Impact of a mass vaccination campaign against a meningitis epidemic in a refugee camp.

Serogroup A meningococcus epidemics occurred in refugee populations in Zaire in August 1994. The paper analyses the public health impact of a mass vaccination campaign implemented in a large refugee camp. We compared meningitis incidence rates from 2 similar camps. In Kibumba camp, vaccination was implemented early in the course of the epidemic whilst in the control camp (Katale), vaccination was delayed. At a threshold of 15 cases per 100 000 population per week an immunization campaign was implemented. Attack rates were 94 and 134 per 100,000 in Kibumba and Katale respectively over 2 months. In Kibumba, one week after crossing the threshold, 121,588 doses of vaccine were administered covering 76% of all refugees. Vaccination may have prevented 68 cases (30% of the expected cases). Despite its rapid institution and the high coverage achieved, the vaccination campaign had a limited impact on morbidity due to meningitis. In the early phase in refugee camps, the relative priorities of meningitis vaccination and case management need to be better defined

Wintertime convection and frontal interleaving in the Southern Ocean

Submitted in partial fulfillment of the requirements for the degree of Doctor of Science at the Massachusetts Institute of Technology and the Woods Hole Oceanographic Institution March, 1980The Southern Ocean as defined here is the body of water between the Antarctic Continent and the Antarctic Polar Front, (APF). This ocean is considered important in the global thermodynamic balance of the ocean-atmosphere system because large planetary heat losses are believed to occur at high latitudes. The ocean and atmosphere must transport heat poleward to balance these losses. In the Southern Hemisphere, the oceanic contribution to this flux involves a southward transport of heat across the APF into the Southern Ocean where it is given up to the atmosphere through air-sea interactions. In Part I, the air-sea interactions and structure of the near surface waters of the Southern Ocean are investigated with a three dimensional time dependent numerical model. The surface waters in this region in summer are characterized by a relatively warm surface mixed layer with low salinity. Below this layer, a cold temperature extremum is usually observed in vertical profiles which is believed to be the remnant of a deep surface mixed layer produced in winter. The characteristics of this layer, the surface mixed layer and the observed distribution of wintertime sea ice are reproduced well by this model. Unlike some other sea-ice models the air-sea heat exchange is a free variable. Model estimates of the annual heat loss by the Southern Ocean exhibit the observed meridional variation of heat gained by the ocean along the APF with heat lost further south. The model's area average heat loss is much smaller than that estimated with direct observations. While several model parameterizations were made which could be in error, the model results suggest that the Southern Ocean does give up vast amounts of heat to the atmosphere away from the continental margins. The model results and direct calculations of air-sea exchanges suggest a southward heat flux must occur across the APF. The lateral water mass transition across the front is not discontinuous but occurs over a finite sized zone of fluid which is dominated by intrusive finestructure. The characteristics and dynamics of these features are investigated in Part II to try and assess their importance in the meridional heat budget. Observations made on two cruises to the APF are presented and the space-time scales of the features and thermohaline characteristics are discussed. It is suggested that double diffusive processes dominated by salt fingering are active within the intrusions. An extension of Stern's (1967) model of the stability of a thermohaline front to intrusive finestructure driven by saltfingering where small scale viscous processes are included, is presented to explain why intrusions are observed in frontal zones. The model successfully predicts vertical scales of intrusions observed in the ocean and the observed dependence of the intrusions' slopes across density surfaces on the vertical scale. Since the fastest growing intrusion is not strongly determined by the model, though, it is likely that finite amplitude effects determine the dominant scale of interleaving in the ocean. The analysis predicts that intrusions transport heat, salt and density down the mean gradients of the front. For the APF, this heat flux is poleward which is the direction required by the global heat budget. This model does not describe intrusions at finite amplitude or in steady state and so cannot be used to estimate the magnitude of the poleward heat flux due to intrusions in the APF.The research reported on here, and my support as a graduate student was provided by the National Science Foundation through grants OCE 75 14056. OCE 76 82036 and OCE 77 28355

Integrating Feminist Approaches in Counseling Work With Adult Women

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. It further illustrates the benefits of FCT as a foundational framework supportive of various women’s concerns and demonstrates how the integration of FCT into counseling settings will enrich the counselor-client relationship and allow for improved outcomes

Coupling Human Mobility and Social Ties

Studies using massive, passively data collected from communication technologies have revealed many ubiquitous aspects of social networks, helping us understand and model social media, information diffusion, and organizational dynamics. More recently, these data have come tagged with geographic information, enabling studies of human mobility patterns and the science of cities. We combine these two pursuits and uncover reproducible mobility patterns amongst social contacts. First, we introduce measures of mobility similarity and predictability and measure them for populations of users in three large urban areas. We find individuals' visitations patterns are far more similar to and predictable by social contacts than strangers and that these measures are positively correlated with tie strength. Unsupervised clustering of hourly variations in mobility similarity identifies three categories of social ties and suggests geography is an important feature to contextualize social relationships. We find that the composition of a user's ego network in terms of the type of contacts they keep is correlated with mobility behavior. Finally, we extend a popular mobility model to include movement choices based on social contacts and compare it's ability to reproduce empirical measurements with two additional models of mobility

Patient Care Technology and the Nurse-Patient Relationship

Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing\u27s history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient\u27s perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the levels of nurse technological competency as caring and patient perceptions of caring and nurse presence, 2) to examine the relationships between patient and nurse demographics and levels of nurse technological competency as caring and patient perceptions of caring and nurse presence, and 3) to explore qualitatively the perceptions of the nurse and patient of technological device use in care delivery. Methods: A mixed methods, descriptive, concurrent embedded design with convenience sampling was conducted in early 2014 with 112 nurse and 115 patient participants. Study measures included the Technological Competency as Caring in Nursing Instrument, the Caring Behaviors Inventory-24, and the Presence of Nursing Scale. Qualitative data was derived from semi-structured interviews with a smaller subset of participants. The setting was a community adult acute care hospital in the southwestern United States. Descriptive and inferential statistics were conducted using SPSS version 22. Results: Nurses rated their technological competency as caring high, with a mean score of 82.71. Demographically, Asians reported a significantly higher mean score (M = 86.04) than other races. Patients rated overall nurse caring behaviors high (M = 5.44) with the positive connectedness subscale having the lowest mean score (M = 5.16). Gender and pain significantly influenced patient caring scores -- males rated overall caring, assurance of human presence, and positive connectedness higher than females. Positive connectedness was inversely related to pain occurrence. Patients rated nurse presence high (M = 115.82); age was positively correlated and significantly predicted presence scores. Qualitative themes included safety, learning and balance. Conclusions: This study examined ratings of nurse technological competency as caring, patient perceptions of caring and nurse presence in the context of an increasingly pervasive high technology environment. Safety, learning, and balance were themes which emerged when providers and patients reflected on how technology and device use was operationalized during care delivery

The Antarctic Circumpolar Current and the oceanic heat and freshwater budgets

Hydrographic sections that span the Antarctic Circumpolar Current are used to estimate the zonal heat and freshwater transports south of Africa, New Zealand and America. These in tum are used to calculate the exchanges of heat and freshwater between the three major oceans...

Fine- and microstructure observations at Fieberling Guyot : R/V New Horizon cruise report

This report describes fine- and microstructure profile data taken on a cruise to Fieberling Guyot, a seamount in the northeast subtropical Pacific Ocean. The work performed at sea, instruments used, data return and processing procedures will be summarized here. This cruise took place between March 4 and March 28, 1991 on the R/V New Horizon. and was part of the interdisciplinary Accelerated Research Initiative (ARI) for Abrupt Topography sponsored by the Office of Naval Research. An overall goal of the ARI was to understand the physical, biological, and geological processes occurring near a seamount. The scientific objective of the Seamount Mixing Cruise was to collect data describing the oceanic fine-scale velocity and density fields, as well as the related turbulence and mixing in the vicinity of the seamount. The High Resolution Profiler (HRP) was deployed 95 times above and around the seamount. As well, two test dives were conducted on the way to the site, and eight deployments completed in deep basdins off the southern California coast before returning to port. The near-synoptic surveys of the seamount were completed with the deployment of 128 Expendable Current Profilers (XCP's). The temperature field of the upper 760 meters of water within a 50 kilometer radius of the seamount was mapped using 144 Expendable Bathythermographs (XBT's).Funding was provided by the Office of Naval Research through Grant No. NOOOI4-89-J-1073

Interannual sea level variability in the western North Atlantic : regional forcing and remote response

© The Author(s), 2013. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Geophysical Research Letters 40 (2013): 5915–5919, doi:10.1002/2013GL058013.Annually averaged sea level (1970–2012) measured by tide gauges along the North American east coast is remarkably coherent over a 1700 km swath from Nova Scotia to North Carolina. Satellite altimetry (1993–2011) shows that this coherent interannual variability extends over the Middle Atlantic Bight, Gulf of Maine, and Scotian Shelf to the shelf break where there is a local minimum in sea level variance. Comparison with National Center for Environmental Prediction reanalysis winds suggests that a significant fraction of the detrended sea level variance is forced by the region's along-shelf wind stress. While interannual changes in sea level appear to be forced locally, altimetry suggests that the changes observed along the coast and over the shelf may influence the Gulf Stream path downstream of Cape Hatteras.M. Andres gratefully acknowledges support from the Woods Hole Oceanographic Institution’s Coastal Ocean Institute. G. Gawarkiewicz acknowledges the support of NSF grant OCE-1129125

A New Discrete Analytic Signal for Reducing Aliasing in the Discrete Wigner-Ville Distribution

It is not possible to generate an alias-free discrete Wigner--Ville distribution (DWVD) from a discrete analytic signal. This is because the discrete analytic signal must satisfy two mutually exclusive constraints. We present, in this article, a new discrete analytic signal that improves on the commonly used discrete analytic signal's approximation of these two constraints. Our analysis shows that---relative to the commonly used signal---the proposed signal reduces aliasing in the DWVD by approximately 50%. Furthermore, the proposed signal has a simple implementation and satisfies two important properties, namely, that its real component is equal to the original real signal and that its real and imaginary components are orthogonal