Epidemiología social y economía política: la UCI como punto de encuentro / Social epidemiology and political economy: ICU as point of convergence / Epidemiologia social e economia política: a UTI como ponto de encontro

Las interrogantes acerca de epidemiología, economía y cuidado crítico suelen estar en la mente de casi cualquier profesional de la salud. Sin embargo, casi nunca se tiene presente que la epidemiología y la economía pueden converger -a pesar de ser campos de estudio aparentemente separados- y que lo pueden hacer para explicar la situación actual o las tendencias futuras de un servicio hospitalario o de salud pública. Este ensayo presenta brevemente el devenir de la epidemiología social y de la economía política y cómo ambas actividades académicas pueden encontrar intereses comunes a propósito de la Unidad de Cuidado Intensivo (UCI), en particular para generar interrogantes, posibles áreas de investigación y alternativas hacia el desarrollo de servicios de salud más eficientes, más efectivos y más humanos.

Questions around epidemiology, economics and critical care are often in the mind of almost any healthcare professional. However, it is seldom realized that epidemiology and economymay converge -in spite of being apparently separated fields of study- in order to explain the present situation or future trends of a hospital or public health service. This essay briefly depictshow social epidemiology and political economy have developed and how both academic activities may find a common ground about the Intensive Care Unit (ICU), particularly to pose questions, to create possible research lines and feasible alternatives towards more efficient, effective and humane health services.

As interrogantes sobre de epidemiologia, economia e cuidado crítico acostumam estar na mente de quase qualquer professional da saúde. Porém, quase nunca se tem presente que a epidemiologia e a economia podem convergir -apesar de ser campos de estudo aparentemente separados- e que o podem fazer para explicar a situação atual ou as tendências futuras de um serviço hospitalar ou de saúde pública. Este ensaio apresenta brevemente o devir da epidemiologia social e da economia política e como ambas atividades acadêmicas podem encontrar interesses comuns a propósito da Unidade de Tratamento Intensivo (UTI), em particular para gerar interrogantes, possíveis áreas de investigação e alternativas para o desenvolvimento de serviços de saúde mais eficientes, maisefetivos e mais humanos.

The Australian Master of Applied Epidemiology Program: Looking back, moving forward.

The Master of Applied Epidemiology Program is Australia's Field Epidemiology Training Program. It was established in 1991 and was run out of the National Centre for Population Health (NCEPH) at the Australian National University. The Program has a strong track record in using field-based training to produce competent applied epidemiologists who have contributed to public health in Australia and globally. A new funding model for the program was implemented in 2012, backed by funds from field placement partners and NCEPH. In this paper we review the program's origins and achievements, discuss the ongoing needs of the program and outline a vision for the future. Commun Dis Intell 2016;40(3):E326-E333.

Podoconiosis: enfermedad olvidada por la sociedad y la comunidad médica / Podoconiosis, a society and medical community neglected disease

La podoconiosis, o «elefantiasis endémica no filariásica», es una enfermedad geoquímica que produce un tipo de linfedema de los miembros inferiores relacionado directamente con caminar descalzo por terrenos de origen volcánico en áreas con un alto índice pluviométrico anual. Posee una distribución geográfica concreta, afecta aproximadamente a un 5% de la población de las áreas endémicas, es debilitadora y desfigurante y con frecuencia lleva a la marginación social de los que la sufren. Es una enfermedad prevenible y, una vez establecida, puede mejorar con medidas terapéuticas sencillas (AU)

Podoconiosis, mossy foot or endemic non-filarial elephantiasis, is a geochemical disease that causes lower limb lymphedema; it is directly related to walking barefoot over soils of volcanic origin, in areas with a high pluviometric annual index. It has a specific geographical distribution, affecting around 5% population in areas where it is endemic. It is debilitating and disfiguring disease, which frequently leads to social margination. Podoconiosis is totally preventable and, once a diagnosis is established, it may improve with simple therapeutic measures (AU)

La infección por el virus Ébola. Podemos hacerlo mejor / Ebola virus infection. We can do better

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Importância econômica, epidemiologia e controle das intoxicações por plantas no Brasil / Economic impact, epidemiology and control poisonous plants in Brazil

A importância econômica, epidemiologia e controle das intoxicações por plantas em animais domésticos no Brasil são revisadas. Com os dados dos laboratórios de diagnóstico de diferentes regiões do país, as perdas anuais por mortes de animais foram estimadas em 820.761 a 1.755.763 bovinos, 399.800 a 445.309 ovinos, 52.675 a 63.292 caprinos e 38.559 equinos. No Brasil, atualmente, o número de plantas tóxicas é de 131 espécies e 79 gêneros e aumenta permanentemente. No entanto, a maioria das perdas são causadas por poucas plantas, incluindo Palicourea marcgravii, Amorimia spp., Senecio spp., Pteridium aquilinum, Ateleia glazioviana e Cestrum laevigatum em bovinos, Brachiaria spp em bovinos e ovinos, Nierembergia veitchii, Mimosa tenuiflora e Ipomoea asarifolia em ovinos, plantas que contêm swainsonina (Ipomoea carnea, Turbina cordata e Sida carpinifolia) em caprinos e Brachiaria humidicola e Crotalaria retusa em equinos. Os principais fatores epidemiológicos relacionados às intoxicações por plantas incluem palatabilidade, fome, sede, facilitação social, desconhecimento da planta, acesso a plantas tóxicas, dose tóxica, período de ingestão, variações de toxicidade e resistência/susceptibilidade dos animais às intoxicações. Quanto aos métodos de controle e profilaxia descrevem-se os resultados obtidos no Brasil com métodos recentemente desenvolvidos, incluindo controle biológico, aversão alimentar condicionada, utilização de variedades não tóxicas de forrageiras, utilização de animais resistentes às intoxicações e técnicas de indução de resistência.

The economic impact, epidemiology and control of plant poisonings in Brazil are reviewed. With the data obtained from diagnostic laboratories from different Brazilian regions, annual losses due to animal deaths are estimated in approximately 820.761 to 1.755.763 cattle, 399.800 to 445.309 sheep, 52.675 to 63.292 goats, and 38.559 horses. In Brazil toxic plants include 131 species within 79 genera, but this number is increasing continuously. However, most economic losses are caused by few plants including Palicourea marcgravii, Amorimia spp., Senecio spp., Pteridium aquilinum, Ateleia glazioviana and Cestrum laevigatum in cattle, Brachiaria spp. in cattle and sheep, Nierembergia veitchii, Mimosa tenuiflora and Ipomoea asarifolia in sheep, swainsonine-containing plants (Ipomoea carnea, Turbina cordata and Sida carpinifolia) in goats, and Brachiaria humidicola and Crotalaria retusa in horses. The main factors that determine the occurrence and frequency of plant poisoning include palatability, hunger, thirst, social facilitation, unawareness of the plant, access to toxic plants, toxic dose, ingestion period, variations in toxicity, and animal resistance/susceptibility. The results obtained in Brazil with the use of biological control, conditioned food aversion, selection of non-toxic varieties of forages, use of resistant animals to poisoning, and techniques to induce resistance are described.

Epidemiology, austerity, and innovation.

In considering the state of epidemiologic research, these are the "best" and the "worst" of times-the "best" from the perspective of scientific opportunities and the "worst" from the perspective of funding. In this commentary, the authors address this time of funding austerity from the points of view of individual researchers and research institutions. For researchers, the new tools of "-omics," large databases, communication by means of the World Wide Web, and global access offer ever-expanding scientific opportunities. The authors comment on research directions for which there is an enhanced likelihood of funding success: clinical and translational research, outcomes and effectiveness research, and global health research. The authors emphasize the need to be innovative and not bound by the conventional. For institutions, the authors suggest attention to innovation and impact, social networking, and finding the "right size" for training programs. Academic institutions also need to invest, supporting researchers and their ideas. Epidemiologists need to be true to their mission and prove that they can use innovation to advance health and welfare in a measurable way. Doing so will ensure that over the long term, epidemiologic research will remain a cornerstone for advancing population health.

Lethal differences: a short history of the concepts of wealth and poverty in Danish epidemiological writings, 1858-1914.

Through a study of the history of the concepts of wealth and poverty, this paper investigates the onset of a tradition in the conceptual architecture of epidemiological research concerning social differences in mortality rates from 1858 to 1914. It raises the question as to what the concepts of wealth and poverty meant to those who used them and what objects of interventions the conceptual architecture surrounding the concepts enabled the researchers to create. It argues that a transition began in the late 19th century in which an important framework for the understanding of causal relations behind the mortality patterns changed and that this change in turn influenced the scope of what was conceived as relevant objects of intervention.

The ethics of clinical and epidemiological research.

The global burden of tuberculosis (TB) demands that research be undertaken. The vulnerability of the populations most at risk for TB demands that such research be subject to ethical review to protect their rights and interests. In this brief article we cannot review the vast and important literature bearing on the ethics of clinical and epidemiological research and public health surveillance. Instead, we have focused on three questions that have been at the center of discussion and debate and which have special relevance for TB. First, we examine a question that has special bearing when wealthy nations or international organizations carry out research in poor countries: what does justice require in the post trial period? Second, we examine the question of how the principles of consent and confidentiality may require modification in record-based epidemiological research. Third, we look at the challenges posed by public health surveillance, which in many cases requires case reporting by clinicians to public health agencies. By way of conclusion, we take note of the centrality of enhancing the institutional capacities for ethical review of research in poor nations.

[The tasks of the Federal Service for the implementation of the legislation of the Russian Federation aimed at optimizing the compliance and enforcement].

The priority of the Federal Service's activity in protecting consumer rights and human welfare is to execute a number of basic documents recently endorsed and directed towards observing the legislation on the optimization of supervision and control activities. To implement measures on the professional orientation and prehigher education preparation of schoolchildren and on the assistance with their entrance into the medical prophylaxis faculties of higher medical educational establishments within the framework of target enrollment, etc. is an urgent problem for the agencies and bodies of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare. Interaction with civil society has recently been activated, which is required to ensure the transparency of the Service's work, to enhance its efficiency, and to optimize supervision. Public reception rooms have been set up, the function of which is to receive citizens, the representatives of legal persons, and individual employers concerning the matters of sanitary-and-epidemiological well-being, protection of the rights of consumers and a consumer market, and the activities of the agencies and bodies of the Russian Inspectorate for the Protection of Consumer Rights and Human Welfare. The better activities of the agencies and bodies of the Service will call for a set of complex tasks to be accomplished in the immediate future. The end result will depend on how competently, responsibly, and cooperatively the appropriate measures will be carried out in all the agencies of the Federal service.

[Epidemiologic research in Italy: a comparison with the rest of Europe and the United States]. / La ricerca epidemiologica in Italia: un confronto con il resto d'Europa e gli Stati Uniti.

OBJECTIVE: the study describes the burden of the Italian epidemiological research compared to that of the other 26 countries belonging to the European Union and to that of the United States, in the period 2007-2009. This is accomplished for both scientific published papers and grants obtained. DESIGN AND SETTING: the searching in Medline database (February 2010) was done through complex search strings based on keywords corresponding to the various epidemiological research fields; grants were identified through 7th Framework Program (FP7), among those funded within February 2010. MAIN OUTCOME MEASURES: proportions of epidemiological papers published by researchers of the different countries and total number and amount of granted research projects for each European country. RESULTS: in the period 2007-2009 epidemiological papers by Italian researchers account for about one-eighth of the total European production. This makes of Italy the second country in production, after the United Kingdom. Moreover, Italy is involved in 51.3%of the 374 studies granted through FP7: at least one Italian research body participates in 154 projects and Italian researches co-ordinate 38 projects. CONCLUSION: in Italy biomedical and epidemiological research is in a developing phase despite the difficulties due to the decrease in the amount of funds available.Moreover, Italian research is carried out mainly by public bodies and by Universities, even if a deeper involvement of local health authorities and regional agencies is desirable.