Tuberculosis screening in the federal prison system: an opportunity to treat and prevent tuberculosis in foreign-born populations.

OBJECTIVES: Despite recent success in tuberculosis (TB) control efforts in the United States, marked declines in TB case rates have not been observed in foreign-born populations. Because foreign-born populations are becoming more important for targeted national TB control efforts, the Federal Bureau of Prisons (BOP) reviewed inmate medical data to evaluate risk factors associated with Mycobacterium tuberculosis infection and active TB disease. To improve screening strategies, BOP implemented chest radiograph screening for all inmates entering a federal detention center in San Diego, California. METHODS: Tuberculin skin test (TST) data from an approximated intake cohort of inmates entering the system from February 1 to June 30, 1999, were analyzed to assess risk factors for M. tuberculosis infection among inmates entering federal prisons. The most recent case reports of inmates diagnosed with TB disease were reviewed. All inmates entering a San Diego detention facility from July 1 to December 31, 1998, were screened for TB by symptom review, TST, and chest radiographs. RESULTS: System-wide, foreign-born inmates were 5.9 times more likely to have a positive TST than US-born inmates, and accounted for 60% of recently diagnosed TB cases. Chest radiograph screening of all inmates entering the San Diego facility reduced exposure time to active TB cases by 75%, but TB incidence remained unchanged. CONCLUSIONS: The high prevalence of M. tuberculosis infection and TB disease among foreign-born inmates entering the federal prison system presents a strategic opportunity to provide preventive therapy to a high-risk population and to identify contagious cases that might elude traditional public health efforts. Universal chest radiograph screening was no more sensitive than TST for detecting active TB cases among newly incarcerated foreign-born inmates with a high prevalence of TB infection, but the screening reduced potential TB exposures through rapid identification of contagious cases.

Categorical perception of face actions: their role in sign language and in communicative facial displays.

Can face actions that carry significance within language be perceived categorically? We used continua produced by computational morphing of face-action images to explore this question in a controlled fashion. In Experiment 1 we showed that question--type--a syntactic distinction in British Sign Language (BSL)--can be perceived categorically, but only when it is also identified as a question marker. A few hearing non-signers were sensitive to this distinction; among those who used sign, late sign learners were no less sensitive than early sign users. A very similar facial-display continuum between "surprise" and "puzzlement" was perceived categorically by deaf and hearing participants, irrespective of their sign experience (Experiment 2). The categorical processing of facial displays can be demonstrated for sign, but may be grounded in universally perceived distinctions between communicative face actions. Moreover, the categorical perception of facial actions is not confined to the six universal facial expressions.

More about brows: how poses that change brow position affect perceptions of gender.

The speeded categorisation of gender from photographs of men's and women's faces under conditions of vertical brow and vertical head movement was explored in two sets of experiments. These studies were guided by the suggestion that a simple cue to gender in faces, the vertical distance between the eyelid and brow, could support such decisions. In men this distance is smaller than in women, and can be further reduced by lowering the brows and also by lowering the head and raising the eyes to camera. How does the gender-classification mechanism take changes in pose into account? Male faces with lowered brows (experiment 1) were more quickly and accurately categorised (there was little corresponding 'feminisation' of raised-brow faces). Lowering gaze had a similar effect, but failed to interact with head lowering in a simple manner (experiment 2). We conclude that the initial classification of gender from the facial image may not involve normalisation of the face image to a canonical state (the 'mug-shot view') for expressive pose (brow movement and direction of gaze). For head pose (relative position of the features when the face is not viewed head-on), normalisation cannot be ruled out. Some perceptual mechanisms for these effects, and their functional implications, are discussed.

Are faces of different species perceived categorically by human observers?

What are the species boundaries of face processing? Using a face-feature morphing algorithm, image series intermediate between human, monkey (macaque), and bovine faces were constructed. Forced-choice judgement of these images showed sharply bounded categories for upright face images of each species. These predicted the perceptual discrimination boundaries for upright monkey-cow and cow-human images, but not human-monkey images. Species categories were also well-judged for inverted face images, but these did not give sharpened discrimination (categorical perception) at the category boundaries. While categorical species judgements are made reliably, only the distinction between primate faces and cow faces appears to be categorically perceived, and only in upright faces. One inference is that humans may judge monkey faces in terms of human characteristics, albeit distinctive ones.

Migration as a consumption activity.

"While a generalized utility maximization approach to migration decisionmaking is not innovative, the principal extensions of this paper involve the search for an instrument capable of measuring changes in utility levels consistent with all preferences (i.e., with all forms of utility functions), requiring only data on observed behaviour. Our approach is to construct a Location-Specific Utility Index (LSUI), whose component variables serve as proxies for the arguments in [U.S.] households' utility functions.... The testable hypothesis is formulated as follows: Assuming constant household preferences and expansion of the household's feasible set over time, the household's utility level is greater following the migration decision.... The results are compared with the households' migration decisions. The empirical evidence shows that migration may reasonably be modelled as a consumption activity by households to maximize utility." (SUMMARY IN FRE AND SPA)

Life response to Crouzon's disease.

This paper describes the life responses of two adult patients with facial deformities associated with untreated Crouzon's disease. Each patient has normal intelligence, and each has two children and close family relatives who exhibit variable degrees of Crouzon's disease. The impact of untreated facial deformity is considered, and recommendations are made for psychosocial management of these patients and their families.