OPPORTUNITIES AND BARRIERS IN THE CONTROL AND PREVENTION OF LYME DISEASE: IMPLICATIONS FOR PRACTICE

Lyme disease is currently the most infectious disease in North America with 300,000 people estimated to be diagnosed with this tick-borne infection per year. While various tick control and Lyme disease prevention practices are documented in the literature review, and comprehensively reflected in an integrated pest management (IPM) strategy, translational studies suggest that very few practices are implemented on a routine basis to influence disease transmission. Public and private sector stakeholders are increasingly playing an important role in tick control and educating populations about personal protective measures. To understand the influence of the public and private sector on the frequency and coverage of Lyme disease control and prevention practices in Maryland during 2009-2014, interviews were conducted with key informants from the federal, state, and non-profit sector. In addition, public and private sector stakeholders from counties with a high incidence of Lyme disease (greater than 50 cases per 100,000 during 2008-2012) participated in an online survey to describe their role in tick control and Lyme disease activities. Results of these interviews provide context to understanding current control and prevention efforts, including the role of the state and county in the implementation of IPM. Results showed significant contributions by the public and private sector in supporting tick control and tick-borne disease prevention practices in Maryland. All major components of IPM were identified in at least one of the targeted counties. Control and prevention practices were not homogenous across counties, reflecting potential differences in stakeholder engagement. To navigate the uncertainty of control and prevention strategies and to create a more comprehensive and inclusive structure for managing IPM, an adaptive resource management (ARM) strategy is recommended. Four major recommendations are supported by study results, including: 1) formation of county level tick borne disease committees (TBDC) as sponsors of IPM change initiatives, 2) facilitation of stakeholder engagement and communication plan workshops, 3) adoption of a behavior change communication (BCC) framework into personal protective measures for TBDs, and 4) development of a state organized IPM certification program for pest control operators and landscape companies.Doctor of Public Healt

In-house deep environmental sentience for smart homecare solutions toward ageing society.

With an increasing amount of elderly people needing home care around the clock, care workers are not able to keep up with the demand of providing maximum support to those who require it. As medical costs of home care increase the quality is care suffering as a result of staff shortages, a solution is desperately needed to make the valuable care time of these workers more efficient. This paper proposes a system that is able to make use of the deep learning resources currently available to produce a base system that could provide a solution to many of the problems that care homes and staff face today. Transfer learning was conducted on a deep convolutional neural network to recognize common household objects was proposed. This system showed promising results with an accuracy, sensitivity and specificity of 90.6%, 0.90977 and 0.99668 respectively. Real-time applications were also considered, with the system achieving a maximum speed of 19.6 FPS on an MSI GTX 1060 GPU with 4GB of VRAM allocated

A survey of weather information possessed by thirty-two pupils randomly selected from sixth and eleventh grades and from special classes

Thesis (Ed.M.)--Boston Universit

Creating a SNOMED CT reference set for common endocrine disorders based on routine clinic correspondence

We are grateful to the staff and patients of the endocrine clinic at Aberdeen Royal Infirmary (ARI) for the survey responses and provision of data used in this study. We are also thankful to Dr Charlotte Lee and Dr Wendy Yap for their help with data analysis. No external funding was sought or obtained for this study.Peer reviewe

Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review.

INTRODUCTION: A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. There are a number of lessons learnt from the Guinea worm surveillance system that are particularly compatible for TT surveillance and the onchocerciasis surveillance system which can provide insights for surveillance of the infectious form of trachoma. METHODS/PRINCIPAL FINDINGS: A literature search of peer-reviewed published papers and grey literature was conducted using PUBMED and Google Scholar for articles relating to dracunculiasis or Guinea worm, onchocerciasis and trachoma, along with surveillance or elimination or eradication. The abstracts of relevant papers were read and inclusion was determined based on specified inclusion and exclusion criteria. The credibility and bias of relevant papers were also critically assessed using published criteria. A total of 41 papers were identified that were eligible for inclusion into the review. The Guinea worm programme is designed around a surveillance-containment strategy and combines both active and passive surveillance approaches, with a focus on village-based surveillance and reporting. Although rumour reporting and a monetary incentive for the identification of confirmed Guinea worm cases have been reported as successful for identifying previously unknown transmission there is little unbiased evidence to support this conclusion. More rigorous evidence through a randomised controlled trial, influenced by motivational factors identified through formative research, would be necessary in order to consider applicability for TT case finding in an elimination setting. The onchocerciasis surveillance strategy focuses on active surveillance through sentinel surveillance of villages and breeding sites. It relies on an entomological component, monitoring infectivity rates of black flies and an epidemiological component, tracking exposure to infection in humans. Challenges have included the introduction of relatively complex diagnostics that are not readily available in onchocerciasis endemic countries and target thresholds, which are practically unattainable with current diagnostic tests. Although there is utility in monitoring for infection and serological markers in trachoma surveillance, it is important that adequate considerations are made to ensure evidence-based and achievable guidelines for their utility are put in place. CONCLUSIONS/SIGNIFICANCE: The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance. The next step would be a real-world evaluation of their relative applicability for trachoma surveillance

A Discussion of Value Metrics for Data Repositories in Earth and Environmental Sciences

Despite growing recognition of the importance of public data to the modern economy and to scientific progress, long-term investment in the repositories that manage and disseminate scientific data in easily accessible-ways remains elusive. Repositories are asked to demonstrate that there is a net value of their data and services to justify continued funding or attract new funding sources. Here, representatives from a number of environmental and Earth science repositories evaluate approaches for assessing the costs and benefits of publishing scientific data in their repositories, identifying various metrics that repositories typically use to report on the impact and value of their data products and services, plus additional metrics that would be useful but are not typically measured. We rated each metric by (a) the difficulty of implementation by our specific repositories and (b) its importance for value determination. As managers of environmental data repositories, we find that some of the most easily obtainable data-use metrics (such as data downloads and page views) may be less indicative of value than metrics that relate to discoverability and broader use. Other intangible but equally important metrics (e.g., laws or regulations impacted, lives saved, new proposals generated), will require considerable additional research to describe and develop, plus resources to implement at scale. As value can only be determined from the point of view of a stakeholder, it is likely that multiple sets of metrics will be needed, tailored to specific stakeholder needs. Moreover, economically based analyses or the use of specialists in the field are expensive and can happen only as resources permit

Synthesis of 3-D coronal-solar wind energetic particle acceleration modules

1. Introduction Acute space radiation hazards pose one of the most serious risks to future human and robotic exploration. Large solar energetic particle (SEP) events are dangerous to astronauts and equipment. The ability to predict when and where large SEPs will occur is necessary in order to mitigate their hazards. The Coronal-Solar Wind Energetic Particle Acceleration (C-SWEPA) modeling effort in the NASA/NSF Space Weather Modeling Collaborative [Schunk, 2014] combines two successful Living With a Star (LWS) (http://lws. gsfc.nasa.gov/) strategic capabilities: the Earth-Moon-Mars Radiation Environment Modules (EMMREM) [Schwadron et al., 2010] that describe energetic particles and their effects, with the Next Generation Model for the Corona and Solar Wind developed by the Predictive Science, Inc. (PSI) group. The goal of the C-SWEPA effort is to develop a coupled model that describes the conditions of the corona, solar wind, coronal mass ejections (CMEs) and associated shocks, particle acceleration, and propagation via physics-based modules. Assessing the threat of SEPs is a difficult problem. The largest SEPs typically arise in conjunction with X class flares and very fast (\u3e1000 km/s) CMEs. These events are usually associated with complex sunspot groups (also known as active regions) that harbor strong, stressed magnetic fields. Highly energetic protons generated in these events travel near the speed of light and can arrive at Earth minutes after the eruptive event. The generation of these particles is, in turn, believed to be primarily associated with the shock wave formed very low in the corona by the passage of the CME (injection of particles from the flare site may also play a role). Whether these particles actually reach Earth (or any other point) depends on their transport in the interplanetary magnetic field and their magnetic connection to the shock

How Intense Policy Demanders Shape Postreform Politics: Evidence from the Affordable Care Act

The implementation of the Affordable Care Act (ACA) has been a politically volatile process. The ACA\u27s institutional design and delayed feedback effects created a window of opportunity for its partisan opponents to launch challenges at both the federal and state level. Yet as recent research suggests, postreform politics depends on more than policy feedback alone; rather, it is shaped by the partisan and interest-group environment. We argue that “intense policy demanders” played an important role in defining the policy alternatives that comprised congressional Republicans\u27 efforts to repeal and replace the ACA. To test this argument, we drew on an original data set of bill introductions in the House of Representatives between 2011 and 2016. Our analysis suggests that business contributions and political ideology affected the likelihood that House Republicans would introduce measures repealing significant portions of the ACA. A secondary analysis shows that intense policy demanders also shaped the vote on House Republicans\u27 initial ACA replacement plan. These findings highlight the role intense policy demanders can play in shaping the postreform political agenda

A Simple Coase-Like Mechanism that Transfers Control of Government Spending Levels from Politicians to Voters

Elected representatives have little incentive to pursue the interests of those electing them once they are elected. This well-known principle-agent problem leads, in a variety of theories of government, to nonoptimally large levels of government expenditure. An implication is that budgetary rules are seen as necessary to constrain politicians? tax and spending behavior. Popular among such constraints are various Balanced Budget Amendment proposals. These approaches, however, are shown here to have serious limitations, including failure to address the central concern of spending level. An alternative approach is advanced here that relies on a Coase-like mechanism that transfers control of government spending to the voter. Prisoner's dilemma incentives and political competition are seen to be critical to the superiority of the present mechanism to approaches requiring budget balance