Age Trajectories of Mortality from All Diseases in the Six Most Populated Countries of the South America During the Last Decades

Age trajectories of total mortality represent an irreplaceable source of information about aging. In principle, age affects mortality from all diseases differently than it affects mortality from external causes. External causes (accidents) are excluded here from all causes, and the resultant category “all-diseases” is tested as a helpful tool to better understand the relationship between mortality and age. Age trajectories of all-diseases mortality are studied in the six most populated countries of the South America during 1996–2010. The numbers of deaths for specific causes of death are extracted from the database of WHO, where the ICD-10 revision is used. The all-diseases mortality shows a strong minimum, which is hidden in total mortality. Two simple deterministic models fit the age trajectories of all-diseases mortality. The inverse proportion between mortality and age fits the mortality decreases up to minimum value in all six countries. All previous models describing mortality decline after birth are discussed. Theoretical relationships are derived between the parameter in the first model and standard mortality indicators: Infant mortality, Neonatal mortality, and Postneonatal mortality. The Gompertz model extended with a small positive quadratic element fit the age trajectories of all-diseases mortality after the age of 10 years.     

Incidence and Reproduction Numbers of Pertussis: Estimates from Serological and Social Contact Data in Five European Countries

Background

Despite large-scale vaccination programmes, pertussis has remained endemic in all European countries and has been on the rise in many countries in the last decade. One of the reasons that have been discussed for the failure of vaccination to eliminate the disease is continued circulation of the pathogen Bordetella pertussis by mostly asymptomatic and mild infections in adolescents and adults. To understand the impact of asymptomatic and undiagnosed infection on the transmission dynamics of pertussis we analysed serological data from five European countries in combination with information about social contact patterns from five of those countries to estimate incidence and reproduction numbers.

Methods and Findings

We compared two different methods for estimating incidence from individual data on IgG pertussis toxin (PT) titres. One method combines the cross-sectional surveys of titres with longitudinal information about the distribution of amplitude and decay rate of titres in a back-calculation approach. The second method uses age-dependent contact matrices and cross-sectional surveys of IgG PT titres to estimate a next generation matrix for pertussis transmission among age groups. The next generation approach allows for computation of basic reproduction numbers for five European countries. Our main findings are that the seroincidence of infections as estimated with the first method in all countries lies between 1% and 6% per annum with a peak in the adolescent age groups and a second lower peak in young adults. The incidence of infections as estimated by the second method lies slightly lower with ranges between 1% and 4% per annum. There is a remarkably good agreement of the results obtained with the two methods. The basic reproduction numbers are similar across countries at around 5.5.

Conclusions

Vaccination with currently used vaccines cannot prevent continued circulation and reinfection with pertussis, but has shifted the bulk of infections to adolescents and adults. If a vaccine conferring lifelong protection against clinical and subclinical infection were available pertussis could be eliminated. Currently, continuing circulation of the pathogen at a subclinical level provides a refuge for the pathogen in which it can evolve and adjust to infect vaccinated populations. Please see later in the article for the Editors'' Summary     

Modeling the Entire Human Mortality Curve: A Regulatory Model of Aging

Biophysics - Abstract—Modeling of the human aging process was performed based on the relationship between overall viability and the processes of growth and self-renewal of tissues, which is...     

Health effects of supplemental work from home in the European Union

Internationalization and technological developments have changed the work organization in developed and developing industrial economies. Information and communication technologies, such as computers and smartphones, are increasingly used, allowing more temporal and spatial flexibility of work. This may lead to an increase in supplemental work, i.e. constant availability or working in addition to contractually agreed work hours. This in turn extends work hours and leads to work hours in evenings and weekends, causing interferences of work hours with biological and social rhythms for sleep, recovery and social interaction. However, empirical findings on the effects of supplemental work and work hours on occupational health are rather scarce. Therefore, the aim of this study was to investigate the association between (1) work-related contacts outside of regular work hours and (2) working in the free time with self-reported work-related health impairments in the fourth and fifth European Working Conditions Surveys (EWCS 2005, EWCS 2010). Out of these cross-sectional, large-scale surveys, data on n?=?22?836 and n?=?34?399 employed workers were used for weighted logistic regression analyses. About half of the sample reported at least occasional supplemental work. The results showed an increased risk of reporting at least one health problem for employees who had been contacted by their employer (EWCS 2005), or worked in their free time to meet work demands (EWCS 2010) in the last 12 months, compared to those reporting no supplemental work or work-related contacts during free time. These results were controlled for demographic variables, physical and mental work load, worker autonomy, and several work hours characteristics (e.g. hours per week, unusual and variable hours). The risk of reporting health problems was increased by being contacted both sometimes (Odds Ratio [OR] 1.26, 95% Confidence Interval [CI] 1.14–1.39) and often (OR 1.13, 95% CI 1.02–1.25), whereas the frequency of working in the free time showed a clear dose-response effect (sometimes: OR 1.14, 95% CI 1.04–1.24; often: OR 1.60, 95% CI 1.47–1.75), both compared to the category “never”. The findings, thus, indicate that even a small amount of supplemental work beyond contractually agreed work hours may increase the risk of work-related health impairments. Working in the free time was associated with a substantial risk increase and might be a better indicator for actual work load than being contacted by the employer outside of contractually agreed work hours. Thus, in order to minimize negative health effects, availability requirements for employees outside their regular work hours should be minimized. While these effects definitely need further study, especially regarding a quantification of actual supplemental work and its temporal location, addressing the company culture and using incentives and policies might be options to reduce the amount of supplemental work and maintain the risks of health impairments in the working population at a lower level.     

Regulatory pathways in the European Union

In principle, there are three defined procedures to obtain approval for a medicinal product in the European Union. As discussed in this overview of the procedures, the decision on which regulatory pathway to use will depend on the nature of the active substance, the target indication(s), the history of product and/or the marketing strategy.     

Work in the European Union.

Continental Europe is now only 20 minutes away by train from mainland Britain, and moving ever closer politically. Mutual recognition of medical qualifications within the European Union is well established: working in other parts of Europe is, in principle, straightforward. Working in different health care systems can offer new perspectives on British medical practice and the NHS. But the cultural differences are not always easy to overcome.     

Contact Profiles in Eight European Countries and Implications for Modelling the Spread of Airborne Infectious Diseases

Background

For understanding the spread of infectious diseases it is crucial to have knowledge of the patterns of contacts in a population during which the infection can be transmitted. Besides contact rates and mixing between age groups, the way individuals distribute their contacts across different locations may play an important role in determining how infections spread through a population.

Methods and Findings

Representative surveys were performed in eight countries to assess the number of social contacts (talking to another person at close distance either with or without physical contact), using a diary approach in which participants recorded individual contacts. The overall sample size was 7290 respondents. We analyzed the reported numbers of contacts per respondent in six different settings (household, work, school, leisure, transportation and others) to define different contact profiles. The identification of the profiles and classification of respondents according to these profiles was conducted using a two-step cluster analysis algorithm as implemented in SPSS.We identified seven distinct contact profiles: respondents having (1) mixed: contacts predominantly at school, during transportation and leisure time, (2) contacts during leisure time, (3) contacts mainly in the household (large family), (4) contacts at work, (5) contacts solely at school, (6) contacts in other places and finally (7) respondents having a low number of contacts in any setting. Similar contact profiles can be found in all eight European countries which participated in the study. The distributions of respondents across the profiles were similar in all countries. The profiles are dominated by work, school and household contacts. But also contacts during leisure activities play an important role in the daily lives of a large fraction of individuals. A surprisingly large number of individuals has only few contacts in all locations. There was a distinct age-dependence in the distribution of the population across contact profiles.

Conclusions

In contrast with earlier studies that focussed on the contribution of different age groups to the spread of an infectious disease, our results open up the opportunity to analyze how an infection spreads between locations and how locations as work or school are interconnected via household contacts. Mathematical models that take these local contact patterns into account can be used to assess the effect of intervention measures like school closure and cancelling of leisure activities on the spread of influenza.     

Costs and benefits of freedom from shrimp diseases in the European Union

The growth in penaeid shrimp aquaculture has been mirrored by the emergence of a number of serious diseases, some of which (e.g. white spot syndrome virus - WSSV) spread rapidly across the globe through movement of infected stock. The World Organisation for Animal Health (OIE) lists six penaeid shrimp pathogens of which three are notifiable in the EU: WSSV (listed as non-exotic to the EU), Taura syndrome virus (TSV) and yellow head disease (YHD) (both listed as exotic). EU Member States (MS) must determine a status for non-exotic diseases (e.g. disease free, unknown, infected). In developing a policy for WSSV, import risk analysis (IRA) can be used to systematically assess the risks of introduction and justify risk mitigation to maintain freedom. OIE guidelines recommend that countries assess the risk of disease introduction via commodities, not listed by the OIE as safe, and apply sanitary measures if necessary. The sanitary measures necessary to maintain freedom from WSSV may not be compatible with current EU animal health legislation. The recent revision by OIE of products listed as safe for international trade strengthens the case for the risks of TSV and YHD introduction into the EU to be assessed. Freedom from WSSV is an important criterion for the development of shrimp aquaculture in the EU. However, in developing disease control policy, governments need to balance the potentially competing interests of all stakeholders, including consumers. Thus economic modelling of the impact of possible sanitary measures on consumer prices of imported products is needed to support decision making. The creation of disease free compartments and post-import risk mitigation for commodities may create the conditions conducive to the development of shrimp aquaculture whilst minimising the costs of maintaining disease freedom.     

Attitudes toward biotechnology in the European Union

Public attitudes toward biotechnology in the European Union have been characterized as negative using Eurobarometer data, but so far little attention has been paid to building a robust metric appropriate for emerging public opinion issues which combine high salience with very limited knowledge by the public. On the basis of the general literature about the formation and structure of attitudes and about public perceptions of science, this article presents a new metric and analysis: first, for estimating the level of awareness and knowledge of biotechnology in Europe; second, for assessing the stability and depth of these evaluative perceptions; and third, for exploring the roles of canonical socio-demographic variables, the knowledge variable and general attitudinal schemas for understanding the perceptions of both benefits and risks of biotech applications. The results show the importance of general value orientations or "worldviews" in shaping positive attitudes, and more of these general cognitive schemas should be measured in future research. The same multivariate model was unable to account for a significant percentage of the total variance in the perception of risks, suggesting that new measures are needed to tap this critical area in the acceptance of biotech in Europe.     

Weed biological control in the European Union: from serendipity to strategy

Biological control of weeds is a globally recognised approach to the management of some of the most troublesome invasive plants in the world. Accidental introductions of agents accounted for all weed biological control agent establishments in the European Union until 2010, but these examples include some current or emerging control successes both large and small, from the redistribution of the weevil Stenopelmus rufinasus Gyllenhal (Coleoptera: Curculionidae) for the control of small outbreaks of Azolla filiculoides Lam. (Azollaceae), to the large scale control provided by the cochineal insect Dactylopius opuntiae (Cockerell) (Hemiptera: Dactylopiidae), used against some problematic prickly pears (Opuntia spp. (Cactaceae)), and the ragweed beetle Ophraella communa LeSage (Coleoptera: Chrysomelidae), against common ragweed, Ambrosia artemisiifolia L. (Asteraceae), which are providing benefits to an increasing number of Member States of the European Union. Recent programmes involving the intentional introduction of biological control agents against target weeds including Fallopia japonica (Hout.) Ronse Decr. (Polygonaceae), Impatiens glandulifera Royle (Balsaminaceae) and Acacia longifolia (Andrews) Willd (Fabaceae) show a shift from luck to judgement in the European Union. The inclusion of new weed targets on the European Invasive Species Regulation should lead to a growth in the profile and use of biological control which would be assisted by the publication of any successes from the few intentional introductions covered in this paper.     

Surveillance of Fish Diseases in the Nordic Countries

Due to the increasing importance of disease problems in the fish farming industry and the impact disease may have on both feral and farmed fish in the Nordic countries, monitoring and surveillance on diseases have for many years been considered to be of socioeconomic importance. All the Nordic countries have a national legislation as basis for their surveillance and disease control in aquatic animals and regulations listing notifiable diseases of concern to the countries. The list of diseases vary between the countries. In addition, Denmark, Finland and Sweden are ruled by [3] as regards placing on the market of aquaculture animals and products. The surveillance for viral diseases in all the Nordic countries has mainly been based on the testing procedures given in the EU Commission [2].     

Strategic dilemmas of biosecurity in the European Union

Systems for societal/homeland security in both Europe and the United States are in flux to adjust to 21st century threats, such as terrorism, the proliferation of weapons of mass destruction, regional conflicts, state failures, and organized crime. It is important that reforms take place on both sides of the Atlantic that recognize the interdependence of Europe and the United States. Security, including biosecurity, for Europe is strongly connected to security in the U.S. Diseases transcend borders, and their consequences can be the same, irrespective of where the outbreak occurs or whether it is a natural occurrence or an act of bioterrorism. This article examines the political and strategic dilemmas and complexities that would confront the European Union (EU) in the event of a bioterrorism attack or a naturally occurring outbreak. Although several initiatives have been taken by the 15 member states and within the EU Commission, the EU is not institutionally prepared for transnational, rapidly moving diseases that could cause grave consequences in Europe and other regions, including the U.S. The prime responsibility for protecting European citizens against outbreaks rests with each member state. However, with intertwined and open European societies, the consequences would likely spill across borders. The EU Commission would have to become involved because such aspects as the internal market and freedom of movement would be affected. Responsibility, but not authority, would be pushed to the top. A coordinated EU response to such crises depends on European political leadership.     

Surveillance of Ruminant Diseases in the Nordic Countries

All the Nordic countries have a basis for their surveillance and disease control in ruminants in national legislation and regulations listing notifiable diseases of concern to the countries. The Nordic countries are a disease-free zone comparing to other parts of the world and the aim of the surveillance is to keep that status and be able to document it. Following is a short summary from each country.     

Surveillance of Ruminant Diseases in the Nordic Countries

All the Nordic countries have a basis for their surveillance and disease control in ruminants in national legislation and regulations listing notifiable diseases of concern to the countries. The Nordic countries are a disease-free zone comparing to other parts of the world and the aim of the surveillance is to keep that status and be able to document it. Following is a short summary from each country.

     

Surveillance of Fish Diseases in the Nordic Countries

Due to the increasing importance of disease problems in the fish farming industry and the impact disease may have on both feral and farmed fish in the Nordic countries, monitoring and surveillance on diseases have for many years been considered to be of socioeconomic importance. All the Nordic countries have a national legislation as basis for their surveillance and disease control in aquatic animals and regulations listing notifiable diseases of concern to the countries. The list of diseases vary between the countries. In addition, Denmark, Finland and Sweden are ruled by [3] as regards placing on the market of aquaculture animals and products. The surveillance for viral diseases in all the Nordic countries has mainly been based on the testing procedures given in the EU Commission [2].

     

Antimicrobial Resistance among Enterococci from Pigs in Three European Countries

Enterococci from pigs in Denmark, Spain, and Sweden were examined for susceptibility to antimicrobial agents and copper and the presence of selected resistance genes. The greatest levels of resistance were found among isolates from Spain and Denmark compared to those from Sweden, which corresponds to the amounts of antimicrobial agents used in food animal production in those countries. Similar genes were found to encode resistance in the different countries, but the tet(L) and tet(S) genes were more frequently found among isolates from Spain. A recently identified transferable copper resistance gene was found in all copper-resistant isolates from the different countries.