Background: Currently, there are no standardized approaches to care or evaluation for tone dysfunction in Canada. The study authors hypothesize that there is significant practice variation across the country. This environmental scan is aimed to describe the current practice for management of patients with hypertonia across Canada. Methods: A web-based survey was developed by the authors with a multi-disciplinary approach and sent to representative rehabilitation sites in each province. All statistical analyses were performed using the R statistical software version 4.0. Results: CP was found to be the most common diagnosis for tone dysfunction, with 58% (7/12) of sites diagnosing greater than 20 new patients per year. All 12 sites offered oral baclofen and gabapentin, and 92% of sites offered trihexyphenidyl. Botulinum toxin injections were offered at 50% of sites. Upper and lower extremity procedures were offered in 83% of the sites. In 8 of 12 sites (67%), patients were seen within a formal multidisciplinary clinic to manage hypertonia. Conclusions: The information gained from this study provides some insight into the current practice across Canada for children with hypertonia. This study may assist in the development of a national, standardized strategy to tone management, potentially facilitating more equitable access to care for patients.

Tuberculosis (TB) in children is a critical public health issue. In Bohol, Philippines, we found a high tuberculin skin test (TST)-positive prevalence (weighted prevalence = 6.4%) among 5476 children (<15 years) from 184 villages, with geographically isolated communities having prevalence as high as 29%. Therefore, we conducted a geospatial and hot spot analysis to examine the association between villages with high TST-positive prevalence (⩾6.5%) and access to medical care (distance (in kilometres and minutes of travel time) to the municipal Rural Health Units (RHU)), access to healthcare resources (distance to Provincial Health Office (PHO)) and socioeconomic determinants of health. Hot spot analysis revealed significant clusters of TST-positive prevalence in villages farthest from the PHO. Based on univariate analysis, the following variables associated with high prevalence were included in the multivariate model: minutes of travel time to the PHO, distance to the PHO, island villages and total deprivation based on socioeconomic indicators. In the final model, only distance to PHO in minutes was significant (P = 0.005). When evaluated further, greater than 1-hour drive significantly increased risk for TST-positivity (P = 0.003). Distance to healthcare resources likely increases the risk of TB transmission within the community. Expanding TB control efforts to geographically isolated areas is critical.

UNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.

It is well known that illite-smectite can form from smectite at elevated temperatures in natural and experimental systems. However, the conversion of smectite to illite-smectite is also found in some natural systems that have never been heated. The present experiments show that illite layers can form from smectite by chemical reaction at 35° and 60°C at high solution pH. The rate of this reaction is accelerated by wetting and drying.

Traditionally health statistics are derived from civil and/or vital registration. Civil registration in low- to middle-income countries varies from partial coverage to essentially nothing at all. Consequently the state of the art for public health information in low- to middle-income countries is efforts to combine or triangulate data from different sources to produce a more complete picture across both time and space – data amalgamation. Data sources amenable to this approach include sample surveys, sample registration systems, health and demographic surveillance systems, administrative records, census records, health facility records and others. We propose a new statistical framework for gathering health and population data – Hyak – that leverages the benefits of sampling and longitudinal, prospective surveillance to create a cheap, accurate, sustainable monitoring platform. Hyak has three fundamental components:

• • Data amalgamation: A sampling and surveillance component that organizes two or more data collection systems to work together: (1) data from HDSS with frequent, intense, linked, prospective follow-up and (2) data from sample surveys conducted in large areas surrounding the Health and Demographic Surveillance System (HDSS) sites using informed sampling so as to capture as many events as possible;

• • Cause of death: Verbal autopsy to characterize the distribution of deaths by cause at the population level; and

• • Socioeconomic status (SES): Measurement of SES in order to characterize poverty and wealth.

We conduct a simulation study of the informed sampling component of Hyak based on the Agincourt HDSS site in South Africa. Compared with traditional cluster sampling, Hyak's informed sampling captures more deaths, and when combined with an estimation model that includes spatial smoothing, produces estimates of both mortality counts and mortality rates that have lower variance and small bias.

Established methods of recruiting population controls for case–control studies to investigate gastrointestinal disease outbreaks can be time consuming, resulting in delays in identifying the source or vehicle of infection. After an initial evaluation of using online market research panel members as controls in a case–control study to investigate a Salmonella outbreak in 2013, this method was applied in four further studies in the UK between 2014 and 2016. We used data from all five studies and interviews with members of each outbreak control team and market research panel provider to review operational issues, evaluate risk of bias in this approach and consider methods to reduce confounding and bias. The investigators of each outbreak reported likely time and cost savings from using market research controls. There were systematic differences between case and control groups in some studies but no evidence that conclusions on the likely source or vehicle of infection were incorrect. Potential selection biases introduced by using this sampling frame and the low response rate are unclear. Methods that might reduce confounding and some bias should be balanced with concerns for overmatching. Further evaluation of this approach using comparisons with traditional methods and population-based exposure survey data is recommended.

In just the last forty years, imprisonment has been transformed from an event experienced by only the most marginalized to a common stage in the life course of American men—especially Black men with low levels of educational attainment. Although much research considers the causes of the prison boom and how the massive uptick in imprisonment has shaped crime rates and the life course of the men who experience imprisonment, in recent years, researchers have gained a keen interest in the spillover effects of mass imprisonment on families, children, and neighborhoods. Unfortunately, although this new wave of research documents the generally harmful effects of having a family member or loved one incarcerated, it remains unclear how much the prison boom shapes social inequality through these spillover effects because we lack precise estimates of the racial inequality in connectedness—through friends, family, and neighbors—to prisoners. Using the 2006 General Social Survey, we fill this pressing research gap by providing national estimates of connectedness to prisoners—defined in this article as knowing someone who is currently imprisoned, having a family member who is currently imprisoned, having someone you trust who is currently imprisoned, or having someone you know from your neighborhood who is currently imprisoned—for Black and White men and women. Most provocatively, we show that 44% of Black women (and 32% of Black men) but only 12% of White women (and 6% of White men) have a family member imprisoned. This means that about one in four women in the United States currently has a family member in prison. Given these high rates of connectedness to prisoners and the vast racial inequality in them, it is likely that mass imprisonment has fundamentally reshaped inequality not only for the adult men for whom imprisonment has become common, but also for their friends and families.

The episcopal silence and secrecy associated with the recent pedophilia scandal echoes a larger inability of the Catholic episcopal hierarchy to enter into open and honest dialogue about a wide range of sexual issues. For more than three decades the chasm between official teachings on sexuality and gender and the belief and/or practice of the majority of Catholic laity, clergy and theologians (and an unknown number of bishops) has been growing. Still, attempts to address or bridge this divide have met with a fourfold silence. It is a silence that has kept bishops from speaking their true minds, a silence sought by restricting, investigating and sanctioning theologians, a silence that renders pastors mute or covert on sexual matters, and a silence that ignores the experience and voices of women. Such a silence undermines magisterial authority and deprives Catholics of a useful and persuasive sexual ethic, while marginalizing those willing to speak out and demoralizing those who feel they cannot.