124 research outputs found

    A Preliminary Assessment of Rotavirus Vaccine Effectiveness in Zambia

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    BACKGROUND: Diarrhea is the third leading cause of child death in Zambia. Up to one-third of diarrhea cases resulting in hospitalization and/or death are caused by vaccine-preventable rotavirus. In January 2012, Zambia initiated a pilot introduction of the Rotarix live, oral rotavirus vaccine in all public health facilities in Lusaka Province. METHODS: Between July 2012 and October 2013, we conducted a case-control study at 6 public sector sites to estimate rotavirus vaccine effectiveness (VE) in age-eligible children presenting with diarrhea. We computed the odds of having received at least 1 dose of Rotarix among children whose stool was positive for rotavirus antigen (cases) and children whose stool was negative (controls). We adjusted the resulting odds ratio (OR) for patient age, calendar month of presentation, and clinical site, and expressed VE as (1 - adjusted OR) × 100. RESULTS: A total of 91 rotavirus-positive cases and 298 rotavirus-negative controls who had under-5 card-confirmed vaccination status and were ≄6 months of age were included in the case-control analysis. Among rotavirus-positive children who were age-eligible to be vaccinated, 20% were hospitalized. Against rotavirus diarrhea of all severity, the adjusted 2-dose VE was 26% (95% confidence interval [CI], -30% to 58%) among children ≄6 months of age. VE against hospitalized children ≄6 months of age was 56% (95% CI, -34% to 86%). CONCLUSIONS: We observed a higher point estimate for VE against increased severity of illness compared with milder disease, but were not powered to detect a low level of VE against milder disease

    E-Leadership or “How to Be Boss in Instant Messaging?” The Role of Nonverbal Communication

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    Doing leadership in the virtual realm has now become a routine part of many leaders’ daily work, yet our understanding of how leadership is enacted in mediated contexts—especially in text-only channels—is very limited. By applying micro-level analysis to naturally occurring instant message conversations, this article exposes the strategies leaders employ to achieve a range of complex communication goals: to get the work done while fostering informality and collegiality and creating the sense of a real—and not virtual—collaboration between team members. The findings further our understanding in two domains: They provide empirical grounding for e-leadership theories by exposing practices from real-life interactions, and they contribute to discursive leadership literature by addressing nonverbal communication practices. The findings of the article could form the basis for management and leadership training by drawing attention to the linguistic and semiotic resources digital leaders have at their disposal in virtual work environments

    Critical Language and Discourse Awareness in Management Education

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    Communication and, through it, language have become key elements of business and organizational life. How organizations interact within their walls and with the outside world fundamentally affects business processes, creating organizational culture, shaping public perceptions, and influencing consumer choices. This essay calls for a greater acknowledgment of language and communication and suggests that management educators may want to review how they are incorporated in management education curricula. Expanding on the skill-based approach typically adopted in business school classes, the essay points to the utility of exposing business students to the dual function of language as a means of doing work and as a social action that constitutes social reality. Drawing on examples from scholarship in linguistics and discourse analysis, the essay demonstrates that the ability to notice, identify, and reflect on linguistic and discourse practices is a crucial managerial skill. Nurturing such analytical and thinking skills enables people to become not only better communicators but also critical thinkers able to understand and challenge when social control, power, or injustice is enacted in organizations

    Investigation into pedestrian exposure to near-vehicle exhaust emissions

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    <p>Abstract</p> <p>Background</p> <p>Inhalation of diesel particulate matter (DPM) is known to have a negative impact on human health. Consequently, there are regulations and standards that limit the maximum concentrations to which persons may be exposed and the maximum concentrations allowed in the ambient air. However, these standards consider steady exposure over large spatial and time scales. Due to the nature of many vehicle exhaust systems, pedestrians in close proximity to a vehicle's tailpipe may experience events where diesel particulate matter concentrations are high enough to cause acute health effects for brief periods of time.</p> <p>Methods</p> <p>In order to quantify these exposure events, instruments which measure specific exhaust constituent concentrations were placed near a roadway and connected to the mouth of a mannequin used as a pedestrian surrogate. By measuring concentrations at the mannequin's mouth during drive-by events with a late model diesel truck, a representative estimate of the exhaust constituent concentrations to which a pedestrian may be exposed was obtained. Typical breathing rates were then multiplied by the measured concentrations to determine the mass of pollutant inhaled.</p> <p>Results</p> <p>The average concentration of diesel particulate matter measured over the duration of a single drive-by test often exceeded the low concentrations used in human clinical studies which are known to cause acute health effects. It was also observed that higher concentrations of diesel particulate matter were measured at the height of a stroller than were measured at the mouth of a mannequin.</p> <p>Conclusion</p> <p>Diesel particulate matter concentrations during drive-by incidents easily reach or exceed the low concentrations that can cause acute health effects for brief periods of time. For the case of a particularly well-tuned late-model year vehicle, the mass of particulate matter inhaled during a drive-by incident is small compared to the mass inhaled daily at ambient conditions. On a per breath basis, however, the mass of particulate matter inhaled is large compared to the mass inhaled at ambient conditions. Finally, it was determined that children, infants, or people breathing at heights similar to that of a passing vehicle's tailpipe may be exposed to higher concentrations of particulate matter than those breathing at higher locations, such as adults standing up.</p

    Integrating Human Indoor Air Pollutant Exposure within Life Cycle Impact Assessment

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    Neglecting health effects from indoor pollutant emissions and exposure, as currently done in Life Cycle Assessment (LCA), may result in product or process optimizations at the expense of workers’ or consumers’ health. To close this gap, methods for considering indoor exposure to chemicals are needed to complement the methods for outdoor human exposure assessment already in use. This paper summarizes the work of an international expert group on the integration of human indoor and outdoor exposure in LCA, within the UNEP/SETAC Life Cycle Initiative. A new methodological framework is proposed for a general procedure to include human-health effects from indoor exposure in LCA. Exposure models from occupational hygiene and household indoor air quality studies and practices are critically reviewed and recommendations are provided on the appropriateness of various model alternatives in the context of LCA. A single-compartment box model is recommended for use as a default in LCA, enabling one to screen occupational and household exposures consistent with the existing models to assess outdoor emission in a multimedia environment. An initial set of model parameter values was collected. The comparison between indoor and outdoor human exposure per unit of emission shows that for many pollutants, intake per unit of indoor emission may be several orders of magnitude higher than for outdoor emissions. It is concluded that indoor exposure should be routinely addressed within LCA

    Genetic identity, biological phenotype, and evolutionary pathways of transmitted/founder viruses in acute and early HIV-1 infection

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    Identification of full-length transmitted HIV-1 genomes could be instrumental in HIV-1 pathogenesis, microbicide, and vaccine research by enabling the direct analysis of those viruses actually responsible for productive clinical infection. We show in 12 acutely infected subjects (9 clade B and 3 clade C) that complete HIV-1 genomes of transmitted/founder viruses can be inferred by single genome amplification and sequencing of plasma virion RNA. This allowed for the molecular cloning and biological analysis of transmitted/founder viruses and a comprehensive genome-wide assessment of the genetic imprint left on the evolving virus quasispecies by a composite of host selection pressures. Transmitted viruses encoded intact canonical genes (gag-pol-vif-vpr-tat-rev-vpu-env-nef) and replicated efficiently in primary human CD4+ T lymphocytes but much less so in monocyte-derived macrophages. Transmitted viruses were CD4 and CCR5 tropic and demonstrated concealment of coreceptor binding surfaces of the envelope bridging sheet and variable loop 3. 2 mo after infection, transmitted/founder viruses in three subjects were nearly completely replaced by viruses differing at two to five highly selected genomic loci; by 12–20 mo, viruses exhibited concentrated mutations at 17–34 discrete locations. These findings reveal viral properties associated with mucosal HIV-1 transmission and a limited set of rapidly evolving adaptive mutations driven primarily, but not exclusively, by early cytotoxic T cell responses

    Genetic identity, biological phenotype, and evolutionary pathways of transmitted/founder viruses in acute and early HIV-1 infection

    Get PDF
    Identification of full-length transmitted HIV-1 genomes could be instrumental in HIV-1 pathogenesis, microbicide, and vaccine research by enabling the direct analysis of those viruses actually responsible for productive clinical infection. We show in 12 acutely infected subjects (9 clade B and 3 clade C) that complete HIV-1 genomes of transmitted/founder viruses can be inferred by single genome amplification and sequencing of plasma virion RNA. This allowed for the molecular cloning and biological analysis of transmitted/founder viruses and a comprehensive genome-wide assessment of the genetic imprint left on the evolving virus quasispecies by a composite of host selection pressures. Transmitted viruses encoded intact canonical genes (gag-pol-vif-vpr-tat-rev-vpu-env-nef) and replicated efficiently in primary human CD4+ T lymphocytes but much less so in monocyte-derived macrophages. Transmitted viruses were CD4 and CCR5 tropic and demonstrated concealment of coreceptor binding surfaces of the envelope bridging sheet and variable loop 3. 2 mo after infection, transmitted/founder viruses in three subjects were nearly completely replaced by viruses differing at two to five highly selected genomic loci; by 12–20 mo, viruses exhibited concentrated mutations at 17–34 discrete locations. These findings reveal viral properties associated with mucosal HIV-1 transmission and a limited set of rapidly evolving adaptive mutations driven primarily, but not exclusively, by early cytotoxic T cell responses
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