An on-line chromatic and scale-space microvasculature-tracing analysis for transmitted light optical images

Limited contrast in optical images from intravital microscopy is problematic for analysing tumour vascular morphology. Moreover, in some cases, changes in vasculature are visible to a human observer but are not easy to quantify. In this paper two quantitative on-line algorithms are presented: scale-space vessel tracing and chromatic decomposition for tumour vasculature from in-vivo transmitted light optical images. The algorithms were tested on intravital window chamber images of the vasculature from SW1222 human colorectal carcinomas, which were treated with a vascular disrupting agent combretastatin-A-4-phosphate (CA-4-P) or saline. The results confirmed the well-known effects of CA-4-P on the constriction of vessels. Furthermore, changes in the chromaticity suggest a deoxygenation of the blood with a recovery to initial levels in CA-4-P-treated tumours relative to the controls. The algorithms can be freely applied to any vascular image through the CAIMAN (CAncer IMage ANalysis: http://www.caiman.org.uk)

Rural and suburban population surge following detonation of an improvised nuclear device: A new model to estimate impact

Background: The objective of the study was to model urban evacuation into surrounding communities after the detonation of an improvised nuclear device (IND) to assist rural and suburban planners in understanding and effectively planning to address the effects of population surges. Methods: Researchers developed parameters for how far evacuees would travel to escape disasters and factors that would influence choice of destination from studies of historical evacuations, surveys of citizens' evacuation intentions in hypothetical disasters, and semistructured interviews with key informants and emergency preparedness experts. Those parameters became the inputs to a "push-pull" model of how many people would flee in the 4 scenarios and where they would go. Results: The expanded model predicted significant population movements from the New York City borough of Manhattan and counties within 20 km of Manhattan to counties within a 150-mi radius of the assumed IND detonation. It also predicted that even in some communities located far from Manhattan, arriving evacuees would increase the population needing services by 50% to 150%. Conclusions: The results suggest that suburban and rural communities could be overwhelmed by evacuees from their center city following an IND detonation. They also highlight the urgency of educating and communicating with the public about radiation hazards to mitigate panic and hysteria, anticipating the ways in which a mass exodus may disrupt or even cripple rescue and response efforts, and devising creative ways to exercise and drill for an event about which there is great denial and fatalism

Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>The all-hazards willingness to respond (WTR) of local public health personnel is critical to emergency preparedness. This study applied a threat-and efficacy-centered framework to characterize these workers' scenario and jurisdictional response willingness patterns toward a range of naturally-occurring and terrorism-related emergency scenarios.</p> <p>Methods</p> <p>Eight geographically diverse local health department (LHD) clusters (four urban and four rural) across the U.S. were recruited and administered an online survey about response willingness and related attitudes/beliefs toward four different public health emergency scenarios between April 2009 and June 2010 (66% response rate). Responses were dichotomized and analyzed using generalized linear multilevel mixed model analyses that also account for within-cluster and within-LHD correlations.</p> <p>Results</p> <p>Comparisons of rural to urban LHD workers showed statistically significant odds ratios (ORs) for WTR context across scenarios ranging from 1.5 to 2.4. When employees over 40 years old were compared to their younger counterparts, the ORs of WTR ranged from 1.27 to 1.58, and when females were compared to males, the ORs of WTR ranged from 0.57 to 0.61. Across the eight clusters, the percentage of workers indicating they would be unwilling to respond regardless of severity ranged from 14-28% for a weather event; 9-27% for pandemic influenza; 30-56% for a radiological 'dirty' bomb event; and 22-48% for an inhalational anthrax bioterrorism event. Efficacy was consistently identified as an important independent predictor of WTR.</p> <p>Conclusions</p> <p>Response willingness deficits in the local public health workforce pose a threat to all-hazards response capacity and health security. Local public health agencies and their stakeholders may incorporate key findings, including identified scenario-based willingness gaps and the importance of efficacy, as targets of preparedness curriculum development efforts and policies for enhancing response willingness. Reasons for an increased willingness in rural cohorts compared to urban cohorts should be further investigated in order to understand and develop methods for improving their overall response.</p

The Journey to Accreditation: Clinton County Health Department

Book Summary: JPHMP\u27s 21 Public Health Case Studies on Policy & Administration , compiled by the founding editor and current editor-in-chief of the Journal of Public Health Management and Practice, provides you with real-life examples of how to strategize and execute policies and practices when confronted with issues such as disease containment, emergency preparedness, and organizational, management, and administrative problems.Feautures: Each case is co-written by a professional writer and tells a “story,” using characters, conflicts, and plot twists designed to compel you to keep reading. Case elements include the core problem, stakeholders, steps taken, challenges, results, conclusions, and discussion questions for analysis. More than 60 contributors—experts in public policy, clinical medicine, pediatrics, social work, pharmacy, bioethics, and healthcare management. Ideal for public health practitioners as well as students in graduate and undergraduate public health and medical education programs. Tracks 2016 CEPH (Council on Education for Public Health) accreditation criteria. These cases can be used as tools to develop competencies designated in the new CEPH (Council on Education for Public Health) accreditation criteria

The association between grandparents as caregivers and overdose mortality in Appalachia and non-Appalachia counties

ObjectiveTo assess the association of drug overdose mortality with grandparents serving as caregivers of children in Appalachia and non-Appalachia in the U.S.MethodsThis study used a cross-sectional design, with percent of grandparents as caregivers and overdose mortality rates being of primary interest. County-level data were combined, and descriptive, bivariate, and multivariable statistics were applied. Multiple sociodemographic and geographic variables were included: median age of the population, percent of the population that is uninsured, percent of the population that is non-Hispanic white, teen birth rate, percent of high school dropouts, and rurality.ResultsThe percent of grandparents as caregivers increased as the overdose mortality rate increased (p &amp;lt; 0.01). For every 1% increase in the overdose mortality rate, the percent of grandparents as caregivers increased by 56% in Appalachian counties compared to 24% in non-Appalachian counties. After adjusting for sociodemographic characteristics, the interaction between overdose mortality and Appalachian vs. non-Appalachian counties was no longer significant (p = 0.3).ConclusionsCounties with higher overdose mortality rates had greater rates of grandparents as caregivers, with Appalachian counties experiencing greater rates of grandparents as caregivers than non-Appalachian counties. Sociodemographic characteristics that are often more prevalent in Appalachia may be driving the observed differences.Policy implicationsPolicies and programs are needed to support grandparents providing caregiving for children impacted by substance use disorders including reform to federal child welfare financing to support children, parents, and grandparent caregivers such as kinship navigation, substance use treatment and prevention services, mental health services and in-home supports.</jats:sec