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Objective. To evaluate the hematological and biochemistry profile of patients with or without HIV-TB at the Georgetown Chest Clinic, Guyana. Methods. An observational, laboratory based study was designed to assess the relationship of PTB and HIV with patients routine biochemical and hematological values. The study was conducted during the period January 2013 to December 2014; a total sample size of 316 patients was enrolled following exclusion and inclusion criteria. Results. Mean age of study population was 40.1 ± 13.8 (95% CI 38.6-41.7) and most were between 40 and 49 age group (27.8%, 95% CI 23.2-33.0). More males were in the study 74.4% (95% CI 69.3-78.8) than females 81% (95% CI 21.1-30.7). 30% (95% CI 25.3-35.3) had a sputum smear grade of 3+ and 62.5% (95% CI 47.0-75.7) showed a CD4 count <200. The study demonstrated significantly low hemoglobin (Hb) 91.7% (95% CI 78.2-97.1), low WBC 27.8% (95% CI 15.8-44.0), high indirect bilirubin 7.4% (95% CI 2.1-23.3), ALT 41.8% (95% CI 28.4-56.7), and AST 72.2% (95% CI 57.3-83.3) among TB-HIV patients. Homelessness RR (relative risk) 2.2 (95% CI 0.48-12.3), smoking RR 1.09 (95% CI 1.01-1.19), and gender (male) RR 1.2 (95% CI 0.61-2.26) were main associated risk factors. Conclusions. There is slight variation among PTB and PTB-HIV coinfected patients in some hematological and biochemistry parameters.

This paper discusses how the epidemiologists who guide the collection, analysis, and sharing of public health data are powerful and can use their influence to bring about changes that will benefit the health of people around the world. They can frame public debate and the actions of policy makers on major health issues because they have the power to determine what health indicators are measured, which questions are asked, and how the raw data are presented. To be effective leaders, these epidemiologists can learn much from the ancient Chinese philosophy of the Tao Te Ching, which advises powerful people to lead others without domination or coercion.

Context: Modifiable behavioral risk factors are leading causes of mortality in the United States. Quantifying these will provide insight into the effects of recent trends and the implications of missed prevention opportunities., Objectives: To identify and quantify the leading causes of mortality in the United States., Design: Comprehensive MEDLINE search of English-language articles that identified epidemiological, clinical, and laboratory studies linking risk behaviors and mortality. The search was initially restricted to articles published during or after 1990, but we later included relevant articles published in 1980 to December 31, 2002. Prevalence and relative risk were identified during the literature search. We used 2000 mortality data reported to the Centers for Disease Control and Prevention to identify the causes and number of deaths. The estimates of cause of death were computed by multiplying estimates of the cause-attributable fraction of preventable deaths with the total mortality data., Main Outcome Measures: Actual causes of death., Results: The leading causes of death in 2000 were tobacco (435 000 deaths; 18.1% of total US deaths), poor diet and physical inactivity (365 000 deaths; 15.2%) [corrected], and alcohol consumption (85 000 deaths; 3.5%). Other actual causes of death were microbial agents (75 000), toxic agents (55 000), motor vehicle crashes (43 000), incidents involving firearms (29 000), sexual behaviors (20 000), and illicit use of drugs (17 000)., Conclusions: These analyses show that smoking remains the leading cause of mortality. However, poor diet and physical inactivity may soon overtake tobacco as the leading cause of death. These findings, along with escalating health care costs and aging population, argue persuasively that the need to establish a more preventive orientation in the US health care and public health systems has become more urgent.

Law, which is a fundamental element of effective public health policy and practice, played a crucial role in many of public health's greatest achievements of the 20th century. Still, conceptual legal frameworks for the systematic application of law to chronic disease prevention and control have not been fully recognized and used to address public health needs. Development and implementation of legal frameworks could broaden the range of effective public health strategies and provide valuable tools for the public health workforce, especially for state and local health department program managers and state and national policy makers. In an effort to expand the range of effective public health interventions, the Centers for Disease Control and Prevention will work with its partners to explore the development of systematic legal frameworks as a tool for preventing chronic diseases and addressing the growing epidemic of obesity, heart disease, stroke, and other chronic diseases and their risk factors.

Scientific knowledge concerning effective preventive measures to preserve and protect the health of the public continues to grow exponentially. Methods for assessing the impact of population-based interventions such as policies and laws have also greatly increased in the past decade, including systematic approaches that allow general findings to be drawn from various studies, especially those developed as part of the Guide to Community Preventive Services (Community Guide). However, the translation of the collected scientific evidence gathered to date has been spotty and problematic. Success stories do exist, including community water fluoridation, a significant factor in improvements in reduction of tooth decay over the past 50 years. Even for interventions with a strong science base, such as community water fluoridation, significant barriers to implementation of effective strategies discovered through research remain. Barriers include public misunderstanding of health issues and proposed solutions such as fluoridation; lack of engagement on the part of the media in communicating known effective strategies; and reluctance on the part of policymakers to champion approaches that concern but may not be advocated by their constituencies. The increasing burden of chronic disease places public policymakers into non-traditional roles, such as advocating behavior change as a preventive measure. Science is a critical tool to help legislators and policymakers "connect the dots" between public policies. For example, the elimination or degrading of physical education programs in schools is an important factor in addressing the national epidemic of childhood overweight and obesity in addition to the increase in rates of Type II diabetes among children. This article provides an overview of the past, present, and future associated with translating science into public health policy and law, including a review of tools and strategies to address existing and expanding public health challenges. The article also provides and discusses examples of translating and implementing science-based solutions to address public health problems effectively.