Exploring the impact of targeted distribution of free bed nets on households bed net ownership, socio-economic disparities and childhood malaria infection rates: analysis of national malaria survey data from three sub-Saharan Africa countries

PubMed Central

2013-01-01

Background The last decade has witnessed increased funding for malaria control. Malaria experts have used the opportunity to advocate for rollout of such interventions as free bed nets. A free bed net distribution strategy is seen as the quickest way to improve coverage of effective malaria control tools especially among poorest communities. Evidence to support this claim is however, sparse. This study explored the effectiveness of targeted free bed net distribution strategy in achieving equity in terms of ownership and use of bed nets and also reduction of malaria prevalence among children under-five years of age. Methods National malaria indicator survey (MIS) data from Angola, Tanzania and Uganda was used in the analysis. Hierarchical multilevel logistic regression models were used to analyse the relationship between variables of interest. Outcome variables were defined as: childhood test-confirmed malaria infections, household ownership of any mosquito net and children’s use of any mosquito nets. Marginal effects of having free bed net distribution on households with different wealth status were calculated. Results Angolan children from wealthier households were 6.4 percentage points less likely to be parasitaemic than those in poorest households, whereas those from Tanzania and Uganda were less likely to test malaria positive by 7 and 11.6 percentage points respectively (p < 0.001). The study estimates and present results on the marginal effects based on the impact of free bed net distribution on children's malaria status given their socio-economic background. Poorest households were less likely to own a net by 21.4% in Tanzania, and 2.8% in Uganda, whereas both poorer and wealthier Angolan households almost achieved parity in bed net ownership (p < 0.001). Wealthier households had a higher margin of using nets than poorest people in both Tanzania and Uganda by 11.4% and 3.9% respectively. However, the poorest household in Angola had a 6.1% net use advantage over children in wealthier households (p < 0.001). Conclusion This is the first study to use nationally representative data to explore inequalities in bed net ownership and related consequences on childhood malaria infection rates across different countries. While targeted distribution of free bed nets improved overall bed net ownership, it did not overcome ownership inequalities as measured by household socioeconomic status. Use of bed nets was disproportionately lower among poorest children, except for Angola where bed net use was higher among poorest households when compared to children in wealthier households. The study highlights the need for malaria control world governing bodies and policy makers to continue working on finding appropriate strategies to improve access to effective malaria control tools especially by the poorest who often times bears the brunt of malaria burden than their wealthier counterparts. PMID:23855893

Planning long lasting insecticide treated net campaigns: should households’ existing nets be taken into account?

PubMed Central

2013-01-01

Background Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. Methods A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net ‘decay’ parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Conclusions Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage. PMID:23763773

Planning long lasting insecticide treated net campaigns: should households' existing nets be taken into account?

PubMed

Yukich, Joshua; Bennett, Adam; Keating, Joseph; Yukich, Rudy K; Lynch, Matt; Eisele, Thomas P; Kolaczinski, Kate

2013-06-14

Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net 'decay' parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage.

An exploratory qualitative study on perceptions about mosquito bed nets in the Niger Delta: what are the barriers to sustained use?

PubMed Central

Galvin, Kathleen T; Petford, Nick; Ajose, Frances; Davies, Dai

2011-01-01

Background: The effectiveness of malaria control programs is determined by an array of complex factors, including the acceptability and sustained use of preventative measures such as the bed net. A small-scale exploratory study was conducted in several locations in the Niger Delta region, Nigeria, to discover barriers against the use of bed nets, in the context of a current drive to scale up net use in Nigeria. Methods: A qualitative approach with a convenience sample was used. One to one interviews with mostly male adult volunteers were undertaken which explored typical living and sleeping arrangements, and perceptions about and barriers against the use of the mosquito prevention bed net. Results: Several key issues emerged from the qualitative data. Bed nets were not reported as widely used in this small sample. The reasons reported for lack of use included issues of convenience, especially net set up and dismantling; potential hazard and safety concerns; issues related to typical family composition and nature of accommodation; humid weather conditions; and perceptions of cost and effectiveness. Most barriers to net use concerned issues about everyday practical living and sleeping arrangements and perceptions about comfort. Interviewees identified were aware of malaria infection risks, but several also indicated certain beliefs that were barriers to net use. Conclusions: Successful control of malaria and scale up of insecticide-treated net coverage relies on community perceptions and practice. This small study has illuminated a number of important everyday life issues, which remain barriers to sustained net use, and has clarified further questions to be considered in net design and in future research studies. The study highlights the need for further research on the human concerns that contribute to sustained use of nets or, conversely, present significant barriers to their use. PMID:21544249

Factors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambézia Province, Mozambique.

PubMed

Moon, Troy D; Hayes, Caleb B; Blevins, Meridith; Lopez, Melanie L; Green, Ann F; González-Calvo, Lazaro; Olupona, Omo

2016-04-11

Malaria remains a major threat to some 3.2 billion persons globally. Malaria contributes heavily to the overall disease burden in Mozambique and is considered endemic. A cornerstone of Mozambique's vector control strategy has been to strive for universal coverage of insecticide-treated nets (ITN). The study is a population-based cross-sectional survey of female heads-of-household in Zambézia Province, Mozambique conducted during August-September, 2010 and April-May, 2014. Analyses accounted for a stratified two-stage cluster sample design. Outcomes of interest included sleeping under a mosquito net during the previous night. Descriptive statistics were calculated for three oversampled districts and for the entire province. Multivariable logistic regression analysis was used to estimate factors associated with both changes over time and increased mosquito bed net usage. Of the 3916 households interviewed in 2010 and 3906 households in 2014, 64.3% were in possession of at least one mosquito bed net. A higher proportion of households in Namacurra (90%) reported possession of a mosquito net, compared to Alto Molócuè (77%) and Morrumbala (34%), respectively in 2014. Of pregnant respondents, 58.6% reported sleeping under a mosquito net the previous night in 2010 compared to 68.4% in 2014. Fifty percent of children 0-59 months slept under a mosquito net the previous night in 2010 compared to 60% in 2014. Factors associated with use of a mosquito net for female head-of-household respondents were higher education, understanding Portuguese, larger household size, having electricity in the household, and larger household monthly income. As travel time to a health facility increased (per 1 h), respondents had 13% lower odds of sleeping under a mosquito net (OR 0.87; 95% CI 0.74-1.01, p = 0.07). Pregnant women in 2014 had a 2.4 times higher odds of sleeping under a bed net if they lived in Namacurra compared to Alto Molócuè (95% CI 0.91-6.32, p = 0.002 for district). Higher maternal education, living in Namacurra, and acquisition of mosquito bed nets were associated with a child 0-59 months reporting sleeping under the net in the previous night in 2014. Intensified focus on the poorest, least educated, and most distant from health services is needed to improve equity of ITN availability and usage. Additionally, while some districts have already surpassed goals in terms of coverage and utilization of ITN, renewed emphasis should be placed on bringing all geographic regions of the province closer to meeting these targets.

Demand and willingness-to-pay for bed nets in Tanzania: results from a choice experiment.

PubMed

Gingrich, Chris D; Ricotta, Emily; Kahwa, Amos; Kahabuka, Catherine; Koenker, Hannah

2017-07-14

Universal coverage campaigns for long-lasting insecticide-treated nets do not always reach the goal of one net for every two household members, and even when ownership of at least one net per household is high, many households may not own enough nets. The retail market provides these households options for replacing or increasing the number of nets they own with products that best fit their needs since a variety of net shapes, sizes, and colours are available. Hence, it is important to understand the factors affecting private net demand. This study explores private demand for nets in Tanzania using a discrete choice experiment. The experiment provides participants the option to buy nets with their own money, and thus should prove more accurate than a hypothetical survey of net preferences. Nearly 800 participants sampled in two regions showed an overall strong demand for nets, with 40% choosing to buy a net across all seven combinations of net prices and characteristics such as size, shape, and insecticide treatment. Only 8% of all participants chose not to buy a single net. A key factor influencing demand was whether a participant's household currently owned sufficient nets for all members, with rural participants showing lower net coverage and greater demand than urban participants. Both poor and less poor households showed strong evidence of making purchase decisions based on more than price alone. Mean willingness-to-pay values for a net started at US$1.10 and grew by US$0.50-1.40 for various attributes such as rectangular shape, large size, and insecticide treatment. The impact of price on demand was negative but small, with elasticity values between -0.25 and -0.45. The results suggest that private demand for nets in Tanzania could potentially supplement future coverage campaigns. Net manufacturers and retailers should advertise and promote consumers' preferred net attributes to improve sales and further expand net access and coverage. To overcome household liquidity concerns and best replicate the experiment results, policy makers should consider making credit available for interested buyers.

The Use of Mosquito Nets and the Prevalence of Plasmodium falciparum Infection in Rural South Central Somalia

PubMed Central

Noor, Abdisalan M.; Moloney, Grainne; Borle, Mohamed; Fegan, Greg W.; Shewchuk, Tanya; Snow, Robert W.

2008-01-01

Background There have been resurgent efforts in Africa to estimate the public health impact of malaria control interventions such as insecticide treated nets (ITNs) following substantial investments in scaling-up coverage in the last five years. Little is known, however, on the effectiveness of ITN in areas of Africa that support low transmission. This hinders the accurate estimation of impact of ITN use on disease burden and its cost-effectiveness in low transmission settings. Methods and Principal Findings Using a stratified two-stage cluster sample design, four cross-sectional studies were undertaken between March-June 2007 across three livelihood groups in an area of low intensity malaria transmission in South Central Somalia. Information on bed net use; age; and sex of all participants were recorded. A finger prick blood sample was taken from participants to examine for parasitaemia. Mantel-Haenzel methods were used to measure the effect of net use on parasitaemia adjusting for livelihood; age; and sex. A total of 10,587 individuals of all ages were seen of which 10,359 provided full information. Overall net use and parasite prevalence were 12.4% and 15.7% respectively. Age-specific protective effectiveness (PE) of bed net ranged from 39% among <5 years to 72% among 5–14 years old. Overall PE of bed nets was 54% (95% confidence interval 44%–63%) after adjusting for livelihood; sex; and age. Conclusions and Significance Bed nets confer high protection against parasite infection in South Central Somalia. In such areas where baseline transmission is low, however, the absolute reductions in parasitaemia due to wide-scale net use will be relatively small raising questions on the cost-effectiveness of covering millions of people living in such settings in Africa with nets. Further understanding of the progress of disease upon infection against the cost of averting its consequent burden in low transmission areas of Africa is therefore required. PMID:18461178

The use of mosquito nets and the prevalence of Plasmodium falciparum infection in rural South Central Somalia.

PubMed

Noor, Abdisalan M; Moloney, Grainne; Borle, Mohamed; Fegan, Greg W; Shewchuk, Tanya; Snow, Robert W

2008-05-07

There have been resurgent efforts in Africa to estimate the public health impact of malaria control interventions such as insecticide treated nets (ITNs) following substantial investments in scaling-up coverage in the last five years. Little is known, however, on the effectiveness of ITN in areas of Africa that support low transmission. This hinders the accurate estimation of impact of ITN use on disease burden and its cost-effectiveness in low transmission settings. Using a stratified two-stage cluster sample design, four cross-sectional studies were undertaken between March-June 2007 across three livelihood groups in an area of low intensity malaria transmission in South Central Somalia. Information on bed net use; age; and sex of all participants were recorded. A finger prick blood sample was taken from participants to examine for parasitaemia. Mantel-Haenzel methods were used to measure the effect of net use on parasitaemia adjusting for livelihood; age; and sex. A total of 10,587 individuals of all ages were seen of which 10,359 provided full information. Overall net use and parasite prevalence were 12.4% and 15.7% respectively. Age-specific protective effectiveness (PE) of bed net ranged from 39% among <5 years to 72% among 5-14 years old. Overall PE of bed nets was 54% (95% confidence interval 44%-63%) after adjusting for livelihood; sex; and age. Bed nets confer high protection against parasite infection in South Central Somalia. In such areas where baseline transmission is low, however, the absolute reductions in parasitaemia due to wide-scale net use will be relatively small raising questions on the cost-effectiveness of covering millions of people living in such settings in Africa with nets. Further understanding of the progress of disease upon infection against the cost of averting its consequent burden in low transmission areas of Africa is therefore required.

Determinants of Bed Net Use in Southeast Nigeria following Mass Distribution of LLINs: Implications for Social Behavior Change Interventions

PubMed Central

Russell, Cheryl L.; Sallau, Adamu; Emukah, Emmanuel; Graves, Patricia M.; Noland, Gregory S.; Ngondi, Jeremiah M.; Ozaki, Masayo; Nwankwo, Lawrence; Miri, Emmanuel; McFarland, Deborah A.; Richards, Frank O.; Patterson, Amy E.

2015-01-01

Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the global malaria control strategy. LLIN ownership, however, does not necessarily guarantee use. Thus, even in the ideal setting in which universal coverage with LLINs has been achieved, maximal malaria protection will only be achieved if LLINs are used both correctly and consistently. This study investigated the factors associated with net use, independent of net ownership. Data were collected during a household survey conducted in Ebonyi State in southeastern Nigeria in November 2011 following a statewide mass LLIN distribution campaign and, in select locations, a community-based social behavior change (SBC) intervention. Logistic regression analyses, controlling for household bed net ownership, were conducted to examine the association between individual net use and various demographic, environmental, behavioral and social factors. The odds of net use increased among individuals who were exposed to tailored SBC in the context of a home visit (OR = 17.11; 95% CI 4.45–65.79) or who received greater degrees of social support from friends and family (ptrend < 0.001). Factors associated with decreased odds of net use included: increasing education level (ptrend = 0.020), increasing malaria knowledge level (ptrend = 0.022), and reporting any disadvantage of bed nets (OR = 0.39; 95% CI 0.23–0.78). The findings suggest that LLIN use is significantly influenced by social support and exposure to a malaria-related SBC home visit. The malaria community should thus further consider the importance of community outreach, interpersonal communication and social support on adoption of net use behaviors when designing future research and interventions. PMID:26430747

Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries.

PubMed

Taylor, Cameron; Florey, Lia; Ye, Yazoume

2017-05-01

To examine the change in equity of insecticide-treated net (ITN) ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative. To assess change in equity in ownership of at least one ITN by households from different wealth quintiles, we used data from Demographic and Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before the launch (2003-2008) as baseline surveys and surveys conducted between 2009-2014 as endpoint surveys. We did country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, we calculated the Lorenz concentration curve and concentration index (C-index). Out of the 19 countries we assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multicountry pooled analysis showed an improvement in equity (baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint survey C-index: 0.00; 95% CI: -0.01 to 0.00). Similar trends were seen in both low- and intermediate-risk and high-risk zones. The mass ITN distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles.

The use of mediation analysis to assess the effects of a behaviour change communication strategy on bed net ideation and household universal coverage in Tanzania.

PubMed

Ricotta, Emily E; Boulay, Marc; Ainslie, Robert; Babalola, Stella; Fotheringham, Megan; Koenker, Hannah; Lynch, Matthew

2015-01-21

SBCC campaigns are designed to act on cognitive, social and emotional factors at the individual or community level. The combination of these factors, referred to as 'ideation', play a role in determining behaviour by reinforcing and confirming decisions about a particular health topic. This study introduces ideation theory and mediation analysis as a way to evaluate the impact of a malaria SBCC campaign in Tanzania, to determine whether exposure to a communication programme influenced universal coverage through mediating ideational variables. A household survey in three districts where community change agents (CCAs) were active was conducted to collect information on ITN use, number of ITNs in the household, and perceptions about ITN use and ownership. Variables relating to attitudes and beliefs were combined to make 'net ideation'. Using an ideational framework, a mediation analysis was conducted to see the impact exposure to a CCA only, mass media and community (M & C) messaging only, or exposure to both, had on household universal coverage, through the mediating variable net ideation. All three levels of exposure (CCA, M & C messaging, or exposure to both) were significantly associated with increased net ideation (CCA: 0.283, 95% CI: 0.136-0.429, p-value: <0.001; M & C: 0.128, 95% CI: 0.032-0.334, p-value: 0.018; both: 0.376, 95% CI: 0.170-0.580, p-value: <0.001). Net ideation also significantly increased the odds of having universal coverage (CCAOR: 1.265, 95% CI: 1.118-1.433, p-value: <0.001; M & COR: 1.264, 95% CI: 1.117-1.432, p-value: <0.001, bothOR: 1.260, 95% CI: 1.114-1.428, p-value: <0.001). There were no significant direct effects between any exposure and universal coverage when controlling for net ideation. The results of this study indicate that mediation analysis is an applicable new tool to assess SBCC campaigns. Ideation as a mediator of the effects of communication exposure on household universal coverage has implications for designing SBCC to support both mass and continuous distribution efforts, since both heavily rely on consumer participation to obtain and maintain ITNs. Such systems can be strengthened by SBCC programming, generating demand through improving social norms about net ownership and use, perceived benefits of nets, and other behavioural constructs.

Physical integrity and residual bio-efficacy of used LLINs in three cities of the South-West region of Cameroon 4 years after the first national mass-distribution campaign.

PubMed

Boussougou-Sambe, Stravensky T; Awono-Ambene, Parfait; Tasse, Geraud C T; Etang, Josiane; Binyang, Jerome A; Nouage, Lynda D; Wamba, Gaston; Enyong, Peter; Fokam, Eric B

2017-01-17

Long-lasting insecticidal nets (LLINs) are effective tools at reducing malaria transmission. In Cameroon, following the first national mass distribution campaign in 2011, there has been no follow up on the efficacy of LLINs distributed. The aim of this report is to assess the physical integrity and insecticidal potency of LLINs distributed in three cities with contrasting socio economic status (SES) and to evaluate the use and care for bed nets owned by individuals. The study was conducted in Limbe, Tiko and Buea three localities in the Fako division of the South West Region of Cameroon. Tiko had the highest SES based on the type of building materials used, followed respectively by Limbe and Buea. The use and care for bed nets was assessed using a questionnaire, the physical state of bed nets evaluated following WHOPES recommendation for determining size of holes and the residual insecticidal activity of retrieved bed nets determined through a cone bioassay using susceptible strains of mosquitoes. Of the 241 households visited in Limbe (n = 81), Tiko (n = 80) and Buea (n = 80), 186 (77.2%) had LLINs, with no significant variations from the selected study locations. However, bed net coverage was not meeting World Health Organization standards (p < 0.0001). Six different brands of LLINs were recorded, and the majority were those provided by the NMCP through the 2011 national mass campaign or antenatal care programme. Based on the calculation of the Proportionate Hole Index (PHI) as indicator of physical integrity of nets, the proportion of nets classified as serviceable (versus too torn) differed statistically according to locations (p value = 0.04), with 63.8% in Tiko, 50% in Limbe and 47% in Buea. Of the 20 nets tested for their efficacy against susceptible strains of mosquito, 42.6% (3 nets) were optimally effective in Tiko, 57.4% (4), 16.7% (1) and 14.3% (1) were minimally effective in Tiko, Buea and Limbe respectively. Finally; 85.7% (6) and 83.3% (5) were not effective in Limbe and Buea. These findings pinpoint the need for more frequent replacement of LLINs especially for people with low SES and also the need for the promotion of good practices on the maintenance and washing of nets.

The underlying reasons for very high levels of bed net use, and higher malaria infection prevalence among bed net users than non-users in the Tanzanian city of Dar es Salaam: a qualitative study.

PubMed

Msellemu, Daniel; Shemdoe, Aloysia; Makungu, Christina; Mlacha, Yeromini; Kannady, Khadija; Dongus, Stefan; Killeen, Gerry F; Dillip, Angel

2017-10-23

Bed nets reduce malaria-related illness and deaths, by forming a protective barrier around people sleeping under them. When impregnated with long-lasting insecticide formulations they also repel or kill mosquitoes attempting to feed upon sleeping humans, and can even suppress entire populations of malaria vectors that feed predominantly upon humans. Nevertheless, an epidemiological study in 2012 demonstrated higher malaria prevalence among bed net users than non-users in urban Dar es Salaam, Tanzania. Focus group discussions were conducted with women from four selected wards of Dar es Salaam city, focusing on four major themes relating to bed net use behaviours: (1) reasons for bed net use, (2) reasons for not using bed nets, (3) stimuli or reminders for people to use a bed net (4) perceived reasons for catching malaria while using a bed net. An analytical method by framework grouping of relevant themes was used address key issues of relevance to the study objectives. Codes were reviewed and grouped into categories and themes. All groups said the main reason for bed net use was protection against malaria. Houses with well-screened windows, with doors that shut properly, and that use insecticidal sprays against mosquitoes, were said not to use bed nets, while frequent attacks from malaria was the main stimulus for people to use bed nets. Various reasons were mentioned as potential reasons that compromise bed net efficacy, the most common of which were: (1) bed net sharing by two or more people, especially if one occupant tends to come to bed late at night, and does not tuck in the net 71%; (2) one person shares the bed but does not use the net, moving it away from the side on which s/he sleeps 68%; (3) ineffective usage habits, called ulalavi, in which a sprawling sleeper either touches the net while sleeping up against it or leaves a limb hanging outside of it 68%. Less common reasons mentioned included: (1) Small bed nets which become un-tucked at night (31%); (2) Bed nets with holes large enough to allow mosquitoes to pass (28%); and (3) Going to bed late after already being bitten outdoors (24%). Behaviours associated with bed net use like; bed sharing, bed net non compliant-bedfellow, sleeping pattern like ulalavi and some physical bed net attributes compromise its effectiveness and supposedly increase of malaria infection to bed net users. While some well-screened houses looked to instigate low malaria prevalence to non-bed net users.

Encouraging impact following 2.5 years of reinforced malaria control interventions in a hyperendemic region of the Republic of Guinea.

PubMed

Tiffany, Amanda; Moundekeno, Faya Pascal; Traoré, Alexis; Haile, Melat; Sterk, Esther; Guilavogui, Timothée; Genton, Blaise; Serafini, Micaela; Grais, Rebecca F

2016-05-28

Malaria is one of the principal causes of morbidity and mortality in the Republic of Guinea, particularly in the highly endemic regions. To assist in malaria control efforts, a multi-component malaria control intervention was implemented in the hyperendemic region of Guéckédou Prefecture. The coverage of the intervention and its impact on malaria parasite prevalence were assessed. Five cross-sectional surveys using cluster-based sampling and stratified by area were conducted from 2011 to 2013 in three sous-préfectures of Guéckédou Préfecture that received the intervention: Guéckédou City, Tékoulo and Guendembou in addition to one comparison sous-préfecture that did not receive the intervention, Koundou. Surveys were repeated every 6 months, corresponding with the dry and rainy seasons. Rapid diagnostic tests (RDT) were used to diagnose malaria infection. In each selected household, bed net use and ownership were assessed. A total of 35,123 individuals participated in the surveys. Malaria parasite prevalence declined in all intervention sous-préfectures from 2011 to 2013 (56.4-45.9 % in Guéckédou City, 64.9-54.1 % in Tékoulo and 69.4-56.9 % in Guendembou) while increasing in the comparison sous-préfecture (64.5-69 %). It was consistently higher in children 5-14 years of age followed by those 1-59 months and ≥15 years. Indicators of intervention coverage, the proportion of households reporting ownership of at least one bed net and the proportion of survey participants with fever who received treatment from a health facility or community health worker also increased significantly in the intervention areas. Implementation of the multi-component malaria control intervention significantly reduced the prevalence of malaria in the sous-préfectures of intervention while also increasing the coverage of bed nets. However, malaria prevalence remains unacceptably high and disproportionately affects children <15 years of age. In such situations additional vector control interventions and age specific interventions should be considered.

Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania.

PubMed

Khatib, Rashid A; Killeen, Gerry F; Abdulla, Salim M K; Kahigwa, Elizeus; McElroy, Peter D; Gerrets, Rene P M; Mshinda, Hassan; Mwita, Alex; Kachur, S Patrick

2008-06-02

Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Net use was 62.7% overall, 87.2% amongst infants (0 to 1 year), 81.8% amongst young children (>1 to 5 years), 54.5% amongst older children (6 to 15 years) and 59.6% amongst adults (>15 years). 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%). Half of nets used by young children (50.0%) and over a third of those used by older children (37.2%) were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use) and was the primary means for protecting adults (60.2% use). All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily suppressed the net market, illustrating that in this setting that these are complementary rather than mutually exclusive approaches.

Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries

PubMed Central

Florey, Lia; Ye, Yazoume

2017-01-01

Abstract Objective To examine the change in equity of insecticide-treated net (ITN) ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative. Methods To assess change in equity in ownership of at least one ITN by households from different wealth quintiles, we used data from Demographic and Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before the launch (2003–2008) as baseline surveys and surveys conducted between 2009–2014 as endpoint surveys. We did country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, we calculated the Lorenz concentration curve and concentration index (C-index). Findings Out of the 19 countries we assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multicountry pooled analysis showed an improvement in equity (baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint survey C-index: 0.00; 95% CI: −0.01 to 0.00). Similar trends were seen in both low- and intermediate-risk and high-risk zones. Conclusion The mass ITN distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles. PMID:28479633

Which family members use the best nets? An analysis of the condition of mosquito nets and their distribution within households in Tanzania.

PubMed

Tsuang, Angela; Lines, Jo; Hanson, Kara

2010-07-22

Household ownership of insecticide-treated mosquito nets (ITNs) is increasing, and coverage targets have been revised to address universal coverage with ITNs. However, many households do not have enough nets to cover everyone, and the nets available vary in physical condition and insecticide treatment status. Since 2004, the Government of Tanzania has been implementing the Tanzania National Voucher Scheme (TNVS), which distributes vouchers for ITNs through antenatal clinics to target pregnant women and their infants. This analysis aimed to determine the following: (1) coverage patterns of bed nets within households according to physical condition and treatment status; (2) who might be at risk if mosquitoes were diverted from occupants of untreated nets to those not using nets? (3) the degree to which those at highest risk of malaria use the most protective nets. Data from the 2006 TNVS household survey were analysed to assess within-household distribution of net use. The associations between net characteristics and net user were also evaluated. Multivariate analysis was applied to the relationship between the number of holes per net and user characteristics while adjusting for confounders. In households with a net:person ratio better than 1:4 (one net for every four household members), more than 80% of the people in such households reported using a net the previous night. ITNs were most likely to be used by infants, young children (1-4 y), and women of childbearing age; they were least likely to be used by older women (>or=50 y), older children (5-14 y), and adult men. The nets used by infants and women of childbearing age were in better-than-average physical condition; the nets used by older women and older children were in worse-than-average condition; while young children and adult men used nets in intermediate (average) condition. When adjusted for confounders, the nets used by young and older children had more holes than nets used by infants. Infants and other vulnerable groups were most likely to sleep under the most protective nets. Nevertheless, more communication efforts are needed to increase use of intact ITNs within households for children. Further research is necessary to fully understand motivations influencing within-household net distribution.

Reported bed net ownership and use in social contacts is associated with uptake of bed nets for malaria prevention in pregnant women in Ghana.

PubMed

Ernst, Kacey C; Erly, Steven; Adusei, Charity; Bell, Melanie L; Kessie, David Komla; Biritwum-Nyarko, Alberta; Ehiri, John

2017-01-04

Despite progress made in the last decades, malaria persists as a pressing health issue in sub-Saharan Africa. Pregnant women are particularly vulnerable to infection and serious health outcomes for themselves and their unborn child. Risk can be mitigated through appropriate use of control measures such as insecticide-treated bed nets. Although social networks can influence uptake of preventive strategies, the role of social influence on bed net ownership has not been explored. During an evaluation of a bed net distribution programme, the influence of non-health care advisors on ownership and use of bed nets by pregnant women in Kumasi, Ghana was examined. Data were collected through in-person interviews with 300 pregnant women seeking antenatal care in an urban hospital in Kumasi, Ghana. Participants were asked about their bed net ownership, bed net use, and information about three personal contacts that they go to for pregnancy advice. Information about these advisors was combined into an influence score. Logistic regression models were used to determine the association between the score and bed net ownership. Those who owned a bed net were further assessed to determine if interpersonal influence was associated with self-reported sleeping under the bed net the previous night. Of the 294 women in the analysis, 229 (78%) reported owning bed nets. Of these bed net owners, 139 (61%) reported using a bed net the previous night. A dose response relationship was observed between the interpersonal influence score and bed net ownership and use. Compared to the lowest influence score, those with the highest influence score (>1 SD above the mean) were marginally more likely to own a bed net [OR = 2.37, 95% CI (0.87, 6.39)] and much more likely to use their bed net [5.38, 95% CI (1.89, 15.25)] after adjusting for other factors. Interpersonal influence appears to have modest impact on ownership and use of bed nets by pregnant women in an urban area of Ghana. Further investigations would need to be conducted to determine if the relationship is causal or if individuals who associate are simply more likely to have similar practices.

The importance of education to increase the use of bed nets in villages outside of Kinshasa, Democratic Republic of the Congo.

PubMed

Ndjinga, Julie K; Minakawa, Noboru

2010-10-12

Malaria is the most prominent disease in the Democratic Republic of the Congo (DRC), and long-lasting insecticide-treated nets (LLINs) have been distributed free of charge since 2006 to combat the disease. However, the success of this bed net campaign depends on sufficient bed net use in all age groups. This study was designed to examine the factors affecting bed net use in villages outside of Kinshasa. Two villages along the Congo River, totalling 142 households with 640 residents, were surveyed using a standard questionnaire. The interview determined the number, ages, and sexes of family members; the education level of the family head; the number, colour, and type of nets owned; and the number of nets used in the previous night. The size of house was also measured, and numbers of rooms and beds were recorded. These variables were examined to reveal important factors that affect bed net use. A total of 469 nets were counted, and nearly all nets were white LLINs. Of these nets, 229 (48.8%) nets were used by 284 (44.4%) residents. Bed nets were used by over 90% of children 5 to 15 years of age, whereas less than 50% of the residents in other age groups used bed nets. The important variables affecting bed net use were numbers of beds and rooms in the house and the education level of the family head of household. Education was the most important factor affecting bed net use in the villages outside Kinshasa. Development of an educational programme, particularly one directed toward parents, is necessary to reduce misconceptions and increase prevalence of bed net use among all age groups.

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

PubMed Central

2012-01-01

Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs). LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan), but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price) and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years), LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price without the cheaper net (of the same type) becoming more cost effective. Distributing replenishment nets each year in addition to the replacement of all nets every 3-4 years increases the number of under-5 deaths averted by 5-14% at a cost of USD 17-25 per additional person protected per annum or USD 1080-1610 per additional under-5 death averted. Conclusions Our results support the World Health Organization recommendation to distribute only LLINs, while giving guidance on the price thresholds above which this recommendation will no longer hold. Programme planners should be willing to pay a premium for nets which have a longer physical lifespan, and if planners are willing to pay USD 1600 per under-5 death averted, investing in replenishment is cost effective. PMID:22475679

Modelling the impact of the long-term use of insecticide-treated bed nets on Anopheles mosquito biting time.

PubMed

Ferreira, Claudia P; Lyra, Silas P; Azevedo, Franciane; Greenhalgh, David; Massad, Eduardo

2017-09-15

Evidence of changing in biting and resting behaviour of the main malaria vectors has been mounting up in recent years as a result of selective pressure by the widespread and long-term use of insecticide-treated bed nets (ITNs), and indoor residual spraying. The impact of resistance behaviour on malaria intervention efficacy has important implications for the epidemiology and malaria control programmes. In this context, a theoretical framework is presented to understand the mechanisms determining the evolution of feeding behaviour under the pressure of use of ITNs. An agent-based stochastic model simulates the impact of insecticide-treated bed nets on mosquito fitness by reducing the biting rates, as well as increasing mortality rates. The model also incorporates a heritability function that provides the necessary genetic plasticity upon which natural selection would act to maximize the fitness under the pressure of the control strategy. The asymptotic equilibrium distribution of mosquito population versus biting time is shown for several daily uses of ITNs, and the expected disruptive selection on this mosquito trait is observed in the simulations. The relative fitness of strains that bite at much earlier time with respect to the wild strains, when a threshold of about 50% of ITNs coverage highlights the hypothesis of a behaviour selection. A sensitivity analysis has shown that the top three parameters that play a dominant role on the mosquito fitness are the proportion of individuals using bed nets and its effectiveness, the impact of bed nets on mosquito oviposition, and the mosquito genetic plasticity related to changing in biting time. By taking the evolutionary aspect into account, the model was able to show that the long-term use of ITNs, although representing an undisputed success in reducing malaria incidence and mortality in many affected areas, is not free of undesirable side effects. From the evolutionary point of view of the parasite virulence, it should be expected that plasmodium parasites would be under pressure to reduce their virulence. This speculative hypothesis can eventually be demonstrated in the medium to long-term use of ITNs.

Comparing ownership and use of bed nets at two sites with differential malaria transmission in western Kenya.

PubMed

Ernst, Kacey C; Hayden, Mary H; Olsen, Heather; Cavanaugh, Jamie L; Ruberto, Irene; Agawo, Maurice; Munga, Stephen

2016-04-14

Challenges persist in ensuring access to and optimal use of long-lasting, insecticidal bed nets (LLINs). Factors associated with ownership and use may differ depending on the history of malaria and prevention control efforts in a specific region. Understanding how the cultural and social-environmental context of bed net use may differ between high- and low-risk regions is important when identifying solutions to improve uptake and appropriate use. Community forums and a household, cross-sectional survey were used to collect information on factors related to bed net ownership and use in western Kenya. Sites with disparate levels of transmission were selected, including an endemic lowland area, Miwani, and a highland epidemic-prone area, Kapkangani. Analysis of ownership was stratified by site. A combined site analysis was conducted to examine factors associated with use of all available bed nets. Logistic regression modelling was used to determine factors associated with ownership and use of owned bed nets. Access to bed nets as the leading barrier to their use was identified in community forums and cross-sectional surveys. While disuse of available bed nets was discussed in the forums, it was a relatively rare occurrence in both sites. Factors associated with ownership varied by site. Education, perceived risk of malaria and knowledge of individuals who had died of malaria were associated with higher bed net ownership in the highlands, while in the lowlands individuals reporting it was easy to get a bed net were more likely to own one. A combined site analysis indicated that not using an available bed net was associated with the attitudes that taking malaria drugs is easier than using a bed net and that use of a bed net will not prevent malaria. In addition, individuals with an unused bed net in the household were more likely to indicate that bed nets are difficult to use, that purchased bed nets are better than freely distributed ones, and that bed nets should only be used during the rainy season. Variations in factors associated with ownership should be acknowledged when constructing messaging and distribution campaigns. Despite reports of bed nets being used for other purposes, those in the home were rarely unused in these communities. Disuse seemed to be related to beliefs that can be addressed through education programmes. As mass distributions continue to take place, additional research is needed to determine if factors associated with LLIN ownership and use change with increasing availability of LLIN.

Are Long-Lasting Insecticidal Nets Effective for Preventing Childhood Deaths among Non-Net Users? A Community-Based Cohort Study in Western Kenya

PubMed Central

Komazawa, Osuke; Kaneko, Satoshi; K’Opiyo, James; Kiche, Ibrahim; Wanyua, Sheru; Shimada, Masaaki; Karama, Mohamed

2012-01-01

Background Increasing the distribution and use of insecticide-treated nets (ITNs) in Sub-Saharan Africa has made controlling malaria with ITNs more practical. We evaluated community effects induced by ITNs, specifically long-lasting insecticidal nets (LLINs), under ordinary conditions in an endemic malaria area of Western Kenya. Methods Using the database from Mbita Health and Demographic Surveillance System (HDSS), children younger than 5 years old were assessed over four survey periods. We analyzed the effect of bed net usage, LLIN density and population density of young people around a child on all-cause child mortality (ACCM) rates using Cox PH models. Results During the study, 14,554 children were followed and 250 deaths were recorded. The adjusted hazard ratios (HRs) for LLIN usage compared with no net usage were not significant among the models: 1.08 (95%CI 0.76–1.52), 1.19 (95%CI 0.69–2.08) and 0.92 (95%CI 0.42–2.02) for LLIN users, untreated net users, and any net users, respectively. A significant increasing linear trend in risk across LLIN density quartiles (HR = 1.25; 95%CI 1.03–1.51) and a decreasing linear trend in risk across young population density quartiles among non-net user children (HR = 0.77; 95%CI 0.63–0.94) were observed. Conclusions Although our data showed that current LLIN coverage level (about 35%) could induce a community effect to protect children sleeping without bed nets even in a malaria-endemic area, it appears that a better system is needed to monitor the current malaria situation globally in order to optimize malaria control programs with limited resources. PMID:23185378

A stitch in time: a cross-sectional survey looking at long lasting insecticide-treated bed net ownership, utilization and attrition in SNNPR, Ethiopia.

PubMed

Batisso, Esey; Habte, Tedila; Tesfaye, Gezahegn; Getachew, Dawit; Tekalegne, Agonafer; Kilian, Albert; Mpeka, Betty; Lynch, Caroline

2012-06-07

Since 2002/03, an estimated 4.7 million nets have been distributed in the Southern Nations, Nationalities and Peoples Region (SNNPR) among an at risk population of approximately 10 million people. Evidence from the region suggests that large-scale net ownership rapidly increased over a relatively short period of time. However, little is known about how coverage is being maintained given that the last mass distribution was in 2006/2007. This study sought to determine the status of current net ownership, utilization and rate of long lasting insecticide-treated nets (LLIN) loss in the previous three years in the context of planning for future net distribution to try to achieve sustainable universal coverage. A total of 750 household respondents were interviewed across malarious, rural kebeles of SNNPR. Households were randomly selected following a two-stage cluster sampling design where kebeles were defined as clusters. Kebeles were chosen using proportional population sampling (PPS), and 25 households within 30 kebeles randomly chosen. Approximately 67.5% (95%CI: 64.1-70.8) of households currently owned at least one net. An estimated 31.0% (95%CI 27.9-34.4) of all nets owned in the previous three years had been discarded by owners, the majority of whom considered the nets too torn, old or dirty (79.9%: 95%CI 75.8-84.0). Households reported that one-third of nets (33.7%) were less than one year old when they were discarded. The majority (58.8%) of currently owned nets had 'good' structural integrity according to a proportionate Hole Index. Nearly two-thirds of households (60.6%) reported using their nets the previous night. The overriding reason for not using nets was that they were too torn (45.7%, 95% CI 39.1-50.7). Yet, few households are making repairs to their nets (3.7%, 95% CI: 2.4-5.1). Results suggest that the life span of nets may be shorter than previously thought, with little maintenance by their owners. With the global move towards malaria elimination it makes sense to aim for sustained high coverage of LLINs. However, in the current economic climate, it also makes sense to hark back to simple tools and messages on the importance of careful net maintenance, which could increase their lifespans.

Effects of educational intervention on long-lasting insecticidal nets use in a malarious area, southeast Iran.

PubMed

Soleimani Ahmadi, Mussa; Vatandoost, Hassan; Shaeghi, Mansoreh; Raeisi, Ahmad; Abedi, Farshid; Eshraghian, Mohammad Reza; Aghamolaei, Teimur; Madani, Abdol Hossein; Safari, Reza; Jamshidi, Mahin; Alimorad, Abbas

2012-01-01

Long-lasting insecticidal nets (LLINs) have been advocated as an effective tool against malaria transmission. However, success of this community based intervention largely depends on the knowledge and practice regarding malaria and its prevention. According to the national strategy plan on evaluation of LLINs (Olyset nets), this study was conducted to determine the perceptions and practices about malaria and to improve use of LLINs in Bashagard district, one of the important foci of malaria in southeast Iran. The study area comprised 14 villages that were randomized in two clusters and designated as LLINs and untreated nets. Each of households in both clusters received two bed nets by the free distribution and delivery. After one month quantitative data collection method was used to collect information regarding the objectives of the study. On the basis of this information, an educational program was carried out in both areas to increase motivation for use of bed nets. Community knowledge and practice regarding malaria and LLIN use assessed pre- and post-educational program. The data were analyzed using SPSS ver.16 software. At baseline, 77.5% of respondents in intervention and 69.4 % in control area mentioned mosquito bite as the cause of malaria, this awareness increased significantly in intervention (90.3%) and control areas (87.9%), following the educational program. A significant increase also was seen in the proportion of households who used LLINs the previous night (92.5%) compared with untreated nets (87.1%). Educational status was an important predictor of LLINs use. Regular use of LLIN was considerably higher than the targeted coverage (80%) which recommended by World Heaths Organization. About 81.1% and 85.3% of respondents from LLIN and control areas reported that mosquito nuisance and subsequent malaria transmission were the main determinants of bed net use. These findings highlight a need for educational intervention in implementation of long-lasting insecticidal nets; this should be considered in planning and decision-making in the national malaria control program during the next campaigns of LLINs in Iran. © 2012 Tehran University of Medical Sciences. All rights reserved.

Can the collection of expired long-lasting insecticidal nets reduce their coverage and use? Sociocultural aspects related to LLIN life cycle management and use in four districts in Madagascar.

PubMed

Ramanantsoa, Ambinina; Wilson-Barthes, Marta; Rahenintsoa, Rindra; Hoibak, Sarah; Ranaivoharimina, Harilala; Rahelimalala, Martha Delphine; Rakotomanga, Avotiana; Finlay, Alyssa; Muela Ribera, Joan; Peeters Grietens, Koen

2017-10-10

There is growing awareness of the likely impact increased numbers of LLINs will have on the environment, if not disposed of or recycled appropriately. As part of a World Health Organization (WHO) and United Nations Environment Programme (UNEP) pilot study to assess environmentally-sound and cost-effective LLIN recycling strategies, the USAID-Deliver Project collected 22,559 used bed nets in Madagascar. A social science study was conducted to provide data on socio-cultural factors related to collection and replacement of LLINs, including impact on primary and other net uses. Ethnographic exploratory research was carried out following the pilot USAID-Deliver net collection and recycling campaign in Betioky, Tsihombe, Fenerive Est and Ambanja districts of Madagascar, triangulating participant observation, interviewing and group discussions. Sampling was theoretical and data analysis was a continuous and iterative process concurrent to data collection. Final analysis was conducted using NVivo10. The following themes emerged as contributing to the success of collecting expired LLINs in the community for recycling purposes: (i) net adequacy and preference: characteristic differences between collected and newly distributed nets lead to communities' reticence to relinquish old nets before confirming new nets were appropriate for intended use. Where newly distributed nets failed to meet local requirements, this was expected to increase alternative uses and decrease household turn over. (ii) Net collection strategies: the net collection campaign brought net use out of the private sphere and into the public arena. Net owners reported feeling ashamed when presenting damaged nets in public for collection, leading to reduced net relinquishment. (iii) Net lifecycle: communities perceived nets as being individually owned and economic value was attributed both to good-condition nets for sleeping and to worn nets for alternative/secondary purposes. Collecting nets at the stage of waste rather than at their prescribed end of life was locally acceptable. The collection of LLINs for recycling/disposal can lead to lower coverage under certain conditions. Collecting used LLINs may be appropriate under the following conditions: (i) nets are collected at the stage of waste; (ii) new nets are in line with community preferences; and (iii) collection strategies have been agreed upon within the community prior to replacement activities. Any collection/recycling of old LLINs should be based on in-depth understanding of the local context and include participatory processes to prevent reduced coverage.

Behavioural responses of females of two anopheline mosquito species to human-occupied, insecticide-treated and untreated bed nets

PubMed Central

2014-01-01

Background Insecticide-treated bed nets (ITNs), used extensively to reduce human exposure to malaria, work through physical and chemical means to block or deter host-seeking mosquitoes. Despite the importance of ITNs, very little is known about how host-seeking mosquitoes behave around occupied bed nets. As a result, evidence-based evaluations of the effects of physical damage on bed net effectiveness are not possible and there is a dearth of knowledge on which to base ITN design. Methods The dispersion of colony-raised female Anopheles gambiae and Anopheles albimanus was observed in 2-hr laboratory experiments in which up to 200 mosquitoes were released inside a mosquito-proof 3 m × 3 m tent housing a bed net arrayed with 18 30 cm × 30 cm sticky screen squares on the sides, ends and roof. Numbers of mosquitoes caught on the sticky squares were interpreted as the ‘mosquito pressure’ on that part of the net. Results Presence of a human subject in the bed net significantly increased total mosquito pressure on the net for both species and significantly re-oriented An. gambiae to the roof of the net. Anopheles albimanus pressure was greatest on the bed net roof in both host-present and no-host conditions. The effects of different human subjects in the bed net, of different ambient conditions (dry, cool conditions vs warm, humid conditions) and of bed net treatment (deltamethrin-treated or no insecticide) on mosquito pressure patterns were tested for both species. Species-specific pressure patterns did not vary greatly as a result of any of these factors though some differences were noted that may be due the size of the different human subjects. Conclusions As a result of the interaction between host-seeking responses and the convective plume from the net occupant, species-specific mosquito pressure patterns manifest more or less predictably on the bed net. This has implications for bed net design and suggests that current methods of assessing damaged bed nets, which do not take damage location into account, should be modified. PMID:25080389

Fishing with bed nets on Lake Tanganyika: a randomized survey.

PubMed

McLean, Kate A; Byanaku, Aisha; Kubikonse, Augustine; Tshowe, Vincent; Katensi, Said; Lehman, Amy G

2014-10-07

Malaria is among the most common causes of death along Lake Tanganyika, a problem which many aid organizations have attempted to combat through the distribution of free mosquito bed nets to high-risk communities. The Lake Tanganyika Floating Health Clinic (LTFHC), a health-based non-governmental organization (NGO), has observed residents of the Lake Tanganyika basin using bed nets to fish small fry near the shoreline, despite a series of laws that prohibit bed net use and other fine-gauge nets for fishing, implemented to protect the near-shore fish ecology. The LTFHC sought to quantify the sources of bed nets and whether they were being used for fishing. The LTFHC conducted a survey of seven lakeside villages in Lagosa Ward, Tanzania. The government has divided each village into two to six pre-existing geographic sub-villages depending on population size. Seven households per sub-village were chosen at random for survey administration. The survey consisted of 23 questions regarding mosquito bed net practices, including the use of bed nets for fishing, as well as questions pertaining to any perceived changes to the fish supply. A total of 196 surveys were administered over a four-week period with a 100% response rate. Over 87% of households surveyed have used a mosquito bed net for fishing at some point. The majority of respondents reported receiving their bed net for free (96.4%), observing "many" residents of their village using bed nets for fishing (97.4%), and noticing a subjective decrease in the fish supply over time (64.9%). The findings of this study raise concerns that the use of free malaria bed nets for fishing is widespread along Lake Tanganyika, and that this dynamic will have an adverse effect on fish ecology. Further studies are indicated to fully define the scope of bed net misuse and the effects of alternative vector control strategies in water-based communities.

Airflow attenuation and bed net utilization: observations from Africa and Asia.

PubMed

von Seidlein, Lorenz; Ikonomidis, Konstantin; Bruun, Rasmus; Jawara, Musa; Pinder, Margaret; Knols, Bart Gj; Knudsen, Jakob B

2012-06-15

Qualitative studies suggest that bed nets affect the thermal comfort of users. To understand and reduce this discomfort the effect of bed nets on temperature, humidity, and airflow was measured in rural homes in Asia and Africa, as well as in an experimental wind tunnel. Two investigators with architectural training selected 60 houses in The Gambia, Tanzania, Philippines, and Thailand. Data-loggers were used to measure indoor temperatures in hourly intervals over a 12 months period. In a subgroup of 20 houses airflow, temperature and humidity were measured at five-minute intervals for one night from 21.00 to 6.00 hrs inside and outside of bed nets using sensors and omni-directional thermo-anemometers. An investigator set up a bed net with a mesh size of 220 holes per inch 2 in each study household and slept under the bed net to simulate a realistic environment. The attenuation of airflow caused by bed nets of different mesh sizes was also measured in an experimental wind tunnel. The highest indoor temperatures (49.0 C) were measured in The Gambia. During the hottest months of the year the mean temperature at night (9 pm) was between 33.1 C (The Gambia) and 26.2 C (Thailand). The bed net attenuated the airflow from a minimum of 27% (Philippines) to a maximum of 71% (The Gambia). Overall the bed nets reduced airflow compared to un-attenuated airflow from 9 to 4 cm sec-1 or 52% (p<0.001). In all sites, no statistically significant difference in temperature or humidity was detected between the inside and outside of the bed net. Wind tunnel experiments with 11 different mesh-sized bed nets showed an overall reduction in airflow of 64% (range 55 - 71%) compared to un-attenuated airflow. As expected, airflow decreased with increasing net mesh size. Nets with a mesh of 136 holes inch-2 reduced airflow by 55% (mean; range 51 - 73%). A denser net (200 holes inch-2) attenuated airflow by 59% (mean; range 56 - 74%). Despite concerted efforts to increase the uptake of this intervention in many areas uptake remains poor. Bed nets reduce airflow, but have no influence on temperature and humidity. The discomfort associated with bed nets is likely to be most intolerable during the hottest and most humid period of the year, which frequently coincides with the peak of malaria vector densities and the force of pathogen transmission. These observations suggest thermal discomfort is a factor limiting bed net use and open a range of architectural possibilities to overcome this limitation.

Free distribution of insecticidal bed nets improves possession and preferential use by households and is equitable: findings from two cross-sectional surveys in thirteen malaria endemic districts of Bangladesh.

PubMed

Ahmed, Syed M; Hossain, Shamim; Kabir, Mohammad M; Roy, Sanjit

2011-12-13

BRAC, an indigenous non-governmental development organization (NGO), has been implementing a programme to prevent and control malaria in the 13 malaria-endemic districts of Bangladesh since 2007. One of the critical preventive interventions is the distribution of insecticidal bed nets (long-lasting insecticide-treated nets, LLINs and insecticide-treated ordinary nets, ITNs) to the community free of cost. This study aimed to assess progress in the possession, preferential use, and knowledge on use of the LLIN/ITNs including the programme's avowed pro-poor inclination one and three and half years after intervention began. A convenient sampling strategy based on malaria endemicity in the districts was adopted. First, thirty upazila (sub-district, with a population around 250,000)s were selected at random, with high prevalent districts contributing more upazilas; second, from each upazila, one (2008) to two (2011) villages (covered by insecticidal bed net distribution programme) were selected. From each village, households that had either one under-five child and/or a pregnant woman were included in the survey, one household being included only once. Data were collected using a pre-tested structured questionnaire. In all, 3,760 households in 2008 and 7,895 households in 2011 were surveyed for collecting relevant information. Proportion of households with at least one LLIN, and at least one LLIN/ITN increased (22-59 to 62-67% and 22-64% to 74-76% respectively) over time, including increase in the mean number of LLIN/ITNs per household (≤ 1 to 1 +). The programme achieved > 80% coverage in sleeping under an LLIN/ITN in the case of under-five children and pregnant women, especially in the high-endemic districts. Knowledge regarding critical time of hanging the net also increased over time (7-22 to 44-54%), but remained low. The pro-poor inclination of the programme is reflected in the status of relevant indicators according to self-rated poverty status of the households. There has been a substantial improvement in possession and usage of insecticidal bed nets especially for the two most vulnerable groups (under-five children and pregnant women), including a reduction of gaps between the high and low endemic districts, and the deficit and non-deficit households during the study period.

Implementation strategies to increase access and demand of long-lasting insecticidal nets: a before-and-after study and scale-up process in Mozambique.

PubMed

Arroz, Jorge A H; Mendis, Chandana; Pinto, Liliana; Candrinho, Baltazar; Pinto, João; Martins, Maria do Rosário O

2017-10-25

The universal coverage bed nets campaign is a proven health intervention promoting increased access, ownership, and use of bed nets to reduce malaria burden. This article describes the intervention and implementation strategies that Mozambique carried out recently in order to improve access and increase demand for long-lasting insecticidal nets (LLINs). A before-and-after study with a control group was used during Stage I of the implementation process. The following strategies were tested in Stage I: (1) use of coupons during household registration; (2) use of stickers to identify the registered households; (3) new LLIN ascription formula (one LLIN for every two people). In Stage II, the following additional strategies were implemented: (4) mapping and micro-planning; (5) training; and (6) supervision. Odds ratio (OR) and 95% confidence interval (CI) were used to compare and establish differences between intervened and control districts in Stage I. Main outcomes were: percentage of LLINs distributed, percentage of target households benefited. In Stage I, 87.8% (302,648) of planned LLINs were distributed in the intervention districts compared to 77.1% (219,613) in the control districts [OR: 2.14 (95% CI 2.11-2.16)]. Stage I results also showed that 80.6% (110,453) of households received at least one LLIN in the intervention districts compared to 72.8% (87,636) in the control districts [OR: 1.56 (95% CI 1.53-1.59)]. In Stage II, 98.4% (3,536,839) of the allocated LLINs were delivered, covering 98.6% (1,353,827) of the registered households. Stage I results achieved better LLINs and household coverage in districts with the newly implemented strategies. The results of stage II were also encouraging. Additional strategies adaptation is required for a wide-country LLIN campaign.

Short and long term evaluation of the efficiency of PermaNet® 2.0 bed net against environmental factors and washing using bioassay tests

PubMed Central

Kayedi, Mohammad Hassan; Khamisabadi, Kiumars; Haghdoost, Ali Akbar; Kayedi, Zohreh; Fallahi, Shirzad; Abdali, Nargess

2017-01-01

ABSTRACT The aim of the present study was to examine the resistance of PermaNet® 2.0 bed nets against repeated washing and environmental factors by using bioassay tests. After 5, 15 and 21 washings with detergents and by using bioassay tests, the resistance of 40 PermaNet® 2.0 bed nets was compared with that of 40 bed nets conventionally treated with one K-O tablet. To examine the long-term resistance, 31 PermaNet® 2.0 bed nets were also distributed among villagers, and were re-collected to perform bioassay tests after 1, 2 and 5 years. In the first phase of this study, the insecticidal effect of the conventionally-treated nets significantly decreased due to repeated washings (P < 0.001); however, it was not significant regarding PermaNet® 2.0 bed nets (P = 0.92 in continuous exposure and P = 0.12 in mortality tests). In the long-term phase of this study, the time required for knockdown of PermaNet® 2.0 increased over the first 2 years and then decreased. In addition, the mortality rate decreased over the first 2 years and then increased. In conclusion, it seems that the technique used by the manufacturer for impregnation of PermaNet® 2.0 bed nets has an acceptable efficiency in comparison with conventional techniques. PMID:28423093

Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda.

PubMed

Wanzira, Humphrey; Yeka, Adoke; Kigozi, Ruth; Rubahika, Denis; Nasr, Sussann; Sserwanga, Asadu; Kamya, Moses; Filler, Scott; Dorsey, Grant; Steinhardt, Laura

2014-05-19

Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged

Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda

PubMed Central

2014-01-01

Background Universal coverage of long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria was adopted by the Uganda National Malaria Control Programme in 2007. The first mass distribution of LLINs was implemented in 2010. Initially, a campaign targeted to households with pregnant women and children aged

Knowledge, access and utilization of bed-nets among stable and seasonal migrants in an artemisinin resistance containment area of Myanmar.

PubMed

Phyo Than, Wint; Oo, Tin; Wai, Khin Thet; Thi, Aung; Owiti, Philip; Kumar, Binay; Deepak Shewade, Hemant; Zachariah, Rony

2017-09-14

Myanmar lies in the Greater Mekong sub-region of South-East Asia faced with the challenge of emerging resistance to artemisinin combination therapies (ACT). Migrant populations are more likely than others to spread ACT resistance. A vital intervention to reduce malaria transmission, resistance spread and eliminate malaria is the use of bed nets. Among seasonal and stable migrants in an artemisinin resistance containment region of Myanmar, we compared a) their household characteristics, b) contact with health workers and information material, and c) household knowledge, access and utilization of bed nets. Secondary data from community-based surveys on 2484 migrant workers (2013 and 2014, Bago Region) were analyzed of which 37% were seasonal migrants. Bed net access and utilization were assessed using a) availability of at least one bed net per household, and b) one bed net per two persons, and c) proportion of household members who slept under abed net during the previous night (Indicator targets = 100%). Over 70% of all migrants were from unstable work settings with short transitory stays. Average household size was five (range 1-25) and almost half of all households had children under-five years. Roughly 10 % of migrants were night-time workers. Less than 40% of households had contact with health workers and less than 30% had exposure to information education and communication (IEC) materials, the latter being significantly lower among seasonal migrants. About 70% of households were aware of the importance of insecticide-treated bed-nets/long-lasting insecticidal nets (ITNs/LLINs), but knowledge on insecticide impregnation and retreatment of ITNs was poor (< 10%). Although over 95% of households had access to at least one bed net, the number with one bed net per two persons was grossly inadequate (13% for stable migrants and 9% for seasonal migrants, P = 0.001). About half of all household members slept under a bed net during the previous night. This study reveals important short-falls in knowledge, access and utilization of bed nets among migrants in Myanmar. Possible ways forward include frequent distribution campaigns to compensate for short transitory stays, matching household distributions to household size, enhanced information campaigns and introducing legislation to make mosquito repellents available for night-time workers at plantations and farms. Better understanding through qualitative research is also merited.

Physical condition and maintenance of mosquito bed nets in Kwale County, coastal Kenya

PubMed Central

2013-01-01

Background Despite the extensive ownership and use of insecticide-treated nets (ITNs) over the last decade, the effective lifespan of these nets, especially their physical integrity, under true operational conditions is not well-understood. Usefulness of nets declines primarily due to physical damage or loss of insecticidal activity. Methods A community based cross-sectional survey was used to determine the physical condition and to identify predictors of poor physical condition for bed nets owned by individuals from communities in Kwale County, coastal Kenya. A proportionate hole index (pHI) was used as a standard measure, and the cut-offs for an ‘effective net’ (offer substantial protection against mosquito bites) and ‘ineffective nets’ (offer little or no protection against mosquito bites) were determined (pHI ≤88 (about ≤500 cm2 of holes surface area) and pHI of >88 (≥500 cm2 of holes surface area), respectively). Results The vast majority (78%) of the surveyed nets had some holes. The median pHI was 92 (range: 1–2,980). Overall, half of the nets were categorized as ‘effective nets’ or ‘serviceable nets’. Physical deterioration of nets was associated with higher use and washing frequency. Young children and older children were found to use ineffective bed nets significantly more often than infants, while the physical integrity of nets owned by pregnant women was similar to those owned by infants. Estuarine environment inhabitants owned nets with the worst physical condition, while nets owned by the coastal slope inhabitants were in fairly good physical condition. The results suggest that bed nets are optimally utilized when they are new and physically intact. Thereafter, bed net utilization decreases gradually with increasing physical deterioration, with most net owners withdrawing physically damaged nets from routine use. This withdrawal commonly happens following 1.5 years of use, making bed net use the most important predictor of physical integrity. On average, the nets were washed twice within six months prior to the survey. Washing frequency was significantly influenced by the bed net colour and bed net age. Lack of knowledge on reasons for net retreatment and the retreatment procedure was evident, while net repair was minimal and did not seem to improve the physical condition of the nets. The “catch-up” bed net distribution strategies are sufficient for ensuring adequate ownership and utilization of ‘effective nets’ in the targeted groups, but bi-annual mass distribution is necessary to provide similar ownership and utilization for the other groups not targeted by “catch-up” strategies. Conclusions Monitoring and maintenance strategies that will deliver locally appropriate education messages on net washing and repair will enhance the effectiveness of malaria control programmes, and further research to assess ineffective nets need is needed. PMID:23374429

Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source.

PubMed

Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Eng, Tony; Papanikolaou, Nikos

2010-09-21

A low-energy electronic brachytherapy source (EBS), the model S700 Axxent x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V(100) reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as compared to 95.2% in water phantoms without RBE enhancement (planned BED). About 10% increase in the source output is required to raise BED PTV V(100) to 95%. As a conclusion, the composite effect of dose reduction in the target due to heterogeneities and RBE enhancement results in a net effect of 5.3% target BED coverage loss for electronic brachytherapy. Therefore, it is suggested that about 10% increase in the source output may be necessary to achieve sufficient target coverage higher than 95%.

Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

NASA Astrophysics Data System (ADS)

Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Eng, Tony; Papanikolaou, Nikos

2010-09-01

A low-energy electronic brachytherapy source (EBS), the model S700 Axxent™ x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V100 reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as compared to 95.2% in water phantoms without RBE enhancement (planned BED). About 10% increase in the source output is required to raise BED PTV V100 to 95%. As a conclusion, the composite effect of dose reduction in the target due to heterogeneities and RBE enhancement results in a net effect of 5.3% target BED coverage loss for electronic brachytherapy. Therefore, it is suggested that about 10% increase in the source output may be necessary to achieve sufficient target coverage higher than 95%.

Traditional nets interfere with the uptake of long-lasting insecticidal nets in the Peruvian Amazon: the relevance of net preference for achieving high coverage and use.

PubMed

Grietens, Koen Peeters; Muela Ribera, Joan; Soto, Veronica; Tenorio, Alex; Hoibak, Sarah; Aguirre, Angel Rosas; Toomer, Elizabeth; Rodriguez, Hugo; Llanos Cuentas, Alejandro; D'Alessandro, Umberto; Gamboa, Dionicia; Erhart, Annette

2013-01-01

While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative methods for collecting information on net preference should be developed before any LLIN procurement decision is made.

Traditional Nets Interfere with the Uptake of Long-Lasting Insecticidal Nets in the Peruvian Amazon: The Relevance of Net Preference for Achieving High Coverage and Use

PubMed Central

Grietens, Koen Peeters; Muela Ribera, Joan; Soto, Veronica; Tenorio, Alex; Hoibak, Sarah; Aguirre, Angel Rosas; Toomer, Elizabeth; Rodriguez, Hugo; Llanos Cuentas, Alejandro; D'Alessandro, Umberto; Gamboa, Dionicia; Erhart, Annette

2013-01-01

Background While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. Methods The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). Results A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Conclusion Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative methods for collecting information on net preference should be developed before any LLIN procurement decision is made. PMID:23300943

Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya-a study protocol.

PubMed

Gama, Elvis; Were, Vincent; Ouma, Peter; Desai, Meghna; Niessen, Louis; Buff, Ann M; Kariuki, Simon

2016-11-21

Historically, Kenya has used various distribution models for long-lasting insecticide-treated bed nets (LLINs) with variable results in population coverage. The models presently vary widely in scale, target population and strategy. There is limited information to determine the best combination of distribution models, which will lead to sustained high coverage and are operationally efficient and cost-effective. Standardised cost information is needed in combination with programme effectiveness estimates to judge the efficiency of LLIN distribution models and options for improvement in implementing malaria control programmes. The study aims to address the information gap, estimating distribution cost and the effectiveness of different LLIN distribution models, and comparing them in an economic evaluation. Evaluation of cost and coverage will be determined for 5 different distribution models in Busia County, an area of perennial malaria transmission in western Kenya. Cost data will be collected retrospectively from health facilities, the Ministry of Health, donors and distributors. Programme-effectiveness data, defined as the number of people with access to an LLIN per 1000 population, will be collected through triangulation of data from a nationally representative, cross-sectional malaria survey, a cross-sectional survey administered to a subsample of beneficiaries in Busia County and LLIN distributors' records. Descriptive statistics and regression analysis will be used for the evaluation. A cost-effectiveness analysis will be performed from a health-systems perspective, and cost-effectiveness ratios will be calculated using bootstrapping techniques. The study has been evaluated and approved by Kenya Medical Research Institute, Scientific and Ethical Review Unit (SERU number 2997). All participants will provide written informed consent. The findings of this economic evaluation will be disseminated through peer-reviewed publications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Clustering of host-seeking activity of Anopheles gambiae mosquitoes at the top surface of a human-baited bed net

PubMed Central

2013-01-01

Background Knowledge of the interactions between mosquitoes and humans, and how vector control interventions affect them, is sparse. A study exploring host-seeking behaviour at a human-occupied bed net, a key event in such interactions, is reported here. Methods Host-seeking female Anopheles gambiae activity was studied using a human-baited ‘sticky-net’ (a bed net without insecticide, coated with non-setting adhesive) to trap mosquitoes. The numbers and distribution of mosquitoes captured on each surface of the bed net were recorded and analysed using non-parametric statistical methods and random effects regression analysis. To confirm sticky-net reliability, the experiment was repeated using a pitched sticky-net (tilted sides converging at apex, i.e., neither horizontal nor vertical). The capture efficiency of horizontal and vertical sticky surfaces were compared, and the potential repellency of the adhesive was investigated. Results In a semi-field experiment, more mosquitoes were caught on the top (74-87%) than on the sides of the net (p < 0.001). In laboratory experiments, more mosquitoes were caught on the top than on the sides in human-baited tests (p < 0.001), significantly different to unbaited controls (p < 0.001) where most mosquitoes were on the sides (p = 0.047). In both experiments, approximately 70% of mosquitoes captured on the top surface were clustered within a 90 × 90 cm (or lesser) area directly above the head and chest (p < 0.001). In pitched net tests, similar clustering occurred over the sleeper’s head and chest in baited tests only (p < 0.001). Capture rates at horizontal and vertical surfaces were not significantly different and the sticky-net was not repellent. Conclusion This study demonstrated that An. gambiae activity occurs predominantly within a limited area of the top surface of bed nets. The results provide support for the two-in-one bed net design for managing pyrethroid-resistant vector populations. Further exploration of vector behaviour at the bed net interface could contribute to additional improvements in insecticide-treated bed net design or the development of novel vector control tools. PMID:23902661

Determinants of household demand for bed nets in a rural area of southern Mozambique

PubMed Central

Chase, Claire; Sicuri, Elisa; Sacoor, Charfudin; Nhalungo, Delino; Nhacolo, Ariel; Alonso, Pedro L; Menéndez, Clara

2009-01-01

Background A key to making insecticide-treated nets (ITNs) a long-term, sustainable solution to the spread of malaria is understanding what drives their purchase and use. Few studies have analysed the determinants of demand for bed nets for malaria prevention at the household level, and in particular, how demand for nets compares with demand for other mosquito prevention methods. Methods This study uses a household survey to assess the determinants of demand for bed nets in an area of endemic malaria transmission in rural, southern Mozambique. The study looks at willingness to pay (WTP) for bed nets, net ownership, usage, and past purchase behaviour, alongside expenditure and frequency of use of alternate methods for malaria prevention. Results While overall net ownership in the sample is low, the evidence fails to suggest that poorer households are less likely to own bed nets, when controlling for covariates, nor does the likelihood of receiving a free net depend on socioeconomic status (SES). Formal schooling and market knowledge seem to indicate higher average willingness to pay, while use of alternate methods for malaria prevention, and receipt of Indoor Residual Spraying (IRS) are found to decrease demand for bed nets. Conclusion For long-term sustainability of ITNs to be realized, results suggest that either full or partial subsidies may be necessary in some contexts to encourage households to obtain and use nets. Given the possible substitution effects of combined malaria control interventions, and the danger of not taking into consideration household preferences for malaria prevention, successful malaria control campaigns should invest a portion of their funds towards educating recipients of IRS and users of other preventive methods on the importance of net use even in the absence of mosquitoes. PMID:19527505

A mathematical model of the impact of present and future malaria vaccines.

PubMed

Wenger, Edward A; Eckhoff, Philip A

2013-04-15

With the encouraging advent of new malaria vaccine candidates, mathematical modelling of expected impacts of present and future vaccines as part of multi-intervention strategies is especially relevant. The impact of potential malaria vaccines is presented utilizing the EMOD model, a comprehensive model of the vector life cycle coupled to a detailed mechanistic representation of intra-host parasite and immune dynamics. Values of baseline transmission and vector feeding behaviour parameters are identified, for which local elimination is enabled by layering pre-erythrocytic vaccines of various efficacies on top of high and sustained insecticide-treated net coverage. The expected reduction in clinical cases is further explored in a scenario that targets children by adding a pre-erythrocytic vaccine to the EPI programme for newborns. At high transmission, there is a minimal reduction in clinical disease cases, as the time to infection is only slightly delayed. At lower transmission, there is an accelerating community-level protection that has subtle dependences on heterogeneities in vector behaviour, ecology, and intervention coverage. At very low transmission, the trend reverses as many children are vaccinated to prevent few cases. The maximum-impact setting is one in which the impact of increasing bed net coverage has saturated, vector feeding is primarily outdoors, and transmission is just above the threshold where small perturbations from a vaccine intervention result in large community benefits.

An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage

PubMed Central

2011-01-01

Background The Timor-Leste Ministry of Health has recently finalized the National Malaria Control Strategy for 2010-2020. A key component of this roadmap is to provide universal national coverage with long-lasting insecticide-treated nets (LLINs) in support of achieving the primary goal of reducing both morbidity and mortality from malaria by 30% in the first three years, followed by a further reduction of 20% by end of the programme cycle in 2020 [1]. The strategic plan calls for this target to be supported by a comprehensive information, education and communication (IEC) programme; however, there is limited prior research into household and personal usage patterns to assist in the creation of targeted, effective, and socio-culturally specific behaviour change materials. Methods Nine separate focus group discussions (FGDs) were carried out in Dili, Manatuto, and Covalima districts, Democratic Republic of Timor-Leste, in July 2010. These focus groups primarily explored themes of perceived malaria risk, causes of malaria, net usage patterns within families, barriers to correct and consistent usage, and the daily experience of users (both male and female) in households with at least one net. Comprehensive qualitative analysis utilized open source analysis software. Results The primary determinants of net usage were a widespread perception that nets could or should only be used by pregnant women and young children, and the availability of sufficient sleeping space under a limited number of nets within households. Both nuisance biting and disease prevention were commonly cited as primary motivations for usage, while seasonality was not a significant factor. Long-term net durability and ease of hanging were seen as key attributes in net design preference. Very frequent washing cycles were common, potentially degrading net effectiveness. Finally, extensive re-purposing of nets (fishing, protecting crops) was both reported and observed, and may significantly decrease availability of nighttime sleeping space for all family members if distributed nets do not remain within the household. Conclusions Emphasizing that net usage is acceptable and important for all family members regardless of age or gender, and addressing the complex behavioural economics of alternative net usages could have significant impacts on malaria control efforts in Timor-Leste, as the country's programmes make progress towards universal net coverage. PMID:21777415

Mathematical evaluation of community level impact of combining bed nets and indoor residual spraying upon malaria transmission in areas where the main vectors are Anopheles arabiensis mosquitoes.

PubMed

Okumu, Fredros O; Kiware, Samson S; Moore, Sarah J; Killeen, Gerry F

2013-01-16

Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset, PermaNet 2.0, Icon Life nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset or PermaNet 2.0 nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus.

Push by a net, pull by a cow: can zooprophylaxis enhance the impact of insecticide treated bed nets on malaria control?

PubMed Central

2014-01-01

Background Mass insecticide treated bed net (ITN) deployment, and its associated coverage of populations at risk, had “pushed” a decline in malaria transmission. However, it is unknown whether malaria control is being enhanced by zooprophylaxis, i.e., mosquitoes diverted to feed on hosts different from humans, a phenomenon that could further reduce malaria entomological transmission risk in areas where livestock herding is common. Methods Between May and July 2009, we collected mosquitoes in 104 houses from three neighboring villages with high ITN coverage (over 80%), along Lake Victoria. We also performed a census of livestock in the area and georeferenced tethering points for all herds, as well as, mosquito larval habitats. Bloodmeal contents from sampled mosquitoes were analyzed, and each mosquito was individually tested for malaria sporozoite infections. We then evaluated the association of human density, ITN use, livestock abundance and larval habitats with mosquito abundance, bloodfeeding on humans and malaria sporozoite rate using generalized linear mixed effects models. Results We collected a total of 8123 mosquitoes, of which 1664 were Anopheles spp. malaria vectors over 295 household spray catches. We found that vector household abundance was mainly driven by the number of householders (P < 0.05), goats/sheep tethered around the house (P < 0.05) and ITNs, which halved mosquito abundance (P < 0.05). In general, similar patterns were observed for Anopheles arabiensis, but not An. gambiae s.s. and An. funestus s.s., whose density did not increase with the presence of livestock animals. Feeding on humans significantly increased in all species with the number of householders (P < 0.05), and only significantly decreased for An. arabiensis in the presence of cattle (P < 0.05). Only 26 Anopheles spp. vectors had malaria sporozoites with the sporozoite rate significantly decreasing as the proportion of cattle feeding mosquitoes increased (P < 0.05). Conclusion Our data suggest that cattle, in settings with large ITN coverage, have the potential to drive an unexpected “push-pull” malaria control system, where An. arabiensis mosquitoes “pushed” out of human contact by ITNs are likely being further “pulled” by cattle. PMID:24472517

Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon.

PubMed

Dionne-Odom, Jodie; Westfall, Andrew O; Apinjoh, Tobias O; Anchang-Kimbi, Judith; Achidi, Eric A; Tita, Alan T N

2017-03-27

Malaria in pregnancy is common in sub-Saharan Africa where it contributes to perinatal morbidity and mortality. Use of insecticide-treated bed nets and intermittent preventive therapy with sulfadoxine-pyrimethamine during pregnancy are effective but underutilized interventions to prevent infection. Factors associated with bed net ownership and usage, and use of prophylaxis among recently pregnant women in Cameroon were investigated. National data from the 2011 Cameroon Demographic Health Survey was used to identify women with a pregnancy within the previous 5 years. Logistic regression models were created to assess for independent predictors of reported bed net ownership, bed net usage, and the use of malaria prophylaxis medications during pregnancy. Nearly one in two women surveyed had a recent pregnancy (n = 7647). In this group, bed net ownership and usage rates were low (33.7 and 16.9%, respectively); 61.6% used medication for malaria prophylaxis during pregnancy. Bed net ownership and usage were associated with maternal literacy (aOR 1.4 for net usage, 95% CI 1.1-1.8) and the presence of children under age 5 in the home (aOR 2.3 for net usage, 95% CI 1.6-3.3). The use of malaria prophylaxis medication was associated with measures of healthcare access (aOR 17.8, 95% CI 13-24.5 for ≥4 antenatal care visits), higher maternal education (aOR 1.5, 95% CI 1.1-2.1) and maternal literacy (aOR 1.4, 95% CI 1.1-1.7). Women in Cameroon and their antenatal providers missed many opportunities to prevent malaria in pregnancy. Efforts toward ensuring universal bed net provision, consistent antenatal care and the education of girls are likely to improve birth outcomes attributable to malaria infection.

Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya

PubMed Central

2011-01-01

Background Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. Methods We quantified the resources and costs to implement a large-scale integrated prevention campaign in Lurambi Division, Western Province, Kenya that reached 47,133 individuals (and 83% of eligible adults) in 7 days. The campaign provided HIV testing, condoms, and prevention education materials; a long-lasting insecticide-treated bed net; and a water filter. Data were obtained primarily from logistical and expenditure data maintained by implementing partners. We estimated the projected cost of a Scaled-Up Replication (SUR), assuming reliance on local managers, potential efficiencies of scale, and other adjustments. Results The cost per person served was $41.66 for the initial campaign and was projected at $31.98 for the SUR. The SUR cost included 67% for commodities (mainly water filters and bed nets) and 20% for personnel. The SUR projected unit cost per person served, by disease, was $6.27 for malaria (nets and training), $15.80 for diarrhea (filters and training), and $9.91 for HIV (test kits, counseling, condoms, and CD4 testing at each site). Conclusions A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person. PMID:22189090

Reports of long-lasting insecticidal bed nets catching on fire: a threat to bed net users and to successful malaria control?

PubMed Central

2014-01-01

Background One of the control tools to reduce malaria transmission is the use of LLINs. However, several studies show that household bed net use is quite low. A study was developed to better understand the cultural factors that might explain these gaps in Benin. One reason mentioned is that bed nets can catch on fire and cause harm. This paper presents a summary of these findings, their analysis and the ensuing issues. Methods This anthropological study is based on an inductive qualitative approach, including 91 semi-structured interviews conducted from July 2011 to March 2012 in a health district in Southern Benin. Results Fifty-six persons stated that bed nets can catch on fire but do not always refer to specific facts. However, 34 of the 56 people narrate specific events they heard or experienced. 39 accounts were geographically located and situated in time, with various details. In 27 situations, people were burned, for which 12 people reportedly died. Discussion The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found. Bed net fires were noted in 10 countries, but it is impossible to ascertain the frequency of such events. Moreover, bodily harm can be significant, and several cases of death attributed to bed net fires were noted. Conclusions Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method. However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some. If some people fear the risk of fires, this possibility must be addressed during information and prevention sessions on malaria, with a communication strategy tailored to specific social contexts. Moreover, all possible measures should be taken to limit the harm suffered by individuals and their families. PMID:24972637

The sand-deposition impact of artificial gravel beds on the protection of the Mogao Grottoes

PubMed Central

Li, Guo Shuai; Qu, Jian Jun; Li, Xu Zhi; Wang, Wan Fu

2014-01-01

Gravel beds can prevent sand-dust emission and weaken sand-dust flux. We used wind-tunnel experiments and field observations on artificial gravel beds above the Mogao Grottoes to quantify their impact. In the report, we identified a significant correlation between gravel roughness and its ability to trap wind-transported sand. The optimal combinations of gravel diameter and coverage were determined. The greatest roughness is achieved when small gravel coverage is 75%, medium 40% and large 45%. We found that initial wind speed and gravel coverage are the key factors controlling the amount of sand trapped by the gravel beds. PMID:24614183

Mathematical evaluation of community level impact of combining bed nets and indoor residual spraying upon malaria transmission in areas where the main vectors are Anopheles arabiensis mosquitoes

PubMed Central

2013-01-01

Background Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. Methods A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset®, PermaNet 2.0®, Icon Life® nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Results Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset® or PermaNet 2.0® nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life® nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Conclusions Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus. PMID:23324456

Infrared video tracking of Anopheles gambiae at insecticide-treated bed nets reveals rapid decisive impact after brief localised net contact

PubMed Central

Parker, Josephine E.A.; Angarita-Jaimes, Natalia; Abe, Mayumi; Towers, Catherine E.; Towers, David; McCall, Philip J.

2015-01-01

Long-lasting insecticidal bed nets (LLINs) protect humans from malaria transmission and are fundamental to malaria control worldwide, but little is known of how mosquitoes interact with nets. Elucidating LLIN mode of action is essential to maintain or improve efficacy, an urgent need as emerging insecticide resistance threatens their future. Tracking multiple free-flying Anopheles gambiae responding to human-occupied bed nets in a novel large-scale system, we characterised key behaviours and events. Four behavioural modes with different levels of net contact were defined: swooping, visiting, bouncing and resting. Approximately 75% of all activity occurred at the bed net roof where multiple brief contacts were focussed above the occupant’s torso. Total flight and net contact times were lower at LLINs than untreated nets but the essential character of the response was unaltered. LLINs did not repel mosquitoes but impacted rapidly: LLIN contact of less than 1 minute per mosquito during the first ten minutes reduced subsequent activity; after thirty minutes, activity at LLINs was negligible. Velocity measurements showed that mosquitoes detected nets, including unbaited untreated nets, prior to contact. This is the most complete characterisation of mosquito-LLIN interactions to date, and reveals many aspects of LLIN mode of action, important for developing the next generation of LLINs. PMID:26323965

Sulfadoxine-Pyrimethamine–Based Intermittent Preventive Treatment, Bed Net Use, and Antenatal Care during Pregnancy: Demographic Trends and Impact on the Health of Newborns in the Kassena Nankana District, Northeastern Ghana

PubMed Central

Oduro, Abraham R.; Fryauff, David J.; Koram, Kwadwo A.; Rogers, William O.; Anto, Francis; Atuguba, Frank; Anyorigiya, Thomas; Adjuik, Martin; Ansah, Patrick; Hodgson, Abraham; Nkrumah, Francis

2010-01-01

Demographics and health practices of 2,232 pregnant women in rural northeastern Ghana and characteristics of their 2,279 newborns were analyzed to determine benefits associated with intermittent preventive treatment (IPTp), antenatal care, and/or bed net use during pregnancy. More than half reported bed net use, 90% reported at least two antenatal care visits, and > 82% took at least one IPTp dose of sulfadoxine-pyrimethamine. Most used a bed net and IPTp (45%) or IPTp alone (38%). Low birth weight (< 2,500 grams) characterized 18.3% of the newborns and was significantly associated with female sex, Nankam ethnicity, first-born status, and multiple births. Among newborns of primigravidae, IPTp was associated with a significantly greater birth weight, significantly fewer low birth weight newborns, improved hemoglobin levels, and less anemia. Babies of multigravidae derived no benefit to birth weight or hemoglobin level from single or multiple doses of sulfadoxine-pyrimethamine during pregnancy. No differences or benefits were seen when a bed net was the only protective factor. PMID:20595482

Expanding the scope of medical mission volunteer groups to include a research component.

PubMed

Rovers, John; Andreski, Michael; Gitua, John; Bagayoko, Abdoulaye; DeVore, Jill

2014-02-20

Serving on volunteer groups undertaking medical mission trips is a common activity for health care professionals and students. Although volunteers hope such work will assist underserved populations, medical mission groups have been criticized for not providing sustainable health services that focus on underlying health problems. As members of a volunteer medical mission group, we performed a bed net indicator study in rural Mali. We undertook this project to demonstrate that volunteers are capable of undertaking small-scale research, the results of which offer locally relevant results useful for disease prevention programs. The results of such projects are potentially sustainable beyond the duration of a mission trip. Volunteers with Medicine for Mali interviewed 108 households in Nana Kenieba, Mali during a routine two-week medical mission trip. Interviewees were asked structured questions about family demographics, use of insecticide treated bed nets the previous evening, as well as about benefits of net use and knowledge of malaria. Survey results were analyzed using logistic regression. We found that 43.7% of households had any family member sleep under a bed net the previous evening. Eighty seven percent of households owned at least one ITN and the average household owned 1.95 nets. The regression model showed that paying for a net was significantly correlated with its use, while low perceived mosquito density, obtaining the net from the public sector and more than four years of education in the male head of the household were negatively correlated with net use. These results differ from national Malian data and peer-reviewed studies of bed net use. We completed a bed net study that provided results that were specific to our service area. Since these results were dissimilar to peer-reviewed literature and Malian national level data on bed net use, the results will be useful to develop locally specific teaching materials on malaria prevention. This preventive focus is potentially more sustainable than clinical services for malaria treatment. Although we were not able to demonstrate that our work is sustainable, our study shows that volunteer groups are capable of undertaking research that is relevant to their service area.

Expanding the scope of medical mission volunteer groups to include a research component

PubMed Central

2014-01-01

Background Serving on volunteer groups undertaking medical mission trips is a common activity for health care professionals and students. Although volunteers hope such work will assist underserved populations, medical mission groups have been criticized for not providing sustainable health services that focus on underlying health problems. As members of a volunteer medical mission group, we performed a bed net indicator study in rural Mali. We undertook this project to demonstrate that volunteers are capable of undertaking small-scale research, the results of which offer locally relevant results useful for disease prevention programs. The results of such projects are potentially sustainable beyond the duration of a mission trip. Methods Volunteers with Medicine for Mali interviewed 108 households in Nana Kenieba, Mali during a routine two-week medical mission trip. Interviewees were asked structured questions about family demographics, use of insecticide treated bed nets the previous evening, as well as about benefits of net use and knowledge of malaria. Survey results were analyzed using logistic regression. Results We found that 43.7% of households had any family member sleep under a bed net the previous evening. Eighty seven percent of households owned at least one ITN and the average household owned 1.95 nets. The regression model showed that paying for a net was significantly correlated with its use, while low perceived mosquito density, obtaining the net from the public sector and more than four years of education in the male head of the household were negatively correlated with net use. These results differ from national Malian data and peer-reviewed studies of bed net use. Conclusions We completed a bed net study that provided results that were specific to our service area. Since these results were dissimilar to peer-reviewed literature and Malian national level data on bed net use, the results will be useful to develop locally specific teaching materials on malaria prevention. This preventive focus is potentially more sustainable than clinical services for malaria treatment. Although we were not able to demonstrate that our work is sustainable, our study shows that volunteer groups are capable of undertaking research that is relevant to their service area. PMID:24555713

How Much Does Malaria Vector Control Quality Matter: The Epidemiological Impact of Holed Nets and Inadequate Indoor Residual Spraying

PubMed Central

Rehman, Andrea M.; Coleman, Mike; Schwabe, Christopher; Baltazar, Giovanna; Matias, Abrahan; Roncon Gomes, Irina; Yellott, Lee; Aragon, Cynthia; Nseng Nchama, Gloria; Mzilahowa, Themba; Rowland, Mark; Kleinschmidt, Immo

2011-01-01

Background Insecticide treated nets (ITN) and indoor residual spraying (IRS) are the two pillars of malaria vector control in Africa, but both interventions are beset by quality and coverage concerns. Data from three control programs were used to investigate the impact of: 1) the physical deterioration of ITNs, and 2) inadequate IRS spray coverage, on their respective protective effectiveness. Methods Malaria indicator surveys were carried out in 2009 and 2010 in Bioko Island, mainland Equatorial Guinea and Malawi to monitor infection with P.falciparum in children, mosquito net use, net condition and spray status of houses. Nets were classified by their condition. The association between infection and quality and coverage of interventions was investigated. Results There was reduced odds of infection with P.falciparum in children sleeping under ITNs that were intact (Odds ratio (OR): 0.65, 95% CI: 0.55–0.77 and OR: 0.81, 95% CI: 0.56–1.18 in Equatorial Guinea and in Malawi respectively), but the protective effect became less with increasingly worse condition of the net. There was evidence for a linear trend in infection per category increase in deterioration of nets. In Equatorial Guinea IRS offered protection to those in sprayed and unsprayed houses alike when neighbourhood spray coverage was high (≥80%) compared to those living in areas of low IRS coverage (<20%), regardless of whether the house they lived in was sprayed or not (adjusted OR = 0.54, 95% CI 0.33–0.89). ITNs provided only personal protection, offering no protection to non users. Although similar effects were seen in Malawi, the evidence was much weaker than in Equatorial Guinea. Conclusions Universal coverage strategies should consider policies for repair and replacement of holed nets and promote the care of nets by their owners. IRS programs should ensure high spray coverage since inadequate coverage gives little or no protection at all. PMID:21559436

Sulfadoxine-Pyrimethamine-Based Intermittent Preventive Treatment, Bed Net Use, and Antenatal Care during Pregnancy: Demographic Trends and Impact on the Health of Newborns in the Kassena Nankana District, Northeastern Ghana

DTIC Science & Technology

2010-01-01

treatment for uncomplicated malaria, whether confirmed, or suspected, in 2004 and SIP- based IPTp was introduced in 2005.1•3 Indoor residual spray - ing...emigrations recorded. Although many women may have been using long - lasting ITNs during pregnancy, this quality of the bed nets could not be determined with...care, provision and wide use of insecticide -treated bed nets (ITNs), and intensified health education. Ghana readily adopted and began implementa

Impact of lambdacyhalothrin capsule suspension treated bed nets on malaria in tribal villages of Malkangiri district, Orissa, India.

PubMed

Sahu, S S; Vijayakumar, T; Kalyanasundaram, M; Subramanian, S; Jambulingam, P

2008-09-01

Insecticide treated mosquito nets are increasingly being used in malaria control programmes. One of the problems with the treatment of bed nets with conventional formulations of insecticides was that regular washing of treated nets diminish insecticidal effect. Lambdacyhalothrin 2.5 capsule suspension (CS) (2.5% a.i., w/v), a new water-based microencapsulated formulation is reported to have wash-resistant property and longer persistence on the netting material than other formulations. We evaluated the impact of the use of nylon bed nets treated with lambdacyhalothrin 2.5 CS at 10 mg (a.i.)/m(2) in comparison to untreated nets and no nets on malaria in tribal villages in Orissa. Nine foothill villages, highly endemic for falciparum malaria, from the Primary Health Centre (PHC) areas of Khairput and Kudumulugumma of Malkangiri district, Orissa, were divided into three groups, each with a population of about 500 and allocated randomly for treated (TN) and untreated nets (UN) and no nets (NN). Bed nets were distributed in September 2001 and retreatment was done in June 2002. The impact was assessed based on the changes in vector density, parous rate, malaria incidence and parasite rates. Indoor-resting collections of Anopheles fluviatilis and An. culicifacies were made at fortnightly intervals from fixed human dwellings. Mass blood surveys before and after distribution of nets and fortnightly active surveillance were carried out to assess the change in parasite rates and malaria incidence. Bioassays were conducted at fortnightly intervals on the bed nets supplied to the villagers. The reductions in indoor resting catches of An. fluviatilis and An. culicifacies were 96 and 38 per cent in villages with treated nets and 2.6 and 23 per cent in villages with untreated nets respectively compared to no net villages. For six months following treatment, 100 per cent mortality of An. fluviatilis was observed on the unwashed nets and on the nets washed once or twice. After re-treatment, 100 per cent mortality of An. fluviatilis or An. culicifacies was observed for nine months even after two washes. Usage rates of treated and untreated nets varied seasonally; 58.9 and 46.3 per cent in rainy season, 48.6 and 37.1 per cent in winter season and 38.1 and 31.6 per cent in summer season respectively. Reductions in malaria parasite rates were about 65 per cent in the treated net villages and 39 per cent in the untreated net villages compared to no net villages. About 75 per cent of treated nets and 60 per cent of untreated nets were in usable condition 19 months after distribution. The estimated protection factor based on malaria incidence was 86 per cent for the treated nets during both post-treatment and post-retreatment periods and 34 and 51 per cent for untreated nets for the corresponding periods compared to no nets. The results of the study showed that the use of bed nets treated nets with CS formulation of lambdacyhalothrin at 10 mg (a.i.)/m(2) was acceptable to the community and re-treatment of nets at nine-monthly intervals can significantly reduce density and survival of An. fluviatilis and incidence of falciparum malaria.

Estimation of effectiveness of interventions for malaria control in pregnancy using the screening method.

PubMed

Msyamboza, K; Senga, E; Tetteh-Ashong, E; Kazembe, P; Brabin, B J

2007-04-01

The evaluation of the effectiveness of antimalarial drugs and bed net use in pregnant women is an important aspect of monitoring and surveillance of malaria control in pregnancy. In principle the screening method for assessing vaccine efficacy can be applied in non-vaccine settings for assessing interventions for malaria control in pregnancy. In this analysis field data on the proportion of placental malaria cases treated with two doses of sulphadoxine-pyrimethamine (SP) and the uptake of two doses of SP in the antenatal clinic was used in a case-coverage method to assess the protective effectiveness (PE) of intermittent preventive treatment with SP for malaria control in pregnancy. PE was assessed using placental malaria, low birthweight and maternal anaemia at delivery as outcome variables. The method was also applied to an evaluation of the protective effectiveness of self-reported use of impregnated bed nets (ITNs). Effectiveness was highest for reduction of low birthweight in multigravidae (87.2%, 95% CI, 83.2-91.3%). PE was lower for placental malaria (61.6% primigravidae, 28.5% multigravidae), and maternal anaemia (Hb < 8.0 g/dl, 37.8% primigravidae, 29.6% multigravidae). Estimates for PE of self-reported use of ITNs gave values for all three outcome parameters that were much lower than for SP use. For women of all parties effectiveness estimates for reduction of low birthweight were 22% (95% CI, 17.7-26.4), prevention of placental malaria (all types) 7.1% (95% CI, 4.4-9.8), prevention of active placental infection 38.9% (95% CI, 27.4-50.4), and for maternal anaemia 8.8% (95% CI, 0-20.0). The case-coverage method could provide a useful and practical approach to routine monitoring and evaluation of drug interventions to control malaria in pregnancy and has potentially wide applications. Effectiveness estimates related to reported ITN use in pregnancy may be less reliable. The method should be further evaluated using currently available data sets.

I get height with a little help from my friends: herd protection from sanitation on child growth in rural Ecuador

PubMed Central

Fuller, James A; Villamor, Eduardo; Cevallos, William; Trostle, James; Eisenberg, Joseph NS

2016-01-01

Abstract Background: Infectious disease interventions, such as vaccines and bed nets, have the potential to provide herd protection to non-recipients. Similarly, improved sanitation in one household may provide community-wide benefits if it reduces contamination in the shared environment. Sanitation at the household level is an important predictor of child growth, but less is known about the effect of sanitation coverage in the community. Methods: From 2008 to 2013, we took repeated anthropometric measurements on 1314 children under 5 years of age in 24 rural Ecuadorian villages. Using mixed effects regression, we estimated the association between sanitation coverage in surrounding households and child growth. Results: Sanitation coverage in the surrounding households was strongly associated with child height, as those with 100% coverage in their surroundings had a 67% lower prevalence of stunting [prevalence ratio (PR) 0.32, 95% CI 0.15-0.69] compared with those with 0% coverage. Children from households with improved sanitation had a lower prevalence of stunting (PR 0.86, 95% CI 0.64-1.15). When analysing height as a continuous outcome, the protective effect of sanitation coverage is manifested primarily among girls during the second year of life, the time at which growth faltering is most likely to occur. Conclusions: Our study highlights that a household’s sanitation practices can provide herd protection to the overall community. Studies which fail to account for the positive externalities that sanitation provides will underestimate the overall protective effect. Future studies could seek to identify a threshold of sanitation coverage, similar to a herd immunity threshold, to provide coverage and compliance targets. PMID:26936912

Aeolian processes over gravel beds: Field wind tunnel simulation and its application atop the Mogao Grottoes, China

NASA Astrophysics Data System (ADS)

Zhang, Weimin; Tan, Lihai; Zhang, Guobin; Qiu, Fei; Zhan, Hongtao

2014-12-01

The aeolian processes of erosion, transport and deposition are threatening the Mogao Grottoes, a world culture heritage site. A field wind tunnel experiment was conducted atop the Mogao Grottoes using weighing sensors to quantify aeolian processes over protective gravel beds. Results reveal that aeolian erosion and deposition over gravel beds are basically influenced by gravel coverage and wind speed. Erosion is a main aeolian process over gravel beds and its strength level is mainly determined by gravel coverage: strong (<30%), medium (30-50%) and slight (>50%). Aeolian deposition only occurs when gravel coverage is equal to or greater than 30% and wind speeds are between 8 and 12 m s-1, and this process continues until the occurrence of the equilibrium coverage. In addition, the change in conditions of external sand supply affects the transition between aeolian deposition and erosion over gravel beds, and the quantity of sand transport at the height of 0-24 mm is an important indicator of aeolian deposition and erosion over gravel beds. Our results also demonstrate that making the best use of wind regime atop the Mogao Grottoes and constructing an artificial gobi surface in staggered arrays, with 30% coverage and 30-mm-high gravels and in 40 mm spacing can trap westerly invading sand flow and enable the stronger easterly wind to return the deposited sand on the gravel surface back to the Mingsha Mountain so as to minimize the damage of the blown sand flux to the Mogao Grottoes.

Permethrin-impregnated bed nets for the prevention of malaria in schoolchildren on the Thai-Burmese border.

PubMed

Luxemburger, C; Perea, W A; Delmas, G; Pruja, C; Pecoul, B; Moren, A

1994-01-01

A double-blind controlled trial was undertaken from August 1990 to February 1991 among Karen children on the Thai-Burmese border to evaluate the effects on malaria incidence and prevalence of permethrin-treated bed nets. Three hundred and fifty schoolchildren, aged 4 to 15 years, were allocated at random to receive either a permethrin-impregnated net or a non-treated net. The incidence of malaria infections, confirmed by a blood film, was assessed during 6 months. Three surveys were conducted, on admission and 3 and 6 months later, to measure the prevalence of infections and spleen rates. Compliance was assessed by monthly home visiting. The use of permethrin-treated bed nets reduced the number of parasitaemic Plasmodium falciparum infections by 38% and the number of symptomatic episodes by 42%. The number of P. vivax malaria attacks was similar in each group. The prevalence of positive blood films in the 2 groups did not change significantly during the study. A reduction in spleen rate by 50% in both groups at the end of the study period could not be related to the overall use of nets. Compliance was high and no side-effect was reported. The long-term effects on morbidity and mortality need to be assessed after distribution of permethrin treated bed nets at the village level.

Malaria-related knowledge and prevention practices in four neighbourhoods in and around Mumbai, India: a cross-sectional study.

PubMed

Dhawan, Gaurav; Joseph, Nidhin; Pekow, Penelope S; Rogers, Christine A; Poudel, Krishna C; Bulzacchelli, Maria T

2014-08-07

India accounts for the highest number of malaria cases outside of Africa. Eighty per cent of India's population lives in malaria-risk areas, with cases increasing in urban areas. Mumbai, India, one of the most populous cities in the world, has experienced such an increase. To be successful, many malaria control efforts require community participation, which in turn depends on individuals' knowledge and awareness of the disease. This study assessed the knowledge and prevention practices regarding malaria in residents of four different areas of Mumbai, India, around the time of a malaria outbreak and the start of a widespread awareness campaign. A cross-sectional comparative study assessed malaria-related knowledge and prevention practices in four geographically and socio-demographically distinct areas of Mumbai, India. A structured interviewer-administered questionnaire was administered to a stratified random sample of 119 households between 16 December 2010 and 30 January 2011. Participant socio-demographic characteristics, malaria knowledge, malaria prevention practices, and household environmental factors were examined overall and compared across the four areas of Mumbai. Overall, respondents had excellent knowledge of the mosquito as the means of transmission of malaria, mosquito biting times and breeding sites, and fever as a symptom of malaria. However, many respondents also held misconceptions about malaria transmission and symptoms. Respondents generally knew that bed nets are an effective prevention strategy, but only 30% used them, and only 4% used insecticide-treated bed nets. Knowledge and prevention practices varied across the four areas of Mumbai. Although most residents know that bed nets are effective in preventing malaria, usage of bed nets is very low, and almost no residents use insecticide-treated bed nets. As the four areas of Mumbai differed in knowledge, prevention practices, and primary sources of information, malaria control campaigns should be tailored according to the knowledge gaps, practices, environments, resources, and preferences in different areas of the city, using the interpersonal and media channels most likely to reach the target audiences. Malaria control efforts involving bed nets should emphasize use of insecticide-treated bed nets.

Impact of permethrin-treated bed nets on entomologic indices in an area of intense year-round malaria transmission.

PubMed

Gimnig, John E; Vulule, John M; Lo, Terrence Q; Kamau, Luna; Kolczak, Margarette S; Phillips-Howard, Penelope A; Mathenge, Evan M; ter Kuile, Feiko O; Nahlen, Bernard L; Hightower, Allen W; Hawley, William A

2003-04-01

The effect of permethrin-treated bed nets (ITNs) on malaria vectors was studied as part of a large-scale, randomized, controlled trial in western Kenya. Indoor resting densities of fed Anopheles gambiae s.l. and An. funestus in intervention houses were 58.5% (P = 0.010) and 94.5% (P = 0.001) lower, respectively, compared with control houses. The sporozoite infection rate in An. gambiae s.l. was 0.8% in intervention areas compared with 3.4% (P = 0.026) in control areas, while the sporozoite infection rates in An. funestus were not significantly different between the two areas. We estimated the overall transmission of Plasmodium falciparum in intervention areas to be 90% lower than in control areas. Permethrin resistance was not detected during the study period. As measured by densities of An. gambiae s.l., the efficacy of bed nets decreased if one or more residents did not sleep under a net or if bed nets had not been re-treated within six months. These results indicate that ITNs are optimally effective if used every night and if permethrin is reapplied at least biannually.

Comparing insecticide-treated bed net use to Plasmodium falciparum infection among schoolchildren living near Lake Victoria, Kenya.

PubMed

Okoyo, Collins; Mwandawiro, Charles; Kihara, Jimmy; Simiyu, Elses; Gitonga, Caroline W; Noor, Abdisalan M; Njenga, Sammy M; Snow, Robert W

2015-12-22

Under trial conditions insecticide-treated nets have been shown to provide significant clinical and mortality protection under a range of malaria transmission intensity conditions. There are, however, few operational impact data, notably in very intense transmission conditions. This study, reports on malaria infection among Kenyan schoolchildren living in areas of intense malaria transmission and their reported use of insecticide-treated bed nets. 5188 children in 54 schools were randomly sampled from seven counties surrounding Lake Victoria between May and June 2014. A questionnaire was administered to schoolchildren in classes 2-6 on the use of a long-lasting, insecticide-treated net (LLIN) the night before the survey and provided a single blood sample for a rapid diagnostic test for malaria infection. Analysis of the impact of insecticide-treated net use on malaria prevalence was undertaken using a multivariable, mixed effects, logistic regression at 95% confidence interval (CI), taking into account hierarchical nature of the data and results adjusted for school clusters. The overall prevalence of malaria infection was 48.7%, two-thirds (67.9%) of the children reported using LLIN, 91.3% of the children reported that their households own at least one LLIN and the household LLIN coverage was 2.5 persons per one LLIN. The prevalence of infection showed variation across the counties, with prevalence being highest in Busia (66.9%) and Homabay (51.8%) counties, and lowest in Migori County (29.6%). Generally, malaria parasite prevalence differed between age groups and gender with the highest prevalence occurring in children below 7 years (50.6%) and males (52.2%). Adjusting for county and school, there was a significant reduction in odds of malaria infection among the schoolchildren who reported LLIN use the previous night by 14 % (aOR 0.86, 95% CI 0.74-0.98, P < 0.027). Malaria transmission continues to be high around Lake Victoria. Despite evidence of increasing pyrethroid resistance and the likely overall efficacy of LLIN distributed several years prior to the survey, LLIN continue to provide protection against infection among school-aged children.

Cost of lifetime immunosuppression coverage for kidney transplant recipients.

PubMed

Page, Timothy F; Woodward, Robert S

2008-01-01

On January 1, 2000, Medicare extended the coverage of immunosuppression medications from 3 years to life for elderly and disabled kidney transplant recipients. This research estimates the impact of extending this lifetime coverage to all kidney transplant recipients on Medicare's cash flows. The study finds that extending coverage to all kidney transplant recipients would have increased Medicare's net cash outflows if the coverage were extended for patients of all income levels. There is evidence that extending coverage to only patients in the lowest income quartile could have resulted in a net cost savings to Medicare.

Success of Senegal's first nationwide distribution of long-lasting insecticide-treated nets to children under five - contribution toward universal coverage

PubMed Central

2011-01-01

Background In 2009, the first national long-lasting insecticide-treated net (LLIN) distribution campaign in Senegal resulted in the distribution of 2.2 million LLINs in two phases to children aged 6-59 months. Door-to-door teams visited all households to administer vitamin A and mebendazole, and to give a coupon to redeem later for an LLIN. Methods A nationwide community-based two-stage cluster survey was conducted, with clusters selected within regions by probability proportional to size sampling, followed by GPS-assisted mapping, simple random selection of households in each cluster, and administration of a questionnaire using personal digital assistants (PDAs). The questionnaire followed the Malaria Indicator Survey format, with rosters of household members and bed nets, and questions on campaign participation. Results There were 3,280 households in 112 clusters representing 33,993 people. Most (92.1%) guardians of eligible children had heard about the campaign, the primary sources being health workers (33.7%), neighbours (26.2%), and radio (22.0%). Of eligible children, 82.4% received mebendazole, 83.8% received vitamin A, and 75.4% received LLINs. Almost all (91.4%) LLINs received during the campaign remained in the household; of those not remaining, 74.4% had been given away and none were reported sold. At least one insecticide-treated net (ITN) was present in 82.3% of all households, 89.2% of households with a child < 5 years and 57.5% of households without a child < 5 years. Just over half (52.4%) of ITNs had been received during the campaign. Considering possible indicators of universal coverage, 39.8% of households owned at least one ITN per two people, 21.6% owned at least one ITN per sleeping space and 34.7% of the general population slept under an ITN the night before the survey. In addition, 45.6% of children < 5 years, and 49.2% of pregnant women had slept under an ITN. Conclusions The nationwide integrated LLIN distribution campaign allowed household ITN ownership of one or more ITNs to surpass the RBM target of 80% set for 2010, though additional distribution strategies are needed to reach populations missed by the targeted campaign and to reach the universal coverage targets of one ITN per sleeping space and 80% of the population using an ITN. PMID:21489278

A qualitative study of community perception and acceptance of biological larviciding for malaria mosquito control in rural Burkina Faso.

PubMed

Dambach, Peter; Jorge, Margarida Mendes; Traoré, Issouf; Phalkey, Revati; Sawadogo, Hélène; Zabré, Pascal; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Becker, Norbert; Beiersmann, Claudia

2018-03-23

Vector and malaria parasite's rising resistance against pyrethroid-impregnated bed nets and antimalarial drugs highlight the need for additional control measures. Larviciding against malaria vectors is experiencing a renaissance with the availability of environmentally friendly and target species-specific larvicides. In this study, we analyse the perception and acceptability of spraying surface water collections with the biological larvicide Bacillus thuringiensis israelensis in a single health district in Burkina Faso. A total of 12 focus group discussions and 12 key informant interviews were performed in 10 rural villages provided with coverage of various larvicide treatments (all breeding sites treated, the most productive breeding sites treated, and untreated control). Respondents' knowledge about the major risk factors for malaria transmission was generally good. Most interviewees stated they performed personal protective measures against vector mosquitoes including the use of bed nets and sometimes mosquito coils and traditional repellents. The acceptance of larviciding in and around the villages was high and the majority of respondents reported a relief in mosquito nuisance and malarial episodes. There was high interest in the project and demand for future continuation. This study showed that larviciding interventions received positive resonance from the population. People showed a willingness to be involved and financially support the program. The positive environment with high acceptance for larviciding programs would facilitate routine implementation. An essential factor for the future success of such programs would be inclusion in regional or national malaria control guidelines.

The potential impact of integrated malaria transmission control on entomologic inoculation rate in highly endemic areas.

PubMed

Killeen, G F; McKenzie, F E; Foy, B D; Schieffelin, C; Billingsley, P F; Beier, J C

2000-05-01

We have used a relatively simple but accurate model for predicting the impact of integrated transmission control on the malaria entomologic inoculation rate (EIR) at four endemic sites from across sub-Saharan Africa and the southwest Pacific. The simulated campaign incorporated modestly effective vaccine coverage, bed net use, and larval control. The results indicate that such campaigns would reduce EIRs at all four sites by 30- to 50-fold. Even without the vaccine, 15- to 25-fold reductions of EIR were predicted, implying that integrated control with a few modestly effective tools can meaningfully reduce malaria transmission in a range of endemic settings. The model accurately predicts the effects of bed nets and indoor spraying and demonstrates that they are the most effective tools available for reducing EIR. However, the impact of domestic adult vector control is amplified by measures for reducing the rate of emergence of vectors or the level of infectiousness of the human reservoir. We conclude that available tools, including currently neglected methods for larval control, can reduce malaria transmission intensity enough to alleviate mortality. Integrated control programs should be implemented to the fullest extent possible, even in areas of intense transmission, using simple models as decision-making tools. However, we also conclude that to eliminate malaria in many areas of intense transmission is beyond the scope of methods which developing nations can currently afford. New, cost-effective, practical tools are needed if malaria is ever to be eliminated from highly endemic areas.

Transport of fine sediment over a coarse, immobile riverbed

USGS Publications Warehouse

Grams, Paul E.; Wilcock, Peter R.

2014-01-01

Sediment transport in cobble-boulder rivers consists mostly of fine sediment moving over a coarse, immobile bed. Transport rate depends on several interrelated factors: boundary shear stress, the grain size and volume of fine sediment, and the configuration of fine sediment into interstitial deposits and bed forms. Existing models do not incorporate all of these factors. Approaches that partition stress face a daunting challenge because most of the boundary shear is exerted on immobile grains. We present an alternative approach that divides the bed into sand patches and interstitial deposits and is well constrained by two clear end-member cases: full sand cover and absence of sand. Entrainment from sand patches is a function of their aerial coverage. Entrainment from interstices among immobile grains is a function of sand elevation relative to the size of the immobile grains. The bed-sand coverage function is used to predict the ratio of the rate of entrainment from a partially covered bed to the rate of entrainment from a completely sand-covered bed, which is determined using a standard sand transport model. We implement the bed-sand coverage function in a morphodynamic routing model and test it against observations of sand bed elevation and suspended sand concentration for conditions of nonuniform fine sediment transport in a large flume with steady uniform flow over immobile hemispheres. The results suggest that this approach may provide a simple and robust method for predicting the transport and migration of fine sediment through rivers with coarse, immobile beds.

Navy Entomologists Assist CDC’s Fight Against Malaria

DTIC Science & Technology

2013-01-01

long - lasting insec- ticide treated bed nets (LLINs): 2) indoor residual spraying (IRS) of living quarters using long - lasting residual ... insecticide susceptible malaria mosquitoes for residual insecticide testing of IRS sprayed walls and long lasting insecticide -treated bed nets . which is...the Navy Entomology Center of Excellence sprays panels, made of materials

Synergy between repellents and organophosphates on bed nets: efficacy and behavioural response of natural free-flying An. gambiae mosquitoes.

PubMed

Pennetier, Cédric; Costantini, Carlo; Corbel, Vincent; Licciardi, Séverine; Dabiré, Roch K; Lapied, Bruno; Chandre, Fabrice; Hougard, Jean-Marc

2009-11-19

Chemicals are used on bed nets in order to prevent infected bites and to kill aggressive malaria vectors. Because pyrethroid resistance has become widespread in the main malaria vectors, research for alternative active ingredients becomes urgent. Mixing a repellent and a non-pyrethroid insecticide seemed to be a promising tool as mixtures in the laboratory showed the same features as pyrethroids. We present here the results of two trials run against free-flying Anopheles gambiae populations comparing the effects of two insect repellents (either DEET or KBR 3023, also known as icaridin) and an organophosphate insecticide at low-doses (pirimiphos-methyl, PM) used alone and in combination on bed nets. We showed that mixtures of PM and the repellents induced higher exophily, blood feeding inhibition and mortality among wild susceptible and resistant malaria vectors than compounds used alone. Nevertheless the synergistic interactions are only involved in the high mortality induced by the two mixtures. These field trials argue in favour of the strategy of mixing repellent and organophosphate on bed nets to better control resistant malaria vectors.

How many holes is too many? A prototype tool for estimating mosquito entry risk into damaged bed nets.

PubMed

Sutcliffe, James; Ji, Xin; Yin, Shaoman

2017-08-01

Insecticide-treated bed nets (ITNs) have played an integral role in malaria reduction but how insecticide depletion and accumulating physical damage affect ITN performance is poorly understood. More accurate methods are needed to assess damage to bed nets so that they can be designed, deployed and replaced optimally. Video recordings of female Anopheles gambiae in near approach (1-½ cm) to occupied untreated rectangular bed nets in a laboratory study were used to quantify the amount of mosquito activity (appearances over time) around different parts of the net, the per-appearance probability of a mosquito coming close to holes of different sizes (hole encounter) and the per-encounter probability of mosquitoes passing through holes of different sizes (hole passage). Appearance frequency on different parts of the net reflected previously reported patterns: the area of the net under greatest mosquito pressure was the roof, followed by the bottom 30 cm of the sides, followed by the 30 cm area immediately above this, followed by the upper two-thirds of the sides. The ratio of activity in these areas was (respectively) 250:33:5:1. Per-appearance probability of hole encounter on all parts of the net was strongly predicted by a factor combining hole perimeter and area. Per-encounter probability of hole passage, in turn, was strongly predicted by hole width. For a given width, there was a 20% greater risk of passage through holes on the roof than holes on the sides. Appearance, encounter and passage predictors correspond to various mosquito behaviours that have previously been described and are combined into a prototype mosquito entry risk tool that predicts mosquito entry rates for nets with various amounts of damage. Scenarios that use the entry risk tool to test the recommendations of the WHOPES proportionate hole index (pHI) suggest that the pHI hole size categories and failure to account for hole location likely sometimes lead to incorrect conclusions about net serviceability that could be avoided by using an entry risk tool of the form presented here instead. Practical methods of collecting hole position, shape and size information for bed net assessments using the tool in the field are discussed and include using image analysis and on-line geometric analysis tools.

Evaluation of Polyethylene-Based Long Lasting Treated Bed Net Netprotect on Anopheles Mosquitoes, Malaria Incidence, and Net Longivity in Western Kenya

PubMed Central

Odhiambo, M. T. O.; Skovmand, O.; Vulule, J. M.; Kokwaro, E. D.

2013-01-01

We studied the effect on malaria incidence, mosquito abundance, net efficacy, net use rate, chemical analysis, and holes of a long lasting insecticide treated bed net (Netprotect) in western Kenya, 2007–2010. Nets were hung in 150 households 6 months before they were hung in a second, 2 km away. Indoor resting densities were monitored by pyrethrum spray catch and malaria cases by passive detection using clinical manifestations and rapid diagnostic test. The probability of finding An. arabiensis in the control area was 2.6 times higher than that in intervention area during the first 6 months. Human blood feeding index of Anopheles funestus declined 17%. After bed nets were hung in the second area, malaria incidence declined 25% down to the level in the first area. Incidence remained at this low level for 2 years. 90% of collected nets were efficacious after 3-year use. Deltamethrin dosage declined from 1.9 to 0.5 g/kg over 3 years. Attrition rate after 3 years was 21%. WHO hole index changed from 333 to 114 to 381 over the three years. This index summarizes the numbers of holes in size categories and multiplies with the mean hole area per category. It is very sensitive to the impact of big holes in a few nets. PMID:24194770

Hospital-level changes in adult ICU bed supply in the United States

PubMed Central

Wallace, David J.; Seymour, Christopher W.; Kahn, Jeremy M.

2017-01-01

Objective Although the number of intensive care beds in the United States is increasing, little is known about the hospitals responsible for this growth. We sought to better characterize national growth in intensive care beds by identifying hospital-level factors associated with increasing numbers of intensive care beds over time. Design We performed a repeated-measures time series analysis of hospital-level intensive care bed supply using data from Centers for Medicare and Medicaid Services. Setting All United States acute care hospitals with adult intensive care beds over the years 1996 to 2011. Measurements & Main Results We described the number of beds, teaching status, ownership, intensive care occupancy and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net +13,471 beds, 72.1% of total growth), hospitals with 250 or more beds (net +18,327 beds, 91.8% of total growth) and hospitals in the highest quartile of occupancy (net +10,157 beds, 54.0% of total growth). In a longitudinal multivariable model, larger hospital size, teaching status, and high intensive care occupancy were associated with subsequent-year growth. Furthermore, the effects of hospital size and teaching status were modified by occupancy: the greatest odds of increasing intensive care unit beds were in hospitals with 500 or more beds in the highest quartile of occupancy (adjusted OR: 18.9; 95% CI: 14.0 – 25.5; p<0.01) and large teaching hospitals in the highest quartile of occupancy (adjusted OR: 7.3; 95% CI: 5.3 – 9.9; p<0.01). Conclusions Increasingly, intensive care bed expansion in the United States is occurring in larger hospitals and teaching centers, particularly following a year with high intensive care unit occupancy. PMID:27661861

Impact of malaria related messages on insecticide-treated net (ITN) use for malaria prevention in Ghana.

PubMed

Owusu Adjah, Ebenezer S; Panayiotou, Andrie G

2014-03-28

Media messages have been used in Ghana to promote insecticide-treated net (ITN)/bed net usage in an effort to impact on malaria prevention. The aim of this study was to assess the effect of such malaria-related messages delivered through electronic/print media and by volunteers/health workers on the use of ITNs by children living in a household. Data was collected from September to November of 2008 using a structured, interviewer-administered questionnaire by the Ghana Statistical Service as part of a national demographic and health survey (DHS). Secondary data analysis was performed on the collected data using multivariate logistic regression for both individual messages and a composite (any of) message variable. From the 11,788 households surveyed, 45% had at least one net. Households with male heads were more likely to have a child sleeping under a bed net the previous night (p = 0.0001). Individual Messages delivered by a health worker or a dedicated radio programme, had the highest effect for one or more children sleeping under a net the night before (OR(adjusted) = 1.65; 95% CI = 1.44 to 1.88 and OR(adjusted) = 1.26; 95% CI =1.12 to 1.42 respectively) while hearing any of the eight messages (composite score) resulted in the highest odds for one or more children (OR(adjusted) = 3.06; 95% CI = 2.27 to 4.12) sleeping under a bed net. Efforts to relate ITN messages to the public are very useful in increasing use of bed nets and having multiple ways of reaching the public increases their effect, with the biggest effect seen when health workers and volunteers were used to deliver malaria-related messages to the public.

The Financial Effect of Value-Based Purchasing and the Hospital Readmissions Reduction Program on Safety-Net Hospitals in 2014: A Cohort Study.

PubMed

Gilman, Matlin; Hockenberry, Jason M; Adams, E Kathleen; Milstein, Arnold S; Wilson, Ira B; Becker, Edmund R

2015-09-15

Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP) could disproportionately affect safety-net hospitals. To determine whether safety-net hospitals incur larger financial penalties than other hospitals under VBP and HRRP. Cross-sectional analysis. United States in 2014. 3022 acute care hospitals participating in VBP and the HRRP. Safety-net hospitals were defined as being in the top quartile of the Medicare disproportionate share hospital (DSH) patient percentage and Medicare uncompensated care (UCC) payments per bed. The differences in penalties in both total dollars and dollars per bed between safety-net hospitals and other hospitals were estimated with the use of bivariate and graphical regression methods. Safety-net hospitals in the top quartile of each measure were more likely to be penalized under VBP than other hospitals (62.9% vs. 51.0% under the DSH definition and 60.3% vs. 51.5% under the UCC per-bed definition). This was also the case under the HRRP (80.8% vs. 69.0% and 81.9% vs. 68.7%, respectively). Safety-net hospitals also had larger payment penalties ($115 900 vs. $66 600 and $150 100 vs. $54 900, respectively). On a per-bed basis, this translated to $436 versus $332 and $491 versus $314, respectively. Sensitivity analysis setting the cutoff at the top decile rather than the top quartile decile led to similar conclusions with somewhat larger differences between safety-net and other hospitals. The quadratic fit of the data indicated that the larger effect of these penalties is in the middle of the distribution of the DSH and UCC measures. Only 2 measures of safety-net status were included in the analyses. Safety-net hospitals were disproportionately likely to be affected under VBP and the HRRP, but most incurred relatively small payment penalties in 2014. Patient-Centered Outcomes Research Institute.

Effect of insecticide-treated bed nets on house-entry by malaria mosquitoes: The flight response recorded in a semi-field study in Kenya.

PubMed

Spitzen, Jeroen; Koelewijn, Teun; Mukabana, W Richard; Takken, Willem

2017-08-01

Insecticide-treated nets are currently a major tool to reduce malaria transmission. Their level of repellency affects contact of the mosquito with the net, but may also influence the mosquito's entry into the house. The response of host-seeking malaria mosquitoes approaching the eave of an experimental house was recorded within a large screen house. We compared entry- and exit rates in relation to the presence in the house of different insecticide-treated bed nets (ITNs) with an untreated net. Mosquitoes were lured towards the house by dispensing a synthetic host-odour blend from within the net in the house. Complementary WHO bioassays revealed that the treated nets caused high knock-down- and mortality responses to the Anopheles gambiae sensu stricto strain tested. The proportion of mosquitoes that came into view of the cameras and subsequently entered the house did not differ between treated nets and the untreated net. Treated nets did not affect proportions of mosquitoes that exited the house and departed from view around the eave. However, the percentage of house-leaving and re-entering mosquitoes when an insecticide- treated net was present, was lower than in the presence of an untreated net. Our results indicated that there was no spatial repellent effect from pyrethroid-treated nets that influences house-entry at eave level. It is argued that the toxic effect of treated bed nets resulted in a reduced number of mosquitoes re-entering the house, which could thereby affect malaria transmission in neighbouring, unprotected houses. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Experiments and simulation of a net closing mechanism for tether-net capture of space debris

NASA Astrophysics Data System (ADS)

Sharf, Inna; Thomsen, Benjamin; Botta, Eleonora M.; Misra, Arun K.

2017-10-01

This research addresses the design and testing of a debris containment system for use in a tether-net approach to space debris removal. The tether-net active debris removal involves the ejection of a net from a spacecraft by applying impulses to masses on the net, subsequent expansion of the net, the envelopment and capture of the debris target, and the de-orbiting of the debris via a tether to the chaser spacecraft. To ensure a debris removal mission's success, it is important that the debris be successfully captured and then, secured within the net. To this end, we present a concept for a net closing mechanism, which we believe will permit consistently successful debris capture via a simple and unobtrusive design. This net closing system functions by extending the main tether connecting the chaser spacecraft and the net vertex to the perimeter and around the perimeter of the net, allowing the tether to actuate closure of the net in a manner similar to a cinch cord. A particular embodiment of the design in a laboratory test-bed is described: the test-bed itself is comprised of a scaled-down tether-net, a supporting frame and a mock-up debris. Experiments conducted with the facility demonstrate the practicality of the net closing system. A model of the net closure concept has been integrated into the previously developed dynamics simulator of the chaser/tether-net/debris system. Simulations under tether tensioning conditions demonstrate the effectiveness of the closure concept for debris containment, in the gravity-free environment of space, for a realistic debris target. The on-ground experimental test-bed is also used to showcase its utility for validating the dynamics simulation of the net deployment, and a full-scale automated setup would make possible a range of validation studies of other aspects of a tether-net debris capture mission.

Video studies of passage by Anopheles gambiae mosquitoes through holes in a simulated bed net: effects of hole size, hole orientation and net environment.

PubMed

Sutcliffe, James; Colborn, Kathryn L

2015-05-13

Holes in netting provide potential routes for mosquitoes to enter ITNs. Despite this, there is little information on how mosquitoes respond to holes in bed nets and how their responses are affected by hole size, shape and orientation or by ambient conditions around the net. Female Anopheles gambiae (G3) were recorded in a simulated bed net consisting of two sizes of untreated netting-covered behavioural arenas placed above and beside (to simulate the bed net roof and sides respectively) the experimenter who was a source of host cues from 'inside' the net. A round hole of 9 mm or 13 mm diameter was cut into the centre of the netting of each arena. Videos of unfed female mosquitoes in arenas were analysed for time spent flying, walking and standing still and for exit through the hole. The effects of the experimenter on temperature and relative humidity around the simulated net were also measured. Mosquitoes were significantly more active in overhead arenas than in arenas to the side. Hole passage was significantly more likely in smaller arenas than larger ones and for larger holes than smaller ones. In arenas to the side, hole passage rate through small holes was about 50% less likely than what could be explained by area alone. Passage rate through holes in overhead arenas was consistent with hole area. Temperature in arenas did not strongly reflect the experimenter's presence in the simulated net. Relative humidity and absolute humidity in overhead arenas, but not in arenas to the side, were immediately affected by experimenter presence. Higher levels of activity in overhead arenas than in arenas to the side were likely due to the rising heat and humidity plume from the experimenter. Lower than expected passage rates through smaller vertically oriented holes may have been be due to an edge effect that does not apply to horizontally oriented holes. Results suggest that current methods of assessing the importance of physical damage to ITNs may not accurately reflect mosquito entry risk in all cases.

Lay perceptions of kala-azar, mosquitoes and bed nets in Bihar, India.

PubMed

Mishra, Rabindra N; Singh, S P; Vanlerberghe, Veerle; Sundar, Shyam; Boelaert, Marleen; Lefèvre, Pierre

2010-07-01

To describe the lay perception of kala-azar (KA) in an endemic area of Muzaffarpur District, Bihar, India: local names, symptoms, affected persons, perceived severity and modes of transmission, as well as perceived mosquito nuisance, modes of protection and use of bed nets. We held 16 focus group discussions (FGD) in eight remote villages with altogether 157 participants in March 2008. Separate FGDs were held according to gender, socio-economic status (SES) and with key informants. Kala-azar is most commonly named pilahi. Poor people were said to be the most affected. Knowledge about symptoms was satisfactory. Fever and prolonged fever were the most stated symptoms. KA was perceived as a life-threatening disease with a heavy economic burden. Mosquito bites were perceived as the main mode of transmission but in lower socio-economic groups, non-vector-related explanations were also provided. The main modes of protection from mosquitoes mentioned were the use of fumes and bed nets. Season was the strongest factor influencing the use of bed nets and non-affordability for not owning them. Although the sand fly is not recognised as the vector, the relatively good awareness of disease transmission by mosquitoes and the nuisance caused by their high density might be an entry point for adopting preventive measures to protect from mosquito bite and thereby indirectly preventing from KA. Educational campaigns targeted to the poorer segments of society are needed to enhance knowledge about KA, its mode of transmission, risks of getting infected and to increase bed net use.

Synergy between Repellents and Organophosphates on Bed Nets: Efficacy and Behavioural Response of Natural Free-Flying An. gambiae Mosquitoes

PubMed Central

Pennetier, Cédric; Costantini, Carlo; Corbel, Vincent; Licciardi, Séverine; Dabiré, Roch K.; Lapied, Bruno; Chandre, Fabrice; Hougard, Jean-Marc

2009-01-01

Background Chemicals are used on bed nets in order to prevent infected bites and to kill aggressive malaria vectors. Because pyrethroid resistance has become widespread in the main malaria vectors, research for alternative active ingredients becomes urgent. Mixing a repellent and a non-pyrethroid insecticide seemed to be a promising tool as mixtures in the laboratory showed the same features as pyrethroids. Methodology/Principal Findings We present here the results of two trials run against free-flying Anopheles gambiae populations comparing the effects of two insect repellents (either DEET or KBR 3023, also known as icaridin) and an organophosphate insecticide at low-doses (pirimiphos-methyl, PM) used alone and in combination on bed nets. We showed that mixtures of PM and the repellents induced higher exophily, blood feeding inhibition and mortality among wild susceptible and resistant malaria vectors than compounds used alone. Nevertheless the synergistic interactions are only involved in the high mortality induced by the two mixtures. Conclusion These field trials argue in favour of the strategy of mixing repellent and organophosphate on bed nets to better control resistant malaria vectors. PMID:19936249

Fungal mycelia in soils - a new method for quantification of their biomass

NASA Astrophysics Data System (ADS)

Drabløs Eldhuset, Toril; Lange, Holger; Svetlik, Jan; Børja, Isabella

2013-04-01

All plant-bearing soils are interwoven with fungal hyphae. Their structure and function are affected by environmental factors like drought, which might be a stress factor of increasing importance in many world regions due to climate change. The fungal mycelium in soil is important both for mycorrhizal symbiosis with plant roots and for litter decomposition, and thereby also for carbon turnover in soils. However, the mycelium biomass has been difficult to assess. Here we describe a simple and feasible method to quantify the biomass of fungal mycelium. We report on a manipulation study in the field where drought stress has been induced. The experiment was performed in a Norway spruce (Picea abies) 20 years old stand planted on former agricultural land, with a control plot and a roofed plot where precipitation was excluded. To investigate the fungal mycelium, nylon nets (mesh size 1 mm, width 7 cm and length 25 cm), were inserted vertically into the soil down to 20 cm depth. The nets were left in the soil from October to June, removed and replaced by new nets that were left in the soil from June to October. After removal, by cutting a block of soil around each net, the nets were cleaned from residual soil and scanned using the image scanner CanoScan 9000F. The resulting images were analyzed using the image processing software ImageJ. The image analysis was based on the distribution of grey values in the individual pixels which characterize the different components in the image (voids, hyphae, the nylon net, and soil). Based on the repeated visual evaluation of hyphal coverage in the net segments, we obtained an exponential equation allowing us to determine automatically the coverage of net windows by hyphae in percentage for each net scanned. In this way we can compare the hyphal coverage in the control and the drought-exposed plots. Based on the hyphal coverage scans together with hyphal dry weight on clean nets, we account for the soil particles adhering to the nets. Using this analysis method, the hyphal mat coverage in mm2 on any net is quantified and the hyphal biomass on the net can be calculated and compared between treatments. Also, the hyphal biomass per cm3 soil at the spot where the net has been inserted can be assessed. In addition, DNA from net-bound hyphae may be extracted to determine the identity of fungal species at different soil depths for the individual treatments.

Hidden burden of malaria in Indian women.

PubMed

Sharma, Vinod P

2009-12-08

Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP); of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state), that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tragic outcome can be averted by following the Roll Back Malaria/WHO recommendations of the use of malaria prevention i.e. indoor residual spraying (IRS)/insecticide-treated bed nets (ITN) preferably long-lasting treated bed nets (LLIN); intermittent preventive therapy (IPT); early diagnosis, prompt and complete treatment using microscopic/malaria rapid diagnostics test (RDT) and case management. High incidence in pregnancy has arisen because of malaria surveillance lacking coverage, lack of age and sex wise data, staff shortages, and intermittent preventive treatment (IPT) applicable in high transmission states/pockets is not included in the national drug policy- an essential component of fighting malaria in pregnancy in African settings. Inadequate surveillance and gross under-reporting has been highlighted time and again for over three decades. As a result the huge problem of malaria in pregnancy reported occasionally by researchers has remained hidden. Malaria in pregnancy may quicken severity in patients with drug resistant parasites, anaemia, endemic poverty, and malnutrition. There is, therefore, urgent need to streamline malaria control strategies to make a difference in tackling this grim scenario in human health.

THE POTENTIAL IMPACT OF INTEGRATED MALARIA TRANSMISSION CONTROL ON ENTOMOLOGIC INOCULATION RATE IN HIGHLY ENDEMIC AREAS

PubMed Central

KILLEEN, GERRY F.; McKENZIE, F. ELLIS; FOY, BRIAN D.; SCHIEFFELIN, CATHERINE; BILLINGSLEY, PETER F.; BEIER, JOHN C.

2008-01-01

We have used a relatively simple but accurate model for predicting the impact of integrated transmission control on the malaria entomologic inoculation rate (EIR) at four endemic sites from across sub-Saharan Africa and the southwest Pacific. The simulated campaign incorporated modestly effective vaccine coverage, bed net use, and larval control. The results indicate that such campaigns would reduce EIRs at all four sites by 30- to 50-fold. Even without the vaccine, 15- to 25-fold reductions of EIR were predicted, implying that integrated control with a few modestly effective tools can meaningfully reduce malaria transmission in a range of endemic settings. The model accurately predicts the effects of bed nets and indoor spraying and demonstrates that they are the most effective tools available for reducing EIR. However, the impact of domestic adult vector control is amplified by measures for reducing the rate of emergence of vectors or the level of infectiousness of the human reservoir. We conclude that available tools, including currently neglected methods for larval control, can reduce malaria transmission intensity enough to alleviate mortality. Integrated control programs should be implemented to the fullest extent possible, even in areas of intense transmission, using simple models as decision-making tools. However, we also conclude that to eliminate malaria in many areas of intense transmission is beyond the scope of methods which developing nations can currently afford. New, cost-effective, practical tools are needed if malaria is ever to be eliminated from highly endemic areas. PMID:11289662

Alluvial substrate mapping by automated texture segmentation of recreational-grade side scan sonar imagery.

PubMed

Hamill, Daniel; Buscombe, Daniel; Wheaton, Joseph M

2018-01-01

Side scan sonar in low-cost 'fishfinder' systems has become popular in aquatic ecology and sedimentology for imaging submerged riverbed sediment at coverages and resolutions sufficient to relate bed texture to grain-size. Traditional methods to map bed texture (i.e. physical samples) are relatively high-cost and low spatial coverage compared to sonar, which can continuously image several kilometers of channel in a few hours. Towards a goal of automating the classification of bed habitat features, we investigate relationships between substrates and statistical descriptors of bed textures in side scan sonar echograms of alluvial deposits. We develop a method for automated segmentation of bed textures into between two to five grain-size classes. Second-order texture statistics are used in conjunction with a Gaussian Mixture Model to classify the heterogeneous bed into small homogeneous patches of sand, gravel, and boulders with an average accuracy of 80%, 49%, and 61%, respectively. Reach-averaged proportions of these sediment types were within 3% compared to similar maps derived from multibeam sonar.

Recreational-Grade Sidescan Sonar: Transforming a Low-Cost Leisure Gadget into a High Resolution Riverbed Remote Sensing Tool

NASA Astrophysics Data System (ADS)

Hamill, D. D.; Buscombe, D.; Wheaton, J. M.; Wilcock, P. R.

2016-12-01

The size and spatial organization of bed material, bed texture, is a fundamental physical attribute of lotic ecosystems. Traditional methods to map bed texture (such as physical samples and underwater video) are limited by low spatial coverage, and poor precision in positioning. Recreational grade sidescan sonar systems now offer the possibility of imaging submerged riverbed sediments at coverages and resolutions sufficient to identify subtle changes in bed texture, in any navigable body of water, with minimal cost, expertise in sonar, or logistical effort, thereby facilitating the democratization of acoustic imaging of benthic environments, to support ecohydrological studies in shallow water, not subject to the rigors of hydrographic standards, nor the preserve of hydroacoustic expertise and proprietary hydrographic industry software. We investigate the possibility of using recreational grade sidescan sonar for sedimentary change detection using a case study of repeat sidescan imaging of mixed sand-gravel-rock riverbeds in a debris-fan dominated canyon river, at a coverage and resolution that meets the objectives of studies of the effects of changing bed substrates on salmonid spawning. A repeat substrate mapping analysis on data collected between 2012 and 2015 on the Colorado River in Glen, Marble, and Grand Canyons will be presented. A detailed method has been developed to interpret and analyze non-survey-grade sidescan sonar data, encoded within an open source software tool developed by the authors. An automated technique to quantify bed texture directly from sidescan sonar imagery is tested against bed sediment observations from underwater video and multibeam sonar. Predictive relationships between known bed sediment observations and bed texture metrics could provide an objective means to quantify bed textures and to relate changes in bed texture to biological components of an aquatic ecosystem, at high temporal frequency, and with minimal logistical effort and cost.

Greedy Sparse Approaches for Homological Coverage in Location Unaware Sensor Networks

DTIC Science & Technology

2017-12-08

GlobalSIP); 2013 Dec; Austin , TX . p. 595– 598. 33. Farah C, Schwaner F, Abedi A, Worboys M. Distributed homology algorithm to detect topological events...ARL-TR-8235•DEC 2017 US Army Research Laboratory Greedy Sparse Approaches for Homological Coverage in Location-Unaware Sensor Net- works by Terrence...8235•DEC 2017 US Army Research Laboratory Greedy Sparse Approaches for Homological Coverage in Location-Unaware Sensor Net- works by Terrence J Moore

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

PubMed Central

Li, Zhihui; Li, Mingqiang; Subramanian, S. V.; Lu, Chunling

2017-01-01

ABSTRACT Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings. PMID:29228888

Surveillance of malaria vector population density and biting behaviour in western Kenya.

PubMed

Ototo, Ednah N; Mbugi, Jenard P; Wanjala, Christine L; Zhou, Guofa; Githeko, Andrew K; Yan, Guiyun

2015-06-17

Malaria is a great public health burden and Africa suffers the largest share of malaria-attributed deaths. Despite control efforts targeting indoor malaria transmission, such as insecticide-treated bed nets (ITNs) and deployment of indoor residual spraying, transmission of the parasite in western Kenya is still maintained. This study was carried out to determine the impact of ITNs on indoor vector densities and biting behaviour in western Kenya. Indoor collection of adult mosquitoes was done monthly in six study sites in western Kenya using pyrethrum spray collections from 2012 to 2014. The rotator trap collections were done in July-August in 2013 and May-June in 2014. Mosquitoes were collected every 2 h between 18.00 and 08.00 h. Human behaviour study was conducted via questionnaire surveys. Species within Anopheles gambiae complex was differentiated by PCR and sporozoite infectivity was determined by ELISA. Species distribution was determined and bed net coverage in the study sites was recorded. During the study a total of 5,469 mosquito vectors were collected from both PSC and Rotator traps comprising 3,181 (58.2%) Anopheles gambiae and 2,288 (41.8%) Anopheles funestus. Compared to all the study sites, Rae had the highest density of An. gambiae with a mean of 1.2 (P<0.001) while Kombewa had the highest density of An. funestus with a mean of 1.08 (P<0.001). Marani had the lowest density of vectors with 0.06 An. gambiae and 0.17 An. funestus (P<0.001). Among the 700 PCR confirmed An. gambiae s.l. individuals, An. gambiae s.s. accounted for 49% and An. arabiensis 51%. Over 50% of the study population stayed outdoors between 18.00 and 20.00 and 06.00 and 08.00 which was the time when highest densities of blood fed vectors were collected. Anopheles gambie s.s. was the main malaria parasite vector in the highland sites and An. arabiensis in the lowland sites. Bed net ownership in 2012 averaged 87% across the study sites. This study suggests that mass distribution of ITNs has had a significant impact on vector densities, species distribution and sporozoite rate. However, shift of biting time poses significant threats to the current malaria vector control strategies which heavily rely on indoor controls.

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries

PubMed Central

Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

2014-01-01

Objective This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. Methods We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. Primary and secondary outcomes The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Results Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. Conclusions IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health. PMID:24969782

The use and misuse of mass distributed free insecticide-treated bed nets in a semi-urban community in Rivers State, Nigeria.

PubMed

Ordinioha, Best

2012-01-01

Insecticide-treated bed net (ITN) is currently distributed free of charge to vulnerable groups in Nigeria, for malaria control. Consistent use of the nets is required for maximum effectiveness; but studies indicate that the nets are often jettisoned in periods of low mosquito activity and high night time temperature. The objective of this study has been to assess the use of mass distributed nets in a semi-urban community in Rivers State, south-south Nigeria, during the late dry season, when mosquito activity is at the lowest in the community. The study was carried out in Ishiodu - Emohua, using a cross-sectional study design. The data was collected using a structured, interviewer-administered questionnaire, administered to female head of households in the community, with under-five children. A total of 170 respondents were studied; they had an average age of 34.3 ± 7.6 years, most were married (86.5%), and had secondary school education (68.2%). All the households owned at least one ITN, and an average of 1.7 nets, with 75.3% of the households owning two or more ITNs. Almost all the nets (99.4%) were obtained free of charge. Of the 170 households that received the nets, 71.8% had hanged the nets as at the time of the survey; 83.6% of these hanged the nets over a bed, while 10.7% used the nets as window curtain. Of the 102 ITNs that were properly deployed, only 27.5% were occupied the night before the survey, by an average of 2.5 persons, mainly under-five children (37.7%). The distribution of free ITNs has resulted in universal household ownership, but the use of the nets is still very poor. Proper health education is required to encourage the consistent use of the nets, even in hot night, with low mosquito activity.

Tanning, Skin Cancer Risk, and Prevention: A Content Analysis of Eight Popular Magazines that Target Female Readers, 1997–2006

PubMed Central

Cho, Hyunyi; Hall, Jennifer G.; Kosmoski, Carin; Fox, Rebekah L.; Mastin, Teresa

2008-01-01

The majority of tanning bed users in the U.S. are women. Previous health communication research frequently focused on the risk of skin cancer, but few studies assessed the mediated communication environment that may surround women’s beliefs and behaviors relevant to tanning. A content analysis of articles in eight magazines targeting girls, young women, older women, and women who are interested in fitness during the ten-year period of 1997–2006 was conducted. The amount of coverage of tanning bed use consequences was less than 50% of the coverage of tanning benefits. About 40% of the tanning benefits coverage touted looking healthy. The coverage of prevention methods focused on sunscreen use (55%), while the more important methods (e.g., protective clothing use) were rarely featured. Longitudinally, the coverage of the risk and prevention relevant issues increased between 1997 and 2006. The data indicate that the coverage of tanning benefits also increased during the same period. PMID:20228954

Threats to the health care safety net.

PubMed

Taylor, T B

2001-11-01

The American health care safety net is threatened due to inadequate funding in the face of increasing demand for services by virtually every segment of our society. The safety net is vital to public safety because it is the sole provider for first-line emergency care, as well as for routine health care of last resort, through hospital emergency departments (ED), emergency medical services providers (EMS), and public/free clinics. Despite the perceived complexity, the causes and solutions for the current crisis reside in simple economics. During the last two decades health care funding has radically changed, yet the fundamental infrastructure of the safety net has change little. In 1986, the Emergency Medical Treatment and Active Labor Act established federally mandated safety net care that inadvertently encouraged reliance on hospital EDs as the principal safety net resource. At the same time, decreasing health care funding from both private and public sources resulted in declining availability of services necessary to support this shift in demand, including hospital inpatient beds, EDs, EMS providers, on-call specialists, hospital-based nurses, and public hospitals/clinics. The result has been ED/hospital crowding and resource shortages that at times limit the ability to provide even true emergency care and threaten the ability of the traditional safety net to protect public health and safety. This paper explores the composition of the American health care safety net, the root causes for its disintegration, and offers short- and long-term solutions. The solutions discussed include restructuring of disproportionate share funding; presumed (deemed) eligibility for Medicaid eligibility; restructuring of funding for emergency care; health care for foreign nationals; the nursing shortage; utilization of a "health care resources commission"; "episodic (periodic)" health care coverage; best practices and health care services coordination; and government and hospital providers' roles. There is a base amount of funding that must be available to the American health care safety net to maintain its infrastructure and provide appropriate growth, research, development, and expansion of services. Fall below this level and the infrastructure will eventually crumble. America must patch the safety net with short-term funding and repair it with long-term health care policy and environmental changes.

Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets.

PubMed

Yukich, Joshua O; Zerom, Mehari; Ghebremeskel, Tewolde; Tediosi, Fabrizio; Lengeler, Christian

2009-03-30

While insecticide-treated nets (ITNs) are a recognized effective method for preventing malaria, there has been an extensive debate in recent years about the best large-scale implementation strategy. Implementation costs and cost-effectiveness are important elements to consider when planning ITN programmes, but so far little information on these aspects is available from national programmes. This study uses a standardized methodology, as part of a larger comparative study, to collect cost data and cost-effectiveness estimates from a large programme providing ITNs at the community level and ante-natal care facilities in Eritrea. This is a unique model of ITN implementation fully integrated into the public health system. Base case analysis results indicated that the average annual cost of ITN delivery (2005 USD 3.98) was very attractive when compared with past ITN delivery studies at different scales. Financing was largely from donor sources though the Eritrean government and net users also contributed funding. The intervention's cost-effectiveness was in a highly attractive range for sub-Saharan Africa. The cost per DALY averted was USD 13 - 44. The cost per death averted was USD 438-1449. Distribution of nets coincided with significant increases in coverage and usage of nets nationwide, approaching or exceeding international targets in some areas. ITNs can be cost-effectively delivered at a large scale in sub-Saharan Africa through a distribution system that is highly integrated into the health system. Operating and sustaining such a system still requires strong donor funding and support as well as a functional and extensive system of health facilities and community health workers already in place.

Planning the Breast Boost: Comparison of Three Techniques and Evolution of Tumor Bed During Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hepel, Jaroslaw T.; Department of Radiation Oncology, Brown University, Rhode Island Hospital, Providence, RI; Evans, Suzanne B.

2009-06-01

Purpose: To evaluate the accuracy of two clinical techniques for electron boost planning compared with computed tomography (CT)-based planning. Additionally, we evaluated the tumor bed characteristics at whole breast planning and boost planning. Methods and Materials: A total of 30 women underwent tumor bed boost planning within 2 weeks of completing whole breast radiotherapy using three planning techniques: scar-based planning, palpation/clinical-based planning, and CT-based planning. The plans were analyzed for dosimetric coverage of the CT-delineated tumor bed. The cavity visualization score was used to define the CT-delineated tumor bed as well or poorly defined. Results: Scar-based planning resulted in inferiormore » tumor bed coverage compared with CT-based planning, with the minimal dose received by 90% of the target volume >90% in 53% and a geographic miss in 53%. The results of palpation/clinical-based planning were significantly better: 87% and 10% for the minimal dose received by 90% of the target volume >90% and geographic miss, respectively. Of the 30 tumor beds, 16 were poorly defined by the cavity visualization score. Of these 16, 8 were well demarcated by the surgical clips. The evaluation of the 22 well-defined tumor beds revealed similar results. A comparison of the tumor bed volume from the initial planning CT scan to the boost planning CT scan revealed a decrease in size in 77% of cases. The mean decrease in volume was 52%. Conclusion: The results of our study have shown that CT-based planning allows for optimal tumor bed coverage compared with clinical and scar-based approaches. However, in the setting of a poorly visualized cavity on CT without surgical clips, palpation/clinical-based planning can help delineate the appropriate target volumes and is superior to scar-based planning. CT simulation at boost planning could allow for a reduction in the boost volumes.« less

Analysing and recommending options for maintaining universal coverage with long-lasting insecticidal nets: the case of Tanzania in 2011

PubMed Central

2013-01-01

Background Tanzania achieved universal coverage with long-lasting insecticidal nets (LLINs) in October 2011, after three years of free mass net distribution campaigns and is now faced with the challenge of maintaining high coverage as nets wear out and the population grows. A process of exploring options for a continuous or “Keep-Up” distribution system was initiated in early 2011. This paper presents for the first time a comprehensive national process to review the major considerations, findings and recommendations for the implementation of a new strategy. Methods Stakeholder meetings and site visits were conducted in five locations in Tanzania to garner stakeholder input on the proposed distribution systems. Coverage levels for LLINs and their decline over time were modelled using NetCALC software, taking realistic net decay rates, current demographic profiles and other relevant parameters into consideration. Costs of the different distribution systems were estimated using local data. Results LLIN delivery was considered via mass campaigns, Antenatal Care-Expanded Programme on Immunization (ANC/EPI), community-based distribution, schools, the commercial sector and different combinations of the above. Most approaches appeared unlikely to maintain universal coverage when used alone. Mass campaigns, even when combined with a continuation of the Tanzania National Voucher Scheme (TNVS), would produce large temporal fluctuations in coverage levels; over 10 years this strategy would require 63.3 million LLINs and a total cost of $444 million USD. Community mechanisms, while able to deliver the required numbers of LLINs, would require a massive scale-up in monitoring, evaluation and supervision systems to ensure accurate application of identification criteria at the community level. School-based approaches combined with the existing TNVS would reach most Tanzanian households and deliver 65.4 million LLINs over 10 years at a total cost of $449 million USD and ensure continuous coverage. The cost of each strategy was largely driven by the number of LLINs delivered. Conclusions The most cost-efficient strategy to maintain universal coverage is one that best optimizes the numbers of LLINs needed over time. A school-based approach using vouchers targeting all students in Standards 1, 3, 5, 7 and Forms 1 and 2 in combination with the TNVS appears to meet best the criteria of effectiveness, equity and efficiency. PMID:23641705

Employer Health Insurance Offerings and Employee Enrollment Decisions

PubMed Central

Polsky, Daniel; Stein, Rebecca; Nicholson, Sean; Bundorf, M Kate

2005-01-01

Objective To determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions. Data Sources The 1996–1997 and the 1998–1999 rounds of the nationally representative Community Tracking Study Household Survey. Study Design We use multinomial logistic regression to analyze the choice between own-employer coverage, alternative source coverage, and no coverage among employees offered health insurance by their employer. The key explanatory variables are the types of health plans offered and the net premium offered. The models include controls for personal, health plan, and job characteristics. Principal Findings When an employer offers only a health maintenance organization married employees are more likely to decline coverage from their employer and take-up another offer (odds ratio (OR)=1.27, p<.001), while singles are more likely to accept the coverage offered by their employer and less likely to be uninsured (OR=0.650, p<.001). Higher net premiums increase the odds of declining the coverage offered by an employer and remaining uninsured for both married (OR=1.023, p<.01) and single (OR=1.035, p<.001) workers. Conclusions The type of health plan coverage an employer offers affects whether its employees take-up insurance, but has a smaller effect on overall coverage rates for workers and their families because of the availability of alternative sources of coverage. Relative to offering only a non-HMO plan, employers offering only an HMO may reduce take-up among those with alternative sources of coverage, but increase take-up among those who would otherwise go uninsured. By modeling the possibility of take-up through the health insurance offers from the employer of the spouse, the decline in coverage rates from higher net premiums is less than previous estimates. PMID:16174133

Employer health insurance offerings and employee enrollment decisions.

PubMed

Polsky, Daniel; Stein, Rebecca; Nicholson, Sean; Bundorf, M Kate

2005-10-01

To determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions. The 1996-1997 and the 1998-1999 rounds of the nationally representative Community Tracking Study Household Survey. We use multinomial logistic regression to analyze the choice between own-employer coverage, alternative source coverage, and no coverage among employees offered health insurance by their employer. The key explanatory variables are the types of health plans offered and the net premium offered. The models include controls for personal, health plan, and job characteristics. When an employer offers only a health maintenance organization married employees are more likely to decline coverage from their employer and take-up another offer (odds ratio (OR)=1.27, p<.001), while singles are more likely to accept the coverage offered by their employer and less likely to be uninsured (OR=0.650, p<.001). Higher net premiums increase the odds of declining the coverage offered by an employer and remaining uninsured for both married (OR=1.023, p<.01) and single (OR=1.035, p<.001) workers. The type of health plan coverage an employer offers affects whether its employees take-up insurance, but has a smaller effect on overall coverage rates for workers and their families because of the availability of alternative sources of coverage. Relative to offering only a non-HMO plan, employers offering only an HMO may reduce take-up among those with alternative sources of coverage, but increase take-up among those who would otherwise go uninsured. By modeling the possibility of take-up through the health insurance offers from the employer of the spouse, the decline in coverage rates from higher net premiums is less than previous estimates.

Alluvial substrate mapping by automated texture segmentation of recreational-grade side scan sonar imagery

PubMed Central

Buscombe, Daniel; Wheaton, Joseph M.

2018-01-01

Side scan sonar in low-cost ‘fishfinder’ systems has become popular in aquatic ecology and sedimentology for imaging submerged riverbed sediment at coverages and resolutions sufficient to relate bed texture to grain-size. Traditional methods to map bed texture (i.e. physical samples) are relatively high-cost and low spatial coverage compared to sonar, which can continuously image several kilometers of channel in a few hours. Towards a goal of automating the classification of bed habitat features, we investigate relationships between substrates and statistical descriptors of bed textures in side scan sonar echograms of alluvial deposits. We develop a method for automated segmentation of bed textures into between two to five grain-size classes. Second-order texture statistics are used in conjunction with a Gaussian Mixture Model to classify the heterogeneous bed into small homogeneous patches of sand, gravel, and boulders with an average accuracy of 80%, 49%, and 61%, respectively. Reach-averaged proportions of these sediment types were within 3% compared to similar maps derived from multibeam sonar. PMID:29538449

48 CFR 9903.201-2 - Types of CAS coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 9903.201-2 Section 9903.201-2 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.201-2 Types of CAS coverage. (a) Full... net CAS-covered awards during its preceding cost accounting period. (b) Modified coverage. (1...

Net use, care and repair practices following a universal distribution campaign in Mali.

PubMed

Leonard, Lori; Diop, Samba; Doumbia, Seydou; Sadou, Aboubacar; Mihigo, Jules; Koenker, Hannah; Berthe, Sara; Monroe, April; Bertram, Kathryn; Weber, Rachel

2014-11-18

The Government of Mali and the President's Malaria Initiative conducted a long-lasting, insecticidal net (LLIN) distribution campaign in April 2011 in the Sikasso region of Mali, with the aim of universal coverage, defined as one insecticide-treated net for every two persons. This study examines how households in post- and pre-campaign regions value and care for nets. The study was conducted in October 2012 in Sikasso and Kayes in the southeast and western regions of Mali, respectively. The regions were purposively selected to allow for comparison between areas that had already had a mass distribution campaign (Sikasso) and areas that had not yet had a mass distribution campaign (Kayes). Study sites and households were randomly selected. Sleeping space questionnaires and structured interviews with household heads were conducted to obtain information on net use, perceived value of free nets in relation to other malaria prevention activities, and net care and repair practices. The study included 40 households, split evenly across the two regions. Forty interviews were conducted with household heads and 151 sleeping spaces were inventoried using the sleeping space questionnaire. Nets obtained through the free distribution were reported to be highly valued in comparison to other malaria prevention strategies. Overall, net ownership and use were higher among households in areas that had already experienced a mass distribution. While participants reported using and valuing these nets, care and repair practices varied. National net use is high in Mali, and comparatively higher in the region covered by the universal distribution campaign than in the region not yet covered. While the Government of Mali and implementing partners have made strides to ensure high net coverage, some gaps remain related to communication messaging of correct and consistent net use throughout the year, and on improving net care and repair behaviour. By focusing on these areas as well as improved access to nets, coverage and use rates should continue to increase, contributing to improvements in malaria control.

Analytical Study on Multi-Tier 5G Heterogeneous Small Cell Networks: Coverage Performance and Energy Efficiency.

PubMed

Xiao, Zhu; Liu, Hongjing; Havyarimana, Vincent; Li, Tong; Wang, Dong

2016-11-04

In this paper, we investigate the coverage performance and energy efficiency of multi-tier heterogeneous cellular networks (HetNets) which are composed of macrocells and different types of small cells, i.e., picocells and femtocells. By virtue of stochastic geometry tools, we model the multi-tier HetNets based on a Poisson point process (PPP) and analyze the Signal to Interference Ratio (SIR) via studying the cumulative interference from pico-tier and femto-tier. We then derive the analytical expressions of coverage probabilities in order to evaluate coverage performance in different tiers and investigate how it varies with the small cells' deployment density. By taking the fairness and user experience into consideration, we propose a disjoint channel allocation scheme and derive the system channel throughput for various tiers. Further, we formulate the energy efficiency optimization problem for multi-tier HetNets in terms of throughput performance and resource allocation fairness. To solve this problem, we devise a linear programming based approach to obtain the available area of the feasible solutions. System-level simulations demonstrate that the small cells' deployment density has a significant effect on the coverage performance and energy efficiency. Simulation results also reveal that there exits an optimal small cell base station (SBS) density ratio between pico-tier and femto-tier which can be applied to maximize the energy efficiency and at the same time enhance the system performance. Our findings provide guidance for the design of multi-tier HetNets for improving the coverage performance as well as the energy efficiency.

Analytical Study on Multi-Tier 5G Heterogeneous Small Cell Networks: Coverage Performance and Energy Efficiency

PubMed Central

Xiao, Zhu; Liu, Hongjing; Havyarimana, Vincent; Li, Tong; Wang, Dong

2016-01-01

In this paper, we investigate the coverage performance and energy efficiency of multi-tier heterogeneous cellular networks (HetNets) which are composed of macrocells and different types of small cells, i.e., picocells and femtocells. By virtue of stochastic geometry tools, we model the multi-tier HetNets based on a Poisson point process (PPP) and analyze the Signal to Interference Ratio (SIR) via studying the cumulative interference from pico-tier and femto-tier. We then derive the analytical expressions of coverage probabilities in order to evaluate coverage performance in different tiers and investigate how it varies with the small cells’ deployment density. By taking the fairness and user experience into consideration, we propose a disjoint channel allocation scheme and derive the system channel throughput for various tiers. Further, we formulate the energy efficiency optimization problem for multi-tier HetNets in terms of throughput performance and resource allocation fairness. To solve this problem, we devise a linear programming based approach to obtain the available area of the feasible solutions. System-level simulations demonstrate that the small cells’ deployment density has a significant effect on the coverage performance and energy efficiency. Simulation results also reveal that there exits an optimal small cell base station (SBS) density ratio between pico-tier and femto-tier which can be applied to maximize the energy efficiency and at the same time enhance the system performance. Our findings provide guidance for the design of multi-tier HetNets for improving the coverage performance as well as the energy efficiency. PMID:27827917

The economics of social marketing: the case of mosquito nets in Tanzania.

PubMed

Kikumbih, Nassor; Hanson, Kara; Mills, Anne; Mponda, Hadji; Schellenberg, Joanna Armstrong

2005-01-01

There is a growing appreciation of the role of the private sector in expanding the use of key health interventions. At the policy level, this has raised questions about how public sector resources can best be used to encourage the private sector in order to achieve public health impact. Social marketing has increasingly been used to distribute public health products in developing countries. The Kilombero and Ulanga Insecticide-Treated Net Project (KINET) project used a social marketing approach in two districts of Tanzania to stimulate the development of the market for insecticide-treated mosquito nets (ITNs) for malaria control. Using evidence from household surveys, focus group discussions and a costing study in the intervention area and a control area, this paper examines two issues: (1) How does social marketing affect the market for ITNs, where this is described in terms of price and coverage levels; and (2) What does the added cost of social marketing "buy" in terms of coverage and equity, compared with an unassisted commercial sector model? It appears that supply improved in both areas, although there was a greater increase in supply in the intervention area. However, the main impact of social marketing on the market for nets was to shift demand in the intervention district, leading to a higher coverage market outcome. While social marketing was more costly per net distributed than the unassisted commercial sector, higher overall levels of coverage were achieved in the social marketing area together with higher coverage of the lowest socioeconomic group, of pregnant women and children under 5 years, and of those living on the periphery of their villages. These findings are interpreted in the context of Tanzania's national plan for scaling up ITNs.

Host-seeking activity of a Tanzanian population of Anopheles arabiensis at an insecticide treated bed net.

PubMed

Parker, Josephine E A; Angarita Jaimes, Natalia C; Gleave, Katherine; Mashauri, Fabian; Abe, Mayumi; Martine, Jackline; Towers, Catherine E; Towers, David; McCall, Philip J

2017-07-04

Understanding how mosquitoes respond to long lasting insecticide treated nets (LLINs) is fundamental to sustaining the effectiveness of this essential control tool. We report on studies with a tracking system to investigate behaviour of wild anophelines at an LLIN, in an experimental hut at a rural site in Mwanza, Tanzania. Groups of adult female mosquitoes (n = 10 per replicate) reared from larvae of a local population, identified as predominantly (95%) Anopheles arabiensis, were released in the hut. An infrared video tracking system recorded flight and net contact activity over 1 h as the mosquitoes attempted to reach a supine human volunteer within a bed net (either a deltamethrin-treated LLIN or an untreated control net). A range of activities, including flight path, position in relation to the bed net and duration of net contact, were quantified and compared between treatments. The total time that female An. arabiensis spent in flight around LLINs was significantly lower than at untreated nets [F(1,10) = 9.26, p = 0.012], primarily due to a substantial reduction in the time mosquitoes spent in persistent 'bouncing' flight [F(1,10) = 18.48, p = 0.002]. Most activity occurred at the net roof but significantly less so with LLINs (56.8% of total) than untreated nets [85.0%; Χ 2 (15) = 234.69, p < 0.001]. Activity levels at the bed net directly above the host torso were significantly higher with untreated nets (74.2%) than LLINs [38.4%; Χ 2 (15) = 33.54, p = 0.004]. 'Visiting' and 'bouncing' rates were highest above the volunteer's chest in untreated nets (39.9 and 50.4%, respectively) and LLINs [29.9 and 42.4%; Χ 2 (13) = 89.91, p < 0.001; Χ 2 (9) = 45.73, p < 0.001]. Highest resting rates were above the torso in untreated nets [77%; Χ 2 (9) = 63.12, p < 0.001], but in LLINs only 33.2% of resting occurred here [Χ 2 (9) = 27.59, p = 0.001], with resting times spread between the short vertical side of the net adjacent to the volunteer's head (21.8%) and feet (16.2%). Duration of net contact by a single mosquito was estimated at 204-290 s on untreated nets and 46-82 s on LLINs. While latency to net contact was similar in both treatments, the reduction in activity over 60 min was significantly more rapid for LLINs [F(1,10) = 6.81, p = 0.026], reiterating an 'attract and kill' rather than a repellent mode of action. The study has demonstrated the potential for detailed investigations of behaviour of wild mosquito populations under field conditions. The results validate the findings of earlier laboratory studies on mosquito activity at LLINs, and reinforce the key role of multiple brief contacts at the net roof as the critical LLIN mode of action.

[Malaria: knowledge, behaviour and practices among a rural population of Gossas, Senegal].

PubMed

Ndour, C T; Ba, O; Manga, N M; Fortes, M L; Nyamwasa, D; Sow, P S

2006-10-01

Malaria remains a major public health problem in Sub-Saharian Africa, in terms of morbidity and mortality rate. To assess the knowledge and behaviour of population regarding the transmission, the treatment and the prevention of malaria, we conducted a cluster sample household survey in Gossas, a rural District in Senegal, from May 2nd to May 6th 2005. A questionnaire that focused on socioeconomic conditions, beliefs, knowledge about and behavior toward antimalarial medication and the prevention means used was given to 480 household owners. Overall, 107 pregnant women and 1,201 children aged less than 5 years old lived within these household. More than a half of the household owners (51%) were illiterate and 25.2% ignored how malaria is transmitted. Fever was the most common symptom suggesting malaria (61%). In 46.1% of febrile cases, people did not seek for treatment from a physician. Home treatment of febrile episodes was based on paracetamol or aspirin (84%), chloroquine (13%) and cotrimoxazole (2.9%). Overall, the proportion of insecticide treated nets users were 22.7%. This percentage was 14.9% and 11.4% for pregnant women and children younger than 5 years old, respectively. People having radio sets, regular access to television, and people aware of the transmission route of malaria were more likely to use bed nets. In most cases, organic material burning was used as repellent against mosquitoes. The low prevalence of bed net use was most often explained by participants' limited accessibility to and by the high cost of insecticide-treated nets. Knowledge about malaria prevention and treatment is low in the rural district of Gossas. The rate of insecticide-treated-bed nets use in vulnerable people is very low, far from the Abuja meeting objective. A sensibilization program and a social marketing plan for insecticide-treated-bed nets could improve this situation.

Economic assessment of conventional and conservation tillage practices in different wheat-based cropping systems of Punjab, Pakistan.

PubMed

Shahzad, Muhammad; Hussain, Mubshar; Farooq, Muhammad; Farooq, Shahid; Jabran, Khawar; Nawaz, Ahmad

2017-11-01

Wheat productivity and profitability is low under conventional tillage systems as they increase the production cost, soil compaction, and the weed infestation. Conservation tillage could be a pragmatic option to sustain the wheat productivity and enhance the profitability on long term basis. This study was aimed to evaluate the economics of different wheat-based cropping systems viz. fallow-wheat, rice-wheat, cotton-wheat, mung bean-wheat, and sorghum-wheat, with zero tillage, conventional tillage, deep tillage, bed sowing (60/30 cm beds and four rows), and bed sowing (90/45 cm beds and six rows). Results indicated that the bed sown wheat had the maximum production cost than other tillage systems. Although both bed sowing treatments incurred the highest production cost, they generated the highest net benefits and benefit: cost ratio (BCR). Rice-wheat cropping system with bed sown wheat (90/45 cm beds with six rows) had the highest net income (4129.7 US$ ha -1 ), BCR (2.87), and marginal rate of return compared with rest of the cropping systems. In contrast, fallow-wheat cropping system incurred the lowest input cost, but had the least economic return. In crux, rice-wheat cropping system with bed sown wheat (90/45 cm beds with six rows) was the best option for getting the higher economic returns. Moreover, double cropping systems within a year are more profitable than sole planting of wheat under all tillage practices.

Composition of Anopheles mosquitoes, their blood-meal hosts, and Plasmodium falciparum infection rates in three islands with disparate bed net coverage in Lake Victoria, Kenya.

PubMed

Ogola, Edwin; Villinger, Jandouwe; Mabuka, Danspaid; Omondi, David; Orindi, Benedict; Mutunga, James; Owino, Vincent; Masiga, Daniel K

2017-09-08

Small islands serve as potential malaria reservoirs through which new infections might come to the mainland and may be important targets in malaria elimination efforts. This study investigated malaria vector species diversity, blood-meal hosts, Plasmodium infection rates, and long-lasting insecticidal net (LLIN) coverage on Mageta, Magare and Ngodhe Islands of Lake Victoria in western Kenya, a region where extensive vector control is implemented on the mainland. From trapping for six consecutive nights per month (November 2012 to March 2015) using CDC light traps, pyrethrum spray catches and backpack aspiration, 1868 Anopheles mosquitoes were collected. Based on their cytochrome oxidase I (COI) and intergenic spacer region PCR and sequencing, Anopheles gambiae s.l. (68.52%), Anopheles coustani (19.81%) and Anopheles funestus s.l. (11.67%) mosquitoes were differentiated. The mean abundance of Anopheles mosquitoes per building per trap was significantly higher (p < 0.001) in Mageta than in Magare and Ngodhe. Mageta was also the most populated island (n = 6487) with low LLIN coverage of 62.35% compared to Ngodhe (n = 484; 88.31%) and Magare (n = 250; 98.59%). Overall, 416 (22.27%) engorged Anopheles mosquitoes were analysed, of which 41 tested positive for Plasmodium falciparum infection by high-resolution melting (HRM) analysis of 18S rRNA and cytochrome b PCR products. Plasmodium falciparum infection rates were 10.00, 11.76, 0, and 18.75% among blood-fed An. gambiae s.s. (n = 320), Anopheles arabiensis (n = 51), An. funestus s.s. (n = 29), and An. coustani (n = 16), respectively. Based on HRM analysis of vertebrate cytochrome b, 16S rRNA and COI PCR products, humans (72.36%) were the prominent blood-meal hosts of malaria vectors, but 20.91% of blood-meals were from non-human vertebrate hosts. These findings demonstrate high Plasmodium infection rates among the primary malaria vectors An. gambiae s.s. and An. arabiensis, as well as in An. coustani for the first time in the region, and that non-human blood-meal sources play an important role in their ecology. Further, the higher Anopheles mosquito abundances on the only low LLIN coverage island of Mageta suggests that high LLIN coverage has been effective in reducing malaria vector populations on Magare and Ngodhe Islands.

Solar tower power plant using a particle-heated steam generator: Modeling and parametric study

NASA Astrophysics Data System (ADS)

Krüger, Michael; Bartsch, Philipp; Pointner, Harald; Zunft, Stefan

2016-05-01

Within the framework of the project HiTExStor II, a system model for the entire power plant consisting of volumetric air receiver, air-sand heat exchanger, sand storage system, steam generator and water-steam cycle was implemented in software "Ebsilon Professional". As a steam generator, the two technologies fluidized bed cooler and moving bed heat exchangers were considered. Physical models for the non-conventional power plant components as air- sand heat exchanger, fluidized bed coolers and moving bed heat exchanger had to be created and implemented in the simulation environment. Using the simulation model for the power plant, the individual components and subassemblies have been designed and the operating parameters were optimized in extensive parametric studies in terms of the essential degrees of freedom. The annual net electricity output for different systems was determined in annual performance calculations at a selected location (Huelva, Spain) using the optimized values for the studied parameters. The solution with moderate regenerative feed water heating has been found the most advantageous. Furthermore, the system with moving bed heat exchanger prevails over the system with fluidized bed cooler due to a 6 % higher net electricity yield.

Duplicate Health Insurance Coverage: Determinants of Variation Across States

PubMed Central

Luft, Harold S.; Maerki, Susan C.

1982-01-01

Although it is recognized that many people have duplicate private health insurance coverage, either through separate purchase or as health benefits in multi-earner families, there has been little analysis of the factors determining duplicate coverage rates. A new data source, the Survey of Income and Education, offers a comparison with the only previous source of state level data, the estimates from the Health Insurance Association of America. The R2 between the two sets is only .3 and certain problems can be traced to the methodology underlying the HIAA figures. Using figures for gross and net coverage, the ratio of total policies to people with private coverage ranges from .94 in Utah to 1.53 in Illinois. Measures of industry distribution, per capita income and employment explain a large portion of the variance, but it appears that these factors operate in opposite directions for group and non-group policies. Similar sociodemographic variables also explain net coverage. These findings have substantial implications for research and the structuring of employee health benefits. PMID:10309638

Malaria

MedlinePlus

... screens on the windows and doors. Use a mosquito net over your bed. Spray the net with permethrin, a spray that repels mosquitoes. Wear light-colored pants and shirts with long sleeves. Protect yourself with a bug repellent spray that contains no more than 35% of ...

A qualitative study on the acceptability and preference of three types of long-lasting insecticide-treated bed nets in Solomon Islands: implications for malaria elimination

PubMed Central

Atkinson, Jo-An; Bobogare, Albino; Fitzgerald, Lisa; Boaz, Leonard; Appleyard, Bridget; Toaliu, Hilson; Vallely, Andrew

2009-01-01

Background In March 2008, the Solomon Islands and Vanuatu governments raised the goal of their National Malaria Programmes from control to elimination. Vector control measures, such as indoor residual spraying (IRS) and long-lasting insecticidal bed nets (LLINs) are key integral components of this programme. Compliance with these interventions is dependent on their acceptability and on the socio-cultural context of the local population. These factors need to be investigated locally prior to programme implementation. Method Twelve focus group discussions (FGDs) were carried out in Malaita and Temotu Provinces, Solomon Islands in 2008. These discussions explored user perceptions of acceptability and preference for three brands of long-lasting insecticide-treated bed nets (LLINs) and identified a number of barriers to their proper and consistent use. Results Mosquito nuisance and perceived threat of malaria were the main determinants of bed net use. Knowledge of malaria and the means to prevent it were not sufficient to guarantee compliance with LLIN use. Factors such as climate, work and evening social activities impact on the use of bed nets, particularly in men. LLIN acceptability plays a varying role in compliance with their use in villages involved in this study. Participants in areas of reported high and year round mosquito nuisance and perceived threat of malaria reported LLIN use regardless of any reported unfavourable characteristics. Those in areas of low or seasonal mosquito nuisance were more likely to describe the unfavourable characteristics of LLINs as reasons for their intermittent or non-compliance. The main criterion for LLIN brand acceptability was effectiveness in preventing mosquito bites and malaria. Discussions highlighted considerable confusion around LLIN care and washing which may be impacting on their effectiveness and reducing their acceptability in Solomon Islands. Conclusion Providing LLINs that are acceptable will be more important for improving compliance in areas of low or seasonal mosquito nuisance and malaria transmission. The implications of these findings on malaria elimination in Solomon Islands are discussed. PMID:19497127

20 CFR 404.1065 - Self-employment coverage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 404.1065 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY... Self-employment coverage. For an individual to have self-employment coverage under social security, the individual must be engaged in a trade or business and have net earnings from self-employment that can be...

Composition and diversity of fish species in seagrass bed ecosystem at Muara Binuangeun, Lebak, Banten

NASA Astrophysics Data System (ADS)

Kholis, N.; Patria, M. P.; Soedjiarti, T.

2017-07-01

Research of composition and diversity of fish species in seagrass bed ecosystem at Muara Binuangeun, Lebak, Banten, had been conducted in May and November 2015. Catch per Unit of Effort (CPUE) was used as a method with push net and boat net as fishing gear. Fishing was conducted during low tide. Collected samples were preserved with 10 % Formalin Solution and then being identified in the laboratory. In total, 286 fishes were collected from 17 families and 38 species. Moolgarda sp. was the most relative abundant species (17,13 %) and Istiblennius edentulus was a fish species with the highest relative frequency. Diversity index value of seagrass bed ecosystem was 2,973. Different sampling time showed the different composition of fish, in an example of Arothron immaculatus.

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

PubMed

Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

2014-06-26

This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Carcinoid Cancer Foundation

MedlinePlus

... heroine . CCF Releases New Infographic for NET Cancer Day: 6 Questions to Ask Your Doctor Have you ... and register. CCF Offers Toolkit for NET Cancer Day Media Coverage The Carcinoid Cancer Foundation, with support ...

Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

PubMed Central

Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

2007-01-01

Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

48 CFR 9903.201-2 - Types of CAS coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... later award of a CAS-covered contract. Full coverage applies to contractor business units that— (1) Receive a single CAS-covered contract award of $50 million or more; or (2) Received $50 million or more in net CAS-covered awards during its preceding cost accounting period. (b) Modified coverage. (1...

48 CFR 9903.201-2 - Types of CAS coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... later award of a CAS-covered contract. Full coverage applies to contractor business units that— (1) Receive a single CAS-covered contract award of $50 million or more; or (2) Received $50 million or more in net CAS-covered awards during its preceding cost accounting period. (b) Modified coverage. (1...

Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra State, Nigeria.

PubMed

Mbachu, Chinyere O; Onwujekwe, Obinna E; Uzochukwu, Benjamin S C; Uchegbu, Eloka; Oranuba, Joseph; Ilika, Amobi L

2012-05-22

In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups. A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles. It was found that 80.5% of the households had an LLIN and 64.4% of the households stated that they actually used the nets the previous night. The findings showed that 42.3% of pregnant women who had fever within the past month received ACTs, while 37.5% of children<5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1-5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women. The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.

Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra state, Nigeria

PubMed Central

2012-01-01

Background In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups. Methods A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles. Results It was found that 80.5 % of the households had an LLIN and 64.4 % of the households stated that they actually used the nets the previous night. The findings showed that 42.3 % of pregnant women who had fever within the past month received ACTs, while 37.5 % of children ≪5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1–5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women. Conclusions The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups. PMID:22545723

Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best?

PubMed

Zegers de Beyl, Celine; Koenker, Hannah; Acosta, Angela; Onyefunafoa, Emmanuel Obi; Adegbe, Emmanuel; McCartney-Melstad, Anna; Selby, Richmond Ato; Kilian, Albert

2016-02-03

The use of insecticide-treated nets (ITNs) is widely recognized as one of the main interventions to prevent malaria. High ITN coverage is needed to reduce transmission. Mass distribution campaigns are the fastest way to rapidly scale up ITN coverage. However, the best strategy to distribute ITNs to ensure household coverage targets are met is still under debate. This paper presents results from 14 post-campaign surveys in five African countries to assess whether the campaign strategy used had any effect on distribution outcome. Data from 13,901 households and 14 campaigns from Ghana, Nigeria, Senegal, South Sudan and Uganda, were obtained through representative cross-sectional questionnaire surveys, conducted three to 16 months after ITN distribution. All evaluations used a multi-stage sampling approach and similar methods for data collection. Key outcomes examined were the proportion of households having received a net from the campaign and the proportion of households with one net for every two people. Household registration rates proved to be the most important determinant of a household receiving any net from the campaign (adjusted odds ratio [OR] 74.8; 95 % confidence interval [CI]: 55.3-101.1) or had enough ITNs for all household members (adjusted OR 19.1; 95 % CI: 55.34-101.05). Factors that positively influenced registration were larger household size (adjusted OR 1.7; 95 % CI: 1.5-2.1) and families with children under five (adjusted OR 1.4; 95 % CI: 1.2-1.6). Urban residence was negatively associated with receipt of a net from the campaign (adjusted OR 0.73; 95 % CI: 0.58-0.92). Registration was equitable in most campaigns except for Uganda and South Sudan, where the poorest wealth quintiles were less likely to have been reached. After adjusting for other factors, delivery strategy (house-to-house vs. fixed point) and distribution approach (integrated versus stand-alone) did not show a systematic impact on registration or owning any ITN. Campaigns that used a universal coverage allocation strategy were more effective in increasing the proportion of households with enough ITNs than campaigns that used a fixed number of ITNs. Registering based on counting usual sleeping spaces resulted in higher levels of households with one net per two people among those receiving any campaign net (adjusted OR 1.6; 95 % CI: 1.07-2.48) than campaigns that registered based on the number of household members. All of the campaigns, irrespective of strategy, successfully increased ownership of at least one ITN. Delivery method and distribution approach were not associated with receipt of at least one ITN from the campaign. Rather, the key determining factor for receipt of at least one ITN from the campaign was a successful registration process, which depends on the ability of community volunteers to reach households during the exercise. Universal coverage campaigns, especially those that used a sleeping space allocation strategy, were more effective in increasing the proportion of households with enough ITNs. Maximizing registration completeness and using a universal coverage allocation strategy are therefore likely to improve campaign outcomes.

Observations of axisymmetric tracer particle orientation during flow through a dilute fixed bed of fibers

NASA Astrophysics Data System (ADS)

Frattini, Paul L.; Shaqfeh, Eric S. G.; Levy, Jeffrey L.; Koch, Donald L.

1991-11-01

Direct microstructural evidence for net tracer particle orientation induced solely by hydrodynamic interactions in a dilute, disordered, fibrous media is reported. A dilute fixed bed of randomly placed fibers was constructed and glycerol/water suspensions of either synthetic akaganeite (βFeOOH, average aspect ratio 6.3) or hematite (αFe2O3, average aspect ratio 1.6) tracer particles were made to flow axially through the bed at prescribed flow rates. Conservative linear dichroism, a noninvasive light scattering technique, was employed to provide a direct measure of the orientational order parameter for the tracer particle population at the end of the bed. The effect of Brownian motion on the hydrodynamically induced order in the suspensions was studied over three orders of magnitude in scaled rotary Peclet number, 5

Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas.

PubMed

Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B; Chongsuvivatwong, Virasakdi; Zhou, Hongning

2017-10-15

Background : In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods : A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old) and eight schools were used for children (<18 years old). A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results : Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion : Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.

Ownership and usage of insecticide-treated bed nets after free distribution via a voucher system in two provinces of Mozambique.

PubMed

Macedo de Oliveira, Alexandre; Wolkon, Adam; Krishnamurthy, Ramesh; Erskine, Marcy; Crenshaw, Dana P; Roberts, Jacquelin; Saúte, Francisco

2010-08-04

Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were to be redeemed at a later date for free ITNs, were distributed in Manica and Sofala provinces. A survey to evaluate ITN ownership and usage post-campaign was conducted. Four districts in each province and four enumeration areas (EAs) in each district were selected using probability proportional to size. Within each EA, 32 households (HHs) were selected using a simple random sample. Interviews to assess ownership and usage were conducted in each of the selected HHs using personal digital assistants. Valid interviews were completed for 947 (92.5%) (440 in Manica and 507 in Sofala) of the 1,024 selected HHs. Among participating HHs, 65.0% in Manica and 63.1% in Sofala reported that at least one child under five years of age slept in the house the previous night. HH ownership of at least one bed net of any kind was 20.6% (95% confidence interval [CI]: 7.9%-43.6%) and 35.6% (95% CI: 27.8%-44.3%) pre-campaign; and 55.1% (95% CI: 43.6%-66.1%) and 59.6 (95% CI: 42.4%-74.7%) post-campaign in Manica and Sofala, respectively. Post-campaign HH ownership of at least one ITN was 50.2% (95% CI: 41.8%-58.5%) for both provinces combined. In addition, 60.3% (95% CI: 50.6%-69.2%) of children under five years of age slept under an ITN the previous night. This ITN distribution increased bed net ownership and usage rates. Integration of ITN distribution with immunization campaigns presents an opportunity for reaching malaria control targets and should continue to be considered.

Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas

PubMed Central

Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B.; Chongsuvivatwong, Virasakdi; Zhou, Hongning

2017-01-01

Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods: A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adults (≥18 years old) and eight schools were used for children (<18 years old). A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results: Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion: Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases. PMID:29036937

Socio-cultural factors associated with malaria transmission: a review.

PubMed

Pinikahana, J

1992-06-01

Poverty creates preconditions for malaria and ways for its spread, thereby making it difficult to control malaria. Individual perceptions of illness, in this case malaria, determine people's response to seeking medical care. For example, in Orissa state, India, tribal peoples do not take treatment for malaria or take part in parasite control because they do not consider mosquito bites to be harmful and consider malaria as a mild disease. Untreated people are potential sources of malaria infection. Research from rural areas in other developing countries show the widespread belief that mosquitoes do not transmit malaria. The bad smell emitted by insecticides keep people from various areas in developing countries from spraying their households. The practice forbidding nonkin males from entering houses where only women assemble (purdah) prevents teams from spraying Muslim households in Sri Lanka. Thus, refusal to allow spraying increases the density of mosquitoes, resulting in an increased frequency of mosquito bites, and spread of malaria. Sleeping habits which contribute to the spread of malaria include not using mosquito nets or any protective device, outdoor sleeping, and children sharing a bed. People should protect themselves from mosquito bites by using bed nets, protective repellents, and screening and site selection for dwellings. A study in the Gambia revealed that, among 3 ethnic groups, Mandinkas children had the lowest prevalence rate because almost everyone used bed nets while 1-6% of people in Fula and Wolof villages did. Further, Mandinka children slept on mattresses and the other children slept on the floor. Research needs to examine whether cultural beliefs and values or poverty prevent some people from not using bed nets or any other protective device.

Large pterygium surgery: When coverage of the scleral bed justifies graft rotation.

PubMed

Gargallo-Benedicto, A; Hernández Pérez, D; Olate-Pérez, Á; Betancur-Delgado, E; Cerdà-Ibáñez, M; Duch-Samper, A

2016-10-01

To perform a 12 month follow-up study to assess the safety and effectiveness of resection and conjunctival autograft fixed with Tissucol® in selected cases of large pterygium. The orientation of the graft was adapted to the morphology of the scleral bed for a better coverage free of traction, with limbal position being lost. A prospective, non-comparative study of 10 cases of grade II or superior pterygium (7 primary, 3 recurrent) with at least 8mm of limbal extension. A wide scleral bed was obtained after pterygium and Tenon resection, with larger grafts being required to cover the defects. A superior conjunctival autograft was harvested and fixed to bare sclera using Tissucol. The orientation was adapted to the morphology of the scleral bed and limbal position was lost. Patients were periodically assessed for recurrence and complications for a period of 12 months. Minor complications occurred in 4 eyes. In one case a buttonhole was formed during dissection of the graft. Two presented with small limbal dehiscence, but epithelialisation was completed in the first week. In a third case, it was necessary to increase topical corticosteroids for pyogenic granuloma on the donor site, with secondary increased intraocular pressure (IOP). There were no recurrences after 12 months follow-up. A conjunctival graft of appropriate size adapted to the morphology of the scleral bed to ensure good coverage free of tension, provides good surgical results in selected cases of pterygium, regardless of the conservation the limbal orientation, with no recurrences after one year follow-up. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Impact of a mass media campaign on bed net use in Cameroon

PubMed Central

2013-01-01

Background In 2011, Cameroon and its health partners distributed over eight million free long-lasting insecticide treated nets (LLINs) in an effort to reduce the significant morbidity and mortality burden of malaria in the country. A national communications campaign was launched in July 2011 to ensure that as the nets were delivered, they would be used consistently to close a net use gap: only 51.6% of adults and 63.4% of their children in households with at least one net were sleeping under nets before the distribution. Even in households with at least one net for every two people, over 35% of adults were not sleeping under a net. Malaria No More (MNM) adapted its signature NightWatch communications programme to fit within the coordinated “KO Palu” (Knock Out Malaria) national campaign. This study evaluates the impact of KO Palu NightWatch activities (that is, the subset of KO Palu-branded communications that were funded by MNM’s NightWatch program) on bed net use. Methods Using national survey data collected at baseline (in March/April 2011, before the national LLIN distribution and KO Palu NightWatch launch) and post-intervention (March/April 2012), this study evaluates the impact of exposure to KO Palu NightWatch activities on last-night net use by Cameroonian adults and their children under five. First, a plausible case for causality was established by comparing net use in 2011 and 2012 and measuring exposure to KO Palu NightWatch; next, a propensity score matching (PSM) model was used to estimate the impact of exposure on net use by simulating a randomized control trial; finally, the model was tested for sensitivity to unmeasured factors. Results The PSM model estimated that among Cameroonians with at least one net in their household, exposure to KO Palu NightWatch activities was associated with a 6.6 percentage point increase in last-night net use among respondents (65.7% vs 59.1%, p < 0.05) and a 12.0 percentage point increase in last-night net use among respondents’ children under five (79.6% vs 67.6%, p < 0.025). Sensitivity analysis suggests only a very small risk of bias from omitted factors influencing exposure and net use. Conclusions Extrapolating the results of the PSM model to the population of Cameroonians with access to at least one mosquito net, this analysis estimates that approximately 298,000 adults and over 221,000 of their children under five slept under a bed net because of the knowledge, motivation, and/or timely reminder provided by KO Palu NightWatch activities. The programme cost less than $0.16 per adult reached, and less than $1.62 per additional person protected by a net. The results suggest a strong role for mass media communication interventions in support of investments in malaria control commodities such as LLINs. PMID:23351674

Effect of malaria transmission reduction by insecticide-treated bed nets (ITNs) on the genetic diversity of Plasmodium falciparum merozoite surface protein (MSP-1) and circumsporozoite (CSP) in western Kenya.

PubMed

Kariuki, Simon K; Njunge, James; Muia, Ann; Muluvi, Geofrey; Gatei, Wangeci; Ter Kuile, Feiko; Terlouw, Dianne J; Hawley, William A; Phillips-Howard, Penelope A; Nahlen, Bernard L; Lindblade, Kim A; Hamel, Mary J; Slutsker, Laurence; Shi, Ya Ping

2013-08-27

Although several studies have investigated the impact of reduced malaria transmission due to insecticide-treated bed nets (ITNs) on the patterns of morbidity and mortality, there is limited information on their effect on parasite diversity. Sequencing was used to investigate the effect of ITNs on polymorphisms in two genes encoding leading Plasmodium falciparum vaccine candidate antigens, the 19 kilodalton blood stage merozoite surface protein-1 (MSP-1(19kDa)) and the Th2R and Th3R T-cell epitopes of the pre-erythrocytic stage circumsporozoite protein (CSP) in a large community-based ITN trial site in western Kenya. The number and frequency of haplotypes as well as nucleotide and haplotype diversity were compared among parasites obtained from children <5 years old prior to the introduction of ITNs (1996) and after 5 years of high coverage ITN use (2001). A total of 12 MSP-1(19kDa) haplotypes were detected in 1996 and 2001. The Q-KSNG-L and E-KSNG-L haplotypes corresponding to the FVO and FUP strains of P. falciparum were the most prevalent (range 32-37%), with an overall haplotype diversity of > 0.7. No MSP-1(19kDa) 3D7 sequence-types were detected in 1996 and the frequency was less than 4% in 2001. The CSP Th2R and Th3R domains were highly polymorphic with a total of 26 and 14 haplotypes, respectively detected in 1996 and 34 and 13 haplotypes in 2001, with an overall haplotype diversity of > 0.9 and 0.75 respectively. The frequency of the most predominant Th2R and Th3R haplotypes was 14 and 36%, respectively. The frequency of Th2R and Th3R haplotypes corresponding to the 3D7 parasite strain was less than 4% at both time points. There was no significant difference in nucleotide and haplotype diversity in parasite isolates collected at both time points. High diversity in these two genes has been maintained overtime despite marked reductions in malaria transmission due to ITNs use. The frequency of 3D7 sequence-types was very low in this area. These findings provide information that could be useful in the design of future malaria vaccines for deployment in endemic areas with high ITN coverage and in interpretation of efficacy data for malaria vaccines based on 3D7 parasite strains.

Digital geologic map database of the Nevada Test Site area, Nevada

USGS Publications Warehouse

Wahl, R.R.; Sawyer, D.A.; Minor, S.A.; Carr, M.D.; Cole, J.C.; Swadley, W.C.; Laczniak, R.J.; Warren, R.G.; Green, K.S.; Engle, C.M.

1997-01-01

Forty years of geologic investigations at the Nevada Test Site (NTS) have been digitized. These data include all geologic information that: (1) has been collected, and (2) can be represented on a map within the map borders at the map scale is included in the map digital coverages. The following coverages are included with this dataset: Coverage Type Description geolpoly Polygon Geologic outcrops geolflts line Fault traces geolatts Point Bedding attitudes, etc. geolcald line Caldera boundaries geollins line Interpreted lineaments geolmeta line Metamorphic gradients The above coverages are attributed with numeric values and interpreted information. The entity files documented below show the data associated with each coverage.

Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage.

PubMed Central

Grabowsky, Mark; Nobiya, Theresa; Ahun, Mercy; Donna, Rose; Lengor, Miata; Zimmerman, Drake; Ladd, Holly; Hoekstra, Edward; Bello, Aliu; Baffoe-Wilmot, Aba; Amofah, George

2005-01-01

OBJECTIVE: To achieve high and equitable coverage of insecticide-treated bednets by integrating their distribution into a measles vaccination campaign. METHODS: In December 2002 in the Lawra district in Ghana, a measles vaccination campaign lasting 1 week targeted all children aged 9 months-15 years. Families with one or more children less than five years old were targeted to receive a free insecticide-treated bednet. The Ghana Health Service, with support from the Ghana Red Cross and UNICEF, provided logistical support, volunteer workers and social mobilization during the campaign. Volunteers visited homes to inform caregivers about the campaign and encourage them to participate. We assessed pre-campaign coverage of bednets by interviewing caregivers leaving vaccination and distribution sites. Five months after distribution, a two-stage cluster survey using population-proportional sampling assessed bednet coverage, retention and use. Both the pre-campaign and post-campaign survey assessed household wealth using an asset inventory. FINDINGS: At the campaign exit interview 636/776 (82.0%) caregivers reported that they had received a home visit by a Red Cross volunteer before the campaign and that 32/776 (4.1%) of the youngest children in each household who were less than 5 years of age slept under an insecticide-treated bednet. Five months after distribution caregivers reported that 204/219 (93.2%) of children aged 9 months to 5 years had been vaccinated during the campaign; 234/248 (94.4%) of households were observed to have an insecticide-treated bednet; and 170/249 (68.3%) were observed to have a net hung over a bed. Altogether 222/248 (89.5%) caregivers reported receiving at least one insecticide-treated bednet during the campaign, and 153/254 (60.2%) said that on the previous night their youngest child had slept under a bednet received during the campaign. For households in the poorest quintile, post-campaign coverage of insecticide-treated bednets was 10 times higher than pre-campaign coverage of households in the wealthiest quintile (46/51 (90.2%) versus 14/156 (9.0%)). The marginal operational cost was 0.32 US dollars per insecticide-treated bednet delivered. CONCLUSION: These findings suggest that linking bednet distribution to measles vaccination campaigns may provide an important opportunity for achieving high and equitable coverage of bednets. PMID:15798843

How small bugs tie down big rocks: Measuring and modeling the forces acting between nets spun by Caddisfly larvae (Hydropsychidae) and gravel particles at the onset of motion

NASA Astrophysics Data System (ADS)

Mclaughlin, M. K.; Tumolo, B.; Sklar, L. S.; Albertson, L.; Daniels, M.

2017-12-01

The influence of life on geomorphic processes is commonly inferred from correlations between the size and abundance of individual organisms and the change in process thresholds and rates from abiotic conditions. However, to understand and model the underlying mechanisms, it is helpful to make direct measurements of the forces acting between organisms and the earth materials they inhabit. For example, flume studies have found that the presence of net-spinning caddisfly larvae (Trichoptera: Hydropsychidae) can increase the shear stress required to initiate particle motion by more than a factor of two, with potentially significant implications for the timing and magnitude of bedload sediment transport in gravel-bedded rivers. To explore the underlying mechanics we conducted flume experiments at the Stroud Water Research center in Avonadale, Pennsylvania, using strain gages to measure the forces acting between caddisfly nets and sediment particles of various sizes, during the process of initial particle motion. We combine these measurements with high-speed video images to document for the first time, the three dimensional dynamics of net stretching, tearing, and detachment that govern the magnitude of the increase in critical shear stress. We are using these data and insights to substantially improve a previously published theoretical model for the mechanics of sediment stabilization by caddisfly larvae. In particular, we seek to constrain the range of particle sizes potentially stabilized by caddisfly larvae and explain mechanistically why the effect of caddisfly nets varies with particle size. These predictions have implications for understanding feedbacks between bed stabilization by caddisflies, insect density, inter-specific niche partitioning, and the movement of sediment that shapes gravel-bed channels.

Nebraska | Midmarket Solar Policies in the United States | Solar Research |

Science.gov Websites

project development, sales, use, and property tax exemptions, and production based tax credits. Net personal property for use in a community-based energy development (C-BED) project. (A C-BED project is limited to $50,000. Nebraska is not accepting applications for the program as of July 2016. Property Tax

A study of actions in operative notes.

PubMed

Wang, Yan; Pakhomov, Serguei; Burkart, Nora E; Ryan, James O; Melton, Genevieve B

2012-01-01

Operative notes contain rich information about techniques, instruments, and materials used in procedures. To assist development of effective information extraction (IE) techniques for operative notes, we investigated the sublanguage used to describe actions within the operative report 'procedure description' section. Deep parsing results of 362,310 operative notes with an expanded Stanford parser using the SPECIALIST Lexicon resulted in 200 verbs (92% coverage) including 147 action verbs. Nominal action predicates for each action verb were gathered from WordNet, SPECIALIST Lexicon, New Oxford American Dictionary and Stedman's Medical Dictionary. Coverage gaps were seen in existing lexical, domain, and semantic resources (Unified Medical Language System (UMLS) Metathesaurus, SPECIALIST Lexicon, WordNet and FrameNet). Our findings demonstrate the need to construct surgical domain-specific semantic resources for IE from operative notes.

Reservoir evaluation of thin-bedded turbidites and hydrocarbon pore thickness estimation for an accurate quantification of resource

NASA Astrophysics Data System (ADS)

Omoniyi, Bayonle; Stow, Dorrik

2016-04-01

One of the major challenges in the assessment of and production from turbidite reservoirs is to take full account of thin and medium-bedded turbidites (<10cm and <30cm respectively). Although such thinner, low-pay sands may comprise a significant proportion of the reservoir succession, they can go unnoticed by conventional analysis and so negatively impact on reserve estimation, particularly in fields producing from prolific thick-bedded turbidite reservoirs. Field development plans often take little note of such thin beds, which are therefore bypassed by mainstream production. In fact, the trapped and bypassed fluids can be vital where maximising field value and optimising production are key business drivers. We have studied in detail, a succession of thin-bedded turbidites associated with thicker-bedded reservoir facies in the North Brae Field, UKCS, using a combination of conventional logs and cores to assess the significance of thin-bedded turbidites in computing hydrocarbon pore thickness (HPT). This quantity, being an indirect measure of thickness, is critical for an accurate estimation of original-oil-in-place (OOIP). By using a combination of conventional and unconventional logging analysis techniques, we obtain three different results for the reservoir intervals studied. These results include estimated net sand thickness, average sand thickness, and their distribution trend within a 3D structural grid. The net sand thickness varies from 205 to 380 ft, and HPT ranges from 21.53 to 39.90 ft. We observe that an integrated approach (neutron-density cross plots conditioned to cores) to HPT quantification reduces the associated uncertainties significantly, resulting in estimation of 96% of actual HPT. Further work will focus on assessing the 3D dynamic connectivity of the low-pay sands with the surrounding thick-bedded turbidite facies.

Exploring the use of routinely-available, retrospective data to study the association between malaria control scale-up and micro-economic outcomes in Zambia.

PubMed

Comfort, Alison; Leegwater, Anthony; Nakhimovsky, Sharon; Kansembe, Henry; Hamainza, Busiku; Bwalya, Benson; Alilio, Martin; Johns, Ben; Olsho, Lauren

2017-01-04

Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production. The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power. Micro-economic outcomes increased (33% increase in food spending) concurrently with malaria control coverage (62% increase) from 2006 to 2010. Despite using data from all 72 districts, both analytic methods yielded wide confidence intervals that do not conclusively link outcomes and malaria control coverage increases. The authors cannot rule out positive, null or negative effects. The upper bound estimates of the results show that if malaria control coverage increases from 60 to 70%, food spending could increase up to 14%, maize production could increase up to 57%, and years of schooling could increase up to 0.5 years. Simulations indicated that the generalized propensity score model did not have good statistical power. While it is technically possible to use routinely available survey data to relate malaria control scale-up and micro-economic outcomes, it is not clear from this analysis that meaningful results can be obtained when survey data are highly aggregated. Researchers in similar settings should assess the feasibility of disaggregating existing survey data. Additionally, large surveys, such as LCMS and MIS, could incorporate data on both malaria coverage and household expenditures, respectively.

Combination of Insecticide Treated Nets and Indoor Residual Spraying in Northern Tanzania Provides Additional Reduction in Vector Population Density and Malaria Transmission Rates Compared to Insecticide Treated Nets Alone: A Randomised Control Trial.

PubMed

Protopopoff, Natacha; Wright, Alexandra; West, Philippa A; Tigererwa, Robinson; Mosha, Franklin W; Kisinza, William; Kleinschmidt, Immo; Rowland, Mark

2015-01-01

Indoor residual spraying (IRS) combined with insecticide treated nets (ITN) has been implemented together in several sub-Saharan countries with inconclusive evidence that the combined intervention provides added benefit. The impact on malaria transmission was evaluated in a cluster randomised trial comparing two rounds of IRS with bendiocarb plus universal coverage ITNs, with ITNs alone in northern Tanzania. From April 2011 to December 2012, eight houses in 20 clusters per study arm were sampled monthly for one night with CDC light trap collections. Anopheles gambiae s.l. were identified to species using real time PCR Taq Man and tested for the presence of Plasmodium falciparum circumsporozoite protein. ITN and IRS coverage was estimated from household surveys. IRS coverage was more than 85% in two rounds of spraying in January and April 2012. Household coverage with at least one ITN per house was 94.7% after the universal coverage net campaign in the baseline year and the proportion of household with all sleeping places covered by LLIN was 50.1% decreasing to 39.1% by the end of the intervention year. An.gambiae s.s. comprised 80% and An.arabiensis 18.3% of the anopheline collection in the baseline year. Mean An.gambiae s.l. density in the ITN+IRS arm was reduced by 84% (95%CI: 56%-94%, p = 0.001) relative to the ITN arm. In the stratum of clusters categorised as high anopheline density at baseline EIR was lower in the ITN+IRS arm compared to the ITN arm (0.5 versus 5.4 per house per month, Incidence Rate Ratio: 0.10, 95%CI: 0.01-0.66, p-value for interaction <0.001). This trial provides conclusive evidence that combining carbamate IRS and ITNs produces major reduction in Anopheles density and entomological inoculation rate compared to ITN alone in an area of moderate coverage of LLIN and high pyrethroid resistance in An.gambiae s.s.

A good night's sleep and the habit of net use: perceptions of risk and reasons for bed net use in Bukoba and Zanzibar.

PubMed

Koenker, Hannah M; Loll, Dana; Rweyemamu, Datius; Ali, Abdullah S

2013-06-13

Intensive malaria control interventions in the United Republic of Tanzania have contributed to reductions in malaria prevalence. Given that malaria control remains reliant upon continued use of long-lasting insecticidal bed nets (LLINs) even when the threat of malaria has been reduced, this qualitative study sought to understand how changes in perceived risk influence LLIN usage, and to explore in more detail the benefits of net use that are unrelated to malaria. Eleven focus group discussions were conducted in Bukoba Rural district and in Zanzibar Urban West district in late 2011. Participants were males aged 18 and over, females between the ages of 18 and 49, and females at least 50 years old. The perceived risk of malaria had decreased among the respondents, and malaria control interventions were credited for the decline. Participants cited reductions in both the severity of malaria and in their perceived susceptibility to malaria. However, malaria was still considered a significant threat. Participants' conceptualization of risk appeared to be an important consideration for net use. At the same time, comfort and aspects of comfort (getting a good night's sleep, avoiding biting pests) appeared to play a large role in personal decisions to use nets consistently or not. Barriers to comfort (feeling uncomfortable or trapped; perceived difficulty breathing, or itching/rashes) were frequently cited as reasons not to use a net consistently. While it was apparent that participants acknowledged the malaria-prevention benefits of net use, the exploration of the risk and comfort determinants of net use provides a richer understanding of net use behaviours, particularly in a setting where transmission has fallen and yet consistent net use is still crucial to maintaining those gains. Future behaviour change communication campaigns should capitalize on the non-malaria benefits of net use that provide a long-term rationale for consistent use even when the immediate threat of malaria transmission has been reduced.

Numerical simulation of large-scale bed load particle tracer advection-dispersion in rivers with free bars

USGS Publications Warehouse

Iwasaki, Toshiki; Nelson, Jonathan M.; Shimizu, Yasuyuki; Parker, Gary

2017-01-01

Asymptotic characteristics of the transport of bed load tracer particles in rivers have been described by advection-dispersion equations. Here we perform numerical simulations designed to study the role of free bars, and more specifically single-row alternate bars, on streamwise tracer particle dispersion. In treating the conservation of tracer particle mass, we use two alternative formulations for the Exner equation of sediment mass conservation: the flux-based formulation, in which bed elevation varies with the divergence of the bed load transport rate, and the entrainment-based formulation, in which bed elevation changes with the net deposition rate. Under the condition of no net bed aggradation/degradation, a 1-D flux-based deterministic model that does not describe free bars yields no streamwise dispersion. The entrainment-based 1-D formulation, on the other hand, models stochasticity via the probability density function (PDF) of particle step length, and as a result does show tracer dispersion. When the formulation is generalized to 2-D to include free alternate bars, however, both models yield almost identical asymptotic advection-dispersion characteristics, in which streamwise dispersion is dominated by randomness inherent in free bar morphodynamics. This randomness can result in a heavy-tailed PDF of waiting time. In addition, migrating bars may constrain the travel distance through temporary burial, causing a thin-tailed PDF of travel distance. The superdiffusive character of streamwise particle dispersion predicted by the model is attributable to the interaction of these two effects.

Numerical simulation of large-scale bed load particle tracer advection-dispersion in rivers with free bars

NASA Astrophysics Data System (ADS)

Iwasaki, Toshiki; Nelson, Jonathan; Shimizu, Yasuyuki; Parker, Gary

2017-04-01

Asymptotic characteristics of the transport of bed load tracer particles in rivers have been described by advection-dispersion equations. Here we perform numerical simulations designed to study the role of free bars, and more specifically single-row alternate bars, on streamwise tracer particle dispersion. In treating the conservation of tracer particle mass, we use two alternative formulations for the Exner equation of sediment mass conservation: the flux-based formulation, in which bed elevation varies with the divergence of the bed load transport rate, and the entrainment-based formulation, in which bed elevation changes with the net deposition rate. Under the condition of no net bed aggradation/degradation, a 1-D flux-based deterministic model that does not describe free bars yields no streamwise dispersion. The entrainment-based 1-D formulation, on the other hand, models stochasticity via the probability density function (PDF) of particle step length, and as a result does show tracer dispersion. When the formulation is generalized to 2-D to include free alternate bars, however, both models yield almost identical asymptotic advection-dispersion characteristics, in which streamwise dispersion is dominated by randomness inherent in free bar morphodynamics. This randomness can result in a heavy-tailed PDF of waiting time. In addition, migrating bars may constrain the travel distance through temporary burial, causing a thin-tailed PDF of travel distance. The superdiffusive character of streamwise particle dispersion predicted by the model is attributable to the interaction of these two effects.

Experience of targeting subsidies on insecticide-treated nets: what do we know and what are the knowledge gaps?

PubMed

Worrall, Eve; Hill, Jenny; Webster, Jayne; Mortimer, Julia

2005-01-01

Widespread coverage of vulnerable populations with insecticide-treated nets (ITNs) constitutes an important component of the Roll Back Malaria (RBM) strategy to control malaria. The Abuja Targets call for 60% coverage of children under 5 years of age and pregnant women by 2005; but current coverage in Africa is unacceptably low. The RBM 'Strategic Framework for Coordinated National Action in Scaling-up Insecticide-Treated Netting Programmes in Africa' promotes coordinated national action and advocates sustained public provision of targeted subsidies to maximise public health benefits, alongside support and stimulation of the private sector. Several countries have already planned or initiated targeted subsidy schemes either on a pilot scale or on a national scale, and have valuable experience which can inform future interventions. The WHO RBM 'Workshop on mapping models for delivering ITNs through targeted subsidies' held in Zambia in 2003 provided an opportunity to share and document these country experiences. This paper brings together experiences presented at the workshop with other information on experiences of targeting subsidies on ITNs, net treatment kits and retreatment services (ITN products) in order to describe alternative approaches, highlight their similarities and differences, outline lessons learnt, and identify gaps in knowledge. We find that while there is a growing body of knowledge on different approaches to targeting ITN subsidies, there are significant gaps in knowledge in crucial areas. Key questions regarding how best to target, how much it will cost and what outcomes (levels of coverage) to expect remain unanswered. High quality, well-funded monitoring and evaluation of alternative approaches to targeting ITN subsidies is vital to develop a knowledge base so that countries can design and implement effective strategies to target ITN subsidies.

Outcomes for Spine Stereotactic Body Radiation Therapy and an Analysis of Predictors of Local Recurrence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishop, Andrew J.; Tao, Randa; Rebueno, Neal C.

Purpose: To investigate local control, survival outcomes, and predictors of local relapse for patients treated with spine stereotactic body radiation therapy. Methods and Materials: We reviewed the records of 332 spinal metastases consecutively treated with stereotactic body radiation therapy between 2002 and 2012. The median follow-up for all living patients was 33 months (range, 0-111 months). Endpoints were overall survival and local control (LC); recurrences were classified as either in-field or marginal. Results: The 1-year actuarial LC and overall survival rates were 88% and 64%, respectively. Patients with local relapses had poorer dosimetric coverage of the gross tumor volume (GTV) compared withmore » patients without recurrence (minimum dose [Dmin] biologically equivalent dose [BED] 23.9 vs 35.1 Gy, P<.001; D98 BED 41.8 vs 48.1 Gy, P=.001; D95 BED 47.2 vs 50.5 Gy, P=.004). Furthermore, patients with marginal recurrences had poorer prescription coverage of the GTV (86% vs 93%, P=.01) compared with those with in-field recurrences, potentially because of more upfront spinal canal disease (78% vs 24%, P=.001). Using a Cox regression univariate analysis, patients with a GTV BED Dmin ≥33.4 Gy (median dose) (equivalent to 14 Gy in 1 fraction) had a significantly higher 1-year LC rate (94% vs 80%, P=.001) compared with patients with a lower GTV BED Dmin; this factor was the only significant variable on multivariate Cox analysis associated with LC (P=.001, hazard ratio 0.29, 95% confidence interval 0.14-0.60) and also was the only variable significant in a separate competing risk multivariate model (P=.001, hazard ratio 0.30, 95% confidence interval 0.15-0.62). Conclusions: Stereotactic body radiation therapy offers durable control for spinal metastases, but there is a subset of patients that recur locally. Patients with local relapse had significantly poorer tumor coverage, which was likely attributable to treatment planning directives that prioritized the spinal cord constraints over tumor coverage. When possible, we recommend maintaining a GTV Dmin above 14 Gy in 1 fraction and 21 Gy in 3 fractions.« less

A preliminary report on a zone containing thick lignite beds, Denver Basin, Colorado

USGS Publications Warehouse

Soister, Paul E.

1973-01-01

A zone of lignite beds of Paleocene age in the Denver Formation (Upper Cretaceous and Paleocene) lies about 800-1,500 feet above the well-known and extensively mined coal beds of the Laramie Formation (Upper Cretaceous). The zone is a few hundred to as much as 500 feet thick. Where lignite beds lie within 1,000 feet of the surface, this zone underlies an area about 30 miles wide by about 75 miles long, stretching from just northeast of Denver to several miles south of Calhan. Fifteen mines were operated at various periods between 1874 and 1940 and probably produced a total of less than 100,000 tons of lignite, mostly for local use. From 1874 to 1974, several geologists have reported on this lignite zone or the enclosing beds, but no detailed reports have been written except for one by this writer. Drill holes are the main source of geologic data, owing to poor exposure. There are generally about 3 to 6 lignite beds, and they are mostly about 15 or 20 to a few tens of feet apart. Most or all beds typically contain numerous non-coal partings from a fraction of an inch to several inches thick, so that thickness of lignite beds should be stated as gross thickness and as net lignite thickness; net lignite thickness is generally from 70 to 90 percent of gross thickness. Many partings are composed of kaolin, but others are composed of other clay minerals, siltstone, and sandstone. The lignite beds range generally from 1 or 2 to several feet thick, and some are as much as 10-25 feet thick; the thickest known bed has a maximum thickness of 54.5 feet, with a net lignite thickness of 40 feet. Most lignite beds seem to have fair lateral continuity, and at least some beds are several miles in extent. The thickest known lignite bed was traced for at least 18 miles, from northwest to southeast of Watkins. The lignite is brownish-black to black, weathers, checks, and disintegrates rapidly, and even in drill cores from a few hundred feet in depth the lignite is easily broken by hand pressure. Quality of the lignite is lowered by the non-coal partings and, locally at least, by some small blebs and balls of clay in the lignite itself, especially at the base. Available analyses indicate that the following general figures, on an as-received basis, may be applied to relatively clean lignite from this zone: 6,000-7,000 Btu, 20-35 percent moisture, 8-18 percent ash, and 0.3-0.5 percent sulfur. Rank of the lignite is lignite A as calculated by the formulas of the American Society for Testing and . Materials (ASTM), although some parts, especially of deeper beds, may be as high as subbituminous C coal in rank. Best utilization of the lignite probably would be by gasification, liquefaction, or similar methods, because of the numerous non-coal partings and low quality. The thickest known lignite bed is estimated to contain at least 1.25 billion short tons of lignite. Two methods of roughly estimating the order of magnitude of lignite resources, in beds at least 4 feet thick and within 1,000 feet of the surface in this zone, indicate resources are on the order of 20 billion tons.

24 CFR 201.55 - Calculation of insurance claim payment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... insurance coverage reserve account established by the Secretary under § 201.32, if the insurance claim is... (net unpaid principal and the uncollected interest earned to the date of default, calculated according... (net unpaid principal and the uncollected interest earned to the date of default, calculated according...

Suspended and Bedload Sand dynamics in the Mekong River Channel and Export to the Coastal Ocean

NASA Astrophysics Data System (ADS)

Stephens, J. D.; Di Leonardo, D. R.; Weathers, H. D., III; Allison, M. A.

2016-02-01

Two field campaigns were conducted in the tidal and estuarine reach of the Song Hau distributary of the Mekong River to examine the dynamics of sand transport and export to the coastal ocean. This study examines variation in suspended sand concentration and net transport with respect to changes in discharge between the October 2014 high discharge and March 2015 low discharge studies, and over semi-diurnal and spring-neap tidal cycles between Can Tho and the Tran De and Dinh An distributary channels in the Mekong Delta. Suspended sand concentrations were measured using a P-61 isokinetic suspended sediment sampler and a Sequoia Scientific LISST-100X used in vertical profiling mode. Stationary ADCP data are used to examine bed stress at cast sites. Bed load transport rates were calculated using a repeat multibeam transect methodology and dune translation rates with flow. Preliminary results indicate that suspended sand concentration increases towards the bed and is positively correlated with increasing shear stress controlled by river discharge and tides. However, sites with non-sandy bottoms, as indicated by multibeam bathymetry, have low suspended sand concentrations, suggesting a close linkage with a bed sand source. Bed load transport rates vary cross-sectionally with shear stress and are linked to dune size. Most bed load transport is taking place in or near the thalweg. The reduction in ebb flows at low discharge and the mantling of sand fields by salinity driven mud deposition, is suspected to control the low suspended sand concentrations observed in March. Results to date suggest that net sand export (suspended plus bed load) to the ocean occurs predominantly during the high discharge monsoon season.

Evaluation of new tools for malaria vector control in Cameroon: focus on long lasting insecticidal nets.

PubMed

Etang, Josiane; Nwane, Philippe; Piameu, Michael; Manga, Blaise; Souop, Daniel; Awono-Ambene, Parfait

2013-01-01

From 2006 to 2011, biological activity of insecticides for Indoor Residual Spraying (IRS), conventional treatment of nets (CTNs) or long lasting insecticidal nets (LLINs) was evaluated before their approval in Cameroon. The objective of the study was to select the best tools for universal malaria vector control coverage. Bioassays were performed using WHO cones and the Kisumu susceptible strain of Anopheles gambiae s.s.. Among tested products, residual activity and wash resistance of Alpha-cypermethrin LLINs (Interceptor) and CTNs (Fendona) were assessed during 5 months in the Ntougou neighborhood. All the 14 tested products were found effective (95-100% knockdown and mortality rates), although a significant decrease of efficacy was seen with lambda-cyhalothrinWP IRS, alpha-cypermethrin CTNs and LLINs (p< 0.05). However, the efficacy of Interceptor nets did not decrease during the 5 months evaluation, even after 25 washes (0.07

Evaluation of New Tools for Malaria Vector Control in Cameroon: Focus on Long Lasting Insecticidal Nets

PubMed Central

Etang, Josiane; Nwane, Philippe; Piameu, Michael; Manga, Blaise; Souop, Daniel; Awono-Ambene, Parfait

2013-01-01

Background From 2006 to 2011, biological activity of insecticides for Indoor Residual Spraying (IRS), conventional treatment of nets (CTNs) or long lasting insecticidal nets (LLINs) was evaluated before their approval in Cameroon. The objective of the study was to select the best tools for universal malaria vector control coverage. Methodology Bioassays were performed using WHO cones and the Kisumu susceptible strain of Anopheles gambiae s.s.. Among tested products, residual activity and wash resistance of Alpha-cypermethrin LLINs (Interceptor) and CTNs (Fendona) were assessed during 5 months in the Ntougou neighborhood. Principal Findings All the 14 tested products were found effective (95–100% knockdown and mortality rates), although a significant decrease of efficacy was seen with lambda-cyhalothrinWP IRS, alpha-cypermethrin CTNs and LLINs (p< 0.05). However, the efficacy of Interceptor nets did not decrease during the 5 months evaluation, even after 25 washes (0.07

Assessment on the ownership and use of mosquito nets in Mozambique

PubMed Central

Arroz, Jorge Alexandre Harrison; Chirrute, Francisco; Mendis, Chandana; e, Marta Honesta Chande; Kollhoff, Veronique

2016-01-01

ABSTRACT OBJECTIVE To assess the ownership and use of mosquito nets in 2014, in Mozambique. METHODS This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before. RESULTS A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively). CONCLUSIONS In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels. PMID:28099655

Measurements of tungsten migration in the DIII-D divertor

NASA Astrophysics Data System (ADS)

Wampler, W. R.; Rudakov, D. L.; Watkins, J. G.; McLean, A. G.; Unterberg, E. A.; Stangeby, P. C.

2017-12-01

An experimental study of migration of tungsten in the DIII-D divertor is described, in which the outer strike point of L-mode plasmas was positioned on a toroidal ring of tungsten-coated metal inserts. Net deposition of tungsten on the divertor just outside the strike point was measured on graphite samples exposed to various plasma durations using the divertor materials evaluation system. Tungsten coverage, measured by Rutherford backscattering spectroscopy (RBS), was found to be low and nearly independent of both radius and exposure time closer to the strike point, whereas farther from the strike point the W coverage was much larger and increased with exposure time. Depth profiles from RBS show this was due to accumulation of thicker mixed-material deposits farther from the strike point where the plasma temperature is lower. These results are consistent with a low near-surface steady-state coverage on graphite undergoing net erosion, and continuing accumulation in regions of net deposition. This experiment provides data needed to validate, and further improve computational simulations of erosion and deposition of material on plasma-facing components and transport of impurities in magnetic fusion devices. Such simulations are underway and will be reported later.

Healthcare Coverage for HIV Provider Visits Before and After Implementation of the Affordable Care Act

PubMed Central

Berry, Stephen A.; Fleishman, John A.; Yehia, Baligh R.; Cheever, Laura W.; Hauck, Heather; Korthuis, P. Todd; Mathews, W. Christopher; Keruly, Jeanne; Nijhawan, Ank E.; Agwu, Allison L.; Somboonwit, Charurut; Moore, Richard D.; Gebo, Kelly A.

2016-01-01

Background. Before implementation of the Patient Protection and Affordable Care Act (ACA) in 2014, 100 000 persons living with human immunodeficiency virus (HIV) (PLWH) lacked healthcare coverage and relied on a safety net of Ryan White HIV/AIDS Program support, local charities, or uncompensated care (RWHAP/Uncomp) to cover visits to HIV providers. We compared HIV provider coverage before (2011–2013) versus after (first half of 2014) ACA implementation among a total of 28 374 PLWH followed up in 4 sites in Medicaid expansion states (California, Oregon, and Maryland), 4 in a state (New York) that expanded Medicaid in 2001, and 2 in nonexpansion states (Texas and Florida). Methods. Multivariate multinomial logistic models were used to assess changes in RWHAP/Uncomp, Medicaid, and private insurance coverage, using Medicare as a referent. Results. In expansion state sites, RWHAP/Uncomp coverage decreased (unadjusted, 28% before and 13% after ACA; adjusted relative risk ratio [ARRR], 0.44; 95% confidence interval [CI], .40–.48). Medicaid coverage increased (23% and 38%; ARRR, 1.82; 95% CI, 1.70–1.94), and private coverage was unchanged (21% and 19%; 0.96; .89–1.03). In New York sites, both RWHAP/Uncomp (20% and 19%) and Medicaid (50% and 50%) coverage were unchanged, while private coverage decreased (13% and 12%; ARRR, 0.86; 95% CI, .80–.92). In nonexpansion state sites, RWHAP/Uncomp (57% and 52%) and Medicaid (18% and 18%) coverage were unchanged, while private coverage increased (4% and 7%; ARRR, 1.79; 95% CI, 1.62–1.99). Conclusions. In expansion state sites, half of PLWH relying on RWHAP/Uncomp coverage shifted to Medicaid, while in New York and nonexpansion state sites, reliance on RWHAP/Uncomp remained constant. In the first half of 2014, the ACA did not eliminate the need for RWHAP safety net provider visit coverage. PMID:27143660

[Supply and demand of clinical practice fields for training undergraduate health sciences students in Peru, 2005-2009].

PubMed

Alva, Javier; Verastegui, George; Velasquez, Edgar; Pastor, Reyna; Moscoso, Betsy

2011-06-01

To describe the supply and demand of clinical fields for undergraduate students of Peru. A descriptive study was considering as supply of clinical fields the total number of existing hospital beds in Peru. The demand was calculated using the total number of alumni registered in health science carrers following the clinical years or the internship. We calculated the number of beds per student and the coverage of clinical fields nationally and in some selected regions (Lima, Arequipa, La Libertad and Lambayeque). In 2009, Peru had 34,539 hospital beds, 78.5% of which pertained to the public sector and 48.4% are from Lima. We estimated that in 2008 44,032 alumni needed clinical fields, 70% from private universities, which grew 65% since 2005. The coverage of clinical fields, considering only interns from four carreers (medicine, nursery, obstetrics and dentistry) was only 31.5% at the national level. The number of beds per student oscillated between 0.5 in La Libertad to 0.82 in Lima with a national mean of 0.45. The supply of clinical fields for teaching undergraduates is insufficient to satisfy the demand, which continues to grow because of private universities, and hence requires urgent regulation.

Modeling the influence of river rehabilitation scenarios on bed material sediment flux in a large river over decadal timescales

USGS Publications Warehouse

Singer, Michael B.; Dunne, Thomas

2006-01-01

A stochastic flood generator and calibrated sediment transport formulae were used to assess the decadal impact of major river rehabilitation strategies on two fraction bed material sediment flux and net storage, first‐order indicators of aquatic riverine habitat, in a large river system. Model boundary conditions were modified to reflect the implementation of three major river rehabilitation strategies being considered in the Sacramento River Valley: gravel augmentation, setting back of levees, and flow alteration. Fifty 30‐year model simulations were used to compute probabilities of the response in sediment flux and net storage to these strategies. Total annual average bed material sediment flux estimates were made at six gauged river cross sections, and ∼60 km reach‐scale sediment budgets were evaluated between them. Gravel augmentation to improve spawning habitat induced gravel accumulation locally and/or downstream, depending on the added mixture. Levee setbacks to recreate the river corridor reduced flow stages for most flows and hence lowered sediment flux. Flow alteration to mimic natural flow regimes systematically decreased total annual average flux, suggesting that high‐magnitude low‐frequency transport events do not affect long‐term trends in bed material flux. The results indicate that each rehabilitation strategy reduces sediment transport in its target reaches and modulates imbalances in total annual bed material sediment budgets at the reach scale. Additional risk analysis is necessary to identify extreme conditions associated with variable hydrology that could affect rehabilitation over decades. Sensitivity analysis suggests that sorting of bed material sediment is the most important determinant of modeled transport and storage patterns.

X3D-Earth: Full Globe Coverage Utilizing Multiple Dataset

DTIC Science & Technology

2010-09-01

DtedNvtProcessor Class ..................................................128 Figure 63. Subversion Checkout in Netbeans ...to the Ant build.xml file within a NetBeans Project: <target name=“moveToHamming” depends=““> <scp todir=“user@hamming.uc.nps.edu:/work/user/DTED...This task was generated using the NetBeans IDE (can be downloaded at www.netbeans.org). The task was then executed within NetBeans . This type of

Socioeconomic and behavioural determinants of malaria among the migrants in gold mining, rubber and oil palm plantation areas in Myanmar.

PubMed

Soe, Htin Zaw; Thi, Aung; Aye, Ni Ni

2017-11-06

Malaria is a major public health problem in Myanmar. Migrant populations are at high risk of contracting malaria and its control is more difficult than for settled population. Studies on malaria and migration are rare in Myanmar. This study was undertaken with the main objective of identifying socioeconomic and behavioural determinants of malaria among the migrant workers involved in gold mining, rubber and oil palm plantations. A cross-sectional analytic study was conducted using pretested interview-administered questionnaires among internal migrants (n = 406) in the malaria endemic townships of Shwegyin, Bago Region, Thanbyuzayat, Mon State and Kawthaung, Taninthayi Region from August to November, 2015. Data were collected by well-trained Basic Health Staff members in study areas, and then analysed by SPSS version 16.0 using Chi-square tests with significant level at 0.05. Majority of participants were male, Bahmar nationals, married and with primary basic education level and below. The mean duration of migratory work was 4.51 years. 43.1% of them gave definite previous history of malaria within last two years during migration. 92.9% (377/406) of them always used bed nets. Malaria determinants found were male gender (OR = 1.84, 95% CI: 1.22-2.77; P = 0.0040), habit of going out at dawn (OR = 2.36, 95% CI: 1.58-3.52; P < 0.001), usual sleeping indoors (OR = 2.14, 95% CI: 1.04-4.42; P = 0.036), torn bed net or net with large hole(s) (OR = 2.0, 95% CI: 1.21-3.3; P = 0.006), habit of not always sleeping under a bed net at night (OR = 2.02, 95% CI: 1.15-3.52; P = 0.014), alcohol drinking (OR = 2.71, 95% CI: 1.73-4.26; P < 0.001) and failure to attend malaria health talk (OR = 1.78, 95% CI: 1.2-2.65; P = 0.004). The present study highlighted that it is warranted to launch an effective health education programme for malaria, and to encourage the proper use of insecticide-treated bed nets, blankets and/or mufflers and mosquito repellents to reduce the occurrence of malaria among the migrants.

Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America.

PubMed

Kroeger, Axel; Aviñna, Ana; Ordoñnez-Gonzalez, José; Escandon, Celia

2002-11-15

Insecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors. The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services. Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs. ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates.

Costs and consequences of large-scale vector control for malaria

PubMed Central

Yukich, Joshua O; Lengeler, Christian; Tediosi, Fabrizio; Brown, Nick; Mulligan, Jo-Ann; Chavasse, Des; Stevens, Warren; Justino, John; Conteh, Lesong; Maharaj, Rajendra; Erskine, Marcy; Mueller, Dirk H; Wiseman, Virginia; Ghebremeskel, Tewolde; Zerom, Mehari; Goodman, Catherine; McGuire, David; Urrutia, Juan Manuel; Sakho, Fana; Hanson, Kara; Sharp, Brian

2008-01-01

Background Five large insecticide-treated net (ITN) programmes and two indoor residual spraying (IRS) programmes were compared using a standardized costing methodology. Methods Costs were measured locally or derived from existing studies and focused on the provider perspective, but included the direct costs of net purchases by users, and are reported in 2005 USD. Effectiveness was estimated by combining programme outputs with standard impact indicators. Findings Conventional ITNs: The cost per treated net-year of protection ranged from USD 1.21 in Eritrea to USD 6.05 in Senegal. The cost per child death averted ranged from USD 438 to USD 2,199 when targeting to children was successful. Long-lasting insecticidal nets (LLIN) of five years duration: The cost per treated-net year of protection ranged from USD 1.38 in Eritrea to USD 1.90 in Togo. The cost per child death averted ranged from USD 502 to USD 692. IRS: The costs per person-year of protection for all ages were USD 3.27 in KwaZulu Natal and USD 3.90 in Mozambique. If only children under five years of age were included in the denominator the cost per person-year of protection was higher: USD 23.96 and USD 21.63. As a result, the cost per child death averted was higher than for ITNs: USD 3,933–4,357. Conclusion Both ITNs and IRS are highly cost-effective vector control strategies. Integrated ITN free distribution campaigns appeared to be the most efficient way to rapidly increase ITN coverage. Other approaches were as or more cost-effective, and appeared better suited to "keep-up" coverage levels. ITNs are more cost-effective than IRS for highly endemic settings, especially if high ITN coverage can be achieved with some demographic targeting. PMID:19091114

Regional Disease Vector Ecology Profile: The Koreas

DTIC Science & Technology

2015-01-01

Lymantriidae): The larvae, pupae and adults of E. flava are covered with hairs that cause dermatitis (papulourticarial reaction) when they contact ...Information Services Division at (301) 295-8310/7476, DSN 295- 8310/7476 or the AFPMB Webmaster, http://www.afpmb.org/ contact . Current Information: Current...timely manner. For insect repellents, pesticides, pesticide application equipment, PPMs (bed nets, head nets, etc.) and respirators contact the DLA

Spatial distribution of impacts to channel bed mobility due to flow regulation, Kootenai River, USA

Treesearch

Michael Burke; Klaus Jorde; John M. Buffington; Jeffrey H. Braatne; Rohan Benjakar

2006-01-01

The regulated hydrograph of the Kootenai River between Libby Dam and Kootenay Lake has altered the natural flow regime, resulting in a significant decrease in maximum flows (60% net reduction in median 1-day annual maximum, and 77%-84% net reductions in median monthly flows for the historic peak flow months of May and June, respectively). Other key hydrologic...

Effect of untreated bed nets on blood-fed Phlebotomus argentipes in kala-azar endemic foci in Nepal and India.

PubMed

Picado, Albert; Kumar, Vijay; Das, Murari; Burniston, Ian; Roy, Lalita; Suman, Rijal; Dinesh, Diwakar; Coosemans, Marc; Sundar, Shyam; Shreekant, Kesari; Boelaert, Marleen; Davies, Clive; Cameron, Mary

2009-12-01

Observational studies in the Indian subcontinent have shown that untreated nets may be protective against visceral leishmaniasis (VL). In this study, we evaluated the effect of untreated nets on the blood feeding rates of Phlebotomus argentipes as well as the human blood index (HBI) in VL endemic villages in India and Nepal. The study had a 'before and after intervention' design in 58 households in six clusters. The use of untreated nets reduced the blood feeding rate by 85% (95% CI 76.5-91.1%) and the HBI by 42.2% (95% CI 11.1-62.5%). These results provide circumstantial evidence that untreated nets may provide some degree of personal protection against sand fly bites.

Health impact and cost-effectiveness of a private sector bed net distribution: experimental evidence from Zambia.

PubMed

Sedlmayr, Richard; Fink, Günther; Miller, John M; Earle, Duncan; Steketee, Richard W

2013-03-18

Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia's cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia's NMCP. The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial.

Protective efficacy of menthol propylene glycol carbonate compared to N, N-diethyl-methylbenzamide against mosquito bites in Northern Tanzania.

PubMed

Kweka, Eliningaya J; Munga, Stephen; Mahande, Aneth M; Msangi, Shandala; Mazigo, Humphrey D; Adrias, Araceli Q; Matias, Jonathan R

2012-09-05

The reduction of malaria parasite transmission by preventing human-vector contact is critical in lowering disease transmission and its outcomes. This underscores the need for effective and long lasting arthropod/insect repellents. Despite the reduction in malaria transmission and outcomes in Tanzania, personal protection against mosquito bites is still not well investigated. This study sought to determine the efficacy of menthol propylene glycol carbonate (MR08), Ocimum suave as compared to the gold standard repellent N, N-diethyl-methylbenzamide (DEET), either as a single dose or in combination (blend), both in the laboratory and in the field against Anopheles gambiae s.l and Culex quinquefasciatus. In the laboratory evaluations, repellents were applied on one arm while the other arm of the same individual was treated with a base cream. Each arm was separately exposed in cages with unfed female mosquitoes. Repellents were evaluated either as a single dose or as a blend. Efficacy of each repellent was determined by the number of mosquitoes that landed and fed on treated arms as compared to the control or among them. In the field, evaluations were performed by human landing catches at hourly intervals from 18:00  hr to 01:00  hr. A total of 2,442 mosquitoes were collected during field evaluations, of which 2,376 (97.30%) were An. gambiae s.l while 66 (2.70%) were Cx. quinquefaciatus. MR08 and DEET had comparatively similar protective efficacy ranging from 92% to 100 for both single compound and blends. These findings indicate that MR08 has a similar protective efficacy as DEET for personal protection outside bed nets when used singly and in blends. Because of the personal protection provided by MR08, DEET and blends as topical applicants in laboratory and field situations, these findings suggest that, these repellents could be used efficiently in the community to complement existing tools. Overall, Cx. quinquefasciatus were significantly prevented from blood feeding compared to An. gambiae s.l. The incorporation of these topical repellents for protection against insect bites can be of additional value in the absence or presence of IRS and ITNs coverage. However, a combination of both the physical (bed nets) and the repellent should be used in an integrated manner for maximum protection, especially before going to bed. Additional research is needed to develop repellents with longer duration of protection.

The effect of insecticide-treated bed nets on the incidence and prevalence of malaria in children in an area of unstable seasonal transmission in western Myanmar.

PubMed

Smithuis, Frank M; Kyaw, Moe Kyaw; Phe, U Ohn; van der Broek, Ingrid; Katterman, Nina; Rogers, Colin; Almeida, Patrick; Kager, Piet A; Stepniewska, Kasia; Lubell, Yoel; Simpson, Julie A; White, Nicholas J

2013-10-11

Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study's objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of -2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval -7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN.

Plant based insect repellent and insecticide treated bed nets to protect against malaria in areas of early evening biting vectors: double blind randomised placebo controlled clinical trial in the Bolivian Amazon.

PubMed

Hill, N; Lenglet, A; Arnéz, A M; Carneiro, I

2007-11-17

To determine the effectiveness in reducing malaria of combining an insect repellent with insecticide treated bed nets compared with the nets alone in an area where vector mosquitoes feed in the early evening. A double blind, placebo controlled cluster-randomised clinical study. Rural villages and peri-urban districts in the Bolivian Amazon. 4008 individuals in 860 households. All individuals slept under treated nets; one group also used a plant based insect repellent each evening, a second group used placebo. Episodes of Plasmodium falciparum or P vivax malaria confirmed by rapid diagnostic test or blood slide, respectively. We analysed 15,174 person months at risk and found a highly significant 80% reduction in episodes of P vivax in the group that used treated nets and repellent (incidence rate ratio 0.20, 95% confidence interval 0.11 to 0.38, P<0.001). Numbers of P falciparum cases during the study were small and, after adjustment for age, an 82% protective effect was observed, although this was not significant (0.18, 0.02 to 1.40, P=0.10). Reported episodes of fever with any cause were reduced by 58% in the group that used repellent (0.42, 0.31 to 0.56, P<0.001). Insect repellents can provide protection against malaria. In areas where vectors feed in the early evening, effectiveness of treated nets can be significantly increased by using repellent between dusk and bedtime. This has important implications in malaria vector control programmes outside Africa and shows that the combined use of treated nets and insect repellents, as advocated for most tourists travelling to high risk areas, is fully justified. NCT 00144716.

Insecticide-treated mosquito nets in rural Burkina Faso: assessment of coverage and equity in the wake of a universal distribution campaign.

PubMed

Zöllner, Caroline; De Allegri, Manuela; Louis, Valérie R; Yé, Maurice; Sié, Ali; Tiendrebéogo, Justin; Jahn, Albrecht; Müller, Olaf

2015-03-01

Insecticide-treated mosquito nets (ITNs) are an essential tool of the Roll Back Malaria strategy. An increasing number of African countries have embarked on mass distribution campaigns of long-lasting insecticide-treated nets (LLINs) with the ultimate goal of universal coverage. Such a national campaign with the goal of one ITN for every two people has been conducted in Burkina Faso in 2010. Our aim was to assess the coverage and equity effect of the universal distribution campaign of LLINs in Burkina Faso and to identify determinants of ITN ownership across households after the campaign. We evaluated its effects through comparison of data from two household surveys conducted in early 2010 (before the campaign) and early 2011 (after the campaign) on a representative rural district in north-western Burkina Faso. Data were collected on household characteristics (including socio-economic status) and ITN ownership. We used concentration curves and indices to compare ITN coverage indicators before and after the campaign and multilevel multivariate logistic regression to estimate factors associated with achievement of the universal coverage target in 2011. The survey included 1106 households in 2010 and 1094 in 2011. We found that the proportion of households with at least one ITN increased from 59% before the campaign to 99% afterwards, whereas the concentration index dropped from 0.087 (standard error (SE): 0.014) to 0.002 (SE: 0.002). Fifty-two per cent of households reached the target of one ITN for every two people per household, with the relevant concentration index at -0.031 (SE: 0.016). Eighty-six per cent of households owned at least one ITN for every three people. The main characteristics significantly associated with the targeted intra-household coverage were family size and distance to the health centre but not socio-economic status. In conclusion, despite not having fully met its target, the national LLIN campaign achieved a high level of coverage and fostered equity. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Possession and Usage of Insecticidal Bed Nets among the People of Uganda: Is BRAC Uganda Health Programme Pursuing a Pro-Poor Path?

PubMed Central

Ahmed, Syed Masud; Zerihun, Abebual

2010-01-01

Background The use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy. Methodology/Principal Findings Information on possession of LLINs and relevant knowledge on its proper use and maintenance was collected from households either with an under-five child and/or a pregnant woman. The sample included three villages from each of the 10 branch offices where BRAC Uganda's community-based health programme was operating. Data were collected by trained enumerators through face-to-face interviews using a hand-held personal digital assistant (PDA). Findings reveal that the study population had superficial knowledge on malaria and its transmission, including the use and maintenance of LLINs. The households' rate of possession of bed nets (41–59%), and the proportion of under-five children (17–19%) and pregnant women (25–27%) who reported sleeping under an LLIN were not encouraging. Inequity was observed in the number of LLINs possessed by the households, in the knowledge on its use and maintenance, and between the two programme areas. Conclusions/Significance The BRAC Uganda's LLINs distribution at a subsidized price appeared to be inadequate and inequitable, and BRAC's knowledge dissemination is insufficient for initiating preventive actions such as proper use of LLINs to interrupt malaria transmission. Findings contribute to the on-going debate on LLINs distribution in Africa and make a strong case for its free distribution. PMID:20844749

"People will say that I am proud": a qualitative study of barriers to bed net use away from home in four Ugandan districts.

PubMed

Monroe, April; Harvey, Steven A; Lam, Yukyan; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel

2014-03-06

Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious "crusades" where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective.

2005 8th Annual Systems Engineering Conference. Volume 4, Thursday

DTIC Science & Technology

2005-10-27

requirements, allocation , and utilization statistics Operations Decisions Acquisition Decisions Resource Management — Integrated Requirements/ Allocation ...Quality Improvement Consultants, Inc. “Automated Software Testing Increases Test Quality and Coverage Resulting in Improved Software Reliability.”, Mr...Steven Ligon, SAIC The Return of Discipline, Ms. Jacqueline Townsend, Air Force Materiel Command Track 4 - Net Centric Operations: Testing Net-Centric

Comparison of the Laboratory Standard Washing Using CIPAC Washing Agent and the Domestic Washing on Three Recommended Types of Long-Lasting Insecticidal Mosquito Nets

PubMed Central

Ouattara, Jean Pierre Nabléni; Louwagie, Johanna; Pigeon, Olivier; Spanoghe, Pieter

2013-01-01

Background One of the best ways to prevent malaria is the use of insecticide-treated bed nets. Manufacturers pursue easier, safer and more efficient nets. Hence, many studies on the efficacy and wash resistance using World Health Organization standards have been reported. The commonly used detergent is “Savon de Marseille”, because it closely resembles actually used soaps. At the 54th Collaborative International Pesticides Analytical Council (CIPAC) Technical Meeting in 2010, it was suggested to replace it by a standardized “CIPAC washing agent”. The aim of this study was to investigate the difference between a laboratory hand washing simulation using the CIPAC washing agent (method-1) and a domestic washing (method-2) on different bed nets, as well as the effect of the drying process on the release of active ingredient. Methods Interceptor®, Permanet®2.0 and Netprotect® nets were used in three treatments, each repeated 20 times. The first treatment included method-1 washing and indoor drying. The second treatment included method-2 washing and indoor drying. The third treatment used method-2 washing and UV-drying. The residual insecticide contents were determined using gas chromatography. Results The washing procedure and the number of washes have a significant effect on the release of active ingredient. Statistically, the two washing methods have the same effect on removing the active ingredient from the Interceptor® and Permanet®2.0 net, but a significantly different influence on the Netprotect® nets. The drying process has no significant effect on the insecticide. Conclusion Both washing procedures affected the amount of insecticide remaining on nets independently of the impregnation technology. The active ingredient decreases with the number of washing cycles following an exponential or logarithmic model for coated nets. The laboratory hand washing simulation had more impact on the decrease of active ingredient content of the Netprotect® nets. All net types seemed to be effectively protected against UV-light. PMID:24130671

The distribution over time of costs and social net benefits for pertussis immunization programs.

PubMed

Girard, Dorota Zdanowska

2010-03-01

The cost of a six-dose pertussis immunization programs for children and adolescents is investigated in relation to estimators of the price of acellular vaccine, the value of a child's life, levels of vaccination rate and discount rates. We compare the cost of the program maintained over time at 90% with three alternative strategies, each involving a decrease in vaccination coverage. Data from England and Wales, 1966-2005, is used to formalize a delay in occurrence of pertussis cases as a result of a fall in coverage. We first apply the criterion of minimization of the total social cost of pertussis to identify the best cost saving immunization strategy. The results are also discussed in form of the discounted present value of the total social net benefits. We find that the discounted present value of the total social net benefit is maximized when a stable vaccination program at 90% is compared to a gradual decrease in vaccination coverage leading to the lowest vaccination rate. The benefits to society of providing sustained immunization strategy, vaccinating the highest proportion of children and adolescents, are systematically proved on the basis of the second optimisation criterion, independently of the level of estimators applied during economic evaluation for the cost variables.

What drives community adherence to indoor residual spraying (IRS) against malaria in Manhiça district, rural Mozambique: a qualitative study.

PubMed

Munguambe, Khátia; Pool, Robert; Montgomery, Catherine; Bavo, Carlos; Nhacolo, Ariel; Fiosse, Lina; Sacoor, Charfudin; Nhalungo, Delino; Mabunda, Samuel; Macete, Eusébio; Alonso, Pedro

2011-11-23

Malaria control remains a challenge in sub-Saharan Africa. In 2006, the World Health Organization (WHO) reinforced the recommendation of indoor residual spraying (IRS) with dichlorodiphenyltrichloroethane (DDT) to reduce malaria transmission. The National Malaria Control Programme has been reporting high coverage rates of IRS in Mozambique. It is important to establish to what extent these rates are a reflection of community acceptability, and to explore the factors associated with adherence, in order to recommend suitable approaches for interventions of this nature. To understand the implementation process, reception and acceptability of the IRS program in Manhiça district, Southern Mozambique. Qualitative data was collected through in-depth interviews, participant observation of IRS activities, informal interviews, and focus group discussions. Study participants comprised householders, community leaders, health care providers, sprayers, and community members. Qualitative data analysis was based on grounded theory. Secondary data from the Manhiça Demographic Surveillance System was used to complement the qualitative data. IRS was well received in most neighbourhoods. The overall coverage rates varied between 29% and 41% throughout the study period. The factors related to adherence to IRS were: immediate impact on insects in general, trust and obedience in the health authority, community leaders' influence, and acquaintance with the sprayers. Fighting malaria was not an important motivation for IRS adherence. There was a perception of limited efficacy of IRS against mosquitoes, but this did not affect adherence. Non-adherence to the intervention was mainly due to the unavailability of key householders, disagreement with the procedures, and the perception that spraying increased the burden of insects. Most respondents strongly favoured bed nets over IRS. The study suggests that the contribution of IRS to malaria and mosquito control is not entirely perceived by the beneficiaries, and that other as cost effective interventions such as insecticide-treated nets are favoured over IRS. Adherence to IRS was found to be influenced by socio-political factors. There is a need to redefine the community sensitization approaches in order to make IRS a genuinely participative, acceptable, and sustainable programme.

Estimated cost of universal public coverage of prescription drugs in Canada

PubMed Central

Morgan, Steven G.; Law, Michael; Daw, Jamie R.; Abraham, Liza; Martin, Danielle

2015-01-01

Background: With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada. Methods: We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator. Results: Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes. Interpretation: The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government. PMID:25780047

Estimated cost of universal public coverage of prescription drugs in Canada.

PubMed

Morgan, Steven G; Law, Michael; Daw, Jamie R; Abraham, Liza; Martin, Danielle

2015-04-21

With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada. We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator. Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes. The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government. © 2015 Canadian Medical Association or its licensors.

"When I sleep under the net, nothing bothers me; I sleep well and I'm happy": Senegal's culture of net use and how inconveniences to net use do not translate to net abandonment.

PubMed

Berthe, Sara; Loll, Dana; Faye, Sylvain L; Wone, Issa; Koenker, Hannah; Arnold, Bethany; Weber, Rachel

2014-09-12

Despite recent advances in the fight against the disease, malaria remains a serious threat to the health and well-being of populations in endemic countries. The use of long-lasting insecticidal nets (LLIN) reduces contact between the vector and humans, thereby reducing transmission of the disease. LLINs have become an essential component of malaria control programmes worldwide. The Culture of Net Use study used qualitative and quantitative methods in a longitudinal and iterative design over two phases, in order to capture changes in net use over a year and a half period and covering both dry and rainy seasons. Data were collected from a total of 56 households in eight regions to understand variations due to geographical, cultural, and universal coverage differences. At the time of the data collection, the universal coverage campaign had been completed in six of the eight regions (Dakar and Thies excluded). Perceived barriers to use were primarily related to the characteristics of the net itself, include shape, insecticide, and a variety of minority responses, such as perceived lack of mosquito density and being unaccustomed to using nets. Insecticide-related complaints found that insecticide did not present a significant barrier to use, but was cited as a nuisance. Feelings of suffocation continued to be the most commonly cited nuisance. Respondents who favoured the use of insecticide on nets appeared to be more aware of the health and malaria prevention benefits of the insecticide than those who perceived it negatively. Despite prior evidence that barriers such as heat, shape, insecticide and perceived mosquito density contribute to non-use of LLINs in other countries, this study has shown that these factors are considered more as nuisances and that they do not consistently prevent the use of nets among respondents in Senegal. Of those who cited inconveniences with their nets, few were moved to stop using a net. Respondents from this study overcame these barriers and continue to value the importance of nets.

The Economic Value of Long-Lasting Insecticidal Nets and Indoor Residual Spraying Implementation in Mozambique.

PubMed

Lee, Bruce Y; Bartsch, Sarah M; Stone, Nathan T B; Zhang, Shufang; Brown, Shawn T; Chatterjee, Chandrani; DePasse, Jay V; Zenkov, Eli; Briët, Olivier J T; Mendis, Chandana; Viisainen, Kirsi; Candrinho, Baltazar; Colborn, James

2017-06-01

AbstractMalaria-endemic countries have to decide how much of their limited resources for vector control to allocate toward implementing long-lasting insecticidal nets (LLINs) versus indoor residual spraying (IRS). To help the Mozambique Ministry of Health use an evidence-based approach to determine funding allocation toward various malaria control strategies, the Global Fund convened the Mozambique Modeling Working Group which then used JANUS, a software platform that includes integrated computational economic, operational, and clinical outcome models that can link with different transmission models (in this case, OpenMalaria) to determine the economic value of vector control strategies. Any increase in LLINs (from 80% baseline coverage) or IRS (from 80% baseline coverage) would be cost-effective (incremental cost-effectiveness ratios ≤ $114/disability-adjusted life year averted). However, LLIN coverage increases tend to be more cost-effective than similar IRS coverage increases, except where both pyrethroid resistance is high and LLIN usage is low. In high-transmission northern regions, increasing LLIN coverage would be more cost-effective than increasing IRS coverage. In medium-transmission central regions, changing from LLINs to IRS would be more costly and less effective. In low-transmission southern regions, LLINs were more costly and less effective than IRS, due to low LLIN usage. In regions where LLINs are more cost-effective than IRS, it is worth considering prioritizing LLIN coverage and use. However, IRS may have an important role in insecticide resistance management and epidemic control. Malaria intervention campaigns are not a one-size-fits-all solution, and tailored approaches are necessary to account for the heterogeneity of malaria epidemiology.

Mosquito Bite Prevention For Travelers

MedlinePlus

... is an insecticide that kills mosquitoes and other insects. - Do not wash bed nets or expose them ... for extra protection. Use only an EPA-registered insect repellent Š Consider bringing insect repellent with you. Š Always ...

Mosquitoes established in Lhasa city, Tibet, China

PubMed Central

2013-01-01

Background In 2009, residents of Lhasa city, Tibet Autonomous Region (TAR), China reported large numbers of mosquitoes and bites from these insects. It is unclear whether this was a new phenomenon, which species were involved, and whether these mosquitoes had established themselves in the local circumstances. Methods The present study was undertaken in six urban sites of Chengguan district Lhasa city, Tibet. Adult mosquitoes were collected by bed net trap, labor hour method and light trap in August 2009 and August 2012. The trapped adult mosquitoes were initially counted and identified according to morphological criteria, and a proportion of mosquitoes were examined more closely using a multiplex PCR assay. Results 907 mosquitoes of the Culex pipiens complex were collected in this study. Among them, 595 were females and 312 were males. There was no significant difference in mosquito density monitored by bed net trap and labor hour method in 2009 and 2012. Of 105 mosquitoes identified by multiplex PCR, 36 were pure mosquitoes (34.29%) while 69 were hybrids (65.71%). The same subspecies of Culex pipiens complex were observed by bed net trap, labor hour method and light trap in 2009 and 2012. Conclusion The local Culex pipiens complex comprises the subspecies Cx. pipiens pipiens, Cx. pipiens pallens, Cx. pipiens quinquefasciatus and its hybrids. Mosquitoes in the Cx. pipiens complex, known to be, potentially, vectors of periodic filariasis and encephalitis, are now present from one season to the next, and appear to be established in Lhasa City, TAR. PMID:24060238

A climate-based malaria model with the use of bed nets.

PubMed

Wang, Xiunan; Zhao, Xiao-Qiang

2018-07-01

Insecticide-treated bed nets (ITNs) are among the most important and effective intervention measures against malaria. In order to investigate the impact of bed net use on disease control, we formulate a periodic vector-bias malaria model incorporating the juvenile stage of mosquitoes and the use of ITNs. We derive the vector reproduction ratio [Formula: see text] and the basic reproduction ratio [Formula: see text]. We show that the global dynamics of the model is completely determined by these two reproduction ratios. More precisely, the mosquito-free periodic solution is globally attractive if [Formula: see text]; the unique disease-free periodic solution is globally attractive if [Formula: see text] and [Formula: see text]; and the model admits a unique positive periodic solution and it is globally attractive if [Formula: see text] and [Formula: see text]. Numerically, we study the malaria transmission case in Port Harcourt, Nigeria. Our findings show that the use of ITNs has a positive effect on reducing [Formula: see text], and that malaria may be eliminated from this area if over 75% of the human population were to use ITNs. The simulation about the long term behavior of solutions has good agreement with the obtained analytic result. Moreover, we find that the ignorance of the vector-bias effect may result in underestimation of the basic reproduction ratio [Formula: see text]. Another notable result is that the infection risk would be underestimated if the basic reproduction ratio [Formula: see text] of the time-averaged autonomous system were used.

Exposing Coverage Data to the Semantic Web within the MELODIES project: Challenges and Solutions

NASA Astrophysics Data System (ADS)

Riechert, Maik; Blower, Jon; Griffiths, Guy

2016-04-01

Coverage data, typically big in data volume, assigns values to a given set of spatiotemporal positions, together with metadata on how to interpret those values. Existing storage formats like netCDF, HDF and GeoTIFF all have various restrictions that prevent them from being preferred formats for use over the web, especially the semantic web. Factors that are relevant here are the processing complexity, the semantic richness of the metadata, and the ability to request partial information, such as a subset or just the appropriate metadata. Making coverage data available within web browsers opens the door to new ways for working with such data, including new types of visualization and on-the-fly processing. As part of the European project MELODIES (http://melodiesproject.eu) we look into the challenges of exposing such coverage data in an interoperable and web-friendly way, and propose solutions using a host of emerging technologies like JSON-LD, the DCAT and GeoDCAT-AP ontologies, the CoverageJSON format, and new approaches to REST APIs for coverage data. We developed the CoverageJSON format within the MELODIES project as an additional way to expose coverage data to the web, next to having simple rendered images available using standards like OGC's WMS. CoverageJSON partially incorporates JSON-LD but does not encode individual data values as semantic resources, making use of the technology in a practical manner. The development also focused on it being a potential output format for OGC WCS. We will demonstrate how existing netCDF data can be exposed as CoverageJSON resources on the web together with a REST API that allows users to explore the data and run operations such as spatiotemporal subsetting. We will show various use cases from the MELODIES project, including reclassification of a Land Cover dataset client-side within the browser with the ability for the user to influence the reclassification result by making use of the above technologies.

Joint malaria surveys lead towards improved cross-border cooperation between Savannakhet province, Laos and Quang Tri province, Vietnam.

PubMed

Pongvongsa, Tiengkham; Ha, Hoang; Thanh, Le; Marchand, Ron P; Nonaka, Daisuke; Tojo, Bumpei; Phongmany, Panom; Moji, Kazuhiko; Kobayashi, Jun

2012-08-03

In Savannakhet province, Laos and Quang Tri province, Vietnam, malaria is still an important health problem and most cases are found in the mountainous, forested border areas where ethnic minority groups live. The objectives of this study were to obtain a better joint understanding of the malaria situation along the border and, on the basis of that, improve malaria control methods through better cooperation between the two countries. Fourteen villages in Savannakhet and 22 villages in Quang Tri were randomly selected within 5 km from the border where a blood survey for microscopic diagnosis (n = 1256 and n = 1803, respectively), household interviews (n = 400, both sides) and vector surveys were conducted between August and October 2010. Satellite images were used to examine the forest density around the study villages. Malaria prevalence was significantly higher in Laos (5.2%) than in Vietnam (1.8%) and many other differences were found over the short distance across the border. Bed net coverage was high (> 90%) in both Laos and Vietnam but, while in Laos more than 60% of the nets were long-lasting insecticide-treated, Vietnam used indoor residual spraying in this area and the nets were untreated. Anopheles mosquitoes were more abundant in Laos than in Vietnam, especially many Anopheles dirus were captured in indoor light traps while none were collected in Vietnam. The forest cover was higher around the Lao than the Vietnamese villages. After this study routine exchange of malaria surveillance data was institutionalized and for the first time indoor residual spraying was applied in some Lao villages. The abundance of indoor-collected An. dirus on the Laos side raises doubts about the effectiveness of a sole reliance on long-lasting insecticide-treated nets in this area. Next to strengthening the early detection, correct diagnosis and prompt, adequate treatment of malaria infections, it is recommended to test focal indoor residual spraying and the promotion of insect repellent use in the early evening as additional vector interventions. Conducting joint malaria surveys by staff of two countries proved to be effective in stimulating better collaboration and improve cross-border malaria control.

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Fidelity bond coverage. 704.18 Section 704.18...

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Fidelity bond coverage. 704.18 Section 704.18...

Billing and reimbursement for a bedside toxicology service at a tertiary care academic center during its first fiscal year.

PubMed

Wiegand, Timothy J; Crane, Peter W; Kamali, Michael; Reif, Marilynn; Wratni, Rose; Montante, Ronald; Loveland, Tracey

2015-03-01

A bedside toxicology consult service may improve clinical care, facilitate patient clearance and disposition, and result in potential cost savings for poisoning exposures. Despite this, there is scant data regarding economic feasibility for such a service. Previously published information suggests low hourly reimbursement at approximately $26.00/h at the bedside for toxicology consultations. A bedside toxicology consultant service was initiated in 2011. Coverage was available 24 h a day for 50 out of 52 weeks. Bedside rounding on toxicology consult patients was available 6/7 days per week. The practice is associated with >800 bed teaching institution in a large upstate NY region with elements of urban and suburban practice. Demographic and billing data was collected for all patients consulted upon from July 1, 2011 to June 31, 2012. In charges of $514,941 were generated during the period of data collection. Monthly average was $42,912. Net reimbursement of charges was 29 % of overall charges at $147,792. In terms of total encounters, net collection rate in which something was reimbursed or "paid" against charges for that encounter was 82.6 % of all encounters at 999/1,210. Average encounter time for inpatients, including critical care, was 1.05 h, and the average time spent for outpatients was 1.18 h. Reimbursement rates appear higher than previously reported. Revenue generated from reimbursement from toxicology consultation can result in recouping a substantial portion of a toxicologist's salary or potentially fund fellowship positions and salaries or toxicology division infrastructure.

Cross-sectional analysis of the association between bedtime and malaria exposure in the Ouest and Sud-Est Departments of Haiti.

PubMed

Stephenson, Caroline J; Rossheim, Matthew E; Frankenfeld, Cara L; Boncy, Jacques; Okech, Bernard A; von Fricken, Michael E

2017-12-01

The governments of Haiti and the Dominican Republic have a binational agreement to work towards malaria elimination for the island of Hispaniola by the year 2020. Understanding malaria-related knowledge and behaviors can help inform elimination efforts. This study examined the association between social-behavioral factors, like bedtime and bed net ownership, with malaria seroconversion status among people in the Ouest and Sud-Est departments of Haiti. In 2013, cross-sectional survey data (n=377) and blood samples were collected from a convenience sample of individuals within community, clinic and school settings. Logistic regression models were constructed to examine associations between social-behavioral factors and malaria exposure, adjusting for potential confounders. Compared to people going to bed between 6 and 8 pm, those going to bed between 8 and 10 pm were 2.67 (OR, 95% CI: 1.16-6.14) times as likely to have been exposed to malaria. Participants who reported going to bed after 10 pm were 5.96 times as likely to have had previous malaria exposure (OR, 95% CI: 2.26-15.7), compared to 6-8 pm. No significant associations were found between malaria exposure and either insecticide use nor bed net ownership. These findings are consistent with suspected feeding behaviors of Anopheles albimanus, which prefers feeding at night and outdoors. Study findings may improve overall understanding of malaria transmission in Haiti and potentially guide future studies conducted in this region. Copyright © 2017 Elsevier B.V. All rights reserved.

Bed texture mapping in large rivers using recreational-grade sidescan sonar

USGS Publications Warehouse

Hamill, Daniel; Wheaton, Joseph M.; Buscombe, Daniel D.; Grams, Paul E.; Melis, Theodore S.

2017-01-01

The size-distribution and spatial organization of bed sediment, or bed ‘texture’, is a fundamental attribute of natural channels and is one important component of the physical habitat of aquatic ecosystems. ‘Recreational-grade’ sidescan sonar systems now offer the possibility of imaging, and subsequently quantifying bed texture at high resolution with minimal cost, or logistical effort. We are investigating the possibility of using sidescan sonar sensors on commercially available ‘fishfinders’ for within-channel bed-sediment characterization of mixed sand-gravel riverbeds in a debris-fan dominated canyon river. We analyzed repeat substrate mapping of data collected before and after the November 2014 High Flow Experiment on the Colorado River in lower Marble Canyon, Arizona. The mapping analysis resulted in sufficient spatial coverage (e.g. reach) and resolutions (e.g. centrimetric) to inform studies of the effects of changing bed substrates on salmonid spawning on large rivers. From this preliminary study, we argue that the approach could become a tractable and cost-effective tool for aquatic scientists to rapidly obtain bed texture maps without specialized knowledge of hydroacoustics. Bed texture maps can be used as a physical input for models relating ecosystem responses to hydrologic management.

North American Magazine Coverage of Skin Cancer and Recreational Tanning Before and After the WHO/IARC 2009 Classification of Indoor Tanning Devices as Carcinogenic.

PubMed

McWhirter, Jennifer E; Hoffman-Goetz, Laurie

2015-09-01

The mass media is an influential source of skin cancer information for the public. In 2009, the World Health Organization's International Agency for Research on Cancer classified UV radiation from tanning devices as carcinogenic. Our objective was to determine if media coverage of skin cancer and recreational tanning increased in volume or changed in nature after this classification. We conducted a directed content analysis on 29 North American popular magazines (2007-2012) to investigate the overall volume of articles on skin cancer and recreational tanning and, more specifically, the presence of skin cancer risk factors, UV behaviors, and early detection information in article text (n = 410) and images (n = 714). The volume of coverage on skin cancer and recreational tanning did not increase significantly after the 2009 classification of tanning beds as carcinogenic. Key-related messages, including that UV exposure is a risk factor for skin cancer and that indoor tanning should be avoided, were not reported more frequently after the classification, but the promotion of the tanned look as attractive was conveyed more often in images afterwards (p < .01). Content promoting high-SPF sunscreen use increased after the classification (p < .01), but there were no significant positive changes in the frequency of coverage of skin cancer risk factors, other UV behaviors, or early detection information over time. The classification of indoor tanning beds as carcinogenic had no significant impact on the volume or nature of skin cancer and recreational tanning coverage in magazines.

“People will say that I am proud”: a qualitative study of barriers to bed net use away from home in four Ugandan districts

PubMed Central

2014-01-01

Background Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. Methods To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. Results In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Conclusions Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious “crusades” where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective. PMID:24602371

Triggered reverse fault and earthquake due to crustal unloading, northwest Transverse Ranges, California.

USGS Publications Warehouse

Yerkes, R.F.; Ellsworth, W.L.; Tinsley, J.C.

1983-01-01

A reverse-right-oblique surface rupture, associated with a ML 2.5 earthquake, formed in a diatomite quarry near Lompoc, California, in the northwesternmost Transverse Ranges on April 7, 1981. The 575-m-long narrow zone of ruptures formed in clay interbeds in diatomite and diatomaceous shale of the Neogene Monterey Formation. The ruptures parallel bedding, dip 39o-59oS, and trend about N84oE on the north limb of an open symmetrical syncline. Maximum net slip was 25 cm; maximum reverse dip slip was 23 cm, maximum right-lateral strike slip was about 9 cm, and average net slip was about 12 cm. The seismic moment of the earthquake is estimated at 1 to 2 X 1018 dyne/cm and the static stress drop at about 3 bar. The removal of an average of about 44 m of diatomite resulted in an average load reduction of about 5 bar, which decreased the normal stress by about 3.5 bar and increased the shear stress on the tilted bedding plane by about 2 bar. The April 7, 1981, event was a very shallow bedding-plane rupture, apparently triggered by crustal unloading. -Authors

The Economic Value of Long-Lasting Insecticidal Nets and Indoor Residual Spraying Implementation in Mozambique

PubMed Central

Lee, Bruce Y.; Bartsch, Sarah M.; Stone, Nathan T. B.; Zhang, Shufang; Brown, Shawn T.; Chatterjee, Chandrani; DePasse, Jay V.; Zenkov, Eli; Briët, Olivier J. T.; Mendis, Chandana; Viisainen, Kirsi; Candrinho, Baltazar; Colborn, James

2017-01-01

Malaria-endemic countries have to decide how much of their limited resources for vector control to allocate toward implementing long-lasting insecticidal nets (LLINs) versus indoor residual spraying (IRS). To help the Mozambique Ministry of Health use an evidence-based approach to determine funding allocation toward various malaria control strategies, the Global Fund convened the Mozambique Modeling Working Group which then used JANUS, a software platform that includes integrated computational economic, operational, and clinical outcome models that can link with different transmission models (in this case, OpenMalaria) to determine the economic value of vector control strategies. Any increase in LLINs (from 80% baseline coverage) or IRS (from 80% baseline coverage) would be cost-effective (incremental cost-effectiveness ratios ≤ $114/disability-adjusted life year averted). However, LLIN coverage increases tend to be more cost-effective than similar IRS coverage increases, except where both pyrethroid resistance is high and LLIN usage is low. In high-transmission northern regions, increasing LLIN coverage would be more cost-effective than increasing IRS coverage. In medium-transmission central regions, changing from LLINs to IRS would be more costly and less effective. In low-transmission southern regions, LLINs were more costly and less effective than IRS, due to low LLIN usage. In regions where LLINs are more cost-effective than IRS, it is worth considering prioritizing LLIN coverage and use. However, IRS may have an important role in insecticide resistance management and epidemic control. Malaria intervention campaigns are not a one-size-fits-all solution, and tailored approaches are necessary to account for the heterogeneity of malaria epidemiology. PMID:28719286

Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America

PubMed Central

Kroeger, Axel; Aviñna, Ana; Ordoñnez-Gonzalez, José; Escandon, Celia

2002-01-01

Background and objectives Insecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors. Methods The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services. Results Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs. Conclusions ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates. PMID:12473181

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors

PubMed Central

2010-01-01

Background Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. Methods A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. Results ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Conclusions Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance. PMID:20682050

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors.

PubMed

Chandre, Fabrice; Dabire, Roch K; Hougard, Jean-Marc; Djogbenou, Luc S; Irish, Seth R; Rowland, Mark; N'guessan, Raphael

2010-08-03

Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance.

Global Warming Potential from early phase decomposition of soil organic matter amendments

NASA Astrophysics Data System (ADS)

Mayer, A.; Silver, W. L.

2015-12-01

Organic matter amendments to soil are widely used as a method of enhancing nutrient availability for crops or grassland. Amendments such as composted manure or greenwaste also have the co-benefits of potentially increasing soil carbon (C) stocks (DeLonge et al., 2013) and diverting organic waste from landfills or manure lagoons. However, application of organic matter amendments can also stimulate emissions of greenhouse gases (GHGs). In this study we determined how the chemical quality of organic matter amendments affected soil C and N content and GHG emissions during early stage decomposition. California grassland soils were amended with six different amendments of varying C and N content including three composts and three feedstocks (goat and horse bedding and cattle manure). Amendments and soils were incubated in the laboratory for 7 weeks; GHG fluxes were measured weekly. The three feedstocks emitted significantly more GHGs than the composted materials. With the exception of cow manure, N content of the amendment was linearly correlated with global warming potential emitted (R2= 0.66, P <0.0001). C:N ratios were not a significant predictor of GHG emissions. Cow manure stimulated a net loss of C (or C equivalents) in the mineral soil, as expected. However, greenwaste compost also surprisingly resulted in net C losses, while goat bedding, horse bedding, and the other compost were either C neutral or a slight net C sink at the end of the incubation. Ongoing analyses are examining the fate of the C incorporated from the amendment to the soil as occluded or free light fraction, as well as N mineralization rates. Our data suggest that N content of organic matter amendments is a good predictor of initial GHG emissions. The study also indicates that composting greenwaste with N-rich bedding and manure can result in lower GHG emissions and C sequestration compared to the individual uncomposted components.

Malaria prevalence, anemia and baseline intervention coverage prior to mass net distributions in Abia and Plateau States, Nigeria.

PubMed

Noland, Gregory S; Graves, Patricia M; Sallau, Adamu; Eigege, Abel; Emukah, Emmanuel; Patterson, Amy E; Ajiji, Joseph; Okorofor, Iheanyichi; Oji, Oji Uka; Umar, Mary; Alphonsus, Kal; Damen, James; Ngondi, Jeremiah; Ozaki, Masayo; Cromwell, Elizabeth; Obiezu, Josephine; Eneiramo, Solomon; Okoro, Chinyere; McClintic-Doyle, Renn; Oresanya, Olusola; Miri, Emmanuel; Emerson, Paul M; Richards, Frank O

2014-03-26

Nigeria suffers the world's largest malaria burden, with approximately 51 million cases and 207,000 deaths annually. As part of the country's aim to reduce by 50% malaria-related morbidity and mortality by 2013, it embarked on mass distribution of free long-lasting insecticidal nets (LLINs). Prior to net distribution campaigns in Abia and Plateau States, Nigeria, a modified malaria indicator survey was conducted in September 2010 to determine baseline state-level estimates of Plasmodium prevalence, childhood anemia, indoor residual spraying (IRS) coverage and bednet ownership and utilization. Overall age-adjusted prevalence of Plasmodium infection by microscopy was similar between Abia (36.1%, 95% CI: 32.3%-40.1%; n = 2,936) and Plateau (36.6%, 95% CI: 31.3%-42.3%; n = 4,209), with prevalence highest among children 5-9 years. P. malariae accounted for 32.0% of infections in Abia, but only 1.4% of infections in Plateau. More than half of children ≤10 years were anemic, with anemia significantly higher in Abia (76.9%, 95% CI: 72.1%-81.0%) versus Plateau (57.1%, 95% CI: 50.6%-63.4%). Less than 1% of households in Abia (n = 1,305) or Plateau (n = 1,335) received IRS in the 12 months prior to survey. Household ownership of at least one bednet of any type was 10.1% (95% CI: 7.5%-13.4%) in Abia and 35.1% (95% CI: 29.2%-41.5%) in Plateau. Ownership of two or more bednets was 2.1% (95% CI: 1.2%-3.7%) in Abia and 14.5% (95% CI: 10.2%-20.3%) in Plateau. Overall reported net use the night before the survey among all individuals, children <5 years, and pregnant women was 3.4%, 6.0% and 5.7%, respectively in Abia and 14.7%, 19.1% and 21.0%, respectively in Plateau. Among households owning nets, 34.4% of children <5 years and 31.6% of pregnant women in Abia used a net, compared to 52.6% of children and 62.7% of pregnant women in Plateau. These results reveal high Plasmodium prevalence and childhood anemia in both states, low baseline coverage of IRS and LLINs, and sub-optimal net use-especially among age groups with highest observed malaria burden.

Can We Do That Here? Establishing the Scope of Surgical Practice at a New Safety-Net Community Hospital Through a Transparent, Collaborative Review of Physician Privileges.

PubMed

O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K

2018-01-01

Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Health impact and cost-effectiveness of a private sector bed net distribution: experimental evidence from Zambia

PubMed Central

2013-01-01

Background Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). Methods The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia’s cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. Results The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP. Conclusions The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial. PMID:23506170

The Hanikoda Method: 3-layered Negative Pressure Wound Therapy in Wound Bed Preparation.

PubMed

Chik, Ian; Kelly, Enda G; Jarmin, Razman; Imran, Farrah-Hani

2016-10-01

Negative pressure wound therapy is a widely used method of wound dressing with various commercially available brands. The authors created the Hanikoda Method (HM) for effective wound bed preparation or definite wound closure. In this case series, the authors discuss 8 different wound cases that presented to their Plastics Unit from January 2014 to June 2015. Patients with traumatic or infected wounds were selected for treatment with the HM. Selected patients underwent multiple cycles of this method until their wounds were ready for definite wound closure or the wounds had closed by secondary closure. The purpose of any wound dressing is to encourage epithelization while ensuring no factors impede wound healing. An additional benefit is to reduce wound bed size so that it may close by secondary intention or require less skin graft coverage. Each layer of the dressing is described, along with its function in wound bed preparation or in closure. The HM facilitates reduction of wound size, wound bed preparation, and overall management.

Medicaid and CHIP Provide Coverage to More than Half of All Children in D.C. Policy Snapshot

ERIC Educational Resources Information Center

DC Action for Children, 2011

2011-01-01

Medicaid and CHIP are crucial parts of the social safety net, providing health insurance coverage to more than half of all children ages 0-21 in D.C. and a third of children nationally. Without these two programs, more than 97,000 children in the District would have been uninsured in 2010. New research indicates that compared with the uninsured,…

Nutrient Removal through Oyster Habitat Restoration in the Indian River Lagoon, Florida

NASA Astrophysics Data System (ADS)

Gallagher, S. M.; Schmidt, C. A.; Walters, L.; Blank, R.

2017-12-01

In 2016, an algae bloom in the Indian River Lagoon (IRL) caused a state of emergency in Florida. As with many estuaries, nutrient loading in the IRL has led to periodic eutrophication. While previous studies have shown oyster bed restoration reduces suspended organic matter in estuaries, similar reductions to net nutrient loads are not well established. In addition, previous studies have focused on seasonal variation rather than ongoing yearly effects. Here, we determine the net nitrogen and phosphorus effects of oyster restoration in the IRL over seven years. Analysis of aerial images from 1943 and 2009 showed 14.7 ha of oyster beds were destroyed by boat traffic in the IRL (40% loss). According to our measurements of restored oyster bed sediment, this equates to a maximum of 1,580,000 kg•N•yr-1 of lost denitrification potential; this is equivalent to 150% of estimated current nitrogen loading in the IRL. Oyster restoration began in the IRL in 2007 and has recovered 7.7% of the lost beds and denitrification potential (1.13 ha and 107,000 kg•N•yr-1•ha-1). In all cases, denitrification reached a maximum within two years and remained significantly higher than open sediment for at least the seven years observed. Denitrification benefits came at the cost of mobilizing a maximum of 3450 kg ha-1 of recalcitrant phosphorus from restored bed sediment. This effect was limited to the two years following restoration, whereas increased denitrification was ongoing. Overall, our results show oyster restoration achieved maximum denitrification within two years and maintained significant denitrification benefits for at least seven years. In addition, our results are useful for future oyster restoration projects since they quantify nitrogen benefits in terms of phosphorus mobilization.

An online spacecraft environment interactions information system

NASA Technical Reports Server (NTRS)

Lauriente, Michael

1990-01-01

This paper reviews the role that EnviroNET assumes as a contemporary system that scientists and engineers can use to share information on networks that are connected globally. Advantage is being taken to use this powerful communication tool for the space community to articulate the various anomalies that our space systems are experiencing. EnviroNET is being considered as a test bed for developing an expert system for diagnosing environmentally induced anomalies for spacecraft. The various offline activities in progress toward this objective are described.

How Does Retiree Health Insurance Influence Public Sector Employee Saving?

PubMed Central

Clark, Robert L.

2017-01-01

Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: -Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers;-Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.-After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. PMID:25479891

How does retiree health insurance influence public sector employee saving?

PubMed

Clark, Robert L; Mitchell, Olivia S

2014-12-01

Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

Data on Mercury in Water, Bed Sediment, and Fish from Streams Across the United States, 1998-2005

USGS Publications Warehouse

Bauch, Nancy J.; Chasar, Lia C.; Scudder, Barbara C.; Moran, Patrick W.; Hitt, Kerie J.; Brigham, Mark E.; Lutz, Michelle A.; Wentz, Dennis A.

2009-01-01

The U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) and Toxic Substances Hydrology Programs conducted the National Mercury Pilot Study in 1998 to examine relations of mercury (Hg) in water, bed sediment and fish in streams across the United States, including Alaska and Hawaii. Water and bed-sediment samples were analyzed for total Hg (THg), methylmercury (MeHg), and other constituents; fish were analyzed for THg. Similar sampling was conducted at additional streams across the country in 2002 and 2004-05. This report summarizes sample collection and processing protocols, analytical methods, environmental data, and quality-assurance data for stream water, bed sediment, and fish for these national studies. To extend the geographic coverage of the data, this report also includes four regional USGS Hg studies conducted during 1998-2001 and 2004. The environmental data for these national and regional Hg studies are provided in an electronic format.

Investigating mosquito net durability for malaria control in Tanzania - attrition, bioefficacy, chemistry, degradation and insecticide resistance (ABCDR): study protocol.

PubMed

Lorenz, Lena M; Overgaard, Hans J; Massue, Dennis J; Mageni, Zawadi D; Bradley, John; Moore, Jason D; Mandike, Renata; Kramer, Karen; Kisinza, William; Moore, Sarah J

2014-12-13

Long-Lasting Insecticidal Nets (LLINs) are one of the major malaria vector control tools, with most countries adopting free or subsidised universal coverage campaigns of populations at-risk from malaria. It is essential to understand LLIN durability so that public health policy makers can select the most cost effective nets that last for the longest time, and estimate the optimal timing of repeated distribution campaigns. However, there is limited knowledge from few countries of the durability of LLINs under user conditions. This study investigates LLIN durability in eight districts of Tanzania, selected for their demographic, geographic and ecological representativeness of the country as a whole. We use a two-stage approach: First, LLINs from recent national net campaigns will be evaluated retrospectively in 3,420 households. Those households will receive one of three leading LLIN products at random (Olyset®, PermaNet®2.0 or Netprotect®) and will be followed up for three years in a prospective study to compare their performance under user conditions. LLIN durability will be evaluated by measuring Attrition (the rate at which nets are discarded by households), Bioefficacy (the insecticidal efficacy of the nets measured by knock-down and mortality of mosquitoes), Chemical content (g/kg of insecticide available in net fibres) and physical Degradation (size and location of holes). In addition, we will extend the current national mosquito insecticide Resistance monitoring program to additional districts and use these data sets to provide GIS maps for use in health surveillance and decision making by the National Malaria Control Program (NMCP). The data will be of importance to policy makers and vector control specialists both in Tanzania and the SSA region to inform best practice for the maintenance of high and cost-effective coverage and to maximise current health gains in malaria control.

Health coverage of low-income citizen and noncitizen wage earners: sources and disparities.

PubMed

Ponce, Ninez A; Cochran, Susan D; Mays, Vickie M; Chia, Jenny; Brown, E Richard

2008-04-01

The health coverage of low-income workers represents an area of continuing disparities in the United States system of health insurance. Using the 2001 California Health Interview Survey, we estimate the effect of low-income wage earners' citizenship and gender on the odds of obtaining primary employment-based health insurance (EBHI), dependent EBHI, public program coverage, and coverage from any source. We find that noncitizen men and women who comprise 40% of California's low-income workforce, share the disadvantage of much lower rates of insurance coverage, compared to naturalized and U.S.-born citizens. However, poor coverage rates of noncitizen men, regardless of permanent residency status, result from the cumulative disadvantage in obtaining dependent EBHI and public insurance. If public policies designed to provide a health care safety net fail to address the health care coverage needs of low-wage noncitizens, health disparities will continue to increase in this group that contributes essentially to the U.S. economy.

An investigation of interference coordination in heterogeneous network for LTE-Advanced systems

NASA Astrophysics Data System (ADS)

Hasan, M. K.; Ismail, A. F.; H, Aisha-Hassan A.; Abdullah, Khaizuran; Ramli, H. A. M.

2013-12-01

The novel "femtocell" in Heterogeneous Network (HetNet) for LTE-Advanced (LTE-A) set-up will allow Malaysian wireless telecommunication operators (Maxis, Celcom, Digi, U-Mobile, P1, YTL and etc2.) to extend connectivity coverage where access would otherwise be limited or unavailable, particularly indoors of large building complexes. A femtocell is a small-sized cellular base station that encompasses all the functionality of a typical station. It therefore allows a simpler and self-contained deployment including private residences. For the Malaysian service providers, the main attractions of femtocell usage are the improvements to both coverage and capacity. The operators can provide a better service to end-users in turn reduce much of the agitations and complaints. There will be opportunity for new services at reduced cost. In addition, the operator not only benefits from the improved capacity and coverage but also can reduce both capital expenditure and operating expense i.e. alternative to brand new base station or macrocell installation. Interference is a key issue associated with femtocell development. There are a large number of issues associated with interference all of which need to be investigated, identified, quantified and solved. This is to ensure that the deployment of any femtocells will take place successfully. Among the most critical challenges in femtocell deployment is the interference between femtocell-to-macrocell and femtocell-to-femtocell in HetNets. In this paper, all proposed methods and algorithms will be investigated in the OFDMA femtocell system considering HetNet scenarios for LTE-A.

ArcView Coal Evaluation User's Guide

USGS Publications Warehouse

Watson, William

2007-01-01

Purpose: The objective of the ArcView Coal Evaluation (ACE) is to estimate the amount and location of coal available to be mined by various coal mining technologies, based on the geologic coverages developed in the National Coal Resource Assessment (NCRA) which are the starting coverages used in the Geographic Information Systems (GIS) evaluation of coal resources. The ACE Users Guide provides many examples of how to apply technical limits based upon mining technology. The methods, which are iterative for any given mining technology, should transfer directly by mining technology to other coal beds.

Inducing Stable α + β Microstructures during Selective Laser Melting of Ti-6Al-4V Using Intensified Intrinsic Heat Treatments.

PubMed

Barriobero-Vila, Pere; Gussone, Joachim; Haubrich, Jan; Sandlöbes, Stefanie; Da Silva, Julio Cesar; Cloetens, Peter; Schell, Norbert; Requena, Guillermo

2017-03-07

Selective laser melting is a promising powder-bed-based additive manufacturing technique for titanium alloys: near net-shaped metallic components can be produced with high resource-efficiency and cost savings [...].

The effect of insecticide-treated bed nets on the incidence and prevalence of malaria in children in an area of unstable seasonal transmission in western Myanmar

PubMed Central

2013-01-01

Background Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study’s objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. Methods A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. Results In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of −2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval −7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. Conclusion In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN. PMID:24119916

Baseline malaria vector transmission dynamics in communities in Ahafo mining area in Ghana.

PubMed

Dery, Dominic B; Asante, Kwaku P; Zandoh, Charles; Febir, Lawrence G; Brown, Charles; Adjei, George; Antwi-Dadzie, Yaw; Mahama, Emmanuel; Tchum, Kofi; Dosoo, David; Amenga-Etego, Seeba; Adda, Robert; Mensah, Christine; Owusu-Sekyere, Kwabena B; Anderson, Chris; Krieger, Gary; Owusu-Agyei, Seth

2015-04-07

Malaria vector dynamics are relevant prior to commencement of mining activities. A baseline entomology survey was conducted in Asutifi and Tano (referred to as Ahafo) in the Brong-Ahafo geo-political region of Ghana during preparatory stages for mining by Newmont Ghana Gold Limited. Between November 2006 and August 2007, eight Centre for Disease Control light traps were set daily (Monday-Friday) to collect mosquitoes. Traps were hanged in rooms that were selected from a pool of 1,100 randomly selected houses. Types of materials used in construction of houses were recorded and mosquito prevention measures were assessed from occupants. A total of 5,393 mosquitoes were caught that comprised Anopheles gambiae (64.8%), Anopheles funestus (4.2%), as well as Culicines, comprising of Culex (30.4%) and Aedes species (0.6%). The entomological inoculation rate in Asutifi (279 infective bites/person/month) and Tano (487 infective bites/person/month) demonstrate relatively high malaria transmission in Ahafo. The presence or absence of Anopheles vectors in rooms was influenced by the type of roofing material (OR 2.33, 95%CI: 1.29-4.22, p = 0.01) as well as the presence of eaves gaps (OR 1.80, 95%CI: 1.37-2.37, p < 0.01). It was also associated with bed net availability in the room (OR 1.39, 95%CI: 1.08-1.80, p = 0.01). Over 80% of the houses were roofed with corrugated zinc sheets. Over 60% of the houses in Ahafo had no eaves gaps to give access to mosquito entry and exit into rooms and mosquito bed net coverage was over 50%. Other measures used in preventing mosquito bites included; coil (22.1%), insecticide spray (9.4%), repellent cream (4.0%) and smoky fires (1.1%), contributed minimally to individual mosquito preventive measures in impact areas. Similarly, levels of protection; coil (16.9%), insecticide spray (2.8%) and repellent cream (0.3%) for the non-impact areas, depict low individual prevention measures. The survey identified areas where intensified vector control activities would be beneficial. It also demonstrates that transmission in Asutifi and Tano is high even before the commencement of mining operations. This study serves as baseline information to assess impact of mining activities in relation to future vector control interventions.

Treatment with tandem [90Y]DOTA-TATE and [177Lu]DOTA-TATE of neuroendocrine tumours refractory to conventional therapy.

PubMed

Seregni, E; Maccauro, M; Chiesa, C; Mariani, L; Pascali, C; Mazzaferro, V; De Braud, F; Buzzoni, R; Milione, M; Lorenzoni, A; Bogni, A; Coliva, A; Lo Vullo, S; Bombardieri, E

2014-02-01

Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been demonstrated to be an effective therapeutic option in patients with disseminated neuroendocrine tumours (NET). Treatment with tandem [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE may improve the efficacy of PRRT without increasing the toxicity. In a phase II study we evaluated the feasibility of combined PPRT with a high-energy beta emitter ((90)Y) and a medium-energy beta/gamma emitter ([(177)Lu) in patients with metastatic NET refractory to conventional therapy. A group of 26 patients with metastatic NET were treated with four therapeutic cycles of alternating [[(177)Lu]DOTA-TATE (5.55 GBq) and [(90)Y]DOTA-TATE (2.6 GBq). A dosimetric evaluation was carried out after administration of [[(177)Lu]DOTA-TATE to calculate the absorbed doses in healthy organs. The acute and long-term toxicities of repeated treatment were analysed. PRRT efficacy was evaluated according to RECIST. Administration of tandem [(90)Y]DOTA-TATE and [[(177)Lu]DOTA-TATE induced objective responses in 42.3 % of patients with metastatic NET with a median progression-free survival longer than 24 months. Of patients with pretreatment carcinoid syndrome, 90 % showed a symptomatic response or a reduction in tumour-associated pain. The cumulative biologically effective doses (BED) were below the toxicity limit in the majority of patients, in the absence of renal function impairment. The results of our study indicates that combined [(90)Y]DOTA-TATE and [(177)Lu]DOTA-TATE therapy is a feasible and effective therapeutic option in NET refractory to conventional therapy. Furthermore, the absence of kidney damage and the evaluated cumulative BEDs suggest that increasing the number of tandem administrations is an interesting approach.

Famine Early Warning System Network (FEWS NET)

USGS Publications Warehouse

Verdin, James P.

2006-01-01

The FEWS NET mission is to identify potentially food-insecure conditions early through the provision of timely and analytical hazard and vulnerability information. U.S. Government decision-makers act on this information to authorize mitigation and response activities. The U.S. Geological Survey (USGS) FEWS NET provides tools and data for monitoring and forecasting the incidence of drought and flooding to identify shocks to the food supply system that could lead to famine. Historically focused on Africa, the scope of the network has expanded to be global coverage. FEWS NET implementing partners include the USGS, National Aeronautics and Space Administration (NASA), National Oceanic and Atmospheric Administration (NOAA), United States Agency for International Development (USAID), United States Department of Agriculture (USDA), and Chemonics International.

Detection of Somatic Mutations in Gastroenteropancreatic Neuroendocrine Tumors Using Targeted Deep Sequencing.

PubMed

Backman, Samuel; Norlén, Olov; Eriksson, Barbro; Skogseid, Britt; Stålberg, Peter; Crona, Joakim

2017-02-01

Mutations affecting the mechanistic target of rapamycin (MTOR) signalling pathway are frequent in human cancer and have been identified in up to 15% of pancreatic neuroendocrine tumours (NETs). Grade A evidence supports the efficacy of MTOR inhibition with everolimus in pancreatic NETs. Although a significant proportion of patients experience disease stabilization, only a minority will show objective tumour responses. It has been proposed that genomic mutations resulting in activation of MTOR signalling could be used to predict sensitivity to everolimus. Patients with NETs that underwent treatment with everolimus at our Institution were identified and those with available tumour tissue were selected for further analysis. Targeted next-generation sequencing (NGS) was used to re-sequence 22 genes that were selected on the basis of documented involvement in the MTOR signalling pathway or in the tumourigenesis of gastroenterpancreatic NETs. Radiological responses were documented using Response Evaluation Criteria in Solid Tumours. Six patients were identified, one had a partial response and four had stable disease. Sequencing of tumour tissue resulted in a median sequence depth of 667.1 (range=404-1301) with 1-fold coverage of 95.9-96.5% and 10-fold coverage of 87.6-92.2%. A total of 494 genetic variants were discovered, four of which were identified as pathogenic. All pathogenic variants were validated using Sanger sequencing and were found exclusively in menin 1 (MEN1) and death domain associated protein (DAXX) genes. No mutations in the MTOR pathway-related genes were observed. Targeted NGS is a feasible method with high diagnostic yield for genetic characterization of pancreatic NETs. A potential association between mutations in NETs and response to everolimus should be investigated by future studies. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Strategies and approaches to vector control in nine malaria-eliminating countries: a cross-case study analysis.

PubMed

Smith Gueye, Cara; Newby, Gretchen; Gosling, Roland D; Whittaker, Maxine A; Chandramohan, Daniel; Slutsker, Laurence; Tanner, Marcel

2016-01-04

There has been progress towards malaria elimination in the last decade. In response, WHO launched the Global Technical Strategy (GTS), in which vector surveillance and control play important roles. Country experiences in the Eliminating Malaria Case Study Series were reviewed to identify success factors on the road to elimination using a cross-case study analytic approach. Reports were included in the analysis if final English language draft reports or publications were available at the time of analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for vector control in malaria elimination was developed, reviewed, formatted as a matrix, and case study data was extracted and entered into the matrix. A workshop was convened during which participants conducted reviews of the case studies and matrices and arrived at a consensus on the evidence and lessons. The framework was revised and a second round of data extraction, synthesis and summary of the case study reports was conducted. Countries implemented a range of vector control interventions. Most countries aligned with integrated vector management, however its impact was not well articulated. All programmes conducted entomological surveillance, but the response (i.e., stratification and targeting of interventions, outbreak forecasting and strategy) was limited or not described. Indoor residual spraying (IRS) was commonly used by countries. There were several examples of severe reductions or halting of IRS coverage and subsequent resurgence of malaria. Funding and operational constraints and poor implementation had roles. Bed nets were commonly used by most programmes; coverage and effectiveness were either not measured or not articulated. Larval control was an important intervention for several countries, preventing re-introduction, however coverage and impact on incidence were not described. Across all interventions, coverage indicators were incomparable, and the rationale for which tools were used and which were not used appeared to be a function of the availability of funding, operational issues and cost instead of evidence of effectiveness to reduce incidence. More work is required to fill gaps in programme guidance, clarify the best methods for choosing and targeting vector control interventions, and support to measure cost, cost-effectiveness and cost-benefit of vector surveillance and control interventions.

Heterogeneity and changes in inequality of malaria risk after introduction of insecticide-treated bed nets in Macha, Zambia.

PubMed

Norris, Laura C; Norris, Douglas E

2013-04-01

In 2007, the first free mass distribution of insecticide-treated bed nets (ITNs) occurred in southern Zambia. To determine the effect of ITNs on heterogeneity in biting rates, human DNA from Anopheles arabiensis blood meals was genotyped to determine the number of hosts that had contributed to the blood meals. The multiple feeding rate decreased from 18.9% pre-ITN to 9.1% post-ITN, suggesting that mosquito biting had focused onto a smaller fraction of the population. Pre-ITN, 20% of persons in a household provided 40% of blood meals, which increased to 59% post-ITN. To measure heterogeneity over a larger scale, mosquitoes were collected in 90 households in two village areas. Of these households, 25% contributed 78.1% of An. arabiensis, and households with high frequencies of An. arabiensis were significantly spatially clustered. The results indicate that substantial heterogeneity in malaria risk exists at local and household levels, and household-level heterogeneity may be influenced by interventions, such as ITNs.

Household training vs. mass campaigns: a better method of health communication for preventing malaria.

PubMed

Chourasia, Mehul Kumar; Abraham, Vinod J; John, Jacob

2014-10-01

Malaria is endemic in several states of India with high tribal population. Effective use of long-lasting insecticide treated bed nets (LLITNs) can reduce the burden of malaria in these settings. This study assessed the knowledge and behaviour regarding malaria in a tribal population and compared two health education strategies for enhancing effective utilisation of bed nets. A community-based intervention study was carried out among 218 households in two villages. One community received household level training on effective utilisation of LLITNs while the others received training in a mass campaign and outcomes were measured after 2 months. The study showed that the proportion utilising LLITNs was significantly higher among those receiving household level training as compared to those who received the mass campaign. Household level training appears to be a more effective form of health education for improving knowledge and promoting use of LLITNs in these isolated community groups. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Charge of the right brigade? Communities, coverage, and care for the uninsured.

PubMed

Brown, Lawrence D; Stevens, Beth

2006-01-01

The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourteen communities that aimed to expand health insurance coverage and improve care for their uninsured residents. Our examination of seven program sites suggests that despite solid community leadership and carefully crafted plans, political, economic, and organizational obstacles precluded much expansion of coverage and constrained reforms. Redistribution of financial and organizational resources among both mainstream and safety-net institutions in these communities was hard to achieve. CIC's record offers little evidence that communities are better equipped than are other sectors of U.S. society to solve the problem of uninsurance.

Dosimetric quality endpoints for low-dose-rate prostate brachytherapy using biological effective dose (bed) vs. conventional dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Singh, Rachana; Al-Hallaq, Hania; Pelizzari, Charles A.

2003-12-31

The purpose of this study was to compare conventional low-dose-rate prostate brachytherapy dosimetric quality parameters with their biological effective dose (BED) counterparts. To validate a model for transformation from conventional dose to BED, the postimplant plans of 31 prostate brachytherapy patients were evaluated using conventional dose-volume histogram (DVH) quality endpoints and analogous BED-DVH endpoints. Based on CT scans obtained 4 weeks after implantation, DVHs were computed and standard dosimetric endpoints V100 (volume receiving 100% of the prescribed dose), V150, V200, HI (1-[V150/V100]), and D90 (dose that 90% of the target volume received) were obtained for quality analysis. Using known andmore » reported transformations, dose grids were transformed to BED-early ({alpha}/{beta} = 10 Gy) and BED-late ({alpha}/{beta} = 3 Gy) grids, and the same dosimetric endpoints were analyzed. For conventional, BED-early and BED-late DVHs, no differences in V100 were seen (0.896, 0.893, and 0.894, respectively). However, V150 and V200 were significantly higher for both BED-early (0.582 and 0.316) and BED-late (0.595 and 0.337), compared with the conventional (0.539 and 0.255) DVHs. D90 was significantly lower for the BED-early (103.1 Gy) and BED-late transformations (106.9 Gy) as compared with the conventional (119.5 Gy) DVHs. The conventional prescription parameter V100 is the same for the corresponding BED-early and BED-late transformed DVHs. The toxicity parameters V150 and V200 are slightly higher using the BED transformations, suggesting that the BED doses are somewhat higher than predicted using conventional DVHs. The prescription/quality parameter D90 is slightly lower, implying that target coverage is lower than predicted using conventional DVHs. This methodology can be applied to analyze BED dosimetric endpoints to improve clinical outcome and reduce complications of prostate brachytherapy.« less

Malaria prevalence, anemia and baseline intervention coverage prior to mass net distributions in Abia and Plateau States, Nigeria

PubMed Central

2014-01-01

Background Nigeria suffers the world’s largest malaria burden, with approximately 51 million cases and 207,000 deaths annually. As part of the country’s aim to reduce by 50% malaria-related morbidity and mortality by 2013, it embarked on mass distribution of free long-lasting insecticidal nets (LLINs). Methods Prior to net distribution campaigns in Abia and Plateau States, Nigeria, a modified malaria indicator survey was conducted in September 2010 to determine baseline state-level estimates of Plasmodium prevalence, childhood anemia, indoor residual spraying (IRS) coverage and bednet ownership and utilization. Results Overall age-adjusted prevalence of Plasmodium infection by microscopy was similar between Abia (36.1%, 95% CI: 32.3%–40.1%; n = 2,936) and Plateau (36.6%, 95% CI: 31.3%–42.3%; n = 4,209), with prevalence highest among children 5-9 years. P. malariae accounted for 32.0% of infections in Abia, but only 1.4% of infections in Plateau. More than half of children ≤10 years were anemic, with anemia significantly higher in Abia (76.9%, 95% CI: 72.1%–81.0%) versus Plateau (57.1%, 95% CI: 50.6%–63.4%). Less than 1% of households in Abia (n = 1,305) or Plateau (n = 1,335) received IRS in the 12 months prior to survey. Household ownership of at least one bednet of any type was 10.1% (95% CI: 7.5%–13.4%) in Abia and 35.1% (95% CI: 29.2%-41.5%) in Plateau. Ownership of two or more bednets was 2.1% (95% CI: 1.2%–3.7%) in Abia and 14.5% (95% CI: 10.2%–20.3%) in Plateau. Overall reported net use the night before the survey among all individuals, children <5 years, and pregnant women was 3.4%, 6.0% and 5.7%, respectively in Abia and 14.7%, 19.1% and 21.0%, respectively in Plateau. Among households owning nets, 34.4% of children <5 years and 31.6% of pregnant women in Abia used a net, compared to 52.6% of children and 62.7% of pregnant women in Plateau. Conclusions These results reveal high Plasmodium prevalence and childhood anemia in both states, low baseline coverage of IRS and LLINs, and sub-optimal net use—especially among age groups with highest observed malaria burden. PMID:24669881

An Innovative Open Data-driven Approach for Improved Interpretation of Coverage Data at NASA JPL's PO.DAA

NASA Astrophysics Data System (ADS)

McGibbney, L. J.; Armstrong, E. M.

2016-12-01

Figuratively speaking, Scientific Datasets (SD) are shared by data producers in a multitude of shapes, sizes and flavors. Primarily however they exist as machine-independent manifestations supporting the creation, access, and sharing of array-oriented SD that can on occasion be spread across multiple files. Within the Earth Sciences, the most notable general examples include the HDF family, NetCDF, etc. with other formats such as GRIB being used pervasively within specific domains such as the Oceanographic, Atmospheric and Meteorological sciences. Such file formats contain Coverage Data e.g. a digital representation of some spatio-temporal phenomenon. A challenge for large data producers such as NASA and NOAA as well as consumers of coverage datasets (particularly surrounding visualization and interactive use within web clients) is that this is still not a straight-forward issue due to size, serialization and inherent complexity. Additionally existing data formats are either unsuitable for the Web (like netCDF files) or hard to interpret independently due to missing standard structures and metadata (e.g. the OPeNDAP protocol). Therefore alternative, Web friendly manifestations of such datasets are required.CoverageJSON is an emerging data format for publishing coverage data to the web in a web-friendly, way which fits in with the linked data publication paradigm hence lowering the barrier for interpretation by consumers via mobile devices and client applications, etc. as well as data producers who can build next generation Web friendly Web services around datasets. This work will detail how CoverageJSON is being evaluated at NASA JPL's PO.DAAC as an enabling data representation format for publishing SD as Linked Open Data embedded within SD landing pages as well as via semantic data repositories. We are currently evaluating how utilization of CoverageJSON within SD landing pages addresses the long-standing acknowledgement that SD producers are not currently addressing content-based optimization within their SD landing pages for better crawlability by commercial search engines.

Joint malaria surveys lead towards improved cross-border cooperation between Savannakhet province, Laos and Quang Tri province, Vietnam

PubMed Central

2012-01-01

Background In Savannakhet province, Laos and Quang Tri province, Vietnam, malaria is still an important health problem and most cases are found in the mountainous, forested border areas where ethnic minority groups live. The objectives of this study were to obtain a better joint understanding of the malaria situation along the border and, on the basis of that, improve malaria control methods through better cooperation between the two countries. Methods Fourteen villages in Savannakhet and 22 villages in Quang Tri were randomly selected within 5 km from the border where a blood survey for microscopic diagnosis (n = 1256 and n = 1803, respectively), household interviews (n = 400, both sides) and vector surveys were conducted between August and October 2010. Satellite images were used to examine the forest density around the study villages. Results Malaria prevalence was significantly higher in Laos (5.2%) than in Vietnam (1.8%) and many other differences were found over the short distance across the border. Bed net coverage was high (> 90%) in both Laos and Vietnam but, while in Laos more than 60% of the nets were long-lasting insecticide-treated, Vietnam used indoor residual spraying in this area and the nets were untreated. Anopheles mosquitoes were more abundant in Laos than in Vietnam, especially many Anopheles dirus were captured in indoor light traps while none were collected in Vietnam. The forest cover was higher around the Lao than the Vietnamese villages. After this study routine exchange of malaria surveillance data was institutionalized and for the first time indoor residual spraying was applied in some Lao villages. Conclusions The abundance of indoor-collected An. dirus on the Laos side raises doubts about the effectiveness of a sole reliance on long-lasting insecticide-treated nets in this area. Next to strengthening the early detection, correct diagnosis and prompt, adequate treatment of malaria infections, it is recommended to test focal indoor residual spraying and the promotion of insect repellent use in the early evening as additional vector interventions. Conducting joint malaria surveys by staff of two countries proved to be effective in stimulating better collaboration and improve cross-border malaria control. PMID:22862795

Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study.

PubMed

Arroz, Jorge A H; Candrinho, Baltazar; Mendis, Chandana; Varela, Pablo; Pinto, João; Martins, Maria do Rosário O

2018-02-05

In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.

Microlith Based Sorber for Removal of Environmental Contaminants

NASA Technical Reports Server (NTRS)

Roychoudhury, S.; Perry, J.

2004-01-01

The development of energy efficient, lightweight sorption systems for removal of environmental contaminants in space flight applications is an area of continuing interest to NASA. The current CO2 removal system on the International Space Station employs two pellet bed canisters of 5A molecular sieve that alternate between regeneration and sorption. A separate disposable charcoal bed removes trace contaminants. An alternative technology has been demonstrated using a sorption bed consisting of metal meshes coated with a sorbent, trademarked and patented as Microlith by Precision Combustion, Inc. (PCI); thesemeshes have the potential for direct electrical heating for this application. This allows the bed to be regenerable via resistive heating and offers the potential for shorter regeneration times, reduced power requirement, and net energy savings vs. conventional systems. The capability of removing both CO2 and trace contaminants within the same bed has also been demonstrated. Thus, the need for a separate trace contaminant unit is eliminated resulting in an opportunity for significant weight savings. Unlike the charcoal bed, zeolites for trace contaminant removal are amenable to periodic regeneration. This paper describes the design and performance of a prototype sorber device for simultaneous CO2 and trace contarninant removal and its attendant weight and energy savings.

Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans.

PubMed

Assari, Shervin

2018-04-24

Environmental stressors, such as perceived discrimination (PD), are linked to Binge Eating Disorder (BED). The current study investigated the association between PD and BED among African Americans, and the variation in such an association based on gender. Data of the National Survey of American Life (NSAL), 2001⁻2003, with a nationally-representative sample of African American adults, were used ( n = 3516). The independent variable in the study was PD. The dependent variable was BED, measured using the Composite International Diagnostic Interview (CIDI). Socio-demographics (age, education, employment, and marital status) were covariates, and gender was the moderator variable. Survey logistic regressions with and without gender × PD interaction terms were used for data analysis. In the pooled sample, PD was associated with higher odds of BED, net of socio-demographic factors. Models also showed a significant gender × PD interaction term suggesting a stronger association between PD and BED for women, compared to men. Gender specific models showed an association between PD and BED among female, but not male, African Americans. Although a link may exist between PD and BED among African Americans, the magnitude of this association depends on gender, with a stronger association among females than males. This finding is in line with the literature that has shown gender-specific consequences of environmental stress for African Americans.

The Cost and Cost-Effectiveness of Scaling up Screening and Treatment of Syphilis in Pregnancy: A Model

PubMed Central

Kahn, James G.; Jiwani, Aliya; Gomez, Gabriela B.; Hawkes, Sarah J.; Chesson, Harrell W.; Broutet, Nathalie; Kamb, Mary L.; Newman, Lori M.

2014-01-01

Background Syphilis in pregnancy imposes a significant global health and economic burden. More than half of cases result in serious adverse events, including infant mortality and infection. The annual global burden from mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million disability-adjusted life years (DALYs) and $309 million in medical costs. Syphilis screening and treatment is simple, effective, and affordable, yet, worldwide, most pregnant women do not receive these services. We assessed cost-effectiveness of scaling-up syphilis screening and treatment in existing antenatal care (ANC) programs in various programmatic, epidemiologic, and economic contexts. Methods and Findings We modeled the cost, health impact, and cost-effectiveness of expanded syphilis screening and treatment in ANC, compared to current services, for 1,000,000 pregnancies per year over four years. We defined eight generic country scenarios by systematically varying three factors: current maternal syphilis testing and treatment coverage, syphilis prevalence in pregnant women, and the cost of healthcare. We calculated program and net costs, DALYs averted, and net costs per DALY averted over four years in each scenario. Program costs are estimated at $4,142,287 – $8,235,796 per million pregnant women (2010 USD). Net costs, adjusted for averted medical care and current services, range from net savings of $12,261,250 to net costs of $1,736,807. The program averts an estimated 5,754 – 93,484 DALYs, yielding net savings in four scenarios, and a cost per DALY averted of $24 – $111 in the four scenarios with net costs. Results were robust in sensitivity analyses. Conclusions Eliminating MTCT of syphilis through expanded screening and treatment in ANC is likely to be highly cost-effective by WHO-defined thresholds in a wide range of settings. Countries with high prevalence, low current service coverage, and high healthcare cost would benefit most. Future analyses can be tailored to countries using local epidemiologic and programmatic data. PMID:24489931

Climate Prediction Center

Science.gov Websites

Climate Stratosphere Pacific Islands International Desks Climate.gov Climate Test Bed (CTB) JAWF USAID FEWS-NET NWS / NCEP Aviation Weather Center Climate Prediction Center Environmental Modeling Center non-operational server hosts the redesigned web pages developed, thus far, as part of the Climate

A Tidally Averaged Sediment-Transport Model for San Francisco Bay, California

USGS Publications Warehouse

Lionberger, Megan A.; Schoellhamer, David H.

2009-01-01

A tidally averaged sediment-transport model of San Francisco Bay was incorporated into a tidally averaged salinity box model previously developed and calibrated using salinity, a conservative tracer (Uncles and Peterson, 1995; Knowles, 1996). The Bay is represented in the model by 50 segments composed of two layers: one representing the channel (>5-meter depth) and the other the shallows (0- to 5-meter depth). Calculations are made using a daily time step and simulations can be made on the decadal time scale. The sediment-transport model includes an erosion-deposition algorithm, a bed-sediment algorithm, and sediment boundary conditions. Erosion and deposition of bed sediments are calculated explicitly, and suspended sediment is transported by implicitly solving the advection-dispersion equation. The bed-sediment model simulates the increase in bed strength with depth, owing to consolidation of fine sediments that make up San Francisco Bay mud. The model is calibrated to either net sedimentation calculated from bathymetric-change data or measured suspended-sediment concentration. Specified boundary conditions are the tributary fluxes of suspended sediment and suspended-sediment concentration in the Pacific Ocean. Results of model calibration and validation show that the model simulates the trends in suspended-sediment concentration associated with tidal fluctuations, residual velocity, and wind stress well, although the spring neap tidal suspended-sediment concentration variability was consistently underestimated. Model validation also showed poor simulation of seasonal sediment pulses from the Sacramento-San Joaquin River Delta at Point San Pablo because the pulses enter the Bay over only a few days and the fate of the pulses is determined by intra-tidal deposition and resuspension that are not included in this tidally averaged model. The model was calibrated to net-basin sedimentation to calculate budgets of sediment and sediment-associated contaminants. While simulated net sedimentation in the four basins that comprise San Francisco Bay was correct, the simulations incorrectly eroded shallows while channels deposited because model surface-layer boxes span both shallows and channels, and neglect lateral variability of suspended-sediment concentration. Validation with recent (1983-2005) net sedimentation in South San Francisco Bay was poor, perhaps owing to poorly quantified sediment supply, and to invasive species that altered erosion and deposition processes. This demonstrates that deterministically predicting future sedimentation is difficult in this or any estuary for which boundary conditions are not stationary. The model would best be used as a tool for developing past and present sediment budgets, and for creating scenarios of future sedimentation that are compared to one another rather than considered a deterministic prediction.

Mapping Plasmodium falciparum Mortality in Africa between 1990 and 2015

PubMed Central

Gething, Peter W.; Casey, Daniel C.; Weiss, Daniel J.; Bisanzio, Donal; Bhatt, Samir; Cameron, Ewan; Battle, Katherine E.; Dalrymple, Ursula; Rozier, Jennifer; Rao, Puja C.; Kutz, Michael J.; Barber, Ryan M.; Huynh, Chantal; Shackelford, Katya A.; Coates, Matthew M.; Nguyen, Grant; Fraser, Maya S.; Kulikoff, Rachel; Wang, Haidong; Naghavi, Mohsen; Smith, David L.; Murray, Christopher J.L.; Hay, Simon I.; Lim, Stephen S.

2017-01-01

Background Malaria control has not been routinely informed by the assessment of subnational variation in malaria deaths. We combined data from the Malaria Atlas Project and the Global Burden of Disease Study to estimate malaria mortality across sub-Saharan Africa on a grid of 5 km2 from 1990 through 2015. Methods We estimated malaria mortality using a spatiotemporal modeling framework of geolocated data (i.e., with known latitude and longitude) on the clinical incidence of malaria, coverage of antimalarial drug treatment, case fatality rate, and population distribution according to age. Results Across sub-Saharan Africa during the past 15 years, we estimated that there was an overall decrease of 57% (95% uncertainty interval, 46 to 65) in the rate of malaria deaths, from 12.5 (95% uncertainty interval, 8.3 to 17.0) per 10,000 population in 2000 to 5.4 (95% uncertainty interval, 3.4 to 7.9) in 2015. This led to an overall decrease of 37% (95% uncertainty interval, 36 to 39) in the number of malaria deaths annually, from 1,007,000 (95% uncertainty interval, 666,000 to 1,376,000) to 631,000 (95% uncertainty interval, 394,000 to 914,000). The share of malaria deaths among children younger than 5 years of age ranged from more than 80% at a rate of death of more than 25 per 10,000 to less than 40% at rates below 1 per 10,000. Areas with high malaria mortality (>10 per 10,000) and low coverage (<50%) of insecticide-treated bed nets and antimalarial drugs included much of Nigeria, Angola, and Cameroon and parts of the Central African Republic, Congo, Guinea, and Equatorial Guinea. Conclusions We estimated that there was an overall decrease of 57% in the rate of death from malaria across sub-Saharan Africa over the past 15 years and identified several countries in which high rates of death were associated with low coverage of antimalarial treatment and prevention programs. (Funded by the Bill and Melinda Gates Foundation and others.) PMID:27723434

Two simple leg net devices designed to protect lower-extremity skin grafts and donor sites and prevent decubitus ulcer.

PubMed

Hedman, Travis L; Chapman, Ted T; Dewey, William S; Quick, Charles D; Wolf, Steven E; Holcomb, John B

2007-01-01

Burn therapists routinely are tasked to position the lower extremities of burn patients for pressure ulcer prevention, skin graft protection, donor site ventilation, and edema reduction. We developed two durable and low-maintenance devices that allow effective positioning of the lower extremities. The high-profile and low-profile leg net devices were simple to fabricate and maintain. The frame was assembled using a three-quarter-inch diameter copper pipe and copper fittings (45 degrees, 90 degrees, and tees). A double layer of elasticized tubular netting was pulled over the frame and doubled back for leg support to complete the devices. The devices can be placed on any bed surface. The netting can be exchanged when soiled and the frame can be disinfected between patients using standard techniques. Both devices were used on approximately 250 patients for a total of 1200 treatment days. No incidence of pressure ulcer was observed, and graft take was not adversely affected. The devices have not required repairs or replacement. Medical providers reported they are easy to apply and effectively maintain proper positioning throughout application. Neither device interfered with the application of other positioning devices. Both devices were found to be an effective method of positioning lower extremities to prevent pressure ulcer, minimize graft loss and donor site morbidity, and reduce edema. The devices allowed for proper wound ventilation and protected grafted lower extremities on any bed surface. The devices are simple to fabricate and maintain. Both devices can be effectively used simultaneously with other positioning devices.

Sand fly control in Kenya with residual pesticide application on HESCO barriers

USDA-ARS?s Scientific Manuscript database

US military operations in hot-arid regions still face significant impacts from mosquito and sand fly vectors of diseases. Personal protective measures (PPM) such as DEET or treated bed nets and clothing can reduce contact with disease vectors and nuisance insects; however, irregular use of PPM coupl...

Sheet flow and suspended sediment due to wave groups in a large wave flume

USGS Publications Warehouse

Dohmen-Janssen, C. M.; Hanes, D.M.

2005-01-01

A series of sand bed experiments was carried out in the Large Wave Flume in Hannover, Germany as a component of the SISTEX99 experiment. The experiments focussed on the dynamic sediment response due to wave group forcing over a flat sand bed in order to improve understanding of cross-shore sediment transport mechanisms and determine sediment concentrations, fluxes and net transport rates under these conditions. Sediment concentrations were measured within the sheet flow layer (thickness in the order of 10 grain diameters) and in the suspension region (thickness in the order of centimetres). Within the sheet flow layer, the concentrations are highly coherent with the instantaneous near-bed velocities due to each wave within the wave group. However, in the suspension layer concentrations respond much more slowly to changes in near-bed velocity. At several centimetres above the bed, the suspended sediment concentrations vary on the time scale of the wave group, with a time delay relative to the peak wave within the wave group. The thickness of the sheet flow changes with time. It is strongly coherent with the wave forcing, and is not influenced by the history or sequence of the waves within the group. The velocity of the sediment was also measured within the sheet flow layer some of the time (during the larger wave crests of the group), and the velocity of the fluid was measured at several cm above the sheet flow layer. The grain velocity and concentration estimates can be combined to estimate the sediment flux. The estimates were found to be consistent with previous measurements under monochromatic waves. Under these conditions, without any significant mean current, the sediment flux within the sheet flow layer was found to greatly exceed the sediment flux in the suspension layer. As a result, net transport rates under wave groups are similar to those under monochromatic waves. ?? 2004 Elsevier Ltd. All rights reserved.

New NREL Method Reduces Uncertainty in Photovoltaic Module Calibrations |

Science.gov Websites

calibration traceability to certified test laboratories. This reliable calibration, in turn, determines the of a spire flash simulator, SOMS outdoor test bed, and LACSS continuous simulator. In NREL's Cell and % (k=2 coverage factor). This value is the lowest reported Pmax uncertainty of any accredited test

42 CFR 409.20 - Coverage of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... with the furnishing of that nursing care. (3) Physical, occupational, or speech therapy. (4) Medical... are considered as posthospital SNF care. For example, a type of medical or surgical procedure that is...) Terminology. In § 409.21 through § 409.36—. (1) The terms SNF and swing-bed hospital are used when the context...

Improving the quality of vascular surgical discharge planning in a hub centre

PubMed Central

Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G

2016-01-01

Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered ‘delayed’ and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results. PMID:26924480

Improving the quality of vascular surgical discharge planning in a hub centre.

PubMed

Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G

2016-04-01

Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered 'delayed' and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results.

Microsimulation of Financial Impact of Demand Surge on Hospitals: The H1N1 Influenza Pandemic of Fall 2009

PubMed Central

Braithwaite, Sabina; Friedman, Bernard; Mutter, Ryan; Handrigan, Michael

2013-01-01

Objective Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately and postponing elective admissions (a “passive” supply response). Methods Epidemiologic assumptions were combined with assumptions from other literature (e.g., staff absenteeism, profitability by payer class), Census data on age groups by region, and baseline hospital utilization data. Hospital discharge records were available from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Hospital bed capacity and staffing were measured with the American Hospital Association's (AHA) Annual Survey. Results Nationwide, in a scenario of relatively severe epidemiologic assumptions, we estimated aggregate net income of $119 million for about 1 million additional influenza-related admissions, and a net loss of $37 million for 52,000 postponed elective admissions. Implications Aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary. The analysis identified needs for better information of several types to improve simulations of hospital behavior and impacts during demand surges. PMID:23398540

A novel video-tracking system to quantify the behaviour of nocturnal mosquitoes attacking human hosts in the field.

PubMed

Angarita-Jaimes, N C; Parker, J E A; Abe, M; Mashauri, F; Martine, J; Towers, C E; McCall, P J; Towers, D P

2016-04-01

Many vectors of malaria and other infections spend most of their adult life within human homes, the environment where they bloodfeed and rest, and where control has been most successful. Yet, knowledge of peri-domestic mosquito behaviour is limited, particularly how mosquitoes find and attack human hosts or how insecticides impact on behaviour. This is partly because technology for tracking mosquitoes in their natural habitats, traditional dwellings in disease-endemic countries, has never been available. We describe a sensing device that enables observation and recording of nocturnal mosquitoes attacking humans with or without a bed net, in the laboratory and in rural Africa. The device addresses requirements for sub-millimetre resolution over a 2.0 × 1.2 × 2.0 m volume while using minimum irradiance. Data processing strategies to extract individual mosquito trajectories and algorithms to describe behaviour during host/net interactions are introduced. Results from UK laboratory and Tanzanian field tests showed that Culex quinquefasciatus activity was higher and focused on the bed net roof when a human host was present, in colonized and wild populations. Both C. quinquefasciatus and Anopheles gambiae exhibited similar behavioural modes, with average flight velocities varying by less than 10%. The system offers considerable potential for investigations in vector biology and many other fields. © 2016 The Authors.

Improving estimates of insecticide-treated mosquito net coverage from household surveys: using geographic coordinates to account for endemicity

PubMed Central

2014-01-01

Background Coverage estimates of insecticide-treated nets (ITNs) are often calculated at the national level, but are intended to be a proxy for coverage among the population at risk of malaria. The analysis uses data for surveyed households, linking survey enumeration areas (clusters) with levels of malaria endemicity and adjusting coverage estimates based on the population at risk. This analysis proposes an approach that is not dependent on being able to identify malaria risk in a location during the survey design (since survey samples are typically selected on the basis of census sampling frames that do not include information on malaria zones), but rather being able to assign risk zones after a survey has already been completed. Methods The analysis uses data from 20 recent nationally representative Demographic and Health Survey (DHS), Malaria Indicator Surveys (MIS), an AIDS Indicator Survey (AIS), and an Anemia and Malaria Prevalence Survey (AMP). The malaria endemicity classification was assigned from the Malaria Atlas Project (MAP) 2010 interpolated data layers, using the Geographic Positioning System (GPS) location of the survey clusters. National ITN coverage estimates were compared with coverage estimates in intermediate/high endemicity zones (i.e., the population at risk of malaria) to determine whether the difference between estimates was statistically different from zero (p-value <0.5). Results Endemicity varies substantially in eight of the 20 studied countries. In these countries with heterogeneous transmission of malaria, stratification of households by endemicity zones shows that ITN coverage in intermediate/high endemicity zones is significantly higher than ITN coverage at the national level (Burundi, Kenya, Namibia, Rwanda, Tanzania, Senegal, Zambia, and Zimbabwe.). For example in Zimbabwe, the national ownership of ITNs is 28%, but ownership in the intermediate/high endemicity zone is 46%. Conclusion Incorporating this study’s basic and easily reproducible approach into estimates of ITN coverage is applicable and even preferable in countries with areas at no/low risk of malaria and will help ensure that the highest-quality data are available to inform programmatic decisions in countries affected by malaria. The extension of this type of analysis to other malaria interventions can provide further valuable information to support evidence-based decision-making. PMID:24993082

Correcting bias due to missing stage data in the non-parametric estimation of stage-specific net survival for colorectal cancer using multiple imputation.

PubMed

Falcaro, Milena; Carpenter, James R

2017-06-01

Population-based net survival by tumour stage at diagnosis is a key measure in cancer surveillance. Unfortunately, data on tumour stage are often missing for a non-negligible proportion of patients and the mechanism giving rise to the missingness is usually anything but completely at random. In this setting, restricting analysis to the subset of complete records gives typically biased results. Multiple imputation is a promising practical approach to the issues raised by the missing data, but its use in conjunction with the Pohar-Perme method for estimating net survival has not been formally evaluated. We performed a resampling study using colorectal cancer population-based registry data to evaluate the ability of multiple imputation, used along with the Pohar-Perme method, to deliver unbiased estimates of stage-specific net survival and recover missing stage information. We created 1000 independent data sets, each containing 5000 patients. Stage data were then made missing at random under two scenarios (30% and 50% missingness). Complete records analysis showed substantial bias and poor confidence interval coverage. Across both scenarios our multiple imputation strategy virtually eliminated the bias and greatly improved confidence interval coverage. In the presence of missing stage data complete records analysis often gives severely biased results. We showed that combining multiple imputation with the Pohar-Perme estimator provides a valid practical approach for the estimation of stage-specific colorectal cancer net survival. As usual, when the percentage of missing data is high the results should be interpreted cautiously and sensitivity analyses are recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Higher moments of multiplicity fluctuations in a hadron-resonance gas with exact conservation laws

NASA Astrophysics Data System (ADS)

Fu, Jing-Hua

2017-09-01

Higher moments of multiplicity fluctuations of hadrons produced in central nucleus-nucleus collisions are studied within the hadron-resonance gas model in the canonical ensemble. Exact conservation of three charges, baryon number, electric charge, and strangeness is enforced in the large volume limit. Moments up to the fourth order of various particles are calculated at CERN Super Proton Synchrotron, BNL Relativistic Heavy Ion Collider (RHIC), and CERN Large Hadron Collider energies. The asymptotic fluctuations within a simplified model with only one conserved charge in the canonical ensemble are discussed where simple analytical expressions for moments of multiplicity distributions can be obtained. Moments products of net-proton, net-kaon, and net-charge distributions in Au + Au collisions at RHIC energies are calculated. The pseudorapidity coverage dependence of net-charge fluctuation is discussed.

A Discrete Event Simulation Model of Patient Flow in a General Hospital Incorporating Infection Control Policy for Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE).

PubMed

Shenoy, Erica S; Lee, Hang; Ryan, Erin E; Hou, Taige; Walensky, Rochelle P; Ware, Winston; Hooper, David C

2018-02-01

Hospitalized patients are assigned to available staffed beds based on patient acuity and services required. In hospitals with double-occupancy rooms, patients must be additionally matched by gender. Patients with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) must be bedded in single-occupancy rooms or cohorted with other patients with similar MRSA/VRE flags. We developed a discrete event simulation (DES) model of patient flow through an acute care hospital. Patients are matched to beds based on acuity, service, gender, and known MRSA/VRE colonization. Outcomes included time to bed arrival, length of stay, patient-bed acuity mismatches, occupancy, idle beds, acuity-related transfers, rooms with discordant MRSA/VRE colonization, and transmission due to discordant colonization. Observed outcomes were well-approximated by model-generated outcomes for time-to-bed arrival (6.7 v. 6.2 to 6.5 h) and length of stay (3.3 v. 2.9 to 3.0 days), with overlapping 90% coverage intervals. Patient-bed acuity mismatches, where patient acuity exceeded bed acuity and where patient acuity was lower than bed acuity, ranged from 0.6 to 0.9 and 8.6 to 11.1 mismatches per h, respectively. Values for observed occupancy, total idle beds, and acuity-related transfers compared favorably to model-predicted values (91% v. 86% to 87% occupancy, 15.1 v. 14.3 to 15.7 total idle beds, and 27.2 v. 22.6 to 23.7 transfers). Rooms with discordant colonization status and transmission due to discordance were modeled without an observed value for comparison. One-way and multi-way sensitivity analyses were performed for idle beds and rooms with discordant colonization. We developed and validated a DES model of patient flow incorporating MRSA/VRE flags. The model allowed for quantification of the substantial impact of MRSA/VRE flags on hospital efficiency and potentially avoidable nosocomial transmission.

Influenza during pregnancy: Incidence, vaccination coverage and attitudes toward vaccination in the French web-based cohort G-GrippeNet.

PubMed

Loubet, Paul; Guerrisi, Caroline; Turbelin, Clément; Blondel, Béatrice; Launay, Odile; Bardou, Marc; Goffinet, François; Colizza, Vittoria; Hanslik, Thomas; Kernéis, Solen

2016-04-29

Pregnancy is a risk factor for severe influenza. However, data on influenza incidence during pregnancy are scarce. Likewise, no data are available on influenza vaccine coverage in France since national recommendation in 2012. We aimed to assess these points using a novel nationwide web-based surveillance system, G-GrippeNet. During the 2014/2015 influenza season, pregnant women living in metropolitan France were enrolled through a web platform (https://www.grippenet.fr/). Throughout the season, participants were asked to report, on a weekly basis, if they had experienced symptoms of influenza-like-illness (ILI). ILI episodes reported were used to calculate incidence density rates based on period of participation from each participant. Vaccination coverage was estimated after weighing on age and education level from national data on pregnant women. Factors associated with higher vaccination coverage were obtained through a logistic regression with Odds Ratio (OR) corrected with the Zhang and Yu method. A total of 153 women were enrolled. ILI incidence density rate was 1.8 per 100 person-week (95% CI, 1.5-2.1). This rate was higher in women older than 40 years (RR = 3.0, 95% CI [1.1-8.3], p = 0.03) and during first/second trimesters compared to third trimester (RR = 4.0, 95% CI [1.4-12.0], p = 0.01). Crude vaccination coverage was 39% (95% CI, 31-47) and weighted vaccination coverage was estimated at 26% (95% CI, 20-34). Health care provider recommendation for vaccination (corrected OR = 7.8; 95% CI [3.0-17.1]) and non-smoking status (cOR = 2.1; 95% CI [1.2-6.9]) were associated with higher vaccine uptake. This original web based longitudinal surveillance study design proved feasible in pregnant women population. First results are of interest and underline that public health policies should emphasize the vaccination promotion through health care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Hybrid Memetic Framework for Coverage Optimization in Wireless Sensor Networks.

PubMed

Chen, Chia-Pang; Mukhopadhyay, Subhas Chandra; Chuang, Cheng-Long; Lin, Tzu-Shiang; Liao, Min-Sheng; Wang, Yung-Chung; Jiang, Joe-Air

2015-10-01

One of the critical concerns in wireless sensor networks (WSNs) is the continuous maintenance of sensing coverage. Many particular applications, such as battlefield intrusion detection and object tracking, require a full-coverage at any time, which is typically resolved by adding redundant sensor nodes. With abundant energy, previous studies suggested that the network lifetime can be maximized while maintaining full coverage through organizing sensor nodes into a maximum number of disjoint sets and alternately turning them on. Since the power of sensor nodes is unevenly consumed over time, and early failure of sensor nodes leads to coverage loss, WSNs require dynamic coverage maintenance. Thus, the task of permanently sustaining full coverage is particularly formulated as a hybrid of disjoint set covers and dynamic-coverage-maintenance problems, and both have been proven to be nondeterministic polynomial-complete. In this paper, a hybrid memetic framework for coverage optimization (Hy-MFCO) is presented to cope with the hybrid problem using two major components: 1) a memetic algorithm (MA)-based scheduling strategy and 2) a heuristic recursive algorithm (HRA). First, the MA-based scheduling strategy adopts a dynamic chromosome structure to create disjoint sets, and then the HRA is utilized to compensate the loss of coverage by awaking some of the hibernated nodes in local regions when a disjoint set fails to maintain full coverage. The results obtained from real-world experiments using a WSN test-bed and computer simulations indicate that the proposed Hy-MFCO is able to maximize sensing coverage while achieving energy efficiency at the same time. Moreover, the results also show that the Hy-MFCO significantly outperforms the existing methods with respect to coverage preservation and energy efficiency.

Entrainment of bed sediment by debris flows: results from large-scale experiments

USGS Publications Warehouse

Reid, Mark E.; Iverson, Richard M.; Logan, Matthew; LaHusen, Richard G.; Godt, Jonathan W.; Griswold, Julie P.

2011-01-01

When debris flows grow by entraining sediment, they can become especially hazardous owing to increased volume, speed, and runout. To investigate the entrainment process, we conducted eight largescale experiments in the USGS debris-flow flume. In each experiment, we released a 6 m3 water-saturated debris flow across a 47-m long, ~12-cm thick bed of partially saturated sediment lining the 31º flume. Prior to release, we used low-intensity overhead sprinkling and real-time monitoring to control the bed-sediment wetness. As each debris flow descended the flume, we measured the evolution of flow thickness, basal total normal stress, basal pore-fluid pressure, and sediment scour depth. When debris flows traveled over relatively dry sediment, net scour was minimal, but when debris flows traveled over wetter sediment (volumetric water content > 0.22), debris-flow volume grew rapidly and flow speed and runout were enhanced. Data from scour sensors showed that entrainment occurred by rapid (5-10 cm/s), progressive scour rather than by mass failure at depth. Overriding debris flows rapidly generated high basal pore-fluid pressures when they loaded and deformed bed sediment, and in wetter beds these pressures approached lithostatic levels. Reduction of intergranular friction within the bed sediment thereby enhanced scour efficiency, entrainment, and runout.

Effect of Residence Time on Net Nitrate Retention in Flow-Regulated Backwaters of the Upper Mississippi River

DTIC Science & Technology

2006-02-01

include Ceratophyllum demersum, Myriophyllum spicatum, and Nymphaea odorata . METHODS: In late April 2004, vertical slide gates were adjusted to...due to a shallow water column and dense N. odorata beds. Flows into Schmokers Lake could not be directly measured because it was not connected to the

Comparative gas-exchange in leaves of intact and clipped, natural and planted cherybark oak (Quercus pagoda Raf.) seedlings

Treesearch

Brian R. Lockhart; John D. Hodges

1994-01-01

Gas-exchange measurements, including CO2-exchange rate (net photosynthesis), stomatal conductance, and transpiration, were conducted on intact and clipped cherrybark oak (Quercus pagoda Raf.) seedlings growing inthe field and in a nursery bed. Seedlings inthe field, released frommidstory and understory woody competition, showed...

The Mental and Physical Health Consequences of Changes in Private Insurance Before and After Early Retirement

PubMed Central

2016-01-01

Objectives. This study evaluated the impact of private insurance coverage on the symptoms of depression, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) in the years leading up to Medicare eligibility focusing on the transition from full-time work to early full retirement. Method. The Health and Retirement Study was used to (a) estimate 2-stage selection equations of (i) the transition to retirement and (ii) current insurance status, and (b) the impact of insurance coverage on health, net of endogeneity associated retirement and insurance coverage. Results. Employment-based insurance coverage was generally associated with better health. Moreover, being without employment-based insurance was particularly problematic during the transition to retirement. Non-group insurance only moderated the association between losing employment-based insurance and IADLs. Discussion. Results indicated that private insurance coverage is an important contextual factor for the health of early retirees. Those who maintain steady coverage tend to fare the best in retirement. This highlights the dynamic nature of changes in health in later life. PMID:25819976

Insecticidal, acaricidal and repellent effects of DEET- and IR3535-impregnated bed nets using a novel long-lasting polymer-coating technique.

PubMed

Faulde, Michael K; Albiez, Gunther; Nehring, Oliver

2010-03-01

A novel long-lasting repellent-treated net (LLRTN) has been designed by binding the skin repellents N,N-diethyl-m-toluamide (DEET), or IR3535, onto the fibres of bed net fabric using a new polymer-coating technique. The repellent toxicological effectiveness and residual activity of a factory-based repellent-impregnated fabric has been evaluated by laboratory testing against adult Aedes aegypti mosquitoes and nymphal Ixodes ricinus ticks. By using this repellent-embedding impregnation technique, concentrations exceeding 10 g/m(2) could be achieved with one single polymer layer. Both DEET- and IR3535-impregnated fabrics revealed a dose-dependent insecticidal as well as acaricidal activity. One hundred percent knockdown times of DEET-treated bed nets ranged from 187.5 +/- 31.8 to 27.5 +/- 3.5 min against A. aegypti, and between 214 +/- 47 and 22.6 +/- 5 min against nymphal I. ricinus, linked to a DEET concentration of 1.08 and 10.58 g/m(2), respectively. With IR3535, A. aegypti produced dose-dependent 100% knockdown times varying from 87.5 +/- 10.6 to 57.5 +/- 3.5 min and between 131.4 +/- 6.5 and 33.8 +/- 5 min against nymphal I. ricinus, respectively, linked to concentrations between 1.59 and 10.02 g/m(2). One hundred percent repellency measured by complete landing and biting protection of impregnated fabric by using the arm-in-cage test could be achieved at DEET concentrations exceeding 3.7 to 3.9 g/m(2), and for IR3535 concentrations over 10 g/m(2). One hundred percent landing and biting protection could be preserved with DEET-treated fabrics for 29 weeks at an initial concentration of 4.66 g/m(2), 54 weeks at 8.8 g/m(2), 58 weeks at 9.96 g/m(2) and 61 weeks at 10.48 g/m(2) for DEET, and 23 weeks for IR3535-treated fabric at a concentration of 10.02 g/m(2). Unlike repellent-treated fabric, a brand of a commercially available long-lasting insecticide-treated net tested containing 500 mg permethrin/m(2) did not protect from mosquito bites. First results on bioactivity and long-lasting efficacy show that the new LLRTN technique is highly promising as a potential candidate for future malaria control strategies, especially in areas where pyrethroid resistance occurs.

IntNetDB v1.0: an integrated protein-protein interaction network database generated by a probabilistic model

PubMed Central

Xia, Kai; Dong, Dong; Han, Jing-Dong J

2006-01-01

Background Although protein-protein interaction (PPI) networks have been explored by various experimental methods, the maps so built are still limited in coverage and accuracy. To further expand the PPI network and to extract more accurate information from existing maps, studies have been carried out to integrate various types of functional relationship data. A frequently updated database of computationally analyzed potential PPIs to provide biological researchers with rapid and easy access to analyze original data as a biological network is still lacking. Results By applying a probabilistic model, we integrated 27 heterogeneous genomic, proteomic and functional annotation datasets to predict PPI networks in human. In addition to previously studied data types, we show that phenotypic distances and genetic interactions can also be integrated to predict PPIs. We further built an easy-to-use, updatable integrated PPI database, the Integrated Network Database (IntNetDB) online, to provide automatic prediction and visualization of PPI network among genes of interest. The networks can be visualized in SVG (Scalable Vector Graphics) format for zooming in or out. IntNetDB also provides a tool to extract topologically highly connected network neighborhoods from a specific network for further exploration and research. Using the MCODE (Molecular Complex Detections) algorithm, 190 such neighborhoods were detected among all the predicted interactions. The predicted PPIs can also be mapped to worm, fly and mouse interologs. Conclusion IntNetDB includes 180,010 predicted protein-protein interactions among 9,901 human proteins and represents a useful resource for the research community. Our study has increased prediction coverage by five-fold. IntNetDB also provides easy-to-use network visualization and analysis tools that allow biological researchers unfamiliar with computational biology to access and analyze data over the internet. The web interface of IntNetDB is freely accessible at . Visualization requires Mozilla version 1.8 (or higher) or Internet Explorer with installation of SVGviewer. PMID:17112386

Applying the net-benefit framework for assessing cost-effectiveness of interventions towards universal health coverage

PubMed Central

2012-01-01

In assessing the cost-effectiveness of an intervention, the interpretation and handling of uncertainties of the traditional summary measure, the Incremental Cost Effectiveness Ratio (ICER), can be problematic. This is particularly the case with strategies towards universal health coverage in which the decision makers are typically concerned with coverage and equity issues. We explored the feasibility and relative advantages of the net-benefit framework (NBF) (compared to the more traditional Incremental Cost-Effectiveness Ratio, ICER) in presenting results of cost-effectiveness analysis of a community based health insurance (CBHI) scheme in Nouna, a rural district of Burkina Faso. Data were collected from April to December 2007 from Nouna’s longitudinal Demographic Surveillance System on utilization of health services, membership of the CBHI, covariates, and CBHI costs. The incremental cost of a 1 increase in utilization of health services by household members of the CBHI was 433,000 XOF ($1000 approximately). The incremental cost varies significantly by covariates. The probability of the CBHI achieving a 1% increase in utilization of health services, when the ceiling ratio is $1,000, is barely 30% for households in Nouna villages compared to 90% for households in Nouna town. Compared to the ICER, the NBF provides more useful information for policy making. PMID:22800192

Malaria burden and control in Bangladesh and prospects for elimination: an epidemiological and economic assessment.

PubMed

Haque, Ubydul; Overgaard, Hans J; Clements, Archie C A; Norris, Douglas E; Islam, Nazrul; Karim, Jahirul; Roy, Shyamal; Haque, Waziul; Kabir, Moktadir; Smith, David L; Glass, Gregory E

2014-02-01

Malaria is endemic in 13 of 64 districts in Bangladesh. About 14 million people are at risk. Some evidence suggests that the prevalence of malaria in Bangladesh has decreased since the the Global Fund to Fight AIDS, Tuberculosis and Malaria started to support the National Malaria Control Program (NMCP) in 2007. We did an epidemiological and economic assessment of malaria control in Bangladesh. We obtained annually reported, district-level aggregated malaria case data and information about disbursed funds from the NMCP. We used a Poisson regression model to examine the associations between total malaria, severe malaria, malaria-attributable mortality, and insecticide-treated net coverage. We identified and mapped malaria hotspots using the Getis-Ord Gi* statistic. We estimated the cost-effectiveness of the NMCP by estimating the cost per confirmed case, cost per treated case, and cost per person of insecticide-treated net coverage. During the study period (from Jan 1, 2008, to Dec 31, 2012) there were 285,731 confirmed malaria cases. Malaria decreased from 6.2 cases per 1000 population in 2008, to 2.1 cases per 1000 population in 2012. Prevalence of all malaria decreased by 65% (95% CI 65-66), severe malaria decreased by 79% (78-80), and malaria-associated mortality decreased by 91% (83-95). By 2012, there was one insecticide-treated net for every 2.6 individuals (SD 0.20). Districts with more than 0.5 insecticide-treated nets per person had a decrease in prevalence of 21% (95% CI 19-23) for all malaria, 25% (17-32) for severe malaria, and 76% (35-91) for malaria-associated mortality among all age groups. Malaria hotspots remained in the highly endemic districts in the Chittagong Hill Tracts. The cost per diagnosed case was US$0.39 (SD 0.02) and per treated case was $0.51 (0.27); $0.05 (0.04) was invested per person per year for health education and $0.68 (0.30) was spent per person per year for insecticide-treated net coverage. Malaria elimination is an achievable prospect in Bangladesh and failure to push for elimination nearly ensures a resurgence of disease. Consistent financing is needed to avoid resurgence and maintain elimination goals. None. Copyright © 2014 Haque et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

Bioreactors configured with distributors and carriers enhance the performance of continuous dark hydrogen fermentation.

PubMed

Lo, Yung-Chung; Lee, Kuo-Shing; Lin, Ping-Jei; Chang, Jo-Shu

2009-10-01

Anaerobic granular sludge bed (AnGSB) bioreactors were supplemented with activated carbon carriers and combined with distributors (e.g., acrylic resin board, stainless steel net and plastic net) installed at different locations to investigate the effect of distributor/carrier on biohydrogen production efficiency. The results show that plastic net stimulated the substrate/microorganisms contact and sludge granulation, thereby leading to a much better H(2) production performance when compared with those obtained from traditional CSTR. The highest H(2) production rate (7.89 L/h/L) and yield (3.42 mol H(2)/mol sucrose) were obtained when two pieces of plastic nets were installed at both 4 cm and 16 cm from the bottom of AnGSB without carrier addition and the bioreactor was operated at a HRT of 0.5h. For the AnGSB installed with two pieces of plastic net distributors, addition of carriers led to significant improvement on the H(2) production efficiency at a longer HRT (1-4h) when compared with the carrier-absent system.

A Three Degrees of Freedom Test-Bed for Nanosatellite and CubeSat Attitude Dynamics, Determination, and Control

DTIC Science & Technology

2009-12-01

Tactical Imaging Nano-sat Yielding Small-Cost Operations and Persistent Earth-coverage UFO UHF Follow On UHF Ultra-High Frequency USCG United...replaced by UHF Follow On ( UFO ) satellites in the 1990s. The UFO satellites are being updated and scheduled for replacement by the Mobile User

Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011–2012): a cluster randomized, control trial

PubMed Central

2014-01-01

Background It is well established that insecticide-treated bed nets (ITNs), in particular long-lasting, insecticidal nets (LLINs), can be used as one of the primary interventions for effective malaria control. A consistent gap between net ownership and use has been observed, indicating that factors exist that prevent an owned mosquito net from being used. One approach used in the context of LLIN campaigns is a post-distribution, door-to-door visit of households with educational messages and to physically assist with hang-up of nets. Methods A cluster randomized trial was conducted in the Plateaux Region of Togo to evaluate the effectiveness of different approaches to post-LLIN campaign home visits (number of visits and timing) by volunteers to enhance LLIN hang-up and utilization. Results It was found that, in general, households that received intervention visits, particularly the most recent intervention visit, had levels of use that were typically 5 to 10% higher than the control households, while access did not differ among control and intervention households. Eight months post-campaign, ITN use by all individuals, children under five years and women of reproductive age was 11.3 to 14.4 percentage points greater in the study arm that received all three intervention visits than in the control communities. In households that received one or two additional door-to-door visits, the majority of respondents indicated that the volunteer provided new information during the visit regarding the use and importance of ITNs despite having received previous multiple visits. Conclusions The impact of the interventions appears to have been primarily through the delivery and reinforcement of key behaviour-change communication (BCC) messages regarding the importance of using an ITN and its care. Regardless of whether the respondents in fact received new information or had forgotten earlier information, this suggests that regular visits from community agents are useful in reinforcing key BCC messages. PMID:25005572

Unmet need for specialised rehabilitation following neurosurgery: can we maximise the potential cost-benefits?

PubMed

Singh, Rajiv; Sinha, Saurabh; Bill, Alan; Turner-Stokes, Lynne

2017-04-01

To identify the needs for specialised rehabilitation provision in a cohort of neurosurgical patients; to determine if these were met, and to estimate the potential cost implications and cost-benefits of meeting any unmet rehabilitation needs. A prospective study of in-patient admissions to a regional neurosurgical ward. Assessment of needs for specialised rehabilitation (Category A or B needs) was made with the Patient Categorisation Tool. The number of patients who were referred and admitted for specialised rehabilitation was calculated. Data from the unit's submission to the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database 2012-2015 were used to estimate the potential mean lifetime savings generated through reduction in the costs of on-going care in the community. Of 223 neurosurgical in-patients over 3 months, 156 (70%) had Category A or B needs. Out of the 105 patients who were eligible for admission to the local specialised rehabilitation service, only 20 (19%) were referred and just 11 (10%) were actually admitted. The mean transfer time was 70.2 (range 28-127) days, compared with the national standard of 42 days. In the 3-year sample, mean savings in the cost of on-going care were £568 per week. Assuming a 10-year reduction in life expectancy, the approximate net lifetime saving for post-neurosurgical patients was estimated as at least £600K per patient. We calculated that provision of additional bed capacity in the specialist rehabilitation unit could generate net savings of £3.6M/bed-year. This preliminary single-centre study identified a considerable gap in provision of specialised rehabilitation for neurosurgical patients, which must be addressed if patients are to fulfil their potential for recovery. A 5-fold increase in bed capacity would cost £9.3m/year, but could lead to potential net savings of £24m/year. Our findings now require confirmation on a wider scale through prospective multi-centre studies.

CARBON BALANCE OF FOREST BIOMES IN THE FORMER USSR

EPA Science Inventory

Sources and sinks of carbon and the sequestration potential of forest biomes in the former Soviet Union (FSU) were assessed under non-equilibrium conditions by considering, 1) net ecosystem productivity (NEP) of different age forest stands and actual forest coverage, 2) carbon fl...

Threat and efficacy uncertainty in news coverage about bed bugs as unique predictors of information seeking and avoidance: an extension of the EPPM.

PubMed

Goodall, Catherine E; Reed, Phillip

2013-01-01

An experiment was conducted from the perspective of the Extended Parallel Process Model (EPPM) investigating readers' responses to print news stories about the issue of bed bugs. Stories containing reference to (a) the threat of bed bugs and (b) efficacy of the solution were manipulated to vary the level of certainty with which the variables were discussed. Results suggest that stories referencing uncertainty regarding presence of the bed-bug threat may be more likely to motivate intention to seek information than stories referencing certainty of the threat. Results also suggest that stories referencing uncertainty regarding feasibility/effectiveness of proposed solutions may be more likely to motivate intention to avoid information than stories referencing certainty of proposed solutions. Given that information avoidance is one of various types of maladaptive responses to fear appeal messages (according to EPPM), results suggest that the presence of uncertainty when discussing solutions to threats in news stories might result in problematic avoidance responses that discourage people from taking protective action.

Supply-Limited Bedforms in a Gravel-Sand Transition

NASA Astrophysics Data System (ADS)

Venditti, J. G.; Nittrouer, J. A.; Humphries, R. P.; Allison, M. A.

2009-12-01

Rivers often exhibit an abrupt transition from gravel to sand-bedded conditions as river channel slopes decrease. A distinct suite of bedforms has been observed through these reaches where sand supply to the bed is limited. The suite of bedforms includes a sequence of sand ribbons, barchans, and channel spanning dunes as sediment supply increases in the downstream direction. While these bedforms have been extensively documented in laboratory channels, there are relatively few observations of this sequence of supply-limited bedforms from large natural channels. Here we examine the sequence through the gravel-sand transition of the Fraser River in Southwestern British Columbia. We mapped the bed using multi-beam swath-bathymetry (Reson 8101 Seabat) at high flow (~9,000 m3s-1) immediately following a high peak flow of 11,800 m3s-1 in June 2007 The bed material grades from >70% gravel to entirely sand through the reach. The bedforms follow the expected sequence where sand ribbons and barchanoid forms cover the bed where it is primarily gravel. Channel spanning dunes form as the sand bed coverage increases. Bedform dimensions (height and length) increase moving downstream as the sand moving on the bed increases. Supply-unlimited bedforms typically scale with the flow depth where the height is 1/5 the flow depth. The bedforms developed over the gravel are undersized by this criterion. Downstream, where the bed is dominantly sand, bedforms do scale with flow depth. These data highlight the dominant role sediment supply can play in bedform morphology and scaling, confirming patterns observed in laboratory data.

Simulation of seagrass bed mapping by satellite images based on the radiative transfer model

NASA Astrophysics Data System (ADS)

Sagawa, Tatsuyuki; Komatsu, Teruhisa

2015-06-01

Seagrass and seaweed beds play important roles in coastal marine ecosystems. They are food sources and habitats for many marine organisms, and influence the physical, chemical, and biological environment. They are sensitive to human impacts such as reclamation and pollution. Therefore, their management and preservation are necessary for a healthy coastal environment. Satellite remote sensing is a useful tool for mapping and monitoring seagrass beds. The efficiency of seagrass mapping, seagrass bed classification in particular, has been evaluated by mapping accuracy using an error matrix. However, mapping accuracies are influenced by coastal environments such as seawater transparency, bathymetry, and substrate type. Coastal management requires sufficient accuracy and an understanding of mapping limitations for monitoring coastal habitats including seagrass beds. Previous studies are mainly based on case studies in specific regions and seasons. Extensive data are required to generalise assessments of classification accuracy from case studies, which has proven difficult. This study aims to build a simulator based on a radiative transfer model to produce modelled satellite images and assess the visual detectability of seagrass beds under different transparencies and seagrass coverages, as well as to examine mapping limitations and classification accuracy. Our simulations led to the development of a model of water transparency and the mapping of depth limits and indicated the possibility for seagrass density mapping under certain ideal conditions. The results show that modelling satellite images is useful in evaluating the accuracy of classification and that establishing seagrass bed monitoring by remote sensing is a reliable tool.

Insecticide-treated nets and treatment service: a trial using public and private sector channels in rural United Republic of Tanzania.

PubMed Central

Fraser-Hurt, N.; Lyimo, E. O.

1998-01-01

The Rotary Net Initiative, implemented in Kilombero District, southern United Republic of Tanzania, allowed us to explore different sales channels for the distribution of insecticide-treated nets (ITNs) and the insecticide treatment service in a rural area of very high malaria transmission. Several types of ITNs were promoted and sold through different channels in the public and private sector, i.e. hospital pharmacy, mother and child health (MCH) clinic, net committee, village health workers and retail shops. The ITNs were sold for US$ 5.0-9.2, with profit margins of 9-16%. Net treatment cost US$ 0.33, with commission fees of 75%. Net transport and treatment were partially subsidized. Some outlets established their own fund by ITN sales. Sales of nets and treatments were seasonal, and certain net types were preferred. Demand for insecticide treatment was generally low. Changes in net coverage were assessed in two villages. A range of outlet features were compared qualitatively. Our experience supports suggestions that ITN technology should be delivered through MCH care services and demonstrates that specific promotion and innovation are necessary to achieve substantial net treatment levels. A large-scale ITN project in the same area and other ITN studies should lead to better understanding of ITN implementation at the population level. PMID:10191557

Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia.

PubMed

Yared, Solomon; Deribe, Kebede; Gebreselassie, Araya; Lemma, Wessenseged; Akililu, Essayas; Kirstein, Oscar D; Balkew, Meshesha; Warburg, Alon; Gebre-Michael, Teshome; Hailu, Asrat

2014-10-14

Visceral leishmaniasis (VL, also called ''kala-azar"), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. A case-control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants.

Impact of simulated microgravity and caloric restriction on autonomic nervous system function in adipose tissue

NASA Astrophysics Data System (ADS)

Boschmann, Michael; Adams, Frauke; Tank, Jens; Schaller, Karin; Boese, Andrea; Heer, Martina; Klause, Susanne; Luft, Friedrich C.; Jordan, Jens

2005-08-01

Long term immobilization and reduced food intake is often associated with development of orthostatic intolerance. Blocking the norepinephrine transporter (NET) can also mimic symptoms of orthostatic intolerance. Therefore, we hypothesized that simulated microgravity (14 days bed rest at head down tilt, BR) can cause changes in postganglionic NET function and adrenoreceptor (AR) sensitivity and these changes can be aggravated by hypocaloric food intake. For testing, two microdialysis probes were inserted into subcutaneous adipose tissue of eight young healthy men at day 1 and 14 of BR and perfused with Ringer's solution and increasing doses of tyramine and isoproterenol in order to simulate NET blockade and stimulate AR, respectively. At day 14 of eucaloric diet and BR, isoproterenol induced lipolysis was greater, whereas at day 14 of hypocaloric diet and BR, tyramine induced lipolysis was greater when compared to day 1. Therefore, the nutritional state affects NET function and AR sensitivity differently during BR.

Sediment Mobilization and Storage Dynamics of a Debris Flow Impacted Stream Channel using Multi-Temporal Structure from Motion Photogrammetry

NASA Astrophysics Data System (ADS)

Bailey, T. L.; Sutherland-Montoya, D.

2015-12-01

High resolution topographic analysis methods have become important tools in geomorphology. Structure from Motion photogrammetry offers a compelling vehicle for geomorphic change detection in fluvial environments. This process can produce arbitrarily high resolution, geographically registered spectral and topographic coverages from a collection of overlapping digital imagery from consumer cameras. Cuneo Creek has had three historically observed episodes of rapid aggradation (1955, 1964, and 1997). The debris flow deposits continue to be major sources of sediment sixty years after the initial slope failure. Previous studies have monitored the sediment storage volume and particle size since 1976 (in 1976, 1982, 1983, 1985, 1986, 1987, 1998, 2003). We reoccupied 3 previously surveyed stream cross sections on Sept 30, 2014 and March 30, 2015, and produced photogrammetric point clouds using a pole mounted camera with a remote view finder to take nadir view images from 4.3 meters above the channel bed. Ground control points were registered using survey grade GPS and typical cross sections used over 100 images to build the structure model. This process simultaneously collects channel geometry and we used it to also generate surface texture metrics, and produced DEMs with point cloud densities above 5000 points / m2. In the period between the surveys, a five year recurrence interval discharge of 20 m3/s scoured the channel. Surface particle size distribution has been determined for each observation period using image segmentation algorithms based on spectral distance and compactness. Topographic differencing between the point clouds shows substantial channel bed mobilization and reorganization. The net decline in sediment storage is in excess of 4 x 10^5 cubic meters since the 1964 aggradation peak, with associated coarsening of surface particle sizes. These new methods provide a promising rapid assessment tool for measurement of channel responses to sediment inputs.

The Role of the United States Military in the Development of Vector Control Products, Including Insect Repellents, Insecticides, and Bed Nets

DTIC Science & Technology

2009-06-01

involves overseas laboratories. Repellents and pesticides used by the U.S. military at present must be U.S. Environmental Protection Agency (EPA...eucalyptus, citronella, catnip, sage, lavender, basil , thyme, and the tea tree) contain oils that repel arthropods when applied to skin, hair, or wood (that

Comparative gas-exchange in leaves of intact and clipped, natural and planted cherrybark oak (Quercus pagoda Raf.) seedlings

Treesearch

Brian R. Lockhart; John D. Hodges

2005-01-01

Gas-exchange measurements, including C022-exchange rate (net photosynthesis), stomatal conductance, and transpiration, were conducted on intact and clipped cherrybark oak (Quercus pagoda Raf.) seedlings growing in the field and in a nursery bed. Seedlings in the field, released from midstory and understory woody competition,...

Climate Prediction Center - NCEP Global Ocean Data Assimilation System:

Science.gov Websites

home page National Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Monthly in NetCDF Other formats Links NOAA Ocean Climate Observation Program (OCO) Climate Test Bed About Prediction (NCEP) are a valuable community asset for monitoring different aspects of ocean climate

Near-Bed Turbulent Kinetic Energy Budget Under a Large-Scale Plunging Breaking Wave Over a Fixed Bar

NASA Astrophysics Data System (ADS)

van der Zanden, Joep; van der A, Dominic A.; Cáceres, Iván.; Hurther, David; McLelland, Stuart J.; Ribberink, Jan S.; O'Donoghue, Tom

2018-02-01

Hydrodynamics under regular plunging breaking waves over a fixed breaker bar were studied in a large-scale wave flume. A previous paper reported on the outer flow hydrodynamics; the present paper focuses on the turbulence dynamics near the bed (up to 0.10 m from the bed). Velocities were measured with high spatial and temporal resolution using a two component laser Doppler anemometer. The results show that even at close distance from the bed (1 mm), the turbulent kinetic energy (TKE) increases by a factor five between the shoaling, and breaking regions because of invasion of wave breaking turbulence. The sign and phase behavior of the time-dependent Reynolds shear stresses at elevations up to approximately 0.02 m from the bed (roughly twice the elevation of the boundary layer overshoot) are mainly controlled by local bed-shear-generated turbulence, but at higher elevations Reynolds stresses are controlled by wave breaking turbulence. The measurements are subsequently analyzed to investigate the TKE budget at wave-averaged and intrawave time scales. Horizontal and vertical turbulence advection, production, and dissipation are the major terms. A two-dimensional wave-averaged circulation drives advection of wave breaking turbulence through the near-bed layer, resulting in a net downward influx in the bar trough region, followed by seaward advection along the bar's shoreward slope, and an upward outflux above the bar crest. The strongly nonuniform flow across the bar combined with the presence of anisotropic turbulence enhances turbulent production rates near the bed.

Ownership and use of insecticide-treated nets during pregnancy in sub-Saharan Africa: a review

PubMed Central

2013-01-01

Over the past decade, significant gains have been made in the implementation of malaria prevention measures in pregnancy in sub-Saharan Africa, including the distribution of insecticide-treated nets (ITNs). These have been shown to cause a reduction in the incidence of malaria and its consequences such as maternal anaemia, stillbirths and intrauterine growth restriction. Currently most nations in Africa have policies for distributing ITNs to pregnant women through various mechanisms, however coverage remains well below the targets. This review summarizes recent evidence regarding the correlation between ownership and use of ITNs and the determinants of both, in pregnancy in sub-Saharan Africa, and reviews interventions directed at improving coverage. A review of the literature using Pubmed, CINAHL and scanning of reference lists was conducted in October 2012 and 59 articles were selected for final review. The research obtained was a mixture of national and district level surveys, and a narrative synthesis of the data was undertaken. Ownership of ITNs varied from as low as 3% to greater than 80%, and the main determinants were found to be education level, knowledge of malaria, community involvement, socio-economic status and parity, although the significance of each varied between the different settings and studies reviewed. In more than half the settings where data were available, the combination of lack of availability and lack of use of an available net meant that less than half of all pregnancies received the recommended intervention. Supply and cost remain major barriers to achieving optimal coverage, but the additional important contributor to reduced efficiency of intervention was the clear discrepancy between ownership and use, with available ITN use below 60% in several settings. Cited reasons for not using an ITN, where one was available, included discomfort, problems with hanging up nets and lack of space, low awareness of need, and seasonal variations in use. These findings highlight the need for context-specific approaches and educational components to be incorporated into ITN distribution programmes to address some of the reasons why some pregnant women do not use the ITNs they own. PMID:23914731

Sorted bed forms as self-organized patterns: 2. complex forcing scenarios

USGS Publications Warehouse

Coco, Giovanni; Murray, A. Brad; Green, Malcom O.; Thieler, E. Robert; Hume, T.M.

2007-01-01

We employ a numerical model to study the development of sorted bed forms under a variety of hydrodynamic and sedimentary conditions. Results indicate that increased variability in wave height decreases the growth rate of the features and can potentially give rise to complicated, a priori unpredictable, behavior. This happens because the system responds to a change in wave characteristics by attempting to self-organize into a patterned seabed of different geometry and spacing. The new wavelength might not have enough time to emerge before a new change in wave characteristics occurs, leading to less regular seabed configurations. The new seabed configuration is also highly dependent on the preexisting morphology, which further limits the possibility of predicting future behavior. For the same reasons, variability in the mean current magnitude and direction slows down the growth of features and causes patterns to develop that differ from classical sorted bed forms. Spatial variability in grain size distribution and different types of net sediment aggradation/degradation can also result in the development of sorted bed forms characterized by a less regular shape. Numerical simulations qualitatively agree with observed geometry (spacing and height) of sorted bed forms. Also in agreement with observations is that at shallower depths, sorted bed forms are more likely to be affected by changes in the forcing conditions, which might also explain why, in shallow waters, sorted bed forms are described as ephemeral features. Finally, simulations indicate that the different sorted bed form shapes and patterns observed in the field might not necessarily be related to diverse physical mechanisms. Instead, variations in sorted bed form characteristics may result from variations in local hydrodynamic and/or sedimentary conditions.

Combining epidemiology with basic biology of sand flies, parasites, and hosts to inform leishmaniasis transmission dynamics and control.

PubMed

Courtenay, Orin; Peters, Nathan C; Rogers, Matthew E; Bern, Caryn

2017-10-01

Quantitation of the nonlinear heterogeneities in Leishmania parasites, sand fly vectors, and mammalian host relationships provides insights to better understand leishmanial transmission epidemiology towards improving its control. The parasite manipulates the sand fly via production of promastigote secretory gel (PSG), leading to the "blocked sand fly" phenotype, persistent feeding attempts, and feeding on multiple hosts. PSG is injected into the mammalian host with the parasite and promotes the establishment of infection. Animal models demonstrate that sand flies with the highest parasite loads and percent metacyclic promastigotes transmit more parasites with greater frequency, resulting in higher load infections that are more likely to be both symptomatic and efficient reservoirs. The existence of mammalian and sand fly "super-spreaders" provides a biological basis for the spatial and temporal clustering of clinical leishmanial disease. Sand fly blood-feeding behavior will determine the efficacies of indoor residual spraying, topical insecticides, and bed nets. Interventions need to have sufficient coverage to include transmission hot spots, especially in the absence of field tools to assess infectiousness. Interventions that reduce sand fly densities in the absence of elimination could have negative consequences, for example, by interfering with partial immunity conferred by exposure to sand fly saliva. A deeper understanding of both sand fly and host biology and behavior is essential to ensuring effectiveness of vector interventions.

Mesozoic cyclostratigraphy, the 405-kyr orbital eccentricity metronome, and the Astronomical Time Scale (Invited)

NASA Astrophysics Data System (ADS)

Hinnov, L.; Ogg, J. G.

2009-12-01

Mesozoic cyclostratigraphy from around the world is being assessed to construct a continuous Astronomical Time Scale (ATS) based on Earth’s cyclic orbital parameters. The recognition of a prevalent sedimentary cycling with a ~400-kyr period associated with forcing by the stable 405-kyr orbital eccentricity variation is an important development. Numerous formations spanning 10 to 20 myr (and longer) intervals in the Cretaceous, Jurassic and Triassic clearly express this dominant cycle and provide a robust basis for 405-kyr-scale calibration of the ATS. This 405-kyr metronome will enable extension of the well-defined Cenozoic ATS for scaling of the past quarter-billion years of Earth history. This astronomical calibration has a resolution comparable to the 1% to 0.1% precision for radioisotope dating of Mesozoic ash beds, with the added benefit of providing continuous stratigraphic coverage between dated beds. Extended portions of the Mesozoic ATS have already provided new insights into long-standing geologic problems of seafloor spreading, tectonics, eustasy, and paleoclimate change. Ongoing work is focused on closing gaps in coverage and on collecting duplicate cyclostratigraphic records for the entire Mesozoic Era.

Improving malaria treatment and prevention in India by aiding district managers to manage their programmes with local information: a trial assessing the impact of Lot Quality Assurance Sampling on programme outcomes.

PubMed

Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary

2014-10-01

This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Natural Ca Isotope Composition of Urine as a Rapid Measure of Bone Mineral Balance

NASA Astrophysics Data System (ADS)

Skulan, J.; Gordon, G. W.; Morgan, J.; Romaniello, S. J.; Smith, S. M.; Anbar, A. D.

2011-12-01

Naturally occurring stable Ca isotope variations in urine are emerging as a powerful tool to detect changes in bone mineral balance. Bone formation depletes soft tissue of light Ca isotopes while bone resorption releases isotopically light Ca into soft tissue. Previously published work found that variations in Ca isotope composition could be detected at 4 weeks of bed rest in a 90-day bed rest study (data collected at 4, 8 and 12 weeks). A new 30-day bed rest study involved 12 patients on a controlled diet, monitored for 7 days prior to bed rest and 7 days post bed rest. Samples of urine, blood and food were collected throughout the study. Four times daily blood samples and per void urine samples were collected to monitor diurnal or high frequency variations. An improved chemical purification protocol, followed by measurement using multiple collector inductively coupled plasma mass spectrometry (MC-ICP-MS) allowed accurate and precise determinations of mass-dependent Ca isotope variations in these biological samples to better than ±0.2% (δ44/42Ca) on <25 μg of Ca. Results from this new study show that Ca isotope ratios shift in a direction consistent with net bone loss after just 7 days, long before detectible changes in bone density by X-ray measurements occur. Consistent with this interpretation, the Ca isotope variations track changes observed in N-teleopeptide, a bone resorption biomarker. Bone-specific alkaline phosphatase, a bone formation biomarker, is unchanged over this period. Ca isotopes can in principle be used to quantify net changes in bone mass. Using a mass-balance model, our results indicate an average loss of 0.62 ± 0.16 % in bone mass over the course of this 30-day study. This is consistent with the rate of bone loss in longer-term studies as seen by X-ray measurements. This Ca isotope technique should accelerate the pace of discovery of new treatments for bone disease and provide novel insights into the dynamics of bone metabolism.

42 CFR 403.253 - Calculation of benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the gross premiums are computed to provide coverage. (iv) Reserve for future contingent benefits means... the loss ratio calculation period. (iii) Net premium means the level portion of the gross premium used... period, to— (B) The total policy reserve at the last day of the loss ratio calculation period: and (ii...

Mass mosquito trapping for malaria control in western Kenya: study protocol for a stepped wedge cluster-randomised trial.

PubMed

Hiscox, Alexandra; Homan, Tobias; Mweresa, Collins K; Maire, Nicolas; Di Pasquale, Aurelio; Masiga, Daniel; Oria, Prisca A; Alaii, Jane; Leeuwis, Cees; Mukabana, Wolfgang R; Takken, Willem; Smith, Thomas A

2016-07-26

Increasing levels of insecticide resistance as well as outdoor, residual transmission of malaria threaten the efficacy of existing vector control tools used against malaria mosquitoes. The development of odour-baited mosquito traps has led to the possibility of controlling malaria through mass trapping of malaria vectors. Through daily removal trapping against a background of continued bed net use it is anticipated that vector populations could be suppressed to a level where continued transmission of malaria will no longer be possible. A stepped wedge cluster-randomised trial design was used for the implementation of mass mosquito trapping on Rusinga Island, western Kenya (the SolarMal project). Over the course of 2 years (2013-2015) all households on the island were provided with a solar-powered mosquito trapping system. A continuous health and demographic surveillance system combined with parasitological surveys three times a year, successive rounds of mosquito monitoring and regular sociological studies allowed measurement of intervention outcomes before, during and at completion of the rollout of traps. Data collection continued after achieving mass coverage with traps in order to estimate the longer term effectiveness of this novel intervention. Solar energy was exploited to provide electric light and mobile phone charging for each household, and the impacts of these immediate tangible benefits upon acceptability of and adherence to the use of the intervention are being measured. This study will be the first to evaluate whether the principle of solar-powered mass mosquito trapping could be an effective tool for elimination of malaria. If proven to be effective, this novel approach to malaria control would be a valuable addition to the existing strategies of long-lasting insecticide-treated nets and case management. Sociological studies provide a knowledge base for understanding the usage of this novel tool. Trialregister.nl: NTR3496 - SolarMal. Registered on 20 June 2012.

Health reform through tax reform: a primer.

PubMed

Furman, Jason

2008-01-01

Tax incentives for employer-sponsored insurance and other medical spending cost about $200 billion annually and have pervasive effects on coverage and costs. This paper surveys a range of proposals to reform health care, either by adding new tax incentives or by limiting or replacing the existing tax incentives. Replacing the current tax preference for insurance with an income-related, refundable tax credit has the potential to expand coverage and reduce inefficient spending at no net federal cost. But such an approach by itself would entail substantial risks, so complementary reforms to the insurance market are essential to ensure success.

Topical Delivery of Immunosuppression to Prolong Xenogeneic and Allogeneic Split-Thickness Skin Graft Survival.

PubMed

Mastroianni, Melissa; Ng, Zhi Yang; Goyal, Ritu; Mallard, Christopher; Farkash, Evan A; Leonard, David A; Albritton, Alexander; Shanmugarajah, Kumaran; Kurtz, Josef M; Sachs, David H; Macri, Lauren K; Kohn, Joachim; Cetrulo, Curtis L

2017-06-07

Cadaveric skin allograft is the current standard of treatment for temporary coverage of large burn wounds. Porcine xenografts are viable alternatives but undergo α-1,3-galactose (Gal)-mediated hyperacute rejection and are lost by POD 3 because of naturally occurring antibodies to Gal in primate recipients. Using baboons, we previously demonstrated that xenografts from GalT-KO swine (lacking Gal) provided wound coverage comparable with allografts with systemic immunosuppression. In this study, we investigate topical immunosuppression as an alternative to prolong xenograft survival. Full-thickness wounds in baboons were created and covered with xenogeneic and allogeneic split-thickness skin grafts (STSGs). Animals were treated with slow-release (TyroSphere-encapsulated) topical formulations (cyclosporine-A [CSA] or Tacrolimus) applied 1) directly to the STSGs only, or 2) additionally to the wound bed before STSG and 1). Topical CSA did not improve either xenograft or allograft survival (median: treated grafts = 12.5 days, control = 14 days; P = 0.27) with similar results when topical Tacrolimus was used. Pretreatment of wound beds resulted in a significant reduction of xenograft survival compared with controls (10 vs 14 days; P = 0.0002), with comparable results observed in allografts. This observation was associated with marked reduction of inflammation on histology with Tacrolimus and not CSA. Prolongation of allograft and xenograft survival after application to full-thickness wound beds was not achieved with the current formulation of topical immunosuppressants. Modulation of inflammation within the wound bed was effective with Tacrolimus pretreatment before STSG application and may serve as a treatment strategy in related fields.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Focal Radiation Therapy Dose Escalation Improves Overall Survival in Locally Advanced Pancreatic Cancer Patients Receiving Induction Chemotherapy and Consolidative Chemoradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krishnan, Sunil, E-mail: skrishnan@mdanderson.org; Chadha, Awalpreet S.; Suh, Yelin

2016-03-15

Purpose: To review outcomes of locally advanced pancreatic cancer (LAPC) patients treated with dose-escalated intensity modulated radiation therapy (IMRT) with curative intent. Methods and Materials: A total of 200 patients with LAPC were treated with induction chemotherapy followed by chemoradiation between 2006 and 2014. Of these, 47 (24%) having tumors >1 cm from the luminal organs were selected for dose-escalated IMRT (biologically effective dose [BED] >70 Gy) using a simultaneous integrated boost technique, inspiration breath hold, and computed tomographic image guidance. Fractionation was optimized for coverage of gross tumor and luminal organ sparing. A 2- to 5-mm margin around the gross tumor volume wasmore » treated using a simultaneous integrated boost with a microscopic dose. Overall survival (OS), recurrence-free survival (RFS), local-regional and distant RFS, and time to local-regional and distant recurrence, calculated from start of chemoradiation, were the outcomes of interest. Results: Median radiation dose was 50.4 Gy (BED = 59.47 Gy) with a concurrent capecitabine-based (86%) regimen. Patients who received BED >70 Gy had a superior OS (17.8 vs 15.0 months, P=.03), which was preserved throughout the follow-up period, with estimated OS rates at 2 years of 36% versus 19% and at 3 years of 31% versus 9% along with improved local-regional RFS (10.2 vs 6.2 months, P=.05) as compared with those receiving BED ≤70 Gy. Degree of gross tumor volume coverage did not seem to affect outcomes. No additional toxicity was observed in the high-dose group. Higher dose (BED) was the only predictor of improved OS on multivariate analysis. Conclusion: Radiation dose escalation during consolidative chemoradiation therapy after induction chemotherapy for LAPC patients improves OS and local-regional RFS.« less

Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.

PubMed

Edelstein, Burton L

2014-01-01

The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.

Estimating the opportunity costs of bed-days.

PubMed

Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

2018-03-01

Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.

Southern Ocean Seasonal Net Production from Satellite, Atmosphere, and Ocean Data Sets

NASA Technical Reports Server (NTRS)

Keeling, Ralph F.; Campbell, J. (Technical Monitor)

2002-01-01

A new climatology of monthly air-sea O2 flux was developed using the net air-sea heat flux as a template for spatial and temporal interpolation of sparse hydrographic data. The climatology improves upon the previous climatology of Najjar and Keeling in the Southern Hemisphere, where the heat-based approach helps to overcome limitations due to sparse data coverage. The climatology is used to make comparisons with productivity derived from CZCS images. The climatology is also used in support of an investigation of the plausible impact of recent global warming an oceanic O2 inventories.

Prevention of malaria with pyrethroid treated bednets.

PubMed

Curtis, C

1997-01-01

Malaria parasites (Plasmodium) are carried from person to person by female mosquitoes of the genus Anopheles. 80-90% of malaria incidence worldwide occurs in Africa. The main Anopheles species in Africa which bite humans are A. gambiae and A. funestus. Since these animals feed upon humans mainly during late night when most people are in bed, the consistent use of bednets can block the transmission of malaria. However, bednets should be treated with synthetic pyrethroid insecticides, for the physical barrier of bednets is often inadequate to prevent the entry of Anopheles. In addition, the mosquitoes are drawn to the bednets by the carbon dioxide and body odor emitted by the occupant. The insecticide-treated nets therefore double as mosquito traps. Bednets are treated by dipping them into an aqueous emulsion of a pyrethroid, wringing them out, then laying them out to dry. A considerable number of mosquitoes can be killed with a relatively small amount of insecticide. A treated net's insecticidal power can be tested by wrapping part of it around a wire frame, then introducing some Anopheles mosquitoes inside the frame. A median mosquito knockdown time of less than 10 minutes inside the net indicates a good pyrethroid deposit. The persistence of a net's insecticidal power is considerably reduced if the net is vigorously washed. People vary in the frequency they wash their nets. Most villagers in Tanzania were found to wash and retreat their nets every 6 months.

Wealth, mother's education and physical access as determinants of retail sector net use in rural Kenya

PubMed Central

2006-01-01

Background Insecticide-treated bed nets (ITN) provide real hope for the reduction of the malaria burden across Africa. Understanding factors that determine access to ITN is crucial to debates surrounding the optimal delivery systems. The influence of homestead wealth on use of nets purchased from the retail sector is well documented, however, the competing influence of mother's education and physical access to net providers is less well understood. Methods Between December 2004 and January 2005, a random sample of 72 rural communities was selected across four Kenyan districts. Demographic, assets, education and net use data were collected at homestead, mother and child (aged < 5 years) levels. An assets-based wealth index was developed using principal components analysis, travel time to net sources was modelled using geographic information systems, and factors influencing the use of retail sector nets explored using a multivariable logistic regression model. Results Homestead heads and guardians of 3,755 children < 5 years of age were interviewed. Approximately 15% (562) of children slept under a net the night before the interview; 58% (327) of the nets used were purchased from the retail sector. Homestead wealth (adjusted OR = 10.17, 95% CI = 5.45–18.98), travel time to nearest market centres (adjusted OR = 0.51, 95% CI = 0.37–0.72) and mother's education (adjusted OR = 2.92, 95% CI = 1.93–4.41) were significantly associated with use of retail sector nets by children aged less than 5 years. Conclusion Approaches to promoting access to nets through the retail sector disadvantage poor and remote communities where mothers are less well educated. PMID:16436216

Efficacy of permethrin treated long-lasting insecticidal nets on malaria transmission and observations on the perceived side effects, collateral benefits and human safety in a hyperendemic tribal area of Orissa, India.

PubMed

Sharma, Surya K; Tyagi, Prajesh K; Upadhyay, Ashok K; Haque, Mohammed A; Mohanty, Suman S; Raghavendra, Kamaraju; Dash, Aditya P

2009-11-01

Studies were conducted on the efficacy of Olyset nets-a long-lasting insecticidal net (LLIN) factory treated with 2% (w/w) permethrin on malaria transmission in an area under the influence of pyrethroid susceptible vector species Anopheles culicifacies and A. fluviatilis in Sundargarh District, Orissa, India. The study area comprised 22 villages that were randomized into three clusters and designated as Olyset net, untreated net, and no net area. Malaria incidence in the study population was measured through longitudinal active surveillance at fortnightly intervals. There was a reduction of 65-70% in malaria incidence in Olyset net area as compared to the control areas. The attack rate of Plasmodium falciparum or number of episodes per person per year in different age groups also showed significant reduction in Olyset net area as compared to untreated net and no net areas. Cross-sectional point prevalence surveys showed 45.7% reduction of malaria prevalence in Olyset net users, whereas there was an increase of 33.3% and 51% in untreated net and no net villages respectively. The compliance rate of Olyset net usage in the study population was 80-98% during different months, whereas it was between 70% and 90% for untreated nets. There were minimal complains of skin irritation (4%), itching (8%) and eye irritation (1.2%). However, these effects were only transitory in nature lasting for few hours of the first usage. Olyset nets also provided collateral benefits in terms of relief not only from mosquitoes and malaria but also from other household pests such as head lice, bed bugs, cockroaches, ants and houseflies. The Olyset nets were found to be safe to humans as no adverse event was recorded in the net users that can be attributed to the use of net. The study showed that Olyset nets are effective personal protection tool that can be used in a community based intervention programme.

[Effect of comprehensive prevention and control of soil-transmitted nematodiasis in Runzhou District of Zhenjiang City].

PubMed

Xia, Ai; Tao, Heng-Ye; Zhao, Ya-Ming; Jiang, Jun; Wang, Jin; Mei, Jin

2014-12-01

To evaluate the effect of comprehensive prevention and control of soil-transmitted nematodiasis in Runzhou District, Zhenjiang City, Jiangsu Province from 1997 to 2012. The comprehensive prevention and control measures included the helminthicide, health education, improvement of water supplier and harmless toilets, and these measures were implemented continuously. At the same time, the infection rates of soil-transmitted nematodes, the local economic indicators, and the coverage rates of tap water and harmless toilets were surveyed. The mass chemotherapy was performed for 202 100 person-times and the diagnosed chemotherapy was performed for 2 006 person-times in Runzhou District from 1997 to 2012. The awareness rates of health knowledge were 57.18% in 1997, and 95.62% in 2012. The coverage rates of tap water and harmless toilets were 10.14% and 10.21% in 1997, and 100.0% and 90.38% in 2012, respectively. There were negative correlations between the awareness rate of per capita GDP, per capita net income, coverage rates of tap water, coverage rates of harmless toilets, health knowledge and the infection rate of soil-transmitted nematodes, respectively (r(per capitaGDP) = -0.526, P < 0.05; r(per capita net income) = -0.671, P < 0.01; r(coverage rates of tap water) = -0.936, P < 0.01; r(coverage rates of harmless toilets) = -0.922, P < 0.01; r(awareness) = -0.774, P < 0.01). The statistical analysis showed that the infection rate of soil-transmitted nematodes had a downward trend as an exponential curve in Runzhou District from 1997 to 2012 (y = 42.031 7e(-0.357 6x), R2 = 0.803 6, F = 57.28, P = 0.000). The infection rate of degradation by an annual rate was 29.18%. The infection rate in farmers was significantly higher than that in students (χ2 = 17.998, P < 0.01). There was no significant difference between men and women in the infection rate of soil-transmitted nematodes (χ2 = 3.627, P = 0.057). The comprehensive prevention and control measures and the development of social economy contribute to the steady decline of soil-transmitted nematode infections.

Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya.

PubMed

Chuma, Jane; Okungu, Vincent; Ntwiga, Janet; Molyneux, Catherine

2010-03-16

Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs) in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households), 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Significant resources have been directed towards addressing affordability barriers through providing free ITNs to vulnerable groups, but the success of these interventions depends largely on the degree to which other barriers to access are addressed. Only if additional efforts are directed towards addressing non-financial barriers to access, will high coverage levels be achieved and sustained.

Streambed Mobility and Dispersal of Aquatic Insect Larvae: Results from a Laboratory Study.

NASA Astrophysics Data System (ADS)

Kenworthy, S. T.

2002-12-01

Three series of flume experiments were conducted to quantify relationships between entrainment of surface layer gravels and displacement of benthic insect larvae. One series (B) utilized a sediment mixture with a median size 6.9 mm, maximum size 45 mm, and 10% < 2mm. Two other series examined the effects of locally coarsening the bed surface (Bc) and increasing the < 2mm fraction to 20% (S). Aquatic insect larvae were collected in the field and placed in an upstream segment of the flume bed. Flow rate, flume slope, and sediment transport rate were varied systematically among experiments. Displaced larvae were collected in a net at the end of the flume. The distribution of larvae remaining in the bed was obtained by sorting larvae from the sediment in 25 channel segments. Flow rate and mean boundary shear stress varied among runs by factors of 1.2 and 2.4 respectively. Proportional entrainment of >11mm surface grains ranged from <0.05 to >0.90. Displacement of insect larvae increased in a regular and consistent manner with increasing flow strength and surface sediment entrainment. Significant displacement occurred for some types of larvae (Ephemerellid mayflies) over a relatively low range of shear stress and bed surface entrainment. Other larvae (Atherix sp.) were displaced only at the highest levels of bed surface entrainment. Displacement was lower from coarsened bed surfaces in series Bc, and higher from sandier sediments in series S experiments. The differential effects of bed surface entrainment upon various types of larvae are consistent with anatomical and behavioral differences that influence exposure to near-bed flow and bedload transport. These results suggest that spatial patterns of sediment mobilization are important for understanding patterns of dispersal and disturbance of streambed communities.

Marine bacterial degradation of brominated methanes

USGS Publications Warehouse

Goodwin, K.D.; Lidstrom, M.E.; Oremland, R.S.

1997-01-01

Brominated methanes are ozone-depleting compounds whose natural sources include marine algae such as kelp. Brominated methane degradation by bacteria was investigated to address whether bacterial processes might effect net emission of these compounds to the atmosphere. Bacteria in seawater collected from California kelp beds degraded CH2Br2 but not CHBr3. Specific inhibitors showed that methanotrophs and nitrifiers did not significantly contribute to CH2Br2 removal. A seawater enrichment culture oxidized 14CH2Br2 to 14CO2 as well as 14CH3Br to 14CO2. The rates of CH2Br2 degradation in laboratory experiments suggest that bacterial degradation of CH2Br2 in a kelp bed accounts for <1% of the CH2Br2 produced by the kelp. However, the half-life of CH2Br2 due to bacterial removal appears faster than hydrolysis and within an order of magnitude of volatilization to the atmosphere.Brominated methanes are ozone-depleting compounds whose natural sources include marine algae such as kelp. Brominated methane degradation by bacteria was investigated to address whether bacterial processes might effect net emission of these compounds to the atmosphere. Bacteria in seawater collected from California kelp beds degraded CH2Br2 but not CHBr3. Specific inhibitors showed that methanotrophs and nitrifiers did not significantly contribute to CH2Br2 removal. A seawater enrichment culture oxidized 14CH2Br2 to 14CO2 as well as 14CH3Br to 14CO2. The rates of CH2Br2 degradation in laboratory experiments suggest that bacterial degradation of CH2Br2 in a kelp bed accounts for <1% of the CH2Br2 produced by the kelp. However, the half-life of CH2Br2 due to bacterial removal appears faster than hydrolysis and within an order of magnitude of volatilization to the atmosphere.

A comparison of jump height, takeoff velocities, and blocking coverage in the swing and traditional volleyball blocking techniques.

PubMed

Ficklin, Travis; Lund, Robin; Schipper, Megan

2014-01-01

The purpose of this study was to compare traditional and swing blocking techniques on center of mass (COM) projectile motion and effective blocking area in nine healthy Division I female volleyball players. Two high-definition (1080 p) video cameras (60 Hz) were used to collect two-dimensional variables from two separate views. One was placed perpendicular to the plane of the net and the other was directed along the top of the net, and were used to estimate COM locations and blocking area in a plane parallel to the net and hand penetration through the plane of the net respectively. Video of both the traditional and swing techniques were digitized and kinematic variables were calculated. Paired samples t-tests indicated that the swing technique resulted in greater (p < 0.05) vertical and horizontal takeoff velocities (vy and vx), jump height (H), duration of the block (tBLOCK), blocking coverage during the block (C) as well as hand penetration above and through the net's plane (YPEN, ZPEN). The traditional technique had significantly greater approach time (tAPP). The results of this study suggest that the swing technique results in both greater jump height and effective blocking area. However, the shorter tAPP that occurs with swing is associated with longer times in the air during the block which may reduce the ability of the athlete to make adjustments to attacks designed to misdirect the defense. Key PointsSwing blocking technique has greater jump height, effective blocking area, hand penetration, horizontal and vertical takeoff velocity, and has a shorter time of approach.Despite these advantages, there may be more potential for mistiming blocks and having erratic deflections of the ball after contact when using the swing technique.Coaches should take more than simple jump height and hand penetration into account when deciding which technique to employ.

Markers of bone resorption and calcium metabolism are related to dietary intake patterns in male and female bed rest subjects

NASA Technical Reports Server (NTRS)

Smith, Scott M.; Zwart, S. R.; Hargens, A. r.

2006-01-01

Dietary potassium and protein intakes predict net endogenous acid production in humans. Intracellular buffers, including exchangeable bone mineral, play a crucial role in balancing chronic acid-base perturbations in the body; subsequently, chronic acid loads can potentially contribute to bone loss. Bone is lost during space flight, and a dietary countermeasure would be desirable for many reasons. We studied the ability of diet protein and potassium to predict levels of bone resorption markers in males and females. Identical twin pairs (8 M, 7 F) were assigned to 2 groups: bed rest (sedentary, SED) or bed rest with supine treadmill exercise in a lower body negative pressure chamber (EX). Diet was controlled for 3 d before and 30 d of bed rest (BR). Urinary Ca, N-telopeptide (NTX), and pyridinium crosslinks (PYD) were measured before and on days 5, 12, 19, and 26 of BR. Data were analyzed by Pearson correlation (P<0.05). The ratio of dietary animal protein/potassium intake was not correlated with NTX before BR for males or females, but they were positively correlated in both groups of males during bed rest. Dietary animal protein/potassium and urine Ca were correlated before and during bed rest for the males, and only during bed rest for the females. Conversely, the ratio of dietary vegetable protein/potassium intake was negatively correlated with urinary calcium during bed rest for the females, but there was no relationship between vegetable protein/potassium intake and bone markers for the males. These data suggest that the ratio of animal protein/potassium intake may affect bone, particularly in bed rest subjects. These data show that the type of protein and gender may be additional factors that modulate the effect of diet on bone metabolism during bed rest. Altering this ratio may help prevent bone loss on Earth and during space flight.

Human Resources for Treating HIV/AIDS: Are the Preventive Effects of Antiretroviral Treatment a Game Changer?

PubMed

Bärnighausen, Till; Bloom, David E; Humair, Salal

2016-01-01

Shortages of human resources for treating HIV/AIDS (HRHA) are a fundamental barrier to reaching universal antiretroviral treatment (ART) coverage in developing countries. Previous studies suggest that recruiting HRHA to attain universal ART coverage poses an insurmountable challenge as ART significantly increases survival among HIV-infected individuals. While new evidence about ART's prevention benefits suggests fewer infections may mitigate the challenge, new policies such as treatment-as-prevention (TasP) will exacerbate it. We develop a mathematical model to analytically study the net effects of these countervailing factors. Using South Africa as a case study, we find that contrary to previous results, universal ART coverage is achievable even with current HRHA numbers. However, larger health gains are possible through a surge-capacity policy that aggressively recruits HRHA to reach universal ART coverage quickly. Without such a policy, TasP roll-out can increase health losses by crowding out sicker patients from treatment, unless a surge capacity exclusively for TasP is also created.

Human Resources for Treating HIV/AIDS: Are the Preventive Effects of Antiretroviral Treatment a Game Changer?

PubMed Central

2016-01-01

Shortages of human resources for treating HIV/AIDS (HRHA) are a fundamental barrier to reaching universal antiretroviral treatment (ART) coverage in developing countries. Previous studies suggest that recruiting HRHA to attain universal ART coverage poses an insurmountable challenge as ART significantly increases survival among HIV-infected individuals. While new evidence about ART’s prevention benefits suggests fewer infections may mitigate the challenge, new policies such as treatment-as-prevention (TasP) will exacerbate it. We develop a mathematical model to analytically study the net effects of these countervailing factors. Using South Africa as a case study, we find that contrary to previous results, universal ART coverage is achievable even with current HRHA numbers. However, larger health gains are possible through a surge-capacity policy that aggressively recruits HRHA to reach universal ART coverage quickly. Without such a policy, TasP roll-out can increase health losses by crowding out sicker patients from treatment, unless a surge capacity exclusively for TasP is also created. PMID:27716813

The combined use of NPWT and instillation using an octenidine based wound rinsing solution: a case study.

PubMed

Matiasek, J; Djedovic, G; Mattesich, M; Morandi, E; Pauzenberger, R; Pikula, R; Verstappen, R; Pierer, G; Koller, R; Rieger, U M

2014-11-01

Effective wound bed preparation is an essential element in the healing of chronic wounds, including pressure ulcers (PUs). Negative pressure wound therapy (NPWT) reduces oedema, stimulates the formation of granulation tissue and helps remove wound exudate. This helps prepare the wound bed for secondary healing, skin grafting or coverage with flaps. Combining NPWT with an instillation phase using an antiseptic (octenidine based) irrigation solution is a novel approach to PU management. Three patients with Category 4 gluteal PUs were treated with NPWT and instillation fluid, following surgical debridement of necrotic tissue. The aim was to achieve optimal wound bed preparation prior to wound closure by local fasciocutaneous flap. The antiseptic efficacy of octenilin wound irrigation solution in microorganism eradication was quantified by in vitro tests simulating real conditions using leg ulcer vacuum exudates. All wounds completely healed after four weeks, and no adverse incidents occurred due to instillation of octenidine. No recurrence of the PU occurred during a one year follow-up.

Nitrogen cycling processes and microbial community composition in bed sediments in the Yukon River at Pilot Station

USGS Publications Warehouse

Repert, Deborah A.; Underwood, Jennifer C.; Smith, Richard L.; Song, Bongkeun

2014-01-01

Information on the contribution of nitrogen (N)-cycling processes in bed sediments to river nutrient fluxes in large northern latitude river systems is limited. This study examined the relationship between N-cycling processes in bed sediments and N speciation and loading in the Yukon River near its mouth at the Bering Sea. We conducted laboratory bioassays to measure N-cycling processes in sediment samples collected over distinct water cycle seasons. In conjunction, the microbial community composition in the bed sediments using genes involved in N-cycling (narG, napA, nosZ, and amoA) and 16S rRNA gene pyrosequences was examined. Temporal variation was observed in net N mineralization, nitrate uptake, and denitrification rate potentials and correlated strongly with sediment carbon (C) and extractable N content and microbial community composition rather than with river water nutrient concentrations. The C content of the bed sediment was notably impacted by the spring flood, ranging from 1.1% in the midst of an ice-jam to 0.1% immediately after ice-out, suggesting a buildup of organic material (OM) prior to scouring of the bed sediments during ice break up. The dominant members of the microbial community that explained differences in N-processing rates belonged to the genera Crenothrix,Flavobacterium, and the family of Comamonadaceae. Our results suggest that biogeochemical processing rates in the bed sediments appear to be more coupled to hydrology, nutrient availability in the sediments, and microbial community composition rather than river nutrient concentrations at Pilot Station.

RIPGIS-NET: a GIS tool for riparian groundwater evapotranspiration in MODFLOW.

PubMed

Ajami, Hoori; Maddock, Thomas; Meixner, Thomas; Hogan, James F; Guertin, D Phillip

2012-01-01

RIPGIS-NET, an Environmental System Research Institute (ESRI's) ArcGIS 9.2/9.3 custom application, was developed to derive parameters and visualize results of spatially explicit riparian groundwater evapotranspiration (ETg), evapotranspiration from saturated zone, in groundwater flow models for ecohydrology, riparian ecosystem management, and stream restoration. Specifically RIPGIS-NET works with riparian evapotranspiration (RIP-ET), a modeling package that works with the MODFLOW groundwater flow model. RIP-ET improves ETg simulations by using a set of eco-physiologically based ETg curves for plant functional subgroups (PFSGs), and separates ground evaporation and plant transpiration processes from the water table. The RIPGIS-NET program was developed in Visual Basic 2005, .NET framework 2.0, and runs in ArcMap 9.2 and 9.3 applications. RIPGIS-NET, a pre- and post-processor for RIP-ET, incorporates spatial variability of riparian vegetation and land surface elevation into ETg estimation in MODFLOW groundwater models. RIPGIS-NET derives RIP-ET input parameters including PFSG evapotranspiration curve parameters, fractional coverage areas of each PFSG in a MODFLOW cell, and average surface elevation per riparian vegetation polygon using a digital elevation model. RIPGIS-NET also provides visualization tools for modelers to create head maps, depth to water table (DTWT) maps, and plot DTWT for a PFSG in a polygon in the Geographic Information System based on MODFLOW simulation results. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.

Health and agricultural productivity: Evidence from Zambia.

PubMed

Fink, Günther; Masiye, Felix

2015-07-01

We evaluate the productivity effects of investment in preventive health technology through a randomized controlled trial in rural Zambia. In the experiment, access to subsidized bed nets was randomly assigned at the community level; 516 farmers were followed over a one-year farming period. We find large positive effects of preventative health investment on productivity: among farmers provided with access to free nets, harvest value increased by US$ 76, corresponding to about 14.7% of the average output value. While only limited information was collected on farming inputs, shifts in the extensive and the intensive margins of labor supply appear to be the most likely mechanism underlying the productivity improvements observed. Copyright © 2015 Elsevier B.V. All rights reserved.

Beryllium-7 as a tracer of short-term sediment deposition and resuspension in the Fox River Wisconsin

USGS Publications Warehouse

Fitzgerald, S.A.; Klump, J.V.; Swarzenski, P.W.; Mackenzie, R.A.; Richards, K.D.

2001-01-01

Short-term (???monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryilium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to ???0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into "new" and "residual" components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to ???0.5 cm of sediment depth, and ???6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to ???130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.Short-term (approximately monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryllium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to approximately 0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into `new' and `residual' components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to approximately 0.5 cm of sediment depth, and approximately 6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to approximately 130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.

A malaria risk map of Kinshasa, Democratic Republic of Congo.

PubMed

Ferrari, Giovanfrancesco; Ntuku, Henry M; Schmidlin, Sandro; Diboulo, Eric; Tshefu, Antoinette K; Lengeler, Christian

2016-01-13

In Kinshasa, malaria remains a major public health problem but its spatial epidemiology has not been assessed for decades now. The city's growth and transformation, as well as recent control measures, call for an update. To identify highly exposed communities and areas where control measures are less critically needed, detailed risk maps are required to target control and optimize resource allocation. In 2009 (end of the dry season) and 2011 (end of the rainy season), two cross-sectional surveys were conducted in Kinshasa to determine malaria prevalence, anaemia, history of fever, bed net ownership and use among children 6-59 months. Geo-referenced data for key parameters were mapped at the level of the health area (HA) by means of a geographic information system (GIS). Among 7517 children aged 6-59 months from 33 health zones (HZs), 6661 (3319 in 2009 and 3342 in 2011) were tested for both malaria (by Rapid Diagnostic Tests) and anaemia, and 856 (845 in 2009 and 11 in 2011) were tested for anaemia only. Fifteen HZs were sampled in 2009, 25 in 2011, with seven HZs sampled in both surveys. Mean prevalence for malaria and anaemia was 6.4% (5.6-7.4) and 65.1% (63.7-66.6) in 2009, and 17.0% (15.7-18.3) and 64.2% (62.6-65.9) in 2011. In two HZs sampled in both surveys, malaria prevalence was 14.1 % and 26.8% in Selembao (peri-urban), in the 2009 dry season and 2011 rainy season respectively, and it was 1.0 % and 0.8% in Ngiri Ngiri (urban). History of fever during the preceding two weeks was 13.2% (12.5-14.3) and 22.3% (20.8-23.4) in 2009 and 2011. Household ownership of at least one insecticide-treated net (ITN) was 78.7% (77.4-80.0) and 65.0% (63.7-66.3) at both time points, while use was 57.7% (56.0-59.9) and 45.0% (43.6-46.8), respectively. This study presents the first malaria risk map of Kinshasa, a mega city of roughly 10 million inhabitants and located in a highly endemic malaria zone. Prevalence of malaria, anaemia and reported fever was lower in urban areas, whereas low coverage of ITN and sub-optimal net use were frequent in peri-urban areas.

Weathering Natural Disasters with a Net of Safety

ERIC Educational Resources Information Center

Berson, Ilene R.; Berson, Michael J.

2008-01-01

Faster and more efficient coverage on television and the Internet is increasingly exposing children to traumatic images of natural devastation both at home and abroad. Natural disasters, such as the wildfires in California or the trauma caused by Hurricane Katrina in New Orleans, have become commonplace. Catastrophic events like these serve as…

75 FR 31419 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... Person Interview (PI) and CCM PFU have been added. These are to be conducted as part of a CCM evaluation... CCM PI OMB package. The CCM program will provide estimates of net coverage error and components of... (PI) and CCM PFU will be conducted. The purpose of the respondent debriefings is to obtain a...

Costs and effects of the Tanzanian national voucher scheme for insecticide-treated nets

PubMed Central

Mulligan, Jo-Ann; Yukich, Joshua; Hanson, Kara

2008-01-01

Background The cost-effectiveness of insecticide-treated nets (ITNs) in reducing morbidity and mortality is well established. International focus has now moved on to how best to scale up coverage and what financing mechanisms might be used to achieve this. The approach in Tanzania has been to deliver a targeted subsidy for those most vulnerable to the effects of malaria while at the same time providing support to the development of the commercial ITN distribution system. In October 2004, with funds from the Global Fund to Fight AIDS Tuberculosis and Malaria, the government launched the Tanzania National Voucher Scheme (TNVS), a nationwide discounted voucher scheme for ITNs for pregnant women and their infants. This paper analyses the costs and effects of the scheme and compares it with other approaches to distribution. Methods Economic costs were estimated using the ingredients approach whereby all resources required in the delivery of the intervention (including the user contribution) are quantified and valued. Effects were measured in terms of number of vouchers used (and therefore nets delivered) and treated nets years. Estimates were also made for the cost per malaria case and death averted. Results and Conclusion The total financial cost of the programme represents around 5% of the Ministry of Health's total budget. The average economic cost of delivering an ITN using the voucher scheme, including the user contribution, was $7.57. The cost-effectiveness results are within the benchmarks set by other malaria prevention studies. The Government of Tanzania's approach to scaling up ITNs uses both the public and private sectors in order to achieve and sustain the level of coverage required to meet the Abuja targets. The results presented here suggest that the TNVS is a cost-effective strategy for delivering subsidized ITNs to targeted vulnerable groups. PMID:18279509

Effects of dietary coarsely ground corn and 3 bedding floor types on broiler live performance, litter characteristics, gizzard and proventriculus weight, and nutrient digestibility.

PubMed

Xu, Y; Lin, Y M; Stark, C R; Ferket, P R; Williams, C M; Brake, J

2017-07-01

The effects of zero or 50% dietary coarsely ground corn (CC) in pelleted and screened grower and finisher diets on broilers reared on 3 bedding floor types (plastic net [NET], new pine wood shavings litter [NEW], or old pine wood shavings litter [OLD]) on broiler live performance, litter characteristics, gizzard and proventriculus weight, and apparent ileal digestibility (AID) were studied in a 2 × 3 factorial arrangement of treatments. Fine corn was produced with a hammermill (271 μm) and CC with a roller mill (1145 μm). Utilization of CC reduced milling cost by 9.47 cents per MT with similar nutrient content of screened pellets. The 50% CC treatment exhibited improved (P ≤ 0.05) feed intake at 42 d (2.5%) and 49 d (3.0%), and BW (5.4%) and FCR from 28 d (1.4%). Birds on NEW litter exhibited improved (P < 0.05) BW at 28 and 35 d and 42 d FCR as compared to NET and 49 d FCR compared to NET and OLD. The 50% CC treatment exhibited increased (P < 0.05) gizzard weight but decreased proventriculus weight at 49 d. NEW litter birds exhibited increased (P ≤ 0.05) gizzard weight at 28 d and 49 d and decreased proventriculus weight as compared to NET at 49 days. The 50% CC treatment exhibited decreased (P ≤ 0.05) litter moisture at 35 and 42 d, litter N at 35 and 49 d, and litter pH at 49 days. OLD litter birds exhibited greater (P < 0.05) litter N at 14, 35, and 49 d, as well as litter moisture, pH, and ammonia concentration at 49 days. The 50% CC group also exhibited improved AID of nitrogen (P < 0.05). Broilers fed pelleted and screened diets containing 50% CC exhibited improved live performance and reduced litter moisture while use of NEW litter resulted in a somewhat similar effect, which indicated that consumption of NEW litter also facilitated gastric development and function. © 2017 Poultry Science Association Inc.

"It is about how the net looks": a qualitative study of perceptions and practices related to mosquito net care and repair in two districts in eastern Uganda.

PubMed

Scandurra, Leah; Acosta, Angela; Koenker, Hannah; Kibuuka, Daniel Musoke; Harvey, Steven

2014-12-17

Prolonging net durability has important implications for reducing both malaria transmission and the frequency of net replacement. Protective behaviour, such as net care and repair, offers promise for improving net integrity and durability. Given the potential cost-savings and public health benefit associated with extending the useful life of long-lasting insecticidal nets (LLINs), prevention and mitigation of damage will become ever more critical to ensuring adequate net coverage at the population level. A qualitative assessment was conducted in two districts in central eastern Uganda in September 2013. Data on household net care and repair behaviour, attitudes and practices were collected from 30 respondents through in-depth interviews (IDIs), observations, photos, and video to gather an in-depth understanding of these behaviours. Net damage was common and the most cited causes were children and rodents. Responses revealed strong social norms about net cleanliness and aesthetics, and strong expectations that others should care for and repair their own nets. Respondents were receptive and able to repair nets, though longer-term repair methods, such as sewing and patching, were not as commonly reported or observed. Self-reported behaviour was not always consistent with observed or demonstrated behaviour, revealing potential misconceptions and the need for clear and consistent net care and repair messaging. Respondents considered both aesthetics and malaria protection important when deciding whether, when, and how to care for and repair nets. BCC should continue to emphasize the importance of maintaining net integrity for malaria prevention purposes as well as for maintaining aesthetic appeal. Additional research is needed, particularly surrounding washing, drying, daily storage routines, and gender roles in care and repair, in order to understand the complexity of these behaviours, and refine existing or develop new behaviour change communication (BCC) messages for net care and repair.

Prevention of malaria in Afghanistan through social marketing of insecticide-treated nets: evaluation of coverage and effectiveness by cross-sectional surveys and passive surveillance.

PubMed

Rowland, Mark; Webster, Jayne; Saleh, Padshah; Chandramohan, Daniel; Freeman, Tim; Pearcy, Barbara; Durrani, Naeem; Rab, Abdur; Mohammed, Nasir

2002-10-01

Malaria is often a major health problem in countries undergoing war or conflict owing to breakdown of health systems, displacement of vulnerable populations, and the increased risk of epidemics. After 23 years of conflict, malaria has become prevalent in many rural areas of Afghanistan. From 1993 to the present, a network of non-governmental organizations, co-ordinated by HealthNet International, has operated a programme of bednet sales and re-treatment in lowland areas. To examine whether a strategy based on insecticide-treated nets (ITN) is a viable public health solution to malaria, communities were given the opportunity to buy nets and then monitored to determine population coverage and disease control impact. This was carried out using two contrasting methods: cross-sectional surveys and passive surveillance from clinics using a case-control design. Nets were purchased by 59% of families. Cross-sectional surveys demonstrated a 59% reduction in the risk of Plasmodium falciparum infection among ITN users compared with non-users (OR 0.41; 95% CI 0.25-0.66). The passive surveillance method showed a comparable reduction in the risk of symptomatic P. falciparum malaria among ITN users (OR 0.31; 95% CI 0.21-0.47). The cross-sectional method showed a 50% reduction in risk of P. vivax infection in ITN users compared with non-users (OR 0.50; 95% CI 0.17-1.49) but this effect was not statistically significant. The passive surveillance method showed a 25% reduction in the risk of symptomatic P. vivax malaria (OR 0.75; 95% CI 0.66-0.85). ITN appeared to be less effective against P. vivax because of relapsing infections; hence an effect took more than one season to become apparent. Passive surveillance was cheaper to perform and gave results consistent with cross-sectional surveys. Untreated nets provided some protection. Data on socioeconomic status, a potential confounding factor, was not collected. However, at the time of net sales, there was no difference in malaria prevalence between buyers and non-buyers. The abundance of Anopheles stephensi, the main vector, did not appear to be affected by ITN. ITN constitute one of the few feasible options for protection against malaria in chronic emergencies.

Flow over gravel beds with clusters

NASA Astrophysics Data System (ADS)

Little, M.; Venditti, J. G.

2014-12-01

The structure of a gravel bed has been shown to alter the entrainment threshold. Structures such as clusters, reticulate stone cells and other discrete structures lock grains together, making it more difficult for them to be mobilized. These structures also generate form drag, reducing the shear stress available for mobilization. Form drag over gravel beds is often assumed to be negligible, but this assumption is not well supported. Here, we explore how cluster density and arrangement affect flow resistance and the flow structure over a fixed gravel bed in a flume experiment. Cluster density was varied from 6 to 68.3 clusters per square meter which corresponds to areal bed coverages of 2 to 17%. We used regular, irregular and random arrangements of the clusters. Our results show that flow resistance over a planar gravel bed initially declines, then increases with flow depth. The addition of clusters increases flow resistance, but the effect is dependent on cluster density, flow depth and arrangement. At the highest density, clusters can increase flow resistance as by as much as 8 times when compared to flat planar bed with no grain-related form drag. Spatially resolved observations of flow over the clusters indicate that a well-defined wake forms in the lee of each cluster. At low cluster density, the wakes are isolated and weak. As cluster density increases, the wakes become stronger. At the highest density, the wakes interact and the within cluster flow field detaches from the overlying flow. This generates a distinct shear layer at the height of the clusters. In spite of this change in the flow field at high density, our results suggest that flow resistance simply increases with cluster density. Our results suggest that the form drag associated with a gravel bed can be substantial and that it depends on the arrangement of the grains on the bed.

Are Latino immigrants a burden to safety net services in nontraditional immigrant states? Lessons from Oregon.

PubMed

López-Cevallos, Daniel

2014-05-01

The significant growth of the Latino population in the midst of an economic recession has invigorated anti-Latino, anti-immigrant sentiments in many US states. One common misconception is that Latino immigrants are a burden to safety net services. This may be particularly true in nontraditional immigrant states that have not historically served Latino immigrants. Oregon data suggest that despite a higher prevalence of poverty, use of safety net services among Latino immigrants in Oregon is lower than that among non-Latino Whites. Immigration status, costs, lack of insurance coverage, and discrimination are among the reasons for this group's limited use of services. Nevertheless, policies designed to strengthen community and institutional support for Latino immigrant families should be considered in the context of current health care and immigration reform efforts.

Are Latino Immigrants a Burden to Safety Net Services in Nontraditional Immigrant States? Lessons From Oregon

PubMed Central

2014-01-01

The significant growth of the Latino population in the midst of an economic recession has invigorated anti-Latino, anti-immigrant sentiments in many US states. One common misconception is that Latino immigrants are a burden to safety net services. This may be particularly true in nontraditional immigrant states that have not historically served Latino immigrants. Oregon data suggest that despite a higher prevalence of poverty, use of safety net services among Latino immigrants in Oregon is lower than that among non-Latino Whites. Immigration status, costs, lack of insurance coverage, and discrimination are among the reasons for this group’s limited use of services. Nevertheless, policies designed to strengthen community and institutional support for Latino immigrant families should be considered in the context of current health care and immigration reform efforts. PMID:24625168

Measurement of coarse gravel and cobble transport using portable bedload traps

Treesearch

Kristin Bunte; Steven R. Abt; John P. Potyondy; Sandra E. Ryan

2004-01-01

Portable bedload traps (0.3 by 0.2 m opening) were developed for sampling coarse bedload transport in mountain gravel-bed rivers during wadable high flows. The 0.9 m long trailing net can capture about 20 kg of gravel and cobbles. Traps are positioned on ground plates anchored in the streambed to minimize disturbance of the streambed during sampling. This design...

Community participation for malaria elimination in Tafea Province, Vanuatu: Part I. Maintaining motivation for prevention practices in the context of disappearing disease.

PubMed

Atkinson, Jo-An M; Fitzgerald, Lisa; Toaliu, Hilson; Taleo, George; Tynan, Anna; Whittaker, Maxine; Riley, Ian; Vallely, Andrew

2010-04-12

In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination.

Community participation for malaria elimination in Tafea Province, Vanuatu: Part I. Maintaining motivation for prevention practices in the context of disappearing disease

PubMed Central

2010-01-01

Background In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Method Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. Results The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. Conclusion In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination. PMID:20380748

[Psychiatric residential care facilities in the Puglia region. Phase 1 results of the PROGRES project].

PubMed

Germinario, Cinzia; Semisa, Domenico; Picoco, Fulvio; Prato, Rosa; Lopalco, Pietro Luigi; Quarto, Michele

2004-01-01

One of the more important aspects of the psychiatric care reform in Italy has been the opening of a great number of psychiatric Non-Hospital Residential Facilities (NHRF). However, 22 years have elapsed since the reform and there are still very scarce data regarding such facilities, the type of patients being accomodated, and the types of treatments provided. The "PROGRES" (PROGetto RESidenze - Residential Project) project is the first national study regarding NHRFs ever carried out in Italy. The objectives of "PROGRES" are to make a survey of all NHRFs in Italy (Phase 1) and to perform a detailed assessment of 20% of the surveyed facilities and of the type of patients being treated (Phase 2). This paper reports the survey (Phase 1) results for the Puglia Region. As of March 31, 2003, 113 psychiatric residential facilities were present in Puglia, with a total of 1.479 beds. This results in an average of 13,08 beds per facility and a rate of 3,86 beds per 10.000 inhabitants. The number of NHRFs present in the territory of each Local Health Unit in Puglia is very variable. Most NHRFs (57%) opened after January 1997. Eighty-three percent have a 24-hour staff coverage while only 5,3% has a 2-hour staff coverage. Eighty five percent of the residential facilities are financed by the Italian National Healthcare System, while a small percentage is privately funded. In over half (69,93%) of the NHRFs the predominant patient age group is 40-59 years; 26,4% of the residential facilities accommodate patients below age 40 and only 3,53% accommodate patients over 60 years old.

Adoption of intensive care unit telemedicine in the United States

PubMed Central

Kahn, Jeremy M.; Cicero, Brandon D.; Wallace, David J.; Iwashyna, Theodore J.

2013-01-01

Objective Intensive care unit (ICU) telemedicine is a novel approach for providing critical care services from a distance. We sought to study the extent of use and patterns of adoption of this technology in United States ICUs. Design Retrospective study combining a systematic listing of ICU telemedicine installations with hospital characteristic data from the Centers for Medicare and Medicaid Services. We examined adoption over time and compared hospital characteristics between facilities that have adopted ICU telemedicine and those that have not. Setting United States hospitals from 2003 to 2010. Measurements and main results The number of hospitals using ICU telemedicine increased from 16 (0.4% of total) to 213 (4.6% of total) between 2003 and 2010. The number of ICU beds covered by telemedicine increased from 598 (0.9% of total) to 5,799 (7.9% of total). The average annual rate of ICU bed coverage growth was 101% per year in the first four study years but slowed to 8.1% per year over the last four study years (p<0.001 for difference in linear trend). Compared to non-adopting hospitals, hospitals adopting ICU telemedicine were more likely to be large (percentage with >400 beds: 11.1% vs. 3.7%, p<0.001), teaching (percentage with resident coverage: 31.4% vs. 21.9%, p=0.003) and urban (percentage located in metropolitan statistical areas with over one million residents: 45.3% vs. 30.1%, p<0.001). Conclusions ICU telemedicine adoption was initially rapid but recently slowed. Efforts are needed to uncover the barriers to future growth, particularly regarding the optimal strategy for using this technology most effectively and efficiently. PMID:24145839

Land status and federal mineral ownership in the Powder River basin, Wyoming and Montana; a digital data set for geographic information systems

USGS Publications Warehouse

Biewick, Laura; Urbanowski, Shayne R.; Cain, Sheila; Neasloney, Larry

1998-01-01

As the Nation's energy resources continue to be examined for development, it is critical that a digital database exist that contains location data for all Federal land and mineral resources. The U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management (BLM), is collecting these ownership files and compiling them in Environmental Systems Research Institute, Inc. (ESRI) ARC/INFO coverages, to form a standardized data library. A coverage is a digital version of a map in the form of vector data storage. These coverages are combined with models of coal deposits from the USGS National Coal Resource Assessment project, a five-year effort to identify and characterize the coal beds and coal zones that will provide fuel for the Nation’s energy needs during the first quarter of the twenty-first century. Geographic and geologic data layers are integrated in a Geographic Information System (GIS) to answer complex geo-spatial questions concerning coal resource occurrence.

Northern Cascadia Subduction Zone Earthquake Records from Onshore and Offshore Core Data

NASA Astrophysics Data System (ADS)

Hausmann, R. B.; Goldfinger, C.; Black, B.; Romsos, C. G.; Galer, S.; Collins, T.

2016-12-01

We are investigating the paleoseismic record at Bull Run Lake, at the latitude of Portland, Oregon, central Cascadia margin. Bull Run is a landslide dammed lake in a cirque basin on the western flanks of Mt. Hood, 65 km east of Portland, and is the City of Portland's primary water supply. We collected full coverage high-resolution multibeam and backscatter data, high resolution CHIRP sub-bottom profiles, and seven sediment cores which contain a correlative turbidite sequence of post Mazama beds. The continuity of the turbidite record shows little or no relationship to the minor stream inlets, suggesting the disturbance beds are not likely to be storm related. CT and physical property data were used to separate major visible beds and background sedimentation, which also contain thin laminae. The XRF element Compton scattering may show grading due to mineralogical variation and a change in wave profile, commonly found at bed boundaries. We have identified 27 post -Mazama event beds and 5 ashes in the lake, and constructed an OxCal age model anchored by radiocarbon ages, the Mazama ash, and the twin Timberline ash beds. The radiocarbon ages, age model results, as well as electron microprobe (EMP) data clearly identify the Mazama ash at the base of our cores. Two closely-spaced ash beds in our cores likely correlate to the Timberline eruptive period at 1.5ka. The number, timing and sequence of the event beds, and physical property log correlation, as well as key bed characteristics, closely matches offshore turbidite sequences off northern Oregon. For example, key regional bed T11, observed as a thick two-pulse bed in all offshore cores, also anchors the Bull Run sequence. One difference is that the twin Timberline ash occupies the stratigraphic position of regional offshore paleoseismic bed T4, which is also a two pulse event at this latitude. The cores also contain many faint laminae that may contain a storm record, however, the identification of small beds is complicated by the low sedimentation rate and low resolution of the Bull Run cores. The watershed and lake may also contain evidence of crustal faulting, though the event sequence appears to be primarily that of the Cascadia subduction zone earthquake sequence. See also Goldfinger et al. for investigation of slope stability and ground motions at Bull Run and other Cascadia lakes.

Significant bed elevation changes related to Gulf Stream dynamics on the South Carolina continental shelf

USGS Publications Warehouse

Gelfenbaum, G.; Noble, M.

1993-01-01

Photographs of the seabed taken from an instrumented bottom tripod located approximately 100 km east of Charleston, South Carolina, reveal bed elevation changes of over 20 cm between July and November 1978. The tripod was in 85 m of water and was equipped with two current meters at 38.7 and 100 cm from the bed, a pressure sensor, a transmissometer, which fouled early during the deployment, a temperature sensor and a camera. The sediment under the tripod was composed of poorly sorted sand, some shell debris and numerous small biological tubes. Bed roughness varied throughout the deployment from biologically-produced mounds (2-5 cm high and 5-20 cm diameter) to streaks to a smooth bed, depending upon the frequency and magnitude of the sediment transporting events. Even though these events were common, especially during the later part of the deployment, the bed was rarely rippled, and there was no evidence of large bedforms such as dunes or sand waves migrating through the field of view of the camera. Photographs did clearly show, however, a gradual net deposition of the bed of nearly 20 cm, followed by erosion of approximately 5 cm. The flow field near the bed was dominated by sub-tidal period currents. Hourly-averaged currents at 100 cm from the bed typically varied between 10 and 30 cm s-1 and occasionally were as high as 60 cm s-1. The large flow events were predominantly toward the southwest along the shelf in the opposite direction of the northeast flowing Gulf Stream. The cross-shore component of the flow near the bed was predominantly directed offshore due to a local topographic steering effect. Current, temperature and satellite data suggest that the largest flow events were associated with the advection of Gulf Stream filaments past the tripod. Erosion events, as seen from the photographs, were highly correlated with the passage of these Gulf Stream filaments past the tripod. Gradual deposition of sediment, which occurred during the first half of the deployment, appears to have been associated with the convergence of the near-bed sediment flux near the shelf break. ?? 1993.

Recent Trends in Coverage of the Mexican-Born Population of the United States: Results From Applying Multiple Methods Across Time

PubMed Central

Van Hook, Jennifer; Bean, Frank D.; Bachmeier, James D.; Tucker, Catherine

2014-01-01

The accuracy of counts of U.S. racial/ethnic and immigrant groups depends on coverage of the foreign-born in official data. Because Mexicans constitute by far the largest single national-origin group among the foreign-born in the United States, we compile new evidence about the coverage of the Mexican-born population in the 2000 census and 2001–2010 American Community Survey (ACS) using three techniques: a death registration, a birth registration, and a net migration method. For the late 1990s and first half of the 2000–2010 decade, results indicate that coverage error was somewhat higher than currently assumed but substantially declined by the latter half of the 2000–2010 decade. Additionally, we find evidence that U.S. census and ACS data miss substantial numbers of children of Mexican immigrants, as well as people who are most likely to be unauthorized: namely, working-aged Mexican immigrants (ages 15–64), especially males. The findings highlight the heterogeneity of the Mexican foreign-born population and the ways in which migration dynamics may affect population coverage. PMID:24570373

Periodic domain boundary ordering in a dense molecular adlayer: Sub-saturation carbon monoxide on Pd(111)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, Pan; Liu, Shizhong; Hong, Sung -Young

Here, we describe a previously unreported ordered phase of carbon monoxide adsorbed on the (111) facet of single crystal palladium at near-saturation coverage. The adlayer superstructure is identified from low energy electron diffraction to be c(16×2) with respect to the underlying Pd(111) surface net. The ideal coverage is determined to be 0.6875 ML, approximately 92% of the 0.75–ML saturation coverage. Density functional theory calculations support a model for the molecular packing characterized by strips of locally-saturated (2×2) regions, with the CO bound near high-symmetry surface sites, separated by antiphase domain boundaries. The structure exists in a narrow coverage range andmore » is prepared by heating the saturated adlayer to desorb a small fraction of the CO. Comparison of the c(16×2) domain-boundary structure with structural motifs at lower coverages suggests that between 0.6 and 0.6875 ML the adlayer order may be more strongly influenced by interadsorbate repulsion than by adsorption-site-specific interactions. The system is an example of the structural complexity that results from the compromise between adsorbate–substrate and adsorbate–adsorbate interactions.« less

Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

PubMed

Nandi, Arijit; Loue, Sana; Galea, Sandro

2009-12-01

As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

Periodic domain boundary ordering in a dense molecular adlayer: Sub-saturation carbon monoxide on Pd(111)

DOE PAGES

Xu, Pan; Liu, Shizhong; Hong, Sung -Young; ...

2016-12-31

Here, we describe a previously unreported ordered phase of carbon monoxide adsorbed on the (111) facet of single crystal palladium at near-saturation coverage. The adlayer superstructure is identified from low energy electron diffraction to be c(16×2) with respect to the underlying Pd(111) surface net. The ideal coverage is determined to be 0.6875 ML, approximately 92% of the 0.75–ML saturation coverage. Density functional theory calculations support a model for the molecular packing characterized by strips of locally-saturated (2×2) regions, with the CO bound near high-symmetry surface sites, separated by antiphase domain boundaries. The structure exists in a narrow coverage range andmore » is prepared by heating the saturated adlayer to desorb a small fraction of the CO. Comparison of the c(16×2) domain-boundary structure with structural motifs at lower coverages suggests that between 0.6 and 0.6875 ML the adlayer order may be more strongly influenced by interadsorbate repulsion than by adsorption-site-specific interactions. The system is an example of the structural complexity that results from the compromise between adsorbate–substrate and adsorbate–adsorbate interactions.« less

The Politics and Coverage of Terror: From Media Images to Public Consciousness.

ERIC Educational Resources Information Center

Wittebols, James H.

This paper presents a typology of terrorism which is grounded in how media differentially cover each type. The typology challenges some of the basic assumptions, such as that the media "allow" themselves to be exploited by terrorists and "encourage" terrorism, and the conventional wisdom about the net effects of the media's…

Comparison of house spraying and insecticide-treated nets for malaria control.

PubMed Central

Curtis, C. F.; Mnzava, A. E.

2000-01-01

The efficacies of using residual house spraying and insecticide-treated nets against malaria vectors are compared, using data from six recent comparisons in Africa, Asia and Melanesia. By all the entomological and malariological criteria recorded, pyrethroid-treated nets were at least as efficacious as house spraying with dichlorodiphenyltrichloroethane (DDT), malathion or a pyrethroid. However, when data from carefully monitored house spraying projects carried out between the 1950s and 1970s at Pare-Taveta and Zanzibar (United Republic of Tanzania), Kisumu (Kenya) and Garki (Nigeria) are compared with recent insecticide-treated net trials with apparently similar vector populations, the results with the insecticide-treated nets were much less impressive. Possible explanations include the longer duration of most of the earlier spraying projects and the use of non-irritant insecticides. Non-irritant insecticides may yield higher mosquito mortalities than pyrethroids, which tend to make insects leave the site of treatment (i.e. are excito-repellent). Comparative tests with non-irritant insecticides, including their use on nets, are advocated. The relative costs and sustainability of spraying and of insecticide-treated net operations are briefly reviewed for villages in endemic and epidemic situations and in camps for displaced populations. The importance of high population coverage is emphasized, and the advantages of providing treatment free of charge, rather than charging individuals, are pointed out. PMID:11196486

Thresholds of flow-induced bed disturbances and their effects on stream metabolism in an agricultural river

USGS Publications Warehouse

O'Connor, Ben L.; Harvey, Judson W.; McPhillips, Lauren E.

2012-01-01

Storm-driven flow pulses in rivers destroy and restructure sediment habitats that affect stream metabolism. This study examined thresholds of bed disturbances that affected patch- and reach-scale sediment conditions and metabolism rates. A 4 year record of discharge and diel changes in dissolved oxygen concentrations (ΔDO) was analyzed for disturbances and recovery periods of the ΔDO signal. Disturbances to the ΔDO signal were associated with flow pulses, and the recovery times for the ΔDO signal were found to be in two categories: less than 5 days (30% of the disturbances) or greater than 15 days (70% of the disturbances). A field study was performed during the fall of 2007, which included a storm event that increased discharge from 3.1 to 6.9 m3/s over a 7 h period. During stable flow conditions before the storm, variability in patch-scale stream metabolism values were associated with sediment texture classes with values ranging from −16.4 to 2.3 g O22/d (negative sign indicates net respiration) that bounded the reach-averaged rate of −5.6 g O22/d. Hydraulic modeling of bed shear stresses demonstrated a storm-induced flow pulse mobilized approximately 25% of the bed and reach-scale metabolism rates shifted from −5 to −40 g O22/d. These results suggest that storm-induced bed disturbances led to threshold behavior with respect to stream metabolism. Small flow pulses resulted in partial-bed mobilization that disrupted stream metabolism by increased turbidity with short recovery times. Large flow pulses resulted in full-bed mobilization that disrupted stream metabolism by destroying periphyton habitats with long recovery times.

Par Pond vegetation status 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mackey, H.E. Jr.; Riley, R.S.

1996-12-01

The water level of Par Pond was lowered approximately 20 feet in mid-1991 in order to protect downstream residents from possible dam failure suggested by subsidence on the downstream slope of the dam and to repair the dam. This lowering exposed both emergent and nonemergent macrophyte beds to drying conditions resulting in extensive losses. A survey of the newly emergent, shoreline aquatic plant communities of Par Pond began in June 1995, three months after the refilling of Par Pond to approximately 200 feet above mean sea level. These surveys continued in July, September, and late October, 1995, and into themore » early spring and late summer of 1996. Communities similar to the pre-drawdown, Par Pond aquatic plant communities continue to become re-established. Emergent beds of maidencane, lotus, waterlily, watershield, and Pontederia are extensive and well developed. Measures of percent cover, width of beds, and estimates of area of coverage with satellite data indicate regrowth within two years of from 40 to 60% of levels prior to the draw down. Cattail occurrence continued to increase during the summer of 1996, especially in the former warm arm of Par Pond, but large beds common to Par Pond prior to the draw down still have not formed. Lotus has invaded and occupies many of the areas formerly dominated by cattail beds. To track the continued development of macrophytes in Par Pond, future surveys through the summer and early fall of 1997, along with the evaluation of satellite data to map the extent of the macrophyte beds of Par Pond, are planned.« less

Production and carbonate dynamics of Halimeda incrassata (Ellis) Lamouroux altered by Thalassia testudinum Banks and Soland ex König

NASA Astrophysics Data System (ADS)

Barry, S.; Frazer, T.; Jacoby, C.

2013-05-01

Ocean acidification poses a serious threat to a broad suite of calcifying organisms. Scleractinian corals and calcareous algae that occupy shallow, tropical waters are vulnerable to global changes in ocean chemistry because they already are subject to stressful and variable carbon dynamics at the local scale. For example, net heterotrophy increases carbon dioxide concentrations, and pH varies with diurnal fluctuations in photosynthesis and respiration. Few researchers, however, have investigated the possibility that carbon dioxide consumption during photosynthesis by non-calcifying photoautotrophs, such as seagrasses, can ameliorate deleterious effects of ocean acidification on sympatric calcareous algae. Naturally occurring variations in the density of seagrasses and associated calcareous algae provide an ecologically relevant test of the hypothesis that diel fluctuations in water chemistry driven by cycles of photosynthesis and respiration within seagrass beds create microenvironments that enhance macroalgal calcification. In Grape Tree Bay off Little Cayman Island BWI, we quantified net production and characterized calcification for thalli of the calcareous green alga Halimeda incrassata growing within beds of Thalassia testudinum with varying shoot densities. Results indicated that individual H. incrassata thalli were ~6% more calcified in dense seagrass beds. On an areal basis, however, far more calcium carbonate was produced by H. incrassata in areas where seagrasses were less dense due to higher rates of production. In addition, diel pH regimes in vegetated and unvegetated areas within the lagoon were not significantly different, suggesting water exchange and mixing throughout the lagoon. These results suggest that, especially in well-mixed lagoons, carbonate production by calcareous algae may be more related to biotic interactions between seagrasses and calcareous algae than to seagrass-mediated changes in local water chemistry.

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

PubMed

Mwandagalirwa, Melchior Kashamuka; Levitz, Lauren; Thwai, Kyaw L; Parr, Jonathan B; Goel, Varun; Janko, Mark; Tshefu, Antoinette; Emch, Michael; Meshnick, Steven R; Carrel, Margaret

2017-11-09

The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveillance in the DRC by monitoring malaria across seasons, age groups and in high and low malaria sites. Across seven sites, 242 households and 1591 individuals are participating in the study. Results of the enrollment questionnaire, rapid diagnostic tests and PCR testing of dried blood spots are presented. Overall malaria prevalence in the study cohort is high, 27% by rapid diagnostic test and 31% by polymerase chain reaction, and malaria prevalence is highly varied across very small geographic distances. Malaria prevalence is highest in children aged 6-15. While the majority of households own bed nets, bed net usage is less than 50%. The study cohort will provide an understanding of how malaria persists in populations that have varying environmental exposures, varying community-level malaria, and varying access to malaria control efforts.

High Mobility and Low Use of Malaria Preventive Measures among the Jarai Male Youth along the Cambodia–Vietnam Border

PubMed Central

Gryseels, Charlotte; Peeters Grietens, Koen; Dierickx, Susan; Xuan, Xa Nguyen; Uk, Sambunny; Bannister-Tyrrell, Melanie; Trienekens, Suzan; Ribera, Joan Muela; Hausmann-Muela, Susanna; Gerrets, René; D'Alessandro, Umberto; Sochantha, Tho; Coosemans, Marc; Erhart, Annette

2015-01-01

Malaria control along the Vietnam–Cambodia border presents a challenge for both countries' malaria elimination targets as the region is forested, inhabited by ethnic minority populations, and potentially characterized by early and outdoor malaria transmission. A mixed methods study assessed the vulnerability to malaria among the Jarai population living on both sides of the border in the provinces of Ratanakiri (Cambodia) and Gia Lai (Vietnam). A qualitative study generated preliminary hypotheses that were quantified in two surveys, one targeting youth (N = 498) and the other household leaders (N = 449). Jarai male youth, especially in Cambodia, had lower uptake of preventive measures (57.4%) and more often stayed overnight in the deep forest (35.8%) compared with the female youth and the adult population. Among male youth, a high-risk subgroup was identified that regularly slept at friends' homes or outdoors, who had fewer bed nets (32.5%) that were torn more often (77.8%). The vulnerability of Jarai youth to malaria could be attributed to the transitional character of youth itself, implying less fixed sleeping arrangements in nonpermanent spaces or non-bed sites. Additional tools such as long-lasting hammock nets could be suitable as they are in line with current practices. PMID:26283747

The biodiversity hotspot as evolutionary hot-bed: spectacular radiation of Erica in the Cape Floristic Region.

PubMed

Pirie, M D; Oliver, E G H; Mugrabi de Kuppler, A; Gehrke, B; Le Maitre, N C; Kandziora, M; Bellstedt, D U

2016-09-17

The disproportionate species richness of the world's biodiversity hotspots could be explained by low extinction (the evolutionary "museum") and/or high speciation (the "hot-bed") models. We test these models using the largest of the species rich plant groups that characterise the botanically diverse Cape Floristic Region (CFR): the genus Erica L. We generate a novel phylogenetic hypothesis informed by nuclear and plastid DNA sequences of c. 60 % of the c. 800 Erica species (of which 690 are endemic to the CFR), and use this to estimate clade ages (using RELTIME; BEAST), net diversification rates (GEIGER), and shifts in rates of diversification in different areas (BAMM; MuSSE). The diversity of Erica species in the CFR is the result of a single radiation within the last c. 15 million years. Compared to ancestral lineages in the Palearctic, the rate of speciation accelerated across Africa and Madagascar, with a further burst of speciation within the CFR that also exceeds the net diversification rates of other Cape clades. Erica exemplifies the "hotbed" model of assemblage through recent speciation, implying that with the advent of the modern Cape a multitude of new niches opened and were successively occupied through local species diversification.

NOTE: Dose area product evaluations with Gafchromic® XR-R films and a flat-bed scanner

NASA Astrophysics Data System (ADS)

Rampado, O.; Garelli, E.; Deagostini, S.; Ropolo, R.

2006-12-01

Gafchromic® XR-R films are a useful tool to evaluate entrance skin dose in interventional radiology. Another dosimetric quantity of interest in diagnostic and interventional radiology is the dose area product (DAP). In this study, a method to evaluate DAP using Gafchromic® XR-R films and a flat-bed scanner was developed and tested. Film samples were exposed to an x-ray beam of 80 kVp over a dose range of 0 10 Gy. DAP measurements with films were obtained from the digitalization of a film sample positioned over the x-ray beam window during the exposure. DAP values obtained with this method were compared for 23 cardiological interventional procedures with DAP values displayed by the equipment. The overall one-sigma dose measurement uncertainty depended on the absorbed dose, with values below 6% for doses above 1 Gy. A maximum discrepancy of 16% was found, which is of the order of the differences in the DAP measurements that may occur with different calibration procedures. Based on the results presented, after an accurate calibration procedure and a thorough inspection of the relationship between the actual dose and the direct measured quantity (net optical density or net pixel value variation), Gafchromic® XR-R films can be used to assess the DAP.

Arsenic and lead concentrations in the Pond Creek and Fire Clay coal beds, eastern Kentucky coal field

USGS Publications Warehouse

Hower, J.C.; Robertson, J.D.; Wong, A.S.; Eble, C.F.; Ruppert, L.F.

1997-01-01

The Middle Pennsylvanian Breathitt Formation (Westphalian B) Pond Creek and Fire Clay coal beds are the 2 largest producing coal beds in eastern Kentucky. Single channel samples from 22 localities in the Pond Creek coal bed were obtained from active coal mines in Pike and Martin Countries, Kentucky, and a total of 18 Fire Clay coal bed channel samples were collected from localities in the central portion of the coal field. The overall objective of this study was to investigate the concentration and distribution of potentially hazardous elements in the Fire Clay and Pond Creek coal beds, with particular emphasis on As and Pb, 2 elements that are included in the 1990 Clean Air Act Amendments as potential air toxics. The 2 coals are discussed individually as the depositional histories are distinct, the Fire Clay coal bed having more sites where relatively high-S lithologies are encountered. In an effort to characterize these coals, 40 whole channel samples, excluding 1-cm partings, were analyzed for major, minor and trace elements by X-ray fluorescence and proton-induced X-ray emission spectroscopy. Previously analyzed samples were added to provide additional geographic coverage and lithotype samples from one site were analyzed in order to provide detail of vertical elemental trends. The As and Pb levels in the Fire Clay coal bed tend to be higher than in the Pond Creek coal bed. One whole channel sample of the Fire Clay coal bed contains 1156 ppm As (ash basis), with a single lithotype containing 4000 ppm As (ash basis). Most of the As and Pb appears to be associated with pyrite, which potentially can be removed in beneficiation (particularly coarser pyrite). Disseminated finer pyrite may not be completely removable by cleaning. In the examination of pyrite conducted in this study, it does not appear that significant concentration of As or Pb occurs in the finer pyrite forms. The biggest potential problem of As- or Pb-enriched pyrite is, therefore, one of refuse disposal.

Moles: Tool-Assisted Environment Isolation with Closures

NASA Astrophysics Data System (ADS)

de Halleux, Jonathan; Tillmann, Nikolai

Isolating test cases from environment dependencies is often desirable, as it increases test reliability and reduces test execution time. However, code that calls non-virtual methods or consumes sealed classes is often impossible to test in isolation. Moles is a new lightweight framework which addresses this problem. For any .NET method, Moles allows test-code to provide alternative implementations, given as .NET delegates, for which C# provides very concise syntax while capturing local variables in a closure object. Using code instrumentation, the Moles framework will redirect calls to provided delegates instead of the original methods. The Moles framework is designed to work together with the dynamic symbolic execution tool Pex to enable automated test generation. In a case study, testing code programmed against the Microsoft SharePoint Foundation API, we achieved full code coverage while running tests in isolation without an actual SharePoint server. The Moles framework integrates with .NET and Visual Studio.

Assessing the impact of scaling-up bednet coverage through agricultural loan programmes: evidence from a cluster randomised controlled trial in Katete, Zambia.

PubMed

Fink, Günther; Masiye, Felix

2012-11-01

To investigate the effectiveness of scaling-up existing bednet distribution campaigns, a randomised controlled trial with 516 farming households in Katete District, a rural area with highly endemic malaria in Zambia's Eastern Province, was evaluated. In the trial, selected farmers were assigned to bednet programmes that allowed them to obtain additional bednets for free or at subsidised prices through agricultural loan programmes. On average, 2.4 nets were distributed in the free distribution group and 0.9 in the net loan group. The marginal health impact of additional nets appears large, reducing the odds of self-reported all-cause morbidity by 40-42% and the odds of self-reported confirmed malaria by 53-60%. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Relief, restoration and reform: economic upturn yields modest and uneven health returns.

PubMed

Hurley, Robert; Katz, Aaron; Felland, Laurie

2008-01-01

The sensitivity of state budgets to economic cycles contributes to fluctuations in health coverage, eligibility, benefits and provider payment levels in public programs, as well as support for safety net hospitals and community health centers (CHCs). The aftershocks of the 2001 recession on state budgets were felt well into 2004. More recently, the economic recovery allowed many states to restore cuts and, in some cases, expand health services for low-income people, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Along with bolstering support of safety net providers and raising Medicaid payments for private physicians, some states advanced even more ambitious health reform proposals. Yet across communities, safety net systems face mounting challenges of caring for more uninsured patients, and these pressures will likely increase given the current economic downturn.

A Theoretical Model of Drumlin Formation Based on Observations at Múlajökull, Iceland

NASA Astrophysics Data System (ADS)

Iverson, N. R.; McCracken, R. G.; Zoet, L. K.; Benediktsson, Í. Ö.; Schomacker, A.; Johnson, M. D.; Woodard, J.

2017-12-01

The drumlin field at the surge-type glacier, Múlajökull, provides an unusual opportunity to build a model of drumlin formation based on field observations in a modern drumlin-forming environment. These observations indicate that surges deposit till layers that drape the glacier forefield, conform to drumlin surfaces, and are deposited in shear. Observations also indicate that erosion helps create drumlin relief, effective stresses in subglacial till are highest between drumlins, and during quiescent flow, crevasses on the glacier surface overlie drumlins while subglacial channels occupy intervening swales. In the model, we consider gentle undulations on the bed bounded by subglacial channels at low water pressure. During quiescent flow, slip of temperate ice across these undulations and basal water flow toward bounding channels create an effective stress distribution that maximizes till entrainment in ice on the heads and flanks of drumlins. Crevasses amplify this effect but are not necessary for it. During surges, effective stresses are uniformly low, and the bed shears pervasively. Vigorous basal melting during surges releases debris from ice and deposits it on the bed, with deposition augmented by transport in the deforming bed. As surge cycles progress, drumlins migrate downglacier and grow at increasing rates, due to positive feedbacks that depend on drumlin height. Drumlin growth can be accompanied by either net aggradation or erosion of the bed, and drumlin heights and stratigraphy generally correspond with observations. This model highlights that drumlin growth can reflect instabilities other than those of bed shear instability models, which require heuristic till transport assumptions.

500-Gray γ-Irradiation May Increase Adhesion Strength of Lyophilized Cadaveric Split-Thickness Skin Graft to Wound Bed.

PubMed

Wei, Lin-Gwei; Chen, Chieh-Feng; Wang, Chi-Hsien; Cheng, Ya-Chen; Li, Chun-Chang; Chiu, Wen-Kuan; Wang, Hsian-Jenn

2017-03-01

Human cadaveric skin grafts are considered as the "gold standard" for temporary wound coverage because they provide a more conductive environment for natural wound healing. Lyophilization, packing, and terminal sterilization with gamma-ray can facilitate the application of cadaveric split-thickness skin grafts, but may alter the adhesion properties of the grafts. In a pilot study, we found that 500 Gy γ-irradiation seemed not to reduce the adherence between the grafts and wound beds. We conducted this experiment to compare the adherences of lyophilized, 500-Gy γ-irradiated skin grafts to that of lyophilized, nonirradiated grafts. Pairs of wounds were created over the backs of Sprague- Dawley rats. Pairs of "lyophilized, 500-Gy γ-irradiated" and "lyophilized, nonirradiated" cadaveric split-thickness skin grafts were fixed to the wound beds. Adhesion strength between the grafts and the wound beds was measured and compared. On post-skin-graft day 7 and day 10, the adhesion strength of γ-irradiated grafts was greater than that of the nonirradiated grafts. Because lyophilized cadaveric skin grafts can be vascularized and the collagen of its dermal component can be remodeled after grafting, the superior adhesion strength of 500-Gy γ-irradiated grafts can be explained by the collagen changes from irradiation.

Nationwide but still inhomogeneous distribution of certified chest pain units across Germany : Need to strengthen rural regions.

PubMed

Varnavas, V; Rassaf, T; Breuckmann, F

2018-02-01

The purpose of this work was to analyze structure, distribution, and bed capacities of certified German chest pain units (CPUs) to unveil potential gaps despite nationwide certification of 230 units till the end of 2015. Analysis of number and structure of CPUs per state, resident count, and population density by standardized telephone interview, online research, and data collection from the registry of the Federal Statistical Office for all certified German CPUs. Nationwide, German health facilities provided a mean of 1 CPU bed within a certified unit per 65,000 inhabitants. Bremen, Hamburg, Hesse, and Rhineland-Palatinate provided more than 1 bed per 50,000 inhabitants. Most CPUs (49%) were located in the emergency room. All university hospitals in Germany provided a certified CPU. Most units were found in academic teaching hospitals (146 CPUs). Only 42 CPUs were found in nonacademic providers of primary health care. The absolute necessary number of CPUs to reach full nationwide coverage is still unknown. The current analysis shows a high number of CPUs and bed capacities within the cities and industrial areas without relevant gaps, but also demonstrates a certain undersupply in more rural areas as well as in some of the former eastern federal states of Germany.

Willingness to pay for small solar powered bed net fans: results of a Becker-DeGroot-Marschak auction in Ghana.

PubMed

Yukich, Joshua O; Briët, Olivier J T; Ahorlu, Collins K; Nardini, Peter; Keating, Joseph

2017-08-07

Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'-a set of solar powered net fan and light consoles with a solar panel and battery-or alternative household water filters, all trial participants were invited to participate in a Becker-DeGroot-Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit.

Examining the impact of larval source management and insecticide-treated nets using a spatial agent-based model of Anopheles gambiae and a landscape generator tool.

PubMed

Arifin, S M Niaz; Madey, Gregory R; Collins, Frank H

2013-08-21

Agent-based models (ABMs) have been used to estimate the effects of malaria-control interventions. Early studies have shown the efficacy of larval source management (LSM) and insecticide-treated nets (ITNs) as vector-control interventions, applied both in isolation and in combination. However, the robustness of results can be affected by several important modelling assumptions, including the type of boundary used for landscapes, and the number of replicated simulation runs reported in results. Selection of the ITN coverage definition may also affect the predictive findings. Hence, by replication, independent verification of prior findings of published models bears special importance. A spatially-explicit entomological ABM of Anopheles gambiae is used to simulate the resource-seeking process of mosquitoes in grid-based landscapes. To explore LSM and replicate results of an earlier LSM study, the original landscapes and scenarios are replicated by using a landscape generator tool, and 1,800 replicated simulations are run using absorbing and non-absorbing boundaries. To explore ITNs and evaluate the relative impacts of the different ITN coverage schemes, the settings of an earlier ITN study are replicated, the coverage schemes are defined and simulated, and 9,000 replicated simulations for three ITN parameters (coverage, repellence and mortality) are run. To evaluate LSM and ITNs in combination, landscapes with varying densities of houses and human populations are generated, and 12,000 simulations are run. General agreement with an earlier LSM study is observed when an absorbing boundary is used. However, using a non-absorbing boundary produces significantly different results, which may be attributed to the unrealistic killing effect of an absorbing boundary. Abundance cannot be completely suppressed by removing aquatic habitats within 300 m of houses. Also, with density-dependent oviposition, removal of insufficient number of aquatic habitats may prove counter-productive. The importance of performing large number of simulation runs is also demonstrated. For ITNs, the choice of coverage scheme has important implications, and too high repellence yields detrimental effects. When LSM and ITNs are applied in combination, ITNs' mortality can play more important roles with higher densities of houses. With partial mortality, increasing ITN coverage is more effective than increasing LSM coverage, and integrating both interventions yields more synergy as the densities of houses increase. Using a non-absorbing boundary and reporting average results from sufficiently large number of simulation runs are strongly recommended for malaria ABMs. Several guidelines (code and data sharing, relevant documentation, and standardized models) for future modellers are also recommended.

Workers who decline employment-related health insurance.

PubMed

Bernard, Didem M; Selden, Thomas M

2006-05-01

Families of workers who decline coverage represent a substantial share of the uninsured and publicly-insured population in the United States. We examined health status, access to health care, utilization, and expenditures among families that declined health insurance coverage offered by employers using data from the Medical Expenditure Panel Survey for 2001 and 2002. We found differences in insurance status for adults and children among families with offers. We found that among low-income families with offers, children are less likely to have private insurance compared with adults. However, the majority of children who decline private insurance end up with public coverage, whereas most of adults who decline offers remain uninsured. Decliners are more likely to report poor health, yet they are also less likely to have high cost medical conditions. Families declining coverage have weaker preferences for insurance than families that take up. Although access to care is lower among the decliners who remain uninsured, decliners with public insurance have similar access to care as those with private insurance. Families turning down coverage are more likely to face high expenditure burdens as a percentage of income and more likely to have financial barriers to care. Families who decline coverage rely heavily on the safety net. Public sources and uncompensated care account for 72% of total expenditures among adults who decline coverage. Our results suggest that policy initiatives aimed at increasing take up among workers need to take into account the incentives workers face given the availability of care through public sources and uncompensated care.

Monitoring nocturnal heart rate with bed sensor.

PubMed

Migliorini, M; Kortelainen, J M; Pärkkä, J; Tenhunen, M; Himanen, S L; Bianchi, A M

2014-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems". The aim of this study is to assess the reliability of the estimated Nocturnal Heart Rate (HR), recorded through a bed sensor, compared with the one obtained from standard electrocardiography (ECG). Twenty-eight sleep deprived patients were recorded for one night each through matrix of piezoelectric sensors, integrated into the mattress, through polysomnography (PSG) simultaneously. The two recording methods have been compared in terms of signal quality and differences in heart beat detection. On average, coverage of 92.7% of the total sleep time was obtained for the bed sensor, testifying the good quality of the recordings. The average beat-to-beat error of the inter-beat intervals was 1.06%. These results suggest a good overall signal quality, however, considering fast heart rates (HR > 100 bpm), performances were worse: in fact, the sensitivity in the heart beat detection was 28.4% while the false positive rate was 3.8% which means that a large amount of fast beats were not detected. The accuracy of the measurements made using the bed sensor has less than 10% of failure rate especially in periods with HR lower than 70 bpm. For fast heart beats the uncertainty increases. This can be explained by the change in morphology of the bed sensor signal in correspondence of a higher HR.

Universal coverage with insecticide-treated nets - applying the revised indicators for ownership and use to the Nigeria 2010 malaria indicator survey data.

PubMed

Kilian, Albert; Koenker, Hannah; Baba, Ebenezer; Onyefunafoa, Emmanuel O; Selby, Richmond A; Lokko, Kojo; Lynch, Matthew

2013-09-10

Until recently only two indicators were used to evaluate malaria prevention with insecticide-treated nets (ITN): "proportion of households with any ITN" and "proportion of the population using an ITN last night". This study explores the potential of the expanded set of indicators recommended by the Roll Back Malaria Monitoring and Evaluation Reference Group (MERG) for comprehensive analysis of universal coverage with ITN by applying them to the Nigeria 2010 Malaria Indicator Survey data. The two additional indicators of "proportion of households with at least one ITN for every two people" and "proportion of population with access to an ITN within the household" were calculated as recommended by MERG. Based on the estimates for each of the four ITN indicators three gaps were calculated: i) households with no ITN, ii) households with any but not enough ITN, iii) population with access to ITN not using it. In addition, coverage with at least one ITN at community level was explored by applying Lot Quality Assurance Sampling (LQAS) decision rules to the cluster level of the data. All outcomes were analysed by household background characteristics and whether an ITN campaign had recently been done. While the proportion of households with any ITN was only 42% overall, it was 75% in areas with a recent mass campaign and in these areas 66% of communities had coverage of 80% or better. However, the campaigns left a considerable intra-household ownership gap with 66% of households with any ITN not having enough for every family member. In contrast, the analysis comparing actual against potential use showed that ITN utilization was good overall with only 19% of people with access not using the ITN, but with a significant difference between the North, where use was excellent (use gap 11%), and the South (use gap 36%) indicating the need for enhanced behaviour change communication. The expanded ITN indicators to assess universal coverage provide strong tools for a comprehensive system effectiveness analysis that produces clear, actionable evidence of progress as well as the need for specific additional interventions clearly differentiating between gaps in ownership and use.

Improving Access to Primary Care for a Growing Latino Population: The Role of Safety Net Providers in the Rural Midwest

ERIC Educational Resources Information Center

Blewett, Lynn A.; Casey, Michelle; Call, Kathleen Thiede

2004-01-01

Many rural Midwestern communities are experiencing rapid growth in Latino populations with low rates of health insurance coverage, limited financial resources, language and cultural differences, and special health care needs. We report on 2-day site visits conducted in 2001 and 2002 in 3 communities (Marshalltown, Iowa; Great Bend, Kansas; and…

Caring for Immigrants: Health Care Safety Nets in Los Angeles, New York, Miami, and Houston.

ERIC Educational Resources Information Center

Ku, Leighton; Freilich, Alyse

This report assesses how the loss of Medicaid coverage following welfare reform has influenced changes in health care systems for immigrants in four urban areas: Los Angeles, California; New York, New York; Houston, Texas; and Miami, Florida. Survey data indicate that over half of low-income immigrants were uninsured in 1998, a level roughly…

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

State policy influence on the early diffusion of buprenorphine in community treatment programs.

PubMed

Ducharme, Lori J; Abraham, Amanda J

2008-06-20

Buprenorphine was approved for use in the treatment of opioid dependence in 2002, but its diffusion into everyday clinical practice in community-based treatment programs has been slow. This study examines the net impact of efforts by state agencies, including provision of Medicaid coverage, on program-level adoption of buprenorphine as of 2006. Interviews were conducted with key informants in 49 of the 50 state agencies with oversight responsibility for addiction treatment services. Information from these interviews was integrated with organizational data from the 2006 National Survey of Substance Abuse Treatment Services. A multivariate logistic regression model was estimated to identify the effects of state efforts to promote the use of this medication, net of a host of organizational characteristics. The availability of Medicaid coverage for buprenorphine was a significant predictor of its adoption by treatment organizations. Inclusion of buprenorphine on state Medicaid formularies appears to be a key element in ensuring that patients have access to this state-of-the-art treatment option. Other potential barriers to the diffusion of buprenorphine require identification, and the value of additional state-level policies to promote its use should be evaluated.

The impact of benthic fauna on fluvial bed load transport: Challenges of upscaling laboratory experiments to river and landscape scales.

NASA Astrophysics Data System (ADS)

Rice, S. P.

2012-04-01

The impact on sediment transport processes and channel morphology of several relatively large, iconic animals including beaver and salmon is increasingly well understood. However, many other aquatic fauna are important zoogeomorphic agents and ecosystem engineers. These somewhat overlooked "Cinderella" species include benthic aquatic insect larvae, freshwater crustaceans and many species of fish. Despite relatively modest individual effects, the ubiquity, abundance and cumulative impact of these organisms makes them a potentially significant agency, with as yet undiscovered and unquantified impacts on channel morphology and sediment fluxes. Their actions (digging, foraging, moving, burrowing), constructions and secretions modify bed sediment characteristics (grain size distribution, interlock, imbrication, protrusion), alter bed topography (thence hydraulic roughness) and contribute to biogenic restraints on grain movement. In turn, they can affect the distribution of surface particle entrainment thresholds and bed shear stresses, with implications for bed load transport. Flume experiments have measured some of these impacts and provided direct observations of the mechanisms involved, but many of the most interesting research questions pertain to the impact of these animals at reach, catchment and even landscape scales: Not least, what is the impact of small aquatic animals on bed load flux and yield? This presentation will consider some of the challenges involved in answering this question; that is, of scaling up experimental understanding of how aquatic animals affect bed load transport processes to river scales. Pertinent themes include: (1) the potential impacts of experimental arrangements on the behaviours and activities that affect hydraulic or geomorphological processes; (2) field coincidence of the spatial and temporal distributions of (a) the animals and their behaviours with (b) the physical conditions (substrates, flows) under which those animals are understood to have an effect; (3) the magnitude of any demonstrable net field impact, relative to those other factors that control bed load transport rates.

Mechanisms of ripple migration on a natural sand bed under waves

NASA Astrophysics Data System (ADS)

Carlson, E.; Foster, D. L.

2016-02-01

In nearshore environments, the wave bottom boundary layer is of particular importance to bedform migration and evolution as it is the location of energy transfer from the water column to the bed. This effort examines the mechanisms responsible for bedform evolution and migration. In a field scale laboratory study, sand ripple dynamics were measured using particle image velocimetry. Both monotonic (T = 4 s, 8 s), bimodal (wave pair T = 3.7, 4.3 s), and solitary wave cases were examined. Bedform states included orbital and anorbital rippled beds with wavelengths ranging from 5 to 15 cm. During cases of moderately high energy, time series of instantaneous ripple migration rates oscillated with the same frequency as the surface waves. The oscillatory ripple migration signature was asymmetric, with higher amplitudes during onshore directed movement. This asymmetry leads to a net onshore migration, ranging from 0.1 to 0.6 cm/min in the wave conditions mentioned. The cyclic motion of the ripple field was compared to concomitant transfer mechanisms affecting the boundary layer dynamics including: bed shear stress, coherent structure generation, and free stream velocity. Coherent structures were identified using the swirling strength criterion, and were present during each half wave developing in the ripple troughs. Two estimates of bed shear stress were made: 1) Meyer-Peter Muller method using the bed migration to determine the necessary stress and 2) double averaging of the velocity field and partitioning into components of stress, following the methods of Rodriguez-Abudo and Foster (2014). Peak ripple migration rates occurred during strengthening onshore flow, which coincides with peak bed shear stresses and the onset of coherent structure formation. Higher energy bimodal wave groups caused periods of high suspension which were coincident with peak onshore migrations, during the low velocity periods of the bimodal forcing the bed did not migrate.

2007 costs and coverage of antiretrovirals under Medicare Part D for people with HIV/AIDS living in North Carolina.

PubMed

Sengupta, Sohini

2008-01-01

Effective January 1, 2006 Medicare Part D became a new source of prescription drug coverage for people with HIV/AIDS in the United States. The implementation of Part D has affected access to antiretrovirals for people with HIV/AIDS. In North Carolina, access can be difficult because of the state's struggling safety net programs and the growing HIV-infected populations among Blacks and in poor rural counties. This analysis examines Medicare Part D antiretroviral coverage in 2007 for beneficiaries with HIV/AIDS in North Carolina, particularly those who did not qualify as dual eligibles or for a full low-income subsidy. Data describing program coverage were obtained from the Web site www.medicare.gov and descriptive analyses were performed to assess changes in antiretroviral coverage in Part D prescription drug plans in North Carolina. Most of the 26 antiretrovirals are covered in some way by 76 North Carolina prescription drug plans. There may be variability in coverage however associated with (a) antiretroviral classification within formularies; (b) drug premiums; (c) whether premiums can be waived; (d) annual deductibles; and (e) whether coverage is provided in the "doughnut hole." The data may not reflect actual patterns of drug use and realized access to the drugs. The findings are limited to antiretroviral coverage in North Carolina's Part D offerings but could be generalized to other states with similar prescription drug plan costs and coverage. These concerns continue to pose significant challenges to accessing antiretrovirals for Part D beneficiaries with HIV/AIDS in North Carolina. Variability demonstrated within prescription drug plans will continue, and beneficiaries with HIV/AIDS who do not qualify as dual eligibles or for low-income subsidies will need to evaluate these issues when selecting a prescription drug plan in future enrollment periods.

Supporting Dynamic Spectrum Access in Heterogeneous LTE+ Networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luiz A. DaSilva; Ryan E. Irwin; Mike Benonis

As early as 2014, mobile network operators’ spectral capac- ity is expected to be overwhelmed by the demand brought on by new devices and applications. With Long Term Evo- lution Advanced (LTE+) networks likely as the future one world 4G standard, network operators may need to deploy a Dynamic Spectrum Access (DSA) overlay in Heterogeneous Networks (HetNets) to extend coverage, increase spectrum efficiency, and increase the capacity of these networks. In this paper, we propose three new management frameworks for DSA in an LTE+ HetNet: Spectrum Accountability Client, Cell Spectrum Management, and Domain Spectrum Man- agement. For these spectrum managementmore » frameworks, we define protocol interfaces and operational signaling scenar- ios to support cooperative sensing, spectrum lease manage- ment, and alarm scenarios for rule adjustment. We also quan- tify, through integer programs, the benefits of using DSA in an LTE+ HetNet, that can opportunistically reuse vacant TV and GSM spectrum. Using integer programs, we consider a topology using Geographic Information System data from the Blacksburg, VA metro area to assess the realistic benefits of DSA in an LTE+ HetNet.« less

Spatially balanced provision of health equipment: a cross-sectional study oriented to the identification of challenges to access promotion.

PubMed

Amaral, Pedro Vasconcelos; Rocha, Thiago Augusto Hernandes; Barbosa, Allan Claudius Queiroz; Lein, Adriana; Vissoci, João Ricardo Nickenig

2017-12-04

Access to health services is in part defined by the spatial distribution of healthcare equipment. To ensure equity in the provision of health services, it is important to examine availability across different health care providers taking into account population demand. Given the importance of the equitable provision of health equipment, we evaluate its spatial distribution in Brazil. This study is classified as cross-sectional with an ecological design. We evaluate Brazilian data on distance to available health equipment considering: dialysis machines (385), magnetic resonance imaging (MRI) (257), hospital beds (3675) and bone densitometers (429). We define two distance thresholds (50 km and 200 km) from a municipality to the center of services provision. The balance between infrastructure capacity and potential demand was evaluated to identify a lack or surplus of health services. The distribution of dialysis equipment and bone densitometers is not balanced across Brazilian states, and unmet demand is high. With respect to MRIs, the large capacity of this equipment results in a large excess of supply. However, this characteristic alone cannot account for excesses of supply of over 700%, as is the case of the Federal District when the range is limited to 50 km. At the same time, four states in the Northeastern region of Brazil show a net excess of demand. Some regions do not meet the standard amount of supply defined by Brazilian Ministry of Health. The quantity and distribution of hospital beds are not sufficient to provide full coverage to the population. Our main focus was to evaluate the network of the provision of health equipment in Brazil, considering both private and public sectors conjointly. We take into account two main aspects of a spatially balanced health system: the regional availability of health equipment and the geographic distance between its demand and supply at the municipality level. Some regions do not meet the minimum requirement defined by the Brazilian Ministry of Health regarding the supply of health services.

Outcomes of polio eradication activities in Uttar Pradesh, India: the Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)

PubMed Central

2011-01-01

Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net) was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE) statistical method to account for Intra-cluster Correlation (ICC), and used 'Quasi-likelihood under the independence model criterion (QIC)' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with more community resistance to polio vaccination and/or are have harder-to-reach populations than non-SM Net areas. Other likely explanations for the relatively good vaccination performance in SM Net areas are not apparent. PMID:21569256

Willingness to pay for insecticide-treated nets in Berehet District, Amhara Region, Northern Ethiopia: implication of social marketing.

PubMed

Aleme, Adisu; Girma, Eshetu; Fentahun, Netsanet

2014-01-01

Understanding the feasibility of achieving widespread coverage with Insecticide-Treated Nets has to be preceded by learning how people value the Insecticide-Treated Nets and estimating the potential demand and willingness to pay so that sustainability of the intervention can be assured. The objective of this study was to determine willingness to pay for Insecticide-Treated Nets among households in Berehet District, Northern Ethiopia. A community-based cross-sectional study was conducted using both quantitative and qualitative methods in five randomly selected Kebeles from January-February 2012. Open ended contingent valuation technique with follow-up method was used. Qualitative data were collected through focus group discussions and observation methods. Binary logistic regression was used to determine the association between dependent and independent variables. The average number of individuals per Insecticide-Treated Nets was 3.83. Nearly 68.5% persons had willingness to buy Insecticide-Treated Nets if they have access to these Nets. The median maximum price a person is willingness to pay for blue rectangular Insecticide-Treated Net was 20 ETB. People had willingness to pay 30 ETB for blue and white conical insecticide-treated nets. Working on knowledge of malaria (OR=0.68, CI (0.47, 0.98; p<0.05), perceived benefit of Insecticide-Treated Nets (OR=0.28, CI (0.2-0.4; p<0.05), perceived susceptibility (OR=0.64(0.44-0.93; p<0.05) and perceived severity of malaria (OR=0.65(0.47-0.91, p<0.05) had significant association with a willingness to pay Insecticide-Treated Nets. Respondents who prefer Kebele/place/ to buy Insecticide-Treated Net for rectangular shape had a significant association with a willingness to pay for Insecticide-Treated Nets (OR=1.92, CI= 1.07-3.92). Promotions, products, price and place had significant association with willingness to pay for Insecticide-Treated Nets. Designing a social marketing strategy helps ensure sustainable supply of Insecticide-Treated Nets and proper use of Insecticide-Treated Nets.

Sediment transport on the Palos Verdes shelf over seasonal to decadal time scales

USGS Publications Warehouse

Wiberg, P.L.; Drake, D.E.; Harris, C.K.; Noble, M.

2002-01-01

We combine direct observations, longer-term wave data, and model calculations to characterize resuspension and transport of fine-grained, effluent-affected sediment on the Palos Verdes shelf. Near-bed waves, currents, and suspended sediment concentrations were monitored during the winter of 1992-93 with a bottom tripod and current-meter mooring at a 63-m-deep site. Wave conditions that winter were moderate (??? 2 year recurrence interval), and mean current was alongshelf to the northwest; currents were not significantly correlated with wave conditions. Seven wave events during the winter (December-March) produced near-bed wave orbital velocities at the study site in excess of 14 cm s-1, the observed threshold for significant resuspension. Three of these events occurred during the bottom tripod deployment and are characterized by the highest persistent suspended sediment concentrations in the tripod record. Suspended sediment flux was alongshelf to the northwest for 5 of the 6 wave events for which current data were available; one event occurred during low southeast currents. Measured suspended sediment concentration and grain size generally agree with values that were calculated using a shelf sediment transport model with no adjustment of parameters from values determined for two muddy sites on the northern California shelf. We extend our seasonal observations to a period of almost 2 decades by applying the observed thresholds for wave-driven resuspension to near-bed wave conditions calculated from NDBC Buoy 46025 surface wave data. An average of 10 resuspension events per year, with an average duration of 1.6 days, were identified at a water depth of 60 m; the number of events dropped to 3 per year at 90 m, beyond the shelf break. For the majority of these events, calculated net suspended sediment flux is toward the northwest (alongshelf) at an average rate of 140 kg m-1 h-1; about a third of the events have net southeastward flux at an average rate of 30 kg m-1 h-1. The calculated thickness of the resuspended surface layer of the bed was less than 1 cm for all events at 60 m. ?? 2002 Elsevier Science Ltd. All rights reserved.

Air-drying beds reduce the quantities of antibiotic resistance genes and class 1 integrons in residual municipal wastewater solids.

PubMed

Burch, Tucker R; Sadowsky, Michael J; LaPara, Timothy M

2013-09-03

This study investigated whether air-drying beds reduce antibiotic resistance gene (ARG) concentrations in residual municipal wastewater solids. Three laboratory-scale drying beds were operated for a period of nearly 100 days. Real-time PCR was used to quantify 16S rRNA genes, 16S rRNA genes specific to fecal bacteria (AllBac) and human fecal bacteria (HF183), the integrase gene of class 1 integrons (intI1), and five ARGs representing a cross-section of antibiotic classes and resistance mechanisms (erm(B), sul1, tet(A), tet(W), and tet(X)). Air-drying beds were capable of reducing all gene target concentrations by 1 to 5 orders of magnitude, and the nature of this reduction was consistent with both a net decrease in the number of bacterial cells and a lack of selection within the microbial community. Half-lives varied between 1.5 d (HF183) and 5.4 d (tet(X)) during the first 20 d of treatment. After the first 20 d of treatment, however, half-lives varied between 8.6 d (tet(X)) and 19.3 d (AllBac), and 16S rRNA gene, intI1, and sul1 concentrations did not change (P > 0.05). These results demonstrate that air-drying beds can reduce ARG and intI1 concentrations in residual municipal wastewater solids within timeframes typical of operating practices.

Bedbug infestation and its control practices in Gbajimba: a rural settlement in Benue state, Nigeria.

PubMed

Omudu, E A; Kuse, C N

2010-12-01

The common bedbug Cimex lectularius Linnaeus 1758 (Hemiptera: Cimicidae) is a globally re-emerging pest of serious public health concern. We investigated bedbug infestation in randomly selected apartments in Gbajimba community in Guma Local Government area in Benue state, Nigeria. Beddings and furniture (bed frames, pillows, mattresses, cushion chairs, mats, mosquito nets and bamboo beds) were thoroughly inspected for bedbug infestation using the hand-picking technique. Data were analysed using chi- square analysis for differences in the infestation levels in harbourages and sampling locations. Only 16% of the apartments investigated showed no evidence of bedbug infestation as egg cases and faecal marks were sighted in 62.2% of apartments surveyed. The highest infestation rate was observed in Angwan Jukun area and infestation here was higher compared to other study locations within the town though the difference was not statistically significant (x2 = 7.92, df = 6, p >0.05). Bamboo beds harboured the highest number of bedbugs collected, accounting for 35.8%, while other harbourages like iron bed frames and sleeping mats had 23 and 22.7% infestation rates respectively. The infestation rates in these household items were significantly higher than other items inspected (x2 = 11.8, df = 4, p > 0.05). This study demonstrates the urgent need for identification of evidences of infestation and bedbug management involving community participation in inspection, detection and education, including physical removal and exclusion as well as pesticide application.

What role do beds of submerged macrophytes play in structuring estuarine fish assemblages? Lessons from a warm-temperate South African estuary

NASA Astrophysics Data System (ADS)

Sheppard, Jill N.; James, Nicola C.; Whitfield, Alan K.; Cowley, Paul D.

2011-11-01

Habitat variability is one of the factors influencing species richness within estuarine systems, and a loss of habitat can result in a restructuring of the estuarine ichthyofaunal assemblage, particularly if these conditions persist over long time periods. The potential effects of the loss of extensive submerged macrophyte beds ( Ruppia cirrhosa and Potamogeton pectinatus) on an estuarine fish assemblage were investigated through an analysis of a long-term seine net catch dataset from the temporarily open/closed East Kleinemonde Estuary, South Africa. Catch data for a 12-year period, encompassing six years of macrophyte presence and six years of macrophyte senescence, indicated that the loss of this habitat did not influence species richness but changes in the relative abundance of certain species were evident. A shift in dominance from vegetation-associated species to those associated with sandy environments ( e.g. members of the family Mugilidae) was observed. However, species wholly dependent on macrophytes such as the critically endangered estuarine pipefish Syngnathus watermeyeri were only recorded during years when macrophyte beds were present, while vegetation-associated species such as the sparid Rhabdosargus holubi persisted at lower levels of relative abundance. The reduced abundance of all vegetation-associated fish species during years of macrophyte senescence was probably reflective of declining food resources resulting from the loss of macrophyte beds and/or increased vulnerability to predation. Submerged beds of aquatic plants are therefore important habitats within temporarily open/closed estuaries, South Africa's dominant estuary type.

Phyto-dewatering of sewage sludge using Panicum repens L.

PubMed

El-Gendy, A S; El-Kassas, H I; Razek, T M A; Abdel-Latif, H

2017-04-01

Experiments in the field environment have been conducted to study the growth of Panicum repens L., an aquatic plant, in the sewage sludge matrix. The experiments were also carried out to investigate the ability of this plant to dewater sewage sludge to increase the capacity of conventional drying beds. In addition, the ability of Panicum repens L. to reduce the sludge contents of certain elements (copper (Cu), Iron (Fe), Sodium (Na), lead (Pb), and Zinc (Zn)) was also investigated. All experiments were carried out in batch reactors. Different plant coverage densities were tested (0.00 to 27.3 kg/m 2 ). The liquid sewage sludge was collected from a wastewater treatment plant in Helwan city, Cairo Governorate, Egypt. The collected sludge represents a mixture of the primary sludge and waste activated sludge before discharging into drying beds.

Material exchange and food web of seagrass beds in the Sylt-Rømø Bight: how significant are community changes at the ecosystem level?

NASA Astrophysics Data System (ADS)

Asmus, H.; Asmus, R.

2000-07-01

Material exchange, biodiversity and trophic transfer within the food web were investigated in two different types of intertidal seagrass beds: a sheltered, dense Zostera marina bed and a more exposed, sparse Z. noltii bed, in the Northern Wadden Sea. Both types of Zostera beds show a seasonal development of above-ground biomass, and therefore measurements were carried out during the vegetation period in summer. The exchange of particles and nutrients between seagrass beds and the overlying water was measured directly using an in situ flume. Particle sedimentation [carbon (C), nitrogen (N) and phosphorus (P) constituents] from the water column prevailed in dense seagrass beds. In the sheltered, dense seagrass bed, a net particle uptake was found even on windy days (7-8 Beaufort). Dissolved inorganic N and orthophosphate were mainly taken up by the dense seagrass bed. At times of strong winds, nutrients were released from the benthic community to tidal waters. In a budget calculation of total N and total P, the dense seagrass beds were characterised as a material sink. The seagrass beds with sparse Z. noltii were a source of particles even during calm weather. The uptake of dissolved inorganic N in the sparse seagrass bed was low but significant, while the uptake of inorganic phosphate and silicate by seagrasses and their epiphytes was exceeded by release processes from the sediment into the overlying water. Estimates at the ecosystem level showed that material fluxes of seagrass beds in the Sylt-Rømø Bight are dominated by the dense type of Zostera beds. Therefore, seagrass beds act as a sink for particles and for dissolved inorganic nutrients. During storms, seagrass beds are distinct sources for inorganic nutrients. The total intertidal area of the Sylt-Rømø Bight could be described as a sink for particles and a source for dissolved nutrients. This balance of the material budget was estimated by either including or excluding seagrass beds. Including the subtidal part, the function of the ecosystem as a source for particles increased, supposing that all seagrass beds were lost from the area. During the vegetation period, seagrass beds act as a storage compartment for material accumulated in the living biomass of the community. There was great biodiversity among the plant and animal groups found in intertidal seagrass beds of the Sylt-Rømø Bay, representing 50-86% of the total number of species investigated, depending on the particular group. Since most species are not exclusively seagrass residents, the loss of intertidal seagrass beds would be of minor importance for biodiversity at the ecosystem level. Food web structure in seagrass beds is different from other intertidal communities. Primary production and detritus input is high, but secondary production is similar to that of unvegetated areas, although the relative importance of the trophic guilds is different. The loss of seagrass beds leads to profound alterations in the food web of the total ecosystem. Historical as well as recent changes in material fluxes and energy flow due to man-made alterations to the ecosystem are discussed.

Effects of wave shape on sheet flow sediment transport

USGS Publications Warehouse

Hsu, T.-J.; Hanes, D.M.

2004-01-01

A two-phase model is implemented to study the effects of wave shape on the transport of coarse-grained sediment in the sheet flow regime. The model is based on balance equations for the average mass, momentum, and fluctuation energy for both the fluid and sediment phases. Model simulations indicate that the responses of the sheet flow, such as the velocity profiles, the instantaneous bed shear stress, the sediment flux, and the total amount of the mobilized sediment, cannot be fully parameterized by quasi-steady free-stream velocity and may be correlated with the magnitude of local horizontal pressure gradient (or free-stream acceleration). A net sediment flux in the direction of wave advance is obtained for both skewed and saw-tooth wave shapes typical of shoaled and breaking waves. The model further suggests that at critical values of the horizontal pressure gradient, there is a failure event within the bed that mobilizes more sediment into the mobile sheet and enhances the sediment flux. Preliminary attempts to parameterize the total bed shear stress and the total sediment flux appear promising. Copyright 2004 by the American Geophysical Union.

CFM technologies for space transportation: Multipurpose hydrogen testbed system definition and tank procurement

NASA Technical Reports Server (NTRS)

Fox, E. C.; Kiefel, E. R.; Mcintosh, G. L.; Sharpe, J. B.; Sheahan, D. R.; Wakefield, M. E.

1993-01-01

The development of a test bed tank and system for evaluating cryogenic fluid management technologies in a simulated upper stage liquid hydrogen tank is covered. The tank is 10 ft long and is 10 ft in diameter, and is an ASME certified tank constructed of 5083 aluminum. The tank is insulated with a combination of sprayed on foam insulation, covered by 45 layers of double aluminized mylar separated by dacron net. The mylar is applied by a continuous wrap system adapted from commercial applications, and incorporates variable spacing between the mylar to provide more space between those layers having a high delta temperature, which minimizes heat leak. It also incorporates a unique venting system which uses fewer large holes in the mylar rather than the multitude of small holes used conventionally. This significantly reduces radiation heat transfer. The test bed consists of an existing vacuum chamber at MSFC, the test bed tank and its thermal control system, and a thermal shroud (which may be heated) surrounding the tank. Provisions are made in the tank and chamber for inclusion of a variety of cryogenic fluid management experiments.

Distribution and stability of eelgrass beds at Izembek Lagoon, Alaska

USGS Publications Warehouse

Ward, David H.; Markon, Carl J.; Douglas, David C.

1997-01-01

Spatial change in eelgrass meadows, Zostera marina L., was assessed between 1978 and 1987 and between 1987 and 1995 at Izembek Lagoon, Alaska. Change in total extent was evaluated through a map to map comparison of data interpreted from a 1978 Landsat multi-spectral scanner image and 1987 black and white aerial photographs. A ground survey in 1995 was used to assess spatial change from 1987. Eelgrass beds were the predominant vegetation type in the lagoon, comprising 44-47% (15000-16000 ha) of the total area in 1978 and 1987. Izembek Lagoon contains the largest bed of seagrass along the Pacific Coast of North America and largest known single stand of eelgrass in the world. There was a high degree of overlap in the spatial distribution of eelgrass among years of change detection. The overall net change was a 6% gain between, 1978 and 1987 and a <1% gain between 1987 and 1995. The lack of significant change in eelgrass cover suggests that eelgrass meadows in Izembek Lagoon have been stable during the 17-year period of our study.

Assessing bed net damage: comparisons of three measurement methods for estimating the size, shape, and distribution of holes on bed nets.

PubMed

Vanden Eng, Jodi L; Mathanga, Don P; Landman, Keren; Mwandama, Dyson; Minta, Anna A; Shah, Monica; Sutcliffe, James; Chisaka, Joseph; Lindblade, Kim A; Steinhardt, Laura

2017-10-10

Measuring the physical condition of long-lasting insecticidal nets (LLINs) under field conditions is of great importance for malaria control programmes to guide decisions on how frequently to replace LLINs. Current guidelines by the World Health Organization Pesticide Evaluation Scheme (WHOPES) propose a proportionate hole index (pHI) for assessing LLIN condition by counting the number of holes the size of a thumb, fist, head, and larger than a head. However, this method does not account for irregular hole shapes or exact hole sizes which could result in inaccurate decisions about when to replace LLINs. LLINs were collected during a 2013 health facility-based malaria case control study in Machinga District, Malawi. To evaluate the accuracy of the pHI, the physical condition of 277 LLINs was estimated by the WHOPES method and then compared with two more thorough measurement methods: image analysis of digital photographs of each LLIN side; and for 10 nets, ruler measurements of the length, width, and location of each hole. Total hole counts and areas per net were estimated by each method, and detailed results of hole shapes and composite pictures of hole locations were generated using image analysis. The WHOPES method and image analysis resulted in similar estimates of total hole counts, each with a median of 10 (inter-quartile range (IQR) 4-24 and 4-23, respectively; p = 0.004); however, estimated hole areas were significantly larger using the WHOPES method (median 162 cm 2 , IQR 28-793) than image analysis (median 13 cm 2 , IQR 3-101; p < 0.0001). The WHOPES method classified fewer LLINs in 'good condition' compared to image analysis (42% vs 74%). The ruler method detected significantly more holes than image analysis did (p = 0.002) in 10 LLINs; however, total hole area was not significantly different (p = 0.16). Most holes were not circular but roughly 2-5 times longer in one direction. The lower quarter of LLIN sides was found to have the most holes. The WHOPES method overestimated total hole area, likely because holes are elongated rather than circular, suggesting further adjustments to the pHI formula may be warranted when considering LLIN replacement strategies.

Coverage and equitability of interventions to prevent child mortality in rural Jimma and West Hararghe Zones, Oromia Region, Ethiopia.

PubMed

Miller, Nathan P; Degefie, Tedbabe; Hazel, Elizabeth; Legesse, Hailemariam; Tolera, Taye; Amouzou, Agbessi

2014-10-01

Interventions to prevent childhood illnesses are important components of the Ethiopian Health Extension Program (HEP). Although the HEP was designed to reduce inequities in access to health care, there is little evidence on equitability of preventive interventions in Ethiopia. This article describes coverage of preventive interventions and how many interventions individual children received We also examined which factors were associated with the number of preventive interventions received, and assessed the extent to which interventions were equitably distributed. We conducted a cross-sectional survey in 3,200 randomly selected households in the rural Jimma and West Hararghe Zones of Ethiopia's Oromia Region. We calculated coverage of 10 preventive interventions and a composite of eight interventions (co-coverage) representing the number of interventions received by children. Mul- tiple linear regressions were used to assess associations between co-coverage and explanatory variables. Finally, we assessed the equitability of preventive interventions by comparing coverage among children in the poorest and the least poor wealth quintiles. Coverage was less than 50% for six of the 10 interventions. Children received on average only three of the eight interventions included in the co-coverage calculation. Zone, gender, caretaker age, religion, and household wealth were all significantly associated with co-coverage, controlling for key covariates. Exclusive breastfeeding, vaccine uptake, and vitamin A supplementation were all relatively equitable. On the other hand, coverage of insecticide-treated nets or indoor residual spraying (ITN/IRS) and access to safe water were significantly higher among the least poor children compared to children in the poorest quintile. Coverage of key interventions to prevent childhood illnesses is generally low in Jimma and West Hararghe. Although a number of interventions were equitably distributed, there were marked wealth-based inequities for interventions that are possessed at the household level, even among relatively homogeneous rural communities.

Overcoming Spatial and Temporal Barriers to Public Access Defibrillators Via Optimization

PubMed Central

Sun, Christopher L. F.; Demirtas, Derya; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.

2016-01-01

BACKGROUND Immediate access to an automated external defibrillator (AED) increases the chance of survival from out-of-hospital cardiac arrest (OHCA). Current deployment usually considers spatial AED access, assuming AEDs are available 24 h a day. OBJECTIVES We sought to develop an optimization model for AED deployment, accounting for spatial and temporal accessibility, to evaluate if OHCA coverage would improve compared to deployment based on spatial accessibility alone. METHODS This was a retrospective population-based cohort study using data from the Toronto Regional RescuNET cardiac arrest database. We identified all nontraumatic public-location OHCAs in Toronto, Canada (January 2006 through August 2014) and obtained a list of registered AEDs (March 2015) from Toronto emergency medical services. We quantified coverage loss due to limited temporal access by comparing the number of OHCAs that occurred within 100 meters of a registered AED (assumed 24/7 coverage) with the number that occurred both within 100 meters of a registered AED and when the AED was available (actual coverage). We then developed a spatiotemporal optimization model that determined AED locations to maximize OHCA actual coverage and overcome the reported coverage loss. We computed the coverage gain between the spatiotemporal model and a spatial-only model using 10-fold cross-validation. RESULTS We identified 2,440 atraumatic public OHCAs and 737 registered AED locations. A total of 451 OHCAs were covered by registered AEDs under assumed 24/7 coverage, and 354 OHCAs under actual coverage, representing a coverage loss of 21.5% (p < 0.001). Using the spatiotemporal model to optimize AED deployment, a 25.3% relative increase in actual coverage was achieved over the spatial-only approach (p < 0.001). CONCLUSIONS One in 5 OHCAs occurred near an inaccessible AED at the time of the OHCA. Potential AED use was significantly improved with a spatiotemporal optimization model guiding deployment. PMID:27539176

Overcrowding and diversion in the emergency department: the health care safety net unravels.

PubMed

Velianoff, George D

2002-03-01

Emergency department overcrowding and diversion of patients are serious problems that are symptomatic of larger health care system issues. Downsizing, government regulations, managed care, increased numbers of uninsured, and reimbursement decreases are issues that have created the overcrowding and diversion issues. The Emergency Medical Treatment and Active Labor Act (EMTALA), poor operations and hospital processes, unavailable inpatient beds and closures, consolidations and workforce shortages are also contributors to the overcrowding and diversion issues. Options and solutions are proposed to alleviate the problem, however, greater collaboration, changed work environments, and reimbursement structures need to be developed and instituted. The safety net of the US health system is unraveling, and without intervention, the emergency department will not be able to provide services to the public at any level of quality and efficiency.

Groundwater-level and storage-volume changes in the Equus Beds aquifer near Wichita, Kansas, predevelopment through January 2015

USGS Publications Warehouse

Whisnant, Joshua A.; Hansen, Cristi V.; Eslick, Patrick J.

2015-10-01

Groundwater levels from January 2014 to January 2015 in the central part of the study area rose about 3 feet in some places, probably because Wichita reduced its withdrawals from the aquifer in 2014 by more than 50 percent. Groundwater levels probably recovered less than anticipated because of decreased recharge and net groundwater flow and increased agricultural pumpage. A volumetric water budget for the central part of the study area between 2013 and 2014 showed that the substantial decrease in total pumping (10,412 acre-feet) did not result in an increase in storage volume because it was more than offset by decreased recharge (6,502 acre-feet; artificial and from precipitation) and an even greater decrease in net groundwater flow (11,710 acre-feet).

A Comparison of Jump Height, Takeoff Velocities, and Blocking Coverage in the Swing and Traditional Volleyball Blocking Techniques

PubMed Central

Ficklin, Travis; Lund, Robin; Schipper, Megan

2014-01-01

The purpose of this study was to compare traditional and swing blocking techniques on center of mass (COM) projectile motion and effective blocking area in nine healthy Division I female volleyball players. Two high-definition (1080 p) video cameras (60 Hz) were used to collect two-dimensional variables from two separate views. One was placed perpendicular to the plane of the net and the other was directed along the top of the net, and were used to estimate COM locations and blocking area in a plane parallel to the net and hand penetration through the plane of the net respectively. Video of both the traditional and swing techniques were digitized and kinematic variables were calculated. Paired samples t-tests indicated that the swing technique resulted in greater (p < 0.05) vertical and horizontal takeoff velocities (vy and vx), jump height (H), duration of the block (tBLOCK), blocking coverage during the block (C) as well as hand penetration above and through the net’s plane (YPEN, ZPEN). The traditional technique had significantly greater approach time (tAPP). The results of this study suggest that the swing technique results in both greater jump height and effective blocking area. However, the shorter tAPP that occurs with swing is associated with longer times in the air during the block which may reduce the ability of the athlete to make adjustments to attacks designed to misdirect the defense. Key Points Swing blocking technique has greater jump height, effective blocking area, hand penetration, horizontal and vertical takeoff velocity, and has a shorter time of approach. Despite these advantages, there may be more potential for mistiming blocks and having erratic deflections of the ball after contact when using the swing technique. Coaches should take more than simple jump height and hand penetration into account when deciding which technique to employ. PMID:24570609

Malaria burden and costs of intensified control in Bhutan, 2006-14: an observational study and situation analysis.

PubMed

Wangdi, Kinley; Banwell, Cathy; Gatton, Michelle L; Kelly, Gerard C; Namgay, Rinzin; Clements, Archie C A

2016-05-01

The number of malaria cases has fallen in Bhutan in the past two decades, and the country has a goal of complete elimination of malaria by 2016. The aims of this study are to ascertain the trends and burden of malaria, the costs of intensified control activities, the main donors of funding for the control activities, and the costs of different preventive measures in the pre-elimination phase (2006-14) in Bhutan. We undertook a descriptive analysis of malaria surveillance data from 2006 to 2014, using data from the Vector-borne Disease Control Programme (VDCP) run by the Department of Public Health of Bhutan's Ministry of Health. Malaria morbidity and mortality in local Bhutanese people and foreign nationals were analysed. The cost of different control and preventive measures were calculated, and the average numbers of long-lasting insecticidal nests per person were estimated. A total of 5491 confirmed malaria cases occurred in Bhutan between 2006 and 2014. By 2013, there was an average of one long-lasting insecticidal net for every 1·51 individuals. The cost of procuring long-lasting insecticidal nets accounted for more than 90% of the total cost of prevention measures. The Global Fund to Fight AIDS, Tuberculosis and Malaria was the main international donor, accounting for more than 80% of the total funds. The malaria burden in Bhutan decreased significantly during the study period with high coverage of long-lasting insecticidal nets. The foreseeable challenges that require national attention to maintain a malaria-free status after elimination are importation of malaria, especially from India; continued protection of the population in endemic districts through complete coverage with long-lasting insecticidal nets and indoor residual spraying; and exploration of local funding modalities post-elimination in the event of a reduction in international funding. None. Copyright © 2016 Wangdi et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Access and adequate utilization of malaria control interventions in rural Malawi: a descriptive quantitative study.

PubMed

Kabaghe, Alinune Nathanael; Chipeta, Michael Give; McCann, Robert Sean; Terlouw, Dianne Jean; Tizifa, Tinashe; Truwah, Zinenani; Phiri, Kamija Samuel; van Vugt, Michèle

2018-03-06

Despite the availability of cost effective malaria control interventions, such as insecticide-treated bed nets (ITN), diagnosis and effective treatment of malaria, and intermittent preventive treatment during pregnancy (IPTp), the lack of equitable access and coverage affect utilization of these interventions in rural communities. Aggregated rates of access and utilization of malaria interventions in national surveys mask substantial variations in intervention coverage. Utilization of interventions and factors affecting utilization need investigation in rural communities. One year of quantitative data collected from a rolling Malaria Indicator Survey (April 2015-April 2016) in Chikhwawa District, Malawi, before the ITN distribution campaign, were analysed. Univariate analyses were used to quantify rates of ITN usage, care-seeking for fever in children aged 6-59 months and women aged 15-49 years and IPTp uptake (for women aged 15-49 years with a recent delivery). Results were compared to national survey estimates; factors associated with these outcomes were determined using multivariate regression models. A total of 2046 participants were included from 1328 households; 56.6% were women aged 15-49 years and 43.4% were children aged 6-59 months. Reported ownership of at least one ITN per household and under-five children ITN use the previous night were 35.3 and 33.5% compared to 70.2 and 67.1%, respectively, in the national survey; ITN use was higher in high wealth quintile households than low quintile ones. For participants with recent fever, 37.6 and 19.5% sought care and sought care within 24 h, respectively. Care-seeking was lower for febrile women than febrile children [aOR, 95% CI 0.53 (0.35-0.81)]. Uptake of two and three or more doses of IPTp were 40.6 and 15.0%, respectively, among women with a pregnancy in the last 2 years. To achieve effective malaria control, fine-scale or district-based surveillance should be used to identify and target communities requiring scaling up of interventions. Qualitative research and a participatory community approach should be used to address behavioural factors affecting how people make use of interventions.

Sediment transport and fluid mud layer formation in the macro-tidal Chikugo river estuary during a fortnightly tidal cycle

NASA Astrophysics Data System (ADS)

Azhikodan, Gubash; Yokoyama, Katsuhide

2018-03-01

The erosion and deposition dynamics of fine sediment in a highly turbid estuarine channel were successfully surveyed during the period from August 29 to September 12, 2009 using an echo sounder in combination with a high-resolution acoustic Doppler current profiler. Field measurements were conducted focusing on the tide driven dynamics of suspended sediment concentration (SSC), and fluid mud at the upstream of the macrotidal Chikugo river estuary during semidiurnal and fortnightly tidal cycles. Morphological evolution was observed especially during the spring tide over a period of two weeks. The elevation of the channel bed was stable during neap tide, but it underwent fluctuations when the spring tide occurred owing to the increase in the velocity and shear stress. Two days of time lag were observed between the maximum SSC and peak tidal flow, which resulted in the asymmetry between neap-to-spring and spring-to-neap transitions. During the spring tide, a hysteresis loop was observed between shear stress and SSC, and its direction was different during flood and ebb tides. Although both fine sediments and flocs were dominant during flood tides, only fine sediments were noticed during ebb tides. Hence, the net elevation change in the bed was positive, and sedimentation took place during the semilunar tidal cycle. Finally, a bed of consolidated mud was deposited on the initial bed, and the height of the channel bed increased by 0.9 m during the two-week period. The observed hysteretic effect between shear stress and SSC during the spring tides, and the asymmetrical neap-spring-neap tidal cycle influenced the near-bed sediment dynamics of the channel, and led to the formation of a fluid mud layer at the bottom of the river.

Ownership and utilisation of long lasting insecticide treated nets following free distribution campaign in South West Nigeria.

PubMed

Aderibigbe, Sunday Adedeji; Olatona, Foluke Adenike; Sogunro, Oluremi; Alawode, Gafar; Babatunde, Oluwole Adeyemi; Onipe, Ambrose Itopa; Bolarinwa, Oladimeji Akeem; Ameen, Hafsat Abolore; Osagbemi, Gordon Kayode; Sanya, Emmanuel Olatunde; Olarinoye, Adebunmi Oyeladun; Akande, Tanimola Makanjuola

2014-01-01

Malaria has proven to be the most horrendous and intractable amongst the health problems confronting countries in the sub-Saharan Africa. This study aims to determine the ownership and utilisation of long lasting insecticide treated nets following free distribution campaign in a state in South West Nigeria. Multi-stage sampling technique was used to recruit 2560 households spread across the 16 LGAs of the state. Interviewer administered standardized questionnaire was used for the survey. Data analysis was done using Stata 10 software. Sixty eight point six percent (68.6%) of the households had at least one under-five child living in the household while 32.6% had at least one pregnant woman living in the household. A total of 2440 (95.3%) households received LLIN during the campaign. Overall, the utilization rate for all respondents was 58.5%. Despite the fact that 2440 households received LLINs during the campaign, only 84.3% of them were seen to have hung theirs during the survey. Coverage and ownership of LLINs increased significantly following the free distribution campaign. There was a discrepancy between net possession and net use with rate of use lower than possession. Post distribution educational campaign should be incorporated into future distribution campaigns to help increase net utilisation.

Access to essential maternal health interventions and human rights violations among vulnerable communities in eastern Burma.

PubMed

Mullany, Luke C; Lee, Catherine I; Yone, Lin; Paw, Palae; Oo, Eh Kalu Shwe; Maung, Cynthia; Lee, Thomas J; Beyrer, Chris

2008-12-23

Health indicators are poor and human rights violations are widespread in eastern Burma. Reproductive and maternal health indicators have not been measured in this setting but are necessary as part of an evaluation of a multi-ethnic pilot project exploring strategies to increase access to essential maternal health interventions. The goal of this study is to estimate coverage of maternal health services prior to this project and associations between exposure to human rights violations and access to such services. Selected communities in the Shan, Mon, Karen, and Karenni regions of eastern Burma that were accessible to community-based organizations operating from Thailand were surveyed to estimate coverage of reproductive, maternal, and family planning services, and to assess exposure to household-level human rights violations within the pilot-project target population. Two-stage cluster sampling surveys among ever-married women of reproductive age (15-45 y) documented access to essential antenatal care interventions, skilled attendance at birth, postnatal care, and family planning services. Mid-upper arm circumference, hemoglobin by color scale, and Plasmodium falciparum parasitemia by rapid diagnostic dipstick were measured. Exposure to human rights violations in the prior 12 mo was recorded. Between September 2006 and January 2007, 2,914 surveys were conducted. Eighty-eight percent of women reported a home delivery for their last pregnancy (within previous 5 y). Skilled attendance at birth (5.1%), any (39.3%) or > or = 4 (16.7%) antenatal visits, use of an insecticide-treated bed net (21.6%), and receipt of iron supplements (11.8%) were low. At the time of the survey, more than 60% of women had hemoglobin level estimates < or = 11.0 g/dl and 7.2% were Pf positive. Unmet need for contraceptives exceeded 60%. Violations of rights were widely reported: 32.1% of Karenni households reported forced labor and 10% of Karen households had been forced to move. Among Karen households, odds of anemia were 1.51 (95% confidence interval [CI] 0.95-2.40) times higher among women reporting forced displacement, and 7.47 (95% CI 2.21-25.3) higher among those exposed to food security violations. The odds of receiving no antenatal care services were 5.94 (95% CI 2.23-15.8) times higher among those forcibly displaced. Coverage of basic maternal health interventions is woefully inadequate in these selected populations and substantially lower than even the national estimates for Burma, among the lowest in the region. Considerable political, financial, and human resources are necessary to improve access to maternal health care in these communities.

Insecticide-treated nets mass distribution campaign: benefits and lessons in Zambia.

PubMed

Masaninga, Freddie; Mukumbuta, Nawa; Ndhlovu, Ketty; Hamainza, Busiku; Wamulume, Pauline; Chanda, Emmanuel; Banda, John; Mwanza-Ingwe, Mercy; Miller, John M; Ameneshewa, Birkinesh; Mnzava, Abraham; Kawesha-Chizema, Elizabeth

2018-04-24

Zambia was an early adopter of insecticide-treated nets strategy in 2001, and policy for mass distribution with long-lasting insecticidal nets (LLINs) in 2005. Since then, the country has implemented mass distribution supplemented with routine delivery through antenatal care and under five clinics in health facilities. The national targets of universal (100%) coverage and 80% utilization of LLINs have not been attained. Free mass LLIN distribution campaign in Zambia offers important lessons to inform future campaigns in the African region. This study reviewed LLIN free mass distribution campaign information derived from Zambia's national and World Health Organization Global Malaria Programme annual reports and strategic plans published between 2001 and 2016. In 2014, a nationwide mass distribution campaign in Zambia delivered all the 6.0 million LLINs in 6 out of 10 provinces in 4 months between June and September before the onset of the rainy season. Compared with 235,800 LLINs and 2.9 million LLINs distributed on a rolling basis in 2008 and 2013, respectively, the 2014 mass campaign, which distributed 6 million LLINs represented the largest one-time-nationwide LLIN distribution in Zambia. The province (Luapula) with highest malaria transmission, mostly with rural settings recorded 98-100% sleeping spaces in homes covered with LLINs. The percentage of households owning at least 1 LLIN increased from 50.9% in 2006 to 77.7% in 2015. The 2014 mass campaign involved a coordinated response with substantial investments into macro (central) and micro (district) level planning, capacity building, tracking and logistics management supported by a new non-health sector partnership landscape. Coordination of LLIN distribution and logistics benefited from the mobile phone technology to transmit "real time" data on commodity tracking that facilitated timely delivery to districts. Free mass distribution of LLINs policy was adopted in 2005 in Zambia. Consistently implemented, has not only contributed to increased coverage of LLINs, but has also produced the added value and lessons of strengthening joint planning, strategic coordination, partnerships with non-health sector institutions and community engagement with traditional leaders at community. Furthermore, the mass distribution, through improving coverage has indirect added (spin-off) value or impact on other arthropod-borne diseases, in addition to malaria.

Netting the malaria menace: Distribution and utilization of long-lasting insecticidal net in a malaria endemic area in Bankura, West Bengal.

PubMed

Mukhopadhyay, D K; Basu, S S; Roy, D; Das, N; Akbar, F; Sarkar, G N

2016-03-01

Long-lasting insecticidal net (LLIN) is considered to be a highly effective intervention against malaria under National Vector Borne Disease Control Programme in India. A cross-sectional study was undertaken to assess the coverage and utilization of LLIN and the factors related thereto. A survey of 1300 households was carried out in Ranibandh block of Bankura district in West Bengal, India, using lot quality assurance sampling (LQAS) method. Coverage/utilization of 80% was considered as minimum acceptable norm. The weighted sample size was calculated from each village of the block. The sociodemographic, economic information of the household along with the availability and use of LLIN was collected through interview and observation. In total, 7320 individuals including 840 children ≤ 5 yr were visited. Overall coverage of adequate LLIN was 65.4% (± 1.5%) and for children ≤ 5 yr, it was 60.5% (± 1.3%). Overall, 66.1% (± 1.4%) people of all ages and 63.7% (± 1.4%) children ≤ 5 yr slept under LLINs in the night before the survey. Out of 26 sub-centres, distribution of LLINs in 10 sub-centres was below the accepted norm, whereas utilization was sub-optimal in 19 sub-centres. In only 18.2% (± 0.5%) households, LLINs remained hanging during daytime. Poverty, caste, education, perception regarding malarial morbidity and preventive action of LLIN were associated significantly with the distribution of LLIN. Similarly, poverty (AOR = 2.14), threat perception regarding malarial morbidity (AOR = 1.51) and mortality (AOR = 2.52) were positively associated with the use of LLIN. Full utilization of bednets by under-fives of the households was higher in villages with sub-centres. Around two-third population of the study area was effectively covered with LLIN. Higher proportion of socially marginalized people received LLIN. Threat perception regarding malaria was directly associated with both receipt and use of LLIN. Behaviour change communication on utilization along with adequate access to LLIN needs to be strengthened.

A Meta-Regression Analysis of the Effectiveness of Mosquito Nets for Malaria Control: The Value of Long-Lasting Insecticide Nets

PubMed Central

Yang, Gi-geun; Pham, Anh

2018-01-01

Long-lasting insecticidal nets (LLINs) have been widely used as an effective alternative to conventional insecticide-treated nets (ITNs) for over a decade. Due to the growing number of field trials and interventions reporting the effectiveness of LLINs in controlling malaria, there is a need to systematically review the literature on LLINs and ITNs to examine the relative effectiveness and characteristics of both insecticide nettings. A systematic review of over 2000 scholarly articles published since the year 2000 was conducted. The odds ratios (ORs) of insecticidal net effectiveness in reducing malaria were recorded. The final dataset included 26 articles for meta-regression analysis, with a sample size of 154 subgroup observations. While there is substantial heterogeneity in study characteristics and effect size, we found that the overall OR for reducing malaria by LLIN use was 0.44 (95% CI = 0.41–0.48, p < 0.01) indicating a risk reduction of 56%, while ITNs were slightly less effective with an OR of 0.59 (95% CI = 0.57–0.61, p <0.01). A meta-regression model confirms that LLINs are significantly more effective than ITNs in the prevention of malaria, when controlling for other covariates. For both types of nets, protective efficacy was greater in high transmission areas when nets were used for an extended period. However, cross-sectional studies may overestimate the effect of the nets. The results surprisingly suggest that nets are less effective in protecting children under the age of five, which may be due to differences in child behavior or inadequate coverage. Compared to a previous meta-analysis, insecticide-treated nets appear to have improved their efficacy despite the risks of insecticide resistance. These findings have practical implications for policymakers seeking effective malaria control strategies. PMID:29562673

Summarizing an Ontology: A "Big Knowledge" Coverage Approach.

PubMed

Zheng, Ling; Perl, Yehoshua; Elhanan, Gai; Ochs, Christopher; Geller, James; Halper, Michael

2017-01-01

Maintenance and use of a large ontology, consisting of thousands of knowledge assertions, are hampered by its scope and complexity. It is important to provide tools for summarization of ontology content in order to facilitate user "big picture" comprehension. We present a parameterized methodology for the semi-automatic summarization of major topics in an ontology, based on a compact summary of the ontology, called an "aggregate partial-area taxonomy", followed by manual enhancement. An experiment is presented to test the effectiveness of such summarization measured by coverage of a given list of major topics of the corresponding application domain. SNOMED CT's Specimen hierarchy is the test-bed. A domain-expert provided a list of topics that serves as a gold standard. The enhanced results show that the aggregate taxonomy covers most of the domain's main topics.

Durability of Olyset campaign nets distributed between 2009 and 2011 in eight districts of Tanzania.

PubMed

Massue, Dennis J; Moore, Sarah J; Mageni, Zawadi D; Moore, Jason D; Bradley, John; Pigeon, Olivier; Maziba, Erasto J; Mandike, Renata; Kramer, Karen; Kisinza, William N; Overgaard, Hans J; Lorenz, Lena M

2016-03-18

Long-lasting insecticidal nets (LLINs) are the first line choice for malaria vector control in sub-Saharan Africa, with most countries adopting universal coverage campaigns. However, there is only limited information on LLIN durability under user conditions. Therefore, this study aimed to assess the durability of Olyset(®) LLINs distributed during campaigns between 2009 and 2011 in Tanzania. A retrospective field survey was conducted in eight districts in Tanzania mainland to assess the durability of Olyset campaign nets. Household questionnaires were used to assess attrition, i.e. net loss. All nets remaining in households were collected. A sub-sample of 198 Olyset campaign nets was examined for bio-efficacy against Anopheles gambiae s.s. mosquitoes, permethrin content and physical integrity following standard World Health Organization (WHO) methods. Of 6067 campaign nets reported to have been received between 2009 and 2011, 35% (2145 nets) were no longer present. Most of those nets had been discarded (84%) mainly because they were too torn (94%). Of the 198 sub-sampled Olyset LLINs, 61% were still in serviceable physical condition sufficient to provide personal protection while 39% were in unserviceable physical condition according to WHO proportionate Hole Index (pHI). More than 96% (116/120) of nets in serviceable condition passed WHO bioefficacy criteria while all nets in unserviceable condition passed WHO bioefficacy criteria. Overall mean permethrin content was 16.5 g/kg (95% CI 16.2-16.9) with 78% of the sub-sampled nets retaining recommended permethrin content regardless of their age or physical condition. Nets aged 4 years and above had a mean permethrin content of 14 g/kg (95% CI 12.0-16.0). The only statistically significant predictor of reduced physical net integrity was rats in the house. Two-to-four years after a mass campaign, only 39% of distributed nets remain both present and in serviceable physical condition, a functional survival considerably below WHO assumptions of 50% survival of a 'three-year' net. However, the majority of nets still retained substantial levels of permethrin and could still be bio-chemically useful against mosquitoes if their holes were repaired, adding evidence to the value of net care and repair campaigns.

Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos

PubMed Central

Shirayama, Yoshihisa; Phompida, Samlane; Shibuya, Kenji

2009-01-01

Background Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. Methods Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. Results As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. Conclusion Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province. PMID:19772628

Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos.

PubMed

Shirayama, Yoshihisa; Phompida, Samlane; Shibuya, Kenji

2009-09-22

Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province.

Cross-subsidization in the market for employment-related health insurance.

PubMed

Monheit, A C; Selden, T M

2000-12-01

This paper uses data from the 1987 National Medical Expenditure Survey to examine the nature of equilibrium in the market for employment-related health insurance. We examine coverage generosity, premiums, and insurance benefits net of expenditures on premiums, showing that despite a degree of market segmentation, there was a substantial amount of pooling of heterogeneous risks in 1987 among households with employment-related coverage. Our results are largely invariant to (i) firm size and (ii) whether or not employers offer a choice among plans. Our results suggest the need for caution concerning incremental reforms that would weaken the link between employment and insurance without substituting alternative institutions for the pooling of risks. Copyright 2000 Published in 2000 by John Wiley & Sons, Ltd.

Experimental Applications of the Modular Acoustic System for the Submersible ALVIN

DTIC Science & Technology

1975-08-01

surface. Data comparlsoIs can be made with results from other on-site instrumental packages, such as rock hammers and drills , and plankton nets...Massachusetts, and Long Island Sound," J. Sedimentary Petrology 33:723-727. Rhoads, D.C. and 1). J. Stanley (1965). "Biogenic Graded Bedding," J...Sedimentary Petrology 35:956-963. Rhoads, D.C. (1967). "Biogenic Reworking of Intertidal and Sub- tidal Sediments in Barnstable Harbor and Buzzards Bay, Massa

Property Investigation of Laser Cladded, Laser Melted and Electron Beam Melted Ti-Al6-V4

DTIC Science & Technology

2006-05-01

UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Figure 3: Examples of electron beam melted net shape parts; powder bed [3]. 1.4 Laser Cladding ...description, www.arcam.com. [4] K.-H. Hermann, S. Orban, S. Nowotny, Laser Cladding of Titanium Alloy Ti6242 to Restore Damaged Blades, Proceedings...Property Investigation of Laser Cladded , Laser Melted and Electron Beam Melted Ti-Al6-V4 Johannes Vlcek EADS Deutschland GmbH Corporate Research

Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.

PubMed

Sistrom, Christopher Lee; McKay, Niccie L

2005-06-01

This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.

Mass distribution of free insecticide-treated nets do not interfere with continuous net distribution in Tanzania

PubMed Central

2014-01-01

Background To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. Methods In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007 2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. Results There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. Conclusion The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria. PMID:24884786

Mass distribution of free insecticide-treated nets do not interfere with continuous net distribution in Tanzania.

PubMed

Eze, Ikenna C; Kramer, Karen; Msengwa, Amina; Mandike, Renata; Lengeler, Christian

2014-05-27

To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007-2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria.

Health insurance tax credits, the earned income tax credit, and health insurance coverage of single mothers.

PubMed

Cebi, Merve; Woodbury, Stephen A

2014-05-01

The Omnibus Budget Reconciliation Act of 1990 enacted a refundable tax credit for low-income working families who purchased health insurance coverage for their children. This health insurance tax credit (HITC) existed during tax years 1991, 1992, and 1993, and was then rescinded. A difference-in-differences estimator applied to Current Population Survey data suggests that adoption of the HITC, along with accompanying increases in the Earned Income Tax Credit (EITC), was associated with a relative increase of about 4.7 percentage points in the private health insurance coverage of working single mothers with high school or less education. Also, a difference-in-difference-in-differences estimator, which attempts to net out the possible influence of the EITC increases but which requires strong assumptions, suggests that the HITC was responsible for about three-quarters (3.6 percentage points) of the total increase. The latter estimate implies a price elasticity of health insurance take-up of -0.42. Copyright © 2013 John Wiley & Sons, Ltd.

Increasing Health Insurance Costs and the Decline in Insurance Coverage

PubMed Central

Chernew, Michael; Cutler, David M; Keenan, Patricia Seliger

2005-01-01

Objective To determine the impact of rising health insurance premiums on coverage rates. Data Sources & Study Setting Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989–1991 and 1998–2000. Measures of premiums are based on data from the Health Insurance Association of America and the Kaiser Family Foundation/Health Research and Educational Trust Survey of Employer-Sponsored Health Benefits. Study Design Probit regression and instrumental variable techniques are used to estimate the association between rising local health insurance costs and the falling propensity for individuals to have any health insurance coverage, controlling for a rich array of economic, demographic, and policy covariates. Principal Findings More than half of the decline in coverage rates experienced over the 1990s is attributable to the increase in health insurance premiums (2.0 percentage points of the 3.1 percentage point decline). Medicaid expansions led to a 1 percentage point increase in coverage. Changes in economic and demographic factors had little net effect. The number of people uninsured could increase by 1.9–6.3 million in the decade ending 2010 if real, per capita medical costs increase at a rate of 1–3 percentage points, holding all else constant. Conclusions Initiatives aimed at reducing the number of uninsured must confront the growing pressure on coverage rates generated by rising costs. PMID:16033490

Dental Use and Expenditures for Older Uninsured Americans: The Simulated Impact of Expanded Coverage

PubMed Central

Manski, Richard J; Moeller, John F; Chen, Haiyan; Schimmel, Jody; Pepper, John V; St Clair, Patricia A

2015-01-01

Objective To determine if providing dental insurance to older Americans would close the current gaps in dental use and expenditure between insured and uninsured older Americans. Data Sources/Study Setting We used data from the 2008 Health and Retirement Survey (HRS) supplemented by data from the 2006 Medical Expenditure Panel Survey (MEPS). Study Design We compared the simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured. Data Collection/Extraction Methods The HRS is a nationally representative survey administered by the Institute for Social Research (ISR). The MEPS is a nationally representative household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ). Principal Findings We found that expanding dental coverage to older uninsured Americans would close previous gaps in dental use and expense between uninsured and insured noninstitutionalized Americans 55 years and older. Conclusions Providing dental coverage to previously uninsured older adults would produce estimated monthly costs net of markups for administrative costs that comport closely to current market rates. Estimates also suggest that the total cost of providing dental coverage targeted specifically to nonusers of dental care may be less than similar costs for prior users. PMID:25040355

Characteristics of sedimentary structures in coarse-grained alluvial rivers

NASA Astrophysics Data System (ADS)

Ackerley, David; Powell, Mark

2013-04-01

The characteristics of coarse-grained alluvial surfaces have important implications for the estimation of flow resistance, entrainment thresholds and sediment transport rates in gravel-bed rivers. This area of research has, thus, demanded attention from geomorphologists, sedimentologists, and river engineers. The majority of research has focused towards understanding the characteristics and adjustments in surface grain size. Bed stability, however, is not ultimately defined by particle size but how grains are arranged within the bed surface. For example, by the organisation of particles into a variety of grain and form scale sedimentary structures and bedforms (e.g. imbrication; pebble clusters, stone nets, transverse ribs). While it is widely acknowledged sedimentary structuring must be considered within estimates of flow resistance and sediment transport, relatively little is known about the structural properties of water-worked river gravels. As a consequence, we remain woefully ignorant of this important aspect of gravel-bed river sedimentology. The aim of this poster is to present some preliminary results of a study designed to characterise the morphodynamics of sedimentary structures in coarse-grained alluvial rivers and their implications upon entrainment thresholds and sediment transport rates. The poster focuses on investigating the variability in grain and form scale sedimentary structuring across a number of field sites. Representative patches of three gravel bars on the Rivers Wharfe, Manifold and Afon Elan, UK, have been surveyed using a Leica HDS 3000 Terrestrial Laser Scanner. The resultant raw point-cloud data, recorded at a 4mm resolution, has been registered, filtered, and interpolated to produce highly detailed 2½D digital elevation models of gravel-bed surface topography. These surfaces have been analysed using a number of structural parameters including bed elevation probability distribution function statistics (standard deviation, skewness, kurtosis), semivariograms, and inclination indices. This research enhances our understanding of alluvial bed surface structures and lays the foundations for developing a more detailed understanding of their morphodynamics.

Paleocene-eocene lignite beds of southwest Alabama: Parasequence beds in highstand systems tracts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mancini, E.A.; Tew, B.H.; Carroll, R.E.

1993-09-01

In southwest Alabama, lignite beds are present in at least four stratigraphic intervals that span approximately 8 m.y. of geologic time. Lignite is found in the Paleocene Oak Hill Member and Coal Bluff Member of the Naheola Formation of the Midway Group and the Paleocene Tuscahoma Sand and the Eocene Hatchetigbee Formation of the Wilcox Group. Lignite beds range in thickness from 0.5 to 11 ft and consist of 32-53% moisture, 13-39% volatile matter, 4-36% fixed carbon, and 5-51% ash. These Paleocene and Eocene lignite beds occur as parasequence deposits in highstand systems tracts of four distinct third-order depositional sequences.more » The lignite beds are interpreted as strata within highstand systems tract parasequences that occur in mud-dominated regressive intervals. Lignite beds were deposited in coastal marsh and low-lying swamp environments as part of deltaic systems that prograded into southwestern Alabama from the west. As sediment was progressively delivered into the basin from these deltas, the effects of relative sea level rise during an individual cycle were overwhelmed, producing a net loss of accommodation and concomitant overall basinward progradation of the shoreline (regression). Small-scale fluctuations in water depth resulting from the interaction of eustasy, sediment yield, and subsidence led to cyclical flooding of the low-lying coastal marshes and swamps followed by periods of progradational and regression. Highstand systems tract deposition within a particular depositional sequence culminated with a relative sea level fall that resulted in a lowering of base level and an abrupt basinward shift in coastal onlap. Following sea level fall and the subsequent accumulation of the lowstand deposits, significant relative sea level rise resulted in the marine inundation of the area previously occupied by coastal marshes and swamps and deposition of the transgressive systems tract of the overlying sequence.« less

Effects of lateral confinement in natural and leveed reaches of a gravel-bed river: Snake River, Wyoming, USA

USGS Publications Warehouse

Leonard, Christina M.; Legleiter, Carl; Overstreet, Brandon T.

2017-01-01

This study examined the effects of natural and anthropogenic changes in confining margin width by applying remote sensing techniques – fusing LiDAR topography with image-derived bathymetry – over a large spatial extent: 58 km of the Snake River, Wyoming, USA. Fused digital elevation models from 2007 and 2012 were differenced to quantify changes in the volume of stored sediment, develop morphological sediment budgets, and infer spatial gradients in bed material transport. Our study spanned two similar reaches that were subject to different controls on confining margin width: natural terraces versus artificial levees. Channel planform in reaches with similar slope and confining margin width differed depending on whether the margins were natural or anthropogenic. The effects of tributaries also differed between the two reaches. Generally, the natural reach featured greater confining margin widths and was depositional, whereas artificial lateral constriction in the leveed reach produced a sediment budget that was closer to balanced. Although our remote sensing methods provided topographic data over a large area, net volumetric changes were not statistically significant due to the uncertainty associated with bed elevation estimates. We therefore focused on along-channel spatial differences in bed material transport rather than absolute volumes of sediment. To complement indirect estimates of sediment transport derived by morphological sediment budgeting, we collected field data on bed mobility through a tracer study. Surface and subsurface grain size measurements were combined with bed mobility observations to calculate armoring and dimensionless sediment transport ratios, which indicated that sediment supply exceeded transport capacity in the natural reach and vice versa in the leveed reach. We hypothesize that constriction by levees induced an initial phase of incision and bed armoring. Because levees prevented bank erosion, the channel excavated sediment by migrating rapidly across the restricted braidplain and eroding bars and islands. 

Buffering the Uneven Impact of the Affordable Care Act: Immigrant-serving Safety-net Providers in New Mexico.

PubMed

Getrich, Christina M; García, Jacqueline M; Solares, Angélica; Kano, Miria

2018-06-01

We conducted a study in early 2014 to document how the initial implementation of the Affordable Care Act (ACA) affected health care provision to different categories of immigrants from the perspective of health care providers in New Mexico. Though ACA navigators led enrollment, a range of providers nevertheless became involved by necessity, expressing concern about how immigrants were faring in the newly configured health care environment and taking on advocacy roles. Providers described interpreting shifting eligibility and coverage, attending to vulnerable under/uninsured patients, and negotiating new bureaucratic barriers for insured patients. Findings suggest that, like past efforts, this recent reform to the fragmented health care system has perpetuated a condition in which safety-net clinics and providers are left to buffer a widening gap for immigrant patients. With possible changes to the ACA ahead, safety-net providers' critical buffering roles will likely become more crucial, underscoring the necessity of examining their experiences with past reforms. © 2017 by the American Anthropological Association.

A review of the effects of impermeable bedding encasements on dust-mite allergen exposure and bronchial hyper-responsiveness in dust-mite-sensitized patients.

PubMed

Recer, G M

2004-02-01

Sensitization and exposure to dust-mite antigens are causative factors in the development and exacerbation of asthma. Impermeable bedding encasements are considered a first-line treatment to reduce dust-mite antigen exposure in clinical asthma-management guidelines. Public-health recommendations for environmental asthma treatments should be based on the weight of evidence supporting the reliability of environmental interventions so that uncertainties regarding their effectiveness can be accurately communicated to patients, and so that limited public-health resources can be most effectively utilized. To evaluate the strength of a clinical-trial evidence supporting the efficacy of bedding encasements as an asthma treatment. A narrative review was conducted of all clinical trials involving bedding encasement for the treatment of asthma. Collective statistical analyses were also performed to characterize the quantitative effect of bedding encasement on dust-mite allergen exposure and bronchial hyper-responsiveness (BHR) when used by asthma patients. Over 30 clinical trials were reviewed. Of those studies reporting adequate exposure and BHR results, four reported significant reduction in dust-mite allergen exposure and concomitant BHR reduction in active-treatment groups using bedding encasements. In 10 studies, mite-allergen exposure was reportedly decreased during the study, but BHR was not changed in the active-treatment group or was reduced to a similar degree in the active-treatment and control groups. Five other studies reported a lack of significant effect of the intervention on exposure and BHR. Collective paired analyses found that the effect of bedding encasement on allergen exposure and BHR tended toward only a modest, non-significant improvement. Collectively, effects of bedding encasement on BHR and dust-mite allergen exposure were modestly correlated only when the baseline exposure was above 2 microg Type 1 antigen per gram settled dust. Although bedding encasement might be an effective asthma treatment under some conditions, when implemented in clinical trials by asthma patients, its effectiveness is inconsistent and appears to be, at best, modest. Therefore, its significance as a reliable asthma management modality for any individual asthma patient is uncertain. Where resource constraints are significant, targeting the use of variably effective interventions such as bedding encasements toward those patient sub-populations most likely to derive substantial benefit may gain the largest net public-health benefit.

Effect of HIV and malaria parasites co-infection on immune-hematological profiles among patients attending anti-retroviral treatment (ART) clinic in Infectious Disease Hospital Kano, Nigeria.

PubMed

Jegede, Feyisayo Ebenezer; Oyeyi, Tinuade Ibijoke; Abdulrahman, Surajudeen Abiola; Mbah, Henry Akwen; Badru, Titilope; Agbakwuru, Chinedu; Adedokun, Oluwasanmi

2017-01-01

Human immunodeficiency virus (HIV) and malaria co-infection may present worse health outcomes in the tropics. Information on HIV/malaria co-infection effect on immune-hematological profiles is critical for patient care and there is a paucity of such data in Nigeria. To evaluate immune-hematological profiles among HIV infected patients compared to HIV/malaria co-infected for ART management improvement. This was a cross sectional study conducted at Infectious Disease Hospital, Kano. A total of 761 consenting adults attending ART clinic were randomly selected and recruited between June and December 2015. Participants' characteristics and clinical details including two previous CD4 counts were collected. Venous blood sample (4ml) was collected in EDTA tube for malaria parasite diagnosis by rapid test and confirmed with microscopy. Hematological profiles were analyzed by Sysmex XP-300 and CD4 count by Cyflow cytometry. Data was analyzed with SPSS 22.0 using Chi-Square test for association between HIV/malaria parasites co-infection with age groups, gender, ART, cotrimoxazole and usage of treated bed nets. Mean hematological profiles by HIV/malaria co-infection and HIV only were compared using independent t-test and mean CD4 count tested by mixed design repeated measures ANOVA. Statistical significant difference at probability of <0.05 was considered for all variables. Of the 761 HIV infected, 64% were females, with a mean age of ± (SD) 37.30 (10.4) years. Prevalence of HIV/malaria co-infection was 27.7% with Plasmodium falciparum specie accounting for 99.1%. No statistical significant difference was observed between HIV/malaria co-infection in association to age (p = 0.498) and gender (p = 0.789). A significantly (p = 0.026) higher prevalence (35.2%) of co-infection was observed among non-ART patients compared to (26%) ART patients. Prevalence of co-infection was significantly lower (20.0%) among cotrimoxazole users compared to those not on cotrimoxazole (37%). The same significantly lower co-infection prevalence (22.5%) was observed among treated bed net users compared to those not using treated bed nets (42.9%) (p = 0.001). Out of 16 hematology profiles evaluated, six showed significant difference between the two groups (i) packed cell volume (p = <0.001), (ii) mean cell volume (p = 0.005), (iii) mean cell hemoglobin concentration (p = 0.011), (iv) absolute lymphocyte count (p = 0.022), (v) neutrophil percentage count (p = 0.020) and (vi) platelets distribution width (p = <0.001). Current mean CD4 count cell/μl (349±12) was significantly higher in HIV infected only compared to co-infected (306±17), (p = 0.035). A significantly lower mean CD4 count (234.6 ± 6.9) was observed among respondents on ART compared to non-ART (372.5 ± 13.2), p<0.001, mean difference = -137.9). The study revealed a high burden of HIV and malaria co-infection among the studied population. Co-infection was significantly lower among patients who use treated bed nets as well as cotrimoxazole chemotherapy and ART. Six hematological indices differed significantly between the two groups. Malaria and HIV co-infection significantly reduces CD4 count. In general, to achieve better management of all HIV patients in this setting, diagnosing malaria, prompt antiretroviral therapy, monitoring CD4 and some hematology indices on regular basis is critical.

Moving toward focal therapy in prostate cancer: dual-isotope permanent seed implants as a possible solution.

PubMed

Todor, Dorin A; Barani, Igor J; Lin, Peck-Sun; Anscher, Mitchell S

2011-09-01

To compare the ability of single- and dual-isotope prostate seed implants to escalate biologically effective dose (BED) to foci of disease while reducing prescription dose to the prostate. Nine plans, using 125I, 103Pd, and 131Cs alone and in combination were created retrospectively for 2 patients. Ultrasound and MRI/MRS datasets were used for treatment planning. Voxel-by-voxel BED was calculated for single- and dual-isotope plans. Equivalent uniform BED (EUBED) was used to compare plans. The MRS-positive planning target volumes (PTVi) were delineated along with PTV (prostate+5 mm), rectum, and urethra. Single-isotope implants, prescribed to conventional doses, were generated to achieve good PTV coverage. The PTVi were prospectively used to generate implants using mixtures of isotopes. For mixed-radioisotope implants, we also explored the impact on EUBED of lowering prescription doses by 15%. The EUBED of PTVi in the setting of primary 125I implant increased 20-66% when 103Pd and 131Cs were used compared with 125I boost. Decreasing prescription dose by 15% in mixed-isotope implants results in a potential 10% reduction in urethral EUBED with preservation of PTV coverage while still boosting PTVi (up to 80%). When radiobiologic parameters corresponding to more-aggressive disease are assigned to foci, faster-decaying isotopes used in mixed implants have the potential to preserve the equivalent biological effect of mono-isotope implants considering less-aggressive disease distributed in the entire prostate. This is a hypothesis-generating study proposing a treatment paradigm that could be the middle ground between whole-gland irradiation and focal-only treatment. The use of two isotopes concurrent with decreasing the minimal peripheral dose is shown to increase EUBED of selected subvolumes while preserving the therapeutic effect at the level of the gland. Copyright © 2011 Elsevier Inc. All rights reserved.

Moving Toward Focal Therapy in Prostate Cancer: Dual-Isotope Permanent Seed Implants as a Possible Solution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Todor, Dorin A., E-mail: dtodor@mcvh-vcu.edu; Barani, Igor J.; Lin, Peck-Sun

2011-09-01

Purpose: To compare the ability of single- and dual-isotope prostate seed implants to escalate biologically effective dose (BED) to foci of disease while reducing prescription dose to the prostate. Methods and Materials: Nine plans, using {sup 125}I, {sup 103}Pd, and {sup 131}Cs alone and in combination were created retrospectively for 2 patients. Ultrasound and MRI/MRS datasets were used for treatment planning. Voxel-by-voxel BED was calculated for single- and dual-isotope plans. Equivalent uniform BED (EUBED) was used to compare plans. The MRS-positive planning target volumes (PTV{sub i}) were delineated along with PTV (prostate + 5 mm), rectum, and urethra. Single-isotope implants,more » prescribed to conventional doses, were generated to achieve good PTV coverage. The PTV{sub i} were prospectively used to generate implants using mixtures of isotopes. For mixed-radioisotope implants, we also explored the impact on EUBED of lowering prescription doses by 15%. Results: The EUBED of PTV{sub i} in the setting of primary {sup 125}I implant increased 20-66% when {sup 103}Pd and {sup 131}Cs were used compared with {sup 125}I boost. Decreasing prescription dose by 15% in mixed-isotope implants results in a potential 10% reduction in urethral EUBED with preservation of PTV coverage while still boosting PTV{sub i} (up to 80%). When radiobiologic parameters corresponding to more-aggressive disease are assigned to foci, faster-decaying isotopes used in mixed implants have the potential to preserve the equivalent biological effect of mono-isotope implants considering less-aggressive disease distributed in the entire prostate. Conclusions: This is a hypothesis-generating study proposing a treatment paradigm that could be the middle ground between whole-gland irradiation and focal-only treatment. The use of two isotopes concurrent with decreasing the minimal peripheral dose is shown to increase EUBED of selected subvolumes while preserving the therapeutic effect at the level of the gland.« less

Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port

PubMed Central

Mori, Hirohito; Kobayashi, Nobuya; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Chiyo, Taiga; Ayaki, Maki; Nagase, Takashi; Masaki, Tsutomu

2016-01-01

AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not. METHODS: Two dogs (11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port. CONCLUSION: We are sure of great feasibility of endoscopic cholecystectomy via single port for human. PMID:27053847

Effect of increased private share of inpatient psychiatric resources on jail population growth: evidence from the United States.

PubMed

Yoon, Jangho

2011-02-01

There is a strong connection between the mental health and criminal justice systems. This research empirically tested whether the privatization of the inpatient mental health system alters this relationship, contributing to jail population growth. Using state-level panel data on U.S. states and the District of Columbia for the years 1985-1998, this study analyzed the relationship between the size of jail populations and private share of hospital psychiatric beds, first for overall private beds and then separately by private for-profit and nonprofit. Empirical models controlled for changes in mental health financing and resources, variations in criminal justice practice, and demographic and socio-economic factors as well as state and year fixed effects. A method of instrumental variables was employed to make a stronger case for causal inference. Results show that a one-percentage point increase in the private for-profit share of psychiatric beds contributes to the growth of jail inmates by approximately 2.3% annually. A greater private nonprofit share of psychiatric beds does not appear to influence the size of jail populations. These findings suggest that the increased private for-profit share of inpatient psychiatric resources undermines the safety-net and some control function of the mental health system and leads to a greater number of jail inmates. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effects of natural-channel-design restoration on habitat quality in Catskill Mountain streams, New York

USGS Publications Warehouse

Ernst, Anne G.; Baldigo, Barry P.; Mulvihill, Christiane; Vian, Mark

2010-01-01

Stream restoration has received much attention in recent years, yet there has been little effort to evaluate its impacts on physical habitat, stability, and biota. A popular but controversial stream restoration approach is natural channel design (NCD), which cannot be adequately evaluated without a long-term, independent assessment of its effects on stream habitat. Six reaches of five Catskill Mountain streams in southeastern New York were restored during 2000–2003 following NCD techniques to decrease bed and bank degradation, decrease sediment loads, and improve water quality. Habitat surveys were conducted during summer low flows from 2001 to 2007. The effects of the NCD projects on stream condition were assessed via a before–after–control–impact study design to quantify the net changes in stream and bank habitat variables relative to those in unaltered control reaches. Analysis of variance tests of three different measures of bank stability show that on average stream stability increased at treatment sites for 2–5 years after restoration. Mean channel depth, thalweg depth, and the pool–riffle ratio generally increased, whereas mean channel width, percent streambank coverage by trees, and shade decreased. Habitat suitability indices for local salmonid species increased at four of six reaches after restoration. The changes in channel dimensions rendered them generally more characteristic of stabler stream forms in the given valley settings. Although these studies were done relatively soon after project completion, our findings demonstrate that habitat conditions can be improved in degraded Catskill Mountain streams through NCD restoration.

Examining the impact of larval source management and insecticide-treated nets using a spatial agent-based model of Anopheles gambiae and a landscape generator tool

PubMed Central

2013-01-01

Background Agent-based models (ABMs) have been used to estimate the effects of malaria-control interventions. Early studies have shown the efficacy of larval source management (LSM) and insecticide-treated nets (ITNs) as vector-control interventions, applied both in isolation and in combination. However, the robustness of results can be affected by several important modelling assumptions, including the type of boundary used for landscapes, and the number of replicated simulation runs reported in results. Selection of the ITN coverage definition may also affect the predictive findings. Hence, by replication, independent verification of prior findings of published models bears special importance. Methods A spatially-explicit entomological ABM of Anopheles gambiae is used to simulate the resource-seeking process of mosquitoes in grid-based landscapes. To explore LSM and replicate results of an earlier LSM study, the original landscapes and scenarios are replicated by using a landscape generator tool, and 1,800 replicated simulations are run using absorbing and non-absorbing boundaries. To explore ITNs and evaluate the relative impacts of the different ITN coverage schemes, the settings of an earlier ITN study are replicated, the coverage schemes are defined and simulated, and 9,000 replicated simulations for three ITN parameters (coverage, repellence and mortality) are run. To evaluate LSM and ITNs in combination, landscapes with varying densities of houses and human populations are generated, and 12,000 simulations are run. Results General agreement with an earlier LSM study is observed when an absorbing boundary is used. However, using a non-absorbing boundary produces significantly different results, which may be attributed to the unrealistic killing effect of an absorbing boundary. Abundance cannot be completely suppressed by removing aquatic habitats within 300 m of houses. Also, with density-dependent oviposition, removal of insufficient number of aquatic habitats may prove counter-productive. The importance of performing large number of simulation runs is also demonstrated. For ITNs, the choice of coverage scheme has important implications, and too high repellence yields detrimental effects. When LSM and ITNs are applied in combination, ITNs’ mortality can play more important roles with higher densities of houses. With partial mortality, increasing ITN coverage is more effective than increasing LSM coverage, and integrating both interventions yields more synergy as the densities of houses increase. Conclusions Using a non-absorbing boundary and reporting average results from sufficiently large number of simulation runs are strongly recommended for malaria ABMs. Several guidelines (code and data sharing, relevant documentation, and standardized models) for future modellers are also recommended. PMID:23965136

The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi

PubMed Central

Stevens, Warren; Wiseman, Virginia; Ortiz, Juan; Chavasse, Desmond

2005-01-01

Background Insecticide-treated nets (ITNs) are a proven intervention to reduce the burden of malaria, yet there remains a debate as to the best method of ensuring they are universally utilized. This study is a cost-effectiveness analysis of an intervention in Malawi that started in 1998, in Blantyre district, before expanding nationwide. Over the 5-year period, 1.5 million ITNs were sold. Methods The costs were calculated retrospectively through analysis of expenditure data. Costs and effects were measured as cost per treated-net year (cost/TNY) and cost per net distributed. Results The mean cost/TNY was calculated at $4.41, and the mean cost/ITN distributed at $2.63. It also shows evidence of economies of scale, with the cost/TNY falling from $7.69 in year one (72,196 ITN) to $3.44 in year five (720,577 ITN). Cost/ITN distributed dropped from $5.04 to $1.92. Conclusion Combining targeting and social marketing has the potential of being both cost-effective and capable of achieving high levels of coverage, and it is possible that increasing returns to scale can be achieved. PMID:15885143

Digging into the low molecular weight peptidome with the OligoNet web server.

PubMed

Liu, Youzhong; Forcisi, Sara; Lucio, Marianna; Harir, Mourad; Bahut, Florian; Deleris-Bou, Magali; Krieger-Weber, Sibylle; Gougeon, Régis D; Alexandre, Hervé; Schmitt-Kopplin, Philippe

2017-09-15

Bioactive peptides play critical roles in regulating many biological processes. Recently, natural short peptides biomarkers are drawing significant attention and are considered as "hidden treasure" of drug candidates. High resolution and high mass accuracy provided by mass spectrometry (MS)-based untargeted metabolomics would enable the rapid detection and wide coverage of the low-molecular-weight peptidome. However, translating unknown masses (<1 500 Da) into putative peptides is often limited due to the lack of automatic data processing tools and to the limit of peptide databases. The web server OligoNet responds to this challenge by attempting to decompose each individual mass into a combination of amino acids out of metabolomics datasets. It provides an additional network-based data interpretation named "Peptide degradation network" (PDN), which unravels interesting relations between annotated peptides and generates potential functional patterns. The ab initio PDN built from yeast metabolic profiling data shows a great similarity with well-known metabolic networks, and could aid biological interpretation. OligoNet allows also an easy evaluation and interpretation of annotated peptides in systems biology, and is freely accessible at https://daniellyz200608105.shinyapps.io/OligoNet/ .

Struct2Net: a web service to predict protein–protein interactions using a structure-based approach

PubMed Central

Singh, Rohit; Park, Daniel; Xu, Jinbo; Hosur, Raghavendra; Berger, Bonnie

2010-01-01

Struct2Net is a web server for predicting interactions between arbitrary protein pairs using a structure-based approach. Prediction of protein–protein interactions (PPIs) is a central area of interest and successful prediction would provide leads for experiments and drug design; however, the experimental coverage of the PPI interactome remains inadequate. We believe that Struct2Net is the first community-wide resource to provide structure-based PPI predictions that go beyond homology modeling. Also, most web-resources for predicting PPIs currently rely on functional genomic data (e.g. GO annotation, gene expression, cellular localization, etc.). Our structure-based approach is independent of such methods and only requires the sequence information of the proteins being queried. The web service allows multiple querying options, aimed at maximizing flexibility. For the most commonly studied organisms (fly, human and yeast), predictions have been pre-computed and can be retrieved almost instantaneously. For proteins from other species, users have the option of getting a quick-but-approximate result (using orthology over pre-computed results) or having a full-blown computation performed. The web service is freely available at http://struct2net.csail.mit.edu. PMID:20513650

Development and evaluation of a dimensionless mechanistic pan coating model for the prediction of coated tablet appearance.

PubMed

Niblett, Daniel; Porter, Stuart; Reynolds, Gavin; Morgan, Tomos; Greenamoyer, Jennifer; Hach, Ronald; Sido, Stephanie; Karan, Kapish; Gabbott, Ian

2017-08-07

A mathematical, mechanistic tablet film-coating model has been developed for pharmaceutical pan coating systems based on the mechanisms of atomisation, tablet bed movement and droplet drying with the main purpose of predicting tablet appearance quality. Two dimensionless quantities were used to characterise the product properties and operating parameters: the dimensionless Spray Flux (relating to area coverage of the spray droplets) and the Niblett Number (relating to the time available for drying of coating droplets). The Niblett Number is the ratio between the time a droplet needs to dry under given thermodynamic conditions and the time available for the droplet while on the surface of the tablet bed. The time available for drying on the tablet bed surface is critical for appearance quality. These two dimensionless quantities were used to select process parameters for a set of 22 coating experiments, performed over a wide range of multivariate process parameters. The dimensionless Regime Map created can be used to visualise the effect of interacting process parameters on overall tablet appearance quality and defects such as picking and logo bridging. Copyright © 2017 Elsevier B.V. All rights reserved.

Validation and Verification of LADEE Models and Software

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen

2013-01-01

The Lunar Atmosphere Dust Environment Explorer (LADEE) mission will orbit the moon in order to measure the density, composition and time variability of the lunar dust environment. The ground-side and onboard flight software for the mission is being developed using a Model-Based Software methodology. In this technique, models of the spacecraft and flight software are developed in a graphical dynamics modeling package. Flight Software requirements are prototyped and refined using the simulated models. After the model is shown to work as desired in this simulation framework, C-code software is automatically generated from the models. The generated software is then tested in real time Processor-in-the-Loop and Hardware-in-the-Loop test beds. Travelling Road Show test beds were used for early integration tests with payloads and other subsystems. Traditional techniques for verifying computational sciences models are used to characterize the spacecraft simulation. A lightweight set of formal methods analysis, static analysis, formal inspection and code coverage analyses are utilized to further reduce defects in the onboard flight software artifacts. These techniques are applied early and often in the development process, iteratively increasing the capabilities of the software and the fidelity of the vehicle models and test beds.

Plant pigment types, distributions, and influences on shallow water submerged aquatic vegetation mapping

NASA Astrophysics Data System (ADS)

Hall, Carlton R.; Bostater, Charles R., Jr.; Virnstein, Robert

2004-11-01

Development of robust protocols for use in mapping shallow water habitats using hyperspectral imagery requires knowledge of absorbing and scattering features present in the environment. These include, but are not limited to, water quality parameters, phytoplankton concentrations and species, submerged aquatic vegetation (SAV) species and densities, epiphytic growth on SAV, benthic microalgae and substrate reflectance characteristics. In the Indian River Lagoon, Fl. USA we conceptualize the system as having three possible basic layers, water column and SAV bed above the bottom. Each layer is occupied by plants with their associated light absorbing pigments that occur in varying proportions and concentrations. Phytoplankton communities are composed primarily of diatoms, dinoflagellates, and picoplanktonic cyanobacteria. SAV beds, including flowering plants and green, red, and brown macro-algae exist along density gradients ranging in coverage from 0-100%. SAV beds may be monotypic, or more typically, mixtures of the several species that may or may not be covered in epiphytes. Shallow water benthic substrates are colonized by periphyton communities that include diatoms, dinoflagellates, chlorophytes and cyanobacteria. Inflection spectra created form ASIA hyperspectral data display a combination of features related to water and select plant pigment absorption peaks.

How coarse is too coarse for salmon spawning substrates?

NASA Astrophysics Data System (ADS)

Wooster, J. K.; Riebe, C. S.; Ligon, F. K.; Overstreet, B. T.

2009-12-01

Populations of Pacific salmon species have declined sharply in many rivers of the western US. Reversing these declines is a top priority and expense of many river restoration projects. To help restore salmon populations, managers often inject gravel into rivers, to supplement spawning habitat that has been depleted by gravel mining and the effects of dams—which block sediment and thus impair habitat downstream by coarsening the bed where salmon historically spawned. However, there is little quantitative understanding nor a methodology for determining when a river bed has become too coarse for salmon spawning. Hence there is little scientific basis for selecting sites that would optimize the restoration benefits of gravel injection (e.g., sites where flow velocities are suitable but bed materials are too coarse for spawning). To develop a quantitative understanding of what makes river beds too coarse for salmon spawning, we studied redds and spawning use in a series of California and Washington rivers where salmon spawning ability appears to be affected by coarse bed material. Our working hypothesis is that for a given flow condition, there is a maximum “threshold” particle size that a salmon of a given size is able to excavate and/or move as she builds her redd. A second, related hypothesis is that spawning use should decrease and eventually become impossible with increasing percent coverage by immovable particles. To test these hypotheses, we quantified the sizes and spatial distributions of immovably coarse particles in a series of salmon redds in each river during the peak of spawning. We also quantified spawning use and how it relates to percent coverage by immovable particles. Results from our studies of fall-run chinook salmon (Oncorhynchus tshawytsha) in the Feather River suggest that immovable particle size varies as a function of flow velocity over the redd, implying that faster water helps fish move bigger particles. Our Feather River study also suggests that the immovable particle size varies as a function of particle shape. Results from our study of fall run chinook salmon in the Sacramento River suggest that spawning is not possible when the bed is more than 40% covered by immovable particles, consistent with our second hypotheses. We will explore these relationships further in fall 2009, when we collect data on threshold particle sizes and spawning use for both pink salmon (O. gorbuscha) in the Puyallup River, and chinook salmon in the Trinity River. Because pink salmon are significantly smaller than chinook salmon, we expect that their redd building success is constrained by a lower average threshold particle size. We expect that there will be a range of threshold sizes for each run, depending on intra-run variability in fish size and variations in flow velocity. Taken together we expect that our results will demonstrate the feasibility of a new methodology for determining when a bed has become too coarse, thus contributing to more effective management of rivers where monitoring of spawning suitability of natural gravels is a priority.

A National Approach to Reimbursement Decision-Making on Drugs for Rare Diseases in Canada? Insights from Across the Ponds.

PubMed

Short, Hilary; Stafinski, Tania; Menon, Devidas

2015-05-01

Regardless of the type of health system or payer, coverage decisions on drugs for rare diseases (DRDs) are challenging. While these drugs typically represent the only active treatment option for a progressive and/or life-threatening condition, evidence of clinical benefit is often limited because of small patient populations and the costs are high. Thus, decisions come with considerable uncertainty and risk. In Canada, interest in developing a pan-Canadian decision-making approach informed by international experiences exists. To develop an inventory of existing policies and processes for making coverage decisions on DRDs around the world. A systematic review of published and unpublished documents describing current policies and processes in the top 20 gross domestic product countries was conducted. Bibliographic databases, the Internet and government/health technology assessment organization websites in each country were searched. Two researchers independently extracted information and tabulated it to facilitate qualitative comparative analyses. Policy experts from each country were contacted and asked to review the information collected for accuracy and completeness. Almost all countries have multiple mechanisms through which coverage for a DRD may be sought. However, they typically begin with a review that follows the same process as drugs for more common conditions (i.e., the centralized review process), although specific submission requirements could differ (e.g., no need to submit a cost-effectiveness analysis). When drugs fail to receive a positive recommendation/decision, they are reconsidered by "safety net"-type programs. Eligibility criteria vary across countries, as do the decision options, which may be applied to individual patients or patient groups. With few exceptions, countries have not created separate centralized review processes for DRDs. Instead, they have modified components of existing mechanisms and added safety nets. Copyright © 2015 Longwoods Publishing.

Guidelines for using bedload traps in coarse-bedded mountain streams: Construction, installation, operation, and sample processing

Treesearch

Kristin Bunte; Kurt W. Swingle; Steven R. Abt

2007-01-01

A bedload trap is a portable sampler designed specifically for collecting gravel and cobble bedload (4 to 180 mm in diameter) in wadeable streams. Bedload traps consist of an aluminum frame with a 12 by 8 inch (0.3 by 0.2 m) opening to which a 3- to 5.5-ft (0.9 to 1.65 m) long trailing net is attached. Bedload traps are installed on ground plates that are anchored to...

An Investigation into the Comparative Costs of Additive Manufacture vs. Machine from Solid for Aero Engine Parts

DTIC Science & Technology

2006-05-01

welding power sources are not totally efficient at converting power drawn from the wall into heat energy used for the welding process . TIG sources are...Powder bed + Laser • Wire + Laser • Wire + Electron Beam • Wire + TIG Each system has its own unique attributes in terms of process variables...relative economics of producing a near net shape by Additive Manufacturing (AM) processes compared with traditional machine from solid processes (MFS

[Hurricane impact on Thalassia testudinum (Hydrocharitaceae) beds in the Mexican Caribbean].

PubMed

Arellano-Méndez, Leonardo U; Liceaga-Correa, María de los Angeles; Herrera-Silveira, Jorge A; Hernández-Núñez, Héctor

2011-03-01

Hurricanes have increased in strength and frequency as a result of global climate change. This research was conducted to study the spatio-temporal distribution and changes of Thalassia testudinum, the dominant species in Bahia de la Ascension (Quintana Roo, Mexico), when affected by heavy weather conditions. To complete this objective, a 2001 Landsat ETM+ image and the information from 525 sampling stations on morpho-functional and coverage of T. testudinum were used, and the seeds generated for the classification of eight benthic habitats. To quantify the changes caused by two hurricanes, we used two images, one of 1988 (Gilberto) and another of 1995 (Roxanne); other three data sets (2003, 2005 and 2007) were also used to describe the study area without major weather effects. Six categorial maps were obtained and subjected to analysis by 8 Landscape Ecology indexes, that describe the spatial characteristics, structure, function, change of the elements (matrix-patch-corridor), effects on ecosystems, connectivity, edges, shape and patch habitat fragmentation. Models indicate that T. testudinum may be classified as a continuum (matrix), since the fragments were not observed intermittently, but as a progression from minimum to maximum areas in reference to their coverage (ecological corridors). The fragments do not have a regular shape, indicating that the impacts are recent and may be due to direct effects (high-intensity hurricanes) or indirect (sediment). Fragments of type "bare soils" have a discontinuous distribution, and are considered to be the sites that have remained stable over a long timescale. While more dense coverage areas ("beds", "medium prairie" and "prairie") have low fragmentation and high connection of fragments. Features have an irregular perimeter and radial growth of formal; suggesting that the impact of meteors has no effect on the resilience of T. testudinum in this ecosystem, indicating good environmental quality to grow in this bay.

Comparative analysis of grapevine whole-genome gene predictions, functional annotation, categorization and integration of the predicted gene sequences

PubMed Central

2012-01-01

Background The first draft assembly and gene prediction of the grapevine genome (8X base coverage) was made available to the scientific community in 2007, and functional annotation was developed on this gene prediction. Since then additional Sanger sequences were added to the 8X sequences pool and a new version of the genomic sequence with superior base coverage (12X) was produced. Results In order to more efficiently annotate the function of the genes predicted in the new assembly, it is important to build on as much of the previous work as possible, by transferring 8X annotation of the genome to the 12X version. The 8X and 12X assemblies and gene predictions of the grapevine genome were compared to answer the question, “Can we uniquely map 8X predicted genes to 12X predicted genes?” The results show that while the assemblies and gene structure predictions are too different to make a complete mapping between them, most genes (18,725) showed a one-to-one relationship between 8X predicted genes and the last version of 12X predicted genes. In addition, reshuffled genomic sequence structures appeared. These highlight regions of the genome where the gene predictions need to be taken with caution. Based on the new grapevine gene functional annotation and in-depth functional categorization, twenty eight new molecular networks have been created for VitisNet while the existing networks were updated. Conclusions The outcomes of this study provide a functional annotation of the 12X genes, an update of VitisNet, the system of the grapevine molecular networks, and a new functional categorization of genes. Data are available at the VitisNet website (http://www.sdstate.edu/ps/research/vitis/pathways.cfm). PMID:22554261

Turbidity Currents With Equilibrium Basal Driving Layers: A Mechanism for Long Runout

NASA Astrophysics Data System (ADS)

Luchi, R.; Balachandar, S.; Seminara, G.; Parker, G.

2018-02-01

Turbidity currents run out over 100 km in lakes and reservoirs, and over 1,000 km in the ocean. They do so without dissipating themselves via excess entrainment of ambient water. Existing layer-averaged formulations cannot capture this. We use a numerical model to describe the temporal evolution of a turbidity current toward steady state under condition of zero net sediment flux at the bed. The flow self-partitions itself into two layers. The lower "driving layer" approaches an invariant flow thickness, velocity profile, and suspended sediment concentration profile that sequesters nearly all of the suspended sediment. This layer can continue indefinitely at steady state over a constant bed slope. The upper "driven layer" contains a small fraction of the suspended sediment. The devolution of the flow into these two layers likely allows the driving layer to run out long distances.

Hydrogeological investigations of river bed clogging at a river bank filtration site along the River Warta, Poland

NASA Astrophysics Data System (ADS)

Przybyłek, Jan; Dragon, Krzysztof; Kaczmarek, Piotr Michał Jan

2017-12-01

River bank filtration (RBF) is a system that enriches groundwater resources by induced infiltration of river water to an aquifer. Problematic during operation of RBF systems is the deterioration of infiltration effectiveness caused by river bed clogging. This situation was observed in the Krajkowo well field which supplies fresh water to the city of Poznań (Poland) during and after the long hydrological drought between the years 1989 and 1992. The present note discusses results of specific hydrogeological research which included drilling of a net of boreholes to a depth of 10 m below river bottom (for sediment sampling as well as for hydrogeological measurements), analyses of grain size distribution and relative density studies. The results obtained have allowed the recognition of the origin of the clogging processes, as well as the documentation of the clogged parts of the river bottom designated for unclogging activities.

NETosis Delays Diabetic Wound Healing in Mice and Humans.

PubMed

Fadini, Gian Paolo; Menegazzo, Lisa; Rigato, Mauro; Scattolini, Valentina; Poncina, Nicol; Bruttocao, Andrea; Ciciliot, Stefano; Mammano, Fabio; Ciubotaru, Catalin Dacian; Brocco, Enrico; Marescotti, Maria Cristina; Cappellari, Roberta; Arrigoni, Giorgio; Millioni, Renato; Vigili de Kreutzenberg, Saula; Albiero, Mattia; Avogaro, Angelo

2016-04-01

Upon activation, neutrophils undergo histone citrullination by protein arginine deiminase (PAD)4, exocytosis of chromatin and enzymes as neutrophil extracellular traps (NETs), and death. In diabetes, neutrophils are primed to release NETs and die by NETosis. Although this process is a defense against infection, NETosis can damage tissue. Therefore, we examined the effect of NETosis on the healing of diabetic foot ulcers (DFUs). Using proteomics, we found that NET components were enriched in nonhealing human DFUs. In an independent validation cohort, a high concentration of neutrophil elastase in the wound was associated with infection and a subsequent worsening of the ulcer. NET components (elastase, histones, neutrophil gelatinase-associated lipocalin, and proteinase-3) were elevated in the blood of patients with DFUs. Circulating elastase and proteinase-3 were associated with infection, and serum elastase predicted delayed healing. Neutrophils isolated from the blood of DFU patients showed an increased spontaneous NETosis but an impaired inducible NETosis. In mice, skin PAD4 activity was increased by diabetes, and FACS detection of histone citrullination, together with intravital microscopy, showed that NETosis occurred in the bed of excisional wounds. PAD4 inhibition by Cl-amidine reduced NETting neutrophils and rescued wound healing in diabetic mice. Cumulatively, these data suggest that NETosis delays DFU healing. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Mapping spatial patterns of stream power and channel change along a gravel-bed river in northern Yellowstone

NASA Astrophysics Data System (ADS)

Lea, Devin M.; Legleiter, Carl J.

2016-01-01

Stream power represents the rate of energy expenditure along a river and can be calculated using topographic data acquired via remote sensing or field surveys. This study sought to quantitatively relate temporal changes in the form of Soda Butte Creek, a gravel-bed river in northeastern Yellowstone National Park, to stream power gradients along an 8-km reach. Aerial photographs from 1994 to 2012 and ground-based surveys were used to develop a locational probability map and morphologic sediment budget to assess lateral channel mobility and changes in net sediment flux. A drainage area-to-discharge relationship and DEM developed from LiDAR data were used to obtain the discharge and slope values needed to calculate stream power. Local and lagged relationships between mean stream power gradient at median peak discharge and volumes of erosion, deposition, and net sediment flux were quantified via spatial cross-correlation analyses. Similarly, autocorrelations of locational probabilities and sediment fluxes were used to examine spatial patterns of sediment sources and sinks. Energy expended above critical stream power was calculated for each time period to relate the magnitude and duration of peak flows to the total volumetric change in each time increment. Collectively, we refer to these methods as the stream power gradient (SPG) framework. The results of this study were compromised by methodological limitations of the SPG framework and revealed some complications likely to arise when applying this framework to small, wandering, gravel-bed rivers. Correlations between stream power gradients and sediment flux were generally weak, highlighting the inability of relatively simple statistical approaches to link sub-budget cell-scale sediment dynamics to larger-scale driving forces such as stream power gradients. Improving the moderate spatial resolution techniques used in this study and acquiring very-high resolution data from recently developed methods in fluvial remote sensing could help improve understanding of the spatial organization of stream power, sediment transport, and channel change in dynamic natural rivers.

Biodegradation of 2,4,6-trichlorophenol in a packed-bed biofilm reactor equipped with an internal net draft tube riser for aeration and liquid circulation.

PubMed

Jesús, A Gómez-De; Romano-Baez, F J; Leyva-Amezcua, L; Juárez-Ramírez, C; Ruiz-Ordaz, N; Galíndez-Mayer, J

2009-01-30

For the aerobic biodegradation of the fungicide and defoliant 2,4,6-trichlorophenol (2,4,6-TCP), a bench-scale packed-bed bioreactor equipped with a net draft tube riser for liquid circulation and oxygenation (PB-ALR) was constructed. To obtain a high packed-bed volume relative to the whole bioreactor volume, a high A(D)/A(R) ratio was used. Reactor's downcomer was packed with a porous support of volcanic stone fragments. PB-ALR hydrodynamics and oxygen mass transfer behavior was evaluated and compared to the observed behavior of the unpacked reactor operating as an internal airlift reactor (ALR). Overall gas holdup values epsilon(G), and zonal oxygen mass transfer coefficients determined at various airflow rates in the PB-ALR, were higher than those obtained with the ALR. When comparing mixing time values obtained in both cases, a slight increment in mixing time was observed when reactor was operated as a PB-ALR. By using a mixed microbial community, the biofilm reactor was used to evaluate the aerobic biodegradation of 2,4,6-TCP. Three bacterial strains identified as Burkholderia sp., Burkholderia kururiensis and Stenotrophomonas sp. constituted the microbial consortium able to cometabolically degrade the 2,4,6-TCP, using phenol as primary substrate. This consortium removed 100% of phenol and near 99% of 2,4,6-TCP. Mineralization and dehalogenation of 2,4,6-TCP was evidenced by high COD removal efficiencies ( approximately 95%), and by the stoichiometric release of chloride ions from the halogenated compound ( approximately 80%). Finally, it was observed that the microbial consortium was also capable to metabolize 2,4,6-TCP without phenol as primary substrate, with high removal efficiencies (near 100% for 2,4,6-TCP, 92% for COD and 88% for chloride ions).

Transport, sloughing and settling rates of estuarine macrophytes: Mechanisms and ecological implications

NASA Astrophysics Data System (ADS)

Flindt, M. R.; Pedersen, C. B.; Amos, C. L.; Levy, A.; Bergamasco, A.; Friend, P. L.

2007-05-01

The study of plant-bound nutrient transport has been largely neglected in estuaries. Lately however, it has been shown that nutrients bound to macroalgae and seagrasses can constitute a major part of the nutrient transport in shallow tidal estuaries. Organic detritus in estuaries comes from various sources. This paper looks into the source of detritus from sloughing, and the transport behaviour of plant detritus under unidirectional flows. In order to determine the extent of the sloughing of macrophytes, the threshold current velocities for the traction and resuspension of the most common submersed macrophytes in Venice Lagoon ( Ulva lactuca, Enteromorpha sp., Ceramium rubrum, Cladophora sp., and Chaetomorpha linum) were studied in a laboratory flume. It was found that all macrophytes subjected to flows of 1.5-3.0 cm s -1 move initially as bed load. The threshold for suspension of the macrophyte tissue was at current speeds >3 cm s -1. The exception was the filamentous macroalgae, C. linum, which moved as bed load at all current speeds. This implies that the advection of plant-bound nutrients in Venice Lagoon is widespread and takes place over virtually all stages of the tide. Initial experiments were carried out on unattached macroalgae. A second study focused on the sloughing of attached macroalgae by steady currents. The threshold current speeds at which sloughing commenced varied between different types of algae, and sloughing rate was related largely to current speed. The resuspension rates were uniform between the different macrophyte groups. Our results help explain why plant matter has been trapped in nets close to the bed of Venice Lagoon on ebbing tides. It shows that a major component of the bedload is organic in origin. The results verify that a large proportion of the net nutrient export from estuaries is bound in macrophyte tissue. These findings need to be included in future ecological models that describe the resuspension, sloughing and settling of macrophytes.

Ecosystem goods and services from Swedish coastal habitats: identification, valuation, and implications of ecosystem shifts.

PubMed

Rönnbäck, Patrik; Kautsky, Nils; Pihl, Leif; Troell, Max; Söderqvist, Tore; Wennhage, Håkan

2007-11-01

Coastal areas are exposed to a variety of threats due to high population densities and rapid economic development. How will this affect human welfare and our dependence on nature's capacity to provide ecosystem goods and services? This paper is original in evaluating this concern for major habitats (macroalgae, seagrasses, blue mussel beds, and unvegetated soft bottoms) in a temperate coastal setting. More than 40 categories of goods and services are classified into provisional, regulating, and cultural services. A wide variety of Swedish examples is described for each category, including accounts of economic values and the relative importance of different habitats. For example, distinguishing characteristics would be the exceptional importance of blue mussels for mitigation of eutrophication, sandy soft bottoms for recreational uses, and seagrasses and macroalgae for fisheries production and control of wave and current energy. Net changes in the provision of goods and services are evaluated for three cases of observed coastal ecosystem shifts: i) seagrass beds into unvegetated substrate; ii) unvegetated shallow soft bottoms into filamentous algal mat dominance; and iii) macroalgae into mussel beds on hard substrate. The results are discussed in a management context including accounts of biodiversity, interconnectedness of ecosystems, and potential of economic valuation.

Forces on a segregating particle

NASA Astrophysics Data System (ADS)

Lueptow, Richard M.; Shankar, Adithya; Fry, Alexander M.; Ottino, Julio M.; Umbanhowar, Paul B.

2017-11-01

Size segregation in flowing granular materials is not well understood at the particle level. In this study, we perform a series of 3D Discrete Element Method (DEM) simulations to measure the segregation force on a single spherical test particle tethered to a spring in the vertical direction in a shearing bed of particles with gravity acting perpendicular to the shear. The test particle is the same size or larger than the bed particles. At equilibrium, the downward spring force and test particle weight are offset by the upward buoyancy-like force and a size ratio dependent force. We find that the buoyancy-like force depends on the bed particle density and the Voronoi volume occupied by the test particle. By changing the density of the test particle with the particle size ratio such that the buoyancy force matches the test particle weight, we show that the upward size segregation force is a quadratic function of the particle size ratio. Based on this, we report an expression for the net force on a single particle as the sum of a size ratio dependent force, a buoyancy-like force, and the weight of the particle. Supported by NSF Grant CBET-1511450 and the Procter and Gamble Company.

Neuroendocrine tumor imaging with 68Ga-DOTA-NOC: physiologic and benign variants.

PubMed

Kagna, Olga; Pirmisashvili, Natalia; Tshori, Sagi; Freedman, Nanette; Israel, Ora; Krausz, Yodphat

2014-12-01

Imaging with (68)Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotide analogs has become an important modality in patients with neuroendocrine tumors (NETs). In addition to high uptake in NET lesions, prominent physiologic radiotracer activity has been reported in the pituitary gland, pancreas, adrenal glands, liver, and spleen, and faint activity has been reported in the thyroid and gastrointestinal tract. This article describes previously unknown sites of 68Ga-DOTA-1-NaI3-octreotide (NOC) uptake unrelated to NETs. One hundred eighty-two patients (96 female and 86 male patients; age range, 4-89 years) with documented (n=156) or suspected (n=26) NETs underwent 207 68Ga-DOTA-NOC PET/CT studies. Studies were retrospectively reviewed for the presence, intensity, and localization of foci of increased uptake that were further correlated with findings on additional imaging studies and clinical follow-up for a period of 4-32 months. Uptake of 68Ga-DOTA-NOC not identified as NET or known physiologic activity was detected in 297 sites with confirmation in 149 of 207 studies (72%). The most common location of non-NET-related 68Ga-DOTA-NOC-avid sites was in small lymph nodes, followed by prostate, uterus, breasts, lungs, brown fat, musculoskeletal system, and other sites, including oropharynx, pineal body, thymus, aortic plaque, genitalia, surgical bed, and subcutaneous granuloma. Intensity of uptake in non-NET-related 68Ga-DOTA-NOC-avid sites ranged in maximum standardized uptake value from 0.8 to 10.5. Previously unreported benign sites of 68Ga-DOTA-NOC uptake were found in the majority of studies, suggesting the presence of somatostatin receptors in physiologic variants or processes with no evidence of tumor. Knowledge of increased tracer uptake in non-NET-related sites is important for accurate interpretation and for avoiding potential pitfalls of 68Ga-DOTA-NOC PET/CT.

Overcoming Spatial and Temporal Barriers to Public Access Defibrillators Via Optimization.

PubMed

Sun, Christopher L F; Demirtas, Derya; Brooks, Steven C; Morrison, Laurie J; Chan, Timothy C Y

2016-08-23

Immediate access to an automated external defibrillator (AED) increases the chance of survival for out-of-hospital cardiac arrest (OHCA). Current deployment usually considers spatial AED access, assuming AEDs are available 24 h a day. The goal of this study was to develop an optimization model for AED deployment, accounting for spatial and temporal accessibility, to evaluate if OHCA coverage would improve compared with deployment based on spatial accessibility alone. This study was a retrospective population-based cohort trial using data from the Toronto Regional RescuNET Epistry cardiac arrest database. We identified all nontraumatic public location OHCAs in Toronto, Ontario, Canada (January 2006 through August 2014) and obtained a list of registered AEDs (March 2015) from Toronto Paramedic Services. Coverage loss due to limited temporal access was quantified by comparing the number of OHCAs that occurred within 100 meters of a registered AED (assumed coverage 24 h per day, 7 days per week) with the number that occurred both within 100 meters of a registered AED and when the AED was available (actual coverage). A spatiotemporal optimization model was then developed that determined AED locations to maximize OHCA actual coverage and overcome the reported coverage loss. The coverage gain between the spatiotemporal model and a spatial-only model was computed by using 10-fold cross-validation. A total of 2,440 nontraumatic public OHCAs and 737 registered AED locations were identified. A total of 451 OHCAs were covered by registered AEDs under assumed coverage 24 h per day, 7 days per week, and 354 OHCAs under actual coverage, representing a coverage loss of 21.5% (p < 0.001). Using the spatiotemporal model to optimize AED deployment, a 25.3% relative increase in actual coverage was achieved compared with the spatial-only approach (p < 0.001). One in 5 OHCAs occurred near an inaccessible AED at the time of the OHCA. Potential AED use was significantly improved with a spatiotemporal optimization model guiding deployment. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009-2016).

PubMed

Moreira, Marta; Castro, Olga; Palmieri, Melissa; Efklidou, Sofia; Castagna, Stefano; Hoet, Bernard

2017-06-03

Higher-valent pneumococcal conjugate vaccines (PCVs) were licensed from 2009 in Europe; similar worldwide clinical effectiveness was observed for PCVs in routine use. Despite a proven medical need, PCV vaccination in Southern Europe remained suboptimal until 2015/16. We searched PubMed for manuscripts published between 2009 and mid-2016. Included manuscripts had to contain data about invasive pneumococcal disease (IPD) incidence, or vaccination coverage with higher-valent PCVs. This review represents the first analysis of vaccination coverage and impact of higher-valent PCVs on overall IPD in Southern European countries (Portugal, Spain, Italy, Greece, Cyprus). Vaccination coverage in the Portuguese private market peaked around 2008 at 75% (children ≤ 2 years) but declined to 63% in 2012. In Madrid, coverage was 95% (2007-2012) but dropped to 67% (2013/14; children ≤ 2 years) after funding termination in May 2012. PCVs were recently introduced in the national immunisation program (NIP) of Portugal (2015) and Spain (2015/16). In Italy, coverage for the complete PCV schedule (children ≤ 2 years) was 88% in 2013, although highly variable between regions (45-99%). In Greece, in 2013, 82.3% had received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months. Overall IPD (net benefit: effect on vaccine types, vaccine-related types, and non-vaccine types) has decreased; in Greece, pneumococcal meningitis incidence remained stable. Continued IPD surveillance or national registers using ICD-10 codes of clinically suspected IPD are necessary, with timely publicly available reports and adequate national vaccination registers to assess trends in vaccination coverage, allowing evaluation of PCVs in NIPs.

Investigating waste rock, tailings, slag and coal ash clinker as adsorbents for heavy metals: Batch and column studies

NASA Astrophysics Data System (ADS)

Letina, D.; Letshwenyo, W. M.

2018-06-01

Wastewater from the mining industry is a concern because most of the time it contains heavy metals with concentrations above permissible levels, posing a threat to terrestrial and aquatic life. The study was conducted to evaluate the effectiveness of locally available waste materials (waste rock, tailings, coal ash clinker, and slag) generated by BCL (Ltd) mine, a copper and nickel mining and smelting company in Botswana, for removal of nickel and copper from the real mining wastewater. Batch adsorption studies were conducted to establish the adsorptive efficiency and kinetics of each media with respect to nickel and copper ions. The best media was further evaluated through fixed bed column studies at 24 and 48 h empty bed contact time. The results indicate that the percentage removal for coal ash clinker, waste rock, smelter slag and tailings was 98%, 15%, 3% and -3% with respect to copper ions, and 46%, 9%, 7% and 2% with respect to nickel ions for each media respectively. Coal ash clinker followed pseudo first order kinetic model and Langmuir isotherm model with respect to nickel ions indicating the dominance of physisorption and mono layer coverage respectively. The Langmuir separation factor (RL) was 0.37 suggesting favourable adsorption onto the media. Fixed bed column studies revealed that copper was completely retained in the bed at both 24 and 48 h contact times. In the case of nickel, removal efficiency ranged between 83% and 99% when contact time was 48 h and between 68% and 99% when the contact time was reduced to 24 h. Breakthrough was not reached after 19 bed volumes. It can be concluded that coal ash clinker is a better candidate for the removal of copper and nickel ions from mining wastewater.

Dimensions of the local health care environment and use of care by uninsured children in rural and urban areas.

PubMed

Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, José J

2006-03-01

Despite concerted policy efforts, a sizeable percentage of children lack health insurance coverage. This article examines the impact of the health care safety net and health care market structure on the use of health care by uninsured children. We used the Medical Expenditure Panel Survey linked with data from multiple sources to analyze health care utilization among uninsured children. We ran analyses separately for children who lived in rural and urban areas and assessed the effects on utilization of the availability of safety net providers, safety net funding, supply of primary care physicians, health maintenance organization penetration, and the percentage of people who are uninsured, controlling for other factors that influence use. Fewer than half of uninsured children had office-based visits to health care providers during the year, 8% of rural and 10% of urban children visited the emergency department at least once, and just over half of children had medical expenditures or charges during the year. Among uninsured children in rural areas, living closer to a safety net provider and living in an area with a higher supply of primary care physicians were positively associated with higher use and medical expenditures. In urban areas, the supply of primary care physicians and the level of safety net funding were positively associated with uninsured children's medical expenditures, whereas the percentage of the population that was uninsured was negatively associated with use of the emergency department. Uninsured children had low levels of utilization over a range of different health care provider types and settings. The availability of safety net providers in the local area and the safety net's capacity to serve the uninsured influence access to care among children. Possible measures for ensuring access to health care among uninsured children include increasing the density of safety net providers in rural areas, enhancing funding for the safety net, and policies to increase primary care physician supply.

Today's sediment budget of the Rhine River channel, focusing on the Upper Rhine Graben and Rhenish Massif

NASA Astrophysics Data System (ADS)

Frings, Roy M.; Gehres, Nicole; Promny, Markus; Middelkoop, Hans; Schüttrumpf, Holger; Vollmer, Stefan

2014-01-01

The river bed of the Rhine River is subject to severe erosion and sedimentation. Such high geomorphological process rates are unwanted for economical, ecological, and safety reasons. The objectives of this study were (1) to quantify the geomorphological development of the Rhine River between 1985 and 2006; (2) to investigate the bed erosion process; and (3) to distinguish between tectonic, hydrological, and human controls. We used a unique data set with thousands of bedload and suspended-load measurements and quantified the fluxes of gravel, sand, silt, and clay through the northern Upper Rhine Graben and the Rhenish Massif. Furthermore, we calculated bed level changes and evaluated the sediment budget of the channel. Sediment transport rates were found to change in the downstream direction: silt and clay loads increase because of tributary supply; sand loads increase because of erosion of sand from the bed; and gravel loads decrease because of reduced sediment mobility caused by the base-level control exerted by the uplifting Rhenish Massif. This base-level control shows tectonic setting, in addition to hydrology and human interventions, to represent a major control on morphodynamics in the Rhine. The Rhine bed appears to be in a state of disequilibrium, with an average net bed degradation of 3 mm/a. Sand being eroded from the bed is primarily washed away in suspension, indicating a rapid supply of sand to the Rhine delta. The degradation is the result of an increased sediment transport capacity caused by nineteenth and twentieth century's river training works. In order to reduce degradation, huge amounts of sediment are fed into the river by river managers. Bed degradation and artificial sediment feeding represent the major sources of sand and gravel to the study area; only small amounts of sediment are supplied naturally from upstream or by tributaries. Sediment sinks include dredging, abrasion, and the sediment output to the downstream area. Large uncertainties exist about the amounts of sediment deposited on floodplains and in groyne fields. Compared to the natural situation during the middle Holocene, the present-day gravel and sand loads seem to be lower, whereas the silt and clay loads seem to be higher. This is probably caused by the present-day absence of meander migration, the deforestation, and the reduced sediment trapping efficiency of the floodplains. Even under natural conditions no equilibrium bed level existed.

Determinants of malaria infection in Dembia district, Northwest Ethiopia: a case-control study.

PubMed

Agegnehu, Fisseha; Shimeka, Alemayehu; Berihun, Firnus; Tamir, Melkamu

2018-04-11

Despite the progress in reducing malaria infections and related deaths, the disease remains a major global public health problem. The problem is among the top five leading causes of outpatient visits in Dembia district of the northwest Ethiopia. Therefore, this study aimed to assess the determinants of malaria infections in the district. An institution-based case-control study was conducted in Dembia district from October to November 2016. Out of the ten health centers in the district, four were randomly selected for the study in which 370 participants (185 cases and 185 controls) were enrolled. Data were collected using a pretested structured questionnaire. Factors associated with malaria infections were determined using logistic regression analysis. Odds ratio with 95% CI was used as a measure of association, and variables with a p-value of ≤0.05 were considered as statistically significant. The median age of all participants was 26 years, while that of cases and controls was 22 and 30 with a range of 1 to 80 and 2 to 71, respectively. In the multivariable logistic regression, over 15 years of age adjusted odds ratio(AOR) and confidence interval (CI) of (AOR = 18; 95% CI: 2.1, 161.5), being male (AOR = 2.2; 95% CI: 1.2, 3.9), outdoor activities at night (AOR = 5.7; 95% CI: 2.5, 12.7), bed net sharing (AOR = 3.9; 95% CI: 2.0, 7.7), and proximity to stagnant water sources (AOR = 2.7; 95% CI: 1.3, 5.4) were independent predictors. Being in over 15 years of age group, male gender, night time activity, bed net sharing and proximity to stagnant water sources were determinant factors of malaria infection in Dembia district. Additional interventions and strategies which focus on men, outdoor work at night, household net utilization, and nearby stagnant water sources are essential to reduce malaria infections in the area.

[Geographical coverage of the Mexican Healthcare System and a spatial analysis of utilization of its General Hospitals in 1998].

PubMed

Hernández-Avila, Juan E; Rodríguez, Mario H; Rodríguez, Norma E; Santos, René; Morales, Evangelina; Cruz, Carlos; Sepúlveda-Amor, Jaime

2002-01-01

To describe the geographical coverage of the Mexican Healthcare System (MHS) services and to assess the utilization of its General Hospitals. A Geographic Information System (GIS) was used to include sociodemographic data by locality, the geographical location of all MHS healthcare services, and data on hospital discharge records. A maximum likelihood estimation model was developed to assess the utilization levels of 217 MHS General Hospitals. The model included data on human resources, additional infrastructure, and the population within a 25 km radius. In 1998, 10,806 localities with 72 million inhabitants had at least one public healthcare unit, and 97.2% of the population lived within 50 km of a healthcare unit; however, over 18 million people lived in rural localities without a healthcare unit. The mean annual hospital occupation rate was 48.5 +/- 28.5 per 100 bed/years, with high variability within and between states. Hospital occupation was significantly associated with the number of physicians in the unit, and in the Mexican Institute of Social Security units utilization was associated with additional health infrastructure, and with the population's poverty index. GIS analysis allows improved estimation of the coverage and utilization of MHS hospitals.

Synergistic insecticidal and repellent effects of combined pyrethroid and repellent-impregnated bed nets using a novel long-lasting polymer-coating multi-layer technique.

PubMed

Faulde, Michael K; Nehring, Oliver

2012-08-01

New and improved strategies for malaria control and prevention are urgently needed. As a contribution to an optimized personal protection strategy, a novel long-lasting insecticide and repellent-treated net (LLIRN) has been designed by binding combinations of permethrin plus N,N-diethyl-m-toluamide (DEET), or insect repellent 3535 (IR3535), and etofenprox plus DEET, onto fibres of bed net fabric employing a new multi-layer polymer-coating technique. Protective repellent efficacy, toxicological effectiveness and residual activity of 12 LLIRN types have been evaluated by laboratory testing against adult Aedes aegypti. The novel multi-layer LLIRN design allowed simultaneous embedding at concentrations up to 5,930 mg/m(2) for DEET, 3,408 mg/m(2) for IR3535, 2,296 mg/m(2) for permethrin and 2,349 mg/m(2) for etofenprox, respectively. IR3535 layers prevented co-binding of additional pyrethroid-containing polymer layers, thus making pyrethroids plus DEET LLIRNs an ideal combination. All LLIRNs revealed synergistic insecticidal effects which, when measured against concentration controls of the isolated compounds, were significant in all LLIRN types designed. DEET in DEET plus permethrin LLIRNs significantly (p < 0.0001) reduced the concentration-dependent permethrin 100 % knockdown (KD) time from 55 to 75 %, the corresponding 100 % kill time (p < 0.0001) from 55 to 64 %. DEET in DEET plus etofenprox LLIRNs reduced the dose-specific 100 % knockdown (KD) time of etofenprox from 42 to 50 % (p = 0.004), the 100 % kill time from 25 to 38 % (p < 0.0001). Permethrin or etofenprox did not influence spatial repellency of DEET or IR3535 on LLIRNs. Vice versa, DEET and IR3535 increased spatial and excitatory repellency and reduced landing and probing frequency on LLIRNs resulting in strongly enhanced biting protection, even at low concentrations. One hundred percent biting and probing protection of stored LLIRNs was preserved for 83 weeks with the 5,930 mg/m(2) DEET and 2,139 mg/m(2) etofenprox LLIRN, for 72 weeks with the 5,002 mg/m(2) DEET and 2,349 mg/m(2) etofenprox LLIRN, for 63 weeks with the 3,590 mg/m(2) DEET and 1,208 mg/m(2) permethrin LLRN, and for 61 weeks with the 4,711 mg/m(2) DEET and 702 mg/m(2) etofenprox LLIRN. Because 100 % bite protection with up to 75 % quicker contact toxicity of pyrethroids were documented, synergistic toxicological and repellent effects of multi-layer polymer-coating LLIRNs may overcome LLIN-triggered selection pressure for development of new kdr- and metabolic pyrethroid resistances while simultaneously increasing protective efficacy also against kdr- and metabolic pyrethroid-resistant mosquitoes substantially due to the repellent-induced effects of LLIRNs thus indicating that this approach is a promising new candidate for future bed net, curtain, and window screen impregnation aiming at optimized prevention from mosquito-borne diseases.

Use of the RISK21 roadmap and matrix: human health risk assessment of the use of a pyrethroid in bed netting

PubMed Central

Doe, John E.; Lander, Deborah R.; Doerrer, Nancy G.; Heard, Nina; Hines, Ronald N.; Lowit, Anna B.; Pastoor, Timothy; Phillips, Richard D.; Sargent, Dana; Sherman, James H.; Young Tanir, Jennifer; Embry, Michelle R.

2016-01-01

Abstract The HESI-coordinated RISK21 roadmap and matrix are tools that provide a transparent method to compare exposure and toxicity information and assess whether additional refinement is required to obtain the necessary precision level for a decision regarding safety. A case study of the use of a pyrethroid, “pseudomethrin,” in bed netting to control malaria is presented to demonstrate the application of the roadmap and matrix. The evaluation began with a problem formulation step. The first assessment utilized existing information pertaining to the use and the class of chemistry. At each stage of the step-wise approach, the precision of the toxicity and exposure estimates were refined as necessary by obtaining key data which enabled a decision on safety to be made efficiently and with confidence. The evaluation demonstrated the concept of using existing information within the RISK21 matrix to drive the generation of additional data using a value-of-information approach. The use of the matrix highlighted whether exposure or toxicity required further investigation and emphasized the need to address the default uncertainty factor of 100 at the highest tier of the evaluation. It also showed how new methodology such as the use of in vitro studies and assays could be used to answer the specific questions which arise through the use of the matrix. The matrix also serves as a useful means to communicate progress to stakeholders during an assessment of chemical use. PMID:26517449

Multiplex serology for impact evaluation of bed net distribution on burden of lymphatic filariasis and four species of human malaria in northern Mozambique

PubMed Central

Candrinho, Baltazar; Chambe, Geraldo; Muchanga, João; Muguande, Olinda; Matsinhe, Graça; Mathe, Guidion; Rogier, Eric; Doyle, Timothy; Zulliger, Rose; Colborn, James; Saifodine, Abu; Lammie, Patrick; Priest, Jeffrey W.

2018-01-01

Background Universal coverage with long-lasting insecticidal nets (LLINs) is a primary control strategy against Plasmodium falciparum malaria. However, its impact on the three other main species of human malaria and lymphatic filariasis (LF), which share the same vectors in many co-endemic areas, is not as well characterized. The recent development of multiplex antibody detection provides the opportunity for simultaneous evaluation of the impact of control measures on the burden of multiple diseases. Methodology/Principal findings Two cross-sectional household surveys at baseline and one year after a LLIN distribution campaign were implemented in Mecubúri and Nacala-a-Velha Districts in Nampula Province, Mozambique. Both districts were known to be endemic for LF; both received mass drug administration (MDA) with antifilarial drugs during the evaluation period. Access to and use of LLINs was recorded, and household members were tested with P. falciparum rapid diagnostic tests (RDTs). Dried blood spots were collected and analyzed for presence of antibodies to three P. falciparum antigens, P. vivax MSP-119, P. ovale MSP-119, P. malariae MSP-119, and three LF antigens. Seroconversion rates were calculated and the association between LLIN use and post-campaign seropositivity was estimated using multivariate regression. The campaign covered 68% (95% CI: 58–77) of the population in Nacala-a-Velha and 46% (37–56) in Mecubúri. There was no statistically significant change in P. falciparum RDT positivity between the two surveys. Population seropositivity at baseline ranged from 31–81% for the P. falciparum antigens, 3–4% for P. vivax MSP-119, 41–43% for P. ovale MSP-119, 46–56% for P. malariae MSP-119, and 37–76% for the LF antigens. The seroconversion rate to the LF Bm33 antigen decreased significantly in both districts. The seroconversion rate to P. malariae MSP-119 and the LF Wb123 and Bm14 antigens each decreased significantly in one of the two districts. Community LLIN use was associated with a decreased risk of P. falciparum RDT positivity, P. falciparum LSA-1 seropositivity, and P. malariae MSP-119 seropositivity, but not LF antigen seropositivity. Conclusions/Significance The study area noted significant declines in LF seropositivity, but these were not associated with LLIN use. The MDA could have masked any impact of the LLINs on population LF seropositivity. The LLIN campaign did not reach adequately high coverage to decrease P. falciparum RDT positivity, the most common measure of P. falciparum burden. However, the significant decreases in the seroconversion rate to the P. malariae antigen, coupled with an association between community LLIN use and individual-level decreases in seropositivity to P. falciparum and P. malariae antigens show evidence of impact of the LLIN campaign and highlight the utility of using multiantigenic serological approaches for measuring intervention impact. PMID:29444078

Multiplex serology for impact evaluation of bed net distribution on burden of lymphatic filariasis and four species of human malaria in northern Mozambique.

PubMed

Plucinski, Mateusz M; Candrinho, Baltazar; Chambe, Geraldo; Muchanga, João; Muguande, Olinda; Matsinhe, Graça; Mathe, Guidion; Rogier, Eric; Doyle, Timothy; Zulliger, Rose; Colborn, James; Saifodine, Abu; Lammie, Patrick; Priest, Jeffrey W

2018-02-01

Universal coverage with long-lasting insecticidal nets (LLINs) is a primary control strategy against Plasmodium falciparum malaria. However, its impact on the three other main species of human malaria and lymphatic filariasis (LF), which share the same vectors in many co-endemic areas, is not as well characterized. The recent development of multiplex antibody detection provides the opportunity for simultaneous evaluation of the impact of control measures on the burden of multiple diseases. Two cross-sectional household surveys at baseline and one year after a LLIN distribution campaign were implemented in Mecubúri and Nacala-a-Velha Districts in Nampula Province, Mozambique. Both districts were known to be endemic for LF; both received mass drug administration (MDA) with antifilarial drugs during the evaluation period. Access to and use of LLINs was recorded, and household members were tested with P. falciparum rapid diagnostic tests (RDTs). Dried blood spots were collected and analyzed for presence of antibodies to three P. falciparum antigens, P. vivax MSP-119, P. ovale MSP-119, P. malariae MSP-119, and three LF antigens. Seroconversion rates were calculated and the association between LLIN use and post-campaign seropositivity was estimated using multivariate regression. The campaign covered 68% (95% CI: 58-77) of the population in Nacala-a-Velha and 46% (37-56) in Mecubúri. There was no statistically significant change in P. falciparum RDT positivity between the two surveys. Population seropositivity at baseline ranged from 31-81% for the P. falciparum antigens, 3-4% for P. vivax MSP-119, 41-43% for P. ovale MSP-119, 46-56% for P. malariae MSP-119, and 37-76% for the LF antigens. The seroconversion rate to the LF Bm33 antigen decreased significantly in both districts. The seroconversion rate to P. malariae MSP-119 and the LF Wb123 and Bm14 antigens each decreased significantly in one of the two districts. Community LLIN use was associated with a decreased risk of P. falciparum RDT positivity, P. falciparum LSA-1 seropositivity, and P. malariae MSP-119 seropositivity, but not LF antigen seropositivity. The study area noted significant declines in LF seropositivity, but these were not associated with LLIN use. The MDA could have masked any impact of the LLINs on population LF seropositivity. The LLIN campaign did not reach adequately high coverage to decrease P. falciparum RDT positivity, the most common measure of P. falciparum burden. However, the significant decreases in the seroconversion rate to the P. malariae antigen, coupled with an association between community LLIN use and individual-level decreases in seropositivity to P. falciparum and P. malariae antigens show evidence of impact of the LLIN campaign and highlight the utility of using multiantigenic serological approaches for measuring intervention impact.

A multiscale cerebral neurochemical connectome of the rat brain

PubMed Central

Schöttler, Judith; Ercsey-Ravasz, Maria; Cosa-Linan, Alejandro; Varga, Melinda; Toroczkai, Zoltan; Spanagel, Rainer

2017-01-01

Understanding the rat neurochemical connectome is fundamental for exploring neuronal information processing. By using advanced data mining, supervised machine learning, and network analysis, this study integrates over 5 decades of neuroanatomical investigations into a multiscale, multilayer neurochemical connectome of the rat brain. This neurochemical connectivity database (ChemNetDB) is supported by comprehensive systematically-determined receptor distribution maps. The rat connectome has an onion-type structural organization and shares a number of structural features with mesoscale connectomes of mouse and macaque. Furthermore, we demonstrate that extremal values of graph theoretical measures (e.g., degree and betweenness) are associated with evolutionary-conserved deep brain structures such as amygdala, bed nucleus of the stria terminalis, dorsal raphe, and lateral hypothalamus, which regulate primitive, yet fundamental functions, such as circadian rhythms, reward, aggression, anxiety, and fear. The ChemNetDB is a freely available resource for systems analysis of motor, sensory, emotional, and cognitive information processing. PMID:28671956

INSECTICIDE-TREATED BED NETS IN RONDÔNIA, BRAZIL: EVALUATION OF THEIR IMPACT ON MALARIA CONTROL

PubMed Central

Vieira, Gabriel de Deus; Basano, Sergio de Almeida; Katsuragawa, Tony Hiroshi; Camargo, Luís Marcelo Aranha

2014-01-01

Mosquito nets treated with long-lasting insecticide (LLINs), when used in compliance with guidelines of the World Health Organization, may be effective for malaria vector control. In 2012, approximately 150,000 LLINs were installed in nine municipalities in the state of Rondônia. However, no studies have assessed their impact on the reduction of malaria incidence. This study analyzed secondary data of malaria incidence, in order to assess the impact of LLINs on the annual parasite incidence (API). The results showed no statistically significant differences in API one year after LLIN installation when compared to municipalities without LLINs. The adoption of measures for malaria vector control should be associated with epidemiological studies and evaluations of their use and efficiency, with the aim of offering convincing advantages that justify their implementation and limit malaria infection in the Amazon Region. PMID:25351543

Health policy making through operative actions: a case study of provider capacity reduction in a public safety-net system.

PubMed

Tataw, David B

2014-01-01

This article describes and assesses the implications of policy decisions affecting health provider capacity in the Los Angeles County municipal safety-net health system from 1980 to 2000. Although never articulated in law or a county ordinance, the county pursued a sustained and discernable policy of cost reductions that affected capacity at King/Drew Medical Center from 1980 to 2000 without the input of beneficiaries or their advocates. Year after year, the county reduced personnel, supplies, and available beds either by reducing formal budgets or through operative actions of facility administrators that prevented the implementation of formally approved expenditures. This policy appears to have undermined the hospital system's mission of providing health services to at-risk populations with nowhere else to go. Decision making during the two decades under study revealed a decision-making pattern that challenged traditional models of policy decision making.

Tectonic rotations south of the Bohemian Massif from palaeomagnetic directions of Permian red beds in Hungary

USGS Publications Warehouse

Marton, E.; Elston, D.P.

1987-01-01

Palaeomagnetic studies were carried out in Permian red beds of the Balaton Highlands, the Mecsek Mountains and the Bu??kk Mountains of Hungary. Statistically well defined directions were obtained from six localities in the Balaton Highlands and two localities in the Mecsek Mountains. No meaningful results were obtained from the Bu??kk Mountains. Three magnetic components were identified from red beds of the Balaton Highlands: (1) in haematite with a very high unblocking temperature (700??C), interpreted as a Permian magnetization (Dc= 79??, Ic=-11??, k = 24, ??95 = 13.6 ??), in six samples from three beds in a single locality (2) a secondary but ancient component residing mainly inmaghemite (D = 314??, I = 49??, k = 48, ??95 = 10.0??), in 84 samples from six localities with a within-locality scatter increasing on unfolding; and (3) a direction parallel to the present field (D = 7??, I = 62??, k = 46, ??95 = 7.7 ??), in nine samples from a single locality. For the Balaton Highlands, the component 1 direction agrees with directions obtained from Permian red beds and volcanics in the eastern part of the Southern and Eastern Alps and the Inner West Carpathians. All show large, apparent rotations relative to stable Europe since the Permian. Component 2 is of post-folding (post-Aptian) age. Its direction agrees with known Late Cretaceous directions from the Transdanubian Central Mountains, which also show significant counterclockwise rotation relative to stable Europe. The characteristic magnetization for the Mecsek Mountains resides in haematite and may be primary. The directions indicate only a slight net counterclockwise rotation of the Mecsek Mountains with respect to stable Europe since the Permian. ?? 1987.

Field trial of a pulsed limestone diversion well

USGS Publications Warehouse

Sibrell, Philip L.; Denholm, C.; Dunn, Margaret

2013-01-01

The use of limestone diversion wells to treat acid mine drainage (AMD) is well-known, but in many cases, acid neutralization is not as complete as would be desired. Reasons for this include channeling of the water through the limestone bed, and the slow reaction rate of the limestone gravel. A new approach to improve the performance of the diversion well was tested in the field at the Jennings Environmental Education Center, near Slippery Rock, PA. In this approach, a finer size distribution of limestone was used so as to allow fluidization of the limestone bed, thus eliminating channeling and increasing particle surface area for faster reaction rates. Also, water flow was regulated through the use of a dosing siphon, so that consistent fluidization of the limestone sand could be achieved. Testing began late in the summer of 2010, and continued through November of 2011. Initial system performance during the 2010 field season was good, with the production of net alkaline water, but hydraulic problems involving air release and limestone sand retention were observed. In the summer of 2011, a finer size of limestone sand was procured for use in the system. This material fluidized more readily, but acid neutralization tapered off after several days. Subsequent observations indicated that the hydraulics of the system was compromised by the formation of iron oxides in the pipe leading to the limestone bed, which affected water distribution and flow through the bed. Although results from the field trial were mixed, it is believed that without the formation of iron oxides and plugging of the pipe, better acid neutralization and treatment would have occurred. Further tests are being considered using a different hydraulic configuration for the limestone sand fluidized bed.

Role of predation by zooplankton in transport and fate of protozoan (oo)cysts in granular activated carbon filtration.

PubMed

Bichai, Françoise; Barbeau, Benoit; Dullemont, Yolanda; Hijnen, Wim

2010-02-01

The significance of zooplankton in the transport and fate of pathogenic organisms in drinking water is poorly understood, although many hints of the role of predation in the persistence of microorganisms through water treatment processes can be found in literature. The objective of this study was to assess the impact of predation by natural zooplankton on the transport and fate of protozoan (oo)cysts in granular activated carbon (GAC) filtration process. UV-irradiated unlabelled Cryptosporidium parvum and Giardia lamblia (oo)cysts were seeded into two pilot-scale GAC filtration columns operated under full-scale conditions. In a two-week period after seeding, a reduction of free (oo)cysts retained in the filter bed was observed. Zooplankton was isolated from the filter bed and effluent water on a 30 microm net before and during the two-week period after seeding; it was enumerated and identified. Rotifers, which are potential predators of (oo)cysts, accounted for the major part of the isolated zooplankton. Analytical methods were developed to detect (oo)cysts internalized in natural zooplankton isolated from the filter bed and effluent water. Sample sonication was optimized to disrupt zooplankton organisms and release internalized microorganisms. (Oo)cysts released from zooplankton after sonication were isolated by IMS and stained (EasyStain) for microscopic counting. Both Cryptosporidium and Giardia (oo)cysts were detected in association with zooplankton in the filter bed samples as well as in the effluent of GAC filters. The results of this study suggest that predation by zooplankton can play a role in the remobilization of persistent pathogens such as Cryptosporidium and Giardia (oo)cysts retained in GAC filter beds, and consequently in the transmission of these pathogens in drinking water. Copyright 2009 Elsevier Ltd. All rights reserved.

Experiences with Health Insurance and Health Care in the Context of Welfare Reform.

PubMed

Narain, Kimberly Danae; Katz, Marian Lisa

2016-11-20

Studies have shown that in the wake of welfare reform there has been a drop in the health insurance coverage and health care utilization of low-income mothers. Using data from 20 telephone interviews, this study explored the health insurance and health care experiences of current and former welfare participants living in Los Angeles County. This study found that half of these women had been uninsured at some point. Many of these lapses in health insurance coverage were linked to employment transitions and lack of knowledge regarding eligibility for different safety net programs. This study also found that satisfaction with access to health care was high among the insured respondents; however, barriers to care remained for many individuals, including appointment scheduling issues, limited scope of health insurance coverage, narrow provider networks, lack of care continuity, and perceived low quality of care. Better linkages between social programs assisting with health insurance coverage and improved knowledge among program clients may reduce health insurance cycling in this group. New rules for Medicaid managed care, currently being considered by the Centers for Medicare and Medicaid Services, have the potential to improve access to health care and the quality of care for these individuals. © 2016 National Association of Social Workers.

A "Cap" on Medicaid: How Block Grants, Per Capita Caps, and Capped Allotments Might Fundamentally Change the Safety Net.

PubMed

Mager-Mardeusz, Haleigh; Lenz, Cosima; Kominski, Gerald F

2017-04-01

Changing the Medicaid program is a top priority for the Republican party. Common themes from GOP proposals include converting Medicaid from a jointly financed entitlement benefit to a form of capped federal financing. While proponents of this reform argue that it would provide greater flexibility and a more predictable budget for state governments, serious consequences would likely result for Medicaid enrollees and state governments. Under all three scenarios promoted by Republicans--block grants, capped allotments, and per capita caps—most states would face increased costs. For all three scenarios, the capped nature of the funding guarantees that the real value of funds would decrease in future years relative to what would be expected from growth under the current program. Although the federal government would undoubtedly realize savings from all three scenarios, the impact might lead states to reduce benefits and services, create waiting lists, impose cost-sharing on a traditionally low-income enrollee population, or impose other obstacles to coverage. Nationally, as many as 20.5 million Americans stand to lose coverage under the proposed Medicaid changes. In California, up to 6 million people could lose coverage if changes to the Medicaid program were coupled with the repeal of coverage for the expansion population.

Full Seismic Waveform Tomography of the Japan region using Adjoint Methods

NASA Astrophysics Data System (ADS)

Steptoe, Hamish; Fichtner, Andreas; Rickers, Florian; Trampert, Jeannot

2013-04-01

We present a full-waveform tomographic model of the Japan region based on spectral-element wave propagation, adjoint techniques and seismic data from dense station networks. This model is intended to further our understanding of both the complex regional tectonics and the finite rupture processes of large earthquakes. The shallow Earth structure of the Japan region has been the subject of considerable tomographic investigation. The islands of Japan exist in an area of significant plate complexity: subduction related to the Pacific and Philippine Sea plates is responsible for the majority of seismicity and volcanism of Japan, whilst smaller micro-plates in the region, including the Okhotsk, and Okinawa and Amur, part of the larger North America and Eurasia plates respectively, contribute significant local intricacy. In response to the need to monitor and understand the motion of these plates and their associated faults, numerous seismograph networks have been established, including the 768 station high-sensitivity Hi-net network, 84 station broadband F-net and the strong-motion seismograph networks K-net and KiK-net in Japan. We also include the 55 station BATS network of Taiwan. We use this exceptional coverage to construct a high-resolution model of the Japan region from the full-waveform inversion of over 15,000 individual component seismograms from 53 events that occurred between 1997 and 2012. We model these data using spectral-element simulations of seismic wave propagation at a regional scale over an area from 120°-150°E and 20°-50°N to a depth of around 500 km. We quantify differences between observed and synthetic waveforms using time-frequency misfits allowing us to separate both phase and amplitude measurements whilst exploiting the complete waveform at periods of 15-60 seconds. Fréchet kernels for these misfits are calculated via the adjoint method and subsequently used in an iterative non-linear conjugate-gradient optimization. Finally, we employ custom smoothing algorithms to remove the singularities of the Fréchet kernels and artifacts introduced by the heterogeneous coverage in oceanic regions of the model.

PSSMHCpan: a novel PSSM-based software for predicting class I peptide-HLA binding affinity

PubMed Central

Liu, Geng; Li, Dongli; Li, Zhang; Qiu, Si; Li, Wenhui; Chao, Cheng-chi; Yang, Naibo; Li, Handong; Cheng, Zhen; Song, Xin; Cheng, Le; Zhang, Xiuqing; Wang, Jian; Yang, Huanming

2017-01-01

Abstract Predicting peptide binding affinity with human leukocyte antigen (HLA) is a crucial step in developing powerful antitumor vaccine for cancer immunotherapy. Currently available methods work quite well in predicting peptide binding affinity with HLA alleles such as HLA-A*0201, HLA-A*0101, and HLA-B*0702 in terms of sensitivity and specificity. However, quite a few types of HLA alleles that are present in the majority of human populations including HLA-A*0202, HLA-A*0203, HLA-A*6802, HLA-B*5101, HLA-B*5301, HLA-B*5401, and HLA-B*5701 still cannot be predicted with satisfactory accuracy using currently available methods. Furthermore, currently the most popularly used methods for predicting peptide binding affinity are inefficient in identifying neoantigens from a large quantity of whole genome and transcriptome sequencing data. Here we present a Position Specific Scoring Matrix (PSSM)-based software called PSSMHCpan to accurately and efficiently predict peptide binding affinity with a broad coverage of HLA class I alleles. We evaluated the performance of PSSMHCpan by analyzing 10-fold cross-validation on a training database containing 87 HLA alleles and obtained an average area under receiver operating characteristic curve (AUC) of 0.94 and accuracy (ACC) of 0.85. In an independent dataset (Peptide Database of Cancer Immunity) evaluation, PSSMHCpan is substantially better than the popularly used NetMHC-4.0, NetMHCpan-3.0, PickPocket, Nebula, and SMM with a sensitivity of 0.90, as compared to 0.74, 0.81, 0.77, 0.24, and 0.79. In addition, PSSMHCpan is more than 197 times faster than NetMHC-4.0, NetMHCpan-3.0, PickPocket, sNebula, and SMM when predicting neoantigens from 661 263 peptides from a breast tumor sample. Finally, we built a neoantigen prediction pipeline and identified 117 017 neoantigens from 467 cancer samples of various cancers from TCGA. PSSMHCpan is superior to the currently available methods in predicting peptide binding affinity with a broad coverage of HLA class I alleles. PMID:28327987

Mass balance and isotope effects during nitrogen transport through septic tank systems with packed-bed (sand) filters

USGS Publications Warehouse

Hinkle, S.R.; Böhlke, J.K.; Fisher, L.H.

2008-01-01

Septic tank systems are an important source of NO3- to many aquifers, yet characterization of N mass balance and isotope systematics following septic tank effluent discharge into unsaturated sediments has received limited attention. In this study, samples of septic tank effluent before and after transport through single-pass packed-bed filters (sand filters) were evaluated to elucidate mass balance and isotope effects associated with septic tank effluent discharge to unsaturated sediments. Chemical and isotopic data from five newly installed pairs and ten established pairs of septic tanks and packed-bed filters serving single homes in Oregon indicate that aqueous solute concentrations are affected by variations in recharge (precipitation, evapotranspiration), NH4+ sorption (primarily in immature systems), nitrification, and gaseous N loss via NH3 volatilization and(or) N2 or N2O release during nitrification/denitrification. Substantial NH4+ sorption capacity was also observed in laboratory columns with synthetic effluent. Septic tank effluent ??15N-NH4+ values were almost constant and averaged + 4.9??? ?? 0.4??? (1 ??). In contrast, ??15N values of NO3- leaving mature packed-bed filters were variable (+ 0.8 to + 14.4???) and averaged + 7.2??? ?? 2.6???. Net N loss in the two networks of packed-bed filters was indicated by average 10-30% decreases in Cl--normalized N concentrations and 2-3??? increases in ??15N, consistent with fractionation accompanying gaseous N losses and corroborating established links between septic tank effluent and NO3- in a local, shallow aquifer. Values of ??18O-NO3- leaving mature packed-bed filters ranged from - 10.2 to - 2.3??? (mean - 6.4??? ?? 1.8???), and were intermediate between a 2/3 H2O-O + 1/3 O2-O conceptualization and a 100% H2O-O conceptualization of ??18O-NO3- generation during nitrification.

Evaluating Effects of Floodplain Constriction Along a High Energy Gravel-Bed River: Snake River, WY

NASA Astrophysics Data System (ADS)

Leonard, Christina M.

This study examined approximately 66 km of the Snake River, WY, USA, spanning a natural reach within Grand Teton National Park and a reach immediately downstream that is confined by artificial levees. We linked the channel adjustments observed within these two reaches between 2007 and 2012 to sediment transport processes by developing a morphological sediment budget. A pair of digital elevation models (DEMs) was generated by fusing LiDAR topography with depth estimates derived from optical image data within wetted channels. Errors for both components of the DEMs (LiDAR and optical bathymetry) were propagated through the DEM of difference and sediment budget calculations. Our results indicated that even with the best available methods for acquiring high resolution topographic data over large areas, the uncertainty associated with bed elevation estimates implied that net volumetric changes were not statistically significant. In addition to the terrain analysis, we performed a tracer study to assess the mobility of different grain size classes in different morphological units. Grain sizes, hydraulic conditions, and flow resistance characteristics along cross-sections were used to calculate critical discharges for entrainment, but this bulk characterization of fluid driving forces failed to predict bed mobility. Our results indicated that over seasonal timescales specific grain classes were not preferentially entrained. Surface and subsurface grain size data were used to calculate armoring and dimensionless sediment transport ratios for both reaches; sediment supply exceeded transport capacity in the natural reach and vice versa in the confined reach. We used a conceptual model to describe channel adjustments to lateral constriction by levees. Initially we suggest levees focused flow energy and incised the bed, resulting in bed armoring. Bed armoring promoted channel widening, but levees prevented this and instead the channel migrated more rapidly within the constricted braidplain, eroding vegetated islands and bars and excavating sediment from the reach.

Evaluation of Uncertainty in Bedload Transport Estimates in a Southern Appalachian Stream

NASA Astrophysics Data System (ADS)

Schwartz, J. S.

2016-12-01

Capacity estimates of bed-material transport rates are generally derived using empirical formulae as a function of bed material gradation and composition, and hydraulic shear stress. Various field techniques may be used to sample and characterize bed material gradation; some techniques assume the existing bar material is representative of that in transport. Other methods use Helly-Smith samplers, pit traps, and net traps. Very few large, complete cross-section pit traps fully instrumented to collect continuous bedload transport have been constructed, and none in the eastern United States to our knowledge. A fully-instrumented bedload collection station was constructed on Little Turkey Creek (LTC) in Farragut, Tennessee. The aim of the research was to characterize bed material transport during stormflows for a southern Appalachian stream in the Ridge and Valley Providence. Bedload transport data from LTC was compared with classic datasets including Oak Creek (Oregon), East Fork River (Wyoming), and Clearwater and Snake rivers (Idaho). In addition, data were evaluated to assess the potential accuracy of both calibrated and uncalibrated bedload transport models using bedload transport data from LTC. Uncalibrated models were assessed with regard to their estimated range of uncertainty according to Monte Carlo uncertainty analyses. Models calibrated using reference shear values determined according to station measurements are evaluated in the same manner. Finally, models calibrated using the small scale, short-term, low rate bedload sampling techniques promoted in the literature for the spreadsheet based Bedload Assessment in Gravel-bedded Streams (BAGS) software for determining the reference shear stress are compared to results of both uncalibrated models and those calibrated using data from the bedload station. This research supports design and construction of dynamically stable alluvial stream restoration projects where stream channels are largely dependent on reach-scale hydraulic geometry that provides a long-term balance between bed-material sediment supply and transport capacity.

ACA dependent coverage provision reduced high out-of-pocket health care spending for young adults.

PubMed

Busch, Susan H; Golberstein, Ezra; Meara, Ellen

2014-08-01

Since September 2010 the Affordable Care Act (ACA) has required that insurers allow children to remain as dependents on their parents' private insurance plans until age twenty-six. Studies have shown that this provision increased coverage rates among young adults. In this article we analyze whether the provision also protected young adults from large and uncertain out-of-pocket expenses. We found that the policy was associated with a statistically significant reduction in the share of young adults facing annual out-of-pocket expenditures greater than $1,500 (decreasing from 4.2 percent to 2.9 percent), compared to an increase in the proportion of their slightly older peers facing such expenditures (increasing from 4.4 percent to 5.4 percent), a net difference of -2.4 percentage points, or 57 percent. We conclude that the dependent coverage provision in the ACA provides financial protection for young adults at a time when they often face high debt burden but low wages. Project HOPE—The People-to-People Health Foundation, Inc.

From Ecosystem-Scale to Litter Biochemistry: Controls on Carbon Sequestration in Coastal Wetlands of the Western Gulf of Mexico

NASA Astrophysics Data System (ADS)

Louchouarn, P.; Kaiser, K.; Norwood, M. J.; Sterne, A. M. E.; Armitage, A. R.; HighField, W.; Brody, S.

2015-12-01

Landscape-level shifts in plant species distribution and abundance can fundamentally change the structure and services of an ecosystem. Such shifts are occurring within mangrove-marsh ecotones of the U.S., where over the last few decades, relatively mild winters have led to mangrove expansion into areas previously occupied by salt marsh plants. Here we present the synthesis of 3 years of multidisciplinary work to quantify ecosystem shifts at the regional scale, along the entire Texas (USA) coast of the western Gulf of Mexico, and transcribe these shifts into carbon (C) sequestration mass balances. We classified Landsat-5 Thematic Mapper images using artificial neural networks to quantify shifts in areal coverage of black mangrove (Avicennia germinans) and salt marsh (Spartina alterniflora and other grass and forb species) over 20 years across the Texas Gulf coast. Between 1990 and 2010, mangrove area expanded by 74% (+16 km2). Concurrently, salt marsh area experienced a net loss of 24% (-78 km2). Most of that loss was due to conversion to tidal flats or water, likely a result of relative sea level rise, with only 6% attributable to mangrove expansion. Although relative carbon load (per surface area) are statistically larger for mangrove wetlands, total C loads are larger for salt marsh wetlands due to their greater aerial coverage. The entire loss of above ground C (~7.0·109 g), was offset by salt marsh expansion (2.0·109 g) and mangrove expansion (5.6·109 g) over the study period. Concurrently, the net loss in salt marsh coverage led to a loss in below ground C accumulation capacity of 2.0·109 g/yr, whereas the net expansion of mangrove wetlands led to an added below ground C accumulation capacity of 0.4·109 g/yr. Biomarker data show that neutral carbohydrates and lignin contributed 30-70% and 10-40% of total C, respectively, in plant litter and surface sediments. Sharp declines of carbohydrate yields with depth occur parallel to increases in lignin degradation ratios, indicating substantial decomposition of both the polysaccharide and lignin components of litter detritus. Further, biomarker data suggest that litter chemistry is the primary control of C preservation in these wetland ecosystems. This study shows that shifts in plant composition influence C sequestration potential from landscape to molecular levels.

A data model of the Climate and Forecast metadata conventions (CF-1.6) with a software implementation (cf-python v2.1)

NASA Astrophysics Data System (ADS)

Hassell, David; Gregory, Jonathan; Blower, Jon; Lawrence, Bryan N.; Taylor, Karl E.

2017-12-01

The CF (Climate and Forecast) metadata conventions are designed to promote the creation, processing, and sharing of climate and forecasting data using Network Common Data Form (netCDF) files and libraries. The CF conventions provide a description of the physical meaning of data and of their spatial and temporal properties, but they depend on the netCDF file encoding which can currently only be fully understood and interpreted by someone familiar with the rules and relationships specified in the conventions documentation. To aid in development of CF-compliant software and to capture with a minimal set of elements all of the information contained in the CF conventions, we propose a formal data model for CF which is independent of netCDF and describes all possible CF-compliant data. Because such data will often be analysed and visualised using software based on other data models, we compare our CF data model with the ISO 19123 coverage model, the Open Geospatial Consortium CF netCDF standard, and the Unidata Common Data Model. To demonstrate that this CF data model can in fact be implemented, we present cf-python, a Python software library that conforms to the model and can manipulate any CF-compliant dataset.

First results of registering ionospheric disturbances obtained with SibNet network of GNSS receivers in active space experiments

NASA Astrophysics Data System (ADS)

Ishin, Artem; Perevalova, Natalia; Voeykov, Sergey; Khakhinov, Vitaliy

2017-12-01

Global and regional networks of GNSS receivers have been successfully used for geophysical research for many years; the number of continuous GNSS stations in the world is steadily growing. The article presents the first results of the use of a new regional network of GNSS stations (SibNet) in active space experiments. The Institute of Solar-Terrestrial Physics of Siberian Branch of Russian Academy of Sciences (ISTP SB RAS) has established this network in the South Baikal region. We describe in detail SibNet, characteristics of receivers in use, parameters of antennas and methods of their installation. We also present the general structure of observation site and the plot of coverage of the receiver operating zone at 50-55° latitudes by radio paths. It is shown that the selected location of receivers allows us to detect ionospheric irregularities of various scales. The purpose of the active space experiments was to reveal and record parameters of the ionospheric irregu larities caused by effects from jet streams of Progress cargo spacecraft. The mapping technique enabled us to identify weak, vertically localized ionospheric irregularities and associate them with the Progress spacecraft engine impact. Thus, it has been shown that SibNet deployed in the Southern Baikal region is an effective instrument for monitoring ionospheric conditions.

Chemical quality of surface waters in Devils Lake basin North Dakota, 1952-60

USGS Publications Warehouse

Mitten, Hugh T.; Scott, C.H.; Rosene, Philip G.

1968-01-01

Above-normal precipitation in 1954, 1956, and 1957 caused the water surface of Devils Lake to rise to an altitude of 1,419.3 feet, its highest in 40 years. Nearly all the water entering the lake flowed through Big Coulee, and about three-fourths of that inflow was at rates greater than 100 cubic feet per second. At these rates, the inflow contained less than 600 ppm (parts per million) dissolved solids and was of the calcium bicarbonate type.Because the inflow was more dilute than the lake water, the dissolved solids in the lake decreased from 8,680 ppm in 1952 to about 6,000 ppm in 1956 and 1957. Subsequently, however, they increased to slightly more than 8,000 ppm and averaged 6,800 ppm for the 1954-60 period. Sodium and sulfate were the principal dissolved constituents in the lake water. Although the concentration of dissolved solids varied significantly from time to time, the relative proportions of the chief constituents remained nearly the same.Water flowed from Devils Lake to Mission Bay in 1956,1957, and 1958, and some flowed from Mission Bay into East Bay. However, no water moved between East Devils Lake, western Stump Lake, and eastern Stump Lake during 1952-60; these lakes received only local runoff, and the variations in their water volume caused only minor variations in dissolved solids. For the periods sampled, concentrations averaged 60,700 ppm for East Devils Lake, 23,100 ppm for western Stump Lake, and 127,000 ppm for eastern Stump Lake.Sodium and sulfate were the chief dissolved constituents in all the lakes of the Devils Lake chain. Water in eastern Stump Lake was saturated with sodium sulfate and precipitated large quantities of granular, hydrated sodium sulfate crystals on the lakebed and shore in fall and winter. A discontinuous layer of consolidated sodium sulfate crystals formed a significant part of the bed throughout the year.Measured concentrations! of zinc, iron, manganese, fluoride, arsenic, boron, copper, and lead were not high enough to harm fish. Data on alpha and beta particle activities in Devils Lake were insufficient to determine if present activities are less than, equal to, or more than activities before nuclear tests began.Miscellaneous surface waters not in the Devils Lake chain contained dissolved solids that ranged from 239 to 61,200 ppm. The lakes that spill infrequently and have little or no ground-water inflow and outflow generally contain high concentrations of dissolved solids.Salt balance computations for Devils Lake for 1952-60 indicate that a net of as much as 89,000 tons of salts was removed from the bed by the water in some years and as much as 35,000 tons was added to the bed in other years. For the 9-year period, the tons removed exceeded the tons added; the net removed averaged 2.7 tons per acre per year. Pickup of these salts from the bed increased the dissolved solids in the lake water an average of 193 ppni per year. Between 1952 and 1960, 201,000 tons of salt was added to the bed of East Devils Lake, 15,100 tons to the bed of western Stump Lake, and 421,000 tons to the bed of eastern Stump Lake.Laboratory examination of shore and bed material indicated that the shore contained less weight of salt per unit weight of dry, inorganic material than the bed. Calcium and bicarbonate were the chief constituents dissolved from bed material of Devils Lake, whereas sodium and sulfate were the chief constituents dissolved from bed material of East Bay, East Devils Lake, and eastern and western Stump Lakes. Generally, calcium and bicarbonate were the chief constitutents dissolved from shore material of all these lakes.Evidence indicates that not more than 20 percent of the salt that "disappeared" from the water of Devils Lake west of State Route 20 as the lake altitudes decreased years ago will redissolve if the lake altitude is restored.

Economic Implications of Potential Changes to Regulatory and Reimbursement Policies for Medical Devices

PubMed Central

Reed, Shelby D.; Shea, Alisa M.

2007-01-01

Objective To evaluate the impact of regulatory scenarios on the financial viability of medical device companies. Design We developed a model to calculate the expected net present value of a hypothetical product throughout preclinical development, clinical testing, regulatory approval, and postmarketing. We tested 3 scenarios: (1) the current regulatory environment; (2) a scenario in which medical devices are subject to the same evidence standards required for pharmaceuticals; and (3) a scenario consistent with the Coverage with Evidence Development: Coverage with Study Participation (CSP) policy proposed by the Centers for Medicare and Medicaid Services, whereby Medicare will pay for beneficiaries to receive new devices that are not currently determined to be “reasonable and necessary” if the patients participate in clinical studies or registries. Measurements and Main results When applying assumptions consistent with the implantable cardioverter-defibrillator market, the net present value at the start of development was an estimated $553 million in the current regulatory environment, $322 million in the pharmaceutical scenario, and $403 million in the CSP scenario. Sensitivity analyses showed that the device industry would likely be profitable in all 3 scenarios over a range of assumptions. Conclusions The environment in which the medical device industry operates is financially attractive. Furthermore, when compared with the alternative of applying the same evidence standards for pharmaceuticals to medical devices, the CSP policy offers improved financial incentives for medical device companies. PMID:18095045

Access To Essential Maternal Health Interventions and Human Rights Violations among Vulnerable Communities in Eastern Burma

PubMed Central

Mullany, Luke C; Lee, Catherine I; Yone, Lin; Paw, Palae; Oo, Eh Kalu Shwe; Maung, Cynthia; Lee, Thomas J; Beyrer, Chris

2008-01-01

Background Health indicators are poor and human rights violations are widespread in eastern Burma. Reproductive and maternal health indicators have not been measured in this setting but are necessary as part of an evaluation of a multi-ethnic pilot project exploring strategies to increase access to essential maternal health interventions. The goal of this study is to estimate coverage of maternal health services prior to this project and associations between exposure to human rights violations and access to such services. Methods and Findings Selected communities in the Shan, Mon, Karen, and Karenni regions of eastern Burma that were accessible to community-based organizations operating from Thailand were surveyed to estimate coverage of reproductive, maternal, and family planning services, and to assess exposure to household-level human rights violations within the pilot-project target population. Two-stage cluster sampling surveys among ever-married women of reproductive age (15–45 y) documented access to essential antenatal care interventions, skilled attendance at birth, postnatal care, and family planning services. Mid-upper arm circumference, hemoglobin by color scale, and Plasmodium falciparum parasitemia by rapid diagnostic dipstick were measured. Exposure to human rights violations in the prior 12 mo was recorded. Between September 2006 and January 2007, 2,914 surveys were conducted. Eighty-eight percent of women reported a home delivery for their last pregnancy (within previous 5 y). Skilled attendance at birth (5.1%), any (39.3%) or ≥ 4 (16.7%) antenatal visits, use of an insecticide-treated bed net (21.6%), and receipt of iron supplements (11.8%) were low. At the time of the survey, more than 60% of women had hemoglobin level estimates ≤ 11.0 g/dl and 7.2% were Pf positive. Unmet need for contraceptives exceeded 60%. Violations of rights were widely reported: 32.1% of Karenni households reported forced labor and 10% of Karen households had been forced to move. Among Karen households, odds of anemia were 1.51 (95% confidence interval [CI] 0.95–2.40) times higher among women reporting forced displacement, and 7.47 (95% CI 2.21–25.3) higher among those exposed to food security violations. The odds of receiving no antenatal care services were 5.94 (95% CI 2.23–15.8) times higher among those forcibly displaced. Conclusions Coverage of basic maternal health interventions is woefully inadequate in these selected populations and substantially lower than even the national estimates for Burma, among the lowest in the region. Considerable political, financial, and human resources are necessary to improve access to maternal health care in these communities. PMID:19108601

Toward a continuous 405-kyr-calibrated Astronomical Time Scale for the Mesozoic Era

NASA Astrophysics Data System (ADS)

Hinnov, Linda; Ogg, James; Huang, Chunju

2010-05-01

Mesozoic cyclostratigraphy is being assembled into a continuous Astronomical Time Scale (ATS) tied to the Earth's cyclic orbital parameters. Recognition of a nearly ubiquitous, dominant ~400-kyr cycling in formations throughout the era has been particularly striking. Composite formations spanning contiguous intervals up to 50 myr clearly express these long-eccentricity cycles, and in some cases, this cycling is defined by third- or fourth-order sea-level sequences. This frequency is associated with the 405-kyr orbital eccentricity cycle, which provides a basic metronome and enables the extension of the well-defined Cenozoic ATS to scale the majority of the Mesozoic Era. This astronomical calibration has a resolution comparable to the 1% to 0.1% precision for radioisotope dating of Mesozoic ash beds, but with the added benefit of providing continuous stratigraphic coverage between dated beds. Extended portions of the Mesozoic ATS provide solutions to long-standing geologic problems of tectonics, eustasy, paleoclimate change, and rates of seafloor spreading.

High pressure adsorption isotherms of nitrogen onto granular activated carbon for a single bed pressure swing adsorption refrigeration system

NASA Astrophysics Data System (ADS)

Palodkar, Avinash V.; Anupam, Kumar; Roy, Zunipa; Saha, B. B.; Halder, G. N.

2017-10-01

Adsorption characteristics of nitrogen onto granular activated carbon for the wide range of temperature (303-323 K) and pressure (0.2027-2.0265 MPa) have been reported for a single bed pressure swing adsorption refrigeration system. The experimental data were fitted to Langmuir, Dubinin-Astakhov and Dubinin-Radushkevich (D-R) isotherms. The Langmuir and D-R isotherm models were found appropriate in correlating experimental adsorption data with an average relative error of ±2.0541% and ±0.6659% respectively. The isosteric heat of adsorption data were estimated as a function of surface coverage of nitrogen and temperature using D-R isotherm. The heat of adsorption was observed to decrease from 12.65 to 6.98 kJ.mol-1 with an increase in surface concentration at 303 K and it followed the same pattern for other temperatures. It was found that an increase in temperature enhances the magnitude of the heat of adsorption.

Assessment on the ownership and use of mosquito nets in Mozambique.

PubMed

Arroz, Jorge Alexandre Harrison; Chirrute, Francisco; Mendis, Chandana; Chande, Marta Honesta; Kollhoff, Veronique

2016-12-22

To assess the ownership and use of mosquito nets in 2014, in Mozambique. This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before. A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively). In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels. Avaliar a posse e o uso das redes mosquiteiras no ano de 2014 em Moçambique. Este estudo observacional transversal avaliou, em fevereiro e março de 2015, 68 distritos (nove das 11 províncias de Moçambique) que se beneficiaram da distribuição de redes em massa. Usou-se a metodologia Lot Quality Assurance Sampling. Cada localidade foi designada de área de supervisão. O Lot Quality Assurance Sampling opta por um mínimo de 19 agregados familiares (neste caso decidiu-se um mínimo de 100 agregados familiares por distrito) de cada área de supervisão, a fim de avaliar um indicador (neste caso dois indicadores foram avaliados: posse e uso de redes mosquiteiras). Duas perguntas nortearam a pesquisa: a) recebeu rede; b) usou rede na noite anterior. Foram avaliados 6.725 agregados familiares . Desses, 83,0% tinham recebido redes na campanha. Dos 6.232 inqueridos, 82,0% disseram que usaram na noite anterior. As províncias com distritos com menores coberturas de posse e uso foram Tete (69,5% e 60,0%, respectivamente), Zambézia (79,0% e 60,0%, respectivamente) e Gaza (81,6% e 70,7%, respectivamente). As maiores coberturas de posse e uso foram observadas nos distritos de Nampula (96,7% e 93,8%, respectivamente) e Niassa (86,0% e 85,4%, respectivamente). Nos distritos avaliados, a progressão para a posse e uso de redes mosquiteiras é satisfatória. Nampula e Niassa são as únicas províncias onde a posse e o uso estão em níveis desejados.

Differences in access to services in rural emergency departments of Quebec and Ontario.

PubMed

Fleet, Richard; Pelletier, Christina; Marcoux, Jérémie; Maltais-Giguère, Julie; Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Tounkara, Fatoumata Korika; Poitras, Julien

2015-01-01

Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

Does extending health insurance coverage to the uninsured improve population health outcomes?

PubMed

Thornton, James A; Rice, Jennifer L

2008-01-01

An ongoing debate exists about whether the US should adopt a universal health insurance programme. Much of the debate has focused on programme implementation and cost, with relatively little attention to benefits for social welfare. To estimate the effect on US population health outcomes, measured by mortality, of extending private health insurance to the uninsured, and to obtain a rough estimate of the aggregate economic benefits of extending insurance coverage to the uninsured. We use state-level panel data for all 50 states for the period 1990-2000 to estimate a health insurance augmented, aggregate health production function for the US. An instrumental variables fixed-effects estimator is used to account for confounding variables and reverse causation from health status to insurance coverage. Several observed factors, such as income, education, unemployment, cigarette and alcohol consumption and population demographic characteristics are included to control for potential confounding variables that vary across both states and time. The results indicate a negative relationship between private insurance and mortality, thus suggesting that extending insurance to the uninsured population would result in an improvement in population health outcomes. The estimate of the marginal effect of insurance coverage indicates that a 10% increase in the population-insured rate of a state reduces mortality by 1.69-1.92%. Using data for the year 2003, we calculate that extending private insurance coverage to the entire uninsured population in the US would save over 75 000 lives annually and may yield annual net benefits to the nation in excess of $US400 billion. This analysis suggests that extending health insurance coverage through the private market to the 46 million Americans without health insurance may well produce large social economic benefits for the nation as a whole.

Cost-Effectiveness of Opt-Out Chlamydia Testing for High-Risk Young Women in the U.S.

PubMed

Owusu-Edusei, Kwame; Hoover, Karen W; Gift, Thomas L

2016-08-01

In spite of chlamydia screening recommendations, U.S. testing coverage continues to be low. This study explored the cost-effectiveness of a patient-directed, universal, opportunistic Opt-Out Testing strategy (based on insurance coverage, healthcare utilization, and test acceptance probabilities) for all women aged 15-24 years compared with current Risk-Based Screening (30% coverage) from a societal perspective. Based on insurance coverage (80%); healthcare utilization (83%); and test acceptance (75%), the proposed Opt-Out Testing strategy would have an expected annual testing coverage of approximately 50% for sexually active women aged 15-24 years. A basic compartmental heterosexual transmission model was developed to account for population-level transmission dynamics. Two groups were assumed based on self-reported sexual activity. All model parameters were obtained from the literature. Costs and benefits were tracked over a 50-year period. The relative sensitivity of the estimated incremental cost-effectiveness ratios to the variables/parameters was determined. This study was conducted in 2014-2015. Based on the model, the Opt-Out Testing strategy decreased the overall chlamydia prevalence by >55% (2.7% to 1.2%). The Opt-Out Testing strategy was cost saving compared with the current Risk-Based Screening strategy. The estimated incremental cost-effectiveness ratio was most sensitive to the female pre-opt out prevalence, followed by the probability of female sequelae and discount rate. The proposed Opt-Out Testing strategy was cost saving, improving health outcomes at a lower net cost than current testing. However, testing gaps would remain because many women might not have health insurance coverage, or not utilize health care. Published by Elsevier Inc.

Immunization Coverage and Medicaid Managed Care in New Mexico: A Multimethod Assessment

PubMed Central

Schillaci, Michael A.; Waitzkin, Howard; Carson, E. Ann; López, Cynthia M.; Boehm, Deborah A.; López, Leslie A.; Mahoney, Sheila F.

2004-01-01

BACKGROUND We wanted to examine the association between Medicaid managed care (MMC) and changing immunization coverage in New Mexico, a predominantly rural, poor, and multiethnic state. METHODS As part of a multimethod assessment of MMC, we studied trends in quantitative data from the National Immunization Survey (NIS) using temporal plots, Fisher’s exact test, and the Cochran-Armitage trend test. To help explain changes in immunization rates in relation to MMC, we analyzed qualitative data gathered through ethnographic observations at safety net institutions: income support (welfare) offices, community health centers, hospital emergency departments, private physicians’ offices, mental health institutions, managed care organizations, and agencies of state government. RESULTS Immunization coverage decreased significantly after implementation of MMC, from 80% in 1996 to 73% in 2001 for the 4:3:1 vaccination series (Fisher’s exact test, P = .031). New Mexico dropped in rank among states from 30th for this vaccination series in 1996 to 50th in 2001. A significant decreasing trend (Cochran-Armitage P = .025) in coverage occurred between 1996 and 2001. Findings from the ethnographic study revealed conditions that might have contributed to decreased immunization coverage: (1) reduced funding for immunizations at public health clinics, and difficulties in gaining access to MMC providers; (2) informal referrals from managed care organizations and contracting physicians to community health centers and state-run public health clinics; and (3) increased workloads and delays at community health centers, linked partly to these informal referrals for immunizations. CONCLUSIONS Medicaid reform in New Mexico did not improve immunization coverage, which declined significantly to among the lowest in the nation. Reduced funding for public health clinics and informal referrals may have contributed to this decline. These observations show how unanticipated and adverse consequences can result from policy interventions in complex insurance systems. PMID:15053278

Preliminary Investigation on Life Cycle Inventory of Powder Bed Fusion of Stainless Steel

NASA Astrophysics Data System (ADS)

Nyamekye, Patricia; Piili, Heidi; Leino, Maija; Salminen, Antti

Manufacturing of work pieces from stainless steel with laser additive manufacturing, known also as laser sintering or 3D printing may increase energy and material efficiency. The use of powder bed fusion offers advantages to make parts for dynamic applications of light weight and near-net-shape products. Due to these advantages among others, PBF may also reduce emissions and operational cost in various applications. However, there are only few life cycle assessment studies examining this subject despite its prospect to business opportunity. The application of Life Cycle Inventory (LCI) in Powder Bed Fusion (PBF) provides a distinct evaluation of material and energy consumption. LCI offers a possibility to improve knowledge of process efficiency. This study investigates effect of process sustainability in terms of raw material, energy and time consumption with PBF and CNC machining. The results of the experimental study indicated lower energy efficiency in the production process with PBF. This study revealed that specific energy consumption in PBF decreased when several components are built simultaneously than if they would be built individually. This is due to fact that energy consumption per part is lower. On the contrary, amount of energy needed to machine on part in case of CNC machining is lower when parts are done separately.

Increased oil production and reserves from improved completion techniques in the Bluebell field, Uinta Basin, Utah. Tenth quarterly technical progress report, January 1, 1996--March 31, 1996. Revised

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allison, M.L.

1996-05-13

The objective of this project is to increase oil production and reserves in the Uinta Basin by demonstrating improved completion techniques. Low productivity of Uinta Basin will is caused by gross production intervals of several thousand feet that contain perforated thief zones, water-bearing zones, and unperforated oil- bearing intervals. Geologic and engineering characterization and computer simulation of the Green River and Wasatch Formations in the Bluefell field will determine reservoir heterogeneities related to fractures and depositional trends. This will be followed by techniques based on the reservoir characterization. Transfer of the project results will be an ongoing component of themore » project. Data (net pay thickness, porosity, and water saturation) of more than 100 individuals beds in he lower Green River and Wasatch Formations were used to generate geostatistical realization (numerical- representation) of the reservoir properties. The data set was derived from the Michelle Ute and Malnar Pike demonstration wells and 22 other wells in a 20 (52 km{sup 2}) square-mile area. Beds were studied independently of each other. Principles of sequential Gaussian simulations were used to generate geostatistical realizations of the beds.« less

Importance of employee vaccination against influenza in preventing cases in long-term care facilities.

PubMed

Wendelboe, Aaron M; Avery, Catherine; Andrade, Bernardo; Baumbach, Joan; Landen, Michael G

2011-10-01

Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation. The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds. Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]). High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.

Mapping spatial resources with GPS animal telemetry: foraging manatees locate seagrass beds in the Ten Thousand Islands, Florida, USA

USGS Publications Warehouse

Slone, Daniel H.; Reid, James P.; Kenworthy, W. Judson

2013-01-01

Turbid water conditions make the delineation and characterization of benthic habitats difficult by traditional in situ and remote sensing methods. Here, we develop and validate modeling and sampling methodology for detecting and characterizing seagrass beds by analyzing GPS telemetry records from radio-tagged manatees. Between October 2002 and October 2005, 14 manatees were tracked in the Ten Thousand Islands (TTI) in southwest Florida (USA) using Global Positioning System (GPS) tags. High density manatee use areas were found to occur off each island facing the open, nearshore waters of the Gulf of Mexico. We implemented a spatially stratified random sampling plan and used a camera-based sampling technique to observe and record bottom observations of seagrass and macroalgae presence and abundance. Five species of seagrass were identified in our study area: Halodule wrightii, Thalassia testudinum, Syringodium filiforme, Halophila engelmannii, and Halophila decipiens. A Bayesian model was developed to choose and parameterize a spatial process function that would describe the observed patterns of seagrass and macroalgae. The seagrasses were found in depths <2 m and in the higher manatee use strata, whereas macroalgae was found at moderate densities at all sampled depths and manatee use strata. The manatee spatial data showed a strong association with seagrass beds, a relationship that increased seagrass sampling efficiency. Our camera-based field sampling proved to be effective for assessing seagrass density and spatial coverage under turbid water conditions, and would be an effective monitoring tool to detect changes in seagrass beds.

Simulation Facilities and Test Beds for Galileo

NASA Astrophysics Data System (ADS)

Schlarmann, Bernhard Kl.; Leonard, Arian

2002-01-01

Galileo is the European satellite navigation system, financed by the European Space Agency (ESA) and the European Commission (EC). The Galileo System, currently under definition phase, will offer seamless global coverage, providing state-of-the-art positioning and timing services. Galileo services will include a standard service targeted at mass market users, an augmented integrity service, providing integrity warnings when fault occur and Public Regulated Services (ensuring a continuity of service for the public users). Other services are under consideration (SAR and integrated communications). Galileo will be interoperable with GPS, and will be complemented by local elements that will enhance the services for specific local users. In the frame of the Galileo definition phase, several system design and simulation facilities and test beds have been defined and developed for the coming phases of the project, respectively they are currently under development. These are mainly the following tools: Galileo Mission Analysis Simulator to design the Space Segment, especially to support constellation design, deployment and replacement. Galileo Service Volume Simulator to analyse the global performance requirements based on a coverage analysis for different service levels and degrades modes. Galileo System Simulation Facility is a sophisticated end-to-end simulation tool to assess the navigation performances for a complete variety of users under different operating conditions and different modes. Galileo Signal Validation Facility to evaluate signal and message structures for Galileo. Galileo System Test Bed (Version 1) to assess and refine the Orbit Determination &Time Synchronisation and Integrity algorithms, through experiments relying on GPS space infrastructure. This paper presents an overview on the so called "G-Facilities" and describes the use of the different system design tools during the project life cycle in order to design the system with respect to availability, continuity and integrity requirements. It gives more details on two of these system design tools: the Galileo Signal Validation Facility (GSVF) and the Galileo System Simulation Facility (GSSF). It will describe the operational use of these facilities within the complete set of design tools and especially the combined use of GSVF and GSSF will be described. Finally, this paper presents also examples and results obtained with these tools.

Searching for SNPs with cloud computing

PubMed Central

2009-01-01

As DNA sequencing outpaces improvements in computer speed, there is a critical need to accelerate tasks like alignment and SNP calling. Crossbow is a cloud-computing software tool that combines the aligner Bowtie and the SNP caller SOAPsnp. Executing in parallel using Hadoop, Crossbow analyzes data comprising 38-fold coverage of the human genome in three hours using a 320-CPU cluster rented from a cloud computing service for about $85. Crossbow is available from http://bowtie-bio.sourceforge.net/crossbow/. PMID:19930550

Base Station Placement Algorithm for Large-Scale LTE Heterogeneous Networks.

PubMed

Lee, Seungseob; Lee, SuKyoung; Kim, Kyungsoo; Kim, Yoon Hyuk

2015-01-01

Data traffic demands in cellular networks today are increasing at an exponential rate, giving rise to the development of heterogeneous networks (HetNets), in which small cells complement traditional macro cells by extending coverage to indoor areas. However, the deployment of small cells as parts of HetNets creates a key challenge for operators' careful network planning. In particular, massive and unplanned deployment of base stations can cause high interference, resulting in highly degrading network performance. Although different mathematical modeling and optimization methods have been used to approach various problems related to this issue, most traditional network planning models are ill-equipped to deal with HetNet-specific characteristics due to their focus on classical cellular network designs. Furthermore, increased wireless data demands have driven mobile operators to roll out large-scale networks of small long term evolution (LTE) cells. Therefore, in this paper, we aim to derive an optimum network planning algorithm for large-scale LTE HetNets. Recently, attempts have been made to apply evolutionary algorithms (EAs) to the field of radio network planning, since they are characterized as global optimization methods. Yet, EA performance often deteriorates rapidly with the growth of search space dimensionality. To overcome this limitation when designing optimum network deployments for large-scale LTE HetNets, we attempt to decompose the problem and tackle its subcomponents individually. Particularly noting that some HetNet cells have strong correlations due to inter-cell interference, we propose a correlation grouping approach in which cells are grouped together according to their mutual interference. Both the simulation and analytical results indicate that the proposed solution outperforms the random-grouping based EA as well as an EA that detects interacting variables by monitoring the changes in the objective function algorithm in terms of system throughput performance.

Channel change and bed-material transport in the Lower Chetco River, Oregon

USGS Publications Warehouse

Wallick, J. Rose; Anderson, Scott W.; Cannon, Charles; O'Connor, Jim E.

2010-01-01

The lower Chetco River is a wandering gravel-bed river flanked by abundant and large gravel bars formed of coarse bed-material sediment. Since the early twentieth century, the large gravel bars have been a source of commercial aggregate for which ongoing permitting and aquatic habitat concerns have motivated this assessment of historical channel change and sediment transport rates. Analysis of historical channel change and bed-material transport rates for the lower 18 kilometers shows that the upper reaches of the study area are primarily transport zones, with bar positions fixed by valley geometry and active bars mainly providing transient storage of bed material. Downstream reaches, especially near the confluence of the North Fork Chetco River, are zones of active sedimentation and channel migration.Multiple analyses, supported by direct measurements of bedload during winter 2008–09, indicate that since 1970 the mean annual flux of bed material into the study reach has been about 40,000–100,000 cubic meters per year. Downstream tributary input of bed-material sediment, probably averaging 5–30 percent of the influx coming into the study reach from upstream, is approximately balanced by bed-material attrition by abrasion. Probably little bed material leaves the lower river under natural conditions, with most net influx historically accumulating in wider and more dynamic reaches, especially near the North Fork Chetco River confluence, 8 kilometers upstream from the Pacific Ocean.The year-to-year flux, however, varies tremendously. Some years may have less than 3,000 cubic meters of bed material entering the study area; by contrast, some high-flow years, such as 1982 and 1997, likely have more than 150,000 cubic meters entering the reach. For comparison, the estimated annual volume of gravel extracted from the lower Chetco River for commercial aggregate during 2000–2008 has ranged from 32,000 to 90,000 cubic meters and averaged about 59,000 cubic meters per year. Mined volumes probably exceeded 140,000 cubic meters per year for several years in the late 1970s.Repeat surveys and map analyses indicate a reduction in bar area and sinuosity between 1939 and 2008, chiefly in the period 1965–95. Repeat topographic and bathymetric surveys show channel incision for substantial portions of the study reach, with local areas of bed lowering by as much as 2 meters. A specific gage analysis at the upstream end of the study reach indicates that incision and narrowing followed aggradation culminating in the late 1970s. These observations are all consistent with a reduction of sediment supply relative to transport capacity since channel surveys in the late 1970s, probably owing to a combination of (1) bed sediment removal and (2) transient river adjustments to large sediment volumes brought by floods such as those in 1964 and, to a lesser extent, 1996.

Channel change and bed-material transport in the Lower Chetco River, Oregon

USGS Publications Warehouse

Wallick, J. Rose; Anderson, Scott W.; Cannon, Charles; O'Connor, Jim E.

2009-01-01

The lower Chetco River is a wandering gravel-bed river flanked by abundant and large gravel bars formed of coarse bed-material sediment. The large gravel bars have been a source of commercial aggregate since the early twentieth century for which ongoing permitting and aquatic habitat concerns have motivated this assessment of historical channel change and sediment transport rates. Analysis of historical channel change and bed-material transport rates for the lower 18 kilometers show that the upper reaches of the study area are primarily transport zones, with bar positions fixed by valley geometry and active bars mainly providing transient storage of bed material. Downstream reaches, especially near the confluence of the North Fork Chetco River, have been zones of active sedimentation and channel migration.Multiple analyses, supported by direct measurements of bedload during winter 2008–09, indicate that since 1970 the mean annual flux of bed material into the study reach has been about 40,000–100,000 cubic meters per year. Downstream tributary input of bed-material sediment, probably averaging 5–30 percent of the influx coming into the study reach from upstream, is approximately balanced by bed-material attrition by abrasion. Probably very little bed material leaves the lower river under natural conditions, with most of the net influx historically accumulating in wider and more dynamic reaches, especially near the North Fork Chetco River confluence, 8 kilometers upstream from the Pacific Ocean.The year-to-year flux, however, varies tremendously. Some years probably have less than 3,000 cubic meters of bed-material entering the study area; by contrast, some high-flow years, such as 1982 and 1997, likely have more than 150,000 cubic meters entering the reach. For comparison, the estimated annual volume of gravel extracted from the lower Chetco River for commercial aggregate during 2000–2008 has ranged from 32,000 to 90,000 cubic meters and averaged about 59,000 cubic meters per year. Mined volumes probably exceeded 140,000 cubic meters per year for several years in the late 1970s.Repeat surveys and map analyses indicate a reduction in bar area and sinuosity between 1939 and 2008, chiefly in the period 1965–95. Repeat topographic and bathymetric surveys show channel incision for substantial portions of the study reach, with local areas of bed lowering by as much as 2 meters. A specific gage analysis at the upstream end of the study reach indicates that incision and narrowing followed aggradation culminating in the late 1970s. These observations are all consistent with a reduction of sediment supply relative to transport capacity since channel surveys in the late 1970s, probably owing to a combination of (1) bed-sediment removal and (2) transient river adjustments to large sediment volumes brought by floods such as those in 1964, and to a lesser extent, 1996.

Channel Change and Bed-Material Transport in the Lower Chetco River, Oregon

NASA Astrophysics Data System (ADS)

O'Connor, J. E.; Wallick, R.; Anderson, S.; Cannon, C.

2009-12-01

The Chetco River drains 914 square kilometers of the Klamath Mountains in far southwestern Oregon. For its lowermost 18 km, it is a wandering gravel-bed river flanked by abundant and large gravel bars formed of coarse bed-material sediment. The large gravel bars have been a source of commercial aggregate since the early twentieth century for which ongoing permitting and aquatic habitat concerns have motivated an assessment of historical channel change and sediment transport rates. Analysis of historical channel change and bed-material transport rates for the lower 18 kilometers show that the upper reaches of the study area are primarily transport zones, with bar positions fixed by valley geometry and active bars mainly providing transient storage of bed material. Downstream reaches, especially near the confluence of the North Fork Chetco River, have been zones of active sedimentation and channel migration. Multiple analyses, supported by direct measurements of bedload during winter 2008-09, indicate that since 1970 the mean annual flux of bed material into the study reach has been about 40,000-100,000 cubic meters per year. Downstream tributary input of bed-material sediment, probably averaging 5-30 percent of the influx coming into the study reach from upstream, is approximately balanced by bed-material attrition by abrasion. Probably very little bed material leaves the lower river under natural conditions, with most of the net influx historically accumulating in wider and more dynamic reaches, especially near the North Fork Chetco River confluence, 8 kilometers upstream from the Pacific Ocean. The year-to-year flux, however, varies tremendously. Some years probably have less than 3,000 cubic meters of bed-material entering the study area; by contrast, some high-flow years, such as 1982 and 1997, likely have more than 150,000 cubic meters entering the reach. For comparison, the estimated annual volume of gravel extracted from the lower Chetco River for commercial aggregate during 2000-2008 has ranged from 32,000 to 90,000 cubic meters and averaged about 59,000 cubic meters per year. Mined volumes probably exceeded 140,000 cubic meters per year for several years in the late 1970s. Repeat surveys and map analyses indicate a reduction in bar area and sinuosity between 1939 and 2008, chiefly in the period 1965-95. Repeat topographic and bathymetric surveys show channel incision for substantial portions of the study reach, with local areas of bed lowering by as much as 2 meters. A specific gage analysis at the upstream end of the study reach indicates that incision and narrowing followed aggradation culminating in the late 1970s. These observations are all consistent with a reduction of sediment supply relative to transport capacity since channel surveys in the late 1970s, probably owing to a combination of (1) bed-sediment removal and (2) transient river adjustments to large sediment volumes brought by floods such as those in 1964, and to a lesser extent, 1996.

Suspended-sediment budget, flow distribution, and lake circulation for the Fox Chain of Lakes in Lake and McHenry Counties, Illinois, 1997-99

USGS Publications Warehouse

Schrader, David L.; Holmes, Robert R.

2000-01-01

The Fox Chain of Lakes is a glacial lake system in McHenry and Lake Counties in northern Illinois and southern Wisconsin. Sedimentation and nutrient overloading have occurred in the lake system since the first dam was built (1907) in McHenry to raise water levels in the lake system. Using data collected from December 1, 1997, to June 1, 1999, suspended-sediment budgets were constructed for the most upstream lake in the system, Grass Lake, and for the lakes downstream from Grass Lake. A total of 64,900 tons of suspended sediment entered Grass Lake during the study, whereas a total of 70,600 tons of suspended sediment exited the lake, indicating a net scour of 5,700 tons of sediment. A total of 44,100 tons of suspended sediment was measured exiting the Fox Chain of Lakes at Johnsburg, whereas 85,600 tons entered the system downstream from Grass Lake. These suspended-sediment loads indicate a net deposition of 41,500 tons downstream from Grass Lake, which represents a trapping efficiency of 48.5 percent. A large amount of recreational boating takes place on the Fox Chain of Lakes during summer months, and suspended-sediment load was observed to rise from 110 tons per day to 339 tons per day during the 1999 Memorial Day weekend (May 26 ?31, 1999). Presumably, this rise was the result of the boating traffic because no other hydrologic event is known to have occurred that might have caused the rise. This study covers a relatively short period and may not represent the long-term processes of the Fox Chain of Lakes system, although the sediment transport was probably higher than an average year. The bed sediments found on the bottom of the lakes are composed of mainly fine particles in the silt-clay range. The Grass Lake sediments were characterized as black peat with an organic content of between 9 and 18 percent, and the median particle size ranged from 0.000811 to 0.0013976 inches. Other bed material samples were collected at streamflow-gaging stations on the tributaries to the Fox Chain of Lakes. With the exception of Grass Lake Outlet at Lotus Woods, most of the bed sediments are sand size or larger. The bed material at the streamflow-gaging station at Grass Lake Outlet at Lotus Woods contains 31.5 percent silt- and clay-sized particles. The bed material at Nippersink Creek near Spring Grove also has higher silt content (10.7 percent) than the bed material found in the Fox River at Wilmot (2.1 percent) and Johnsburg (1.3 percent). Additionally, water velocities at 80 cross sections in the Fox Chain of Lakes were collected to provide sample circulation patterns during two separate 1-week periods, and discharge was measured at 18 locations in the lakes. These data were collected to be available for use in hydrodynamic models.

Comparative study of the germination of Ulva prolifera gametes on various substrates

NASA Astrophysics Data System (ADS)

Geng, Huixia; Yan, Tian; Zhou, Mingjiang; Liu, Qing

2015-09-01

Since 2007, massive green tides have occurred every summer in the southern Yellow Sea (YS), China. They have caused severe ecological consequences and huge economic losses. Ulva prolifera originated from Subei Shoal of the YS was confirmed as causative species of the green tides. The Porphyra yezoensis aquaculture rafts in the Subei Shoal have been highly suspected to be the "seed bed" of the green tides, because U. prolifera abundantly fouled the Porphyra yezoensis aquaculture facilities. Besides, various habitats of aquaculture ponds along the Jiangsu coastline and mudflat in the Subei Shoal were proposed to be possible sources of green tides. To understand the "seed" of the green tides in the southern YS and mitigate the original biomass of the green tide, various materials used as substrates for the germination of U. prolifera gametes were tested in this study. Culture experiments showed the following: 1) materials used in the P. yezoensis rafts (plastic, bamboo, jute rope, plastic rope, nylon netting, and plastic netting) displayed a significantly higher germination rate than those associated with mudflats and aquaculture ponds (mud, sand and rock); 2) plastics were the best substrates for the germination of U. prolifera gametes; 3) poor germination was found on old fronds of U. prolifera,, and rubber showed inhibitory effect on germination. The success in germination on P. yezoensis rafts related materials supports the notion that these mariculture structures may be involved in acting as a seed bed for green tide macroalgae. The lack of germination on rubber surfaces may suggest one way to limit the proliferation of early stages of U. prolifera.

Exploiting the behaviour of wild malaria vectors to achieve high infection with fungal biocontrol agents

PubMed Central

2012-01-01

Background Control of mosquitoes that transmit malaria has been the mainstay in the fight against the disease, but alternative methods are required in view of emerging insecticide resistance. Entomopathogenic fungi are candidate alternatives, but to date, few trials have translated the use of these agents to field-based evaluations of their actual impact on mosquito survival and malaria risk. Mineral oil-formulations of the entomopathogenic fungi Metarhizium anisopliae and Beauveria bassiana were applied using five different techniques that each exploited the behaviour of malaria mosquitoes when entering, host-seeking or resting in experimental huts in a malaria endemic area of rural Tanzania. Results Survival of mosquitoes was reduced by 39-57% relative to controls after forcing upward house-entry of mosquitoes through fungus treated baffles attached to the eaves or after application of fungus-treated surfaces around an occupied bed net (bed net strip design). Moreover, 68 to 76% of the treatment mosquitoes showed fungal growth and thus had sufficient contact with fungus treated surfaces. A population dynamic model of malaria-mosquito interactions shows that these infection rates reduce malaria transmission by 75-80% due to the effect of fungal infection on adult mortality alone. The model also demonstrated that even if a high proportion of the mosquitoes exhibits outdoor biting behaviour, malaria transmission was still significantly reduced. Conclusions Entomopathogenic fungi strongly affect mosquito survival and have a high predicted impact on malaria transmission. These entomopathogens represent a viable alternative for malaria control, especially if they are used as part of an integrated vector management strategy. PMID:22449130

How effective is integrated vector management against malaria and lymphatic filariasis where the diseases are transmitted by the same vector?

PubMed

Stone, Christopher M; Lindsay, Steve W; Chitnis, Nakul

2014-12-01

The opportunity to integrate vector management across multiple vector-borne diseases is particularly plausible for malaria and lymphatic filariasis (LF) control where both diseases are transmitted by the same vector. To date most examples of integrated control targeting these diseases have been unanticipated consequences of malaria vector control, rather than planned strategies that aim to maximize the efficacy and take the complex ecological and biological interactions between the two diseases into account. We developed a general model of malaria and LF transmission and derived expressions for the basic reproductive number (R0) for each disease. Transmission of both diseases was most sensitive to vector mortality and biting rate. Simulating different levels of coverage of long lasting-insecticidal nets (LLINs) and larval control confirms the effectiveness of these interventions for the control of both diseases. When LF was maintained near the critical density of mosquitoes, minor levels of vector control (8% coverage of LLINs or treatment of 20% of larval sites) were sufficient to eliminate the disease. Malaria had a far greater R0 and required a 90% population coverage of LLINs in order to eliminate it. When the mosquito density was doubled, 36% and 58% coverage of LLINs and larval control, respectively, were required for LF elimination; and malaria elimination was possible with a combined coverage of 78% of LLINs and larval control. Despite the low level of vector control required to eliminate LF, simulations suggest that prevalence of LF will decrease at a slower rate than malaria, even at high levels of coverage. If representative of field situations, integrated management should take into account not only how malaria control can facilitate filariasis elimination, but strike a balance between the high levels of coverage of (multiple) interventions required for malaria with the long duration predicted to be required for filariasis elimination.

Vectorial capacity and vector control: reconsidering sensitivity to parameters for malaria elimination

PubMed Central

Brady, Oliver J.; Godfray, H. Charles J.; Tatem, Andrew J.; Gething, Peter W.; Cohen, Justin M.; McKenzie, F. Ellis; Perkins, T. Alex; Reiner, Robert C.; Tusting, Lucy S.; Sinka, Marianne E.; Moyes, Catherine L.; Eckhoff, Philip A.; Scott, Thomas W.; Lindsay, Steven W.; Hay, Simon I.; Smith, David L.

2016-01-01

Background Major gains have been made in reducing malaria transmission in many parts of the world, principally by scaling-up coverage with long-lasting insecticidal nets and indoor residual spraying. Historically, choice of vector control intervention has been largely guided by a parameter sensitivity analysis of George Macdonald's theory of vectorial capacity that suggested prioritizing methods that kill adult mosquitoes. While this advice has been highly successful for transmission suppression, there is a need to revisit these arguments as policymakers in certain areas consider which combinations of interventions are required to eliminate malaria. Methods and Results Using analytical solutions to updated equations for vectorial capacity we build on previous work to show that, while adult killing methods can be highly effective under many circumstances, other vector control methods are frequently required to fill effective coverage gaps. These can arise due to pre-existing or developing mosquito physiological and behavioral refractoriness but also due to additive changes in the relative importance of different vector species for transmission. Furthermore, the optimal combination of interventions will depend on the operational constraints and costs associated with reaching high coverage levels with each intervention. Conclusions Reaching specific policy goals, such as elimination, in defined contexts requires increasingly non-generic advice from modelling. Our results emphasize the importance of measuring baseline epidemiology, intervention coverage, vector ecology and program operational constraints in predicting expected outcomes with different combinations of interventions. PMID:26822603

Geologic controls on the recent evolution of oyster reefs in Apalachicola Bay and St. George Sound, Florida

USGS Publications Warehouse

Twichell, D.; Edmiston, L.; Andrews, Brian; Stevenson, W.; Donoghue, J.; Poore, Richard; Osterman, Lisa E.

2010-01-01

Apalachicola Bay and St. George Sound contain the largest oyster fishery in Florida, and the growth and distribution of the numerous oyster reefs here are the combined product of modern estuarine conditions in the bay and its late Holocene evolution. Sidescan-sonar imagery, bathymetry, high-resolution seismic profiles, and sediment cores show that oyster beds occupy the crests of a series of shoals that range from 1 to 7 km in length, trend roughly north-south perpendicular to the long axes of the bay and sound, and are asymmetrical with steeper sides facing to the west. Surface sediment samples show that the oyster beds consist of shelly sand, while much of the remainder of the bay floor is covered by mud delivered by the Apalachicola River. The present oyster reefs rest on sandy delta systems that advanced southward across the region between 6400 and 4400 yr BP when sea level was 4–6 m lower than present. Oysters started to colonize the region around 5100 yr BP and became extensive by 1200 and 2400 yr BP. Since 1200 yr BP, their aerial extent has decreased due to burial of the edges of the reefs by the prodelta mud that continues to be supplied by the Apalachicola River. Oyster reefs that are still active are narrower than the original beds, have grown vertically, and become asymmetrical in cross-section. Their internal bedding indicates they have migrated westward, suggesting a net westerly transport of sediment in the bay.

Geologic Investigations in the Basin and Range of Nevada Using Skylab/EREP Data

NASA Technical Reports Server (NTRS)

Quade, J. G. (Principal Investigator); Trexler, D. T.

1975-01-01

The author has identified the following significant results. Working from the S190A photography at a scale of 1:702,000 and comparing the results with existing geologic maps has suggested that the larger scale structural features can be mapped and related to regional trends which provide an overall view not available at lower altitudes. All S190B in-house coverage was in stereo. The stereo capability was helpful in resolving problems relating to elevations and attitude of bedding, etc., but the greatest single contribution was the resolution capability.

The subglacial roughness of Antarctica: Analogs, interpretation and implications for ice thickness uncertainities

NASA Astrophysics Data System (ADS)

Young, D. A.; Grima, C.; Greenbaum, J. S.; Beem, L.; Cavitte, M. G.; Quartini, E.; Kempf, S. D.; Roberts, J. L.; Siegert, M. J.; Ritz, C.; Blankenship, D. D.

2017-12-01

Over the last twenty five years, extensive ice penetrating radar (IPR) coverage of Antarctica has been obtained, at lines spacings down to 1 km in some cases. However, many glacial processes occur at finer scales, so infering likely landscape parameters is required for a useful interpolation between lines. Profile roughness is also important for understanding the uncertainties inherent in IPR observations. Subglacial roughness has also been used to infer large scale bed rock properties and history. Similar work has been conducted on a regional basis with complilations of data from the 1970's and more recent local studies. Here we present a compilation of IPR-derived profile roughness data covering three great basins of Antarctica: the Byrd Subglacial Basin in West Antarctica, and the Wilkes Subglacial Basin and Aurora Subglacial Basins in East Antarctica; and treat these data using root mean squared deviation (RMSD). Coverage is provied by a range of IPR systems with varying vintages with differing instrument and processing parameters; we present approaches to account for the differences between these systems. We use RMSD, a tool commonly used in planetary investigations, to investigate the self-affine behaviour of the bed at kilometer scales and extract fractal parameters from the data to predict roughness and uncertainties in ice thickness measurement. Lastly, we apply a sensor model to a range of bare-earth terrestrial digital elevation models to futher understand the impact of the sensor model on the inference of subglacial topography and roughness, and to the first order analogies for the lithology of the substrate. This map of roughness, at scales between the pulse limited radar footprint and typical line spacings, provides an understanding of the distribution of Paleogene subglacial sediments, insight in to the distribution of uncertainties and a potential basal properties mask for ice sheet models. A particular goal of this map is to provide insight into required IPR coverage needs for site selection for old ice and subglacial samples for subglacial access systems like US-RAID and SUBGLACIOR.