7,891 research outputs found
Bayesian geostatistical analysis and prediction of Rhodesian human African trypanosomiasis
No full textBackgroundThe persistent spread of Rhodesian human African trypanosomiasis (HAT) in Uganda in recent years has increased concerns of a potential overlap with the Gambian form of the disease. Recent research has aimed to increase the evidence base for targeting control measures by focusing on the environmental and climatic factors that control the spatial distribution of the disease.ObjectivesOne recent study used simple logistic regression methods to explore the relationship between prevalence of Rhodesian HAT and several social, environmental and climatic variables in two of the most recently affected districts of Uganda, and suggested the disease had spread into the study area due to the movement of infected, untreated livestock. Here we extend this study to account for spatial autocorrelation, incorporate uncertainty in input data and model parameters and undertake predictive mapping for risk of high HAT prevalence in future.Materials and MethodsUsing a spatial analysis in which a generalised linear geostatistical model is used in a Bayesian framework to account explicitly for spatial autocorrelation and incorporate uncertainty in input data and model parameters we are able to demonstrate a more rigorous analytical approach, potentially resulting in more accurate parameter and significance estimates and increased predictive accuracy, thereby allowing an assessment of the validity of the livestock movement hypothesis given more robust parameter estimation and appropriate assessment of covariate effects.ResultsAnalysis strongly supports the theory that Rhodesian HAT was imported to the study area via the movement of untreated, infected livestock from endemic areas. The confounding effect of health care accessibility on the spatial distribution of Rhodesian HAT and the linkages between the disease's distribution and minimum land surface temperature have also been confirmed via the application of these methods.ConclusionsPredictive mapping indicates an increased risk of high HAT prevalence in the future in areas surrounding livestock markets, demonstrating the importance of livestock trading for continuing disease spread. Adherence to government policy to treat livestock at the point of sale is essential to prevent the spread of sleeping sickness in Uganda
Peter M. Mach
No full textabstract: Peter was 12 years old when he heard gunshots and bombing at his village.
“Lost Boys Found” is an ongoing, interdisciplinary project that is collecting, recording and archiving the oral histories of the Lost Boys/Girls of Sudan. The collection is a work-in-progress, seeking to record the oral history of as many Lost Boys/Girls as are willing, and will be used in a future book.Age: 28Region: Upper NileThis picture and bio was donated to the Lost Boys Found project from The Arizona Lost Boys Cente
Geographical access to care at birth in Ghana: a barrier to safe motherhood
No full textBackground: appropriate facility-based care at birth is a key determinant of safe motherhood but geographical access remains poor in many high burden regions. Despite its importance, geographical access is rarely audited systematically, preventing integration in national-level maternal health system assessment and planning. In this study, we develop a uniquely detailed set of spatially-linked data and a calibrated geospatial model to undertake a national-scale audit of geographical access to maternity care at birth in Ghana, a high-burden country typical of many in sub-Saharan Africa.Methodology and findings: we assembled detailed spatial data on health facilities, roads, rivers, and other landscape features influencing journeys. These were used in a geospatial model to estimate journey-time for all women of childbearing age (WoCBA) to their nearest health facility offering differing levels of care at birth, taking into account different transport types and availability. We calibrated the model using data on actual journeys made by women seeking care at birth. We found that a third of women (34%) in Ghana live beyond the clinically significant two-hour threshold from any facility likely to offer emergency obstetric and neonatal care (EmONC) classed at the ‘partial’ standard or better. Nearly half (45%) live that distance or further from ‘comprehensive’ EmONC facilities, offering life-saving blood transfusion and surgery. In the most remote regions these figures rose to 63% and 81%, respectively. Poor levels of access were found in many regions that meet international targets based on facilities-per-capita ratios.Conclusions and significance: detailed data assembly combined with geospatial modelling can provide nation-wide audits of geographical access to care at birth to support systemic maternal health planning, human resource deployment, and strategic targeting. Current international benchmarks of maternal health care provision are inadequate for these purposes because they fail to take account of the location and accessibility of services relative to the women they serve<br/
Treeline identification from pollen data: beyond the limit?
No full textAim The boreal tree line is a prominent biogeographic feature, the position of which reflects climatic conditions. Pollen is the key sensor used to reconstruct past tree line patterns. Our aims in this study were to investigate pollen– vegetation relationships at the boreal tree line and to assess the success of a modified version of the biomization method that incorporates pollen productivity and dispersal in distinguishing the tree line. Location Northern Canada (307 sites) and Alaska (316 sites).Methods The REVEALS method for estimating regional vegetation composition from pollen data was simplified to provide correction factors to account for differential production and dispersal of pollen among taxa. The REVEALS-based correction factors were used to adapt the biomization method and applied as a set of experiments to pollen data from lake sediments and moss polsters from the boreal tree line. Proportions of forest and tundra predicted from modern pollen samples along two longitudinal transects were compared with those derived from a vegetation map by: (1) a tally of ‘correct’ versus ‘incorrect’ assignments using vegetation in the relevant map pixels, and (2) a comparison of the shape and position of north–south forest-cover curves generated from all transect pixels and from pollen data. Possible causes of bias in the misclassifications were assessed.Results Correcting for pollen productivity alone gave fewest misclassifications and the closest estimate of the modern mapped tree line position (Canada, + 300 km; Alaska, + 10 km). In Canada success rates were c. 40–70% and all experiments over-predicted forest cover. Most corrections improved results over uncorrected biomization; using only lakes improved success rates to c. 80%. In Alaska success rates were 70–80% and classification errors were more evenly distributed; there was little improvement over uncorrected biomization.Main conclusions Corrected biomization should improve broad-scale reconstructions of spatial patterns in forest/non-forest vegetation mosaics and across climate-sensitive ecotones. The Canadian example shows this is particularly the case in regions affected by taxa with extremely high pollen productivity (such as Pinus). Improved representation of actual vegetation distribution is most likely if pollen data from lake sediments are used because the REVEALS algorithm is based on the pollen dynamics of lake-based systems
Joseph Bimeler letter to Peter Kaufmann, June 8, 1844
No full textLetter from J. M. Bimeler (by Christian Weibel) to Peter Kaufmann, acknowledging receipt of Bibles and spelling books and ordering more Bibles. He repeats his statement from his letter of April 31, 1844, of a preference for Bibles that embrace the Apocrypha. The letter also requests a catalog of books on hand at Kaufmann's establishment.
Led by Joseph Bimeler (sometimes spelled Bäumeler) in 1817, a group of Lutheran separatists left Germany and eventually established the small community of Zoar in Tuscarawas County, Ohio. The group formed the Society of Separatists of Zoar, in which each person donated his or her property to the community as a whole, and in exchange for their work, the society would provide for them. After decades of economic prosperity, the unity of the village declined, and by 1898 the Zoarites disbanded the society.
Peter Kaufmann was a German immigrant and intellectual. He arrived first in Philadelphia, Pennsylvania, in 1820; in 1826 he became professor of languages at the Harmony Society town of Economy, Pennsylvania. In 1827, Kaufmann led the establishment of Teutonia, a utopian community in Columbiana County, Ohio, and published its weekly titled "Teutonia: The Herald of a Better Time." Following this he moved to Canton, Ohio, where he became translator and editor of "Der Vaterlandsfreund und Geist der Zeit" under Solomon Sala. Additionally, Kaufmann wrote a number of books on education, as well as a German almanac. He was also an influential Democrat, counting President Van Buren among his friends, and knew Ralph Waldo Emerson
Information for decision making from imperfect national data: tracking major changes in health care use in Kenya using geostatistics
No full textBackground: most Ministries of Health across Africa invest substantial resources in some form of health management information system (HMIS) to coordinate the routine acquisition and compilation of monthly treatment and attendance records from health facilities nationwide. Despite the expense of these systems, poor data coverage means they are rarely, if ever, used to generate reliable evidence for decision makers. One critical weakness across Africa is the current lack of capacity to effectively monitor patterns of service use through time so that the impacts ofchanges in policy or service delivery can be evaluated. Here, we present a new approach that, for the first time, allows national changes in health service use during a time of major health policy change to be tracked reliably using imperfect data from a national HMIS.Methods: monthly attendance records were obtained from the Kenyan HMIS for 1 271 government-run and 402 faith-based outpatient facilities nationwide between 1996 and 2004. Aspace-time geostatistical model was used to compensate for the large proportion of missing records caused by non-reporting health facilities, allowing robust estimation of monthly and annualuse of services by outpatients during this period.Results: we were able to reconstruct robust time series of mean levels of outpatient utilisation of health facilities at the national level and for all six major provinces in Kenya. These plots revealed reliably for the first time a period of steady nationwide decline in the use of health facilities in Kenyabetween 1996 and 2002, followed by a dramatic increase from 2003. This pattern was consistent across different causes of attendance and was observed independently in each province.Conclusion: the methodological approach presented can compensate for missing records in health information systems to provide robust estimates of national patterns of outpatient service use. This represents the first such use of HMIS data and contributes to the resurrection of these hugely expensive but underused systems as national monitoring tools. Applying this approach to Kenya has yielded output with immediate potential to enhance the capacity of decision makers in monitoring nationwide patterns of service use and assessing the impact of changes in health policy and service deliver
Developing geostatistical space–time models to predict outpatient treatment burdens from incomplete national data
No full textBasic health system data such as the number of patients utilizing different health facilities and the types of illness for which they are being treated are critical for managing service provision. These data requirements are generally addressed with some form of national Health Management Information System (HMIS), which coordinates the routine collection and compilation of data from national health facilities. HMIS in most developing countries are characterized by widespread underreporting. Here we present a method to adjust incomplete data to allow prediction of national outpatient treatment burdens. We demonstrate this method with the example of outpatient treatments for malaria within the Kenyan HMIS. Three alternative modeling frameworks were developed and tested in which space–time geostatistical prediction algorithms were used to predict the monthly tally of treatments for presumed malaria cases (MC) at facilities where such records were missing. Models were compared by a crossvalidation exercise and the model found to most accurately predict MC incorporated available data on the total number of patients visiting each facility each month. A space–time stochastic simulation framework to accompany this model was developed and tested in order to provide estimates of both local and regional prediction uncertainty. The level of accuracy provided by the predictive model, and the accompanying estimates of uncertainty around the predictions, demonstrate how this tool can mitigate the uncertainties caused by missing data, substantially enhancing the utility of existing HMIS data to health-service decision makers
Spatial predictions of Rhodesian Human African Trypanosomiasis (Sleeping Sickness) prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda
No full textThe continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT) within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda
Peter Logan: Victorian Fetishism [Audio interview]
No full textPeter Logan is the author of Nerves and Narratives: A Cultural History of Hysteria in Nineteenth-Century British Prose (1997) and, more recently, Victorian Fetishism: Intellectuals and Primitives (2009). On May 15, 2012, Fred Rowland interviewed Peter Logan to discuss Victorian Fetishism, which details the development of ideas about the primitive and how these concepts set the boundaries of culture in Victorian Britain. Drawing from Lucretius, Vico, and Auguste Comte, Peter Logan explains how fetishism – the defining feature of culture’s absence – figured in the works of literary and cultural critic Matthew Arnold, realist novelist George Eliot, and anthropologist Edward Tylor.Temple University. College of Liberal ArtsTemple University. LibrariesEnglishLearning and Research ServicesAudacityAudacit
Der Wahrheitssucher : su Peter Weiss, Dante e l’utopia
No full textThe contribution outlines the utopian dimension of the work and aesthetics of the German-Jewish-Swedish author Peter Weiss (1916-1982), focusing mainly on his "DC-Projekt", the plan of a political rewriting of Dantes' Divine Comedy for the modern stage (1960s). The contribution contends that the medieval poet, called "the truthsearcher" in the posthumous drama "Inferno", is the key figure of the author's utopian concern in his lifelong alternation of autobiographical, poetical and political issues
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