Reconstruction of diffusion processes at local scales: the 1846, 1882 and 1904 measles epidemics in northwest Iceland

Because medical records of individuals contracting measles were not kept in northwest lceland for epidemics before 1904, the spread of the disease in 1846 and 1882 has been traced from notifications of death recorded in burial registers and census returns. Using this evidence, a time-space matrix of measles deaths has been constructed and the dynamics of the diffusion process through a necklace of small communities strung along the coast has been analysed. In each of the three epidemics the mortality curve corresponded closely to an S-shaped logistic model, each new epidemic passing through the area more rapidly than its predecessor. The operation of a neighbourhood effect from a single point of introduction implies that the disease should move in a wave-like form through the area. Whereas the 1882 epidemic advanced steadily as a wave-front progression characteristic of the neighbourhood effect, those of 1846 and 1904 had strong spatial biases towards the parish of Eyri. The intense localization of the outbreaks in 1846 and 1904 appears not to be related directly to distinctive features in the demography or form of the settlement. In 1904 a confirmation service held in Eyri church brought many victims into contact with a measles carrier, but no special circumstances have been reported or can be deduced for 1846.     

民国时期江南地区疫灾地理研究

疫灾自古以来就是人类健康和生命安全的巨大威胁。本文通过编制疫灾序列,采用历史文献分析、数理统计分析和GIS空间分析等方法,对民国时期江南地区的疫灾时空变迁进行研究,结果发现: 一、 民国时期江南地区无年不疫,疫灾季发率高达94.70%,秋、夏、春三季疫灾多发,集中了全年近九成的疫灾县数,秋、夏季尤甚,集中了全年四分之三的疫灾县数;逐年的疫灾广度总体呈上升趋势,但波动特征明显;在明初至民国末年的582年间,江南地区疫灾的波动周期越来越短,年均发生疫灾的县数越来越多,说明随着时间的推移,疫灾越来越频繁,民国时期是江南地区历史上疫灾最频繁最严重的时期。二、 民国时期江南地区的疫灾主要分布于大运河、宁沪杭铁路沿线及其以东的地区,苏州—无锡一带和环上海地区为疫灾热点区,江苏溧阳地区和浙西山丘地区为疫灾冷点区;疫灾分布重心始终位于苏州境内。三、 民国时期江南地区疫灾分布的一般规律是: 交通沿线城市都是疫灾高发点,人口稠密区多为疫灾频发区,水旱灾害严重区也是疫灾严重区,平原地区的疫灾多于山丘地区的疫灾。     

先秦两汉时期疫灾地理研究

疫灾是由传染病大规模流行导致人类健康与生命损失的灾害。先秦两汉时期(公元前771～220年)见于记载的疫灾年份57个,疫灾频度5.74%。其中,春秋战国为1.64%;西汉为7.33%;东汉为15.90%;公元前二世纪为4%,公元前一世纪为9%,公元一世纪为12%,公元二世纪为15%。不排除疫灾记载有近详远略的可能,但从全国范围看,先秦两汉时期疫灾越来越频繁的趋势是客观存在的。疫灾发生的季节除秋季较少外,春、夏、冬季的概率差不多。在周期性规律上,该时期经历了2个大的疫灾稀少期和3个大的疫灾频繁期,第一个波动周期(公元前200～公元前120年)约80年时间,波峰不很明显;第二个波动周期(公元前120～80年)长达2个世纪,其中公元前50～50年的疫灾频度高达17%,为两汉之际的疫灾高峰;第三个波动周期始于80年,东汉灭亡尚未结束,而是下接三国时期的疫灾高峰。在空间分布上,疫灾分布与人口分布有高度相关性,先秦时期仅黄河、长江流域有疫灾发生,西汉时期由于匈奴的介入,蒙新高原开始有疫灾记载,东汉时期南方人口大量增加,东南沿海开始有疫灾记载。总体来说,先秦两汉时期的疫灾是北方甚于南方,但随着时间推移,南方疫灾比重不断提高,反映了南方人口与经济的发展。     

检方施治:防疫方书与清代的疫情防控

抄录、编撰、刊印、传播、参阅防疫方书,是清代疫情期间常见的医疗实践活动。防疫方书的大量涌现是一次次疫病流行激发的结果,是疫情防控实践本身的重要组成部分。它们在染疫病人救治、防疫力量动员、防疫知识整合和普及等方面发挥着独特的媒介作用,是相关人、事、物实现链接和互动的一种重要途径,是人们积极主动地应对疫病、控制疫情、维护生命健康的一种"原动力"。相较于其他常见防疫举措,防疫方书深度参与到多种疫情防控实践中,实际构成了一种自发性、分散性、非制度性的疫病应对机制,具有成本低廉、传导性强、覆盖面广、溢出效应大等特征。     

The changing shape of island epidemics: historical trends in Icelandic infectious disease waves, 1902–1988

Iceland's centuries-long history of epidemics with its unusually complete disease records has attracted study from several disciplines. But detailed spatial data of particular interest to historical geographers date only from 1895 and were consistently maintained for about a century thereafter. Within this period, this paper concentrates on morbidity records of reported cases of infectious diseases for an 87-year window which was open between 1902 and 1988. In this time slice, spatially detailed data for seven demographically important infectious diseases allow the geography of 131 discrete epidemic waves with a recorded total of 529,000 cases to be tracked. Changes in the behaviour of the seven diseases over the period are analyzed and related to both epidemiological theory and to the changing historical geography of the island. The paper complements earlier Icelandic work by the authors on the historical geography of single diseases (measles, influenza and poliomyelitis) by extending the range of diseases, and by considering their common spatial behaviour and their interrelationships.     

Epidemiological spaces: the use of multidimensional scaling to identify cholera diffusion processes in wake of the Philippines insurrection, 1899–1902

Between 1902 and 1904 an epidemic of cholera, fuelled initially by the operations of the Philippine-American War (1899–1902), swept through the Philippine Islands in two waves. In earlier papers, the authors showed that spatially contagious spread dominated the waves at the geographical levels of province, island and nation (Smallman-Raynor and Cliff 1998a, b). To explore the visualization and analysis of epidemic transmission in an alternative metric, the present paper uses multidimensional scaling (MDS) to translate the spread corridors followed by the waves from conventional geographical space into non-Euclidean cholera spaces. The re-mapping confirms the importance of contagious diffusion in the spread of the epidemic, but also picks out the moments in time in which spread driven through the population hierarchy switched in. In addition, the analysis illustrates the utility of constructing non-Euclidean spaces to identify disease diffusion processes.     

乾隆朝(1736—1795)疫灾地理研究

清代是中国历史上疫灾流行高峰期,乾隆朝又是其中重要阶段之一。综合运用疫灾指标法、Grapher时序分析法、GIS空间分析法、SPSS相关分析法对乾隆朝疫灾地理进行研究,结果表明: (1) 乾隆朝有疫灾之年58个,疫灾频度为96.67%,其中1748、1756、1786年为三次大规模饥疫。疫灾流行以夏季最多,春秋次之,冬季最少,且以多季节流行为主。 (2) 省域尺度上,形成南北两条疫灾指标高值区分布带,疫灾指标总体自西向东逐渐上升,其中江苏省(含上海)受灾最严重。县域尺度分布具有阶段特征和集聚特征,疫域范围不断拓展,集聚程度持续提升;疫灾分布具有区域差异,疫灾重心始终位于南方。 (3) 疫灾分布格局受制于人口分布格局、区域开发强度、自然灾害多寡等因素,表现为省级尺度上与疫灾强度呈显著正相关性,相关系数R值分别为0.886、0.664和0.685(P均为0.01)。     

英语教学史百年回顾——改革运动前后语法翻译法与自然法的变迁

改革运动(Reform Movement)是指1882～1904期间主要在欧洲掀起的外语教学改革。回顾改革运动前后语法翻译法与自然法的变迁,时间跨度在一百年以上,为现在语言教育研究人员提供一些外语教育研究的理论基础,希望语言教学和研究者可以从中找出更多的教学发现从而提高现代语言教学质量。     

Health in Papua New Guinea: a Decline in Development

Papua New Guinea has experienced the start of an epidemiological transition in health status from infectious towards non-communicable diseases, though the latter were absent until the post-war years. This transition is particularly marked in urban and coastal areas, where life expectancies are higher and mortality rates lower. Tropical diseases remain significant, malaria has worsened and new mobility has increased the severity of epidemics of influenza and measles. Indigenous medical systems have increasingly given way to modern medical systems, though disease aetiology is usually perceived through traditional cognitive models. Modern medical systems were mainly developed in the 1960s and 1970s, on either side of independence, but despite an official focus on primary health care, have had much reduced effectiveness since the 1980s. Rural health centres have been poorly maintained and serviced, and health workers have limited skills and access to resources. The health budget has been increasingly concentrated in urban areas, though the bulk of the population and of the health problems are in rural areas, resulting in a worsening ‘inverse care law’, that is particularly significant for women. Overall health status has declined in the past decade despite overseas advocacy of new policies and the prospects for improvement are poor.     

Effect of Small-World Networks on Epidemic Propagation and Intervention

The small-world network, characterized by special structural properties of high connectivity and clustering, is one of the highlights in recent advances in network science and has the potential to model a variety of social contact networks. In an attempt to better understand how these structural properties of small-world networks affect epidemic propagation and intervention, this article uses an agent-based approach to investigate the interplay between an epidemic process and its underlying network structure. Small-world networks are derived from a network "rewiring" process, which readjusts edges in a completely regular two-dimensional network by different rewiring probabilities (0–1) to produce a spectrum of modified networks on which an agent-based simulation of epidemic propagation can be conducted. A comparison of simulated epidemics discloses the effect of small-world networks on epidemic propagation as well as the effectiveness of different intervention strategies, including mass vaccination, acquaintance vaccination, targeted vaccination, and contact tracing. Epidemics taking place on small-world networks tend to reach large-scale epidemic peaks within a short time period. Among the four intervention strategies tested, only one strategy—the targeted vaccination—proves to be effective for containing epidemics, a finding supported by a simulation of the severe acute respiratory syndrome epidemic in a large-scale realistic social contact network in Portland, OR.     

魏晋南北朝时期疫灾时空分布规律研究

魏晋南北朝时期是中国历史上的第一个疫灾高峰期,疫灾频度平均为21.0%,其中西晋时期疫灾最为频繁,疫灾频度高达34.6%。夏季是疫灾流行的最主要的季节,约41%的疫灾发生在夏季。疫灾周期具有波幅越来越小、波长越来越短的趋势。在空间分布上,疫灾范围有逐步扩大的趋势,疫灾重心有由北向南迁移的趋势,都城所在地为疫灾多发区,都城区位的变迁影响着疫灾重心的变迁。三国时期的疫灾重心在河南,西晋时期的疫灾重心在陕西与河南,东晋以后的疫灾重心在江苏。总体来看,经济相对发达、人口相对稠密、战争相对频仍的黄河中下游地区、长江中下游地区以及它们之间的淮河流域是魏晋南北朝时期疫灾的主要流行区域。     

明清以来的疫病应对与历史省思

明清时期,国家对疫病救疗虽有行动,但缺乏制度上的规定,日渐兴起的民间社会力量发挥了重要的作用。近代以降,国家逐渐建立了现代卫生防疫机制,应对疫病的观念也日渐积极。这些启示我们:第一,国家对救疫在制度上的缺失,既反映了传统国家在统治理念上缺乏对民众生命的真正关怀,同时也是承认自身能力不足的务实之举;第二,利用日渐兴起的民间社会力量,不仅有助于实际的疫病救疗,而且也实现了官民之间的良性互补;第三,现代卫生防疫机制的引建,实际也是国家权力的扩展与深化,虽然意义重大,但需充分重视其限度;第四,应历史和人文地认识传统时期多元的疫病和防疫观念;第五,畅达而有效的信息传递对于瘟疫的防治至关重要。     

Epidemic temporalities: A concise literature review

How do individuals and institutions make sense of epidemics in time, before, during and after outbreaks? This concise review follows a linear chronology of outbreak ‘events’ to explore debates in medical anthropology on epidemic temporalities. It excavates key notions relating to the technologies, imaginary and governance of epidemic anticipation, epidemic emergency and epidemic aftermaths. Building upon ethnographic works which depict how epidemic temporalities are constructed, and how they travel and affect social life, it argues that they are an integral component of the evental construction of epidemics.     

Review article: Religion,modernization and Zionism

Ehud Luz, Parallels Meet: Religion and Nationalism in the Early Zionist Movement (1882–1904), Philadelphia, Jewish Publication Society of America, 1988 (Originally published in Hebrew — Tel Aviv, Am Oved, 1985), xix + 365 pp.

Yosef Salmon, Religion and Zionism — First Encounters: Essays (Hebrew), Jerusalem, Hassifriya Hazionit, 1990, 366 pp.     

Effect of Scale on the Links between Walking and Urban Design

Studies of the relationship between walking and urban form consistently show that pedestrian‐friendly neighbourhoods encourage local walking. However, the geographic scale of measurement of the built environment for developing walkability indices and their relationship with different types of walking (e.g. for transport and recreation) has not been fully examined. In this study, objective measures of the built environment were developed at three geographic scales: suburb, census collection district, and 15 min walk neighbourhood for each participant. Walking for transport and recreation within the neighbourhood was measured using the Neighbourhood Physical Activity Questionnaire. The likelihood of walking at all (yes/no) and as recommended for health benefit (150 min per week) were assessed using logistic regression. The walkability index captured a strong positive relationship between urban form and walking for transport, but found no relationship at any scale for recreational walking. Participants walking for transport and living in high versus low walkable areas were 63% more likely to walk at the suburb scale (odds ratio 1.63; 95% confidence interval 1.22–2.18), twice as likely to walk at the census collection district scale, and nearly three times more likely to walk at the 15 min walk scale (odds ration 2.79; 95% confidence interval 2.09–3.73). The scale at which environmental data are measured influenced the strength of the relationship, showing that the neighbourhood 15 min from home was most predictive of transport walking. This has research and policy implications. Standardised scales across studies would both improve comparability of results and enhance understanding of the influences on walking.     

‘Turning Sex into a Game’: Gogodala Men's Response to the AIDS Epidemic and Condom Promotion in Rural Papua New Guinea

ABSTRACT Rugby league is the national sport of Papua New Guinea and the game's huge popularity and international profile has been used in recent condom promotion campaigns in the nation's fight against the HIV/AIDS epidemic. In this paper, I argue that the promotion of condom use through rugby league requires a national campaign strategy that includes understandings of condom use and masculinity at the rural level. I demonstrate this through a study of Gogodala men's understandings of the epidemic and condom use in Western Province. The Gogodala are a Christian‐based society and many blame the national condom promotion strategy for an increase in promiscuity and for ‘turning sex into a game’. Condom availability in this rural area continues to be restricted to a family planning program that promotes Christian values and excludes unmarried men. I explore the male condom dilemma where young men are more concerned with avoiding accusations that their sexual behaviour puts them at risk of contracting HIV despite acknowledging the preventative value of using condoms. In this context young men disassociate themselves from the disease and condom use through a process of calculated risk or risk minimisation.     

Benefits,safety, and risks of immunisation programmes

Abstract

Immunisation is potentially the most effective and efficient of all preventive medical activities. It is also unique among interventions in that it protects both the individual and the community. The UK's immunisation programme has been highly successful in controlling a number of life threatening infectious diseases, and consequently public concern has shifted from the diseases to vaccine safety. In recent years a series of vaccine myths and vaccine safety scares have affected the UK and other industrialised countries. Although an effective vaccine without any risk is probably unachievable, the vaccines in use in the UK are very safe. Serious adverse outcomes truly attributable to vaccination are extremely rare, always far rarer than adverse outcomes among individuals acquiring the vaccines' target infections. Vaccine safety may be called into question, however, on the basis of spurious coincidental associations between vaccination and adverse events. An inadequate public health response in the 1970s to a scare over whooping cough vaccine allowed substantial losses of professional and public confidence to take place. Vaccine coverage halved and much preventable morbidity and mortality resulted. Plausible vaccine associations must be investigated thoroughly, and the UK has become a world leader in developing techniques for rapid investigations. The public health response to scares over MMR (measles, mumps, and rubella) vaccine safety has been faster and firmer than for whooping cough and no link has been found between MMR vaccine and inflammatory bowel disease or autism. Consequently the impact on immunisation coverage has been small, though the cumulative threat of measles, mumps, and rubella epidemics is growing. Recently an international investigation excluded a possible association of intussusception with oral polio vaccine before it could become a vaccine scare. A clearer chain of communication in responding to vaccine myths and scares is needed. This must provide rapid information and, if appropriate, reassurance to professionals and the public. Considerably more training is needed for professionals in providing information to the public and supporting parents in making difficult decisions over vaccination. Though there is no place for complacency, and improvements are needed, the UK's ability to monitor vaccine effectiveness, safety, and risks is strong. As a consequence it has a vaccination programme that is very safe and very effective.     

Lies, damn lies, and Manchester's recruiting statistics: degeneration as an "urban legend" in Victorian and Edwardian Britain

Few historians have attempted to discuss British medicine, health and welfare policies, or the biological sciences around 1900 without due reference to the concept of degeneration. Most tie public concern with degeneration to a specific set of military recruiting figures, which stated that of 11,000 would-be volunteers in Manchester, 8,000 had to be turned away due to physical defects. Further, most histories point out that these figures had a direct influence on the formation of the Inter-Departmental Committee on Physical Deterioration in 1904. With its absolute denial of hereditary decline, the 1904 Report acts as a dénouement of degenerationist fears in Britain. No historian has sought to contextualize these recruiting figures: Where did they come from? How did Manchester react? What role did that city play in the subsequent 1904 Report? Far from being the epitome of urban decay, the 1904 Report repeatedly hails Manchester as a glowing example of innovative urban reform. This article contextualizes the recruiting figures and explores how Manchester had been tackling the three key problems of Physical Deterioration-diet, exercise, and alcohol-for thirty years prior to the 1904 Report. By discussing Manchester, a new understanding of degeneration is outlined; as slogan, rhetorical tool, and urban legend, degeneration was largely feminized and domesticated. Military/masculine problems such as the recruiting figures were the exception, not the rule.     

Age Patterns of Mortality During the Black Death in London, A.D. 1349-1350

This paper examines adult age-specific mortality patterns of one of the most devastating epidemics in recorded history, the Black Death of A.D. 1347-351. The goal was to determine whether the epidemic affected all ages equally or if it targeted certain age groups. Analyses were done using a sample of 337 individuals excavated from the East Smithfield cemetery in London, which contains only individuals who died during the Black Death in London in 1349-1350. The age patterns from East Smithfield were compared to a sample of 207 individuals who died from non-epidemic causes of mortality. Ages were estimated using the method of transition analysis, and age-specific mortality was evaluated using a hazards model. The results indicate that the risk of mortality during the Black Death increased with adult age, and therefore that age had an effect on risk of death during the epidemic. The age patterns in the Black Death cemetery were similar to those from the non-epidemic mortality sample. The results from this study are consistent with previous findings suggesting that despite the devastating nature of the Black Death, the 14(th)-century disease had general patterns of selectivity that were similar to those associated with normal medieval mortality.