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PubMed1983

The ecology of infectious and neoplastic disease: a conceptual unification.

The ecology of disease is framed in conceptual terms as the study of the relationships of entities and events in the natural history of disease, a definition allowing it to embrace both the infectious and neoplastic (i.e. chronic, non-infectious) diseases. Those relationships of most conceptual interest and operational relevance are the causal relationships, and thus the ecology of disease properly embraces both epidemiologic and pathologic theory. The classic epidemiologic triad of 'agent-host-environment' is integrated into hierarchical, natural historical frameworks embracing both disease causation and course. Within these ecologic frameworks and based upon discipline-related concepts of causation, it is possible to derive conceptual/operational criteria of causality applicable to both infectious and neoplastic diseases. As approaches to the comprehension of infectious and neoplastic disease share considerable conceptual common ground, it follows that approaches to their control share considerable operational common ground. Indeed, insofar as actions follow ideas, the ecology of disease provides the basis for medical ecology and the planning, conduct and evaluation of overall operational approaches to the control of disease, to include both preventive and therapeutic interventions. From these perspectives, contemporary approaches to the control of neoplastic diseases seem to be derived largely from clinical-pathologic viewpoints of effectual disease process and emphasize non-specific (agent-unrelated) therapeutic interventions. Those general approaches most successful in controlling infectious diseases (i.e. preventive interventions and agent/defect-specific therapeutic interventions) need greater emphasis and application in approaches to controlling neoplastic diseases.

Animals↗
PubMed2002

Research that influences policy and practice - characteristics of operational research to improve malaria control in Mpumalanga Province, South Africa.

BACKGROUND: Much communicable disease control research has had little impact on local control programme policy and practice for want of an operational component. The operational research model - the systematic search for knowledge on interventions, tools or strategies that enhance programme effectiveness - is gaining recognition as an appropriate method for addressing perplexing questions within public health programmes. METHODS: A series of operational research studies were conducted to refine malaria diagnosis in Mpumalanga Province, South Africa between 1995 and 1999. The grounded theory approach was used with groups of experienced Masters of Public Health students in South Africa and Australia to analyse a compilation of these studies for determining positive and negative attributes of operational research that affect its ability to influence communicable disease control policy and practice. RESULTS: The principal positive attributes of the operational research studies were high local relevance, greater ability to convince local decision-makers, relatively short lag-time before implementation of findings, and the cost-effective nature of this form of research. Potential negative features elicited included opportunities forfeited by using scarce resources to conduct research and the need to adequately train local health staff in research methodology to ensure valid results and accurate interpretation of findings. CONCLUSIONS: Operational research effectively influenced disease control policy and practice in rural South Africa, by providing relevant answers to local questions and engaging policy-makers. This resulted in accelerated inclusion of appropriate measures into a local communicable disease control programme.

Adult↗