pandemics. It supports the adoption of a UK-wide National Vaccine Injury Compensation Programme, similar to the one in the US, to be administered by the Secretary of State for Health and Social Care. To balance the need for rigorous criteria to determine causation with the need for fairness, the programme should adopt the US practice of allowing negotiated settlements between parties in circumstances where review of the evidence has not concluded that the vaccine(s) caused the alleged injury but there are close calls concerning causation. [ABSTRACT FROM AUTHOR]

Since the beginning of the coronavirus (COVID-19) global pandemic, digital contact-tracing applications (apps) have been at the centre of attention as a digital tool to enable citizens to monitor their social distancing, which appears to be one of the leading practices for mitigating the spread of airborne infectious diseases. Many countries have been working towards developing suitable digital contact-tracing apps to allow the measurement of the physical distance between citizens and to alert them when contact with an infected individual has occurred. However, the adoption of digital contact-tracing apps has faced several challenges so far, including interoperability between mobile devices and users' privacy concerns. There is a need to reach a trade-off between the achievable technical performance of new technology, false-positive rates, and social and behavioural factors. This paper reviews a wide range of factors and classifies them into three categories of technical, epidemiological and social ones, and incorporates these into a compact mathematical model. The paper evaluates the effectiveness of digital contact-tracing apps based on received signal strength measurements. The results highlight the limitations, potential and challenges of the adoption of digital contact-tracing apps. [ABSTRACT FROM AUTHOR]

This paper argues that the existing definition of pandemics is not nuanced enough, because it is predicated solely on the criterion of spread, rather than on the criteria of spread and severity. This definitional challenge is what I call 'the conflation problem': there is a conflation of two different realities of global health, namely global health emergencies (i.e., severe communicable diseases that spread across borders) and nonemergencies (i.e., communicable or noncommunicable diseases that spread across borders and that may be severe). To put this argument forth, this paper begins by discussing the existing and internationally accepted definition of pandemics, its requirements, as well as its strengths (section 1). Section 2 then considers the problem with the standard definition of pandemics (i.e., the conflation problem) and some examples of it. Finally, section 3 evaluates some practical implications of the conflation problem to then explore conceptual clarity as the adequate solution. [ABSTRACT FROM AUTHOR]

Trachoma is an infectious disease and it is the leading cause of preventable blindness worldwide. To achieve its elimination, the World Health Organization set a goal of reducing the prevalence in endemic areas to less than $5$ % by 2020, utilizing the SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) strategy. However, in Burundi, trachoma prevalences of greater than $5$ % are still reported in 11 districts and it is hypothesized that this is due to the poor implementation of the environmental improvement factor of the SAFE strategy. In this paper, a model based on an ordinary differential equation, which includes an environmental transmission component, is developed and analysed. The model is calibrated to recent field data and is used to estimate the reductions in trachoma that would have occurred if adequate environmental improvements were implemented in Burundi. Given the assumptions in the model, it is clear that environmental improvement should be considered as a key component of the SAFE strategy and, hence, it is crucial for eliminating trachoma in Burundi. [ABSTRACT FROM AUTHOR]

Almost 19% of the GDP of Ethiopia results from livestock production. Ruminants, in particular, form the majority of the national herd and are a critical source of income for smallholder farmers. Infectious diseases have been identified as a major cause of reduced livestock productivity in low- and middle-income countries (LMICs); therefore, a sound and comprehensive understanding of the relevant evidence would be beneficial in order to enable decision making on disease control policies. However, livestock disease data from sub-Saharan Africa is variable and disparate, which poses a challenge for evidence synthesis. This paper describes a protocol for a systematic mapping review of the recent available evidence on ruminant disease prevalence and associated mortality in Ethiopia. Literature sources will be identified using database search strategies. The titles, abstracts and, subsequently, full texts will be screened for inclusion based on predefined eligibility criteria. Specific data will be extracted and a preliminary qualitative assessment of the evidence will be performed using predefined indicators. The planned systematic map will be the first to provide a large-scale overview of the available ruminant disease evidence in Ethiopia; the final output will be an interactive dashboard tool to inform critical stakeholders in policy and research. [ABSTRACT FROM AUTHOR]

This paper is concerned with two frequency-dependent susceptible–infected–susceptible epidemic reaction–diffusion models in heterogeneous environment, with a cross-diffusion term modelling the effect that susceptible individuals tend to move away from higher concentration of infected individuals. It is first shown that the corresponding Neumann initial-boundary value problem in an n-dimensional bounded smooth domain possesses a unique global classical solution which is uniformly in-time bounded regardless of the strength of the cross-diffusion and the spatial dimension n. It is further shown that, even in the presence of cross-diffusion, the models still admit threshold-type dynamics in terms of the basic reproduction number $\mathcal {R}_0$ – i.e. the unique disease-free equilibrium is globally stable if $\mathcal {R}_0\lt1$ , while if $\mathcal {R}_0\gt1$ , the disease is uniformly persistent and there is an endemic equilibrium (EE), which is globally stable in some special cases with weak chemotactic sensitivity. Our results on the asymptotic profiles of EE illustrate that restricting the motility of susceptible population may eliminate the infectious disease entirely for the first model with constant total population but fails for the second model with varying total population. In particular, this implies that such cross-diffusion does not contribute to the elimination of the infectious disease modelled by the second one. [ABSTRACT FROM AUTHOR]

Objective: Despite the usefulness of quantitative research, qualitative research methodologies are equally needed to allow researchers to better understand the important social and environmental factors affecting food choice and eating habits. The present paper contributes insights from narrative inquiry, a well-established qualitative methodology, to a food-related doctoral research study. The connections between food shoppers and the producer, family, friends and others in the food system, between eaters and the earth, and how these connections affect people's meaning-making of food and pathways to food citizenship, were explored in the research.Design: The research used narrative inquiry methodology and focus groups for data collection.Setting: Five different food-ways in the Canberra region of Australia were selected for the present research; that is, community gardens, community-supported agriculture, farmers' markets, fresh food markets and supermarkets.Subjects: Fifty-two people voluntarily attended eight focus groups with four to nine participants in each.Results: From a practical perspective, the present paper offers a guide to the way in which narrative inquiry has been applied to one research project. The paper describes the application of narrative inquiry methodology, revealing the important place of narratives in generating new knowledge. The paper further outlines how phased narrative analysis can lead to a defensible and rigorous interpretive framework grounded in the data generated from people's stories and meaning-making.Conclusions: We argue that individual, social and system change will not be possible without further rigorous qualitative studies to inform and complement the empirical basis of public health nutrition practice. [ABSTRACT FROM AUTHOR]

The two questions, “What is public health law?” and “How can law improve the public's health?” are perennial ones for public health law scholars. This paper proposes a framework for conceptualizing discussion and debate about the scope and opportunities for public health law within liberal democracies. Part 2 of the paper draws selectively on this framework in order to highlight some areas where law's potential role deserves greater acknowledgment and exploration. [ABSTRACT FROM AUTHOR]

This paper explores the usefulness of the ‘asset vulnerability framework’, as devised by Moser (1998), for assessing the economic wellbeing of older people living in poor rural and urban communities in Thailand. Gaining an accurate view of older people's material situation is essential for the development of policies that target the needs of older people in contexts of resource scarcity. The paper shows the limitations and potential biases of assessments based purely on reported income levels. It then sets out the key principles of the asset vulnerability framework, which seeks to combine information about exposure to different economic risks with the relative capacity to deal with them. Drawing on survey data, the paper maps resilience to economic risk, finding that the very old and those living in rural communities are in the most precarious position, whereas gender differences are less apparent. The asset vulnerability framework is then applied to specific forms of risk: catastrophic health expenditure and the death of a child caused by HIV/AIDS. Patterns of vulnerability revealed by the framework roughly accord with those revealed by reported income, but there are important differences, such as the size of the vulnerability gap between rural and urban populations. The framework provides a much fuller picture of why some groups of older people are in a more precarious economic situation than others. The paper recommends that future surveys draw on Moser's framework, and place emphasis on identifying the risks that older people consider most important. [ABSTRACT FROM AUTHOR]

This paper argues for the inclusion of ethnography as a research methodology for understanding the effects of public health policy. To do this, the implementation of DOTS (Directly Observed Therapy, Short-course) – the World Health Organization (WHO) prescribed policy for the control of the infectious disease tuberculosis – is explored in the context of Nepal. A brief history of DOTS and its implementation in Nepal is outlined, and the way it has been represented by those within the Nepal Tuberculosis Programme (NTP) is described. This is followed by an outline of the research done in relation to this, and the ethnographic methods used. These ethnographic data are then interpreted and analysed in relation to two specific areas of concern. Firstly, the effects around the epidemiological uses of ‘cases’ is explored; it is argued that a tightening of the definitional categories so necessary for the programme to be stabilized for comparative purposes has profound material effects in marginalizing some from treatment. Secondly, the paper examines some of the implications and effects relating to the way that the ‘directly observed’ component was implemented. The discussion explores how current debate on DOTS has been played out in some medical journals. It argues for the importance of ethnography as a method for understanding certain questions that cannot be answered by particular, and increasingly dominant, research ideologies informed by randomized controlled trials. This raises important issues about the nature of ‘evidence’ in debates on the relationship of research to policy. [ABSTRACT FROM AUTHOR]

Objective: Dietary guidelines are important education and policy tools to address local nutrition concerns. The current paper presents a comparative analysis of nutrition messages from three Spanish-speaking Caribbean countries (Cuba, Puerto Rico and Dominican Republic) to explore how these dietary guidelines address common public health nutrition concerns, contextualized in different changing food environments and food culture similarities.Design: Qualitative, comparative analysis of current dietary guideline documents and key recommendations.Results: Key recommendations were categorized into sixteen themes (two diet-based, ten food-based and four 'other'). Only the Cuban dietary guidelines included diet-based key recommendations. Of the ten food-based key recommendations, only four themes overlapped across the three dietary guidelines (the encouragement of fruits and vegetables, addressing protein sources and fat). Other overlaps were found between dietary guideline pairs, except between Cuba and Puerto Rico. Further analysis revealed differences in levels of specificity and acknowledgement of local dietary patterns and issues, as well as the need to revise the guidelines to account for current scientific advances.Conclusions: The present study underscored the importance of context in the framing of dietary advice and the influence of national socio-economic and political situations on nutrition policy and education efforts. The results contribute to inform efforts to improve nutrition communication in the region and among migrant communities. [ABSTRACT FROM AUTHOR]

Introduction: Infectious diseases have been humanity's constant problem throughout history and they have shown how vulnerable we remain. COVID-19, commonly known as coronavirus pandemic, has already triggered a variety of psychological problems including fear, anxiety, and suicidal attempts. It has been hypothesized that immigrants who lost their job and have lower income or lower education level are more worried and fearful. Objectives: This paper aims to investigate the psychological conditions and stress level of immigrants in the NPZR. Moreover, the parameters influencing stress levels of the immigrants were analyzed. Methods: Demographics, level of stress and current psychological conditions of participants were gathered and analyzed through a structured survey. Besides, in-person interviews were conducted to explore the responses of the participants to receive more and deeper information. Results: The sample consists of 110 responders (45.3 % males; 51.8 %females). The findings of the study illustrated that while there was no relationship between gender of the immigrants and the level of stress, participants with low income (27.5 %) and unemployed immigrants (24.2 %) felt more worried and anxious. As time passes, the anxiety level of the participants decreased by 49.1 % but 40.9 % of the participants still experience severe anxiety. Conclusions: The findings demonstrate that having low income or being unemployed as well as the cancellation of travel plans, are positively related with the depression level of the participants. The result of this paper show that more attention has to be given towards immigrants with low income as they are more vulnerable during the COVID-19 Pandemic. [ABSTRACT FROM AUTHOR]

Adult height reflects long-term nutritional status and exposure to infectious diseases, both of which are influenced by socioeconomic factors. Very little research has been done on these inequalities from a longitudinal perspective. This paper explores the links between body height at different life stages and socioeconomic characteristics. Data were obtained from 1008 Polish schoolgirls aged 16–18 years for whom earlier data on height were available. The height of each subject was measured. Socioeconomic status and age at menarche were assessed based on information received from the surveyed girls. Girls' heights in early life were ascertained from medical records. All girls were measured by trained school nurses at 7, 9 and 14 years of age. Socioeconomic status was found to be related to body height, but not to the rate of height gain during childhood and adolescence. Girls of a higher socioeconomic status were taller than girls of a lower socioeconomic status. On dividing the research material into homogeneous groups by maturity status, the same relationship was observed. No significant relationships were found between socioeconomic status and rate of height gain between ages 7 and 16, 17, 18 years. The findings suggest that socioeconomic variation in height is the result of living conditions during the first years of life. [ABSTRACT FROM AUTHOR]

Zoonoses are an issue of growing interest in South-East Asia, where environmental factors and socio-economic context favor the endemization of well-known diseases and the emergence of new pathogens at the human–wildlife interface. However, the health status of the region with respect to many zoonotic diseases remains poorly defined, despite the high overall burden of zoonoses on the countries of the area, and the global risk of new biological threats in the region. The first objective of this paper was to provide an update of data on the zoonoses commonly described by the scientific community and reported by governmental institutions and international organizations in continental South-East Asia. The analysis of the available data led to the identification of some trends in the evolution of the diseases, as well as some gaps in knowledge and in the current surveillance and control networks. In light of these findings, we discuss measures for effectively addressing zoonotic disease issues in South-East Asia, such as the allocation of funds for research and for surveillance and control programs, and a multi-sectoral and multi-disciplinary approach at various levels. [ABSTRACT FROM PUBLISHER]

Communicable diseases, especially those that are highly contagious, are on the rise and each of us, no matter who we are or where we live, is equally at risk of transmitting contagious diseases to others as we are of contracting such diseases from others. Because contagious diseases are as readily passed state-to-state as person-to-person, we all have a stake in every country's ability to enact effective infectious disease control policies, while policies grounded in shared values are more likely to gain widespread acceptance and thereby prove most effective. This paper suggests that principlism proved invaluable as an ethical framework for resolving hard medical cases and setting health care policy because it nicely 'fits' dilemmas that arise in the context of the special relationship between doctors and patients or within family units. It then argues that communitarianism provides the better foundation for crafting infectious diseases control policies because contagious diseases, which often pass between perfect strangers, raise questions about the moral obligations we owe to (or are entitled to demand of) people with whom we share no 'special' relationship. Accordingly, a socially embedded framework such as communitarianism may be a better fit for the more socially embedded ethical dilemmas of communicable diseases. [ABSTRACT FROM AUTHOR]

This paper examines mortality by cause of death in a rural area of Machakos district in Kenya. The cause-of-death data collected between 1975 and 1978 were likely to be of fairly good quality. The number of deaths was higher among infants and children. Infectious diseases and diseases of the respiratory system were the leading causes of death among children below 5 years of age. Next in prominence were the causes ascribed to congenital anomalies and perinatal conditions. Among adolescents and young adults, injury and poisoning, together with tuberculosis and other infectious and parasitic diseases, were the leading causes of death. Degenerative diseases, especially diseases of the circulatory system and neoplasms and respiratory illness, were responsible for the majority of deaths among the older population. [ABSTRACT FROM AUTHOR]