Abstract Exposure to risks throughout life results in a wide variety of outcomes. Objectively judging the relative impact of these risks on personal and population health is fundamental to individual survival and societal prosperity. Existing mechanisms to quantify and rank the magnitude of these myriad effects and the uncertainty in their estimation are largely subjective, leaving room for interpretation that can fuel academic controversy and add to confusion when communicating risk. We present a new suite of meta-analyses—termed the Burden of Proof studies—designed specifically to help evaluate these methodological issues objectively and quantitatively. Through this data-driven approach that complements existing systems, including GRADE and Cochrane Reviews, we aim to aggregate evidence across multiple studies and enable a quantitative comparison of risk–outcome pairs. We introduce the burden of proof risk function (BPRF), which estimates the level of risk closest to the null hypothesis that is consistent with available data. Here we illustrate the BPRF methodology for the evaluation of four exemplar risk–outcome pairs: smoking and lung cancer, systolic blood pressure and ischemic heart disease, vegetable consumption and ischemic heart disease, and unprocessed red meat consumption and ischemic heart disease. The strength of evidence for each relationship is assessed by computing and summarizing the BPRF, and then translating the summary to a simple star rating. The Burden of Proof methodology provides a consistent way to understand, evaluate and summarize evidence of risk across different risk–outcome pairs, and informs risk analysis conducted as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. 

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The Burden of Proof studies: assessing the evidence of risk

Background: Hypertension is a cardiovascular disease of increasing global burden with prevalence in Nigeria ranging from 8% to 46.4%. Aim: To determine the prevalence and determinants of hypertension in Igbeagu, a rural community in SouthâÂÂÂÂEastern Nigeria. Subjects and Methods: Consenting residents aged 18 years and above participated in this survey. A structured questionnaire was administered on the participants in their native dialect. Blood pressure (BP) and anthropometric parameters of the participants were measured using standard techniques. Hypertension was defined as systolic BP ≥ 140 mmHg and diastolic BP of ≥ 90 mmHg. Results: Two hundred and sixtyâÂÂÂÂseven participants had their BP and data completed satisfactorily. SixtyâÂÂÂÂtwo persons were hypertensive, giving a prevalence rate of 23.2% (62/267). Age, consumption of red meat, body mass index (BMI), and the number of children in the family were associated with hypertension. Regression analysis showed that only BMI and age were independent risk factors for hypertension. Conclusion: Although the prevalence of hypertension in this study and their associated risk factors were in agreement with studies done previously in Nigeria, the association between number of children in the family and hypertension is yet to be understood. Efforts are needed to curb the high prevalence of hypertension in this community.

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Prevalence and determinants of hypertension in an agrarian rural community in southeast Nigeria.

This study analysed the determinants of small ruminant farmers’ participation in veterinary services in Northern Ghana. Multi-stage sampling technique was used to collect data on 249 farm households in different locations in Northern Ghana. Analytical tools including frequencies, means and logistic regression model were used to analyse the data. The regression analysis indicates a positive relationship between participation in veterinary services and sex of household head (p<0.05), education (p<0.05), household income level (P<0.05), herd size (p<0.05), and affordability of veterinary service (P<0.01). In addition, the study shows that diseases and pests menace, insufficient veterinary offices and animal health professionals were the major three constraints affecting animal health management in northern Ghana. In order to improve quality delivery of veterinary service in the area, the result of the logistic model provides a guideline to select farm households for implementation of veterinary extension programs in the region. Such guideline should be based on the important socio-economic and farm-related variables identified from the regression analysis. Furthermore, sustainable livestock production can be enhanced when animal health centers and professionals are made visible at local farming communities. Therefore, policies that provide an enabling environment for more private veterinary practice is relevant. More so, more qualified animal health professionals need to be trained to commensurate with the increasing number of livestock smallholders in the country. 

	 

	Key words: Small ruminant, farm households, veterinary services, logistic regression, Northern Ghana.

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Determinants of small ruminant farmers decision to participate in veterinary services in Northern Ghana

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Studies linking diet with health must get a whole lot better

The objective of this study was to assess the contribution of small ruminants to farm household's income in Kharga Oasis, which is one of the 3 Oases, of the New Valley Governorate. One hundred and three farmers were randomly selected from six villages and interviewed with a structured questionnaire. Results revealed that the average family size was 5.82 household members from which 1.84 males and 0.38 females participating in agriculture activities. The average (±SE) farm size in the study area was 7.55 ± 1.36 acres .The area cultivated with animal fodder ranged from 30 to 32.5% around the year. The percentage of cattle in the total herd size was 52.88% which was more than other animal species in the herd. Preference for buffalo was very low (1.57%). The second important animal contributing towards the total herd size was goat (20.94%). Livestock alone contribute 49.44% of the total agriculture income in the study area. Within the livestock sector; cattle contribute the highest (42.93%). Small ruminants contribute a mere 5.27%. Nevertheless, the study showed that small ruminant enterprise is economically viable. Small ruminants provided a return of 19.8% from capital invested. This exceeding the returns obtained from various crop production enterprises. These findings have important implication for the improvement of small ruminant enterprises of households in the Oasis. Making farmers aware of the financial benefits of small ruminants may convince them to consider it as a better alternative to crop production in the study area in terms of income generation. This will probably influence their decision on the allocation of their limited resources to the competing alternatives.

https://jappmu.journals.ekb.eg/article_71612_3b5c529ee53b2a4e363ef9fef29060a7.pdf

Importance of small ruminants for household's farm income in the new valley governorate

As a leading behavioral risk factor for numerous health outcomes, smoking is a major ongoing public health challenge. Although evidence on the health effects of smoking has been widely reported, few attempts have evaluated the dose-response relationship between smoking and a diverse range of health outcomes systematically and comprehensively. In the present study, we re-estimated the dose-response relationships between current smoking and 36 health outcomes by conducting systematic reviews up to 31 May 2022, employing a meta-analytic method that incorporates between-study heterogeneity into estimates of uncertainty. Among the 36 selected outcomes, 8 had strong-to-very-strong evidence of an association with smoking, 21 had weak-to-moderate evidence of association and 7 had no evidence of association. By overcoming many of the limitations of traditional meta-analyses, our approach provides comprehensive, up-to-date and easy-to-use estimates of the evidence on the health effects of smoking. These estimates provide important information for tobacco control advocates, policy makers, researchers, physicians, smokers and the public. 

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Health effects associated with smoking: a Burden of Proof study

Socio-economic factors affecting access and utilization of veterinary services by small ruminant producers in izzi local government area of ebonyi state, nigeria

Chukwuma Odii Okereke

Papers

Health effects associated with smoking: a Burden of Proof study

Socio-economic factors affecting access and utilization of veterinary services by small ruminant producers in izzi local government area of ebonyi state, nigeria