Improving Ebola infection prevention and control in primary healthcare facilities in Sierra Leone: a single-group pretest post-test, mixed-methods study

Background Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. Methods We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015. Quantitative methods administered to HCWs at baseline and follow-up included a survey on attitudes and self-efficacy towards IPC, and structured observations of behaviours. The intervention involved a workshop for HCWs to develop improvement plans for their facility. We analysed the changes between rounds in survey responses and behaviours. We used interviews to explore attitudes and self-efficacy throughout the study period. Results HCWs described IPC as ‘life-saving’ and personal protective equipment (PPE) as uncomfortable for providers and frightening for patients. At baseline, self-efficacy was high (median=4/strongly agree). Responses reflecting unfavourable attitudes were low for glove use (median=1/strongly disagree, IQR, 1–2) and PPE use with ill family members (median=1, IQR, 1–2), and mixed for PPE use with ill HCWs (median=2/disagree, IQR, 1–4). Observations demonstrated consistent glove reuse and poor HCW handwashing. The maintenance of distance (RR 1.09, 95% CI 1.02 to 1.16) and patient handwashing (RR 1.19, 95% CI 1.3 to 1.25) improved to >90%. Conclusions We found favourable attitudes towards IPC and gaps in practice. Risk perceptions of HCWs and tendencies to ration PPE where chronic supply chain issues normally lead to PPE stock-outs may affect practice. As Sierra Leone's Ebola Recovery Strategy aims to make all facilities IPC compliant, socio-behavioural improvements and a secure supply chain are essential

Optical modeling and polarization calibration for CMB measurements with ACTPol and Advanced ACTPol

The Atacama Cosmology Telescope Polarimeter (ACTPol) is a polarization sensitive upgrade to the Atacama Cosmology Telescope. Located at an elevation of 5190 m, ACTPol measures the Cosmic Microwave Background (CMB) temperature and polarization with arcminute-scale angular resolution. Calibration of the detector angles is a critical step in producing maps of the CMB polarization. Polarization angle offsets in the detector calibration can cause leakage in polarization from E to B modes and induce a spurious signal in the EB and TB cross correlations, which eliminates our ability to measure potential cosmological sources of EB and TB signals, such as cosmic birefringence. We present our optical modeling and measurements associated with calibrating the detector angles in ACTPol.Comment: 12 pages, 8 figures, conference proceedings submitted to Proceedings of SPIE; added reference in section 2 and merged repeated referenc

Discovery of high-amplitude X-ray variability in the Seyfert-LINER transition galaxy NGC7589

We present the first result of a programme to search for large flux variations in the X-ray sources of the XMM Serendipitous Survey compared to previous ROSAT observations. An increase in X-ray flux by a factor >10 was discovered from the nucleus of the galaxy NGC7589 on a timescale of less than 5 years. The 0.4-10keV XMM spectrum can be approximated by a power-law with photon index of 1.7-1.8, though it seems to flatten above 5keV, suggesting a possible complex model, such as partial covering or disc reflection. A classification based on an analysis of its optical spectrum places NGC7589 in the Seyfert region, but close to the Seyfert-LINER border-line on the AGN diagnostic diagrams. We classify NGC7589 as either Seyfert1.9 or LINERI, in the light of the detection of a broad H_alpha line, which makes NGC7589 an AGN in the low-luminosity regime. We interpret the observed variability in terms of either changes in covering factor of absorbing gas in the AGN, or variability in the intrinsic X-ray luminosity. Should the latter be the case, the inferred Eddington accretion rate increased from the radiatively inefficient accretion dominated regime to a value close to the putative critical value, at which a transition of the accretion mode is supposed to take place. This possibility presents a new prospect of studying accretion physics in the central black holes of external galaxies by direct observing changes of `spectral state', as is common in stellar black hole binary systems.Comment: 6 pages, 4 figures, accepted for publication in MNRAS Lette

Photometric Selection of Emission Line Galaxies, Clustering Analysis and a Search for the ISW effect

We investigate the use of simple colour cuts applied to the SDSS optical imaging to perform photometric selections of emission line galaxies out to z<1. From colour-cuts using the SDSS g, r and i bands, we obtain mean photometric redshifts of z=0.32+-0.08, z=0.44+-0.12 and z=0.65+-0.21. We further calibrate our high redshift selection using spectroscopic observations with the AAOmega spectrograph on the 4m Anglo-Australian Telescope (AAT), observing ~50-200 galaxy candidates in 4 separate fields. With just 1-hour of integration time and with seeing of ~1.6", we successfully determined redshifts for ~65% of the targeted candidates. We calculate the angular correlation functions of the samples and find correlation lengths of r0=2.64 h-1 Mpc, r0=3.62 h-1 Mpc and r0=5.88 h-1 Mpc for the low, mid and high redshift samples respectively. Comparing these results with predicted dark matter clustering, we estimate the bias parameter for each sample to be b=0.70, b=0.92 and b=1.46. We calculate the 2-point redshift-space correlation function at z~0.6 and find a clustering amplitude of s0=6.4 h-1 Mpc. Finally, we use our photometric sample to search for the Integrated Sachs-Wolfe signal in the WMAP 5yr data. We cross-correlate our three redshift samples with the WMAP W, V, Q and K bands and find an overall trend for a positive signal similar to that expected from models. However, the signal in each is relatively weak. Combining all three galaxy samples we find a signal of wTg(<100')=0.20+-0.12 microK in the WMAP W-band, a significance of 1.7sigma.Comment: 14 pages, 17 figures, submitted to MNRA

Mechanical design and development of TES bolometer detector arrays for the Advanced ACTPol experiment

The next generation Advanced ACTPol (AdvACT) experiment is currently underway and will consist of four Transition Edge Sensor (TES) bolometer arrays, with three operating together, totaling ~5800 detectors on the sky. Building on experience gained with the ACTPol detector arrays, AdvACT will utilize various new technologies, including 150mm detector wafers equipped with multichroic pixels, allowing for a more densely packed focal plane. Each set of detectors includes a feedhorn array of stacked silicon wafers which form a spline profile leading to each pixel. This is then followed by a waveguide interface plate, detector wafer, back short cavity plate, and backshort cap. Each array is housed in a custom designed structure manufactured from high purity copper and then gold plated. In addition to the detector array assembly, the array package also encloses cryogenic readout electronics. We present the full mechanical design of the AdvACT high frequency (HF) detector array package along with a detailed look at the detector array stack assemblies. This experiment will also make use of extensive hardware and software previously developed for ACT, which will be modified to incorporate the new AdvACT instruments. Therefore, we discuss the integration of all AdvACT arrays with pre-existing ACTPol infrastructure.Comment: 9 pages, 5 figures, SPIE Astronomical Telescopes and Instrumentation conference proceeding

Survey strategy optimization for the Atacama Cosmology Telescope

In recent years there have been significant improvements in the sensitivity and the angular resolution of the instruments dedicated to the observation of the Cosmic Microwave Background (CMB). ACTPol is the first polarization receiver for the Atacama Cosmology Telescope (ACT) and is observing the CMB sky with arcmin resolution over about 2000 sq. deg. Its upgrade, Advanced ACTPol (AdvACT), will observe the CMB in five frequency bands and over a larger area of the sky. We describe the optimization and implementation of the ACTPol and AdvACT surveys. The selection of the observed fields is driven mainly by the science goals, that is, small angular scale CMB measurements, B-mode measurements and cross-correlation studies. For the ACTPol survey we have observed patches of the southern galactic sky with low galactic foreground emissions which were also chosen to maximize the overlap with several galaxy surveys to allow unique cross-correlation studies. A wider field in the northern galactic cap ensured significant additional overlap with the BOSS spectroscopic survey. The exact shapes and footprints of the fields were optimized to achieve uniform coverage and to obtain cross-linked maps by observing the fields with different scan directions. We have maximized the efficiency of the survey by implementing a close to 24 hour observing strategy, switching between daytime and nighttime observing plans and minimizing the telescope idle time. We describe the challenges represented by the survey optimization for the significantly wider area observed by AdvACT, which will observe roughly half of the low-foreground sky. The survey strategies described here may prove useful for planning future ground-based CMB surveys, such as the Simons Observatory and CMB Stage IV surveys.Comment: 14 Pages, 9 Figures, 4 Table

The Atacama Cosmology Telescope: The polarization-sensitive ACTPol instrument

The Atacama Cosmology Telescope (ACT) is designed to make high angular resolution measurements of anisotropies in the Cosmic Microwave Background (CMB) at millimeter wavelengths. We describe ACTPol, an upgraded receiver for ACT, which uses feedhorn-coupled, polarization-sensitive detector arrays, a 3 degree field of view, 100 mK cryogenics with continuous cooling, and meta material anti-reflection coatings. ACTPol comprises three arrays with separate cryogenic optics: two arrays at a central frequency of 148 GHz and one array operating simultaneously at both 97 GHz and 148 GHz. The combined instrument sensitivity, angular resolution, and sky coverage are optimized for measuring angular power spectra, clusters via the thermal Sunyaev-Zel'dovich and kinetic Sunyaev-Zel'dovich signals, and CMB lensing due to large scale structure. The receiver was commissioned with its first 148 GHz array in 2013, observed with both 148 GHz arrays in 2014, and has recently completed its first full season of operations with the full suite of three arrays. This paper provides an overview of the design and initial performance of the receiver and related systems

Controversies in HIV cure research

International audienceABSTRACT: BACKGROUND: Antiretroviral therapy significantly reduces HIV viral burden and prolongs life, but does not cure HIV infection. The major scientific barrier to a cure is thought to be the persistence of the virus in cellular and/or anatomical reservoirs. DISCUSSION: Most efforts to date, including pharmaco, immuno or gene therapy, have failed to cure patients, with the notable exception of a stem cell transplant recipient commonly known as the Berlin patient. This case has revived interest in the potential to cure HIV infection and has highlighted the need to resolve critical questions in the basic, pre-clinical and clinical research spheres as they pertain specifically to efforts to eradicate HIV from the body of an infected person (a sterilizing cure) or at least render the need for lifelong antiretroviral therapy obsolete (functional cure). This paper describes ongoing debates in each of these research spheres as they were presented and discussed at a satellite session that took place at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome in July 2011. SUMMARY: The resolution of these debates may have important implications for the search for a cure, the most efficient ways to identify and test promising interventions, and ultimately the availability of such a cure to diverse groups of HIV patients around the world