Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program

The Centers for Disease Control and Prevention’s Sustainable Management Development Program (SMDP) partners with low - and middle - resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program’s impact however, was variable. Hence, there was a need to both engage in a strategic planning process and collect useful data to inform the process. We therefore designed a qualitative evaluation and findings that emerged concerning o ur program’s contribution to individual career advancement and professional growth; the need for institutional support and a champion to move public health management capacity development efforts forward in low - and middle - resource countries; and interest in diverse professional learning opportunities contributed to program improvement and suggested new strategic directions for CDC’s global public health management service delivery. Our inquiry provides a concrete example of how qualitative methods, specifically key informant interviews, can provide useful data for strategic planning within public health settings. It may be useful to readers who are interested in conducting strategic planning within public health and other related areas including health care, mental and behavioral health, and the social sciences

Eye See Eye Learn The Benefit of Comprehensive Eye Examinations for Preschoolers

Objective: Undetected vision problems in children can lead to permanent vision loss, a condition known as amblyopia. Early detection and treatment of the causes of amblyopia may prevent this vision loss. The objective of this paper is to look for evidence that comprehensive eye examinations upon entry to junior Kindergarten are an effective way to identify and treat vision problems early. methods: Relevant peer-reviewed publications on amblyopia and the importance of comprehensive eye examinations were reviewed. Specific areas investigated include: the prevalence and causes of amblyopia; impact of vision problems on child development and education; impact of amblyopia and/or strabismus on quality of life; and the cost effectiveness of treating amblyopia. The validity of vision screening compared to a comprehensive eye examination was also reviewed. Synthesis:The review suggests that without a complete eye examination many eye or vision problems remain undetected at school entry. Left uncorrected these problems negatively impact child development, education and quality of life. Reduced vision due to amblyopia also restricts future employment opportunities and increases the risk of bilateral visual impairment in adulthood. Examination procedures with high sensitivity and specificity are required to accurately detect these problems. Studies show that amblyopia treatment initiated at an early age is one of the most cost-effective of all health interventions. Conclusion: There is good evidence in the literature that a full eye examination is critical to detect all cases of amblyopia. This and other visual problems can be detected and managed at an early age, which leads to better visual quality of life and economical outcomes. The Eye See Eye Learn program offers the “gold standard” of eye care

Does the choice of neighbourhood supermarket access measure influence associations with individual-level fruit and vegetable consumption? A case study from Glasgow

BackgroundPrevious studies have provided mixed evidence with regards to associations between food store access and dietary outcomes. This study examines the most commonly applied measures of locational access to assess whether associations between supermarket access and fruit and vegetable consumption are affected by the choice of access measure and scale.MethodSupermarket location data from Glasgow, UK (n = 119), and fruit and vegetable intake data from the \u27Health and Well-Being\u27 Survey (n = 1041) were used to compare various measures of locational access. These exposure variables included proximity estimates (with different points-of-origin used to vary levels of aggregation) and density measures using three approaches (Euclidean and road network buffers and Kernel density estimation) at distances ranging from 0.4 km to 5 km. Further analysis was conducted to assess the impact of using smaller buffer sizes for individuals who did not own a car. Associations between these multiple access measures and fruit and vegetable consumption were estimated using linear regression models.ResultsLevels of spatial aggregation did not impact on the proximity estimates. Counts of supermarkets within Euclidean buffers were associated with fruit and vegetable consumption at 1 km, 2 km and 3 km, and for our road network buffers at 2 km, 3 km, and 4 km. Kernel density estimates provided the strongest associations and were significant at a distance of 2 km, 3 km, 4 km and 5 km. Presence of a supermarket within 0.4 km of road network distance from where people lived was positively associated with fruit consumption amongst those without a car (coef. 0.657; s.e. 0.247; p0.008).ConclusionsThe associations between locational access to supermarkets and individual-level dietary behaviour are sensitive to the method by which the food environment variable is captured. Care needs to be taken to ensure robust and conceptually appropriate measures of access are used and these should be grounded in a clear a priori reasoning

Quantifying distance of edge influence: a comparison of methods and a new randomization method

Published VersionDespite many studies on edge influence in forests, there is no common method for estimating distance of edge influence (DEI, = edge width). We introduce a new randomization method (RTEI) for estimating DEI that tests the significance of edge influence compared to the reference forest. Using artificial datasets we compared DEI as estimated by nine different methods and examined effects of sampling design and the nature of the edge response. DEI estimates varied widely among methods; parametric, randomization and curve-fitting analyses produced the lowest, intermediate and greatest values, respectively. Sampling design and the nature of the edge response affected estimates of DEI differently among methods. RTEI was the only method that was generally invariable to sampling design while being sensitive to variation in the reference ecosystem but not at the edge. A standard method of quantifying DEI is important for comparing edge responses among different studies for conservation research

Multiwavelength Variations of 3C 454.3 during the November 2010 to January 2011 Outburst

We present multiwavelength data of the blazar 3C 454.3 obtained during an extremely bright outburst from November 2010 through January 2011. These include flux density measurements with the Herschel Space Observatory at five submillimeter-wave and far-infrared bands, the Fermi Large Area Telescope at gamma-ray energies, Swift at X-ray, ultraviolet (UV), and optical frequencies, and the Submillimeter Array at 1.3 mm. From this dataset, we form a series of 52 spectral energy distributions (SEDs) spanning nearly two months that are unprecedented in time coverage and breadth of frequency. Discrete correlation anlaysis of the millimeter, far-infrared, and gamma-ray light curves show that the variations were essentially simultaneous, indicative of co-spatiality of the emission, at these wavebands. In contrast, differences in short-term fluctuations at various wavelengths imply the presence of inhomegeneities in physical conditions across the source. We locate the site of the outburst in the parsec-scale core, whose flux density as measured on 7 mm Very Long Baseline Array images increased by 70 percent during the first five weeks of the outburst. Based on these considerations and guided by the SEDs, we propose a model in which turbulent plasma crosses a conical standing shock in the parsec-scale region of the jet. Here, the high-energy emission in the model is produced by inverse Compton scattering of seed photons supplied by either nonthermal radiation from a Mach disk, thermal emission from hot dust, or (for X-rays) synchrotron radiation from plasma that crosses the standing shock. For the two dates on which we fitted the model SED to the data, the model corresponds very well to the observations at all bands except at X-ray energies, where the spectrum is flatter than observed.Comment: Accepted for publication in Astrophysical Journal. 82 pages, 13 figure

Eye See Eye Learn L’avantage des examens complets de la vue chez les enfants d’âge préscolaire

Objectifs : Chez les enfants, les problèmes de vision non détectés peuvent entraîner une perte permanente de la vision, problème appelé amblyopie. La détection et le traitement précoces des causes de l’amblyopie peuvent éviter cette perte de vision. Cette communication vise à chercher des éléments probants démontrant que les examens complets de la vue au moment de l’entrée en prématernelle constituent un moyen efficace de repérer et de traiter rapidement les problèmes de vision. Méthodes : Nous avons étudié des publications pertinentes critiquées par des pairs portant sur l’amblyopie et sur l’importance des examens complets de la vue. Les aspects précis étudiés comprennent la prévalence et les causes de l’amblyopie, l’effet des problèmes de vision sur le développement et l’éducation de l’enfant, l’effet de l’amblyopie ou du strabisme sur la qualité de vie et la rentabilité du traitement de l’amblyopie. Nous avons évalué aussi la validité de ces tests de dépistage comparativement à l’examen complet de la vue. Résumé : L ’étude indique que sans examen complet de la vue, beaucoup de problèmes oculovisuels ne sont pas détectés à l’arrivée de l’enfant à l’école. S’ils ne sont pas corrigés, ces problèmes ont un effet négatif sur le développement, l’éducation et la qualité de vie de l’enfant. La baisse de la vue causée par l’amblyopie limite aussi les possibilités d’emploi futures et accroît le risque de déficience visuelle bilatérale chez l’adulte. Des méthodes d’examen très sensibles et spécifiques s’imposent pour repérer ces problèmes avec précision. Des études montrent que le traitement de l’amblyopie à un jeune âge constitue une des interventions les plus rentables en santé. Conclusion : Les publications contiennent de bons éléments de preuve indiquant qu’un examen complet de la vue joue un rôle crucial dans la détection de tous les cas d’amblyopie. Il est possible de détecter et de traiter l’amblyopie et d’autres problèmes de vision à un jeune âge, ce qui améliore les résultats reliés à la vue, à la qualité de vie et à l’économie. Le programme Eye See Eye Learn offre « l'étalon-or » des soins oculovisuels. &nbsp

Oxidized phospholipids are proinflammatory and proatherogenic in hypercholesterolaemic mice.

Oxidized phospholipids (OxPL) are ubiquitous, are formed in many inflammatory tissues, including atherosclerotic lesions, and frequently mediate proinflammatory changes 1 . Because OxPL are mostly the products of non-enzymatic lipid peroxidation, mechanisms to specifically neutralize them are unavailable and their roles in vivo are largely unknown. We previously cloned the IgM natural antibody E06, which binds to the phosphocholine headgroup of OxPL, and blocks the uptake of oxidized low-density lipoprotein (OxLDL) by macrophages and inhibits the proinflammatory properties of OxPL2-4. Here, to determine the role of OxPL in vivo in the context of atherogenesis, we generated transgenic mice in the Ldlr-/- background that expressed a single-chain variable fragment of E06 (E06-scFv) using the Apoe promoter. E06-scFv was secreted into the plasma from the liver and macrophages, and achieved sufficient plasma levels to inhibit in vivo macrophage uptake of OxLDL and to prevent OxPL-induced inflammatory signalling. Compared to Ldlr-/- mice, Ldlr -/- E06-scFv mice had 57-28% less atherosclerosis after 4, 7 and even 12 months of 1% high-cholesterol diet. Echocardiographic and histologic evaluation of the aortic valves demonstrated that E06-scFv ameliorated the development of aortic valve gradients and decreased aortic valve calcification. Both cholesterol accumulation and in vivo uptake of OxLDL were decreased in peritoneal macrophages, and both peritoneal and aortic macrophages had a decreased inflammatory phenotype. Serum amyloid A was decreased by 32%, indicating decreased systemic inflammation, and hepatic steatosis and inflammation were also decreased. Finally, the E06-scFv prolonged life as measured over 15 months. Because the E06-scFv lacks the functional effects of an intact antibody other than the ability to bind OxPL and inhibit OxLDL uptake in macrophages, these data support a major proatherogenic role of OxLDL and demonstrate that OxPL are proinflammatory and proatherogenic, which E06 counteracts in vivo. These studies suggest that therapies inactivating OxPL may be beneficial for reducing generalized inflammation, including the progression of atherosclerosis, aortic stenosis and hepatic steatosis

RNA:DNA hybrids are a novel molecular pattern sensed by TLR9.

The sensing of nucleic acids by receptors of the innate immune system is a key component of antimicrobial immunity. RNA:DNA hybrids, as essential intracellular replication intermediates generated during infection, could therefore represent a class of previously uncharacterised pathogen-associated molecular patterns sensed by pattern recognition receptors. Here we establish that RNA:DNA hybrids containing viral-derived sequences efficiently induce pro-inflammatory cytokine and antiviral type I interferon production in dendritic cells. We demonstrate that MyD88-dependent signalling is essential for this cytokine response and identify TLR9 as a specific sensor of RNA:DNA hybrids. Hybrids therefore represent a novel molecular pattern sensed by the innate immune system and so could play an important role in host response to viruses and the pathogenesis of autoimmune disease

Subsoil contraints and their management: Overview from five years of R&D

Subsoil constraints cost the grains industry more than $1.6b in lost production each year. Diagnosing and mapping subsoil constraints (SSC) was achieved at a shire scale using the DPIRD soils database and historic surveys