The peacebuilding potential of healthcare training programs.

Global health professionals regularly conduct healthcare trainings, such as first aid courses, in disadvantaged communities across the world. Many of these communities lack healthcare infrastructure because of war and political conflict. The authors draw on their experience conducting a first aid course in South Sudan to provide a perspective on how healthcare trainings for people with no medical background can be used to bridge ethnic, political, and religious differences. They argue that a necessary step for turning a healthcare training into a vehicle for peacebuilding is to bring people from different communities to the same physical space to learn the course material together. Importantly, simply encouraging contact between communities is unlikely to improve intergroup relations and could be detrimental if the following features are not incorporated. Buy-in from respected community leaders is essential to ensure that training participants trust that their safety during the training sessions is not at risk. Trainers should also create a supportive environment by conferring equal status and respect on all trainees. Finally, hands-on training exercises allow for positive interactions between trainees from different groups, which in turn can challenge stereotypes and facilitate cross-group friendships. These features map onto social psychological principles that have been shown to improve intergroup relations and are consistent with lessons learned from peace through health initiatives in public health and medicine. By adopting peacebuilding features, healthcare trainings can serve their primary goal of medical education and provide the added benefit of strengthening social relations

Estimating the number of classes

Estimating the unknown number of classes in a population has numerous important applications. In a Poisson mixture model, the problem is reduced to estimating the odds that a class is undetected in a sample. The discontinuity of the odds prevents the existence of locally unbiased and informative estimators and restricts confidence intervals to be one-sided. Confidence intervals for the number of classes are also necessarily one-sided. A sequence of lower bounds to the odds is developed and used to define pseudo maximum likelihood estimators for the number of classes.Comment: Published at http://dx.doi.org/10.1214/009053606000001280 in the Annals of Statistics (http://www.imstat.org/aos/) by the Institute of Mathematical Statistics (http://www.imstat.org

Towards an Ontological Representation of Resistance: The Case of MRSa

This paper addresses a family of issues surrounding the biological phenomenon of resistance and its representation in realist ontologies. Resistance terms from various existing ontologies are examined and found to be either overly narrow, inconsistent, or
otherwise problematic. We propose a more coherent ontological representation using the antibiotic resistance in Methicillin-Resistant _Staphylococcus aureus_ (MRSa) as a case study

Ontological representation of CDC Active Bacterial Core Surveillance Case Reports

The Center for Disease Control and Prevention’s Active Bacterial Core Surveillance (CDC ABCs) Program is a collaborative effort betweeen the CDC, state health departments, laboratories, and universities to track invasive bacterial pathogens of particular importance to public health [1]. The year-end surveillance reports produced by this program help to shape public policy and coordinate responses to emerging infectious diseases over time. The ABCs case report form (CRF) data represents an excellent opportunity for data reuse beyond the original surveillance purposes

Constructing a lattice of Infectious Disease Ontologies from a Staphylococcus aureus isolate repository

A repository of clinically associated Staphylococcus aureus (Sa) isolates is used to semi‐automatically generate a set of application ontologies for specific subfamilies of Sa‐related disease. Each such application ontology is compatible with the Infectious Disease Ontology (IDO) and uses resources from the Open Biomedical Ontology (OBO) Foundry. The set of application ontologies forms a lattice structure beneath the IDO‐Core and IDO‐extension reference ontologies. We show how this lattice can be used to define a strategy for the construction of a new taxonomy of infectious disease incorporating genetic, molecular, and clinical data. We also outline how faceted browsing and query of annotated data is supported using a lattice application ontology

Perceptions of a service redesign by adults living with type 2 diabetes

<b>Aim:</b> This article is a report of a study conducted to explore the perceptions of adults with type 2 diabetes towards the service redesign. <b>Background:</b> Diabetes is reaching epidemic proportions and the management of this chronic illness is changing in response to this challenge. In the United Kingdom, there is ongoing restructuring of healthcare services for people with chronic illnesses to ensure that their general health and clinical needs are met predominantly in primary care. <b>Method:</b> An explorative qualitative approach was used. Eight focus groups were conducted with 35 people with type 2 diabetes in one urban location between 2003 and 2004. Five focus groups were conducted with people who had recently experienced the restructured service and three groups with people who had up to 2 years' experience of the new service. Concurrent data collection and thematic analysis were conducted by three researchers and credibility and verification sought by feedback to participants. <b>Findings:</b> Five main themes were identified: impact of living with diabetes; understanding diabetes; drivers for organizational change; care in context and individual concerns. Participants identified issues for ongoing development of the service. <b>Conclusion:</b> People with type 2 diabetes appreciate their care management within the primary care setting where there has been investment in staff to deliver this care. Healthcare resources are required to support the development of staff and the necessary infrastructure to undertake management in primary care. Policy makers need to address the balance of resources between primary and secondary care

Experience of cardiac rehabilitation after coronary artery surgery: effects on health and risk factors

Objective:Cardiac rehabilitation (CR) programs are provided to support the recovery process following acute myocardial infarction and coronary artery bypass grafting (CABG). Attendance varies. We related attendance following CABG to severity of cardiac symptoms, general health status (Short Form-36) and prevalence of modifiable coronary artery disease (CAD) risk factors. METHODS: 209 patients due to undergo CABG were recruited and assessed preoperatively as well as at a mean of 16.4 months postoperatively. General health status was measured using the Short Form-36 questionnaire. Severity of cardiac symptoms was assessed on a visual analogue scale. Modifiable coronary artery disease risk factors (smoking, body mass index, hypertension and elevated cholesterol) and social deprivation index were noted

Building and using semiparametric tolerance regions for parametric multinomial models

We introduce a semiparametric ``tubular neighborhood'' of a parametric model in the multinomial setting. It consists of all multinomial distributions lying in a distance-based neighborhood of the parametric model of interest. Fitting such a tubular model allows one to use a parametric model while treating it as an approximation to the true distribution. In this paper, the Kullback--Leibler distance is used to build the tubular region. Based on this idea one can define the distance between the true multinomial distribution and the parametric model to be the index of fit. The paper develops a likelihood ratio test procedure for testing the magnitude of the index. A semiparametric bootstrap method is implemented to better approximate the distribution of the LRT statistic. The approximation permits more accurate construction of a lower confidence limit for the model fitting index.Comment: Published in at http://dx.doi.org/10.1214/08-AOS603 the Annals of Statistics (http://www.imstat.org/aos/) by the Institute of Mathematical Statistics (http://www.imstat.org

Improving CMB non-Gaussianity estimators using tracers of local structure

Local non-Gaussianity causes correlations between large scale perturbation modes and the small scale power. The large-scale CMB signal has contributions from the integrated Sachs Wolfe (ISW) effect, which does not correlate with the small scale power. If this ISW contribution can be removed, the sensitivity to local non-Gaussianity is improved. Gravitational lensing and galaxy counts can be used to trace the ISW contribution; in particular we show that the CMB lensing potential is highly correlated with the ISW signal. We construct a nearly-optimal estimator for the local non-Gaussianity parameter \fnl and investigate to what extent we can use this to decrease the variance on {\fnl}. We show that the variance can be decreased by up to $20\%$ at Planck sensitivity using galaxy counts. CMB lensing is a good bias-independent ISW tracer for future more sensitive observations, though the fractional decrease in variance is small if good polarization data is also available.Comment: 8 pages, 3 figures. Comments welcom