Planning an integrated disease surveillance and response system: a matrix of skills and activities

<p>Abstract</p> <p>Background</p> <p>The threat of a global influenza pandemic and the adoption of the World Health Organization (WHO) International Health Regulations (2005) highlight the value of well-coordinated, functional disease surveillance systems. The resulting demand for timely information challenges public health leaders to design, develop and implement efficient, flexible and comprehensive systems that integrate staff, resources, and information systems to conduct infectious disease surveillance and response. To understand what resources an integrated disease surveillance and response system would require, we analyzed surveillance requirements for 19 priority infectious diseases targeted for an integrated disease surveillance and response strategy in the WHO African region.</p> <p>Methods</p> <p>We conducted a systematic task analysis to identify and standardize surveillance objectives, surveillance case definitions, action thresholds, and recommendations for 19 priority infectious diseases. We grouped the findings according to surveillance and response functions and related them to community, health facility, district, national and international levels.</p> <p>Results</p> <p>The outcome of our analysis is a matrix of generic skills and activities essential for an integrated system. We documented how planners used the matrix to assist in finding gaps in current systems, prioritizing plans of action, clarifying indicators for monitoring progress, and developing instructional goals for applied epidemiology and in-service training programs.</p> <p>Conclusion</p> <p>The matrix for Integrated Disease Surveillance and Response (IDSR) in the African region made clear the linkage between public health surveillance functions and participation across all levels of national health systems. The matrix framework is adaptable to requirements for new programs and strategies. This framework makes explicit the essential tasks and activities that are required for strengthening or expanding existing surveillance systems that will be able to adapt to current and emerging public health threats.</p

Improved Nonrelativistic QCD for Heavy Quark Physics

We construct an improved version of nonrelativistic QCD for use in lattice simulations of heavy quark physics, with the goal of reducing systematic errors from all sources to below 10\%. We develop power counting rules to assess the importance of the various operators in the action and compute all leading order corrections required by relativity and finite lattice spacing. We discuss radiative corrections to tree level coupling constants, presenting a procedure that effectively resums the largest such corrections to all orders in perturbation theory. Finally, we comment on the size of nonperturbative contributions to the coupling constants.Comment: 40 pages, 2 figures (not included), in LaTe

A Test of the MSEC Method for Paleoclimate and intersite correlations from Late Pleistocene/Holocene cave sites in southern Europe : results from Cova de les Cendres, SE Spain

En los ultlmos diez alios, se han utilizado las mediciones de la susceptibilidad magnetica (MS) de los sedimentos de los yacimientos arqueologicos en cueva para establecer correlaciones entre yacimientos y una estimacion del paleoclima. Ello es posible porque la MS correspondiente a estos sedimentos es el resultado de los procesos activos del clima en el exterior de las cavidades y las variaciones en las propiedades magneticas de los sedimentos, que finalmente se acumulan en el interior de las cavidades. Una vez que se ban depositado, estos materiales son preservados y su estratigraffa proporciona una informacion sobre el clima que puede ser inferida. En este trabajo, al usar la magnetosusceptibilidad, el metodo de cicloestratigrafia (MSEC) y la correlacion grafica, presentamos informacion sobre la Cova de les Cendres y situamos estos resultados en un marco paleoclimatico que abarca los ultimos 43.000 anos (fechas BP sin calibrar) de la Europa meridional. Estos resultados correlacionan bien con otros indicadores independientes de clima. Ademas, a causa de que los sedimentos de la parte superior de la Cova de les Cendres se depositaron relativamente rapidos, es posible observar cambios climaticos de escala ultra-fina en los dates de esta parte de la secuencia en la cavidad.During the last 10 years or so, magnetic susceptibility (MS) measurements of cave sediments from archaeological sites have been used for intra-site correlation and paleoclimate estimation. This is possible because the MS of these sediments results from climate processes active outside caves causing variations in magnetic properties of the sediments ultimately accumulating inside of caves. Once deposited, these materials are preserved and their stratigraphy provides a climate proxy that can be extracted. Here, using the magnetosusceptibility event and cyclostratigraphy (MSEC) method and graphic correlation, we present data from Cova de les Cendres and place these results into a paleoclimatic framework for the last 43,000 years (uncalibrated BP) for southern Europe. These results correlate well with independent climate indicators. In addition, because sediments in the upper part of Cova de les Cendres were deposited relatively quickly, it is possible to see ultra fine scale climatic changes in the data set from this cave

National Case-Control Study of Kaposi\u27s Sarcoma and Pneumocystis Carinii Pneumonia in Homosexual Men: Part 1. Epidemiologic Results

To identify risk factors for the occurrence of Kaposi\u27s sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi\u27s sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi\u27s sarcoma and pneumocystis pneumonia

Quantum state preparation and macroscopic entanglement in gravitational-wave detectors

Long-baseline laser-interferometer gravitational-wave detectors are operating at a factor of 10 (in amplitude) above the standard quantum limit (SQL) within a broad frequency band. Such a low classical noise budget has already allowed the creation of a controlled 2.7 kg macroscopic oscillator with an effective eigenfrequency of 150 Hz and an occupation number of 200. This result, along with the prospect for further improvements, heralds the new possibility of experimentally probing macroscopic quantum mechanics (MQM) - quantum mechanical behavior of objects in the realm of everyday experience - using gravitational-wave detectors. In this paper, we provide the mathematical foundation for the first step of a MQM experiment: the preparation of a macroscopic test mass into a nearly minimum-Heisenberg-limited Gaussian quantum state, which is possible if the interferometer's classical noise beats the SQL in a broad frequency band. Our formalism, based on Wiener filtering, allows a straightforward conversion from the classical noise budget of a laser interferometer, in terms of noise spectra, into the strategy for quantum state preparation, and the quality of the prepared state. Using this formalism, we consider how Gaussian entanglement can be built among two macroscopic test masses, and the performance of the planned Advanced LIGO interferometers in quantum-state preparation

Searching for a Stochastic Background of Gravitational Waves with LIGO

The Laser Interferometer Gravitational-wave Observatory (LIGO) has performed the fourth science run, S4, with significantly improved interferometer sensitivities with respect to previous runs. Using data acquired during this science run, we place a limit on the amplitude of a stochastic background of gravitational waves. For a frequency independent spectrum, the new limit is $\Omega_{\rm GW} < 6.5 \times 10^{-5}$. This is currently the most sensitive result in the frequency range 51-150 Hz, with a factor of 13 improvement over the previous LIGO result. We discuss complementarity of the new result with other constraints on a stochastic background of gravitational waves, and we investigate implications of the new result for different models of this background.Comment: 37 pages, 16 figure

Neuroinflammation, Mast Cells, and Glia: Dangerous Liaisons

The perspective of neuroinflammation as an epiphenomenon following neuron damage is being replaced by the awareness of glia and their importance in neural functions and disorders. Systemic inflammation generates signals that communicate with the brain and leads to changes in metabolism and behavior, with microglia assuming a pro-inflammatory phenotype. Identification of potential peripheral-to-central cellular links is thus a critical step in designing effective therapeutics. Mast cells may fulfill such a role. These resident immune cells are found close to and within peripheral nerves and in brain parenchyma/meninges, where they exercise a key role in orchestrating the inflammatory process from initiation through chronic activation. Mast cells and glia engage in crosstalk that contributes to accelerate disease progression; such interactions become exaggerated with aging and increased cell sensitivity to stress. Emerging evidence for oligodendrocytes, independent of myelin and support of axonal integrity, points to their having strong immune functions, innate immune receptor expression, and production/response to chemokines and cytokines that modulate immune responses in the central nervous system while engaging in crosstalk with microglia and astrocytes. In this review, we summarize the findings related to our understanding of the biology and cellular signaling mechanisms of neuroinflammation, with emphasis on mast cell-glia interactions