Challenges to the census: international trends and a need to consider public health benefits.

The Canadian government decision to cancel the mandatory long-form census in 2010 (subsequently restored in 2015), along with similar discussions in the United Kingdom (UK) and the United States of America (USA), have brought the purpose and use of census data into focus for epidemiologists and public health professionals. Policy decision-makers should be well-versed in the public health importance of accurate and reliable census data for emergency preparedness planning, controlling disease outbreaks, and for addressing health concerns among vulnerable populations including the elderly, low-income, racial/ethnic minorities, and special residential groups (e.g., nursing homes). Valid census information is critical to ensure that policy makers and public health practitioners have the evidence needed to: (1) establish incidence rates, mortality rates, and prevalence for the full characterization of emerging health issues; (2) address disparities in health care, prevention strategies and health outcomes among vulnerable populations; and (3) plan and effectively respond in times of disaster and emergency. At a time when budget and sample size cuts have been implemented in the UK, a voluntary census is being debated in the US. In Canada, elimination of the mandatory long-form census in 2011 resulted in unreliable population enumeration, as well as a substantial waste of money and resources for taxpayers, businesses and communities. The purpose of this article is to provide a brief overview of recent international trends and to review the foundational role of the census in public health management and planning using historical and current examples of environmental contamination, cancer clusters and emerging infections. Citing a general absence of public health applications of the census in cost-benefit analyses, we call on policy makers to consider its application to emergency preparedness, outbreak response, and chronic disease prevention efforts. At the same time, we call on public health professionals to improve published estimates of monetary benefit (via either cost-benefit or cost-effectiveness analysis) to a given public health intervention.

The evaluation of human papillomavirus genotyping in cervical liquid-based cytology specimens; using the Roche Linear Array HPV genotyping assay.

OBJECTIVE: To ascertain the usefulness of the Roche Linear Array human papillomavirus (HPV) genotyping assay for assessing HPV genotypes in liquid-based cytology (LBC) samples and to evaluate this methodology within a cytopathology laboratory. These tests are of importance as persistent infection with high-risk HPV genotypes is considered a causal factor in the development of cervical cancer. METHODS: A total of 175 cervical LBC samples were tested using the Roche Linear Array HPV genotyping test. The suitability of the assay use in routine cytopathology laboratory was considered. HPV genotypes were matched to the cervical cytology results, which included negative, borderline nuclear abnormalities, mild, moderate and severe dyskaryosis. RESULTS: The assay could be applied to screening samples with the combined result available at the reporting stage. There were no test failures. All samples used after cytological analysis had sufficient DNA for testing. The results were reproducible and easily read and there was concordance of results between biomedical scientists. The results of the assay showed co-infection with multiple HPV genotypes was common in both high-grade and low-grade cytology samples. The percentage of HPV+ samples in the normal cytology samples (although in this grouping the number of samples was low) was 37%. In the cytology samples reported as severe dyskaryosis the HPV genotypes most commonly found were HPV16 and HPV51. CONCLUSION: The assay was able to detect multiple HPV infection with a wide range of genotypes in LBC samples sent for routine cytological analysis. It would be suitable for use in a cytopathology laboratory. The results of the assay show that the genotype profile has some variation from other geographical regions, and more work is needed to determine population prevalence, to ascertain the impact of the HPV vaccine, to evaluate test for cure and HPV triage management.

Perceptions and problems of disease in the one-humped camel in southern Africa in the late 19th and early 20th centuries.

The one-humped camel (Camelus dromedarius) was first introduced to German South West Africa (Namibia) for military purposes in 1889. Introductions to the Cape of Good Hope (South Africa) in 1897 and Rhodesia (Zimbabwe) in 1903 were initially with a view to replacing oxen that died of rinderpest. Disease risks attendant on these introductions were recognised and to some extent guarded against. There were, however, relatively few problems. One camel was diagnosed as having foot-and-mouth disease. Mange in camels from India caused some concern as did trypanosomosis from Sudan. Trypanosomosis was introduced into both the Cape of Good Hope and Transvaal. Antibodies to some common livestock disease were found in later years.

Vitamin D receptor polymorphisms and renal cancer risk in Central and Eastern Europe.

Previous studies investigated the role of vitamin D intake and cancer risk. The kidney is a major organ for vitamin D metabolism, activity, and calcium homeostasis; therefore, it was hypothesized that dietary vitamin D intake and polymorphisms in the vitamin D receptor (VDR) gene may modify renal cell carcinoma (RCC) risk. Three common VDR gene polymorphisms (BsmI, FokI, TaqI) were evaluated among 925 RCC cases and 1192 controls enrolled in a hospital-based case-control study conducted in Central and Eastern Europe. Overall associations with RCC risk were not observed; however, subgroup analyses revealed associations after stratification by median age of diagnosis and family history of cancer. Among subjects over 60 yr, reduced risks were observed among carriers of the f alleles in the FokI single-nucleotide polymorphism (SNP) (odds ratio [OR] = 0.61 for Ff and OR = 0.74 for ff genotypes) compared to subjects with the FF genotype (P trend = 0.04; P interaction = 0.004). Subjects with the BB BsmI genotype and a positive family history of cancer had lower risk compared to subjects with the bb allele (OR = 0.60; 95% CI: 0.33-1.1; P trend = 0.05). Genotype associations with these subgroups were not modified when dietary sources of vitamin D or calcium were considered. Additional studies of genetic variation in the VDR gene are warranted.

Biodiversity of domestic livestock in the Republic of Yemen.

This paper describes the domestic livestock of the Republic of Yemen and aspires to complement earlier sources listing or partially describing 'breeds'. It attempts to cover all species and provide indications of production parameters through a literature review and via field observations made by the author in 1999. Information is provided on livestock numbers and the economic importance of animal production. Most animals are kept in sedentary mixed crop-livestock production systems; transhumant systems have the next greatest number of stock; with nomadic systems being of least and declining importance. Yemen's livestock appear to comprise at least 11 breeds of sheep, 5 breeds of goat, 2 breeds of cattle, 4 breeds of camel, 2 breeds of donkey and 1 breed of horse. There are no data on breeds of poultry but domestic fowl (where clearly considerable diversity exists) and pigeons are kept. There is little formal information on the history and relationships of most breeds. Some appear to be of ancient local origin, whereas others show affinities with those of neighbouring and other countries. None of the identified types is considered endangered, so conservation would be premature. A more formal and detailed genetic characterization, to add to the largely morphological and traditional classification, may, however, reveal such a need.

Animal health and disease control in the Usangu Wetland of Southwestern Tanzania.

The Usangu Wetland in the Southern Highlands of Tanzania has always been a major livestock production area. This paper describes the physical and social enviroment of these Plains before presenting a short history of the veterinary services in the area. The main part of the paper examines, through historical records and interviews with livestock owners and administrative officials, the history of the major diseases affecting livestock.

Linked insurance-tumor registry database for health services research.

OBJECTIVE: Breast cancer screening and treatment data are often limited to restricted populations, including women older than 65 years old. The goal of this project was to develop procedures to link tumor registry and insurance claims databases on women younger than 65 years old with breast cancer and to assess the accuracy and validity of the linked dataset. METHODS: Iowa Cancer Registry (ICR) and Wellmark Blue Cross/Blue Shield of Iowa (BC/BS) membership files of women with incident in situ or invasive breast cancer from 1989 to 1996 were linked. An automated deterministic match was followed with visual inspection from three independent reviewers applying a matching protocol. Matched and overall registry data were compared to assess population representativeness. Claims from BC/BS for incident cases during 1994 were examined for coding of a recent breast cancer diagnosis or treatment. RESULTS: The final dataset included 4,397 matched cases of patients aged 21 years and older from 1989 to 1996. The sociodemographic and tumor characteristics of the ICR population younger than 65 years old (n = 7,469) with breast cancer or carcinoma in situ were nearly identical with those of the matched patients younger than 65 years old (n = 3,449). Nearly all (96%) of the 445 matched incident cases in 1994 had claims data (CPT, DRG, or ICD-9 code) indicative of breast cancer. Treatment patterns varied by data source, with agreement ranging from 76% to 82%. CONCLUSIONS: The validity and generalizability of these data demonstrate their potential for further health services research among younger insured women with breast cancer. Additionally, the process outlined may be useful for developing other datasets to study other cancers in the population younger than 65 years old.

Servant leadership.

As corporations are eagerly pursuing reengineering and reorganization, leadership functions are changing to champion these efforts. Traditionally, organizations have had a "top-down" management approach, however, there is a gradual shift to other leadership models. Servant leadership is being successfully implemented in many settings. Servant leadership, first popularized by Robert Greenleaf in 1970, puts serving others as the number one priority. Ten characteristics of a servant leader include: Listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community. Both servant leadership and the chaos theory have in common the central tenet of relationships. Since America is now approximately 80 percent a "service-economy," servant leadership can greatly benefit the individual employees, as well as help to facilitate the organization's pursuit of its changing strategic plans.

Trypanosomes, tsetse and trypanotolerance: coevolution in tropical Africa.

Trypanotolerance reaches varying degrees of stability in wild and domestic animals according to their co-evolutionary contacts with tsetse flies and trypanosomes. In this context, various mechanisms developed by wild and domestic Bovidae to cope with tsetse and trypanosome challenge are discussed.

Four-laboratory validation study of the determination of chloramphenicol in veal calf urine.

A four-laboratory validation study of a method for the quantitation and confirmation of low part-per-billion levels of chloramphenicol extracted from veal calf urine was done. With this method, chloramphenicol, derivatized to the bis(trimethylsilyl)ether, was quantitated by gas chromatography with electron capture detection (GC-ECD) and confirmed by selected-ion monitoring in a negative ion chemical ionization gas chromatograph-mass spectrometer (GC-NICI-MS). Four analysts from 4 laboratories participated in the portion of the study devoted to chloramphenicol quantitation. Every analyst analyzed 5 sets, one set per day, on 5 different days. Each set included 6 samples consisting of a blank, 2 fortified samples, 2 incurred urine samples, and one duplicate. Thus, each analyst worked on a total of 30 samples. Chloramphenicol concentrations ranged from 0 to 9.7 ppb. All data were reported to 0.1 ppb. Coefficients of variation for distribution, CVd, ranged from 8.82 to 14.14% and for precision, CVr, ranged from 9.15 to 14.80%. Three analysts from 3 laboratories also participated in the confirmatory portion of the study, which was carried out to test whether the NICI-MS method developed earlier for higher concentrations of chloramphenicol and for an extract of muscle tissue could be applied to lower levels of chloramphenicol and to an extract prepared from urine. The extracts of 10 of the 30 samples were designated for confirmation only, but were obtained by the same procedure as extracts used for the quantitation part of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Confirmation of leucogentian violet in chicken fat by gas chromatography/mass spectrometry.

A gas chromatographic/mass spectrometric (GC/MS) procedure for confirming the identity of leucogentian violet (LGV) in chicken fat was developed for regulatory application. The unused portion of the extract remaining from a determinative procedure was back-extracted into an organic phase, concentrated, and analyzed by GC/MS. Confirmation of the identity of LGV was based on matching the retention times and relative abundances of 6 ions in the extract to corresponding values obtained for the LGV standard. The procedure was validated by replicate analyses of negative control, fortified control, and residue-incurred chicken fat. The presence of LGV was confirmed by the GC/MS procedure in all samples found to contain LGV by prior liquid chromatographic analyses. There were no interferences in the control samples.

Determination of clenbuterol in cattle, sheep, and swine tissues by electron ionization gas chromatography/mass spectrometry.

A gas chromatographic/mass spectrometric procedure is described for the quantitation and confirmation of clenbuterol residues from cattle, sheep, and swine tissues. After liquid-liquid extraction and derivatization with phosgene in an aqueous pH 10.1 buffer, the cyclic oxazolidone derivative is quantitated with a clenbuterol analogue as internal standard (NAB-760 Cl). Confirmation is accomplished by comparison of ion ratios with those of a pure synthesized standard of clenbuterol oxazolidin-3-one obtained by selected ion monitoring, electron ionization gas chromatography/mass spectrometry on a benchtop instrument. Statistical information based on a series of standard curves for fortified tissues is included to describe method performance. Ion ratio variations were under 15%, and coefficients of variation for spiked tissue standard curves were above 0.997. Recoveries averaged 87.1 +/- 6.6% for liver tissues across all 3 species and 67.1 +/- 3.8% for muscle tissue across all 3 species.

Identification and isolation of chlorhexidine digluconate impurities.

We report the identification of 11 impurities in variously stressed chlorhexidine digluconate (CHG) solutions. The structural assignment of each CHG impurity involved tentative identification from HPLC-MS data followed by synthesis of the appropriate standard, isolation of the impurity from the CHG solution by flash chromatography, and comparison of HPLC-MS, HPLC-UV, and NMR data of the impurity with the standard. Six of the synthetic impurity standards represent new compounds. Degradation studies of CHG solutions systematically stressed by heat, light, and low pH are reported with identification and approximate quantification of resulting impurities. Degradation mechanisms were proposed for each set of stress conditions applied to CHG solutions. Parallels were noted between the way CHG degrades in the thermospray interface of the HPLC-MS and the way CHG degrades with shelf time. Similarities were noted in the synthetic starting materials of CHG and the final degradation products.

Multiresidue assay for benzimidazole anthelmintics by liquid chromatography and confirmation by gas chromatography/selected-ion monitoring electron impact mass spectrometry.

A multiresidue method utilizing all-disposable labware has been developed for 8 benzimidazole anthelmintics from ovine, bovine, and swine muscle and liver tissues. After an initial extraction with ethyl acetate and subsequent evaporation, a 3-component extraction using hexane, ethanol, and 0.2N HCl was used for final cleanup. Clean extracts were produced for separation and determination by reverse-phase liquid chromatography at 298 nm, using methanol and aqueous buffer as mobile phase. A synthesized internal standard, 2-(n-butylmercapto)benzimidazole, was used for quantitation of all drugs. Results are included along with statistical information verifying the performance of the method. Spiked control tissues and incurred drug tissues were used for an intralaboratory study with a concentration range of 50-1470 ppb. A series of standard curves at 0, 50, 100, and 200 ppb were analyzed. Overall recovery at the 100 ppb level averaged 92% (CV 8%) in liver tissues, across all 3 species and 88% (CV 5%) in muscle tissues across all 3 species. Results were confirmed by gas chromatography/mass spectrometry with acid hydrolysis of the remaining extract in 2N HCl followed by re-extraction of the amine and derivatization to the tert-butyldimethylsilyl derivative. The anthelmintics were identified by gas chromatography/selected ion monitoring electron-impact mass spectrometry. Ion ratio measurements were taken and compared to standard material. CVs averaged 10% or less for all drugs tested.

Productivity of the small East African goat and its crosses with the Anglo-Nubian and the Alpine in Rwanda.

Data from a research station in the central African country of Rwanda relating to purebred Small East African (SEA) goats, Anglo-Nubian x SEA and Alpine x SEA goats were analysed. Both SEA (598 days) and Alpine crosses (557 days) were younger at first kidding than the Anglo-Nubian crosses (766 days). There were no differences among genotypes in kidding interval which averaged 343 days nor did they differ in litter size (1.75). Mortality to 150 days (17.8%) was significantly higher in the Anglo-Nubian crosses than in Alpine crosses with the SEA being intermediate and not differing from either. Birth weights of individual kids were significantly lighter for purebred SEA (2.35 kg) than for Anglo-Nubians (2.68 kg) which were significantly lighter than the Alpine crosses (2.89 kg). Total litter weight at 150 days was significantly lower for SEA (14.5 kg) than for Alpine (18.8 kg), the Anglo-Nubian (16.9 kg) not differing significantly from either. Female postpartum weights differed significantly among genotypes, SEA being lightest (37.5 kg), Alpine crosses (42.1 kg) intermediate and Anglo-Nubian crosses (51.4 kg) heaviest. Productivity indices (total weight of live young at 150 days per kg of dam per year) averaged 442 g and did not differ among genotypes.

Livestock production in central Mali: Reproductive performance and reproductive wastage in ruminants in the agro-pastoral system.

Results of a 7-yr field study and a 3-yr slaughterhouse study into reproductive performance and reproductive wastage of ruminants in central Mali are reported. Cattle had delayed age at first puberty (40), long calving intervals (644) and produced few young (3.02) per lifetime. Goats and sheep first conceived at about 11 mo, had shorter parturition intervals (298 and 280 d) but also produced few young (2.64 and 1.92) per lifetime. Conceptions showed a strong seasonality in cattle and mainly occurred during and shortly after the short rainy season. Seasonality was less marked in small ruminants, but most females conceived before the rains. However, maximum litter sizes were associated with late-rain and post-rain conceptions. Early embryonic wastage did not appear to be a major problem but abortions, stillbirths and heavy preweaning mortality were sources of loss of reproductive potential. Additionally at a secondary (government controlled) abattoir, 15.0 % of cows, 31.7 % of goats and 20.0 % of sheep that were slaughtered were found to be pregnant.

Milk production characteristics of the Kenana breed of Bos indicus cattle in Sudan.

Data were analyzed on the Kenana, a Bos indicus breed of cattle indigenous to northern Sudan. Cattle were kept at Um Banein in a hot dry tropical environment 13 degrees .04' latitude north at an altitude of 435 m. Analyzed were lactation yield (1597 kg), lactation length (264), calving interval (530), and annual lactation yield (1225 kg). Between 1966 and 1980 all these traits except lactation length were significantly affected by lactation number and year. None was significantly influenced by the season in which lactation started. Kenana have considerable potential in the Sudan environment as a dairy breed, but further selection and an open nucleus system of breeding to introduce additional genetic material is required to express this potential.

Livestock production in central Mali: reproduction, growth and mortality of domestic fowl under traditional management.

In an 18-month study the domestic fowl in 42 households in three traditional management systems were recorded to determine reproduction, growth and mortality parameters. There were significant differences for all systems combined in the number of clutches started per month with the lowest number being laid in the cool dry season of January and February. Mean number of eggs per clutch was 8.8; the number of eggs increased significantly throughout the career of the hen but there were no significant systems differences. Egg weight was 34.4g there being no significant differences due to age of hen or system. Intervals between clutches were 92 days, annual egg output was 35 per hen (assuming that birds were present in the flock for a year) equivalent to about 118% of mean adult hen body weight: hens actually in the flocks during the study had produced 2.1 clutches on average. Hatchability of eggs was 69.1% there being significant seasonal and systems differences in this parameter, lowest hatchability being in the hot dry season (March to June) and in the rainfed millet system. Mortality rates to eight weeks were 56% of chicks hatched. Growth to 10 weeks averaged 4g/d. Mature cocks weighted 1.60 kg and mature hens 1.02 kg: hen weights were significantly affected by reproductive state, laying hens being heavier than both incubating hens and those rearing chicks, while those rearing chicks were heavier than those incubating. Suggestions for improving productivity are made.