Self-force on a scalar charge in radial infall from rest using the Hadamard-WKB expansion

We present an analytic method based on the Hadamard-WKB expansion to calculate the self-force for a particle with scalar charge that undergoes radial infall in a Schwarzschild spacetime after being held at rest until a time t = 0. Our result is valid in the case of short duration from the start. It is possible to use the Hadamard-WKB expansion in this case because the value of the integral of the retarded Green's function over the particle's entire past trajectory can be expressed in terms of two integrals over the time period that the particle has been falling. This analytic result is expected to be useful as a check for numerical prescriptions including those involving mode sum regularization and for any other analytical approximations to self-force calculations.Comment: 22 pages, 2 figures, Physical Review D version along with the corrections given in the erratu

Antiretroviral therapy for refugees and internally displaced persons: a call for equity.

Available evidence suggests that refugees and internally displaced persons (IDPs) in stable settings can sustain high levels of adherence and viral suppression. Moral, legal, and public health principles and recent evidence strongly suggest that refugees and IDPs should have equitable access to HIV treatment and support. Exclusion of refugees and IDPs from HIV National Strategic Plans suggests that they may not be included in future national funding proposals to major donors. Levels of viral suppression among refugees and nationals documented in a stable refugee camp suggest that some settings require more intensive support for all population groups. Detailed recommendations are provided for refugees and IDPs accessing antiretroviral therapy in stable settings

Health Issues Affecting Displaced Populations: The Evolution of Public Health Response in Emergency and Post-Emergency Phases of Complex Emergencies

The field of humanitarian response has made tremendous strides over the past decade. In the Cambodian refugee camps in the 1980s, the establishment o

Who should be undertaking population-based surveys in humanitarian emergencies?

<p>Abstract</p> <p>Background</p> <p>Timely and accurate data are necessary to prioritise and effectively respond to humanitarian emergencies. 30-by-30 cluster surveys are commonly used in humanitarian emergencies because of their purported simplicity and reasonable validity and precision. Agencies have increasingly used 30-by-30 cluster surveys to undertake measurements beyond immunisation coverage and nutritional status. Methodological errors in cluster surveys have likely occurred for decades in humanitarian emergencies, often with unknown or unevaluated consequences.</p> <p>Discussion</p> <p>Most surveys in humanitarian emergencies are done by non-governmental organisations (NGOs). Some undertake good quality surveys while others have an already overburdened staff with limited epidemiological skills. Manuals explaining cluster survey methodology are available and in use. However, it is debatable as to whether using standardised, 'cookbook' survey methodologies are appropriate. Coordination of surveys is often lacking. If a coordinating body is established, as recommended, it is questionable whether it should have sole authority to release surveys due to insufficient independence. Donors should provide sufficient funding for personnel, training, and survey implementation, and not solely for direct programme implementation.</p> <p>Summary</p> <p>A dedicated corps of trained epidemiologists needs to be identified and made available to undertake surveys in humanitarian emergencies. NGOs in the field may need to form an alliance with certain specialised agencies or pool technically capable personnel. If NGOs continue to do surveys by themselves, a simple training manual with sample survey questionnaires, methodology, standardised files for data entry and analysis, and manual for interpretation should be developed and modified locally for each situation. At the beginning of an emergency, a central coordinating body should be established that has sufficient authority to set survey standards, coordinate when and where surveys should be undertaken and act as a survey repository. Technical expertise is expensive and donors must pay for it. As donors increasingly demand evidence-based programming, they have an obligation to ensure that sufficient funds are provided so organisations have adequate technical staff.</p

Notes from the Field in Kigoma, Tanzania

In these short notes the authors provide some insight to their visit to displaced persons camps in Kigoma, Tanzania. This trip marks the fourth set of camps examined in the Post Emergency Phase Indicators Project, a joint collaboration between the Johns Hopkins Center for Refugee and Disaster Studies, and the International Emergency and Refugee Health Branch at the Centers for Disease Control.Dans ces brèves notes, les auteurs fournissent un aperçu de leur visite au camps pour personnes deplacees de Kigoma, en Tanzanie. Ce voyage marque la conclusion de la quatrième série de visites de camps de réfugiés examinés dans Ie cadre du Projet sur les Indicateurs d'Etapes en Situation Post- Urgente (Post-Emergency Phase Indicators Project), une collaboration conjointe du Centre John Hopkins pour les Etudes sur les Réfugiés et les Désastres, et la Section pour la Santé des Réfugiés et l'Urgence Internationale, du Centre pour Ie Contrôle Epidemique

Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp.

BACKGROUND: Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011-2013) were compared on outcome measures that included viral suppression and adherence to ART. METHODS: This study used a repeated cross-sectional design (Round One and Round Two). All adults (≥18 years) receiving care from the refugee camp clinic and taking antiretroviral therapy (ART) for ≥30 days were invited to participate. Adherence was measured by self-report and monthly pharmacy refills. Whole blood was measured on dried blood spots. HIV-1 RNA was quantified and treatment failures were submitted for drug resistance testing. A remedial intervention was implemented in response to baseline testing. The primary outcome was viral load <5000 copies/mL. The two study rounds took place in 2011-2013. RESULTS: Among eligible adults, 86% (73/85) of refugees and 84% (86/102) of Kenyan host nationals participated in the Round One survey; 60% (44/73) and 58% (50/86) of Round One participants were recruited for Round Two follow-up viral load testing. In Round One, refugees were older than host nationals (median age 36 years, interquartile range, IQR 31, 41 vs 32 years, IQR 27, 38); the groups had similar time on ART (median 147 weeks, IQR 38, 64 vs 139 weeks, IQR 39, 225). There was weak evidence for a difference between proportions of refugees and host nationals who were virologically suppressed (<5000 copies/mL) after 25 weeks on ART (58% vs 43%, p = 0.10) and no difference in the proportions suppressed at Round Two (74% vs 70%, p = 0.66). Mean adherence within each group in Round One was similar. Refugee status was not associated with viral suppression in multivariable analysis (adjusted odds ratio: 1.69, 95% CI 0.79, 3.57; p = 0.17). Among those not suppressed at either timepoint, 69% (9/13) exhibited resistance mutations. CONCLUSIONS: Virologic outcomes among refugees and host nationals were similar but unacceptably low. Slight improvements were observed after a remedial intervention. Virologic monitoring was important for identifying an underperforming ART program in a remote facility that serves refugees alongside host nationals. This work highlights the importance of careful laboratory monitoring of vulnerable populations accessing ART in remote settings

Continuous Quality Improvement Applied to Outpatient Health Care Delivery in Displaced Persons Camps

Continuous Quality Improvement (CQI) has been shown to be a highly effective approach for the evaluation and management of hospitals in developed countries, but it has barely begun to be utilised in less developed countries. This article defines the principles and the main tools of CQI and then applies them to the postemergency phase of a displaed persons camp situation, specifically towards improving the utilisation and the quality of care in an out patient department.L'Accroissement Continu de la Qualité s'est révélé une approche très efficace pour l'évaluation et la gestion des hôpitaux dans les pays développés, mais n'a à toutes fins pratiques jamais été mise à profit dans les pays moins développés. Cet article définit les principes et les principaux instruments, Accroissement Continu de la Qualité, et les applique à la phase post-urgente dans la situation des camps pour personnes déplacées. L'attention porte plus spécifiquementsur les possibilités d'amélioration de l'utilisation des services et de la qualité des soins en clinique externe

Evidence and Ideology in Macroeconomics: The Case of Investment Cycles

The paper reports the principal findings of a long term research project on the description and explanation of business cycles. The research strongly confirmed the older view that business cycles have large systematic components that take the form of investment cycles. These quasi-periodic movements can be represented as low order, stochastic, dynamic processes with complex eigenvalues. Specifically, there is a fixed investment cycle of about 8 years and an inventory cycle of about 4 years. Maximum entropy spectral analysis was employed for the description of the cycles and continuous time econometrics for the explanatory models. The central explanatory mechanism is the second order accelerator, which incorporates adjustment costs both in relation to the capital stock and the rate of investment. By means of parametric resonance it was possible to show, both theoretically and empirically how cycles aggregate from the micro to the macro level. The same mathematical tool was also used to explain the international convergence of cycles. I argue that the theory of investment cycles was abandoned for ideological, not for evidential reasons. Methodological issues are also discussed