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Meningococcal and pneumococcal meningitis in Northern Ghana
Get PDFDespite improvements in technology, treatments and understanding of how bacterial meningitis
develops, the disease remains a potentially life-threatening emergency capable of causing significant
morbidity and mortality. N. meningitidis, S. pneumoniae and H. influenzae type b, which are
commensally normal human nasopharyngeal flora, are the most important and common causes of
bacterial meningitis. N. meningitidis (especially, serogroup A) is well known for its association with
epidemics in the meningitis belt of sub-Saharan Africa. This nearly always starts during the dry
season and stops during the onset of the rains and occurs every 8-12 years in the “meningitis belt”
with attack rates sometimes exceeding 1% during these epidemics. H. influenzae type b and S.
pneumoniae are mostly endemic affecting certain risk groups. N. meningitidis serogroup W135,
traditionally known to cause isolated cases, has raised general concern in recent years due to
outbreaks in Burkina Faso since 2002 attributed to it.
Following a major meningococcal meningitis epidemic in Northern Ghana in 1996/7 the Navrongo
Health Research Centre in collaboration with the Swiss Tropical Institute in 1998 initiated a longterm
colonization and disease study in the Kassena Nankana District (KND), with the aim of
contributing to the understanding of the epidemiology, pathogenesis, improved intervention and
early detection of bacterial meningitis epidemics in the “meningitis belt”. As part of this long term
study, this thesis focuses on meningococcal colonization and invasive disease surveillance
(pneumococcal and meningococcal), burden of pneumococcal meningitis and the relationship
between environmental factors and the risk of meningococcal and pneumococcal meningitis.
From 1998 to 2005 clonal waves of nasopharyngeal colonization with pathogenic and nonpathogenic
meningococcal genoclouds were observed in the KND through the longitudinal
meningococcal colonization study of residents of 37 randomly selected compounds. These
meningococci were not only less diverse and unstable in composition with rare non-groupable
strains, but they were also mostly made up of predominantly hyperinvasive strains (up 71%) with
constant microevolution. In 1998 serogroup A meningococci ST5 caused an outbreak of
meningococcal meningitis in the KND with persistent carriage up to 1999, disappearing in 2001. In
2000 serogroup X ST571 meningococci emerged with high carriage rates and few cases. Carriage of
this serotype persisted until 2001 when it was replaced by serogroup A ST7 which only disappeared
at the latter part of 2005 after causing outbreaks between 2002 and 2004.
Although N. meningitidis serogroup W135 has been the cause of epidemics in neighbouring Burkina
Faso since 2002, only sporadic cases (4) were reported in Ghana from 2003 to 2004. The disease
isolates were very similar to the Burkinabe epidemic strains by Pulse Field Gel Electrophoresis
analysis. Colonization surveys over a one-year period in one of the patient home communities
(which has semi-closed features) showed an initial high carriage rate of 17.5% and persistence of
carriage with rapid microevolution.
Between 2000 and 2004 there was an outbreak of pneumococcal meningitis (PCM) caused by a S.
pneumoniae serotype 1 clonal complex in the KND with features (seasonality, clonality and broad
age spectrum of the patients) characteristic of meningococcal meningitis (MCM). This hypervirulent
serotype is repeatedly being isolated in various parts of sub-Saharan Africa.
A two-year survival analysis comparing 67 PCM cases recorded at the War Memorial Hospital
(WMH), Navrongo, Ghana, identifiable on a demographic surveillance system, with equal numbers
of MCM and community controls, showed profound excess mortality of the PCM compared with
both MCM and community controls. A case-control study of sequelae (using a structured disability
questionnaire, neuropsychological and audiometric examinations of both cases and controls),
matching for age, sex and geographical location, including 46 traceable survivors of PCM (cases),
46 community controls (CC) and 34 survivors of MCM, showed that hearing and speech impairment
as well as psychiatric disorders are much more frequent and severe in PCM than MCM.
Epidemics of MCM and PCM are closely related to climate. A time series analysis of weekly
meteorological data (humidity, rain fall, dust, wind speed, temperature and sunshine) from the local
weather station and the corresponding reported epidemiological data (confirmed meningococcal and
pneumococcal cases) from 1998 - 2004 from the WMH microbiology database was carried out using
negative binomial regression and Bayesian methods. The aim of these micro epidemiological
analyses was to describe as well as provide an early warning system for the short-term prediction of
likely meningococcal and pneumococcal meningitis outbreaks in the KND.
The environmental factors that influence the incidence of PCM and MCM were found to be similar
but not always the same. The duration of a preceding absence of rainfall appears to be the best
predictor of both PCM and MCM outbreaks. Outbreaks of MCM are best predicted by concurrent
decrease in rainfall with increase in weekly mean maximum temperature. Those of PCM are
influenced by concurrent decrease in rainfall.
The natural variations in the predominance of different pharyngeal meningococcal serotypes and
serogroups over time might contribute to meningococcal meningitis epidemics in the African
meningitis belt. The future epidemiological trend of meningococcal and pneumococcal meningitis
will be influenced by changes in the use of antibiotics, immune status, aging of the global population
and technology. The introduction of carbohydrate-conjugate or common protein vaccines to routine
immunization schedules, together with maternal immunization and enhanced disease (and/or
colonization) surveillance, could make pneumococcal and meningococcal diseases of less public
health importance
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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