Modeling emergency department visit patterns for infectious disease complaints: results and application to disease surveillance

BACKGROUND: Concern over bio-terrorism has led to recognition that traditional public health surveillance for specific conditions is unlikely to provide timely indication of some disease outbreaks, either naturally occurring or induced by a bioweapon. In non-traditional surveillance, the use of health care resources are monitored in "near real" time for the first signs of an outbreak, such as increases in emergency department (ED) visits for respiratory, gastrointestinal or neurological chief complaints (CC). METHODS: We collected ED CCs from 2/1/94 – 5/31/02 as a training set. A first-order model was developed for each of seven CC categories by accounting for long-term, day-of-week, and seasonal effects. We assessed predictive performance on subsequent data from 6/1/02 – 5/31/03, compared CC counts to predictions and confidence limits, and identified anomalies (simulated and real). RESULTS: Each CC category exhibited significant day-of-week differences. For most categories, counts peaked on Monday. There were seasonal cycles in both respiratory and undifferentiated infection complaints and the season-to-season variability in peak date was summarized using a hierarchical model. For example, the average peak date for respiratory complaints was January 22, with a season-to-season standard deviation of 12 days. This season-to-season variation makes it challenging to predict respiratory CCs so we focused our effort and discussion on prediction performance for this difficult category. Total ED visits increased over the study period by 4%, but respiratory complaints decreased by roughly 20%, illustrating that long-term averages in the data set need not reflect future behavior in data subsets. CONCLUSION: We found that ED CCs provided timely indicators for outbreaks. Our approach led to successful identification of a respiratory outbreak one-to-two weeks in advance of reports from the state-wide sentinel flu surveillance and of a reported increase in positive laboratory test results

Neoconservatism as Discourse:Virtue, Power and US Foreign Policy

Neoconservatism in US foreign policy is a hotly contested subject, yet most scholars broadly agree on what it is and where it comes from. From a consensus that it first emerged around the 1960s, these scholars view neoconservatism through what we call the ‘3Ps’ approach, defining it as a particular group of people (‘neocons’), an array of foreign policy preferences and/or an ideological commitment to a set of principles. While descriptively intuitive, this approach reifies neoconservatism in terms of its specific and often static ‘symptoms’ rather than its dynamic constitutions. These reifications may reveal what is emblematic of neoconservatism in its particular historical and political context, but they fail to offer deeper insights into what is constitutive of neoconservatism. Addressing this neglected question, this article dislodges neoconservatism from itsperceived home in the ‘3Ps’ and ontologically redefines it as a discourse. Adopting aFoucauldian approach of archaeological and genealogical discourse analysis, we trace itsdiscursive formations primarily to two powerful and historically enduring discourses ofthe American self — virtue and power — and illustrate how these discourses produce aparticular type of discursive fusion that is ‘neoconservatism’. We argue that to betterappreciate its continued effect on contemporary and future US foreign policy, we needto pay close attention to those seemingly innocuous yet deeply embedded discoursesabout the US and its place in the world, as well as to the people, policies and principlesconventionally associated with neoconservatism

A Cost-Benefit Analysis of Management Training Programs June-December 1987

A Cost-Benefit Analysis of Management Training Programs investigates the costs associated with providing educational enrichment to employees and the subsequent benefits to the company as well as the individual. The problem lies in acquiring adequate proof that the benefits of training are greater than the costs. Companies involved in or considering management training need to buildup a source of information by trying to identify cost and benefits associated with the training process so that the premise that management training is a worthwhile undertaking can continue to exist in the corporate world. The research for this paper was taken from books, periodicals, current newspaper articles and interviews with people who have had training or are in the training field. The main emphasis of this paper is a questionnaire mailed to local companies to obtain current data in the spring of 1987. I feel the response to the survey has limited my research. Because the information needed to do an adequate cost-benefit analysis is considered confidential or is scattered throughout a firm or is expensed as overhead and is not categorized as a cost or benefit of training, the information necessary to do an analysis may not even be available within some companies. The commitment to educational enrichment in the tri-state area explored in this research is strongly influenced by local colleges and universities and the scholars they produce. This commitment has found its way into the corporate world. The result of my research is that benefits must exceed costs of management training programs or the time and money spent on training over the past ten years would not have continued to increase. My hope is that managers reading this paper will come to understand the importance of management training and understand the need to document their programs as thoroughly as possible

A POLYNOMIAL APPROACH TO STRUCTURAL GENE DYNAMICS MODELLING

Abstract: A new approach for modelling the dynamics of gene expression from time series microarray data is presented. A modelling method based on a continuous rep-resentation of Boolean functions in the form of Zhegalkin Polynomials is proposed. Structural information known from theoretical biology like the canalizing property can be included as well as continuous measurements of gene expression levels. As an example, its applicability to yeast data is demonstrated. The complexity of the problem requires efficient methods and tools. The discrete set of all Canalizing Boolean models consistent with the measurements is large and grows exponentially as the connectivity degree of each gene increases. This set can be defined in terms of the Zhegalkin Polynomial coefficients. Moreover, this paper gives two theorems on structural properties of Canalizing Zhegalkin Polynomials. An algorithm based upon them shows how these results can be used for identifying Canalizing Boolean functions. Copyright c©2005 IFA