Principles of risk decision-making.

Risk management decisions in public health require consideration of a number of complex, often conflicting factors. The aim of this review was to propose a set of 10 fundamental principles to guide risk decision-making. Although each of these principles is sound in its own right, the guidance provided by different principles might lead the decision-maker in different directions.

Modeling the Impact of Climate Change on Cervid Chronic Wasting Disease in Semi-Arid South Texas.

Chronic wasting disease (CWD) is a spongiform encephalopathy disease caused by the transmission of infectious prion agents. CWD is a fatal disease that affects wild and farmed cervids in North America with few cases reported overseas. Social interaction of cervids, feeding practices by wildlife keepers and climate effects on the environmental carrying capacity all can affect CWD transmission in deer.

Using a stochastic continuous-time Markov chain model to examine alternative timing and duration of the COVID-19 lockdown in Kuwait: what can be done now?

Background: Kuwait had its first COVID-19 in late February, and until October 6, 2020 it recorded 108,268 cases and 632 deaths. Despite implementing one of the strictest control measures-including a three-week complete lockdown, there was no sign of a declining epidemic curve. The objective of the current analyses is to determine, hypothetically, the optimal timing and duration of a full lockdown in Kuwait that would result in controlling new infections and lead to a substantial reduction in case hospitalizations.

Evaluation of the United States COVID-19 vaccine allocation strategy.

Background: Anticipating an initial shortage of vaccines for COVID-19, the Centers for Disease Control (CDC) in the United States developed priority vaccine allocations for specific demographic groups in the population. This study evaluates the performance of the CDC vaccine allocation strategy with respect to multiple potentially competing vaccination goals (minimizing mortality, cases, infections, and years of life lost (YLL)), under the same framework as the CDC allocation: four priority vaccination groups and population demographics stratified by age, comorbidities, occupation and living condition (congested or non-congested).

Methods And Findings: We developed a compartmental disease model that incorporates key elements of the current pandemic including age-varying susceptibility to infection, age-varying clinical fraction, an active case-count dependent social distancing level, and time-varying infectivity (accounting for the emergence of more infectious virus strains).

Mitigating the externality of diseases of poverty through health aid.

Externality exists in healthcare when an individual benefits from others being healthy as it reduces the probability of getting sick from illness. Healthy workers are considered to be the more productive labourers leading to a country's positive economic growth over time. Several research studies have modelled disease transmission and its economic impact on a single country in isolation.

Analysis of intervention effectiveness using early outbreak transmission dynamics to guide future pandemic management and decision-making in Kuwait.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a World Health Organization designated pandemic that can result in severe symptoms and death that disproportionately affects older patients or those with comorbidities. Kuwait reported its first imported cases of COVID-19 on February 24, 2020. Analysis of data from the first three months of community transmission of the COVID-19 outbreak in Kuwait can provide important guidance for decision-making when dealing with future SARS-CoV-2 epidemic wave management.

Modeling the effect of lockdown timing as a COVID-19 control measure in countries with differing social contacts.

The application, timing, and duration of lockdown strategies during a pandemic remain poorly quantified with regards to expected public health outcomes. Previous projection models have reached conflicting conclusions about the effect of complete lockdowns on COVID-19 outcomes. We developed a stochastic continuous-time Markov chain (CTMC) model with eight states including the environment (SEAMHQRD-V), and derived a formula for the basic reproduction number, R, for that model.

Analysis of the Healthcare MERS-CoV Outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 Using a SEIR Ward Transmission Model.

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic coronavirus that has a tendency to cause significant healthcare outbreaks among patients with serious comorbidities. We analyzed hospital data from the MERS-CoV outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 using the susceptible-exposed-infectious-recovered (SEIR) ward transmission model. The SEIR compartmental model considers several areas within the hospital where transmission occurred.

Expert elicitation on the uncertainties associated with chronic wasting disease.

A high degree of uncertainty exists for chronic wasting disease (CWD) transmission factors in farmed and wild cervids. Evaluating the factors is important as it helps to inform future risk management strategies. Expert opinion is often used to assist decision making in a number of health, science, and technology domains where data may be sparse or missing.

Using expert judgments to improve chronic wasting disease risk management in Canada.

ABSTARCT Chronic wasting disease (CWD) is a neurodegenerative, protein misfolding disease affecting cervids in North America in epidemic proportions. While the existence of CWD has been known for more than 40 years, risk management efforts to date have not been able to curtail the spread of this condition. An expert elicitation exercise was carried out in May 2011 to obtain the views of international experts on both the etiology of CWD and possible CWD risk management strategies.

Expert elicitation for the judgment of prion disease risk uncertainties.

There is a high level of uncertainty surrounding the potential for iatrogenic prion transmission through transplantation, medical instrument reuse, blood transfusion, and blood product use due to a lack of evidence-based research on this important risk issue. A group of specialists was enlisted to evaluate some of the knowledge gaps in this area using the "Classical Model," a structured elicitation procedure for weighting and pooling expert judgment. The elicitation exercise was undertaken in March 2009 with 11 transmissible spongiform encephalopathy (TSE) experts who were first calibrated using a series of seed questions for which the answers are known; they were then asked to answer a number of target questions that are important for risk assessment purposes, but for which there remains high uncertainty at this time.

Prionet Canada: a network of centres of excellence for research into prions and prion diseases.

PrioNet Canada's strength in basic, applied, and social research is helping to solve the food, health safety, and socioeconomic problems associated with prion diseases. Prion diseases are transmissible, fatal neurodegenerative diseases of humans and animals. Examples of prion diseases include bovine spongiform encephalopathy (BSE, commonly known as "mad cow" disease), Creutzfeldt-Jakob disease in humans, and chronic wasting disease (CWD) in deer and elk.

Multi-jurisdictional expert opinion for improving children's environmental health protection.

Expert opinion from Canada, the United States and European Union countries was solicited to examine the regulatory and non-regulatory approaches used to protect children's environmental health. Thirty-five experts were interviewed by telephone from June 2004 to March 2005 using an open-ended survey questionnaire. Experts were asked to name legislative and non-legislative tools used to protect children's environmental health in their jurisdiction as well as the effectiveness of approaches taken, barriers, facilitators, methods of evaluation, and recommendations for improving children's health protection.

The impact of social amplification and attenuation of risk and the public reaction to mad cow disease in Canada.

Following the detection of bovine spongiform encephalopathy (BSE) in Canada, and subsequently in the United States, confidence in the safety of beef products remained high. Consumers actually increased their consumption of beef slightly after the news of an increased risk from mad cow disease, which has been interpreted as public support for beef farmers and confidence in government regulators. The Canadian public showed a markedly different reaction to the news of domestic BSE than the furious and panicked responses observed in the United Kingdom, Germany, and Japan.

Locust retinoid X receptors: 9-Cis-retinoic acid in embryos from a primitive insect.

The retinoid X receptor (RXR) is activated by its often elusive cognate ligand, 9-cis-retinoic acid (9-cis-RA). In flies and moths, molting is mediated by a heterodimer ecdysone receptor consisting of the ecdysone monomer (EcR) and an RXR homolog, ultraspiracle (USP); the latter is believed to have diverged from its RXR origin. In the more primitive insect, Locusta migratoria (Lm), RXR is more similar to human RXRs than to USPs.

Risk communication of endocrine-disrupting chemicals: improving knowledge translation and transfer.

Public perception of the negative effects of endocrine-disrupting chemicals appears to be higher compared to other chemical pollutants, due to (1) chronic, low-probability effects, and (2) uncertainties about which biological effects may be relevant for human health. Individuals, both expert and lay public, require credible, trustworthy, and understandable information about the scientific evidence of endocrine-disrupting chemicals in order to make informed risk decisions. The creation of a dedicated web site, http://www.

Regulatory and nonregulatory strategies for improving children's environmental health in Canada.

Epidemiological and toxicological studies established positive associations between environmental hazards and adverse child health outcomes, including cancer, learning disabilities, behavioral problems, developmental effects, low birth weight, and birth defects. The economic and societal costs associated with children's environmental health disorders were estimated to be substantial. The existence of knowledge gaps, lack of capacity, and the jurisdictional overlap of children's environmental health issues are some of the barriers that impede effective policy decision making.

Men having sex with men donor deferral risk assessment: an analysis using risk management principles.

This article discusses issues associated with the lifetime deferral from donating blood of men having sex with men (MSM), in the context of well-established risk management principles, including ethical considerations associated with the risk-based approach to social policy matters. Specifically, it deals with the questions about the rationale for the existing policy in Canada of lifetime deferral for MSM, a rationale applied in practice by blood collection agencies and supported by the regulatory authority of Health Canada. We identify several alternative time frames for MSM deferral: sexual abstinence over either a 10-, 5-, or 1-year period or no deferral.

Management of natural and bioterrorism induced pandemics.

A recent approach for bioterrorism risk management calls for stricter regulations over biotechnology as a way to control subversion of technology that may be used to create a man-made pandemic. This approach is largely unworkable given the increasing pervasiveness of molecular techniques and tools throughout society. Emerging technology has provided the tools to design much deadlier pathogens but concomitantly the ability to respond to emerging pandemics to reduce mortality has also improved significantly in recent decades.