Needs Assessment of Barriers to Cervical Cancer Screening in Vietnamese American Health Care Providers

Vietnamese women living in the United States have a cervical cancer incidence rate that is five times that of White women. The low rate of cervical cancer screening among this high-risk population contributes to this disparity. In 2004, the National Cancer Institute collaborated with the Vietnamese American Medical Association to conduct a short needs assessment questionnaire (Pap Test Barriers Questionnaire for Health Care Providers) among its members to assess provider views about cervical cancer, barriers to Pap testing among Vietnamese women living in the United States, and types of patient education materials needed to help motivate Vietnamese women to receive a Pap test. Information from the questionnaire was used to inform development of a brochure and identify additional strategies to enhance outreach to Vietnamese women and providers. Almost all of the respondents (95%) thought that Pap tests were “very important” in the early detection of cervical cancer in Vietnamese women. In addition, knowledge about the importance of Pap tests was identified as the most influential factor for Vietnamese women not seeking a Pap test. Print materials that included both English and Vietnamese translations in the same publication were cited as a preferred communication tool. Further, health education through Vietnamese media was recommended as a primary strategy for reaching women with educational messages. Findings from this needs assessment contributes to a larger formative research effort to build NCI’s cervical cancer education program within its Office of Education and Special Initiatives

A survey of UK healthcare workers' attitudes on volunteering to help with the Ebola outbreak in West Africa

Objective To understand the barriers and enablers for UK healthcare workers who are considering going to work in the current Ebola outbreak in West Africa, but have not yet volunteered. Design After focus group discussions, and a pilot questionnaire, an anonymous survey was conducted using SurveyMonkey to determine whether people had considered going to West Africa, what factors might make them more or less likely to volunteer, and whether any of these were modifiable factors. Participants The survey was publicised among doctors, nurses, laboratory staff and allied health professionals. 3109 people answered the survey, of whom 472 (15%) were considering going to work in the epidemic but had not yet volunteered. 1791 (57.6%) had not considered going, 704 (22.6%) had considered going but decided not to, 53 (1.7%) had volunteered to go and 14 (0.45%) had already been and worked in the epidemic. Results For those considering going to West Africa, the most important factor preventing them from volunteering was a lack of information to help them decide; fear of getting Ebola and partners’ concerns came next. Uncertainty about their potential role, current work commitments and inability to get agreement from their employer were also important barriers, whereas clarity over training would be an important enabler. In contrast, for those who were not considering going, or who had decided against going, family considerations and partner concerns were the most important factors. Conclusions More UK healthcare workers would volunteer to help tackle Ebola in West Africa if there was better information available, including clarity about roles, cover arrangements, and training. This could be achieved with a well-publicised high quality portal of reliable information

Risk of Subsequent Coronary Heart Disease in Patients Hospitalized for Immune-Mediated Diseases: A Nationwide Follow-Up Study from Sweden

Background: Certain immune-mediated diseases (IMDs), such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to cardiovascular disorders. We examined whether there is an association between 32 different IMDs and risk of subsequent hospitalization for coronary heart disease (CHD) related to coronary atherosclerosis in a nationwide follow up study in Sweden. Methods and Findings: All individuals in Sweden hospitalized with a main diagnosis of an IMD (n = 336,479) without previous or coexisting CHD, between January 1, 1964 and December 31 2008, were followed for first hospitalization for CHD. The reference population was the total population of Sweden. Standardized incidence ratios (SIRs) for CHD were calculated. Overall risk of CHD during the first year after hospitalization for an IMD was 2.92 (95 % CI 2.84–2.99). Twentyseven of the 32 IMDs studied were associated with an increased risk of CHD during the first year after hospitalization. The overall risk of CHD decreased over time, from 1.75 after 1–5 years (95 % CI 1.73–1.78), to 1.43 after 5–10 years (95 % CI 1.41– 1.46) and 1.28 after 10+ years (95 % CI 1.26–1.30). Females generally had higher SIRs than males. The IMDs for which the SIRs of CDH were highest during the first year after hospitalization included chorea minor 6.98 (95 % CI 1.32–20.65), systemic lupus erythematosus 4.94 (95 % CI 4.15–5.83), rheumatic fever 4.65 (95 % CI 3.53–6.01), Hashimoto’s thyroiditis 4.30 (95 % CI 3.87–4.75), polymyositis/dermatomyositis 3.81 (95 % CI 2.62–5.35), polyarteritis nodosa 3.81 (95 % CI 2.72–5.19), rheumatoi

Genotype V Japanese Encephalitis Virus Is Emerging

Japanese encephalitis (JE) is a global public health issue that has spread widely to more than 20 countries in Asia and has extended its geographic range to the south Pacific region including Australia. JE has become the most important cause of viral encephalitis in the world. Japanese encephalitis viruses (JEV) are divided into five genotypes, based on the nucleotide sequence of the envelope (E) gene. The Muar strain, isolated from patient in Malaya in 1952, is the sole example of genotype V JEV. Here, the XZ0934 strain of JEV was isolated from Culex tritaeniorhynchus, collected in China. The complete nucleotide and amino acid sequence of XZ0934 strain have been determined. The nucleotide divergence ranged from 20.3% to 21.4% and amino acid divergence ranged from 8.4% to 10.0% when compared with the 62 known JEV isolates that belong to genotype I–IV. It reveals low similarity between XZ0934 and genotype I–IV JEVs. Phylogenetic analysis using both complete genome and structural gene nucleotide sequences demonstrates that XZ0934 belongs to genotype V. This, in turn, suggests that genotype V JEV is emerging in JEV endemic areas. Thus, increased surveillance and diagnosis of viral encephalitis caused by genotype V JEV is an issue of great concern to nations in which JEV is endemic

The geographical distribution and burden of trachoma in Africa.

BACKGROUND: There remains a lack of epidemiological data on the geographical distribution of trachoma to support global mapping and scale up of interventions for the elimination of trachoma. The Global Atlas of Trachoma (GAT) was launched in 2011 to address these needs and provide standardised, updated and accessible maps. This paper uses data included in the GAT to describe the geographical distribution and burden of trachoma in Africa. METHODS: Data assembly used structured searches of published and unpublished literature to identify cross-sectional epidemiological data on the burden of trachoma since 1980. Survey data were abstracted into a standardised database and mapped using geographical information systems (GIS) software. The characteristics of all surveys were summarized by country according to data source, time period, and survey methodology. Estimates of the current population at risk were calculated for each country and stratified by endemicity class. RESULTS: At the time of writing, 1342 records are included in the database representing surveys conducted between 1985 and 2012. These data were provided by direct contact with national control programmes and academic researchers (67%), peer-reviewed publications (17%) and unpublished reports or theses (16%). Prevalence data on active trachoma are available in 29 of the 33 countries in Africa classified as endemic for trachoma, and 1095 (20.6%) districts have representative data collected through population-based prevalence surveys. The highest prevalence of active trachoma and trichiasis remains in the Sahel area of West Africa and Savannah areas of East and Central Africa and an estimated 129.4 million people live in areas of Africa confirmed to be trachoma endemic. CONCLUSION: The Global Atlas of Trachoma provides the most contemporary and comprehensive summary of the burden of trachoma within Africa. The GAT highlights where future mapping is required and provides an important planning tool for scale-up and surveillance of trachoma control

Risk of subsequent ischemic and hemorrhagic stroke in patients hospitalized for immune-mediated diseases: a nationwide follow-up study from Sweden

Background: Certain immune-mediated diseases (IMDs) have been associated with increased risk for cardiovascular disorders. The aim of the present study was to examine whether there is an association between 32 different IMDs and first hospitalization for ischemic or hemorrhagic stroke. Methods: All individuals in Sweden hospitalized with a main diagnosis of IMD (without previous or coexisting stroke), between January 1, 1987 and December 31, 2008 (n = 216,291), were followed for first hospitalization for ischemic or hemorrhagic stroke. The reference population was the total population of Sweden. Adjusted standardized incidence ratios (SIRs) for ischemic and hemorrhagic stroke were calculated. Results: Totally 20 and 15 of the 32 IMDs studied, respectively, were associated with an increased risk of ischemic and hemorrhagic stroke during the follow-up. The overall risks of ischemic and hemorrhagic stroke during the first year after hospitalization for IMD were 2.02 (95 % CI 1.90-2.14) and 2.65 (95 % CI 2.27-3.08), respectively. The overall risk of ischemic or hemorrhagic stroke decreased over time, to 1.50 (95 % CI 1.46-1.55) and 1.83 (95 % CI 1.69-1.98), respectively, after 1-5 years, and 1.29 (95 % CI 1.23-1.35) and 1.47 (95 % CI 1.31-1.65), respectively, after 10+ years. The risk of hemorrhagic stroke was >= 2 during the first year after hospitalization for seven IMDs: ankylosing spondylitis (SIR = 8.11), immune thrombocytopenic purpura (SIR = 8.60), polymyalgia rheumatica (SIR = 2.06), psoriasis (SIR = 2.88), rheumatoid arthritis (SIR = 3.27), systemic lupus erythematosus (SIR = 8.65), and Wegener ' s granulomatosis (SIR = 5.83). The risk of ischemic stroke was >= 2 during the first year after hospitalization for twelve IMDs: Addison's disease (SIR = 2.71), Crohn's disease (SIR = 2.15), Grave's disease (SIR = 2.15), Hashimoto's thyroiditis (SIR = 2.99), immune thrombocytopenic purpura (SIR = 2.35), multiple sclerosis (SIR = 3.05), polymyositis/dermatomyositis (SIR = 3.46), rheumatic fever (SIR = 3.91), rheumatoid arthritis (SIR = 2.08), Sjgren's syndrome (SIR = 2.57), systemic lupus erythematosus (SIR = 2.21), and ulcerative colitis (SIR = 2.15). Conclusions: Hospitalization for many IMDs is associated with increased risk of ischemic or hemorrhagic stroke. The findings suggest that several IMDs are linked to cerebrovascular disease

Spatial distribution estimation of malaria in northern China and its scenarios in 2020, 2030, 2040 and 2050

© 2016 The Author(s). Background: Malaria is one of the most severe parasitic diseases in the world. Spatial distribution estimation of malaria and its future scenarios are important issues for malaria control and elimination. Furthermore, sophisticated nonlinear relationships for prediction between malaria incidence and potential variables have not been well constructed in previous research. This study aims to estimate these nonlinear relationships and predict future malaria scenarios in northern China. Methods: Nonlinear relationships between malaria incidence and predictor variables were constructed using a genetic programming (GP) method, to predict the spatial distributions of malaria under climate change scenarios. For this, the examples of monthly average malaria incidence were used in each county of northern China from 2004 to 2010. Among the five variables at county level, precipitation rate and temperature are used for projections, while elevation, water density index, and gross domestic product are held at their present-day values. Results: Average malaria incidence was 0.107 per annum in northern China, with incidence characteristics in significant spatial clustering. A GP-based model fit the relationships with average relative error (ARE) = 8.127 % for training data (R2 = 0.825) and 17.102 % for test data (R2 = 0.532). The fitness of GP results are significantly improved compared with those by generalized additive models (GAM) and linear regressions. With the future precipitation rate and temperature conditions in Special Report on Emission Scenarios (SRES) family B1, A1B and A2 scenarios, spatial distributions and changes in malaria incidences in 2020, 2030, 2040 and 2050 were predicted and mapped. Conclusions: The GP method increases the precision of predicting the spatial distribution of malaria incidence. With the assumption of varied precipitation rate and temperature, and other variables controlled, the relationships between incidence and the varied variables appear sophisticated nonlinearity and spatially differentiation. Using the future fluctuated precipitation and the increased temperature, median malaria incidence in 2020, 2030, 2040 and 2050 would significantly increase that it might increase 19 to 29 % in 2020, but currently China is in the malaria elimination phase, indicating that the effective strategies and actions had been taken. While the mean incidences will not increase even reduce due to the incidence reduction in high-risk regions but the simultaneous expansion of the high-risk areas

Flux Phase as a Dynamic Jahn-Teller Phase: Berryonic Matter in the Cuprates?

There is considerable evidence for some form of charge ordering on the hole-doped stripes in the cuprates, mainly associated with the low-temperature tetragonal phase, but with some evidence for either charge density waves or a flux phase, which is a form of dynamic charge-density wave. These three states form a pseudospin triplet, demonstrating a close connection with the E X e dynamic Jahn-Teller effect, suggesting that the cuprates constitute a form of Berryonic matter. This in turn suggests a new model for the dynamic Jahn-Teller effect as a form of flux phase. A simple model of the Cu-O bond stretching phonons allows an estimate of electron-phonon coupling for these modes, explaining why the half breathing mode softens so much more than the full oxygen breathing mode. The anomalous properties of $O^{2-}$ provide a coupling (correlated hopping) which acts to stabilize density wave phases.Comment: Major Revisions: includes comparisons with specific cuprate phonon modes, 16 eps figures, revte