From Manaus to Maputo: Toward a Public Health and Biodiversity Framework

The linkages between human health, biodiversity, ecosystems, and the life-supporting services that they provide are varied and complex. The traditional neglect of this nexus by policy-makers perpetuates threats posed to ecosystems with potentially critical impacts on global health. The Convention on Biological Diversity and the World Health Organization recently co-convened two regional workshops on these intricate but vital linkages. From discussions held with policy-makers and experts in the biodiversity and health sectors, spanning some 50 countries in Africa and the Americas, we derive a broad framework for the development of national and regional public health and biodiversity strategies relevant to strategic planning processes in the emerging post-2015 development context.     

From shallow to deep divergences: mixed messages from Amazon Basin cichlids

Cichlids are a conspicuous component of Amazonian ichthyofauna, filling a wide range of niches. Yet taxonomy of many groups is still poorly known in the Amazon, and most of the yet-to-be discovered species are concentrated there. We analyzed 230 individuals sampled from six major Amazonian River Basins representing 56 morpho-species, 34 nominal and 22 undescribed species in 18 cichlid genera. We used four different single-locus species-discovery (SLSD) methods, delimiting between 53 (mPTP) and 57 (GMYC) species/lineages. When detected, species/lineages are hierarchically geographically structured. Many groups such as the Geophaginae and the Cichlinae have recently diversified, and species of genera such as Cichla and Symphysodon hybridize or have a history of hybridization; thus, these species will not be detected by SLSD methods. At the same time, for example, the genera Apistogramma and Biotodoma harbor cryptic species. For all these reasons, species/lineage diversity of Amazonian cichlids is significantly underestimated. The diversity of Amazonian cichlids is particularly remarkable given that the 570 species of Neotropical cichlids, many of which are from the Amazon Basin, are found in just 1.7% of the freshwater aquatic habitat in which the ~ 2,000 species of the East African rift lake cichlids evolved.

     

健康医疗可穿戴设备数据隐私相关问题研究

归纳、总结健康医疗可穿戴设备采集的数据内容,重点绘制健康医疗可穿戴设备的数据流动环节,并将数据流动划分为采集、上传、集成交互以及信息反馈等主要环节,并分析各主要环节中以及其他方面存在及潜在的数据安全与隐私问题,希望能为健康医疗可穿戴设备的数据隐私保护机制提供不同角度的理论参考。     

A Qualitative Study of Service Provision for Alcohol Related Health Issues in Mid to Later Life

Aims

Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over.

Methods

Qualitative interviews (n = 24, 12 male/12 female, ages 51–90 years) and focus groups (n = 27, 6 male/21 female, ages 50–95 years) were carried out with a purposive sample of participants who consumed alcohol or had been dependent.

Findings

Participants’ alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people.

Conclusion

Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced alcohol problems themselves.     

Hepatitis C virus prevalence among an immigrant community to the southern Amazon, Brazil

A community-based random survey was conducted in a southern Brazilian Amazonian county aiming to investigate hepatitis C virus (HCV) infection prevalence and the association of demographic variables and lifestyle behaviours. Seven hundred eighty individuals were serologically screened with a third generation enzyme-linked immunosorbent assay to detect anti-HCV antibodies between 1994/1995. Positive samples were retested for confirmation with a line immunoassay (LIA, Inno-LIA HCV Ab III). Most of these subjects were low income and came from southern Brazilian states (65.8). Two point four percent (IC 95% 1.2%- 4.6%) of the subjects had LIA-confirmed anti-HCV antibodies reactivity. The age-specific prevalence of HCV antibodies slightly increased with age, with the highest prevalence after the age of 40 years. The results of multivariate analysis indicate a strong association between HCV antibodies and previous surgery and history of intravenous drug use. There were no apparent association with gender, hepatitis B virus markers, blood transfusion, and sexual activity. Mean time living in Amazon did not differ between confirmed and negative anti-HCV individuals. The present data point out an intermediate endemicity of HCV infection among this immigrant community to the Amazon region and that few HCV infected participants presented known risk factors.     

From re-emergence to hyperendemicity: the natural history of the dengue epidemic in Brazil

Background

Dengue virus (DENV) was reintroduced into Brazil in 1986 and by 1995 it had spread throughout the country. In 2007 the number of dengue hemorrhagic fever (DHF) cases more than doubled and a shift in the age distribution was reported. While previously the majority of DHF cases occurred among adults, in 2007 53% of cases occurred in children under 15 years old. The reasons for this shift have not been determined.

Methods and Findings

Age stratified cross-sectional seroepidemiologic survey conducted in Recife, Brazil in 2006. Serostatus was determined by ELISA based detection of Dengue IgG. We estimated time-constant and time-varying forces of infection of DENV between 1986 and 2006. We used discrete-time simulation to estimate the accumulation of monotypic and multitypic immunity over time in a population previously completely susceptible to DENV. We projected the age distribution of population immunity to dengue assuming similar hazards of infection in future years. The overall prevalence of DENV IgG was 0.80 (n = 1427). The time-constant force of infection for the period was estimated to be 0.052 (95% CI 0.041, 0.063), corresponding to 5.2% of susceptible individuals becoming infected each year by each serotype. Simulations show that as time since re-emergence of dengue goes by, multitypic immunity accumulates in adults while an increasing proportion of susceptible individuals and those with monotypic immunity are among young age groups. The median age of those monotypically immune can be expected to shift from 24 years, 10 years after introduction, to 13 years, 50 years after introduction. Of those monotypically immune, the proportion under 15 years old shifts from 27% to 58%. These results are consistent with the dengue notification records from the same region since 1995.

Interpretation

Assuming that persons who have been monotypically exposed are at highest risk for severe dengue, the shift towards younger patient ages observed in Brazil can be partially explained by the accumulation of multitypic immunity against DENV-1, 2, and 3 in older age groups, 22 years after the re-introduction of these viruses. Serotype specific seroepidemiologic studies are necessary to accurately estimate the serotype specific forces of infection.     

The Politics of Mediation: Local–Global Interactions in the Central Amazon of Brazil

The proliferation of a nongovernmental sector held the promise of linking local actors with national and international ones, thereby contributing to a highly participatory, Habermasian ideal in which the formerly marginalized would find greater participation and expression. Yet the role of international agents in community-based resource management projects has recently come under scrutiny. In addressing these issues in this article, I consider the roles of different interlocutors in two contrastive phases in an Amazonian community's movement to preserve its endangered fisheries. The comparative exercise demonstrates how institutional agents, by establishing a discourse that structures the criteria through which collective demands may be problematized, may inadvertently shift from mediation to domination, and from local partnering to local production.     

Epidemic and Endemic Malaria Transmission Related to Fish Farming Ponds in the Amazon Frontier

Fish farming in the Amazon has been stimulated as a solution to increase economic development. However, poorly managed fish ponds have been sometimes associated with the presence of Anopheles spp. and consequently, with malaria transmission. In this study, we analyzed the spatial and temporal dynamics of malaria in the state of Acre (and more closely within a single county) to investigate the potential links between aquaculture and malaria transmission in this region. At the state level, we classified the 22 counties into three malaria endemicity patterns, based on the correlation between notification time series. Furthermore, the study period (2003–2013) was divided into two phases (epidemic and post-epidemic). Higher fish pond construction coincided both spatially and temporally with increased rate of malaria notification. Within one malaria endemic county, we investigated the relationship between the geolocation of malaria cases (2011–2012) and their distance to fish ponds. Entomological surveys carried out in these ponds provided measurements of anopheline abundance that were significantly associated with the abundance of malaria cases within 100 m of the ponds (P < 0.005; r = 0.39). These results taken together suggest that fish farming contributes to the maintenance of high transmission levels of malaria in this region.     

From Sub- to Super-Citizenship: Sex Hormones and the Body Politic in Brazil

Sex hormones in Brazil are mobilised as modes of regulatory control and to discipline subjectivites. Their packaging effectively differentiates between two forms of citizenship. The first, available to those with private health, is founded on notions of personal autonomy, individual choice and self-enhancement, while the second frames decisions in terms of the individual's moral responsibility to the wider collectivity. Here, technical and biomedical interventions on middle-class bodies have personalising tendencies, while those effected on the bodies of the urban poor can be read as modes of inclusion through standardisation. Personalisation, in the Brazilian sense, concerns the attribution of privileges which place a person above the undifferentiated mass of individuals. The paper critically engages with approaches to bio-citizenships developed in contexts where biological inclusion is predicated on patient activism and shows how, in Brazil, complying with medical regimes is an integral part of constituting oneself as a citizen     

One Million Genomes:From Discovery to Health

正June 4-8,2018|Herrenhausen Palace|Hannover|Germany Scientific Organizers:Geoffrey S.Ginsburg,Duke University,USA Teri Manolio,National Institutes of Health,USA Patrick Boon Ooi Tan,Genome Institute of Singapore,Singapore Organized in collaboration w ith Volkwagen Foundation The completion o f the Human Genome Project in 2003 has catalyzed innovations in scientific