HEALTH POLICY RESPONSES AND NEWS MEDIA COVERAGE OF AN EMERGING OUTBREAK: THE CASE OF EBOLA

The Ebola outbreak of 2014-2015 and the resulting media and policy responses provide an important case for studying dreaded communicable diseases and other public health emergencies that will test public health policy development and emergency communication. This research examined public health response policies to the Ebola outbreak as well as media messages about these policies and risks from Ebola. Federal guidance and state policies determining how to manage individuals within the U.S. who may have been exposed to Ebola were systematically identified and analyzed. In addition, the volume of news coverage and content of U.S.-focused news stories about Ebola was analyzed for risk-related messages that were judged to potentially increase or decrease perception of risk and policy-related messages about the Ebola response. Policies on quarantine, movement restrictions, exposure categories, and monitoring varied. A number of states enacted more aggressive policies than were called for in guidance from the Centers for Disease Control and Prevention (CDC). Examination of news coverage showed that the volume of stories about Ebola rapidly increased following diagnosis of the Ebola case in Dallas in September 2014. Furthermore, all policy-related messages studied showed significant increases in frequency after this date, with the exception of messages related to isolation, which showed a significant decrease. Overall, 96% of news stories contained one or more risk-elevating messages, with messages about foreigners or travelers bringing Ebola to the U.S. (72%), those describing the disease causing deaths (66%), and those about a potential U.S. outbreak/people in the U.S. contracting Ebola (35%) appearing most frequently. In addition, 82% of news stories contained at least one or more policy-related message, with those about isolation (47%) and quarantine (40%) appearing most frequently. Findings provide greater understanding of the interplay between news media coverage of emerging risks and theories on risk perception as well as how the news media covers policies to manage emerging disease threats. This research may help public health practitioners and policymakers anticipate what policies could be implemented in response to future infectious disease threats and to understand and improve the messaging landscape around infectious disease risks and policies

Defensive Cyber Maneuvers to Disrupt Cyber Attackers

erimeter based defenses are limited in deterring and defeating cyberattacks. Multi-layered approaches are needed to provide robust cybersecurity and defend against Advanced Persistent Threats. Proactive defensive cyber actions can provide positional or temporal advantages over an adversary in the cognitive, technical, and physical domains. These actions comprise cyber maneuvers, which are implemented reconfigurations to a network that aim to make attackers more visible and detectable, impede attacker progress, and reduce attackers’ chances of mission success. Technical actions and response are the primary focus of most current cyber defense frameworks with little attention on adversary behavioral and cognitive effects. We describe the enhanced cyber maneuver framework which addresses cognitive and behavioral responses to cyber effects. We present experimental results that demonstrate the framework and a testing approach to collect supporting findings on the effects of cyber maneuvers

The Relationship Between Hip Strength and Postural Stability in Collegiate Athletes Who Participate in Lower Extremity Dominant Sports

# Background Lower extremity (LE) injuries are common across many sports. Both core strength (including hip strength) deficits and poor postural stability have been linked to lower extremity (LE) injury. The relationship between these two characteristics is unknown. # Purpose To explore the relationships between hip strength, static postural stability, and dynamic postural stability. # Study Design Descriptive Cross-Sectional Study # Methods 162 Division I student-athletes (111 males and 51 females) participated in this study. Isometric hip strength was measured using a hand-held dynamometer and both single-leg static (eyes open EO and eyes closed EC) and dynamic postural stability were assessed with a force plate. Pairwise correlations were calculated to examine the relationship between the hip strength variables and the postural stability scores for all subjects and separately for males and females. # Results There were no significant correlations between hip strength and dynamic postural stability for any of the pairwise correlations. Significant, albeit minimal, correlations between EO and EC static postural stability and each of the hip strength variables for all subjects and male subjects (correlation coefficients ranged from -0.19 to -0.34). However, there were only two significant correlations between hip strength and EC static postural stability (hip internal/external rotation) and one for hip strength and EO postural stability (hip internal rotation) found for female subjects (correlation coefficients ranged from -0.28 to -0.31). # Conclusion There was no relationship between isometric hip strength and dynamic postural stability; whereas, there were some relationships between the strength measures and static postural stability. These significant, but minimal correlations were observed in more of the comparisons within the male cohort potentially demonstrating a sex difference. # Level of Evidence 3

A Public Health Systems View of Risk Communication About Zika

Objectives The spread of Zika virus throughout Latin America and parts of the United States in 2016 and 2017 presented a challenge to public health communicators. The objective of our study was to describe emergency risk communication practices during the 2016-2017 Zika outbreak to inform future infectious disease communication efforts. Methods We conducted semi-structured telephone interviews with 13 public health policy makers and practitioners, 10 public information officers, and 5 vector-control officials from May through August 2017. Results Within the public health macro-environment, extended outbreak timeframe, government trust, US residence status, and economic insecurity set the backdrop for Zika communication efforts. Limited resources, staffing, and partnerships negatively affected public health structural capacity for communication efforts. Public health communicators and practitioners used a range of processes and practices to engage in education and outreach, including fieldwork, community meetings, and contact with health care providers. Overall, public health agencies’ primary goals were to prevent Zika infection, reduce transmission, and prevent adverse birth outcomes. Conclusions Lessons learned from this disease response included understanding the macro-environment, developing partnerships across agencies and the community, and valuing diverse message platforms. These lessons can be used to improve communication approaches for health officials at the local, state, and federal levels during future infectious disease outbreaks. Conclusions Lessons learned from this disease response included understanding the macro-environment, developing partnerships across agencies and the community, and valuing diverse message platforms. These lessons can be used to improve communication approaches for health officials at the local, state, and federal levels during future infectious disease outbreaks

A Public Health Systems View of Risk Communication About Zika

The spread of Zika virus throughout Latin America and parts of the United States in 2016 and 2017 presented a challenge to public health communicators. The objective of our study was to describe emergency risk communication practices during the 2016-2017 Zika outbreak to inform future infectious disease communication efforts

Mouse Models Reveal Role of T-Cytotoxic and T-Reg Cells in Immune Response to Influenza: Implications for Vaccine Design

Immunopathologic examination of the lungs of mouse models of experimental influenza virus infection provides new insights into the immune response in this disease. First, there is rapidly developing perivascular and peribronchial infiltration of the lung with T-cells. This is followed by invasion of T-cells into the bronchiolar epithelium, and separation of epithelial cells from each other and from the basement membrane leading to defoliation of the bronchial epithelium. The intraepithelial reaction may involve either CD8 or CD4 T-cytotoxic cells and is analogous to a viral exanthema of the skin, such as measles and smallpox, which occur when the immune response against these infections is activated and the infected cells are attacked by T-cytotoxic cells. Then there is formation of B-cell follicles adjacent to bronchi, i.e., induced bronchial associated lymphoid tissue (iBALT). iBALT reacts like the cortex of a lymph node and is a site for a local immune response not only to the original viral infection, but also related viral infections (heterologous immunity). Proliferation of Type II pneumocytes and/or terminal bronchial epithelial cells may extend into the adjacent lung leading to large zones filled with tumor-like epithelial cells. The effective killing of influenza virus infected epithelial cells by T-cytotoxic cells and induction of iBALT suggests that adding the induction of these components might greatly increase the efficacy of influenza vaccination