Treatment-seeking rates in malaria endemic countries

BACKGROUND: The proportion of individuals who seek treatment for fever is an important quantity in understanding access to and use of health systems, as well as for interpreting data on disease incidence from routine surveillance systems. For many malaria endemic countries (MECs), treatment-seeking information is available from national household surveys. The aim of this paper was to assemble sub-national estimates of treatment-seeking behaviours and to predict national treatment-seeking measures for all MECs lacking household survey data. METHODS: Data on treatment seeking for fever were obtained from Demographic and Health Surveys, Malaria Indicator Surveys and Multiple Cluster Indicator Surveys for every MEC and year that data were available. National-level social, economic and health-related variables were gathered from the World Bank as putative covariates of treatment-seeking rates. A generalized additive mixed model (GAMM) was used to estimate treatment-seeking behaviours for countries where survey data were unavailable. Two separate models were developed to predict the proportion of fever cases that would seek treatment at (1) a public health facility or (2) from any kind of treatment provider. RESULTS: Treatment-seeking data were available for 74 MECs and modelled for the remaining 24. GAMMs found that the percentage of pregnant women receiving prenatal care, vaccination rates, education level, government health expenditure, and GDP growth were important predictors for both categories of treatment-seeking outcomes. Treatment-seeking rates, which varied both within and among regions, revealed that public facilities were not always the primary facility type used. CONCLUSIONS: Estimates of treatment-seeking rates show how health services are utilized and help correct reported malaria case numbers to obtain more accurate measures of disease burden. The assembled and modelled data demonstrated that while treatment-seeking rates have overall increased over time, access remains low in some malaria endemic regions and utilization of government services is in some areas limited

Abstract polymer models with general pair interactions

A convergence criterion of cluster expansion is presented in the case of an abstract polymer system with general pair interactions (i.e. not necessarily hard core or repulsive). As a concrete example, the low temperature disordered phase of the BEG model with infinite range interactions, decaying polynomially as $1/r^{d+\lambda}$ with $\lambda>0$, is studied.Comment: 19 pages. Corrected statement for the stability condition (2.3) and modified section 3.1 of the proof of theorem 1 consistently with (2.3). Added a reference and modified a sentence at the end of sec. 2.

Orbital Structure and Magnetic Ordering in Layered Manganites: Universal Correlation and Its Mechanism

Correlation between orbital structure and magnetic ordering in bilayered manganites is examined. A level separation between the $3d_{3z^2-r^2}$ and $3d_{x^2-y^2}$ orbitals in a Mn ion is calculated in the ionic model for a large number of the compounds. It is found that the relative stability of the orbitals dominates the magnetic transition temperatures as well as the magnetic structures. A mechanism of the correlation between orbital and magnetism is investigated based on the theoretical model with the two $e_g$ orbitals under strong electron correlation.Comment: 4 pages, 4 figure

The Robinson Gravitational Wave Background Telescope (BICEP): a bolometric large angular scale CMB polarimeter

The Robinson Telescope (BICEP) is a ground-based millimeter-wave bolometric array designed to study the polarization of the cosmic microwave background radiation (CMB) and galactic foreground emission. Such measurements probe the energy scale of the inflationary epoch, tighten constraints on cosmological parameters, and verify our current understanding of CMB physics. Robinson consists of a 250-mm aperture refractive telescope that provides an instantaneous field-of-view of 17 degrees with angular resolution of 55 and 37 arcminutes at 100 GHz and 150 GHz, respectively. Forty-nine pair of polarization-sensitive bolometers are cooled to 250 mK using a 4He/3He/3He sorption fridge system, and coupled to incoming radiation via corrugated feed horns. The all-refractive optics is cooled to 4 K to minimize polarization systematics and instrument loading. The fully steerable 3-axis mount is capable of continuous boresight rotation or azimuth scanning at speeds up to 5 deg/s. Robinson has begun its first season of observation at the South Pole. Given the measured performance of the instrument along with the excellent observing environment, Robinson will measure the E-mode polarization with high sensitivity, and probe for the B-modes to unprecedented depths. In this paper we discuss aspects of the instrument design and their scientific motivations, scanning and operational strategies, and the results of initial testing and observations.Comment: 18 pages, 11 figures. To appear in Millimeter and Submillimeter Detectors and Instrumentation for Astronomy III, Proceedings of SPIE, 6275, 200

Temperature-dependent soft x-ray photoemission and absorption studies of charge disproportionation in La1−x_{1-x}Srx_xFeO3_3

We have measured the temperature dependence of the photoemission and x-ray absorption spectra of La$_{1-x}$Sr$_x$FeO$_3$ (LSFO) epitaxial thin films with $x=0.67$, where charge disproportionation ($3{Fe}^{3.67+}\to 2{Fe}^{3+}+ {Fe}^{5+}$) resulting in long-range spin and charge ordering is known to occur below $T_{CD}=190$ K. With decreasing temperature we observed gradual changes of the spectra with spectral weight transfer over a wide energy range of $\sim 5$ eV. Above $T_{CD}$ the intensity at the Fermi level ($E_F$) was relatively high compared to that below $T_{CD}$ but still much lower than that in conventional metals. We also found a similar temperature dependence for $x=0.4$, and to a lesser extent for $x=0.2$. These observations suggest that a local charge disproportionation occurs not only in the $x=0.67$ sample below $T_{CD}$ but also over a wider temperature and composition range in LSFO. This implies that the tendency toward charge disproportionation may be the origin of the unusually wide insulating region of the LSFO phase diagram.Comment: 6 pages, 8 figure

Controls on the movement and composition of firn air at the West Antarctic Ice Sheet Divide

We sampled interstitial air from the perennial snowpack (firn) at a site near the West Antarctic Ice Sheet Divide (WAIS-D) and analyzed the air samples for a wide variety of gas species and their isotopes. We find limited convective influence (1.4–5.2 m, depending on detection method) in the shallow firn, gravitational enrichment of heavy species throughout the diffusive column in general agreement with theoretical expectations, a ~10 m thick lock-in zone beginning at ~67 m, and a total firn thickness consistent with predictions of Kaspers et al. (2004). Our modeling work shows that the air has an age spread (spectral width) of 4.8 yr for CO<sub>2</sub> at the firn-ice transition. We also find that advection of firn air due to the 22 cm yr<sup>−1</sup> ice-equivalent accumulation rate has a minor impact on firn air composition, causing changes that are comparable to other modeling uncertainties and intrinsic sample variability. Furthermore, estimates of Δage (the gas age/ice age difference) at WAIS-D appear to be largely unaffected by bubble closure above the lock-in zone. Within the lock-in zone, small gas species and their isotopes show evidence of size-dependent fractionation due to permeation through the ice lattice with a size threshold of 0.36 nm, as at other sites. We also see an unequivocal and unprecedented signal of oxygen isotope fractionation within the lock-in zone, which we interpret as the mass-dependent expression of a size-dependent fractionation process

Long-term Course and Prognosis of Idiopathic Pulmonary Fibrosis in the Modern Era

The American Thoracic Society and European Respiratory Society guidelines for the diagnosis and treatment of idiopathic pulmonary fibrosis (IPF) have been published recently. However, the influence, practical application, and utility of the prior consensus statement for IPF have never been evaluated. Demographics, diagnostic criteria, pulmonary function data, and disposition of patients with IPF evaluated at an interstitial lung disease center between 2000 and 2009 were analyzed. Enrollment in clinical drug trials, lung transplantation, and mortality also were assessed. A total of 521 patients with IPF were evaluated, with pulmonary function testing available in 446. In the 64% of patients without surgical lung biopsy, the most common major criterion not fulfilled was bronchoscopy. Lung transplantation was performed in 16.1% of patients, whereas 27.4% of prescreened patients were enrolled in a prospective drug study. Patients with mild, moderate, and severe disease categorized by FVC % predicted had median survivals of 55.6, 38.7, and 27.4 months, respectively. The attrition rate of patients who survived beyond 5 years was attenuated in subsequent years. IPF remains a deadly disease with a poor prognosis. Bronchoscopy does not appear to be required for an accurate diagnosis. A minority of patients were accommodated within a clinical trial or with transplantation. Categorization by baseline FVC % predicted effectively discriminates groups with different long-term outcomes. Our analysis supports the view that the value of statements also can be realized in the subsequent demonstration of their impact on patient management, which might enable further refinements in a continuous, iterative rediscovery process

Charge Ordering and Phase Competition in the Layered Perovskite Lasr2mn2o7

Charge-lattice fluctuations are observed in the layered perovskite manganite LaSr2Mn2O7 by Raman spectroscopy as high as 340 K and with decreasing temperature they become static and form a charge ordered (CO) phase below TCO=210 K. In the static regime, superlattice reflections are observed through neutron and x-ray diffraction with a propagation vector (h+1/4,k-1/4,l). Crystallographic analysis of the CO state demonstrates that the degree of charge and orbital ordering in this manganite is weaker than the charge ordering in three dimensional perovskite manganites. A TN=170K a type-A antiferromagnetism (AF) develops and competes with the charge ordering, that eventually melts below T*=100K. High resolution diffraction measurements suggest that that CO- and AF-states do not coincide within the same region in the material but rather co-exist as separate phases. The transition to type-A antiferromagnetism at lower temperatures is characterized by the competition between these two phases.Comment: 9 pages, 6 figure

Parental bonding and identity style as correlates of self-esteem among adult adoptees and nonadoptees

Adult adoptees (n equals 100) and non-adoptees (n equals 100) were compared with regard to selfesteem, identity processing style, and parental bonding. While some differences were found with regard to self-esteem, maternal care, and maternal overprotection, these differences were qualified by reunion status such that only reunited adoptees differed significantly from nonadoptees. Moreover, hierarchical regression analyses indicated that parental bonding and identity processing style were more important than adoptive status per se in predicting self esteem. Implications for practitioners who work with adoptees are discussed