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The method requires numbering each member of the survey population gastritis diet menu generic biaxin 250 mg free shipping, whereas nonrandom sampling involves taking every nth member gastritis red flags order 500mg biaxin otc. Findings indicate that as long as the attribute being sampled is randomly distributed among the population, the two methods give essentially the same results. If the attribute is not randomly distributed, the two methods give radically different results. In some instances the nonrandom methods yield much better inferences about the population; in other instances, its inferences are much worse. Rand Corporation; Statistics Solutions One Health: A collaborative, multisectoral, and transdisciplinary approach-working at local, regional, national and global levels-to achieve optimal health and well-being outcomes recognizing the interconnections between people, animals, plants and their shared environments. An influenza pandemic occurs when a new influenza virus emerges and spreads around the world and most people do not have immunity. British Society for Immunology Pathogenicity: the absolute ability of an infectious agent to cause disease/damage in a host-an infectious agent is either pathogenic or not. WordSense Dictionary Permafrost: A thick subsurface layer of soil that remains frozen throughout the year, occurring chiefly in polar regions. Oxford Dictionary Phylogenetic analysis: Phylogeny is the relationship between all the organisms on Earth that have descended from a common ancestor, whether they are extinct or extant. Phylogenetics is the science of studying the evolutionary relatedness among biological groups and a phylogenetic tree is used to graphically represent this evolutionary relation related to the species of interest. Put simply, planetary health is the health of human civilization and the state of the natural systems on which it depends". First identified and reported in 1971, it affects pigs of all ages, but most severely neonatal piglets, reaching a morbidity and mortality of up to 100 per cent, with mortality decreasing as age increases. The prevention and management control are focused on strict biosecurity and early detection. YourDictionary Q fever: A disease caused by bacteria of the species Coxiella burnetii. People can get infected by breathing in dust that has been contaminated by infected animal faeces, urine, milk and birth products or by eating contaminated unpasteurized dairy products. It refers to the expected number of secondary infections arising from a single individual during his or her entire infectious period, in a population of susceptible individuals. This concept is fundamental to the study of epidemiology and within-host pathogen dynamics. Most importantly, R0 often serves as a threshold parameter that predicts whether an infection will spread. It can spread to people and pets if they are bitten or scratched by a rabid animal. In up to 99 per cent of cases, domestic dogs are responsible for rabies virus transmission to humans but it can affect both domestic and wild animals. Rabies is present on all continents, except Antarctica, with over 95 per cent of human deaths occurring in the Asia and Africa regions. Rabies is one of the `neglected tropical diseases that predominantly affects poor and vulnerable populations who live in remote rural locations. Although effective human vaccines and immunoglobulins exist for rabies, they are not readily available or accessible to those in need. Encyclopedia Britannica; Biology Online; Wikipedia Reservoir: the habitat in which the agent normally lives, grows, and multiplies. The reservoir may or may not be the source from which an agent is transferred to a host. Once discovered, natural reservoirs elucidate the complete life cycle of infectious diseases, providing effective prevention and control. The disease occurs in explosive outbreaks following periods of above-normal and persistent rainfall. People can become infected with Rift Valley fever after being bitten by an infected mosquito or through close contact with acutely infected animals or their tissues. In people, the disease manifests itself as a mild influenza-like syndrome in over 80 per cent of cases or a severe disease with haemorrhagic fever, encephalitis or retinitis in a few cases. Because of its episodic occurrence and predilection 70 Glossary Preventing the next pandemic: Zoonotic diseases and how to break the chain of transmission for remote pastoral areas, the impact of the disease is often exacerbated by delays in the deployment of prevention and control measures. Livestock vaccination is regarded as the most reliable method for controlling the disease. Biology Online Salmonella bacteria cause foodborne illness, commonly called food poisoning, with symptoms of diarrhoea, fever and stomach cramps.

Second gastritis ulcer order biaxin 250mg line, each of the dynamic processes influencing population size and growth gastritis symptoms remedy buy biaxin 500 mg free shipping, structure, and distribution, namely, fertility, mortality, and migration, will also affect health status. Thus, any discussion of disease control priorities and of the health system for delivering interventions requires an understanding of the demographic context and how it is changing. This chapter begins by providing an overview of global population trends in each major region of the world and the current size and composition of the population. This includes both an assessment of trends in age-specific mortality and summary measures of the age schedule of mortality, such as life expectancy and the probability of dying within certain age ranges, as well as a specific discussion of trends in the main causes of child mortality. The focus on child mortality is entirely appropriate because (a) the fact that at the end of 17 the 20th century, we remained woefully ignorant of its levels, let alone its causes, is highlighted; (b) the reduction of child mortality should remain a priority for global health development efforts, and the moral imperative to do so remains as relevant today as it was 30 years ago, when efforts to improve child survival became increasingly organized and focused; and (c) the resulting emphasis by the global public health community on reducing child mortality has yielded vastly more epidemiological information that can be used to assess trends in levels and causes. Nevertheless, we argue later in the chapter that large and unacceptable uncertainties about trends in cause-specific child mortality rates persist, with important implications for program planning and evaluation. Sources of Population Data and Methodology the population and mortality estimates for various regions summarized here are based on different data sources and methods, and thus are not strictly comparable. This primarily concerns the impact of different estimates of deaths by age and sex on population size and structure. Because the effect of mortality on population size and structure is generally modest, such differences have little impact on the findings reported in this chapter. Where necessary, it adjusts the data to achieve internal consistency and cross-country comparability. Because the 2002 revision was produced without complete data for 2001 for all countries, the baseline estimates are also projections, and the population figures in this chapter are therefore a mixture of both observed and projected data. In addition to total population, the baseline assessment includes a breakdown of population by sex and age (in five-year aggregates). Fertility is specified as age-specific fertility rates for females and mortality rates are based on survival probabilities from life tables. Age-specific patterns of migration are also incorporated for countries in which migration flows are observed or are thought to occur. It does not provide information about the adjustments made to reported fertility rates, age and sex structures, or mortality rates. Basic information on population size and composition is available for most countries for 1990, and with the exception of Sub-Saharan Africa, for 2000 (or thereabouts) as well (table 2. Around both dates, censuses covered more than 90 percent of populations in all the regions except Sub-Saharan Africa. Lopez, Stephen Begg, and Ed Bos the model pattern, in which case the country-specific pattern is followed (United Nations 2003). Our 2001 estimates and future projections are generated on the basis of the cohort component methodology. This approach applies estimated trends in birth and death rates and migration by age and sex to a baseline age and sex structure. Population growth rates are determined by the levels of age-specific fertility and mortality rates and migration and the size of the initial age groups (base year population) against which these levels are applied. The aggregates are thus weighted by the different population sizes of individual countries. As a result, the age and sex structures reported here, as well as any indicators derived from them (such as crude birth and death rates) are not strictly internally consistent. Distribution by Age, Sex, and Location Population Size and Growth Between 1990 and 2001, global population increased from about 5. Estimates at the global level conceal large differences in population growth among regions, which in turn consist of countries that may have quite different demographic trends. For example, Europe and Central Asia added just 1 million people per year between 1990 and 2001, whereas South Asia added 25 million people each year. The World Bank regions (see map 1 inside the front cover of this volume) vary substantially in terms of population How populations are distributed by age matters a great deal for public health, because many aspects of risk behavior, as well as disease and injury outcomes, are strongly associated with age. While many other factors contribute to mortality and fertility levels, the age distribution of a population is an important factor in explaining differences in demographic and epidemiological indicators. Regions differ significantly in how their populations are distributed across age groups, with almost 45 percent of the population of Sub-Saharan Africa being younger than 15, compared with 20 percent of the population in high-income countries, where fertility has been low for decades. At the same time, the population aged 70 and older has been increasing in most regions as mortality has declined, and this age group now represents more than 10 percent of the population in the high-income countries.

Examples of such integrated strategies include using education and economic tools to promote physical activity and a healthier diet coupled with screening and lowering cholesterol gastritis diet 9000 generic biaxin 500 mg fast delivery, and addressing the overall childhood nutrition and physical environment instead of focusing on individual components gastritis stomach pain buy biaxin 500 mg low cost. In such research, risk factor groups should be selected based on both biological relationships and socioeconomic factors that affect multiple diseases. Examples include those risk factors that are affected by the same policies and distal socioeconomic factors, such as malnutrition; unsafe water, sanitation, and hygiene; indoor smoke from household use of solid fuels; and rural development policies, or affect the same group of diseases, for instance, the previous example for childhood infectious diseases and smoking, diet, physical activity, and blood pressure for vascular diseases. Once risk factors are selected, the emphasis on reducing confounding should be matched by equally important inquiry into independent and mediated hazard sizes that are stratified based on the levels of other risks. Finally, to inform interventions and policies, similar analyses should take place at smaller scales than global or regional levels, for example, rural and urban areas or different geographical regions of individual countries, and should include micro-level data and possibly a more comprehensive list of both distal and proximal risk factors, such as adverse life events and stress, risk factors for injuries, salt and fat intake, and blood glucose. These are coupled with hazards such as alcohol use, smoking, high blood pressure, high cholesterol, and overweight and obesity that are globally widespread and have large health effects. The large remaining burden due to childhood mortality risks such as undernutrition; unsafe water, sanitation, and hygiene; and indoor smoke from household use of solid Comparative Quantification of Mortality and Burden of Disease Attributable to Selected Risk Factors 267 fuels indicates the persistent need for developing and delivering effective interventions, including lowering the costs of pertinent technological interventions. At the same time, four of the five leading causes of lost healthy life affect adults: high blood pressure, unsafe sex, smoking, and alcohol use (figure 4. Risk factors for both adult communicable and noncommunicable diseases already make substantial contributions to the disease burden even in regions with low income and high infant mortality. Therefore, the public health community should continually reassess the need for interventions addressing both childhood disease risk factors and those that affect adult health. Dynamic and systematic policy responses can, to a large extent, mitigate the spread of such risk factors and their more distal causes throughout the development process, for example, through cleaner environmental or healthier nutritional transitions (Arrow and others 1995; Lee, Popkin, and Kim 2000). Risk factors that were not among the leading global causes of the disease burden should not be neglected for a number of reasons. First, the analysis could be expanded with other risk factors that are both prevalent and hazardous. Second, although smaller than other risk factors, many make non-negligible contributions to the burden of disease in various populations. For example, in the low- and middle-income countries of East Asia and the Pacific, which is dominated by China in terms of population, urban air pollution from transportation and industrial and household energy use based on coal has health effects comparable to those of micronutrient deficiencies. Similarly, non-use and use of ineffective methods of contraception was associated with a larger disease burden than most chronic disease risk factors among females in South Asia and Sub-Saharan Africa. Third, for other risk factors, such as child sexual abuse, ethical considerations may outweigh direct contribu- tions to the disease burden in policy debate. Finally, while the burden of disease due to a risk factor may be comparatively small, effective or cost-effective interventions may be known. Examples include reducing the number of unnecessary injections at health facilities coupled with the use of sterile syringes and the reduction in exposure to urban air pollution in industrial countries in the second half of the 20th century, which often also led to benefits such as energy savings. A small number of risks account for large contributions to the global loss of healthy life. Furthermore, several are relatively prominent in regions at all stages of development. While reducing all the risks discussed to their theoretical minimums may not be possible using current interventions, the results illustrate that preventing disease by addressing known distal and proximal risk factors can provide substantial and underutilized public health gains. Treating established disease will always have a role in public health, especially in the case of diseases such as tuberculosis, where treatment contributes to prevention. At the same time, the current devotion of a disproportionately small share of resources to prevention by reducing major known risk factors through personal and nonpersonal interventions should be reconsidered in a more systematic way in light of the evidence presented here. The estimates of the joint contributions of 19 selected global risk factors showed that these risks together contributed to a considerable loss of healthy life in different regions of the world. This concentration of the disease burden further emphasizes the contribution of leading risks such as undernutrition, unsafe sex, high blood pressure, and smoking and alcohol use to the loss of healthy life globally. The results further emphasize that for more effective and affordable implementation of a prevention paradigm, policies, programs, and scientific research should acknowledge and take advantage of the interactive and correlated role of major risks to health, across and within causality layers. Comparative Quantification of Mortality and Burden of Disease Attributable to Selected Risk Factors 269 Table 4A.

Investigators have undertaken a number of efforts to estimate the causes of child mortality over the past decade or so (Bryce and others 2005; Lopez 1993; Morris gastritis diet ôàöåáîîê cheap 500mg biaxin amex, Black gastritis diet ïùùïäó order 250mg biaxin visa, and Tomaskovic 2004; Williams and others 2002), but undoubtedly the most comprehensive was the study by Murray and Lopez (1996) and its 2001 revision (chapter 3 in this volume). Differences in regional estimates between 1990 and 2001 arise in part because the countries included in the regions differed and, more important, because of better information for more recent periods. Yet, despite improved information, the true level of child death rates from major causes such as malaria and perinatal conditions (birth trauma, birth asphyxia, sepsis, and prematurity) remains largely unknown. These estimates have been simply obtained as the difference between the regional estimates for 1990 and 2001, but the implied pattern of change is interesting nonetheless. By contrast, the 2001 estimates were prepared as regional aggregates of country-specific estimates (see chapter 3,) and this has undoubtedly affected comparisons further. The proportion of all child deaths due to malaria doubled from 5 percent in 1990 to 10 percent in 2001 worldwide and increased from 15 percent in 1990 to 22 percent in 2001 in Sub-Saharan Africa. Causes that appear to have declined substantially include acute respiratory infections (2. The implied pattern of change in the risk of child death varies across regions for all major conditions listed in table 2. While these changes may be in accord with what is known about regional health development and economic growth, they need to be confirmed. Some of the suggested changes warrant further investigation, for example, death rates from perinatal causes appear to have risen in both East Asia and the Pacific and South Asia and remained unchanged in Latin America and the Caribbean, which may or may not be in line with what is known about developments in prenatal care and safe motherhood initiatives. Similarly, measles appears to have disappeared as a cause of child death in Latin America and the Caribbean. The risk of child death from congenital anomalies appears to have risen in both Latin America and the Caribbean and the Middle East and North Africa, but why is unclear. Similarly, the large suggested declines in the risk of child deaths because of injury in South Asia and Sub-Saharan Africa appear unlikely and may largely reflect better data and methods for measuring injury deaths. Knowledge about the size and composition of populations and how they are changing is critical for health planning and priority setting. Such estimates and projections have been useful for social and economic development for countries, regions, and the world as a whole. They suggest that health and social policies need to pay increasing attention to the key demographic trends observed in the 1990s, namely, rapidly falling fertility virtually everywhere, rapidly aging populations, and unprecedented reversals of the long-term path of mortality decline in Europe and Central Asia and Sub-Saharan Africa the causes of these so-called mortality shocks are reasonably well understood, but the lessons for health policy cannot be overemphasized. Thus, despite the substantial and continued declines in mortality from major vascular diseases in high-income countries, worldwide the risk of death in adulthood did not change in the 1990s, although some gains in reducing mortality in the elderly were achieved, particularly in rich countries. The trend in child mortality during the 1990s was only marginally more satisfactory. While most regions achieved significant gains in child survival, progress was modest in Sub-Saharan Africa, and as a result, the global decline in child mortality slowed to an annual average of about 1 percent over the decade. The trends in the leading causes of child mortality are, however, much more difficult to establish (Rudan and others 2005). Much debate in the literature has centered on whether the risk of malaria infection in Sub-Saharan Africa increased in the 1990s, and thus whether the massive increase in malaria deaths suggested in table 2. Most malaria mortality in Sub-Saharan Africa is diagnosed via verbal autopsies, which, where studied, have been shown to be a poor diagnostic tool for malaria (Snow and others 1992). While some evidence from demographic surveillance sites using verbal autopsies indicates that malaria mortality rates have increased in eastern and southern Africa (summarized in Korenromp and others 2003) and that the spread of chloroquine resistance may have been the primary reason (Snow and others 1999; Trape 2001), whether this is sufficiently widespread to account for the implied rise of almost 50 percent in malaria mortality rates over the decade (figure 2. Lopez, Stephen Begg, and Ed Bos a general deterioration in clinical care and a decline in the efficacy of chloroquine therapy, may also have contributed (Snow and others 2001), but how much of the rise is real and how much is due to different interpretations of available data in 1990 and 2001 remains unknown. Similarly, the substantial implied declines in the risk of child death from acute respiratory infections and diarrheal diseases need to be understood in the context of likely contributing factors. One of these is no doubt malnutrition, because it is a major risk factor for both conditions (Black, Morris, and Bryce 2003; Pelletier, Frongillo, and Habicht 1993; Rice and others 2000; Tupasi and others 1988). In the 1990s, malnutrition, as assessed by childhood stunting, declined in all regions except Sub-Saharan Africa (de Onis, Frongillo, and Blossner 2000), which is consistent with the modest declines in mortality from respiratory infections among children in the region. Increased use of oral rehydration therapy and improved access to safe water and sanitation in the 1990s would suggest some decline in mortality from diarrheal disease, but whether they were sufficient to account for the one-third decline in risk, including in Sub-Saharan Africa, is also unclear (Victora and others 2000). Malnutrition is also a leading risk factor for measles mortality, and hence changes in the proportion and distribution of underweight children should be broadly consistent with mortality trends from the disease (Fishman and others 2004). Effective vaccination coverage is a primary determinant of mortality from measles, and further increases in vaccination coverage in the 1990s should have led to lower mortality. This is certainly apparent from the estimates reported here, but the extent of that decline is subject to some controversy, depending on the methods used to estimate current mortality. Using proportionate mortality models largely derived from verbal autopsy data, Morris, Black, and Tomaskovic (2003) estimate that measles deaths account for only about 2.

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• https://www.jabfm.org/content/jabfp/27/4/549.full.pdf
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