Scabies is a contagious skin infection commonly occurring in institutions such as care homes. However, a large proportion of vulnerable people in England receive domiciliary care in the community and their experience of scabies has not been described. We undertook a pragmatic cross-sectional survey of Health Protection Teams (HPTs) in England to determine the burden of scabies related to domiciliary care. Fifteen cases or outbreaks were notified to HPTs between January 2013 and December 2017. Although a relatively uncommon event for individual HPTs, they were complex to manage and required the co-ordination of multiple stakeholders. Diagnosis was often delayed and required several clinical consultations. A lack of guidance led to difficulties establishing stakeholder roles and responsibilities and sources of funding for treatment. The stigmatisation of scabies sometimes affected the quality of care provided to patients, such as use of excessive personal protective equipment. Our study demonstrates that scabies is an issue of public health importance for domiciliary care service providers and users, and research is required to better understand the impacts of the disease and to develop evidence-based guidance. More generally, there is a need for simpler treatment regimens and methods of diagnosing scabies.

Earth’s climate is changing and national and international decision-makers are recognizing that global health security requires urgent attention and a significant investment to protect the future. In most locations, current data are inadequate to conduct a full assessment of the direct and indirect health impacts of climate change. All states require this information to evaluate community-level resilience to climate extremes and climate change. A model that is being used successfully in the United Kingdom, Australia, and New Zealand is recommended to generate rapid information to assist decision-makers in the event of a disaster. The model overcomes barriers to success inherent in the traditional ‘‘top-down’’ approach to managing crises and recognizes the capacity of capable citizens and community organizers to facilitate response and recovery if provided the opportunity and resources. Local information is a prerequisite for strategic and tactical statewide planning. Time and resources are required to analyze risks within each community and what is required to prevent (mitigate), prepare, respond, recover (rehabilitate), anticipate, and assess any threatening events. Specific requirements at all levels from state to community must emphasize community roles by focusing on how best to maintain, respond, and recover public health protections and the infrastructure necessary for health security. (Disaster Med Public Health Preparedness. 2015;9:619–624)

Introduction. Les effets de la consommation de fruits et légumes vis-à-vis de pathologies ont été déjà mis en évidence par de nombreuses études dans lesquelles, en particulier, la consommation de la pomme a pu être corrélée à un effet protecteur significatif. Le document présente une synthèse des résultats qui ont été obtenus à l'issue de cette série d'études. Les fractions nutritionnellement actives de la pomme. Les apports de la pomme en glucides, polyphénols, minéraux, anions organiques et vitamines ont été successivement analysés et commentés en fonction des effets de ces éléments sur la santé humaine. Les effets santé potentiels de la pomme. Les effets protecteurs de la pomme vis-à-vis du risque cardiovasculaire ont été tout d'abord exposés ; des effets plus spécifiques ont ensuite été passés en revue : effets sur le statut insulinique et sur le statut antioxydant, effets antiacidosiques et impact sur les fermentations digestives dans le côlon. Conclusion. La pomme possède, d'un point de vue nutrition préventive, des potentialités très intéressantes. Un grand nombre d'effets santé qui lui sont attribués dépendrait d'interactions entre divers nutriments comme, par exemple, les interactions entre les fibres et certains polyphénols. Ces interactions sont encore mal connues ; leur étude semble prometteuse et pourrait être transposée à de nombreux aliments d'origine végétale.