Selecting Nonpharmaceutical Interventions for Influenza

Models of influenza transmission have focused on the ability of vaccination, antiviral therapy, and social distancing strategies to mitigate epidemics. Influenza transmission, however, may also be interrupted by hygiene interventions such as frequent hand washing and wearing masks or respirators. We apply a model of influenza disease transmission that incorporates hygiene and social distancing interventions. The model describes population mixing as a Poisson process, and the probability of infection upon contact between an infectious and susceptible person is parameterized by p. While social distancing interventions modify contact rates in the population, hygiene interventions modify p. Public health decision making involves tradeoffs, and we introduce an objective function that considers the direct costs of interventions and new infections to determine the optimum intervention type (social distancing versus hygiene intervention) and population compliance for epidemic mitigation. Significant simplifications have been made in these models. However, we demonstrate that the method is feasible, provides plausible results, and is sensitive to the selection of model parameters. Specifically, we show that the optimum combination of nonpharmaceutical interventions depends upon the probability of infection, intervention compliance, and duration of infectiousness. Means by which realism can be increased in the method are discussed.     

Motor unit number estimation using reversible jump Markov chain Monte Carlo methods

Summary.  We present an application of reversible jump Markov chain Monte Carlo sampling from the field of neurophysiology where we seek to estimate the number of motor units within a single muscle. Such an estimate is needed for monitoring the progression of neuromuscular diseases such as amyotrophic lateral sclerosis. Our data consist of action potentials that were recorded from the surface of a muscle in response to stimuli of different intensities applied to the nerve supplying the muscle. During the gradual increase in intensity of the stimulus from the threshold to supramaximal, all motor units are progressively excited. However, at any given submaximal intensity of stimulus, the number of units that are excited is variable, because of random fluctuations in axonal excitability. Furthermore, the individual motor unit action potentials exhibit variability. To account for these biological properties, Ridall and co-workers developed a model of motor unit activation that is capable of describing the response where the number of motor units, N , is fixed. The purpose of this paper is to extend that model so that the possible number of motor units, N , is a stochastic variable. We illustrate the elements of our model, show that the results are reproducible and show that our model can measure the decline in motor unit numbers during the course of amyotrophic lateral sclerosis. Our method holds promise of being useful in the study of neurogenic diseases.     

哲里木盟地区猪病发生和流行的基本趋势及其对策

哲里木盟地区自1980年到1998年猪病的发生和传播出现如下特征：新的传染病（如猪呼吸—综合症）不断增多,旧的传染病以并发、非典型性为主。细菌性传染病、遗传性疾病及代谢性疾病是增多趋势。因此,猪病的防治是一个系统工程,应统筹规划,重点防治,制定科学的免疫程序,科学地使用抗菌药物,并深入研究和利用中草药及各类生物制剂,为防治猪病提供新的手段。     

Major Depressive Disorder and Cardiovascular Disease in African-American Women

Major depression is a risk factor for cardiovascular disease (CVD). This study used the National Survey of American Life (NSAL) to examine the co-occurrence of major depressive disorder (MDD) and CVD in a nationally representative sample of African American women (n = 2,216). Results from a series of logistic regression models indicated high rates of MDD and CVD in the sample, and the African American women with MDD were 1.59 times more likely to have CVD compared to those without MDD. High rates of MDD/CVD co-morbidity appeared across those living in and not living in poverty. These individuals demonstrated greater functional impairment and were high users of mental health services. Our findings validate that MDD and CVD co-occur and the need for more holistic interventions are warranted. The interface of co-morbid health conditions is critical to developing integrated models of care. Integrated health care systems are central for improving physical and mental health outcomes. These findings facilitate developing targeted assessment procedures and culturally appropriate treatment interventions. Increased knowledge regarding the role of gender, chronic health conditions, and the burden of mental illness in African American Women provides the opportunity to examine other chronic health conditions co-occurring with MDD.     

Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review

Background

In some countries, up to 30% of women are exposed to intrapartum antibiotic prophylaxis for prevention of early-onset group B Streptococcal infection. Intrapartum antibiotic prophylaxis aims to reduce the risk of neonatal morbidity and mortality from this infection. The intervention may adversely affect non-pathogenic bacteria which are passed to the newborn during birth and are considered important in optimising health. Since many women are offered intrapartum antibiotic prophylaxis, effectiveness and implications of this intervention need to be established. This review considers clinical trials and observational studies analysing the effectiveness of intrapartum antibiotic prophylaxis.

Statistical considerations in a delayed‐start design to demonstrate disease modification effect in neurodegenerative disorders

There has been a paradigm shift in diagnostic conceptualization of Alzheimer's disease (AD) based on the current evidence suggesting that structure and biology changes start to occur before clinical symptoms emerge. Consequently, therapeutic drug development is also shifting to treat early AD patients using biomarkers for enrichment in clinical trials. A similar paradigm shift is occurring for Parkinson disease. In the absence of acceptable biomarkers that could be combined with a clinical endpoint to demonstrate a disease modification (DM) effect in neurodegenerative disorders, a delayed‐start design can be applied to demonstrate a lasting effect on the disease course. The delayed‐start design includes two treatment periods, where in period 1, patients are randomized to receive an active treatment or placebo, and in period 2, placebo patients are switched to the active treatment while patients in the active treatment arm will continue the same treatment. The hypothesis is that patients who start the active treatment later will fail to catch up to the treatment benefit achieved by patients who receive the active treatment in both periods. A usual analytical approach has sought to demonstrate the divergence of slope during period 1 and the parallelism of slopes during period 2 as the DM effect. However, due to heterogeneity in timing and the magnitude of maximal effect among patients, nonlinear response over time could be observed within the two treatment arms in both periods. We propose an approach to evaluate the DM effect with the linearity assumption for treatment differences, but not for each arm separately.     

Communicating about infectious disease threats: Insights from public health information officers

The public health communication challenges that arise in times of infectious disease threats (IDTs) were examined using the Risk Amplification through Media Spread (RAMS) Framework and in-depth phone interviews with 40 national, state, and local public health information officers (PIOs). Interviewees shared their experiences and insights related to how IDTs are communicated to the public, including the different types of traditional and social media used, how they develop and assess IDT messages, and their perceptions regarding the IDT risk amplification process. Theoretical and practical implications for health public relations and public health communication are discussed.     

Self-efficacy and social support for psychological well-being of family caregivers of care recipients with dementia with Lewy bodies,Parkinson’s disease dementia,or Alzheimer’s disease

The study identified factors associated with depressive symptoms in family caregivers of persons with dementia with Lewy bodies, Alzheimer’s disease, or Parkinson’s disease dementia. An Internet-based survey generated 606 response sets. Regression analysis indicated that care recipients’ memory and behavioral problems, caregivers’ self-efficacy, grief, and tangible, emotional, and affectionate support were significantly associated with caregivers’ depressive symptoms. Self-efficacy mediated caregiver burden to improve psychological well-being. Social support mediated the association between caregiver grief and psychological well-being. Social workers can provide psychoeducational interventions to help caregivers to manage emotional distress and improve capacity to manage tasks related to the dementia.     

鸡卡氏住白细胞原虫病的研究进展

鸡卡氏住白细胞原虫病在我国许多省市呈大规模爆发 ,引起鸡只大批死亡 ,造成巨大的经济损失 ,本文综述了近年来国内外对本病的病原、流行病学、临床症状和病理变化、诊断方法、防治等方面的研究进展     

小儿股骨头缺血性坏死的X线平片与CT对照研究

目的：探讨ＣＴ 在小儿股骨头缺血性坏死（ＬＰＤ） 诊断中的作用和价值－ 材料和方法：回顾性分析５０ 例５８ 髋小儿股骨头缺血性坏死的Ｘ 线平片与ＣＴ 表现,按Ｃａｔｔｅｒａｌｌ 分期标准比较各自的征象－ 结果：ＣＴ在早期病变中可发现较多的征象,包括骺骨化中心微小密度改变、骺软骨的改变和少量关节积液等,对病变的定位和定量更清楚,分期更准确;Ｘ 线平片完全可满足中后期病变诊断和分期要求－ 结论：Ｘ 线平片是ＬＰＤ的首选影像检查方法,ＣＴ在ＬＰＤ 的早期诊断中有帮助,中晚期病变无需ＣＴ扫描