Global Preparedness for Public Health

There are many reasons to be interested in public health in China. China is the single most populous nation on earth and was the point of origin for SARS and probably for most pandemic influenza viruses, past and future. In this issue of the Journal, we get a valuable window into the organization of public health emergency preparedness in China in the form of the paper, "Preparing and responding to public health emergencies in China: Results of a focus group study". This paper summarizes the results of focus groups conducted with 47 local- and provincial-level public health officials, and includes some of the most complete information on Chinese public health emergency preparedness at the working level. That makes it an invaluable contribution to the growing literature on public health emergency preparedness

Global Infectious Disease Surveillance And Health Intelligence

Current concerns about the spread of infectious diseases, especially unexpected (“emerging”) infections such as pandemic influenza or severe acute respiratory syndrome (SARS), have renewed focus on the critical importance of global early warning and rapid response. Although considerable progress has been made, many gaps remain. A number of the gaps can be addressed through increased political will, resources for reporting, improved coordination and sharing of information, raising clinicians’ awareness, and additional research to develop more rigorous triggers for action. The increasing availability of communications and information technologies worldwide offers new opportunities for reporting even in low-capacity settings

First Steps: A Pilot Preparedness Program for Public Health Nurses

Public health will face major challenges in the coming decades. The 1999 West Nile outbreak in New York City and other recent incidents demonstrate how important public health is as a frontline defense against emerging infections, bioterrorism, and other unexpected emergencies. A well-prepared public health workforce is more critical than ever. The challenges are particularly great in urban areas, which traditionally serve as ports of entry, may be appealing targets to terrorists, and have large and diverse populations with complex health risk factors. To better prepare the public health workforce to carry out routine functions effectively and fulfill the additional roles required in emergencies, a national network of "Centers for Public Health Preparedness" has been established by the Centers for Disease Control and Prevention (CDC). The network currently includes seven academic Centers funded through a cooperative agreement with the Association of Schools of Public Health (ASPH). Goals include the development of competency-based public health practice courses primarily designed to utilize distance-learning technology (such as World Wide Web-based instruction) that can be implemented locally and replicated nationally. The Center for Public Health Preparedness at the Mailman School of Public Health, Columbia University, is working toward these goals in partnership with the New York City Department of Health (NYC DOH)

First Steps: A Pilot Preparedness Program for Public Health Nurses

Public health will face major challenges in the coming decades. The 1999 West Nile outbreak in New York City and other recent incidents demonstrate how important public health is as a frontline defense against emerging infections, bioterrorism, and other unexpected emergencies. A well-prepared public health workforce is more critical than ever. The challenges are particularly great in urban areas, which traditionally serve as ports of entry, may be appealing targets to terrorists, and have large and diverse populations with complex health risk factors. To better prepare the public health workforce to carry out routine functions effectively and fulfill the additional roles required in emergencies, a national network of "Centers for Public Health Preparedness" has been established by the Centers for Disease Control and Prevention (CDC). The network currently includes seven academic Centers funded through a cooperative agreement with the Association of Schools of Public Health (ASPH). Goals include the development of competency-based public health practice courses primarily designed to utilize distance-learning technology (such as World Wide Web-based instruction) that can be implemented locally and replicated nationally. The Center for Public Health Preparedness at the Mailman School of Public Health, Columbia University, is working toward these goals in partnership with the New York City Department of Health (NYC DOH)

Life under the "new normal": notes on the future of preparedness

Being prepared for emergencies is not a new concept. At every level of government there are contingency plans for natural disasters, accidental catastrophes, local events and personal emergencies of every conceivable manner. Organizations from the Red Cross to the Federal Emergency Management Agency to hospital emergency departments are in a constant state of readiness. Often, regionally specific plans are in place based on expectations of particular kinds of disasters: earthquakes in the West, hurricanes on the East Coast, and tornados in the Midwest. In fact, long before 9/11, even terrorism had been on the minds of at least a handful of stalwart preparedness experts – mostly in the military and in special governmental agencies (Benjamin & Simon, 2002; Stern, 2003; Clarke, 2004). The chapters in this volume survey the state of our understanding of the psychological response to terrorism and other exigent events. It is clear that much has been learned. At the same time, many questions remain. What are the best interventions post-event? How do we recognize those in most immediate need, or those who may be most susceptible, other than those with pre-existing psychopathology? (North et al. this volume). What sorts of pre-event messages are the most useful for preparing the community

Life under the "new normal": notes on the future of preparedness

Being prepared for emergencies is not a new concept. At every level of government there are contingency plans for natural disasters, accidental catastrophes, local events and personal emergencies of every conceivable manner. Organizations from the Red Cross to the Federal Emergency Management Agency to hospital emergency departments are in a constant state of readiness. Often, regionally specific plans are in place based on expectations of particular kinds of disasters: earthquakes in the West, hurricanes on the East Coast, and tornados in the Midwest. In fact, long before 9/11, even terrorism had been on the minds of at least a handful of stalwart preparedness experts – mostly in the military and in special governmental agencies (Benjamin & Simon, 2002; Stern, 2003; Clarke, 2004). The chapters in this volume survey the state of our understanding of the psychological response to terrorism and other exigent events. It is clear that much has been learned. At the same time, many questions remain. What are the best interventions post-event? How do we recognize those in most immediate need, or those who may be most susceptible, other than those with pre-existing psychopathology? (North et al. this volume). What sorts of pre-event messages are the most useful for preparing the community

The US pandemic influenza implementation plan at six months

There has been great concern recently about pandemic influenza. The US government developed a National Strategy for Pandemic Influenza in November 2005, followed by an implementation plan in May 2006. A six-month progress report was published in late December. The current strategies are intended to improve preparedness and response for the next influenza pandemic. In comparison with the optimistic neglect that often characterized past planning for pandemic influenza, there has been considerable progress on a number of fronts in the past year. Despite this progress, major gaps remain. These include the coordination, encouragement and funding of international surveillance and cooperation; the need for new and more agile vaccine technologies; limitations in the use and distribution of antiviral agents; and communication with, and resources for, local responders and the public. One question is why, despite an estimated 36,000 seasonal influenza deaths annually in the United States alone, and a much greater number during pandemics, relatively little new basic research has been done for decades. This emphasizes both the need for and the difficulty of sustaining pandemic preparedness

Factores en la emergencia de las enfermedades infecciosas : (HIV, Hantavirus, Enfermedad de Lyme, Sindrome urémico hemolítico, Dengue, Ebola)

Las enfermedades infecciosas «Emergentes» pueden definirse como infecciones nuevas que han aparecido en una población o han existido pero rápidamente aumentan en incidencia o distribución geográfica. Entre los ejemplos recientes están el HIV/SIDA, síndrome pulmonar por hantavirus, Enfermedad de Lyme, y síndrome urémico-hemolítico (una infección alimenticia ocasionada por ciertas cepas de Escherichia coli). Los factores específicos que precipitan a las enfermedades emergentes pueden identificarse en virtualmente todos los casos. Estos incluyen factores demográficos, ambientales, o ecológicos para la gente del lugar con un mayor contacto con un microorganismo no familiarizado anteriormente o con su hospedador natural o que promueve su diseminación. Estos factores aumentan la prevalencia; y este aumento, junto con la evolución de variantes microbianas y virales y la selección de resistencia a drogas, sugiere que las infecciones continuarán apareciendo y probablemente aumentarán, lo que refuerza la urgente necesidad del control para una vigilancia efectiva. El artículo del Dr. David Satcher y esta descripción inaugura «Perspectivas» una sección regular en esta revista destinada a presentar y desarrollar conceptos uniformes y estrategias para considerar a las infecciones emergentes y sus factores subyacentes. Los editores reciben, como contribuciones a la sección Perspectivas, descripciones, síntesis, y estudios de casos que vislumbren sobre como y por qué surgen las infecciones, y como pueden anticiparse y prevenirse.Facultad de Ciencias Veterinaria

Zoom invariant vision of figural shape: The mathematics of cores

Believing that figural zoom invariance and the cross-figural boundary linking implied by medial loci are important aspects of object shape, we present the mathematics of and algorithms for the extraction of medial loci directly from image intensities. The medial loci called cores are defined as generalized maxima in scale space of a form of medial information that is invariant to translation, rotation, and in particular, zoom. These loci are very insensitive to image disturbances, in strong contrast to previously available medial loci, as demonstrated in a companion paper. Core-related geometric properties and image object representations are laid out which, together with the aforementioned insensitivities, allow the core to be used effectively for a variety of image analysis objectives.