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Sample records for active surveillance study

  1. Short-term outcomes of the prospective multicentre 'Prostate Cancer Research International : Active Surveillance' study

    NARCIS (Netherlands)

    van den Bergh, Roderick C. N.; Vasarainen, Hanna; van der Poel, Henk G.; Vis-Maters, Jenneke J.; Rietbergen, John B.; Pickles, Tom; Cornel, Erik B.; Valdagni, Riccardo; Jaspars, Joris J.; van der Hoeven, John; Staerman, Frederic; Oomens, Eric H. G. M.; Rannikko, Antti; Roemeling, Stijn; Steyerberg, Ewout W.; Roobol, Monique J.; Schroder, Fritz H.; Bangma, Chris H.

    2010-01-01

    OBJECTIVE To evaluate the short-term outcomes of the prospective international Prostate Cancer Research International: Active Surveillance ('PRIAS') study (Dutch Trial Register NTR1718), as active surveillance (AS) for early prostate cancer might provide a partial solution to the current overtreatme

  2. Surveillance Metrics Sensitivity Study

    Energy Technology Data Exchange (ETDEWEB)

    Bierbaum, R; Hamada, M; Robertson, A

    2011-11-01

    In September of 2009, a Tri-Lab team was formed to develop a set of metrics relating to the NNSA nuclear weapon surveillance program. The purpose of the metrics was to develop a more quantitative and/or qualitative metric(s) describing the results of realized or non-realized surveillance activities on our confidence in reporting reliability and assessing the stockpile. As a part of this effort, a statistical sub-team investigated various techniques and developed a complementary set of statistical metrics that could serve as a foundation for characterizing aspects of meeting the surveillance program objectives. The metrics are a combination of tolerance limit calculations and power calculations, intending to answer level-of-confidence type questions with respect to the ability to detect certain undesirable behaviors (catastrophic defects, margin insufficiency defects, and deviations from a model). Note that the metrics are not intended to gauge product performance but instead the adequacy of surveillance. This report gives a short description of four metrics types that were explored and the results of a sensitivity study conducted to investigate their behavior for various inputs. The results of the sensitivity study can be used to set the risk parameters that specify the level of stockpile problem that the surveillance program should be addressing.

  3. Active surveillance: Oncologic outcome

    NARCIS (Netherlands)

    L.D.F. Venderbos (Lionne); L.P. Bokhorst (Leonard); C.H. Bangma (Chris); M.J. Roobol-Bouts (Monique)

    2013-01-01

    textabstractPURPOSE OF REVIEW: To give insight into recent literature (during the past 12-18 months) reporting on oncologic outcomes of men on active surveillance. RECENT FINDINGS: From recent published trials comparing radical prostatectomy vs. watchful waiting, we learn that radical treatment only

  4. European active surveillance study of women taking HRT (EURAS-HRT: study protocol [NCT00214903

    Directory of Open Access Journals (Sweden)

    Heinemann Lothar AJ

    2006-01-01

    Full Text Available Abstract Background The post marketing safety surveillance program for a drug containing a new chemical entity should assess both, the safety outcomes that relate specifically to the targeted population, as well as those that could potentially be related to special pharmacological characteristics of the drug. Active safety surveillance using valid epidemiological study designs has been proven to be a pertinent and reliable method to approach this endeavor. Methods/design The primary objective of the study is to compare incidence rates of serious adverse events in users of all types of newly prescribed oral HRT products. This active surveillance study will assess pertinent cardiovascular outcomes - in particular venous and arterial thromboembolism - and other serious adverse events (SAEs in new HRT users over a period of several years. One product under surveillance is Angeliq®, which contains the novel progestagen drospirenone (DRSP combined with estradiol. In addition, all other oral combined HRT products with a novel progestagen or estrogen that will be newly marketed during the study period will be studied. These new HRT products will be compared with established HRT products. The combined cohort will include at least 30,000 women recruited in several European countries. At least 90,000 years of observation are expected from the field work which started in early 2002 and will end around 2008. The participating women will complete a baseline survey using a self-administered questionnaire to describe the baseline risk. After 6 months, 12 months, and then on an annual basis, they will fill out a questionnaire in which they record complaints and events during the use of the prescribed HRTs. All adverse outcomes occurring during the observational period will be evaluated. Discussion A complete lifetime medical history, individually validated SAEs over time, and a low loss to follow-up rate are essential for a robust safety assessment. Therefore

  5. Introduction to surveillance studies

    CERN Document Server

    Petersen, JK

    2012-01-01

    Introduction & OverviewIntroduction Brief History of Surveillance Technologies & TechniquesOptical SurveillanceAerial Surveillance Audio Surveillance Radio-Wave SurveillanceGlobal Positioning Systems Sensors Computers & the Internet Data Cards Biochemical Surveillance Animal Surveillance Biometrics Genetics Practical ConsiderationsPrevalence of Surveillance Effectiveness of Surveillance Freedom & Privacy IssuesConstitutional Freedoms Privacy Safeguards & Intrusions ResourcesReferences Glossary Index

  6. 522 Postmarket Surveillance Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 522 Postmarket Surveillance Studies Program encompasses design, tracking, oversight, and review responsibilities for studies mandated under section 522 of the...

  7. 522 Postmarket Surveillance Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 522 Postmarket Surveillance Studies Program encompasses design, tracking, oversight, and review responsibilities for studies mandated under section 522 of the...

  8. A Longitudinal Study of Predictors of Sexual Dysfunction in Men on Active Surveillance for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Shane M. Pearce, MD

    2015-09-01

    Conclusions: Men on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA‐SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS. Pearce SM, Wang CHE, Victorson DE, Helfand BT, Novakovic KR, Brendler CB, and Albaugh JA. A longitudinal study of predictors of sexual dysfunction in men on active surveillance for prostate cancer. Sex Med 2015;3:156–164.

  9. Potential metal impurities in active pharmaceutical substances and finished medicinal products - A market surveillance study.

    Science.gov (United States)

    Wollein, Uwe; Bauer, Bettina; Habernegg, Renate; Schramek, Nicholas

    2015-09-18

    A market surveillance study has been established by using different atomic spectrometric methods for the determination of selected elemental impurities of particular interest, to gain an overview about the quality of presently marketed drug products and their bulk drug substances. The limit tests were carried out with respect to the existing EMA guideline on the specification limits for residuals of metal catalysts or metal reagents. Also attention was given to the future implementation of two new chapters of the United States Pharmacopoeia (USP) stating limit concentrations of elemental impurities. The methods used for determination of metal residues were inductively coupled plasma-mass spectrometry (ICP-MS), inductively coupled plasma-optical emission spectrometry (ICP-OES), and atomic absorption spectrometry technologies (GFAAS, CVAAS, HGAAS). This article presents the development and validation of the methods used for the determination of 21 selected metals in 113 samples from drug products and their active pharmaceutical ingredients.

  10. Active surveillance for clinically localized prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Brasso, Klaus; Klotz, Laurence H

    2014-01-01

    Active surveillance (AS) has been introduced as an observational strategy to delay or avoid curative treatment without compromising long-term cancer-specific survival. The 10 studies included in this review, published between 2008 and 2013, generally agreed upon patients selection for the AS stra......Active surveillance (AS) has been introduced as an observational strategy to delay or avoid curative treatment without compromising long-term cancer-specific survival. The 10 studies included in this review, published between 2008 and 2013, generally agreed upon patients selection...

  11. The plays and arts of surveillance: studying surveillance as entertainment

    NARCIS (Netherlands)

    Albrechtslund, Anders; Dubbeld, L.

    2006-01-01

    This paper suggests a direction in the development of Surveillance Studies that goes beyond current attention for the caring, productive and enabling aspects of surveillance practices. That is, surveillance could be considered not just as positively protective, but even as a comical, playful,

  12. In Vitro Activity of Cefepime against Multidrug-Resistant Gram-Negative Bacilli, Viridans Group Streptococci and Streptococcus pneumoniae from a Cross-Canada Surveillance Study

    Directory of Open Access Journals (Sweden)

    Donald E Low

    1999-01-01

    Full Text Available OBJECTIVE: To determine the in vitro activity of cefepime against multidrug-resistant Gram-negative bacilli and Gram-positive cocci obtained from an ongoing cross-Canada surveillance study.

  13. Qualitative study on decision-making by prostate cancer physicians during active surveillance.

    Science.gov (United States)

    Loeb, Stacy; Curnyn, Caitlin; Fagerlin, Angela; Braithwaite, Ronald Scott; Schwartz, Mark D; Lepor, Herbert; Carter, Herbert Ballentine; Sedlander, Erica

    2017-07-01

    To explore and identify factors that influence physicians' decisions while monitoring patients with prostate cancer on active surveillance (AS). A purposive sampling strategy was used to identify physicians treating prostate cancer from diverse clinical backgrounds and geographic areas across the USA. We conducted 24 in-depth interviews from July to December 2015, until thematic saturation was reached. The Applied Thematic Analysis framework was used to guide data collection and analysis. Interview transcripts were reviewed and coded independently by two researchers. Matrix analysis and NVivo software were used for organization and further analysis. Eight key themes emerged to explain variation in AS monitoring: (i) physician comfort with AS; (ii) protocol selection; (iii) beliefs about the utility and quality of testing; (iv) years of experience and exposure to AS during training; (v) concerns about inflicting 'harm'; (vi) patient characteristics; (vii) patient preferences; and (viii) financial incentives. These qualitative data reveal which factors influence physicians who manage patients on AS. There is tension between providing standardized care while also considering individual patients' needs and health status. Additional education on AS is needed during urology training and continuing medical education. Future research is needed to empirically understand whether any specific protocol is superior to tailored, individualized care. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  14. Low Risk Prostate Cancer and Active Surveillance

    OpenAIRE

    Bul, Meelan

    2013-01-01

    textabstractThe first part of this thesis comprises an introduction to prostate cancer and screening (chapter 1). The European Randomized study of Screening for Prostate Cancer (ERSPC) has shown an effect of screening on prostate cancer mortality in favor of the screening population, however, controversies remain. One of the most important side-effects of screening is overdiagnosis with subsequent overtreatment, which has led to the introduction of active surveillance as an alternative to the...

  15. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk

    Science.gov (United States)

    Adams, Gillian G W; Xing, Wen; Butler, Lucilla; Long, Vernon; Reddy, Aravind

    2017-01-01

    Objectives To estimate the incidence of severe retinopathy of prematurity (ROP) requiring treatment and describe current treatment patterns in the UK. Design Nationwide population-based case ascertainment study via the British Ophthalmic Surveillance Unit and a national collaborative ROP special interest group. Practitioners completed a standardised case report form (CRF). Setting All paediatric ophthalmologists providing screening and/or treatment for retinopathy in the UK were invited to take part. Participants Any baby with ROP treated or referred for treatment between 1 December 2013 and 30 November 2014, treated with laser, cryotherapy, vascular endothelial growth factor (VEGF) inhibitor or vitrectomy/scleral buckling, or a combination. Main outcome measure Incidence of ROP requiring treatment. Results We received 370 CRFs; 327 were included. Denominator from epidemiological data: 8112 infants with birth weight of <1500 g. The incidence of ROP requiring treatment was 4% (327/8112, 95% CI 3.6% to 4.5%). Median gestational age was 25 weeks (IQR 24.3–26.1), and median birth weight 706 g (IQR 620–821). Median age at first treatment was 80 days (IQR 71–96). 204 right eyes (62.39%) had type 1 ROP, and 27 (8.26%) had aggressive posterior ROP. Infants were also treated for milder disease: 9 (2.75%) right eyes were treated for type 2 ROP, and 74 (22.63%) for disease milder than type 1 with plus or preplus, which we defined here as ‘type 2 plus’ disease. First-line treatment was diode laser photoablation of the avascular retina in 90.5% and injection of VEGF inhibitor in 8%. Conclusions ROP treatment incidence in the UK is 2.5 times higher than previously estimated. 8% of treated infants receive intravitreal VEGF inhibitor, currently unlicensed. Research is needed urgently to establish safety and efficacy of this approach. Earlier treatment and increasing numbers of surviving premature infants require an increase in appropriate eye care facilities and

  16. Surveillance

    DEFF Research Database (Denmark)

    Albrechtslund, Anders; Coeckelbergh, Mark; Matzner, Tobias;

    Studying surveillance involves raising questions about the very nature of concepts such as information, technology, identity, space and power. Besides the maybe all too obvious ethical issues often discussed with regard to surveillance, there are several other angles and approaches that we should...... like to encourage. Therefore, our panel will focus on the philosophical, yet non-ethical issues of surveillance in order to stimulate an intense debate with the audience on the ethical implications of our enquiries. We also hope to provide a broader and deeper understanding of surveillance....

  17. Impact of multiparametric endorectal coil prostate magnetic resonance imaging on disease reclassification among active surveillance candidates: a prospective cohort study.

    Science.gov (United States)

    Margel, David; Yap, Stanley A; Lawrentschuk, Nathan; Klotz, Laurence; Haider, Masoom; Hersey, Karen; Finelli, Antonio; Zlotta, Alexandre; Trachtenberg, John; Fleshner, Neil

    2012-04-01

    We report magnetic resonance imaging findings among unselected men with low risk prostate cancer before active surveillance. We prospectively enrolled men with low grade, low risk, localized prostate cancer. All patients underwent multiparametric endorectal coil magnetic resonance imaging and were offered confirmatory biopsy within 1 year of imaging. The primary outcome was the impact of magnetic resonance imaging on identifying patients who were reclassified by confirmatory biopsy as no longer fulfilling active surveillance criteria. We further identified clinical parameters associated with reclassification. The cohort was stratified as patients with 1) normal magnetic resonance imaging, 2) cancer on magnetic resonance imaging concordant with initial biopsy (less than 1 cm) and 3) cancer on magnetic resonance imaging larger than 1 cm. We performed univariate analysis to assess differences in clinical parameters among the groups. Magnetic resonance imaging did not detect cancer in 23 cases (38%) while magnetic resonance imaging and initial biopsy were concordant in 24 (40%). Magnetic resonance imaging detected a 1 cm or larger lesion in 13 patients (22%). Of the cases 18 (32.14%) were reclassified. When no cancer was identified on magnetic resonance imaging, only 2 cases (3.5%) were reclassified. The positive and negative predictive values for magnetic resonance imaging predicting reclassification were 83% (95% CI 73-93) and 81% (95% CI 71-91), respectively. Prostate specific antigen density was increased in patients with lesions larger than 1 cm on magnetic resonance imaging compared to those with no cancer on imaging (median 0.15 vs 0.07 ng/ml/cc, p=0.016). Magnetic resonance imaging appears to have a high yield for predicting reclassification among men who elect active surveillance. Upon confirmation of our results magnetic resonance imaging may be used to better select and guide patients before active surveillance. Copyright © 2012 American Urological

  18. Prospective Cohort Study with Active Surveillance for Fever in Four Dengue Endemic Countries in Latin America

    Science.gov (United States)

    Dayan, Gustavo; Arredondo, Jose L.; Carrasquilla, Gabriel; Deseda, Carmen C.; Dietze, Reynaldo; Luz, Kleber; Costa, Maria Selma N.; Cunha, Rivaldo V.; Rey, Luis C.; Morales, Javier; Reynales, Humberto; Miranda, Maria; Zambrano, Betzana; Rivas, Enrique; Garbes, Pedro; Noriega, Fernando

    2015-01-01

    To prepare for a Phase III dengue vaccine efficacy trial, 20 investigational sites were selected for this observational study to identify dengue infections in a closed cohort (N = 3,000 children 9–16 years of age). Of 255 acute febrile episodes experienced by 235 children, 50 (21.3%) were considered serologically probable dengue, and 18 (7.7%) were considered virologically confirmed (i.e., dengue NS1 antigen positive) dengue cases. Considering the disease-free and at-risk period from study start to onset of symptoms, the overall incidence density of acute febrile episodes was 17.7 per 100 person-years of follow-up, ranging from 15.3 in Colombia to 22.0 in Puerto Rico. This study showed that all sites were capable of capturing and following up acute febrile episodes within a specific timeframe among the established cohort and to detect dengue cases. PMID:26013373

  19. Prospective cohort study with active surveillance for fever in four dengue endemic countries in Latin America.

    Science.gov (United States)

    Dayan, Gustavo; Arredondo, Jose L; Carrasquilla, Gabriel; Deseda, Carmen C; Dietze, Reynaldo; Luz, Kleber; Costa, Maria Selma N; Cunha, Rivaldo V; Rey, Luis C; Morales, Javier; Reynales, Humberto; Miranda, Maria; Zambrano, Betzana; Rivas, Enrique; Garbes, Pedro; Noriega, Fernando

    2015-07-01

    To prepare for a Phase III dengue vaccine efficacy trial, 20 investigational sites were selected for this observational study to identify dengue infections in a closed cohort (N = 3,000 children 9-16 years of age). Of 255 acute febrile episodes experienced by 235 children, 50 (21.3%) were considered serologically probable dengue, and 18 (7.7%) were considered virologically confirmed (i.e., dengue NS1 antigen positive) dengue cases. Considering the disease-free and at-risk period from study start to onset of symptoms, the overall incidence density of acute febrile episodes was 17.7 per 100 person-years of follow-up, ranging from 15.3 in Colombia to 22.0 in Puerto Rico. This study showed that all sites were capable of capturing and following up acute febrile episodes within a specific timeframe among the established cohort and to detect dengue cases. © The American Society of Tropical Medicine and Hygiene.

  20. The Nordic Obstetric Surveillance Study

    DEFF Research Database (Denmark)

    Colmorn, Lotte B.; Petersen, Kathrine B; Jakobsson, Maija

    2015-01-01

    OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study...... (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases...... hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. CONCLUSION: The studied obstetric complications are rare...

  1. Is "Active Surveillance" an Acceptable Alternative?: A Qualitative Study of Couples' Decision Making about Early-Stage, Localized Prostate Cancer.

    Science.gov (United States)

    Le, Chi L; McFall, Stephanie L; Byrd, Theresa L; Volk, Robert J; Cantor, Scott B; Kuban, Deborah A; Mullen, Patricia Dolan

    2016-01-01

    The objective of our study was to describe decision making by men and their partners regarding active surveillance (AS) or treatment for early-stage, localized prostate cancer. Fifteen couples were recruited from a cancer center multispecialty clinic, which gave full information about all options, including AS. Data were collected via individual, semi-structured telephone interviews. Most patients were white, non-Hispanic, had private insurance, had completed at least some college, and were aged 49-72 years. Ten chose AS. All partners were female, and couples reported strong marital satisfaction and cohesion. All couples described similar sequences of a highly emotional initial reaction and desire to be rid of the cancer, information seeking, and decision making. The choice of AS was built on a nuanced evaluation of the man's condition in which the couple differentiated prostate cancer from other cancers and early stage from later stages, wanted to avoid/delay side effects, and trusted the AS protocol to identify negative changes in time for successful treatment. Treated couples continued to want immediate treatment to remove the cancer. We concluded that having a partner's support for AS may help a man feel more comfortable with choosing and adhering to AS. Using decision aids that address both a man's and his partner's concerns regarding AS may increase its acceptability. Our research shows that some patients want to and do involve their partners in the decision-making process. Ethical issues are related to the tension between desire for partner involvement and the importance of the patient as autonomous decision-maker. The extended period of decision making, particularly for AS, is also an ethical issue that requires additional support for patients and couples in the making of fully informed choices that includes AS.

  2. Dengue and other common causes of acute febrile illness in Asia: an active surveillance study in children.

    Directory of Open Access Journals (Sweden)

    Maria Rosario Capeding

    Full Text Available BACKGROUND: Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever in dengue-endemic Asian countries are needed. METHODS AND PRINCIPAL FINDINGS: This prospective, multicenter, active fever surveillance, cohort study was conducted in selected centers in Indonesia, Malaysia, Philippines, Thailand and Vietnam to determine the incidence density of acute febrile episodes (≥ 38 °C for ≥ 2 days in 1,500 healthy children aged 2-14 years, followed for a mean 237 days. Causes of fever were assessed by testing acute and convalescent sera from febrile participants for dengue, chikungunya, hepatitis A, influenza A, leptospirosis, rickettsia, and Salmonella Typhi. Overall, 289 participants had acute fever, an incidence density of 33.6 per 100 person-years (95% CI: 30.0; 37.8; 57% were IgM-positive for at least one of these diseases. The most common causes of fever by IgM ELISA were chikungunya (in 35.0% of in febrile participants and S. Typhi (in 29.4%. The overall incidence density of dengue per 100 person-years was 3.4 by nonstructural protein 1 (NS1 antigen positivity (95% CI: 2.4; 4.8 and 7.3 (95% CI: 5.7; 9.2 by serology. Dengue was diagnosed in 11.4% (95% CI: 8.0; 15.7 and 23.9% (95% CI: 19.1; 29.2 of febrile participants by NS1 positivity and serology, respectively. Of the febrile episodes not clinically diagnosed as dengue, 5.3% were dengue-positive by NS1 antigen testing and 16.0% were dengue-positive by serology. CONCLUSIONS: During the study period, the most common identified causes of pediatric acute febrile illness among the seven tested for were chikungunya, S. Typhi and dengue. Not all dengue cases were clinically diagnosed; laboratory confirmation

  3. Current Management Strategy for Active Surveillance in Prostate Cancer.

    Science.gov (United States)

    Syed, Jamil S; Javier-Desloges, Juan; Tatzel, Stephanie; Bhagat, Ansh; Nguyen, Kevin A; Hwang, Kevin; Kim, Sarah; Sprenkle, Preston C

    2017-02-01

    Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.

  4. Epidemiological models to support animal disease surveillance activities

    DEFF Research Database (Denmark)

    Willeberg, Preben; Paisley, Larry; Lind, Peter

    2011-01-01

    Epidemiological models have been used extensively as a tool in improving animal disease surveillance activities. A review of published papers identified three main groups of model applications: models for planning surveillance, models for evaluating the performance of surveillance systems and mod...

  5. Epidemiological models to support animal disease surveillance activities

    DEFF Research Database (Denmark)

    Willeberg, Preben; Paisley, Larry; Lind, Peter

    2011-01-01

    Epidemiological models have been used extensively as a tool in improving animal disease surveillance activities. A review of published papers identified three main groups of model applications: models for planning surveillance, models for evaluating the performance of surveillance systems...... and models for interpreting surveillance data as part of ongoing control or eradication programmes. Two Danish examples are outlined. The first illustrates how models were used in documenting country freedom from disease (trichinellosis) and the second demonstrates how models were of assistance in predicting...

  6. A qualitative approach to measure the effectiveness of active avian influenza virus surveillance with respect to its cost: a case study from Switzerland.

    Science.gov (United States)

    Häsler, B; Howe, K S; Hauser, R; Stärk, K D C

    2012-07-01

    The aim of the project was to apply cost-effectiveness analysis to the economic appraisal of avian influenza virus (AIV) surveillance, using the implemented surveillance programme in Switzerland as a case study. First a qualitative risk assessment approach was used to assess the expected impact of surveillance on the transmission and spread of AIV. The effectiveness of surveillance was expressed as the difference in defined probabilities between a scenario with surveillance and a scenario without surveillance. The following probabilities were modelled (i) transmission of highly pathogenic AIV (HPAIV) from wild birds to poultry, (ii) mutation from low pathogenic AIV (LPAIV) into HPAIV in poultry, and (iii) transmission of HPAIV to other poultry holdings given a primary outbreak. The cost-effectiveness ratio was defined conventionally as the difference in surveillance costs (ΔC) divided by the change in probability (ΔP), the technical objective, on the presumption that surveillance diminishes the respective probabilities. However, results indicated that surveillance in both wild birds and poultry was not expected to change the probabilities of primary and secondary AIV outbreaks in Switzerland. The overall surveillance costs incurred were estimated at 31,000 €/year, which, to be a rational investment of resources, must still reflect the value policy makers attribute to other benefits from having surveillance (e.g. peace of mind). The advantage of the approach adopted is that it is practical, transparent, and thus able to clarify for policy makers the key variables to be taken into account when evaluating the economic efficiency of resources invested in surveillance, prevention and intervention to exclude AIV.

  7. RAMA Surveillance Capsule and Component Activation Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Watkins, Kenneth E.; Jones, Eric N. [TransWare Enterprises Inc., 1565 Mediterranean Dr., Sycamore, IL 60178 (United States); Carter, Robert G. [Electric Power Research Institute, 1300 West W. T. Harris Blvd., Charlotte, NC 28262 (United States)

    2011-07-01

    This paper presents the calculated-to-measured ratios associated with the application of the RAMA Fluence Methodology software to light water reactor surveillance capsule and reactor component activation evaluations. Comparisons to measurements are performed for pressurized water reactor and boiling water reactor surveillance capsule activity specimens from seventeen operating light water reactors. Comparisons to measurements are also performed for samples removed from the core shroud, top guide, and jet pump brace pads from two reactors. In conclusion: The flexible geometry modeling capabilities provided by RAMA, combined with the detailed representation of operating reactor history and anisotropic scattering detail, produces accurate predictions of the fast neutron fluence and neutron activation for BWR and PWR surveillance capsule geometries. This allows best estimate RPV fluence to be determined without the need for multiplicative bias corrections. The three-dimensional modeling capability in RAMA provides an accurate estimate of the fast neutron fluence for regions far removed from the core mid-plane elevation. The comparisons to activation measurements for various core components indicate that the RAMA predictions are reasonable, and notably conservative (i.e., C/M ratios are consistently greater than unity). It should be noted that in the current evaluations, the top and bottom fuel regions are represented by six inch height nodes. As a result, the leakage-induced decrease in power near the upper and lower edges of the core are not well represented in the current models. More precise predictions of fluence for components that lie above and below the core boundaries could be obtained if the upper and lower fuel nodes were subdivided into multiple axial regions with assigned powers that reflect the neutron leakage at the top and bottom of the core. This use of additional axial sub-meshing at the top and bottom of the core is analogous to the use of pin

  8. Strategic Priorities for Physical Activity Surveillance in the United States.

    Science.gov (United States)

    Fulton, Janet E; Carlson, Susan A; Ainsworth, Barbara E; Berrigan, David; Carlson, Cynthia; Dorn, Joan M; Heath, Gregory W; Kohl, Harold W; Lee, I-Min; Lee, Sarah M; Másse, Louise C; Morrow, James R; Gabriel, Kelley Pettee; Pivarnik, James M; Pronk, Nicolaas P; Rodgers, Anne B; Saelens, Brian E; Sallis, James F; Troiano, Richard P; Tudor-Locke, Catrine; Wendel, Arthur

    2016-10-01

    Develop strategic priorities to guide future physical activity surveillance in the United States. The Centers for Disease Control and Prevention and the American College of Sports Medicine convened a scientific roundtable of physical activity and measurement experts. Participants summarized the current state of aerobic physical activity surveillance for adults, focusing on practice and research needs in three areas: 1) behavior, 2) human movement, and 3) community supports. Needs and challenges for each area were identified. At the conclusion of the meeting, experts identified one overarching strategy and five strategic priorities to guide future surveillance. The identified overarching strategy was to develop a national plan for physical activity surveillance similar to the U.S. National Physical Activity Plan for promotion. The purpose of the plan would be to enhance coordination and collaboration within and between sectors, such as transportation and public health, and to address specific strategic priorities identified at the roundtable. These strategic priorities were used 1) to identify and prioritize physical activity constructs; 2) to assess the psychometric properties of instruments for physical activity surveillance; 3) to provide training and technical assistance for those collecting, analyzing, or interpreting surveillance data; 4) to explore accessing data from alternative sources; and 5) to improve communication, translation, and dissemination about estimates of physical activity from surveillance systems. This roundtable provided strategic priorities for physical activity surveillance in the United States. A first step is to develop a national plan for physical activity surveillance that would provide an operating framework from which to execute these priorities.

  9. Surveillance studies about "rear-window ethics"%Surveillance studies about"rear-window ethics"

    Institute of Scientific and Technical Information of China (English)

    黄婷婷

    2016-01-01

    It can be said that people now live in a surveillance society. Some forms of surveillance have always existed as people watch over each other for mutual care, for moral caution and to discover information under the table. Alfred Hitchcock's Rear Window is a typical fi lm for surveillance studies.What is happening on the screen is merely a projection of our own anxieties, our own existence, and our self-ambiguity as portrayed by the characters in this wonderful film.

  10. Active surveillance of visual impairment due to adverse drug reactions: findings from a national study in the United Kingdom.

    Science.gov (United States)

    Cumberland, Phillippa M; Russell-Eggitt, Isabelle; Rahi, Jugnoo S

    2015-02-01

    As visual impairment (VI) due to adverse drug reactions (ADR) is rare in adults and children, there is an incomplete evidence base to inform guidance for screening and for counseling patients on the potential risks of medications. We report on suspected drugs and the eye conditions found in a national study of incidence of diagnosis of visual impairment due to suspected ADR. Case ascertainment was via the British Ophthalmological Surveillance Unit (BOSU), between March 2010 and February 2012, with follow-up after 6 months. any child or adult with bilateral or unilateral visual impairment due to a suspected ADR, using distance acuity worse than Snellen 6/18 (logMAR 0.48) in the better eye (bilateral) or affected eye (unilateral). Anonymized patient information on potential cases was provided by managing ophthalmologists, comprising visual status before and after suspected ADR, ophthalmic condition attributable to the ADR, preexisting eye disease and prescribed medications at the time of the ADR. Permanency and causality of the visual impairment were confirmed by the managing clinician, after 6 months, using the WHO Uppsala Monitoring Committee criteria. Over 2 years, 36 eligible cases were reported of whom 23 had permanent VI. While most cases were due to drugs known to have adverse side-effects, some were unanticipated sporadic cases. Visual impairment due to ADRs is rare. However, with for example, increasing polypharmacy in the elderly, monitoring of ocular ADRs, although challenging, is necessary.

  11. Study of Avian Tuberculosis in a Zoo at the Bogota savannah through Tuberculin Testing and Active Epidemiologic Surveillance

    Directory of Open Access Journals (Sweden)

    Germán Rodríguez Martínez

    2011-06-01

    Full Text Available The flow of wild birds is a weakness in epidemiologic surveillance because of its unknown potential as a source of disease dissemination. The investigation focused on an epidemiological tracking of the mixed wild bird population in a zoo in the Bogota Savannah, where three birds died with a presumptive diagnosis of tuberculosis. In order to verify the presence of Mycobacterium avium and to plan the required measures to avoid risk factors, a control group of five poultry birds of the Hy Line Brown variety that had already been exposed was used, as well as a sentinel group of the poultry birds from the same batch as the control group, and an external control group of 102 birds from cages near the area of the problem. Retrospective and prospective studies were carried out through histopathological, microbiological, epidemiological and molecular analysis. One hundred percent (100% of the birds from the original cages that died were genotypically diagnosed with tuberculosis caused by Mycobacterium avium. Thirty-five percent (35.5% of the sentinel group was affected by Mycobacterium avium, 28.6% by Mycobacterium gordonae, 14.3% by Mycobacterium chelonae and 21.4% by a mycobacterium that is very difficult to classify. The other animals outside the cage showed no evidence of infection. It is concluded that the problematic enclosure is affected by avian tuberculosis, which is of high risk both for birds and for humans. The poultry used as sentinels are excellent infective agent detectors, particularly of mycobacteria present in the environment, and the tuberculin test is a good indicator of infection with this type of microorganisms in poultry.

  12. Prudential regulation and surveillance - essential elements of the banking activity

    Directory of Open Access Journals (Sweden)

    Gheorghe, C. A.

    2012-01-01

    Full Text Available Without being an exhaustive study, the analysis aims to identify the intrinsic correlations of essential notions for the banking field - prudence, prudential supervision, international publishing and sanctions, quartered obviously in risk area. We mention that risk, as related to surveillance and caution, represents the possibility of potential, expected or unexpected events to have a negative impact on the bank capital or the bank revenue. We will not use the notion of control, which seems included in that broader surveillance, but we remind that a prudential supervision aims at preventing internal or external risk at a credit institution level, and at avoiding their spread. Macroeconomic prudential supervision is an internal management activity, given the evolution of constraints that come from outside, the change of activity place or the redefinition of prudential rules at national and international level.

  13. How has early testicular cancer affected your life? A study of sexual function in men attending active surveillance for stage one testicular cancer.

    Science.gov (United States)

    Brand, Sue; Williams, Hilary; Braybrooke, Jeremy

    2015-06-01

    Testicular cancer is the most common cancer in young men, it is frequently diagnosed at key times in relationship formation. In early stage disease the vast majority of tumours will be cured by surgery alone with patients being offered active surveillance rather than adjuvant therapies. To date, research has not evaluated how surveillance alone impacts on sexual function. The aim of this quantitative longitudinal study was to ascertain the sexual function of men with stage one disease at 3 and 12 months post diagnosis and to compare with normative data. Additional data was collected on the information men sought regarding sexual function and media they used to access this. This study shows that men's sexual function is altered at diagnosis and improves by 3 months. At 12 months, whilst not statistically significant, sexual function improves but not to the same level as normative data comparison. Men appear to find verbal information useful at 3 months, however men appear to be seeking written and online information at 12 months. The intricacies of sexual function together with the low number of participants may have been best met with a qualitative approach. However, the information data indicates the importance of further research into the effects of early stage testicular cancer on sexual function. Therefore, further qualitative research is recommended to explore the effects of early stage testicular cancer in relation to sexual function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Monitoring activities review of the Radiological Environmental Surveillance Program

    Energy Technology Data Exchange (ETDEWEB)

    Ritter, P.D.

    1992-03-01

    The 1992 Monitoring Activities Review (MAR) is directed at the Radiological Environment Surveillance Program (RESP) activities at the Radioactive Waste Management Complex (RWMC) of Idaho Engineering Laboratory (INEL). MAR panelists studied RESP documents and discussed their concerns with Environmental Monitoring Unit (EMU) staff and other panel members. These concerns were subsequently consolidated into a collection of recommendations with supporting discussions. Recommendations focus on specific monitoring activities, as well as the overall program. The MAR report also contains pertinent comments that should not require further action.

  15. Activity Surveillance and Hawthorne Effect to Prevent Programming Plagiarism

    Directory of Open Access Journals (Sweden)

    Sufian Sufian

    2010-01-01

    Full Text Available Problem statement: Course instructors are facing serious problems in dealing with students who plagiarize programs especially when the number of students in the course is high. Among the proposed approach to handle this problem is by using automatic detection of plagiarism in programming projects. Preventive action is required rather than curing the problem so that programming students get the right message from the beginning. Approach: To address this problem, a surveillance system was proposed to record every programming activity. It is developed in an integrated development environment so that programming activity profile in Java format is created when students are developing their Java program. A non-intrusive and non-experimental setting approach was applied in which hidden data collection is conducted to observe students’ behavior in natural programming setting. Experimental study effect i.e., Hawthorne effect and effect of expectation on subject behavior was exploited as prevention on plagiarism. Surveillance system produces two file types: Activity log to keep programming activity log information and Backup file to save the program writing record. Results: The proposed programming activity surveillance system, DwiCoder presented a programming activity report at the end of each programming session. Students can assess their own progress in developing a program in these three activities: Compilation, execution and modification. The report was presented in a simple and meaningful way to encourage student spend their own time in programming activity. Conclusion: By using DwiCoder, student’s programming activity is continuously monitored and their behavior is under control. This system provides an effective prevention method in tackling plagiarism.

  16. Can we expand active surveillance criteria to include biopsy Gleason 3+4 prostate cancer? A multi-institutional study of 2,323 patients

    NARCIS (Netherlands)

    Ploussard, G.; Isbarn, H.; Briganti, A.; Sooriakumaran, P.; Surcel, C.I.; Salomon, L.; Freschi, M.; Mirvald, C.; Poel, H.G. van der; Jenkins, A.; Ost, P.; Oort, I.M. van; Yossepowitch, O.; Giannarini, G.; Bergh, R.C. van den

    2015-01-01

    OBJECTIVE: To test the expandability of active surveillance (AS) to Gleason score 3+4 cancers by assessing the unfavorable disease risk in a large multi-institutional cohort. MATERIALS AND METHODS: We performed a retrospective analysis including 2,323 patients with localized Gleason score 3+4 prosta

  17. The validation of a three-stage screening methodology for detecting active convulsive epilepsy in population-based studies in health and demographic surveillance systems

    Directory of Open Access Journals (Sweden)

    Ngugi Anthony K

    2012-11-01

    Full Text Available Abstract Background There are few studies on the epidemiology of epilepsy in large populations in Low and Middle Income Countries (LMIC. Most studies in these regions use two-stage population-based screening surveys, which are time-consuming and costly to implement in large populations required to generate accurate estimates. We examined the sensitivity and specificity of a three-stage cross-sectional screening methodology in detecting active convulsive epilepsy (ACE, which can be embedded within on-going census of demographic surveillance systems. We validated a three-stage cross-sectional screening methodology on a randomly selected sample of participants of a three-stage prevalence survey of epilepsy. Diagnosis of ACE by an experienced clinician was used as ‘gold standard’. We further compared the expenditure of this method with the standard two-stage methodology. Results We screened 4442 subjects in the validation and identified 35 cases of ACE. Of these, 18 were identified as false negatives, most of whom (15/18 were missed in the first stage and a few (3/18 in the second stage of the three-stage screening. Overall, this methodology had a sensitivity of 48.6% and a specificity of 100%. It was 37% cheaper than a two-stage survey. Conclusion This was the first study to evaluate the performance of a multi-stage screening methodology used to detect epilepsy in demographic surveillance sites. This method had poor sensitivity attributed mainly to stigma-related non-response in the first stage. This method needs to take into consideration the poor sensitivity and the savings in expenditure and time as well as validation in target populations. Our findings suggest the need for continued efforts to develop and improve case-ascertainment methods in population-based epidemiological studies of epilepsy in LMIC.

  18. Evaluation of Aryoseven Safety (Recombinant Activated Factor VII) in Patients with Bleeding Disorders (An Observational Post-Marketing Surveillance Study)

    Science.gov (United States)

    Toogeh, Gholamreza; Abolghasemi, Hassan; Eshghi, Peyman; Managhchi, Mohammadreza; Shaverdi-niasari, Mohammadreza; Karimi, Katayoon; Roostaei, Samin; Emran, Neda; Abdollahi, Alireza

    2016-01-01

    Background: Recombinant activated factor VII induces hemostasis in patients with coagulopathy disorders. AryoSeven™ as a safe Iranian Recombinant activated factor VII has been available on our market. This study was performed to establish the safety of AryoSeven on patients with coagulopathy disorder. Methods: This single-center, descriptive, cross sectional study was carried out in Thrombus and Homeostasis Research Center ValiAsr Hospital during 2013-2014. Fifty one patients with bleeding disorders who received at least one dose of Aryoseven were enrolled. Patients’ demographic data and adverse effect of drug and reaction related to Aryoseven or previous usage of Recombinant activated FVII were recorded in questionnaires. Finally data were analyzed to compare side effects of Aryoseven and other Recombinant activated FVII brands. Results: Aryoseven was prescribed for 51 Patients. Of all participants with mean age 57.18+21.38 yr, 31 cases were male and 26 subjects had past history of recombinant activated FVII usage. Glanzman was the most frequent disorder followed by congenital FVII deficiency, hemophilia with inhibitors, factor 5 deficiency, acquired hemophilia, hemophilia A with inhibitor, and hemophilia A or B with inhibitor. The majority of bleeding episodes had occurred in joints. Three patients (5.9%) complained about adverse effects of Aryoseven vs. 11.5 % about adverse effects of other brands. However this difference was not significant, statistically. Conclusion: Based on monitor patients closely for any adverse events, we concluded that Aryoseven administration under careful weighing of benefit versus potential harm may comparable with other counterpart drugs. PMID:27799968

  19. Nutrition, Physical Activity, and Obesity - Youth Risk Behavior Surveillance System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes data on adolescent's diet, physical activity, and weight status from Youth Risk Behavior Surveillance System. This data is used for DNPAO's...

  20. Nutrition, Physical Activity, and Obesity - Behavioral Risk Factor Surveillance System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes data on adult's diet, physical activity, and weight status from Behavioral Risk Factor Surveillance System. This data is used for DNPAO's Data,...

  1. Lessons learned during active epidemiological surveillance of Ebola ...

    African Journals Online (AJOL)

    Lessons learned during active epidemiological surveillance of Ebola And Marburg Viral Hemorrhagic Fever Epidemics in Africa. ... During epidemics in rural settings, outbreak investigations have shown multiple introductions of the virus into ...

  2. Tamper Detection for Active Surveillance Systems

    DEFF Research Database (Denmark)

    Theodore, Tsesmelis; Christensen, Lars; Fihl, Preben;

    2013-01-01

    If surveillance data are corrupted they are of no use to neither manually post-investigation nor automatic video analysis. It is therefore critical to automatically be able to detect tampering events such as defocusing, occlusion and displacement. In this work we for the first time ad- dress...

  3. Appropriateness Criteria for Active Surveillance of Prostate Cancer.

    Science.gov (United States)

    Cher, Michael L; Dhir, Apoorv; Auffenberg, Gregory B; Linsell, Susan; Gao, Yuqing; Rosenberg, Bradley; Jafri, S Mohammad; Klotz, Laurence; Miller, David C; Ghani, Khurshid R; Bernstein, Steven J; Montie, James E; Lane, Brian R

    2017-01-01

    The adoption of active surveillance varies widely across urological communities, which suggests a need for more consistency in the counseling of patients. To address this need we used the RAND/UCLA Appropriateness Method to develop appropriateness criteria and counseling statements for active surveillance. Panelists were recruited from MUSIC urology practices. Combinations of parameters thought to influence decision making were used to create and score 160 theoretical clinical scenarios for appropriateness of active surveillance. Recent rates of active surveillance among real patients across the state were assessed using the MUSIC registry. Low volume Gleason 6 was deemed highly appropriate for active surveillance whereas high volume Gleason 6 and low volume Gleason 3+4 were deemed appropriate to uncertain. No scenario was deemed inappropriate or highly inappropriate. Prostate specific antigen density, race and life expectancy impacted scores for intermediate and high volume Gleason 6 and low volume Gleason 3+4. The greatest degree of score dispersion (disagreement) occurred in scenarios with long life expectancy, high volume Gleason 6 and low volume Gleason 3+4. Recent rates of active surveillance use among real patients ranged from 0% to 100% at the provider level for low or intermediate biopsy volume Gleason 6, demonstrating a clear opportunity for quality improvement. By virtue of this work urologists have the opportunity to present specific recommendations from the panel to their individual patients. Community-wide efforts aimed at increasing rates of active surveillance and reducing practice and physician level variation in the choice of active surveillance vs treatment are warranted. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Care Planning for Prostate Cancer Patients on Active Surveillance

    Science.gov (United States)

    2016-10-01

    medical tests, exams, biopsies, and treating physicians, specialists, and other care providers involved in your cancer surveillance. You will... Conditions : Allergies: Past major surgeries: Date: Clinical Trial: ☐ Yes ☐No Name/Number: Active Surveillance Treatment Date Starting Active...cancer 1 0 j) Loss of eyesight 1 0 k) Hearing loss 1 0 l) Anemia 1 0 m) Asthma 1 0 n) Severe allergies 1 0 o) Stomach problems 1 0 p) Sexual or

  5. Active surveillance of abused and misused prescription opioids using poison center data: a pilot study and descriptive comparison.

    Science.gov (United States)

    Hughes, Alice A; Bogdan, Gregory M; Dart, Richard C

    2007-01-01

    Prescription opioids are abused throughout the United States. Several monitoring programs are in existence, however, none of these systems provide up-to-date information on prescription opioid abuse. This article describes the use of poison centers as a real-time, geographically specific, surveillance system for prescription opioid abuse and compares our system with an existing prescription drug abuse monitoring program, the Drug Abuse Warning Network (DAWN). Data were collected from eight geographically dispersed poison centers for a period of twelve months. Any call involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone was considered a case. Any case coded as intentional exposure (abuse, intentional misuse, suicide, or intentional unknown) was regarded as misuse and abuse. Comparative data were obtained from DAWN. Poison center rates of abuse and misuse were highest for hydrocodone at 3.75 per 100,000 population, followed by oxycodone at 1.81 per 100,000 population. DAWN emergency department (ED) data illustrate a similar pattern of abuse with most mentions involving hydrocodone and oxycodone. Poison center data indicate that people aged 18 to 25 had the highest rates of abuse. DAWN reported the majority of ED mentions among 35 to 44-year-olds. Geographically, Kentucky had the uppermost rates of abuse and misuse for all opioids combined at 20.69 per 100,000 population. CONCLUSIONS. Comparing poison center data to DAWN yielded mostly comparable results, including hydrocodone as the most commonly mentioned drug. Our results suggest poison center data can be used as an indicator for prescription opioid abuse and misuse and can provide timely, geographically specific information on prescription drug abuse.

  6. Surveillance of avian influenza in the Caribbean through the Caribbean Animal Health Network: surveillance tools and epidemiologic studies.

    Science.gov (United States)

    Lefrançois, T; Hendrikx, P; Ehrhardt, N; Millien, M; Gomez, L; Gouyet, L; Gaidet, N; Gerbier, G; Vachiéry, N; Petitclerc, F; Carasco-Lacombe, C; Pinarello, V; Ahoussou, S; Levesque, A; Gongora, H V; Trotman, M

    2010-03-01

    The Caribbean region is considered to be at risk for avian influenza (AI) due to a large backyard poultry system, an important commercial poultry production system, the presence of migratory birds, and disparities in the surveillance systems. The Caribbean Animal Health Network (CaribVET) has developed tools to implement AI surveillance in the region with the goals to have 1) a regionally harmonized surveillance protocol and specific web pages for AI surveillance on www.caribvet.net, and 2) an active and passive surveillance for AI in domestic and wild birds. A diagnostic network for the Caribbean, including technology transfer and AI virus molecular diagnostic capability in Guadeloupe (real-time reverse transcription-polymerase chain reaction for the AI virus matrix gene), was developed. Between 2006 and 2009, 627 samples from four Caribbean countries were tested for three circumstances: importation purposes, following a clinical suspicion of AI, or through an active survey of wild birds (mainly waders) during the southward and northward migration periods in Guadeloupe. None of the samples tested were positive, suggesting a limited role of these species in the AI virus ecology in the Caribbean. Following low pathogenic H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for a risk analysis of AI spread in the region through fighting cocks. The infection pathway of the Martinique commercial poultry sector by AI, through introduction of infected cocks, was designed, and recommendations were provided to the Caribbean Veterinary Services to improve cock movement control and biosecurity measures. The CaribVET and its organization allowed interaction between diagnostic and surveillance tools on the one hand and epidemiologic studies on the other, both of them developed in congruence with regional strategies. Together, these CaribVET activities contribute to strengthening surveillance of avian influenza virus (AIV) in the

  7. Cross-sectional surveillance study to phenotype lorry drivers' sedentary behaviours, physical activity and cardio-metabolic health

    National Research Council Canada - National Science Library

    Veronica Varela-Mato; Orlagh O'Shea; James A King; Thomas Yates; David J Stensel; Stuart JH Biddle; Myra A Nimmo; Stacy A Clemes

    2017-01-01

    ...) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers' sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health...

  8. Patients' motives for participating in active post-marketing surveillance

    NARCIS (Netherlands)

    Harmark, Linda; Lie-Kwie, Miguel; Berm, Lisette; de Gier, Han; van Grootheest, Kees

    2013-01-01

    Purpose Web-based intensive monitoring is a method to actively collect information about adverse drug reactions (ADRs) using patients as a source of information. To date, little is known about patients' motivation to participate in this kind of active post-marketing surveillance (PMS). Increased ins

  9. The Role of MRI in Prostate Cancer Active Surveillance

    Directory of Open Access Journals (Sweden)

    Linda M. Johnson

    2014-01-01

    Full Text Available Prostate cancer is the most common cancer diagnosis in American men, excluding skin cancer. The clinical behavior of prostate cancer varies from low-grade, slow growing tumors to high-grade aggressive tumors that may ultimately progress to metastases and cause death. Given the high incidence of men diagnosed with prostate cancer, conservative treatment strategies such as active surveillance are critical in the management of prostate cancer to reduce therapeutic complications of radiation therapy or radical prostatectomy. In this review, we will review the role of multiparametric MRI in the selection and follow-up of patients on active surveillance.

  10. Active case surveillance, passive case surveillance and asymptomatic malaria parasite screening illustrate different age distribution, spatial clustering and seasonality in western Kenya.

    Science.gov (United States)

    Zhou, Guofa; Afrane, Yaw A; Malla, Sameer; Githeko, Andrew K; Yan, Guiyun

    2015-01-28

    Epidemiological characteristics of clinical malaria may differ from asymptomatic infections, thus both cross-sectional parasite screening and longitudinal clinical case surveillance are necessary for malaria transmission monitoring and control. In order to monitor malaria transmission, surveillance of clinical malaria from two years of active case surveillance in three cohorts of 6,750 individuals, asymptomatic parasitaemia cases of 5,300 individuals and clinical cases in three study areas were carried out in the western Kenyan highlands in 2009 and 2010. Age distribution, seasonality and spatial clustering were analysed. The results revealed a significant difference in the age distribution of clinical cases between passive and active case surveillance, and between clinical case rate and asymptomatic parasite rate. The number of reported cases from health facilities significantly underestimated clinical malaria incidence. The increase in asymptomatic parasite prevalence from low to high transmission seasons was significantly higher for infants (malaria cases emerged in the uphill areas during the peak season. Different surveillance methods revealed different characteristics of malaria infections. The new transmission hotspots identified during the peak season with only active case surveillance is an important observation with clear implications in the context of malaria elimination. Both mass parasite screening and active case surveillance are essential for malaria transmission monitoring and control.

  11. Understanding the data-action cycle of surveillance: a qualitative study of federal and state stakeholders.

    Science.gov (United States)

    Lindsay, Ana Cristina; Sussner, Katarina M; Greaney, Mary L; Mierzwa, Sharon; Rich-Edwards, Janet; Wiecha, Jean; Peterson, Karen

    2010-03-01

    This qualitative study aims to understand how personnel in state and federal agencies view surveillance systems and the extent to which systematically collected data inform nutrition and physical activity policies and interventions addressing obesity. In-depth interviews were conducted with 17 respondents purposively sampled from state health departments, federal public health agencies, and prevention research centers. All informants acknowledged the importance of surveillance systems and influence of the data-action cycle for monitoring trends and increasing obesity awareness. However, state-level respondents believed surveillance systems should be designed for programmatic purposes, whereas federal participants thought they should be designed for monitoring. Respondents held differing opinions about the flexibility, timeliness, accessibility, and usefulness of existing national surveillance systems, highlighting significant differences in state and federal agencies' perceptions and utilization of surveillance systems. Such discrepancies call for increased communication surrounding purposes and uses of surveillance data, enabling stronger partnerships between state and federal agencies.

  12. Measles in Italy, laboratory surveillance activity during 2010

    Directory of Open Access Journals (Sweden)

    Claudia Fortuna

    2014-12-01

    Full Text Available INTRODUCTION: The European Regional Office of the World Health Organization (WHO/Europe developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. This study describes the measles laboratory surveillance activity performed by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità during 2010. METHODS: Urine, oral fluid and capillary blood samples from 211 suspected measles cases arrived to the NRL from different regions of Italy for confirmation of the clinical diagnosis. Serological and/or molecular assays were performed; after molecular detection, positive samples were sequenced and genotyped. RESULTS AND DISCUSSION: 85% (180/211 of the specimens were confirmed as measles cases and 139 of these were analyzed phylogenetically. The phylogenetic analysis revealed a co-circulation of D4 and D8 genotypes for the reviewed period.

  13. Active surveillance for low-risk prostate cancer.

    Science.gov (United States)

    Bangma, Chris H; Bul, Meelan; van der Kwast, Theo H; Pickles, Tom; Korfage, Ida J; Hoeks, Caroline M; Steyerberg, Ewout W; Jenster, Guido; Kattan, Michael W; Bellardita, Lara; Carroll, Peter R; Denis, Louis J; Parker, Chris; Roobol, Monique J; Emberton, Mark; Klotz, Laurence H; Rannikko, Antti; Kakehi, Yoshiyuki; Lane, Janet A; Schröder, Fritz H; Semjonow, Axel; Trock, Bruce J; Valdagni, Riccardo

    2013-03-01

    Active surveillance (AS) is an important management strategy for men diagnosed with low-risk prostate cancer (PCa). The need for AS is increasing due to the awareness that many PCa are identified that show a low growth potential and therefore are likely to remain clinically asymptomatic during the lifetime of an individual. Currently there is no good method to prevent the overdiagnosis of indolent cancers upfront. During the last decade, several studies on AS around the world have made observations that feed the discussion on how to select and monitor these patients, how to proceed with the research to develop a better and more precise clinical definition of indolent cancers and how to manage men under AS clinically. Furthermore, patients' perspectives have become clearer, and quality of life studies give direction to the practical approach and care for patients and partners. This paper reflects the consensus on the state of the art and the future direction of AS, based on the Inside Track Conference "Active Surveillance for low risk prostate cancer" (Chairmen: C.H. Bangma, NL, and L. Klotz, CA; Co-Chairmen: L.J. Denis, BE, and C. Parker, UK; Scientific Coordinators: M. J. Roobol, NL, and E.W. Steyerberg, NL), organized by the European School of Oncology in collaboration with Europa Uomo in Rotterdam, the Netherlands in January 2012. Topics for discussion were the optimisation of patient selection based on indolent disease definition, the incorporation of therapeutic agents into AS programs, the optimisation of patient care, and the application of emerging technologies and biomarkers.

  14. Low-cost active optical system for fire surveillance

    Science.gov (United States)

    Utkin, A. B.; Lavrov, A. V.; Vilar, R. M.

    2009-06-01

    Detection of smoke plumes using active optical sensors provides many advantages with respect to passive methods of fire surveillance. However, the price of these sensors is often too high as compared to passive fire detection instruments, such as infrared and video cameras. This article describes robust and cost effective diode-laser optical sensor for automatic fire surveillance in industrial environment. Physical aspects of the sensing process allowing to simplify the hardware and software design, eventually leading to significant reduction of manufacturing and maintenance costs, are discussed.

  15. Metabolomic Profiling of Prostate Cancer Progression During Active Surveillance

    Science.gov (United States)

    2012-10-01

    cancer or a history of transurethral resection of the prostate (TURP) for benign prostatic hypertrophy are excluded. Somewhat surprisingly...AD_________________ Award Number: W81XWH-11-1-0451 TITLE: Metabolomic Profiling of Prostate Cancer...29 September 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Metabolomic Profiling of Prostate Cancer Progression During Active Surveillance 5b

  16. Monitoring influenza activity in the United States: a comparison of traditional surveillance systems with Google Flu Trends.

    Directory of Open Access Journals (Sweden)

    Justin R Ortiz

    Full Text Available BACKGROUND: Google Flu Trends was developed to estimate US influenza-like illness (ILI rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. METHODS AND FINDINGS: Influenza activity data from 2003-04 through 2007-08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance, and US Influenza Virologic Surveillance System (CDC Virus Surveillance. Pearson's correlation coefficients with 95% confidence intervals (95% CI were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79. The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89. Most of the outlier observations in both comparisons were from the 2003-04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87 or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90. CONCLUSIONS: This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003-04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior.

  17. Monitoring Influenza Activity in the United States: A Comparison of Traditional Surveillance Systems with Google Flu Trends

    Science.gov (United States)

    Ortiz, Justin R.; Zhou, Hong; Shay, David K.; Neuzil, Kathleen M.; Fowlkes, Ashley L.; Goss, Christopher H.

    2011-01-01

    Background Google Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. Methods and Findings Influenza activity data from 2003–04 through 2007–08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus Surveillance). Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79). The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89). Most of the outlier observations in both comparisons were from the 2003–04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87) or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90). Conclusions This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003–04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior. PMID:21556151

  18. LOW RISK PROSTATE CANCER: ACTIVE TREATMENT OR ACTIVE SURVEILLANCE?

    Science.gov (United States)

    Tomašković, Igor

    2015-09-01

    The widely used screening for prostate cancer with prostate specific antigen has resulted in identification of potentially lethal prostate cancers at a much more curable stage and has been associated with significant falls in prostate cancer mortality. In spite of the fact that prostate cancer is one of the deadliest malignancies in men, the advent of sensitive diagnostic testing has also resulted in detection of low risk cancers due to the high incidence of latent prostate cancer in aging men and prolonged natural history of the disease. This, in turn, has entailed the problem of cancer overdiagnosis and subsequent overtreatment. Approximately 6 times as many men will be diagnosed with the disease as will die from it. Active surveillance appeared as a response to the clearly documented risks of overdiagnosis and overtreatment of low risk prostate cancer for localized prostate cancer. It entails initial expectant management rather than immediate therapy, with 'curative-intent' treatment deferred until there is evidence that the patient is at an increased risk of disease progression. This approach attempts to balance the risks and side effects of overtreatment against the possibility of disease progression and lost opportunity for cure. A systematic literature review brings current knowledge on the subject.

  19. Active surveillance for carbapenem-resistant Enterobacteriaceae using stool specimens submitted for testing for Clostridium difficile.

    Science.gov (United States)

    Banach, David B; Francois, Jeannette; Blash, Stephanie; Patel, Gopi; Jenkins, Stephen G; LaBombardi, Vincent; Kreiswirth, Barry N; Srinivasan, Arjun; Calfee, David P

    2014-01-01

    Active surveillance to identify asymptomatic carriers of carbapenem-resistant Enterobacteriaceae (CRE) is a recommended strategy for CRE control in healthcare facilities. Active surveillance using stool specimens tested for Clostridium difficile is a relatively low-cost strategy to detect CRE carriers. Further evaluation of this and other risk factor-based active surveillance strategies is warranted.

  20. Active surveillance strategy for patients with localised prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk

    2014-01-01

    BACKGROUND: Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving...... resulted in a significant risk of being misclassified according to the definition of progression. The interobserver agreement of biopsy histopathology between expert uropathologist was substantial. Still, the pathologists' disagreement would have resulted in different treatment recommendations in up to 10...... with defined final histopathological findings at radical prostatectomy that was perceived as unacceptable for a continued observational strategy. CONCLUSION: The thesis has demonstrated that active surveillance is feasible and reduces the number of patients undergoing curative intended treatment. However...

  1. Activity-Based Scene Decomposition for Topology Inference of Video Surveillance Network

    Directory of Open Access Journals (Sweden)

    Hongguang Zhang

    2014-01-01

    Full Text Available The topology inference is the study of spatial and temporal relationships among cameras within a video surveillance network. We propose a novel approach to understand activities based on the visual coverage of a video surveillance network. In our approach, an optimal camera placement scheme is firstly presented by using a binary integer programming algorithm in order to maximize the surveillance coverage. Then, each camera view is decomposed into regions based on the Histograms of Color Optical Flow (HCOF, according to the spatial-temporal distribution of activity patterns observed in a training set of video sequences. We conduct experiments by using hours of video sequences captured at an office building with seven camera views, all of which are sparse scenes with complex activities. The results of real scene experiment show that the features of histograms of color optic flow offer important contextual information for spatial and temporal topology inference of a camera network.

  2. The importance of perceived stress management skills for patients with prostate cancer in active surveillance.

    Science.gov (United States)

    Yanez, Betina; Bustillo, Natalie E; Antoni, Michael H; Lechner, Suzanne C; Dahn, Jason; Kava, Bruce; Penedo, Frank J

    2015-04-01

    Little is known about whether and how stress management skills may improve adjustment for men diagnosed with prostate cancer who opt for active surveillance. This study examined whether two types of perceived stress management skills, specifically the ability to relax and confidence in coping, moderated the relationship between prostate cancer (PC) concerns and psychological distress. Participants were 71 ethnically diverse men in active surveillance. Coping confidence moderated the relationship between PC concerns and intrusive thoughts (p .05. Coping confidence also moderated the relationship between PC treatment concerns (a subscale of PC concerns) and intrusive thoughts. At low levels of coping confidence, PC treatment concerns was positively associated with intrusive thoughts, β = .73, p .05. Findings underscore the importance of interventions aimed at improving coping in men undergoing active surveillance.

  3. Low Risk Prostate Cancer and Active Surveillance

    NARCIS (Netherlands)

    M. Bul (Meelan)

    2013-01-01

    textabstractThe first part of this thesis comprises an introduction to prostate cancer and screening (chapter 1). The European Randomized study of Screening for Prostate Cancer (ERSPC) has shown an effect of screening on prostate cancer mortality in favor of the screening population, however, contro

  4. Rule-based versus probabilistic selection for active surveillance using three definitions of insignificant prostate cancer

    NARCIS (Netherlands)

    L.D.F. Venderbos (Lionne); M.J. Roobol-Bouts (Monique); C.H. Bangma (Chris); R.C.N. van den Bergh (Roderick); L.P. Bokhorst (Leonard); D. Nieboer (Daan); Godtman, R; J. Hugosson (Jonas); van der Kwast, T; E.W. Steyerberg (Ewout)

    2016-01-01

    textabstractTo study whether probabilistic selection by the use of a nomogram could improve patient selection for active surveillance (AS) compared to the various sets of rule-based AS inclusion criteria currently used. We studied Dutch and Swedish patients participating in the European Randomized s

  5. A prospective study of health-related quality-of-life outcomes for patients with low-risk prostate cancer managed by active surveillance or radiation therapy.

    Science.gov (United States)

    Banerji, John S; Hurwitz, Lauren M; Cullen, Jennifer; Wolff, Erika M; Levie, Katherine E; Rosner, Inger L; Brand, Timothy C; LʼEsperance, James O; Sterbis, Joseph R; Porter, Christopher R

    2017-05-01

    Patients with low-risk prostate cancer (PCa) often have excellent oncologic outcomes. However, treatment with curative intent can lead to decrements in health-related quality of life (HRQoL). Patients treated with radical prostatectomy have been shown to suffer declines in urinary and sexual HRQoL as compared to those managed with active surveillance (AS). Similarly, patients treated with external-beam radiation therapy (EBRT) are hypothesized to experience greater declines in bowel HRQoL. As health-related quality-of-life (HRQoL) concerns are paramount when selecting among treatment options for low-risk PCa, this study examined HRQoL outcomes in men undergoing EBRT as compared to AS in a prospective, racially diverse cohort. A prospective study of HRQoL in patients with PCa enrolled in the Center for Prostate Disease Research (CPDR) Multicenter National Database was initiated in 2007. The current study included patients diagnosed through April 2014. HRQoL was assessed with the Expanded Prostate Cancer Index Composite (EPIC) and the Medical Outcomes Study Short Form (SF-36). Temporal changes in HRQoL were compared for patients with low-risk PCa managed on AS vs. EBRT at baseline, 1-, 2-, and 3 years post-PCa diagnosis. Longitudinal patterns were modeled using linear regression models fitted with generalized estimating equations (GEE), adjusting for baseline HRQoL, demographic, and clinical patient characteristics. Of the 499 eligible patients with low-risk PCa, 103 (21%) selected AS and 60 (12%) were treated with EBRT. Demographic characteristics of the treatment groups were similar, though a greater proportion of patients in the EBRT group were African American (P = 0.0003). At baseline, both treatment groups reported comparable HRQoL. EBRT patients experienced significantly worse bowel function and bother at 1 year (adjusted mean score: 87 vs. 95, P = 0.001 and 89 vs. 95, P = 0.008, respectively) and 2 years (87 vs. 93, P = 0.007 and 87 vs. 96, P = 0

  6. Online Nonparametric Bayesian Activity Mining and Analysis From Surveillance Video.

    Science.gov (United States)

    Bastani, Vahid; Marcenaro, Lucio; Regazzoni, Carlo S

    2016-05-01

    A method for online incremental mining of activity patterns from the surveillance video stream is presented in this paper. The framework consists of a learning block in which Dirichlet process mixture model is employed for the incremental clustering of trajectories. Stochastic trajectory pattern models are formed using the Gaussian process regression of the corresponding flow functions. Moreover, a sequential Monte Carlo method based on Rao-Blackwellized particle filter is proposed for tracking and online classification as well as the detection of abnormality during the observation of an object. Experimental results on real surveillance video data are provided to show the performance of the proposed algorithm in different tasks of trajectory clustering, classification, and abnormality detection.

  7. An active vision system for multitarget surveillance in dynamic environments.

    Science.gov (United States)

    Bakhtari, Ardevan; Benhabib, Beno

    2007-02-01

    This paper presents a novel agent-based method for the dynamic coordinated selection and positioning of active-vision cameras for the simultaneous surveillance of multiple objects-of-interest as they travel through a cluttered environment with a-priori unknown trajectories. The proposed system dynamically adjusts not only the orientation but also the position of the cameras in order to maximize the system's performance by avoiding occlusions and acquiring images with preferred viewing angles. Sensor selection and positioning are accomplished through an agent-based approach. The proposed sensing-system reconfiguration strategy has been verified via simulations and implemented on an experimental prototype setup for automated facial recognition. Both simulations and experimental analyses have shown that the use of dynamic sensors along with an effective online dispatching strategy may tangibly improve the surveillance performance of a sensing system.

  8. Qualitative insights into how men with low-risk prostate cancer choosing active surveillance negotiate stress and uncertainty.

    Science.gov (United States)

    Mader, Emily M; Li, Hsin H; Lyons, Kathleen D; Morley, Christopher P; Formica, Margaret K; Perrapato, Scott D; Irwin, Brian H; Seigne, John D; Hyams, Elias S; Mosher, Terry; Hegel, Mark T; Stewart, Telisa M

    2017-05-08

    Active surveillance is a management strategy for men diagnosed with early-stage, low-risk prostate cancer in which their cancer is monitored and treatment is delayed. This study investigated the primary coping mechanisms for men following the active surveillance treatment plan, with a specific focus on how these men interact with their social network as they negotiate the stress and uncertainty of their diagnosis and treatment approach. Thematic analysis of semi-structured interviews at two academic institutions located in the northeastern US. Participants include 15 men diagnosed with low-risk prostate cancer following active surveillance. The decision to follow active surveillance reflects the desire to avoid potentially life-altering side effects associated with active treatment options. Men on active surveillance cope with their prostate cancer diagnosis by both maintaining a sense of control over their daily lives, as well as relying on the support provided them by their social networks and the medical community. Social networks support men on active surveillance by encouraging lifestyle changes and serving as a resource to discuss and ease cancer-related stress. Support systems for men with low-risk prostate cancer do not always interface directly with the medical community. Spousal and social support play important roles in helping men understand and accept their prostate cancer diagnosis and chosen care plan. It may be beneficial to highlight the role of social support in interventions targeting the psychosocial health of men on active surveillance.

  9. Worldwide Surveillance, Policy, and Research on Physical Activity and Health: The Global Observatory for Physical Activity.

    Science.gov (United States)

    Varela, Andrea Ramirez; Pratt, Michael; Powell, Kenneth; Lee, I-Min; Bauman, Adrian; Heath, Gregory; Martins, Rafaela Costa; Kohl, Harold; Hallal, Pedro C

    2017-09-01

    The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide. Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information's accuracy and completeness. Associations were calculated among surveillance, policy and research categories. Of the 139 countries, 90.6% reported having completed 1 or more PA survey, but less than one-third had 3 or more. 106 included PA on a national plan, but only one-quarter of these were PA-specific. At least 1 peer reviewed publication was identified for 63.3% of the countries. Positive associations (P < .001) were found between research and policy (ρ = 0.35), research and surveillance (ρ = 0.41), and surveillance and policy (ρ = 0.31). Countries with a standalone plan were more likely to have surveillance. Countries with more research were more likely to have a standalone plan and surveillance. Surveillance, policy, and research indicators were positively correlated, suggesting that action at multiple levels tends to stimulate progress in other areas. Efforts to expand PA-related surveillance, policy, and research in lower income countries are needed.

  10. Active surveillance of prostate cancer in African American men.

    Science.gov (United States)

    Silberstein, Jonathan L; Feibus, Allison H; Maddox, Michael M; Abdel-Mageed, Asim B; Moparty, Krishnarao; Thomas, Raju; Sartor, Oliver

    2014-12-01

    Active surveillance (AS) is a treatment strategy for prostate cancer (PCa) whereby patients diagnosed with PCa undergo ongoing characterization of their disease with the intent of avoiding radical treatment. Previously, AS has been demonstrated to be a reasonable option for men with low-risk PCa, but existing cohorts largely consist of Caucasian Americans. Because African Americans have a greater incidence, more aggressive, and potentially more lethal PCa than Caucasian Americans, it is unclear if AS is appropriate for African Americans. We performed a review of the available literature on AS with a focus on African Americans.

  11. [The limits and possibilities of the Schistosomiasis Information System (SISPCE) for surveillance and control activities].

    Science.gov (United States)

    Farias, Leila Maria Mattos de; Resendes, Ana Paula da Costa; Magalhães, Rosely de Oliveira; Souza-Santos, Reinaldo; Sabroza, Paulo Chagastelles

    2011-10-01

    The aim of this study was to analyze the limits and possibilities of the Information System in the Schistosomiasis Control Program (SISPCE) for characterization and surveillance of the disease at the local level. The data were aggregated to calculate epidemiological indicators such as the program's coverage and intensity of mansoni schistosomiasis infection in the endemic municipalities (counties) in Bahia State, Brazil, from 1999 to 2005. The results indicate that few municipalities have the program activities properly in place, with insufficient records in the system and lack of reporting for characterizing the endemic or providing feedback for proper surveillance and control. However, the SISPCE is still a step forward in schistosomiasis surveillance, requiring systematic action by the municipalities and maintaining a continuous data flow to orient health system managers. It is necessary to incorporate local communities as units of analysis, given their unique characteristics in the production and reproduction of schistosomiasis.

  12. Active surveillance and control programme for Salmonella Dublin in Cattle

    DEFF Research Database (Denmark)

    Nielsen, Liza Rosenbaum; Rattenborg, Erik

    2011-01-01

    surveillance systems. Register data might be useful for design of effective surveillance programmes for Salmonella Dublin in cattle in the future. Statistical analysis of register-based variables confirmed previously known risk factors for becoming test-positive (i.e. purchase of animals from test......This study illustrates how prevalence and incidence of Salmonella Dublin in cattle has been markedly reduced in dairy herds during active surveillance and a control programme targeting infected herds in Denmark from 2002 to 2010. The results suggest that this might by a good alternative to passive......-positive herds, number of cattle in test-positive neighbouring herds, herd size and season), but also pointed out additional factors affecting the risk of dairy herds changing status from test-negative to test-positive (indicative of new or recurrent infection). Increasing geometric cell count measured through...

  13. Species distribution and susceptibility profile of yeasts isolated from blood cultures: results of a multicenter active laboratory-based surveillance study in Argentina.

    Science.gov (United States)

    Córdoba, Susana; Vivot, Walter; Bosco-Borgeat, Maria E; Taverna, Constanza; Szusz, Wanda; Murisengo, Omar; Isla, Guillermina; Davel, Graciela

    2011-01-01

    The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST). A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %), Candida parapsilosis (26 %), Candida tropicalis (15.4 %) and Candida glabrata (4.3 %). Other uncommon species, such as Candida viswanathii (0.6 %), Candida haemulonii (0.4 %), Candida inconspicua (0.2 %) and Candida fermentati (0.2 %) were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC 8 mg/l), 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.

  14. Vascular access surveillance: case study of a false paradigm.

    Science.gov (United States)

    Paulson, William D; Moist, Louise; Lok, Charmaine E

    2013-01-01

    The hemodialysis vascular access surveillance controversy provides a case study of how enthusiasm for a new test or treatment can lead to adoption of a false paradigm. Paradigms are the beliefs and assumptions shared by those in a field of knowledge, and are commonly included in clinical practice guidelines. The guidelines of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative recommend that arteriovenous vascular accesses undergo routine surveillance for detection and correction of stenosis. This recommendation is based on the paradigm that surveillance of access blood flow or dialysis venous pressure combined with correction of stenosis improves access outcomes. However, the quality of evidence that supports this paradigm has been widely criticized. We tested the validity of the surveillance paradigm by applying World Health Organization (WHO) criteria for evaluating screening tests to a literature review of published vascular access studies. These criteria include four components: undesired condition, screening test, intervention, and desired outcome. The WHO criteria show that surveillance as currently practiced fails all four components and provides little or no significant benefit, suggesting that surveillance is a false paradigm. Once a paradigm is established, however, challenges to its validity are usually resisted even as new evidence indicates the paradigm is not valid. Thus, it is paramount to apply rigorous criteria when developing guidelines. Regulators may help promote needed changes in paradigms when cost and safety considerations coincide. © 2013 Wiley Periodicals, Inc.

  15. Foodborne Diseases Active Surveillance Network-2 Decades of Achievements, 1996-2015.

    Science.gov (United States)

    Henao, Olga L; Jones, Timothy F; Vugia, Duc J; Griffin, Patricia M

    2015-09-01

    The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States. FoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome. Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet's major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care-seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues. The importance of FoodNet's ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly.

  16. Pathological findings following radical prostatectomy in patients who are candidates for active surveillance: impact of varying PSA levels

    Institute of Scientific and Technical Information of China (English)

    Dong Il Kang; Thomas L.Jang; Jeongyun Jeong; Eun Young Choi; Kelly Johnson; Dong Hyeon Lee; Wun-Jae Kim; Isaac Yi Kim1

    2011-01-01

    Active surveillance is an acceptable treatment option in men with a low-risk prostate cancer.In the present study,we have retrospectively reviewed the outcomes of 509 men who fit the criteria for active surveillance but selected radical prostatectomy.Then,the impact of varying prostate-specific antigen (PSA) levels on the risk of upstaging and upgrading in these patients was assessed.Pathological characteristics of patients who fulfilled the inclusion criteria under three active surveillance criteria-those of the University of California-San Francisco,the National Cancer Institute and the European Association of Urology-were examined.The proportion of men who were deemed candidates for active surveillance but were subsequently upstaged or upgraded was determined.Of 509 patients,186 (36.5%),132 (25.9%) and 88 (17.3%) men fulfilled the active surveillance criteria,respectively.Upgrading (Gleason scores 7-10) ranged from 32.8% to 38.6%,while upstaging ( ≥ pT3) ranged from 10.2% to 12.5%,depending on the three active surveillance criteria.After a median follow-up of 24 months,three patients developed a biochemical recurrence.When the impact of varying PSA levels was examined using a test for trend analysis in the context of PSA for each protocol,rates of upstaging were lower in men with PSA <4 ng ml-1.However,there was no impact of varying PSA levels on upgrading.In conclusion,commonly used active surveillance protocols carry the risks of upgrading and upstaging.More reliable and accurate markers are needed to better stratify the risks of men who are appropriate candidates for active surveillance.

  17. Obesity and Prostate Cancer: A Focused Update on Active Surveillance, Race, and Molecular Subtyping.

    Science.gov (United States)

    Vidal, Adriana C; Freedland, Stephen J

    2017-07-01

    In 2012, we published a detailed review on obesity and prostate cancer. Since then, new studies have brought further understanding regarding the role of obesity in selecting active surveillance candidates, and differing associations between obesity and prostate cancer as a function of race and molecular subtype of prostate cancer. To review new manuscripts on these new concepts for which there were limited data before 2012. A PubMed search from July 2012 to March 2016 was performed using the terms "prostate cancer" and "obesity". Of 450 articles, we included 15 related to these three topics. Among men on active surveillance or candidates for active surveillance, multiple studies suggest that the risk of upgrading is higher for obese men. No study has shown long-term oncologic differences, and the risk of prostate cancer mortality remains low. One study suggested that the link between obesity and prostate cancer risk is stronger among black men; however, other studies found that obesity is correlated with aggressive disease regardless of race. Two studies found that the associations between obesity and prostate cancer (ie, fewer low-grade cancers and yet more aggressive cancers) was limited to men with TMPRSS2-ERG-positive tumors. The past 4 yr has seen much new work on the obesity-prostate cancer link. If confirmed in other studies, these findings provide novel insights into not only the link between obesity and prostate cancer but also prostate cancer biology in general. While their outcomes may be slightly worse, obese men with localized prostate cancer should not be discouraged from active surveillance. Early studies suggest there may be subtypes of patients in whom obesity is more strongly linked to aggressive disease. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  18. Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality.

    Science.gov (United States)

    Necyk, Candace; Tsuyuki, Ross T; Boon, Heather; Foster, Brian C; Legatt, Don; Cembrowski, George; Murty, Mano; Barnes, Joanne; Charrois, Theresa L; Arnason, John T; Ware, Mark A; Rosychuk, Rhonda J; Vohra, Sunita

    2014-03-28

    To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. Cross-sectional study of screened patients. 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30 July 2011. The participating pharmacy staff screened consecutive patients, or agents of patients, who were dropping or picking up prescription medications. Patients were screened to determine the proportions of them using prescription drugs and/or NHPs, as well as their respective AE rates. All AEs reported by the screened patients who took a NHP, consented to, and were available for, a detailed telephone interview (14%) were adjudicated fully to assess for causality. Over a total of 105 pharmacy weeks and 1118 patients screened, 410 patients reported taking prescription drugs only (36.7%; 95% CI 33.9% to 39.5%), 37 reported taking NHPs only (3.3%; 95% CI 2.4% to 4.5%) and 657 reported taking prescription drugs and NHPs concurrently (58.8%; 95% CI 55.9% to 61.6%). In total, 54 patients reported an AE, representing 1.2% (95% CI 0.51% to 2.9%), 2.7% (95% CI 0.4% to 16.9%) and 7.3% (95% CI 5.6% to 9.6%) of each population, respectively. Compared with patients who reported using prescription drugs, the patients who reported using prescription drugs and NHPs concurrently were 6.4 times more likely to experience an AE (OR; 95% CI 2.52 to 16.17; ppharmacies take NHPs and prescription drugs concurrently, and of those, 7.4% (95% CI 6.3% to 8.8%) report an AE. A substantial proportion of community pharmacy patients use prescription drugs and NHPs concurrently; these patients are at a greater risk of experiencing an AE. Active surveillance provides a means of detecting such AEs and collecting high-quality data on which causality assessment can be based.

  19. Surveillance strategies for Classical Swine Fever in wild boar – a comprehensive evaluation study to ensure powerful surveillance

    Science.gov (United States)

    Schulz, Katja; Peyre, Marisa; Staubach, Christoph; Schauer, Birgit; Schulz, Jana; Calba, Clémentine; Häsler, Barbara; Conraths, Franz J.

    2017-01-01

    Surveillance of Classical Swine Fever (CSF) should not only focus on livestock, but must also include wild boar. To prevent disease transmission into commercial pig herds, it is therefore vital to have knowledge about the disease status in wild boar. In the present study, we performed a comprehensive evaluation of alternative surveillance strategies for Classical Swine Fever (CSF) in wild boar and compared them with the currently implemented conventional approach. The evaluation protocol was designed using the EVA tool, a decision support tool to help in the development of an economic and epidemiological evaluation protocol for surveillance. To evaluate the effectiveness of the surveillance strategies, we investigated their sensitivity and timeliness. Acceptability was analysed and finally, the cost-effectiveness of the surveillance strategies was determined. We developed 69 surveillance strategies for comparative evaluation between the existing approach and the novel proposed strategies. Sampling only within sub-adults resulted in a better acceptability and timeliness than the currently implemented strategy. Strategies that were completely based on passive surveillance performance did not achieve the desired detection probability of 95%. In conclusion, the results of the study suggest that risk-based approaches can be an option to design more effective CSF surveillance strategies in wild boar. PMID:28266576

  20. Surveillance strategies for Classical Swine Fever in wild boar - a comprehensive evaluation study to ensure powerful surveillance.

    Science.gov (United States)

    Schulz, Katja; Peyre, Marisa; Staubach, Christoph; Schauer, Birgit; Schulz, Jana; Calba, Clémentine; Häsler, Barbara; Conraths, Franz J

    2017-03-07

    Surveillance of Classical Swine Fever (CSF) should not only focus on livestock, but must also include wild boar. To prevent disease transmission into commercial pig herds, it is therefore vital to have knowledge about the disease status in wild boar. In the present study, we performed a comprehensive evaluation of alternative surveillance strategies for Classical Swine Fever (CSF) in wild boar and compared them with the currently implemented conventional approach. The evaluation protocol was designed using the EVA tool, a decision support tool to help in the development of an economic and epidemiological evaluation protocol for surveillance. To evaluate the effectiveness of the surveillance strategies, we investigated their sensitivity and timeliness. Acceptability was analysed and finally, the cost-effectiveness of the surveillance strategies was determined. We developed 69 surveillance strategies for comparative evaluation between the existing approach and the novel proposed strategies. Sampling only within sub-adults resulted in a better acceptability and timeliness than the currently implemented strategy. Strategies that were completely based on passive surveillance performance did not achieve the desired detection probability of 95%. In conclusion, the results of the study suggest that risk-based approaches can be an option to design more effective CSF surveillance strategies in wild boar.

  1. An early (3-6 weeks) active surveillance study to assess the safety of pandemic influenza vaccine Focetria in a province of Emilia-Romagna region, Italy - part one.

    Science.gov (United States)

    Candela, Silvia; Pergolizzi, Sara; Ragni, Pietro; Cavuto, Silvio; Nobilio, Lucia; Di Mario, Simona; Dragosevic, Valentina; Groth, Nicola; Magrini, Nicola

    2013-02-27

    An observational, non-comparative, prospective, surveillance study of individuals vaccinated with the MF59-adjuvanted A/H1N1 influenza vaccine, Focetria, (Novartis Vaccines & Diagnostics, Siena, Italy), was performed in Italy during the 2009 A/H1N1 influenza pandemic. This study assessed the short-term (six-week) safety profile of the investigational vaccine in real time. After vaccination (N=7943), adverse events (AE) were assessed using both active (telephone) and passive (healthcare database) follow-up in enrolled vaccinated subjects, including infants (6-23 months), pregnant women, and the immunosuppressed. The treating physicians of all subjects experiencing AEs post-vaccination were consulted for clinical information on the conditions reported. All AEs were coded according to ICD-10. A total of 1583 AEs occurred during the study, 67 (4.2%) of which were serious adverse events (SAEs). One SAE was considered to be possibly related to vaccination (transitory and ill-defined neurologic disorder experienced by a 16-year-old asthmatic male). Three adverse events of special interest (AESI) were identified (convulsions experienced by two epileptic subjects), none of which were considered to be vaccine-related. Six individuals died during the study period, in each case the cause of death was not related to vaccination (four cases of severe underlying co-morbidity, one case of psychoactive drug misuse, and one case of acute myocardial infarction). No cases of clinically relevant AEs, SAEs, or AESI were observed within a six-week period of vaccine administration. In accordance with existing clinical and post-marketing safety data, the results of this active surveillance study demonstrate a good safety profile for the MF59-adjuvanted A/H1N1 vaccine, Focetria, within the general population. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. The study of parasite sharing for surveillance of zoonotic diseases

    Science.gov (United States)

    Farrell, Maxwell J.; Berrang-Ford, Lea; Davies, T. Jonathan

    2013-03-01

    Determining the factors that influence the transmission of parasites among hosts is important for directing surveillance of animal parasites before they successfully emerge in humans, and increasing the efficacy of programs for the control and management of zoonotic diseases. Here we present a review of recent advances in the study of parasite sharing, wildlife ecology, and epidemiology that could be extended and incorporated into proactive surveillance frameworks for multi-host infectious diseases. These methods reflect emerging interdisciplinary techniques with significant promise for the identification of future zoonotic parasites and unknown reservoirs of current zoonoses, strategies for the reduction of parasite prevalence and transmission among hosts, and decreasing the burden of infectious diseases.

  3. [From surveillance to work-related accident prevention: the contribution of the ergonomics of the activity].

    Science.gov (United States)

    Vilela, Rodolfo Andrade de Gouveia; Almeida, Ildeberto Muniz de; Mendes, Renata Wey Berti

    2012-10-01

    Work-related accidents are complex phenomena determined by the work organization process, the dimensions of which are usually invisible to surveillance agents. The scope of this paper was a case study based on documentary evidence to analyze and compare the success of an intervention conducted at a meat processing and packaging factory, by focusing on checking health and safety norms in 1997, and incorporating ergonomic concepts in 2008. In 1997, surveillance actions focused primarily on visible risk factors. Despite fulfilling sanitation requirements, the company still had an annual accident rate of 26% in 2008, which motivated the search for a new approach. In 2008, it was seen that accidents were caused by a vicious cycle involving intense work, technical inadequacy, absenteeism and high turnover (84%) that led the company to recruit inexperienced workers. This scenario was aggravated by authoritarian management practices. The ergonomics of the activity contributed to the understanding of organizational causes -thus superseding the normative aspects of traditional surveillance - which revealed the importance of ensuring that surveillance actions for prevention are more effective.

  4. Species distribution and susceptibility profile of yeasts isolated from blood cultures: results of a multicenter active laboratory-based surveillance study in Argentina

    Directory of Open Access Journals (Sweden)

    Susana Córdoba

    2011-09-01

    Full Text Available The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST. A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %, Candida parapsilosis (26 %, Candida tropicalis (15.4 % and Candida glabrata (4.3 %. Other uncommon species, such as Candida viswanathii (0.6 %, Candida haemulonii (0.4 %, Candida inconspicua (0.2 % and Candida fermentati (0.2 % were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC 8 mg/l, 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.Distribución de especies y perfil de sensibilidad de levaduras aisladas de hemocultivos: resultados de un estudio multicéntrico de vigilancia de laboratorio en Argentina. El Departamento Micología del Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán" condujo el segundo estudio multicéntrico nacional sobre funge- mias debidas a levaduras. El objetivo fue obtener datos actualizados sobre la distribución de especies

  5. Brucella abortus surveillance of cattle in Fiji, Papua New Guinea, Vanuatu, the Solomon Islands and a case for active disease surveillance as a training tool.

    Science.gov (United States)

    Tukana, Andrew; Hedlefs, Robert; Gummow, Bruce

    2016-10-01

    There have been no surveys of the cattle population for brucellosis in the Pacific Island Countries and Territories (PICTs) for more than 15 years. This study used disease surveillance as a capacity building training tool and to examine some of the constraints that impede surveillance in PICTs. The study also developed and implemented a series of surveys for detecting antibodies to B. abortus in cattle in Fiji, Papua New Guinea, Vanuatu and the Solomon Islands contributing to OIE requirements. The findings indicated lack of funds, lack of technical capacity, shortage of veterinarians, high turnover of in-country officials and lack of awareness on the impacts of animal diseases on public health that were constraining active disease surveillance. During the development and implementation of the surveys, constraints highlighted were outdated census data on farm numbers and cattle population, lack of funds for mobilisation of officials to carry out the surveys, lack of equipment for collecting and processing samples, lack of staff knowledge on blood sampling, geographical difficulties and security in accessing farms. Some of the reasons why these were constraints are discussed with likely solutions presented. The detection surveys had the objectives of building capacity for the country officials and demonstrating freedom from brucellosis in cattle for PNG, Vanuatu and the Solomon Islands. PNG, Vanuatu and the Solomon Islands all demonstrated freedom from bovine brucellosis in the areas surveyed using the indirect ELISA test. Fiji had an outbreak of brucellosis, and the objective was to determine its distribution and prevalence on untested farms. The Muaniweni district surveyed during the training had a 95 % confidence interval for true prevalence between 1.66 and 5.45 %. The study showed that active disease surveillance could be used as a tool for training officials thus, improves surveillance capacity in resource poor countries.

  6. Surveillance of Autism.

    Science.gov (United States)

    Boyle, Coleen A.; Bertrand, Jacquelyn; Yeargin-Allsopp, Marshalyn

    1999-01-01

    This article describes the autism surveillance activities of the Center for Disease Control and Prevention. It considers why surveillance to track prevalence of autistic disorders is needed, how such surveillance is conducted, and the special challenges of autism surveillance. (DB)

  7. An assessment of self-reported physical activity instruments in young people for population surveillance: Project ALPHA

    Directory of Open Access Journals (Sweden)

    Pearson Natalie

    2011-01-01

    Full Text Available Abstract Background The assessment of physical activity is an essential part of understanding patterns and influences of behaviour, designing interventions, and undertaking population surveillance and monitoring, but it is particularly problematic when using self-report instruments with young people. This study reviewed available self-report physical activity instruments developed for use with children and adolescents to assess their suitability and feasibility for use in population surveillance systems, particularly in Europe. Methods Systematic searches and review, supplemented by expert panel assessment. Results Papers (n = 437 were assessed as potentially relevant; 89 physical activity measures were identified with 20 activity-based measures receiving detailed assessment. Three received support from the majority of the expert group: Physical Activity Questionnaire for Children/Adolescents (PAQ-C/PAQ-A, Youth Risk Behaviour Surveillance Survey (YRBS, and the Teen Health Survey. Conclusions Population surveillance of youth physical activity is strongly recommended and those involved in developing and undertaking this task should consider the three identified shortlisted instruments and evaluate their appropriateness for application within their national context. Further development and testing of measures suitable for population surveillance with young people is required.

  8. Syndromic surveillance in Vanuatu since Cyclone Pam: a descriptive study

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    George Worwor

    2016-12-01

    Full Text Available In 2012, Vanuatu designed and implemented a syndromic surveillance system based on the guidelines developed by the Pacific Community and the World Health Organization to provide early warning of outbreaks and other important public health events. Four core syndromes were endorsed for surveillance: acute fever and rash, prolonged fever, influenza-like illness and acute watery diarrhoea. In March 2015, Vanuatu was struck by Cyclone Pam, after which several important changes and improvements to the country's syndromic surveillance were made. To date, there has been no formal evaluation of whether regular reports are occurring or that core syndromes are being documented. We therefore carried out a descriptive study in the 11 sentinel sites in Vanuatu conducting syndromic surveillance between July and December 2015. There was a total of 53 822 consultations which were higher in the first 13 weeks (n = 29 622 compared with the last 13 weeks (n = 24 200. During the six months, there were no cases of acute fever and rash or prolonged fever. There were cases with influenza-like illness from week 27 to 35, but no case was reported after week 35. Acute watery diarrhoea occurred in one or two cases per week during the whole study period. For these two core syndromes, there were generally more females than males, and about one third were children aged under 5 years. In conclusion, Vanuatu implemented changes to its new syndromic surveillance system from July to December 2015, although laboratory components had not yet been incorporated. The laboratory components are working in 2016 and will be the subject of a further report.

  9. Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

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    Jevremović Ivana

    2002-01-01

    Full Text Available The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome – the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization.

  10. Active surveillance for avian influenza virus, Egypt, 2010-2012.

    Science.gov (United States)

    Kayali, Ghazi; Kandeil, Ahmed; El-Shesheny, Rabeh; Kayed, Ahmed S; Gomaa, Mokhtar M; Maatouq, Asmaa M; Shehata, Mahmoud M; Moatasim, Yassmin; Bagato, Ola; Cai, Zhipeng; Rubrum, Adam; Kutkat, Mohamed A; McKenzie, Pamela P; Webster, Robert G; Webby, Richard J; Ali, Mohamed A

    2014-04-01

    Continuous circulation of influenza A(H5N1) virus among poultry in Egypt has created an epicenter in which the viruses evolve into newer subclades and continue to cause disease in humans. To detect influenza viruses in Egypt, since 2009 we have actively surveyed various regions and poultry production sectors. From August 2010 through January 2013, >11,000 swab samples were collected; 10% were positive by matrix gene reverse transcription PCR. During this period, subtype H9N2 viruses emerged, cocirculated with subtype H5N1 viruses, and frequently co-infected the same avian host. Genetic and antigenic analyses of viruses revealed that influenza A(H5N1) clade 2.2.1 viruses are dominant and that all subtype H9N2 viruses are G1-like. Cocirculation of different subtypes poses concern for potential reassortment. Avian influenza continues to threaten public and animal health in Egypt, and continuous surveillance for avian influenza virus is needed.

  11. [Active surveillance in prostate cancer and quality of life].

    Science.gov (United States)

    Dominguez Escrig, Jose L; Romero, Rocio

    2014-06-01

    Active surveillance was born as a therapeutic strategy for a well selected group of patients with low risk prostate cancer with the aim to defer or completely avoid the negative impact of secondary effects of curative therapies. Nevertheless, the patient who chooses this treatment does it at the expense of greater anxiety and doubts about the possible progression of the disease. The main psychological features influencing the quality of life of these patients are, on one hand anxiety, due to the uncertainty and fear to disease progression, and on the other hand, the difficult decision making process. Among the factors that seem to influence the election are: urologist's recommendation, effects on urinary function, age and impact of the therapy on sexual function. In the timorous journey walked, it is recommended to apply psycho-educational programs, with the objective of increasing the perceived control and adaptive confrontation. We propose an intervention with 4 group sessions, the objectives of which would be first to improve the decision making process and diminish the fear to progression and, second to reinforce the information already given at the time of diagnosis and increase the sensation of control, e.g promoting healthy habits.

  12. Real-time Prescription Surveillance and its Application to Monitoring Seasonal Influenza Activity in Japan

    Science.gov (United States)

    Ohkusa, Yasushi; Ibuka, Yoko; Kawanohara, Hirokazu; Taniguchi, Kiyosu; Okabe, Nobuhiko

    2012-01-01

    Background Real-time surveillance is fundamental for effective control of disease outbreaks, but the official sentinel surveillance in Japan collects information related to disease activity only weekly and updates it with a 1-week time lag. Objective To report on a prescription surveillance system using electronic records related to prescription drugs that was started in 2008 in Japan, and to evaluate the surveillance system for monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. Methods We developed an automatic surveillance system using electronic records of prescription drug purchases collected from 5275 pharmacies through the application service provider’s medical claims service. We then applied the system to monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. The surveillance system collected information related to drugs and patients directly and automatically from the electronic prescription record system, and estimated the number of influenza cases based on the number of prescriptions of anti-influenza virus medication. Then it shared the information related to influenza activity through the Internet with the public on a daily basis. Results During the 2009–2010 influenza season, the number of influenza patients estimated by the prescription surveillance system between the 28th week of 2009 and the 12th week of 2010 was 9,234,289. In the 2010–2011 influenza season, the number of influenza patients between the 36th week of 2010 and the 12th week of 2011 was 7,153,437. The estimated number of influenza cases was highly correlated with that predicted by the official sentinel surveillance (r = .992, P prescription surveillance system produced a good approximation of activity patterns. Conclusions Our prescription surveillance system presents great potential for monitoring influenza activity and for providing early detection of infectious disease outbreaks. PMID:22249906

  13. Development of an active risk-based surveillance strategy for avian influenza in Cuba.

    Science.gov (United States)

    Ferrer, E; Alfonso, P; Ippoliti, C; Abeledo, M; Calistri, P; Blanco, P; Conte, A; Sánchez, B; Fonseca, O; Percedo, M; Pérez, A; Fernández, O; Giovannini, A

    2014-09-01

    The authors designed a risk-based approach to the selection of poultry flocks to be sampled in order to further improve the sensitivity of avian influenza (AI) active surveillance programme in Cuba. The study focused on the western region of Cuba, which harbours nearly 70% of national poultry holdings and comprise several wetlands where migratory waterfowl settle (migratory waterfowl settlements - MWS). The model took into account the potential risk of commercial poultry farms in western Cuba contracting from migratory waterfowl of the orders Anseriformes and Charadriiformes through dispersion for pasturing of migratory birds around the MWS. We computed spatial risk index by geographical analysis with Python scripts in ESRI(®) ArcGIS 10 on data projected in the reference system NAD 1927-UTM17. Farms located closer to MWS had the highest values for the risk indicator pj and in total 31 farms were chosen for targeted surveillance during the risk period. The authors proposed to start active surveillance in the study area 3 weeks after the onset of Anseriformes migration, with additional sampling repeated twice in the same selected poultry farms at 15 days interval (Comin et al., 2012; EFSA, 2008) to cover the whole migration season. In this way, the antibody detectability would be favoured in case of either a posterior AI introduction or enhancement of a previous seroprevalence under the sensitivity level. The model identified the areas with higher risk for AIV introduction from MW, aiming at selecting poultry premises for the application of risk-based surveillance. Given the infrequency of HPAI introduction into domestic poultry populations and the relative paucity of occurrences of LPAI epidemics, the evaluation of the effectiveness of this approach would require its application for several migration seasons to allow the collection of sufficient reliable data.

  14. Comparative in vitro activity of carbapenems against major Gram-negative pathogens: results of Asia-Pacific surveillance from the COMPACT II study.

    Science.gov (United States)

    Kiratisin, Pattarachai; Chongthaleong, Anan; Tan, Thean Yen; Lagamayo, Evelina; Roberts, Sally; Garcia, Jemelyn; Davies, Todd

    2012-04-01

    Resistance rates amongst Gram-negative pathogens are increasing in the Asia-Pacific region. The Comparative Activity of Carbapenem Testing (COMPACT) II study surveyed the carbapenem susceptibility and minimum inhibitory concentrations (MICs) of doripenem, imipenem and meropenem against 1260 major Gram-negative pathogens isolated from hospitalised patients at 20 centres in five Asia-Pacific countries (New Zealand, the Philippines, Singapore, Thailand and Vietnam) during 2010. Pseudomonas aeruginosa (n=625), Enterobacteriaceae (n=500), and other Gram-negative pathogens including Acinetobacter baumannii (n=135) were collected from patients with bloodstream infection (32.2%), nosocomial pneumonia including ventilator-associated pneumonia (58.1%), and complicated intra-abdominal infection (9.7%), with 36.7% being isolated from patients in an Intensive Care Unit. As high as 29.8% of P. aeruginosa and 73.0% of A. baumannii isolates were not susceptible to at least a carbapenem, whereas the majority of Enterobacteriaceae (97.2%) were susceptible to all carbapenems. Respective MIC(50)/MIC(90) values (MICs for 50% and 90% of the organisms, respectively) of doripenem, imipenem and meropenem were: 0.38/8, 1.5/32 and 0.38/16 mg/L for P. aeruginosa; 0.023/0.094, 0.25/0.5 and 0.032/0.094 mg/L for Enterobacteriaceae; and 32/64, 32/128 and 32/64 mg/L for A. baumannii. Doripenem and meropenem had comparable activity against P. aeruginosa, both being more active than imipenem. All carbapenems were highly potent against Enterobacteriaceae, although imipenem demonstrated higher MIC values than doripenem and meropenem. The three carbapenems showed less activity against A. baumannii. The high prevalence of carbapenem resistance amongst important nosocomial pathogens (P. aeruginosa and A. baumannii) warrants rigorous infection control measures and appropriate antimicrobial use in the Asia-Pacific region.

  15. [Results of active surveillance in low and intermediate risk prostate cancer].

    Science.gov (United States)

    Llorente, Carlos; Diaz Goizueta, Francisco Javier; Hernandez, Virginia; de la Morena, Jose Manuel; de la Peña, Enrique

    2014-06-01

    In this article we review the most significant published papers on active surveillance in prostate cancer and present the results of our case series. We used as main response variables the percentage of patients remaining in surveillance and the oncological results presented as global, cancer specific and metastasis free survivals. Globally, in published series 71.2% of patients included in active surveillance programs, 10-year overall survival is 68% in the series with longer follow up, and cancer-specific survival varies from 97% to 100%. In our series of 144 patients with median follow up of 3.2 years, 76.3% of the patients continue on surveillance. 24 patients (15.9%) stopped surveillance due to histological progression. 5 patients (21.3%) out of the 23 undergoing surgery presented unfavorable pathological criteria on prostatectomy specimen. No patient has died or developed metastases.

  16. [Risk factors in police activities: operational criticism in surveillance programs].

    Science.gov (United States)

    Ciprani, Fabrizio; Moroni, Maria; Conte, Giovanni

    2014-01-01

    The planning of specific health surveillance programs for police officers is extremely complex due to difficulty in predictability and variety of occupational hazards. Even in the case of conventional occupational risk factors clearly identified by current regulations, particular working conditions may require specific assessment to effectively identify and quantify the risk of occupational exposure. An extensive program of health surveillance, aimed at promoting overall health and effectiveness of the operators, would be really desirable, in order to help better address a number of risks that cannot be easily predicted. The progressive increase in the average age of the working population and the increasing prevalence of chronic degenerative diseases, may also suggest the need for health surveillance procedures designed to verify continued unqualified suitability to police service, providing for the identification of diversified suitability profiles in relation to age and state of health: accordingly, in regard to our field of interest, there is a close link between medico-legal eligibility and occupational medicine.

  17. A simulation study comparing aberration detection algorithms for syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Painter Ian

    2007-03-01

    Full Text Available Abstract Background The usefulness of syndromic surveillance for early outbreak detection depends in part on effective statistical aberration detection. However, few published studies have compared different detection algorithms on identical data. In the largest simulation study conducted to date, we compared the performance of six aberration detection algorithms on simulated outbreaks superimposed on authentic syndromic surveillance data. Methods We compared three control-chart-based statistics, two exponential weighted moving averages, and a generalized linear model. We simulated 310 unique outbreak signals, and added these to actual daily counts of four syndromes monitored by Public Health – Seattle and King County's syndromic surveillance system. We compared the sensitivity of the six algorithms at detecting these simulated outbreaks at a fixed alert rate of 0.01. Results Stratified by baseline or by outbreak distribution, duration, or size, the generalized linear model was more sensitive than the other algorithms and detected 54% (95% CI = 52%–56% of the simulated epidemics when run at an alert rate of 0.01. However, all of the algorithms had poor sensitivity, particularly for outbreaks that did not begin with a surge of cases. Conclusion When tested on county-level data aggregated across age groups, these algorithms often did not perform well in detecting signals other than large, rapid increases in case counts relative to baseline levels.

  18. Surveillance for Neisseria meningitidis Disease Activity and Transmission Using Information Technology.

    Directory of Open Access Journals (Sweden)

    S Sohail Ahmed

    Full Text Available While formal reporting, surveillance, and response structures remain essential to protecting public health, a new generation of freely accessible, online, and real-time informatics tools for disease tracking are expanding the ability to raise earlier public awareness of emerging disease threats. The rationale for this study is to test the hypothesis that the HealthMap informatics tools can complement epidemiological data captured by traditional surveillance monitoring systems for meningitis due to Neisseria meningitides (N. meningitides by highlighting severe transmissible disease activity and outbreaks in the United States.Annual analyses of N. meningitides disease alerts captured by HealthMap were compared to epidemiological data captured by the Centers for Disease Control's Active Bacterial Core surveillance (ABCs for N. meningitides. Morbidity and mortality case reports were measured annually from 2010 to 2013 (HealthMap and 2005 to 2012 (ABCs.HealthMap N. meningitides monitoring captured 80-90% of alerts as diagnosed N. meningitides, 5-20% of alerts as suspected cases, and 5-10% of alerts as related news articles. HealthMap disease alert activity for emerging disease threats related to N. meningitides were in agreement with patterns identified historically using traditional surveillance systems. HealthMap's strength lies in its ability to provide a cumulative "snapshot" of weak signals that allows for rapid dissemination of knowledge and earlier public awareness of potential outbreak status while formal testing and confirmation for specific serotypes is ongoing by public health authorities.The underreporting of disease cases in internet-based data streaming makes inadequate any comparison to epidemiological trends illustrated by the more comprehensive ABCs network published by the Centers for Disease Control. However, the expected delays in compiling confirmatory reports by traditional surveillance systems (at the time of writing, ABCs data

  19. Situational awareness of influenza activity based on multiple streams of surveillance data using multivariate dynamic linear model.

    Directory of Open Access Journals (Sweden)

    Eric H Y Lau

    Full Text Available BACKGROUND: Multiple sources of influenza surveillance data are becoming more available; however integration of these data streams for situational awareness of influenza activity is less explored. METHODS AND RESULTS: We applied multivariate time-series methods to sentinel outpatient and school absenteeism surveillance data in Hong Kong during 2004-2009. School absenteeism data and outpatient surveillance data experienced interruptions due to school holidays and changes in public health guidelines during the pandemic, including school closures and the establishment of special designated flu clinics, which in turn provided 'drop-in' fever counts surveillance data. A multivariate dynamic linear model was used to monitor influenza activity throughout epidemics based on all available data. The inferred level followed influenza activity closely at different times, while the inferred trend was less competent with low influenza activity. Correlations between inferred level and trend from the multivariate model and reference influenza activity, measured by the product of weekly laboratory influenza detection rates and weekly general practitioner influenza-like illness consultation rates, were calculated and compared with those from univariate models. Over the whole study period, there was a significantly higher correlation (ρ = 0.82, p≤0.02 for the inferred trend based on the multivariate model compared to other univariate models, while the inferred trend from the multivariate model performed as well as the best univariate model in the pre-pandemic and the pandemic period. The inferred trend and level from the multivariate model was able to match, if not outperform, the best univariate model albeit with missing data plus drop-in and drop-out of different surveillance data streams. An overall influenza index combining level and trend was constructed to demonstrate another potential use of the method. CONCLUSIONS: Our results demonstrate the

  20. A REVIEW OF HUMAN ACTIVITY RECONGNITION AND BEHAVIOR UNDERSTANDING IN VIDEO SURVEILLANCE

    Directory of Open Access Journals (Sweden)

    A.R.Revathi

    2012-07-01

    Full Text Available This paper presents a survey of activity recognition and understanding the behaviour of human activity in video sequence. The major goal of this paper is to provide a general review on the overall process of a surveillance system used in the current trend. Visual surveillance system is directed on automatic identification of events of interest, especially on tracking and classification of moving objects. The processing step of the video surveillance system includes the following stages: Surrounding model, object representation, object tracking, activity recognition and behaviour understanding. It describes techniques that use to define a general set of activities that are applicable to a wide range of scenes and environments in video sequence. The review methods used for real-time surveillance through a set of events for further analysis triggering, including virtual fencing, speed profiling, behaviour classification, anomaly detection, and object interaction.

  1. Tools to identify the men with prostate cancer most appropriate for active surveillance?

    Directory of Open Access Journals (Sweden)

    Robert H Getzenberg

    2014-02-01

    Full Text Available A great deal of effort is underway in order to identify those men with prostate cancer felicitous for active surveillance with greater precision than that afforded to us today. In the manuscript by Irshad et al. the authors evaluate a novel set of genes associated with senescence and aging as tools that can provide guidance regarding the indolent nature of an individual's prostate cancer with validation using both mRNA and protein analyses. While additional studies are required to understand the full impact of these findings, the innovative approach taken enhances our understanding of distinct phenotypes of prostate cancer.

  2. Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study [v1; ref status: indexed, http://f1000r.es/p2

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

    2013-08-01

    Full Text Available Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs and the satisfaction with those services during the pre-hospital and hospital periods. Methods: We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region, between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL survey. We explored the association between outcomes and city, type of health care facility (HCF, and type of provider. Results: We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial “golden” hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR 5.05, 95% confidence interval (CI 1.88-13.54. This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70. Conclusions: Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall

  3. Role of serial multiparametric magnetic resonance imaging in prostate cancer active surveillance

    Institute of Scientific and Technical Information of China (English)

    Larissa J Vos; Michele Janoski; Keith Wachowicz; Atiyah Yahya; Oleksandr Boychak; John Amanie; Nadeem Pervez; Matthew B Parliament; Edith Pituskin; B Gino Fallone; Nawaid Usmani

    2016-01-01

    AIM:To examine whether addition of 3T multiparametric magnetic resonance imaging(mp MRI)to an active surveillance protocol could detect aggressive or progressive prostate cancer.METHODS:Twenty-three patients with low risk disease were enrolled on this active surveillance study,all of which had Gleason score 6 or less disease.All patients had clinical assessments,including digital rectal examination and prostate specific antigen(PSA)testing,every 6 mo with annual 3T mp MRI scans with gadolinium contrast and minimum sextant prostate biopsies.The MRI images were anonymized of patient identifiers and clinical information and each scan underwentradiological review without the other results known.Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mp MRI to identify prostate cancer and progressive disease were calculated.RESULTS:During follow-up(median 24.8 mo)11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment.Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years.All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mp MRI scans at baseline(43.5% sensitivity).Aggressive disease prediction from baseline mpM RI scans had satisfactory specificity(81.8%)but low sensitivity(58.3%).Twentytwo patients had serial mp MRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy(30% specificity and 100% sensitivity).CONCLUSION:Addition of mp MRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods.

  4. In vitro activity of ceftobiprole against key pathogens associated with pneumonia in hospitalized patients: results from the PEG surveillance study, 2010

    OpenAIRE

    Kresken, Michael; Körber-Irrgang, Barbara; Kaase, Martin; Layer, Franziska; Pfeifer, Yvonne; Werner, Guido; Hafner, Dieter

    2015-01-01

    Empirical treatment of hospital-acquired pneumonia (HAP) has increasingly been threatened by methicillin-resistant Staphylococcus aureus (MRSA) and multidrug resistant Gram-negative pathogens. In contrast, empirical treatment of community-acquired pneumonia (CAP) is primarily impeded by antimicrobial-resistant pneumococci. Ceftobiprole, recently approved for the treatment of HAP and CAP in Europe, is active against a broad-spectrum of Gram-positive and Gram-negative pathogens, including MRSA ...

  5. Resistance surveillance studies: a multifaceted problem--the fluoroquinolone example.

    Science.gov (United States)

    Dalhoff, A

    2012-06-01

    This review summarizes data on the fluoroquinolone resistance epidemiology published in the previous 5 years. The data reviewed are stratified according to the different prescription patterns by either primary- or tertiary-care givers and by indication. Global surveillance studies demonstrate that fluoroquinolone- resistance rates increased in the past several years in almost all bacterial species except Staphylococcus pneumoniae and Haemophilus influenzae causing community-acquired respiratory tract infections (CARTIs), as well as Enterobacteriaceae causing community-acquired urinary tract infections. Geographically and quantitatively varying fluoroquinolone resistance rates were recorded among Gram-positive and Gram-negative pathogens causing healthcare-associated respiratory tract infections. One- to two-thirds of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) were fluoroquinolone resistant too, thus, limiting the fluoroquinolone use in the treatment of community- as well as healthcare-acquired urinary tract and intra-abdominal infections. The remaining ESBL-producing or plasmid-mediated quinolone resistance mechanisms harboring Enterobacteriaceae were low-level quinolone resistant. Furthermore, 10-30 % of H. influenzae and S. pneumoniae causing CARTIs harbored first-step quinolone resistance determining region (QRDR) mutations. These mutants pass susceptibility testing unnoticed and are primed to acquire high-level fluoroquinolone resistance rapidly, thus, putting the patient at risk. The continued increase in fluoroquinolone resistance affects patient management and necessitates changes in some current guidelines for the treatment of intra-abdominal infections or even precludes the use of fluoroquinolones in certain indications like gonorrhea and pelvic inflammatory diseases in those geographic areas in which fluoroquinolone resistance rates and/or ESBL production is high. Fluoroquinolone resistance has been selected among the commensal

  6. An overview of environmental surveillance of waste management activities at the Idaho National Engineering Laboratory

    Science.gov (United States)

    Smith, T.H.; Chew, E.W.; Hedahl, T.G.; Mann, L.J.; Pointer, T.F.; Wiersma, G.B.

    1986-01-01

    The Idaho National Engineering Laboratory (INEL), in southeastern Idaho, is a principal center for nuclear energy development for the Department of Energy (DOE) and the U.S. Nuclear Navy. Fifty-two reactors have been built at the INEL, with 15 still operable. Extensive environmental surveillance is conducted at the INEL by DOE's Radiological Environmental Sciences Laboratory (RESL), and the U.S. Geological Survey (USGS), the National Oceanic and Atmospheric Administration (NOAA), EG&G Idaho, Inc., and Westinghouse Idaho Nuclear Company (WINCO). Surveillance of waste management facilities radiation is integrated with the overall INEL Site surveillance program. Air, warer, soil, biota, and environmental radiation are monitored or sampled routinely at INEL. Results to date indicate very small or no impacts from INEL on the surrounding environment. Environmental surveillance activities are currently underway to address key environmental issues at the INEL.

  7. Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France

    Directory of Open Access Journals (Sweden)

    Filleul Laurent

    2009-02-01

    Full Text Available Abstract Background The health impacts of heat waves are serious and have prompted the development of heat wave response plans. Even when they are efficient, these plans are developed to limit the health effects of heat waves. This study was designed to determine relevant indicators related to health effects of heat waves and to evaluate the ability of a syndromic surveillance system to monitor variations in the activity of emergency departments over time. The study uses data collected during the summer 2006 when a new heat wave occurred in France. Methods Data recorded from 49 emergency departments since July 2004, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected on patients included diagnosis (ICD10 codes, outcome, and age. Statistical t-tests were used to compare, for several health conditions, the daily averages of patients within different age groups and periods (whether 'on alert' or 'off alert'. Results A limited number of adverse health conditions occurred more frequently during hot period: dehydration, hyperthermia, malaise, hyponatremia, renal colic, and renal failure. Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day, but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p Conclusion Our results show the interest to monitor specific indicators during hot periods and to focus surveillance efforts on the elderly. Syndromic surveillance allowed the collection of data in real time and the subsequent optimization of the response by public health agencies. This method of surveillance should therefore be considered as an essential part of efforts to prevent the health effects of heat waves.

  8. Management of clinical stage I testicular seminoma: active surveillance versus adjuvant chemotherapy.

    Science.gov (United States)

    Ondrusova, M; Ondrus, D; Miskovska, V; Kajo, K; Szoldova, K; Usakova, V; Stastna, V

    2015-07-01

    Surveillance after orchiectomy alone has become popular in the management of clinical stage I nonseminomatous germ cell testicular tumors (CSI NSGCTT), and adjuvant chemotherapy has been accepted in high-risk CSI NSGCTT. Because of the late toxicity of standard radiotherapy in CSI testicular seminoma (SGCTT), this therapeutic approach has been accepted also in the management of CSI SGCTT. In the current study, we analyzed single-center experience with risk-adapted therapeutic approaches (active surveillance and adjuvant chemotherapy) in patients with CSI SGCTT. The study analyzed a total of 90 patients collected at a single center from April 2008 to March 2015 with CSI SGCTT who were stratified into two groups according to risk-adapted therapeutic approaches. In the group A (low-risk CSI SGCTT-no rete testis invasion, tumor size 4 cm or pT ≥ 2 stage), which consisted of 16 patients who were treated with adjuvant chemotherapy, relapse occurred in two (12.5 %) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100 %. The statistically significant difference in progression-free survival between these two groups was not found. Radiotherapy is currently not recommended as an adjuvant treatment in CSI SGCTT patients. The benefit of using risk-adapted therapeutic approaches in CSI SGCTTs patients is evident.

  9. 77 FR 52317 - Record of Decision for Surveillance Towed Array Sensor System Low Frequency Active Sonar

    Science.gov (United States)

    2012-08-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Department of the Navy Record of Decision for Surveillance Towed Array Sensor System Low Frequency Active... Array Sensor System Low Frequency Active (SURTASS LFA) sonar systems with certain geographical...

  10. Potential use of school absenteeism record for disease surveillance in developing countries, case study in rural Cambodia.

    Directory of Open Access Journals (Sweden)

    Calvin K Y Cheng

    Full Text Available BACKGROUND: Disease surveillance allows prospective monitoring of patterns in disease incidence in the general community, specific institutions (e.g. hospitals, elderly care homes, and other important population subgroups. Surveillance activities are now routinely conducted in many developed countries and in certain easy-to-reach areas of the developing ones. However due to limited health resources, population in rural area that consisted of the most the vulnerable groups are not under surveillance. Cheaper alternative ways for disease surveillance were needed in resource-limited settings. METHODS AND FINDINGS: In this study, a syndromic surveillance system using disease specific absenteeism rates was established in 47 pre-schools with 1,417 students 3-6 y of age in a rural area of Kampot province, Cambodia. School absenteeism data were collected via short message service. Data collected between 1st January and 31st December 2012 was used for system evaluation for future potential use in larger scale. The system appeared to be feasible and acceptable in the rural study setting. Moderate correlation was found between rates of school absenteeism due to illness and the reference data on rates of attendance at health centers in persons <16 y (maximum cross-correlation coefficient = 0.231 at lag = -1 week. CONCLUSIONS: School absenteeism data is pre-existing, easily accessible and requires minimum time and resources after initial development, and our results suggest that this system may be able to provide complementary data for disease surveillance, especially in resource limited settings where there is very little information on illnesses in the community and traditional surveillance systems are difficult to implement. An important next step is to validate the syndromic data with other forms of surveillance including laboratory data.

  11. Potential use of school absenteeism record for disease surveillance in developing countries, case study in rural Cambodia.

    Science.gov (United States)

    Cheng, Calvin K Y; Channarith, Hing; Cowling, Benjamin J

    2013-01-01

    Disease surveillance allows prospective monitoring of patterns in disease incidence in the general community, specific institutions (e.g. hospitals, elderly care homes), and other important population subgroups. Surveillance activities are now routinely conducted in many developed countries and in certain easy-to-reach areas of the developing ones. However due to limited health resources, population in rural area that consisted of the most the vulnerable groups are not under surveillance. Cheaper alternative ways for disease surveillance were needed in resource-limited settings. In this study, a syndromic surveillance system using disease specific absenteeism rates was established in 47 pre-schools with 1,417 students 3-6 y of age in a rural area of Kampot province, Cambodia. School absenteeism data were collected via short message service. Data collected between 1st January and 31st December 2012 was used for system evaluation for future potential use in larger scale. The system appeared to be feasible and acceptable in the rural study setting. Moderate correlation was found between rates of school absenteeism due to illness and the reference data on rates of attendance at health centers in persons absenteeism data is pre-existing, easily accessible and requires minimum time and resources after initial development, and our results suggest that this system may be able to provide complementary data for disease surveillance, especially in resource limited settings where there is very little information on illnesses in the community and traditional surveillance systems are difficult to implement. An important next step is to validate the syndromic data with other forms of surveillance including laboratory data.

  12. Active chinese mistletoe lectin-55 enhances colon cancer surveillance through regulating innate and adaptive immune responses

    Institute of Scientific and Technical Information of China (English)

    Yan-Hui Ma; Wei-Zhi Cheng; Fang Gong; An-Lun Ma; Qi-Wen Yu; Ji-Ying Zhang; Chao-Ying Hu; Xue-Hua Chen; Dong-Qing Zhang

    2008-01-01

    AIM:To investigate the potential role of Active Chinese mistletoe lectin-55 (ACML-55) in tumor immune surveillance.METHODS:In this study,an experimental model was established by hypodermic inoculating the colon cancer cell line CT26 (5×105 cells) into BALB/c mice.The experimental treatment was orally administered with ACML-55 or PBS,followed by the inoculation of colon cancer cell line CT26.Intracellular cytokine staining was used to detect IFN-y production by tumor antigen specific CD8+ T cells.FACS analysis was employed to profile composition and activation of CD4+,CD8+,γδ T and NK cells.RESULTS:Our results showed,compared to PBS treated mice,ACML-55 treatment significantly delayed colon cancer development in colon cancer-bearing Balb/c mice in vivo.Treatment with ACML-55 enhanced both Ag specific activation and proliferation of CD4+ and CD8+ T cells,and increased the number of tumor Ag specific CD8+ T cells,it was more important to increase the frequency of tumor Ag specific IFN-γ producing-CD8+ T cells.Interestingly,ACML-55 treatment also showed increased cell number of NK,and γδT cells,indicating the role of ACML-55 in activation of innate lymphooltes.CONCLUSION:Our results demonstrate that ACML-55therapy can enhance function in immune surveillance in colon cancer-bearing mice through regulating both innate and adaptive immune responses.

  13. Active screening and surveillance in the United Kingdom for Middle East respiratory syndrome coronavirus in returning travellers and pilgrims from the Middle East: a prospective descriptive study for the period 2013–2015

    Directory of Open Access Journals (Sweden)

    Sowsan F. Atabani

    2016-06-01

    Conclusions: Respiratory tract infections in travellers/pilgrims returning to the UK from the Middle East are mainly due to rhinoviruses, influenza A, and influenza B. Whilst MERS-CoV was not detected in the 202 patients studied, heightened awareness of the possibility of MERS-CoV and continuous proactive surveillance are essential to rapidly identify cases of MERS-CoV and other seasonal respiratory tract viruses such as avian influenza, in patients presenting to hospital. Early identification and isolation may prevent outbreaks in nosocomial settings.

  14. Frequent observation: sexualities, self-surveillance, confession and the construction of the active patient.

    Science.gov (United States)

    Pryce, A

    2000-06-01

    Following Foucault's analyses of the development of the disciplinary power of the medical gaze, this paper describes the themes that are relocating the 'active patient' as the central object of health scrutiny by professionals. A key element in these discourses has been the deployment of power through disciplinary knowledge and techniques of social control through ritual forms of confession, thereby positing the patient/client as the subject of self-surveillance. The individual is also engaged their own sexuality, performativity and 'truths' of sexual experience. These Foucauldian insights have constructed the notion of surveillance medicine, whereby with the assistance of professional technologies, not only the patient's body but also the 'self' can be probed through incitement to confess. However, the actor is not docile; resistances to disciplinary techniques are evident and within the professional practices of the clinic, there is resistance to the power of the erotic. The paper draws on recent research on the social construction of male sexualities in the fields of genitourinary practice, and explores how the ceremonial practices of the clinic engage with the rise of surveillance medicine and the medicalisation of everyday life. The individual actor is exhorted to engage in increased sexual and medical self-surveillance and to be recruited in the project of becoming an 'active patient'. It concludes with an examination of some of the implications this surveillance of self may have for practitioners in terms of power and the professional lens through which the sexualised, symbolic body is viewed.

  15. Is active surveillance a safe alternative in the management of localized prostate cancer? Pathological features of radical prostatectomy specimens in potential candidates for active surveillance

    Directory of Open Access Journals (Sweden)

    Zambrano Norman

    2014-04-01

    Full Text Available Introduction and objectiveActive surveillance (AS has become an accepted alternative for patients with low risk prostate cancer. The purpose of AS is to defer definitive therapy in these patients to avoid treatment-related complications. Our aim was to determine the pathological features of the surgical specimen from potential AS candidates that underwent radical prostatectomy (RP.Materials and MethodsWe retrospectively reviewed a group of patients submitted to RP who met criteria for AS: Gleason score (GS ≤ 3+3 = 6, PSA ≤ 10ng/mL, T1c - T2a, 6 in the RPS (GS 7 n = 49; GS 8 n = 3. Extracapsular extension, seminal vesicle and lymph node involvement was found in 6.1%, 3.1% and 1.2% of the specimens, respectively.ConclusionIn this study a significant proportion of potential candidates for AS showed features of aggressive and/or high-risk tumors in the RPS. Therefore, before considering a patient for an AS protocol, a proper and strict selection must be performed, and informed consent is crucial for these patients.

  16. Prevalence of Physical Activity in the United States: Behavioral Risk Factor Surveillance System, 2001

    Directory of Open Access Journals (Sweden)

    Barbara E. Ainsworth, PhD, MPH

    2005-03-01

    Full Text Available Introduction The health benefits of regular cardiovascular exercise are well-known. Such exercise, however, has traditionally been defined as vigorous physical activity, such as jogging, swimming, or aerobic dance. Exercise of moderate intensity also promotes health, and many U.S. adults may be experiencing the health benefits of exercise through lifestyle activities of moderate intensity, such as yard work, housework, or walking for transportation. Until recently, public health surveillance systems have not included assessments of this type of physical activity, focusing on exercise of vigorous intensity. We used an enhanced surveillance tool to describe the prevalence and amount of both moderate-intensity and vigorous-intensity physical activity among U.S. adults. Methods We analyzed data from the 2001 Behavioral Risk Factor Surveillance System, a state-based, random-digit–dialed telephone survey administered to U.S. adults aged 18 years and older (n = 82,834 men and 120,286 women. Physical activity behavior was assessed using questions designed to quantify the frequency of participation in moderate- or vigorous-intensity physical activities performed during leisure time or for household chores and transportation. Results Overall, 45% of adults (48% of men and 43% of women were active at recommended levels during nonworking hours (at least 30 minutes five or more days per week in moderate-intensity activities, equivalent to brisk walking, or at least 20 minutes three or more days per week in vigorous activities, equivalent to running, heavy yard work, or aerobic dance. Less than 16% of adults (15% of men and 17% of women reported no moderate or vigorous activity in a usual week. Conclusion Integrating surveillance of lifestyle activities into national systems is possible, and doing so may provide a more accurate representation of the prevalence of recommended levels of physical activity. These results, however, suggest that the majority of U

  17. Lessons learned during active epidemiological surveillance of Ebola and Marburg viral hemorrhagic fever epidemics in Africa.

    Science.gov (United States)

    Allaranga, Yokouide; Kone, Mamadou Lamine; Formenty, Pierre; Libama, Francois; Boumandouki, Paul; Woodfill, Celia J I; Sow, Idrissa; Duale, Sambe; Alemu, Wondimagegnehu; Yada, Adamou

    2010-03-01

    To review epidemiological surveillance approaches used during Ebola and Marburg hemorrhagic fever epidemics in Africa in the past fifteen years. Overall, 26 hemorrhagic epidemic outbreaks have been registered in 12 countries; 18 caused by the Ebola virus and eight by the Marburg virus. About 2551 cases have been reported, among which 268 were health workers (9,3%). Based on articles and epidemic management reports, this review analyses surveillance approaches, route of introduction of the virus into the population (urban and rural), the collaboration between the human health sector and the wildlife sector and factors that have affected epidemic management. Several factors affecting the epidemiological surveillance during Ebola and Marburg viruses hemorrhagic epidemics have been observed. During epidemics in rural settings, outbreak investigations have shown multiple introductions of the virus into the human population through wildlife. In contrast, during epidemics in urban settings a single introduction of the virus in the community was responsible for the epidemic. Active surveillance is key to containing outbreaks of Ebola and Marburg viruses Collaboration with those in charge of the conservation of wildlife is essential for the early detection of viral hemorrhagic fever epidemics. Hemorrhagic fever epidemics caused by Ebola and Marburg viruses are occurring more and more frequently in Sub-Saharan Africa and only an adapted epidemiological surveillance system will allow for early detection and effective response.

  18. Meaningful end points and outcomes in men on active surveillance for early-stage prostate cancer.

    Science.gov (United States)

    Welty, Christopher J; Cooperberg, Matthew R; Carroll, Peter R

    2014-05-01

    Active surveillance is a management strategy for early-stage prostate cancer designed to balance early detection of aggressive disease and overtreatment of indolent disease. We evaluate recently reported outcomes and discuss the potentially most important endpoints for such an approach. The past 2 years have seen the publication of two trials of watchful waiting versus immediate treatment and updates of multiple active surveillance cohorts for men with early-stage prostate cancer. The watchful waiting trials demonstrated a small potential mortality benefit to immediate treatment when applied to all risk levels (6% absolute difference at 15 years), emphasizing the importance of a risk-adapted strategy. In reported active surveillance cohorts, prostate cancer death and metastasis remain rare events. Intermediate outcomes such as progression to treatment and upgrading/upstaging on final disease appear consistent among cohorts, but must be interpreted with caution when compared with historical controls of immediate treatment because of potential selection bias. The safety of active surveillance has been reinforced by recent reports. Accumulation of additional data on men with intermediate risk cancer and development and validation of new biomarkers of risk will allow refined and, likely, expanded use of this approach.

  19. Surveillance Pleasures

    DEFF Research Database (Denmark)

    Albrechtslund, Anders

    and leisure have not been studied with the same intensity as e.g. policing, civil liberties and social sorting. This paper offers a study of trends in surveillance pleasures, i.e. watching and eavesdropping in popular culture. My focus is the existential aspects and ethical dilemmas of surveillance...

  20. Applying participatory approaches in the evaluation of surveillance systems: A pilot study on African swine fever surveillance in Corsica.

    Science.gov (United States)

    Calba, Clémentine; Antoine-Moussiaux, Nicolas; Charrier, François; Hendrikx, Pascal; Saegerman, Claude; Peyre, Marisa; Goutard, Flavie L

    2015-12-01

    The implementation of regular and relevant evaluations of surveillance systems is critical in improving their effectiveness and their relevance whilst limiting their cost. The complex nature of these systems and the variable contexts in which they are implemented call for the development of flexible evaluation tools. Within this scope, participatory tools have been developed and implemented for the African swine fever (ASF) surveillance system in Corsica (France). The objectives of this pilot study were, firstly, to assess the applicability of participatory approaches within a developed environment involving various stakeholders and, secondly, to define and test methods developed to assess evaluation attributes. Two evaluation attributes were targeted: the acceptability of the surveillance system and its the non-monetary benefits. Individual semi-structured interviews and focus groups were implemented with representatives from every level of the system. Diagramming and scoring tools were used to assess the different elements that compose the definition of acceptability. A contingent valuation method, associated with proportional piling, was used to assess the non-monetary benefits, i.e., the value of sanitary information. Sixteen stakeholders were involved in the process, through 3 focus groups and 8 individual semi-structured interviews. Stakeholders were selected according to their role in the system and to their availability. Results highlighted a moderate acceptability of the system for farmers and hunters and a high acceptability for other representatives (e.g., private veterinarians, local laboratories). Out of the 5 farmers involved in assessing the non-monetary benefits, 3 were interested in sanitary information on ASF. The data collected via participatory approaches enable relevant recommendations to be made, based on the Corsican context, to improve the current surveillance system.

  1. Survey of surveillance systems and select prevention activities for hepatitis B and C, European Union/European Economic Area, 2009.

    Science.gov (United States)

    Duffell, E F; van de Laar, M J

    2015-04-02

    Hepatitis B and C viral infections are leading causes of hepatic cirrhosis and cancer. The incidence and prevalence of both hepatitis B and C varies across European countries. European wide surveillance data help to understand the dynamic epidemiology of hepatitis B and C, which is important for the implementation and effectiveness of prevention and control activities.Comparison of surveillance data between countries in Europe is hampered by the differences in national healthcare and reporting systems. This report presents the results of a survey in 2009 which was undertaken to collect baseline information on surveillance systems and core prevention programmes for hepatitis B and C in individual European Union/ European Economic Area countries. The results provide key information to aid the interpretation of surveillance data, and while indicating heterogeneity in national surveillance systems and programmes, they highlight the potential of these systems. This resource has supported the implementation of a standardised European enhanced surveillance programme.

  2. Using a data fusion-based activity recognition framework to determine surveillance system requirements

    CSIR Research Space (South Africa)

    Le Roux, WH

    2007-07-01

    Full Text Available activity recognition framework for maritime applications (Adapted from [20]) III. APPLYING THE FRAMEWORK A. Use Cases Use cases [12] are valuable means of capturing transactions between users and systems. In the maritime surveillance environment, a.... D. Vessel Capabilities In terms of capabilities, the design, deployment and devel- opment sub-elements have to be estimated from information and data sources. To establish that a vessel is engaged in illegal fishing activities, basic criteria...

  3. Surveillance and Critical Theory

    Directory of Open Access Journals (Sweden)

    Christian Fuchs

    2015-09-01

    Full Text Available In this comment, the author reflects on surveillance from a critical theory approach, his involvement in surveillance research and projects, and the status of the study of surveillance. The comment ascertains a lack of critical thinking about surveillance, questions the existence of something called “surveillance studies” as opposed to a critical theory of society, and reflects on issues such as Edward Snowden’s revelations, and Foucault and Marx in the context of surveillance.

  4. Metabolomic Profiling of Prostate Cancer Progression During Active Surveillance

    Science.gov (United States)

    2015-10-01

    genetic regulation , enzyme activity and metabolic reactions in a dynamic profile of the biological state of a tissue (3). Our industry contractor...Payment and Remuneration a. Detail compensation for participants including possible total compensation, proposed bonus, and any proposed reductions...or penalties for not completing the protocol. Participants did not receive payment or remuneration for their original donation of specimens or consent

  5. Workers’ health surveillance: a study of major accidents at work

    Directory of Open Access Journals (Sweden)

    Karini da Rosa

    2016-10-01

    Full Text Available Background and objectives: Work accidents are the biggest health problem of Brazilian workers, thus, the objective of the study is to characterize sociodemographic and occupational data affected by serious accidents workers work in the municipality of Santa Cruz do Sul/RS. Method: this is a field study, documental, retrospective, with data collection in epidemiological report forms of the Municipal Unit Worker Health Reference (UMREST in the period of 2008 to 2010. Results: We conducted data collection in 1263 patient notification forms of the UMREST, and found 986 cases of serious work accident, and 78.59% of cases with male workers aged 20 to 29 years. In 2008 there were more cases reported in the information systems of Occupational Health. The occupations with the highest occurrence were the production line feeders (13,48%, tobacco processing assistant (8.0%, workers in the maintenance and conservation of buildings and public parks (7.0%. Among the types of accidents, 66.63% were typical accidents and 31.23% of commuting accidents. It identified the central area of the city as the most frequent cases with 47.2%, followed by the Industrial District neighborhood with 27.1% of cases. Final Thoughts: it was found that the accidents occurred more often on male workers, young, from labor institutions located in the central area of the city. Thus, we emphasize the need for prevention and care actions that meet the profile of the workers studied. KEYWORDS: Accidents at work. Occupational health surveillance. Occupational health

  6. Motivation of health surveillance assistants in Malawi: A qualitative study.

    Science.gov (United States)

    Chikaphupha, Kingsley R; Kok, Maryse C; Nyirenda, Lot; Namakhoma, Ireen; Theobald, Sally

    2016-06-01

    Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of HSAs. A qualitative study capturing the perspectives of purposively selected participants was conducted in two districts: Salima and Mchinji. Participants included HSAs, health managers, and various community members. Data were collected through focus group discussions (n = 16) and in-depth interviews (n = 44). The study sample was comprised of 112 women and 65 men. Qualitative data analysis was informed by existing frameworks on factors influencing health worker motivation. Our analysis identified five key themes shaping HSA motivation: salary, accommodation, human resource management, supplies and logistics, and community links. Each of these played out at different levels-individual, family, community, and organisational-with either positive or negative effects. Demotivating factors related primarily to the organisational level, while motivating factors were more often related to individual, family, and community levels. A lack of financial incentives and shortages of basic supplies and materials were key factors demotivating HSAs. Supervision was generally perceived as unsupportive, uncoordinated, and top-down. Most HSAs complained of heavy workload. Many HSAs felt further recognition and support from the Ministry of Health, and the development of a clear career pathway would improve their motivation. Factors shaping motivation of HSAs are complex and multilayered; experiences at one level will impact other levels. Interventions are required to enhance HSA motivation, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. HSAs have unique experiences, and there is need to hear

  7. Annual report on surveillance and maintenance activities at Oak Ridge National Laboratory, Oak Ridge, Tennessee, fiscal year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    In fiscal year (FY) 1995, the sites and facilities from both the Remedial Action (RA) and Decontamination and Decommissioning (D and D) programs were combined to form the Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Surveillance and Maintenance (S and M) Program. Surveillance and Maintenance activities were conducted throughout FY 1996 at the RA facilities. Overall, the RA S and M Program consists of approximately 650 acres that include 14 waste area groupings with approximately 200 sites. These sites include 46 major facilities, several leak and contaminated soil sites, 38 inactive tanks, approximately 50 environmental study areas and approximately 2,973 wells and boreholes. Site inspections were conducted at established frequencies on appropriate sites in the RA S and M Program in accordance with the established S and M FY 1996 Incentive Task Order (ITO).

  8. The use of early summer mosquito surveillance to predict late summer West Nile virus activity

    Science.gov (United States)

    Ginsberg, Howard S.; Rochlin, Ilia; Campbell, Scott R.

    2010-01-01

    Utility of early-season mosquito surveillance to predict West Nile virus activity in late summer was assessed in Suffolk County, NY. Dry ice-baited CDC miniature light traps paired with gravid traps were set weekly. Maximum-likelihood estimates of WNV positivity, minimum infection rates, and % positive pools were generally well correlated. However, positivity in gravid traps was not correlated with positivity in CDC light traps. The best early-season predictors of WNV activity in late summer (estimated using maximum-likelihood estimates of Culex positivity in August and September) were early date of first positive pool, low numbers of mosquitoes in July, and low numbers of mosquito species in July. These results suggest that early-season entomological samples can be used to predict WNV activity later in the summer, when most human cases are acquired. Additional research is needed to establish which surveillance variables are most predictive and to characterize the reliability of the predictions.

  9. Elevated Prostate Health Index (phi and Biopsy Reclassification During Active Surveillance of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Darian Andreas

    2016-07-01

    Full Text Available The Prostate Health Index (phi has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer.

  10. Fluoroquinolone resistance in the rectal carriage of men in an active surveillance cohort: longitudinal analysis.

    Science.gov (United States)

    Cohen, Jason E; Landis, Patricia; Trock, Bruce J; Patel, Hiten D; Ball, Mark W; Auwaerter, Paul G; Schaeffer, Edward; Carter, H Ballentine

    2015-02-01

    Rectal swabs can identify men with fluoroquinolone resistant bacteria and decrease the infection rate after transrectal ultrasound guided prostate biopsy by targeted antimicrobial prophylaxis. We evaluated the rate of fluoroquinolone resistance in an active surveillance cohort with attention to factors associated with resistance and changes in resistance with time. We evaluated 416 men with prostate cancer on active surveillance who underwent rectal swabs to assess the rate of fluoroquinolone resistance compared to that in men undergoing diagnostic transrectal ultrasound guided prostate biopsy. The chi-square test and Student t-test were used to compare categorical and continuous variables, respectively. Poisson regression analysis was used for multivariate analysis. On the initial swab fluoroquinolone resistance was found in 95 of 416 men (22.8%) on active surveillance compared to 54 of 221 (24.4%) in the diagnostic biopsy cohort (p = 0.675). Diabetes was found in 4.0% of the fluoroquinolone sensitive group vs 14.7% of the resistant group (p fluoroquinolone. Resistance is significantly associated with diabetes but the number of prior biopsies is not. Men with fluoroquinolone resistant flora tend to remain resistant with time. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

    Directory of Open Access Journals (Sweden)

    Zaher Bahouth

    2015-01-01

    Full Text Available Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89. The mean follow-up period was 34 months (12–112. In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15% masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

  12. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Directory of Open Access Journals (Sweden)

    Sirenda Vong

    Full Text Available BACKGROUND: Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. METHODS AND FINDINGS: Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons. The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5. During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, p<0.001. CONCLUSION: The large-scale active surveillance study for dengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly

  13. Postmarketing Safety Study Tool: A Web Based, Dynamic, and Interoperable System for Postmarketing Drug Surveillance Studies

    Directory of Open Access Journals (Sweden)

    A. Anil Sinaci

    2015-01-01

    Full Text Available Postmarketing drug surveillance is a crucial aspect of the clinical research activities in pharmacovigilance and pharmacoepidemiology. Successful utilization of available Electronic Health Record (EHR data can complement and strengthen postmarketing safety studies. In terms of the secondary use of EHRs, access and analysis of patient data across different domains are a critical factor; we address this data interoperability problem between EHR systems and clinical research systems in this paper. We demonstrate that this problem can be solved in an upper level with the use of common data elements in a standardized fashion so that clinical researchers can work with different EHR systems independently of the underlying information model. Postmarketing Safety Study Tool lets the clinical researchers extract data from different EHR systems by designing data collection set schemas through common data elements. The tool interacts with a semantic metadata registry through IHE data element exchange profile. Postmarketing Safety Study Tool and its supporting components have been implemented and deployed on the central data warehouse of the Lombardy region, Italy, which contains anonymized records of about 16 million patients with over 10-year longitudinal data on average. Clinical researchers in Roche validate the tool with real life use cases.

  14. Integrated production surveillance: a case study in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Nunes, Joao Otavio L.; Soffried, Klaus; Silva, Ricardo L. [Halliburton/Landmark Division, Houston, TX (United States); Milanez, Raphael F. [Pontificia Univ. Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil). Dept. de Engenharia Civil. Grupo de Tecnologia e Engenharia de Petroleo

    2004-07-01

    This paper describes the field experience with an integrated production surveillance pilot project, deployed for PETROBRAS, in the Rio de Janeiro Business Unit, in the Marlim Sul Production Asset. The Marlim Sul field, located in the Campos Basin, is one of the biggest fields of PETROBRAS. As part of the scope of this project, dynamic links were created connecting to various Geology, Drilling and Production Databases. All information coming from these distinct data sources was simultaneously visualized and analyzed within one common application interface. A secondary application was developed to transfer operational data from a current spreadsheet format to the commercial database of the new production surveillance system. SQL views were created to allow the connection among these databases and the system. The system proved to be very agile, making the otherwise time consuming task of field surveillance easier, faster and more efficient. Additional benefits were the ability to quickly detect any anomalies in the field and provide for a more efficient work over planning, thereby avoiding costly well downtimes. (author)

  15. Prostatic and dietary omega-3 fatty acids and prostate cancer progression during active surveillance.

    Science.gov (United States)

    Moreel, Xavier; Allaire, Janie; Léger, Caroline; Caron, André; Labonté, Marie-Ève; Lamarche, Benoît; Julien, Pierre; Desmeules, Patrice; Têtu, Bernard; Fradet, Vincent

    2014-07-01

    The association between omega-3 (ω-3) fatty acids and prostate cancer has been widely studied. However, little is known about the impact of prostate tissue fatty acid content on prostate cancer progression. We hypothesized that compared with the estimated dietary ω-3 fatty acids intake and the ω-3 fatty acids levels measured in red blood cells (RBC), the prostate tissue ω-3 fatty acid content is more strongly related to prostate cancer progression. We present the initial observations from baseline data of a phase II clinical trial conducted in a cohort of 48 untreated men affected with low-risk prostate cancer, managed under active surveillance. These men underwent a first repeat biopsy session within 6 months after the initial diagnosis of low-risk prostate cancer, at which time 29% of the men had progressed from a Gleason score of 6 to a Gleason score of 7. At the first repeat biopsy session, fatty acid levels were assessed with a food-frequency questionnaire, and determined in the RBC and in the prostate tissue biopsy. We found that eicosapentaenoic acid (EPA) was associated with a reduced risk of prostate cancer progression when measured directly in the prostate tissue. Thus, this initial interim study analysis suggests that prostate tissue ω-3 fatty acids, especially EPA, may be protective against prostate cancer progression in men with low-risk prostate cancer.

  16. The effects of synoptic weather on influenza infection incidences: a retrospective study utilizing digital disease surveillance

    Science.gov (United States)

    Zhao, Naizhuo; Cao, Guofeng; Vanos, Jennifer K.; Vecellio, Daniel J.

    2017-02-01

    The environmental drivers and mechanisms of influenza dynamics remain unclear. The recent development of influenza surveillance-particularly the emergence of digital epidemiology-provides an opportunity to further understand this puzzle as an area within applied human biometeorology. This paper investigates the short-term weather effects on human influenza activity at a synoptic scale during cold seasons. Using 10 years (2005-2014) of municipal level influenza surveillance data (an adjustment of the Google Flu Trends estimation from the Centers for Disease Control's virologic surveillance data) and daily spatial synoptic classification weather types, we explore and compare the effects of weather exposure on the influenza infection incidences in 79 cities across the USA. We find that during the cold seasons the presence of the polar [i.e., dry polar (DP) and moist polar (MP)] weather types is significantly associated with increasing influenza likelihood in 62 and 68% of the studied cities, respectively, while the presence of tropical [i.e., dry tropical (DT) and moist tropical (MT)] weather types is associated with a significantly decreasing occurrence of influenza in 56 and 43% of the cities, respectively. The MP and the DP weather types exhibit similar close positive correlations with influenza infection incidences, indicating that both cold-dry and cold-moist air provide favorable conditions for the occurrence of influenza in the cold seasons. Additionally, when tropical weather types are present, the humid (MT) and the dry (DT) weather types have similar strong impacts to inhibit the occurrence of influenza. These findings suggest that temperature is a more dominating atmospheric factor than moisture that impacts the occurrences of influenza in cold seasons.

  17. Inspection of surveillance activities and administrative leave policy at Bonneville Power Administration, Portland, Oregon

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The authors conducted an inspection of surveillance activities and administrative leave policy at the Bonneville Power Administration, Portland, Oregon. The purpose of their inspection was to determine if a covert video surveillance operation conducted at Bonneville Power Administration was consistent with Department of Energy policies and procedures and other applicable regulations and procedures, and to determine if administrative leave policies and procedures used at Bonneville Power Administration in a specific instance were consistent with Department of Energy requirements and the Code of Federal Regulations. This inspection focused on a specific incident that occurred in 1989 on the 5th floor of the BPA Headquarters Building located in Portland, Oregon. The incident involved the soiling of an employee`s personal property with what appeared to be urine.

  18. Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France.

    Science.gov (United States)

    Josseran, Loïc; Caillère, Nadège; Brun-Ney, Dominique; Rottner, Jean; Filleul, Laurent; Brucker, Gilles; Astagneau, Pascal

    2009-02-20

    The health impacts of heat waves are serious and have prompted the development of heat wave response plans. Even when they are efficient, these plans are developed to limit the health effects of heat waves. This study was designed to determine relevant indicators related to health effects of heat waves and to evaluate the ability of a syndromic surveillance system to monitor variations in the activity of emergency departments over time. The study uses data collected during the summer 2006 when a new heat wave occurred in France. Data recorded from 49 emergency departments since July 2004, were transmitted daily via the Internet to the French Institute for Public Health Surveillance. Items collected on patients included diagnosis (ICD10 codes), outcome, and age. Statistical t-tests were used to compare, for several health conditions, the daily averages of patients within different age groups and periods (whether 'on alert' or 'off alert'). A limited number of adverse health conditions occurred more frequently during hot period: dehydration, hyperthermia, malaise, hyponatremia, renal colic, and renal failure. Over all health conditions, the total number of patients per day remained equal between the 'on alert' and 'off alert' periods (4,557.7/day vs. 4,511.2/day), but the number of elderly patients increased significantly during the 'on alert' period relative to the 'off alert' period (476.7/day vs. 446.2/day p waves.

  19. Incidence of surgical site infections in children: active surveillance in an Italian academic children's hospital.

    Science.gov (United States)

    Ciofi Degli Atti, M L; Serino, L; Piga, S; Tozzi, A E; Raponi, M

    2017-01-01

    Surgical Site Infections (SSIs) account for 16-34% of all health-care associated infections. This study aimed to assess the incidence rate of SSIs in children who underwent surgical procedures in an academic children's hospital in Italy. Prospective cohort study. We actively followed-up 0-17 year old children at 30 days of surgical procedures without implants conducted during one index week per quarter, from the second quarter of 2014, to the first quarter of 2016 (8 index weeks in total). Follow up data were collected by telephone interview, or derived by clinical records if patients were still hospitalized. SSIs were defined according to case definitions of Centers for Diseases Control, Atlanta, USA. We calculated cumulative incidence of SSIs per 100 surgical procedures, by patient characteristics, procedure characteristics, and quarter. To investigate variables associated with SSIs, we compared characteristics of procedures with SSIs with those of procedures without SSIs. Over the study period, SSI incidence was 1.0% (19 cases/1,830 surgical procedures). SSI incidence was significantly lower after ear, nose and throat procedures compared to all other procedures, and significantly decreased over time. Duration of surgery was a risk factor for SSIs; patients with SSIs had a significantly longer total length of stay (LOS), due to a prolonged post-operative LOS. As reported in adults, this study confirms that SSIs are associated with longer hospitalizations in children. Active surveillance of SSIs is an important component of the overall strategy to reduce the incidence of these infections in children.

  20. Active surveillance of Hansen's Disease (leprosy): importance for case finding among extra-domiciliary contacts.

    Science.gov (United States)

    Moura, Maria L N; Dupnik, Kathryn M; Sampaio, Gabriel A A; Nóbrega, Priscilla F C; Jeronimo, Ana K; do Nascimento-Filho, Jose M; Miranda Dantas, Roberta L; Queiroz, Jose W; Barbosa, James D; Dias, Gutemberg; Jeronimo, Selma M B; Souza, Marcia C F; Nobre, Maurício L

    2013-01-01

    Hansen's disease (leprosy) remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615). The two groups had the same background in relation to education (p = 0.510), household income (p = 0.582), and the number of people living in the residence (p = 0.188). Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae.

  1. Active surveillance of Hansen's Disease (leprosy: importance for case finding among extra-domiciliary contacts.

    Directory of Open Access Journals (Sweden)

    Maria L N Moura

    Full Text Available Hansen's disease (leprosy remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615. The two groups had the same background in relation to education (p = 0.510, household income (p = 0.582, and the number of people living in the residence (p = 0.188. Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae.

  2. Reporting Magnetic Resonance Imaging in Men on Active Surveillance for Prostate Cancer: The PRECISE Recommendations-A Report of a European School of Oncology Task Force.

    Science.gov (United States)

    Moore, Caroline M; Giganti, Francesco; Albertsen, Peter; Allen, Clare; Bangma, Chris; Briganti, Alberto; Carroll, Peter; Haider, Masoom; Kasivisvanathan, Veeru; Kirkham, Alex; Klotz, Laurence; Ouzzane, Adil; Padhani, Anwar R; Panebianco, Valeria; Pinto, Peter; Puech, Philippe; Rannikko, Antti; Renard-Penna, Raphaele; Touijer, Karim; Turkbey, Baris; van Poppel, Heinrik; Valdagni, Riccardo; Walz, Jochen; Schoots, Ivo

    2017-04-01

    Published data on prostate magnetic resonance imaging (MRI) during follow-up of men on active surveillance are lacking. Current guidelines for prostate MRI reporting concentrate on prostate cancer (PCa) detection and staging. A standardised approach to prostate MRI reporting for active surveillance will facilitate the robust collection of evidence in this newly developing area. To develop preliminary recommendations for reporting of individual MRI studies in men on active surveillance and for researchers reporting the outcomes of cohorts of men having MRI on active surveillance. The RAND/UCLA Appropriateness Method was used. Experts in urology, radiology, and radiation oncology developed a set of 394 statements relevant to prostate MRI reporting in men on active surveillance for PCa. Each statement was scored for agreement on a 9-point scale by each panellist prior to a panel meeting. Each statement was discussed and rescored at the meeting. Measures of agreement and consensus were calculated for each statement. The most important statements, derived from both group discussion and scores of agreement and consensus, were used to create the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) checklist and case report form. Key recommendations include reporting the index lesion size using absolute values at baseline and at each subsequent MRI. Radiologists should assess the likelihood of true change over time (ie, change in size or change in lesion characteristics on one or more sequences) on a 1-5 scale. A checklist of items for reporting a cohort of men on active surveillance was developed. These items were developed based on expert consensus in many areas in which data are lacking, and they are expected to develop and change as evidence is accrued. The PRECISE recommendations are designed to facilitate the development of a robust evidence database for documenting changes in prostate MRI findings over time of men on active

  3. ERG Protein Expression in Diagnostic Specimens Is Associated with Increased Risk of Progression During Active Surveillance for Prostate Cancer

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Vainer, Ben; Thomsen, Frederik Birkebæk;

    2014-01-01

    BACKGROUND: Compelling biomarkers identifying prostate cancer patients with a high risk of progression during active surveillance (AS) are needed. OBJECTIVE: To examine the association between ERG expression at diagnosis and the risk of progression during AS. DESIGN, SETTING, AND PARTICIPANTS......: This study included 265 patients followed on AS with prostate-specific antigen (PSA) measurements, clinical examinations, and 10-12 core rebiopsies from 2002 to 2012 in a prospectively maintained database. ERG immunohistochemical staining was performed on diagnostic paraffin-embedded formalin-fixed sections...

  4. Collective resistance to HPAI H5N1 surveillance in the Thai cockfighting community: Insights from a social anthropology study.

    Science.gov (United States)

    Paul, Mathilde C; Figuié, Muriel; Kovitvadhi, Attawit; Valeix, Sophie; Wongnarkpet, Sirichai; Poolkhet, Chaithep; Kasemsuwan, Suwicha; Ducrot, Christian; Roger, François; Binot, Aurélie

    2015-06-01

    Farmers may organize themselves to collectively manage risks such as animal diseases. Our study shows some evidence of such organization among fighting cock owners in Thailand. Fighting cocks were specifically targeted by HPAI (Highly Pathogenic Avian Influenza) H5N1 surveillance and control measures in Thailand because they were thought to pose a high risk of spreading diseases. In this work, we used a social-anthropological approach to gain an inside view of the issues associated with HPAI H5N1 surveillance in the cockfighting community in Thailand. Based on a qualitative analysis of data collected through in-depth interviews and observation of cockfighters' practices, we found that fighting cock owners share a sense of belonging to the same community based on a common culture, values, interests, practices, and internal rules, including rules to manage poultry diseases. During the HPAI H5N1 outbreaks, these rules may have contributed to mitigating the potential risk associated with the intense movements of fighting cocks inside the country. Nevertheless, this community, despite the high awareness and know-how of its members regarding poultry diseases, has shown a strong reluctance to comply with HPAI surveillance programs. We suggest that this reluctance is due to important gaps between the logic and rationales underlying surveillance and those associated with cockfighting activities. Our study highlights the need for multi and trans-disciplinary research involving the social sciences to analyze interactions between stakeholders and the collective actions implemented by communities to face risks.

  5. RISUS study: Rugby Injury Surveillance in Ulster Schools.

    Science.gov (United States)

    Archbold, H A P; Rankin, A T; Webb, M; Nicholas, R; Eames, N W A; Wilson, R K; Henderson, L A; Heyes, G J; Bleakley, C M

    2017-04-01

    To examine injury patterns in adolescent rugby players and determine factors associated with injury risk. Prospective injury surveillance study. N=28 Grammar Schools in Ulster, Ireland (2014-2015 playing season). 825 adolescent rugby players, across in 28 school first XV rugby squads; mean age 16.9 years. Injuries were classified by body part and diagnosis, and injury incidence using injuries per 1000 match hours of exposure. HRs for injury were calculated through Cox proportional hazard regression after correction for influential covariates. A total of n=426 injuries were reported across the playing season. Over 50% of injuries occurred in the tackle situation or during collisions (270/426), with few reported during set plays. The 3 most common injury sites were head/face (n=102, 23.9%), clavicle/shoulder (n=65, 15.3%) and the knee (n=56, 13.1%). Sprain (n=133, 31.2%), concussion (n=81, 19%) and muscle injury (n=65, 15.3%) were the most common diagnoses. Injury incidence is calculated at 29.06 injuries per 1000 match hours. There were no catastrophic injuries. A large percentage of injuries (208/424) resulted in absence from play for more than 28 days. Concussion carried the most significant time out from play (n=33; 15.9%), followed by dislocations of the shoulder (n=22; 10.6%), knee sprains (n=19, 9.1%), ankle sprains (n=14, 6.7%), hand/finger/thumb (n=11; 5.3%). 36.8% of participants in the study (304/825) suffered at least one injury during the playing season. Multivariate models found higher risk of injury (adjusted HR (AHR); 95% CI) with: higher age (AHR 1.45; 1.14 to 1.83), heavier weight (AHR 1.32; 1.04 to 1.69), playing representative rugby (AHR 1.42; 1.06 to 1.90) and undertaking regular strength training (AHR 1.65; 1.11 to 2.46). Playing for a lower ranked team (AHR 0.67; 0.49 to 0.90) and wearing a mouthguard (AHR 0.70; 0.54 to 0.92) were associated with lower risk of injury. There was a high incidence of severe injuries, with concussion, ankle and

  6. Acute flaccid paralysis surveillance: A 6 years study, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Alireza Emami Naeini

    2015-01-01

    Full Text Available Background: Poliomyelitis is still an endemic disease in many areas of the world including Africa and South Asia. Iran is polio free since 2001. However, due to endemicity of polio in neighboring countries of Iran, the risk of polio importation and re-emergence of wild polio virus is high. Case definition through surveillance system is a well-defined method for maintenance of polio eradication in polio free countries. Methods: In a cross-sectional survey from 2007 to 2013, we reviewed all the records of under 15 years old patients reported to Acute Flaccid Paralysis Committee (AFPC in Isfahan province, Iran. All cases were visited by members of the AFPC. Three stool samples were collected from each reported case within 2 weeks of onset of paralysis and sent to National Polio Laboratory in Tehran, Iran, for poliovirus isolation. Data were analyzed by SSPS software (version 22. Student′s t-test and Chi-square was used to compare variables. Statistical significance level was set at P 94%, with six doses of oral polio vaccine (OPV. Accurate surveillance for poliomyelitis is essential for continuing eradication.

  7. Rotavirus Surveillance at a WHO-Coordinated Invasive Bacterial Disease Surveillance Site in Bangladesh: A Feasibility Study to Integrate Two Surveillance Systems.

    Science.gov (United States)

    Tanmoy, Arif Mohammad; Ahmed, Asm Nawshad Uddin; Arumugam, Rajesh; Hossain, Belal; Marzan, Mahfuza; Saha, Shampa; Arifeen, Shams El; Baqui, Abdullah H; Black, Robert E; Kang, Gagandeep; Saha, Samir Kumar

    2016-01-01

    The World Health Organization (WHO) currently coordinates rotavirus diarrhea and invasive bacterial disease (IBD) surveillance at 178 sentinel sites in 60 countries. However, only 78 sites participate in both surveillance systems using a common sentinel site. Here, we explored the feasibility of extending a WHO-IBD surveillance platform to generate data on the burden of rotaviral diarrhea and its epidemiological characteristics to prepare the countries to measure the impact of rotaviral vaccine. A six-month (July to December, 2012) surveillance, managed by IBD team, collected stool samples and clinical data from under-five children with acute watery diarrhea at an IBD sentinel site. Samples were tested for rotavirus antigen by ELISA and genotyped by PCR at the regional reference laboratory (RRL). Specimens were collected from 79% (n=297) of eligible cases (n=375); 100% of which were tested for rotavirus by ELISA and 54% (159/297) of them were positive. At RRL, all the cases were confirmed by PCR and genotyped (99%; 158/159). The typing results revealed the predominance of G12 (40%; 64/159) genotype, followed by G1 (31%; 50/159) and G9 (19%; 31/159). All in all, this exploratory surveillance collected the desired demographic and epidemiological data and achieved almost all the benchmark indicators of WHO, starting from enrollment number to quality assurance through a number of case detection, collection, and testing of specimens and genotyping of strains at RRL. The success of this WHO-IBD site in achieving these benchmark indicators of WHO can be used by WHO as a proof-of-concept for considering integration of rotavirus surveillance with WHO-IBD platforms, specifically in countries with well performing IBD site and no ongoing rotavirus surveillance.

  8. A description of malaria sentinel surveillance: a case study in Oromia Regional State, Ethiopia.

    Science.gov (United States)

    Yukich, Joshua O; Butts, Jessica; Miles, Melody; Berhane, Yemane; Nahusenay, Honelgn; Malone, Joseph L; Dissanayake, Gunawardena; Reithinger, Richard; Keating, Joseph

    2014-03-11

    and disseminate surveillance data in a timely way. High quality malaria surveillance in Ethiopia remains a resource intensive activity and extending the generalizability of sentinel surveillance findings to other contexts remains a major limitation of these strategies.

  9. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    Directory of Open Access Journals (Sweden)

    Mark V Mishra

    Full Text Available OBJECTIVES: Qualitative research aimed at identifying patient acceptance of active surveillance (AS has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs could be utilized to identify unmet public needs regarding AS. METHODS: English-language ICs regarding prostate cancer (PC treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC-(#Negative IC/#Total IC x 100]. RESULTS: A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. CONCLUSIONS: This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

  10. [Planning, realization and evaluation of post-marketing surveillance studies. Recommendations of the Society for Phytotherapy].

    Science.gov (United States)

    Kraft, K; Loew, D; Schneider, B; Kemper, F H

    1997-08-01

    Post-marketing-surveillance studies with herbal drugs usually are prospective prescription-epidemiological studies, which should allow statements on quality, efficacy and safety. Until now neither laws nor concrete normative guidelines for the methodology and the evaluation of post-marketing-surveillance studies are existing which could be used for pharmacovigilance. In the present paper guidelines for planning, realisation and evaluation are presented which should allow studies of high quality. The essential components required for the investigational plan are focussed. Also recommendations on the obligatory, optional and special components of the study protocols are made. Additionally statistical methods which allow the evaluation of the therapeutic efficacy are presented.

  11. A nationwide cohort study of stage I seminoma patients followed on a surveillance program

    DEFF Research Database (Denmark)

    Mortensen, Mette Saksø; Lauritsen, Jakob; Gundgaard, Maria Gry

    2014-01-01

    BACKGROUND: Increasing concerns about late effects after adjuvant treatment for stage I seminoma have made surveillance an attractive alternative. OBJECTIVE: To evaluate the surveillance strategy in a nationwide cohort study. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, population-based st......BACKGROUND: Increasing concerns about late effects after adjuvant treatment for stage I seminoma have made surveillance an attractive alternative. OBJECTIVE: To evaluate the surveillance strategy in a nationwide cohort study. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, population......-based study of Danish patients diagnosed with stage I seminoma between 1984 and 2008 and followed for 5 yr (n=1954). Patient data were linked with national registries on November 30, 2012, to obtain information on late relapse, vital status, and cause of death. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS...... factor was excluded from analysis. Limitations include the retrospective nature of the study and the number of missing values in analysis. CONCLUSIONS: In the world's largest study of stage I seminoma patients, we found surveillance to be a safe alternative to adjuvant therapies. Tumor size...

  12. Risk factors for loss to follow-up during active surveillance of patients with Stage I seminoma.

    Science.gov (United States)

    Endo, Tsuyoshi; Kawai, Koji; Kamba, Tomomi; Inai, Hiromu; Uchida, Kazunori; Miyazaki, Jun; Kamoto, Toshiyuki; Ogawa, Osamu; Nishiyama, Hiroyuki

    2014-04-01

    To elucidate the patterns and risk factors for loss to follow-up during active surveillance for Stage I seminoma. A total of 425 cases with Stage I seminoma underwent radical orchiectomy from 1985 to 2006 at 25 Japanese institutions, including 22 community hospitals and 3 university hospitals. The post-orchiectomy management selected was active surveillance for 186 patients, adjuvant radiotherapy for 182 patients and chemotherapy for 57 patients. The Kaplan-Meier method was used to estimate the recurrence-free survival and loss to follow-up rate. The risk factors for loss to follow-up were examined using Cox's proportional hazards model with multiple variables. The 2-, 5- and 10-year loss to follow-up rates in the active surveillance group were 14.2, 37.8 and 71.3%, respectively, which were not significantly different in comparison with those in the active surveillance and adjuvant radiotherapy or chemotherapy groups. With regard to the active surveillance group, the multivariate analysis demonstrated that patients younger than 36 years at diagnosis, patients diagnosed since 2000 and patients treated at hospitals that enrolled more than 10 cases had a significant risk for loss to follow-up. No significant correlation between the loss to follow-up rate and pathological risk factors such as tumor size (≤4 versus >4 cm) and rete testis invasion (presence versus absence) was shown. The loss to follow-up rates beyond 5 years were unsatisfactorily high during active surveillance. Further approaches to improve the quality of active surveillance are needed, especially for high-risk patients such as those of younger age.

  13. RHINO–an autonomous interactive surveillance robot for the needed ones: design and study case

    Directory of Open Access Journals (Sweden)

    Ochoa Michel

    2016-01-01

    Full Text Available Healthcare services are in need of new tools and gadgets that could provide surveillance and people interaction of the needed ones with their surrounding environment. In order to address this problematic, an autonomous-interactive surveillance robot system is proposed in this research. RHINO (Robotic-Human Interface for the Needed Ones was designed under particular normative and will provide commonly needed features in the healthcare field. One of the principal aspects of the device is its particular design which allows the patient to have some privacy under a surveilled environment and without causing any interference in their daily lives. Another main factor is the ability of notifying the care provider or the family of the patient with e-mail or text-sms notifications in case of abnormal activities; so that video access by provider or Skype calls by family relatives could be performed throughout RHINO.

  14. Extended followup and risk factors for disease reclassification in a large active surveillance cohort for localized prostate cancer.

    Science.gov (United States)

    Welty, Christopher J; Cowan, Janet E; Nguyen, Hao; Shinohara, Katsuto; Perez, Nannette; Greene, Kirsten L; Chan, June M; Meng, Maxwell V; Simko, Jeffry P; Cooperberg, Matthew R; Carroll, Peter R

    2015-03-01

    Active surveillance to manage prostate cancer provides an alternative to immediate treatment in men with low risk prostate cancer. We report updated outcomes from a long-standing active surveillance cohort and factors associated with reclassification. We retrospectively reviewed data on all men enrolled in the active surveillance cohort at our institution with at least 6 months of followup between 1990 and 2013. Surveillance consisted of quarterly prostate specific antigen testing, repeat imaging with transrectal ultrasound at provider discretion and periodic repeat prostate biopsies. Factors associated with repeat biopsy reclassification and local treatment were determined by multivariate Cox proportional hazards regression. We also analyzed the association of prostate specific antigen density and outcomes stratified by prostate size. A total of 810 men who consented to participate in the research cohort were followed on active surveillance for a median of 60 months. Of these men 556 (69%) met strict criteria for active surveillance. Five-year overall survival was 98%, treatment-free survival was 60% and biopsy reclassification-free survival was 40%. There were no prostate cancer related deaths. On multivariate analysis prostate specific antigen density was positively associated with the risk of biopsy reclassification and treatment while the number of biopsies and time between biopsies were inversely associated with the 2 outcomes (each p <0.01). When stratified by prostate volume, prostate specific antigen density remained significantly associated with biopsy reclassification for all strata but prostate specific antigen density was only significantly associated with treatment in men with a smaller prostate. Significant prostate cancer related morbidity and mortality remained rare at intermediate followup. Prostate specific antigen density was independently associated with biopsy reclassification and treatment while on active surveillance. Copyright © 2015

  15. Postdischarge surveillance for infection following cesarean section: A prospective cohort study comparing methodologies.

    Science.gov (United States)

    Halwani, Muhammad A; Turnbull, Alison E; Harris, Meredith; Witter, Frank; Perl, Trish M

    2016-04-01

    To assess how enhanced postdischarge telephone follow-up calls would improve case finding for surgical site infection (SSI) surveillance after cesarean section. We conducted a prospective cohort study of all patients who delivered by cesarean section between April 22 and August 22, 2010. In addition to our routine surveillance, using clinical databases and electronic patient records, we also made follow-up calls to the patients at 7, 14, and 30 days postoperation. A standard questionnaire with questions about symptoms of SSI, health-seeking behaviors, and treatment received was administered. Descriptive statistics and univariate analysis were performed to assess the effect of the enhanced surveillance. One hundred ninety-three patients underwent cesarean section during this study period. Standard surveillance identified 14 infections with telephone follow-ups identifying an additional 5 infections. Using the call as a gold standard, the sensitivity of the standard methodology to capture SSI was 73.3%. The duration of the calls ranged from 1 to 5 minutes and were well received by the patients. Results suggest that follow-up telephone calls to patients following cesarean section identifies 26.3% of the total SSIs. Enhanced surveillance can provide more informed data to enhance performance and avoid underestimation of rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Evaluating a surveillance system: live-bird market surveillance for highly pathogenic avian influenza, a case study.

    Science.gov (United States)

    Waziri, Ndadilnasiya Endie; Nguku, Patrick; Olayinka, Adebola; Ajayi, Ike; Kabir, Junaidu; Okolocha, Emmanuel; Tseggai, Tesfai; Joannis, Tony; Okewole, Phillip; Kumbish, Peterside; Ahmed, Mohammed; Lombin, Lami; Nsubuga, Peter

    2014-01-01

    Highly pathogenic avian influenza H5N1 was first reported in poultry in Nigeria in February 2006. The only human case that occurred was linked to contact with poultry in a live bird market (LBM). LBM surveillance was instituted to assess the degree of threat of human exposure to H5N1. The key indicator was detection of H5N1 in LBMs. We evaluated the surveillance system to assess its operations and attributes. We used the US Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems. We reviewed and analyzed passive surveillance data for HPAI (January 2006-March 2009) from the Avian Influenza National Reference Laboratory, and live bird market surveillance data from the Food and Agriculture Organization of the United Nations, Nigeria. We interviewed key stakeholders and reviewed reports of live bird market surveillance to obtain additional information on the operations of the system. We assessed the key system attributes. A total of 299 cases occurred in 25 (72%) states and the Federal Capital Territory (FCT). The system detected HPAI H5N1 virus in 7 (9.5%) LBMs; 2 (29%) of which were from 2 (18.2%) states with no previous case. A total of 17,852 (91.5%) of samples arrived at the laboratory within 24 hours but laboratory analysis took over 7 days. The sensitivity and positive predictive value (PPV) were 15.4% and 66.7% respectively. The system is useful, flexible, complex and not timely, but appears to be meeting its objectives. The isolation of HPAI H5N1 virus in some of these markets is an indication that the markets are possible reservoirs of the virus in Nigeria. We recommend that the Federal Government of Nigeria should dedicate more funds for surveillance for HPAI as this will aid early warning and reduce the risk of a pandemic.

  17. Dengue Incidence in Urban and Rural Cambodia: Results from Population-Based Active Fever Surveillance, 2006–2008

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G. William; Margolis, Harold S.; Buchy, Philippe

    2010-01-01

    Background Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19–year age group in rural villages and urban areas during 2006–2008. Methods and Findings Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4–57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19–year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5–211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural

  18. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G William; Margolis, Harold S; Buchy, Philippe

    2010-11-30

    Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural and urban areas. It also confirmed the

  19. A 24-hour remote surveillance system for terrestrial wildlife studies

    Science.gov (United States)

    Sykes, P.W.; Ryman, W.E.; Kepler, C.B.; Hardy, J.W.

    1995-01-01

    The configuration, components, specifications and costs of a state-of-the-art closed-circuit television system with wide application for wildlife research and management are described. The principal system components consist of color CCTV camera with zoom lens, pan/tilt system, infrared illuminator, heavy duty tripod, coaxial cable, coaxitron system, half-duplex equalizing video/control amplifier, timelapse video cassette recorder, color video monitor, VHS video cassettes, portable generator, fuel tank and power cable. This system was developed and used in a study of Mississippi sandhiIl Crane (Grus canadensis pratensis) behaviors during incubation, hatching and fledging. The main advantages of the system are minimal downtime where a complete record of every event, its time of occurrence and duration, are permanently recorded and can be replayed as many times as necessary thereafter to retrieve the data. The system is particularly applicable for studies of behavior and predation, for counting individuals, or recording difficult to observe activities. The system can be run continuously for several weeks by two people, reducing personnel costs. This paper is intended to provide biologists who have litte knowledge of electronics with a system that might be useful to their specific needs. The disadvantages of this system are the initial costs (about $9800 basic, 1990-1991 U.S. dollars) and the time required to playback video cassette tapes for data retrieval, but the playback can be sped up when litte or no activity of interest is taking place. In our study, the positive aspects of the system far outweighed the negative.

  20. The use of surveillance data and market research to promote physical activity.

    Science.gov (United States)

    Fridinger, Fred; Macera, Carol; Cordell, H Ken

    2002-08-01

    Using various types of data sources for assessing and monitoring physical activity behaviors on a population level adds to our ability to explain the relationships between individuals and their surrounding social and physical environments. This article presents the findings from part of a panel presentation on available data sets at the 2001 Cooper Conference on Innovative Approaches to Understanding and Influencing Physical Activity. First, an overview of large national epidemiologic and surveillance data sets is offered, followed by a discussion on the use of market segmentation data to complement more traditional sources of data by adding new dimensions to our understanding of target groups and potential intervention strategies. The relative advantages and disadvantages of using each type of data are also given, as well as recommendations for further use.

  1. STUDY OF MICROBIOLOGICAL SURVEILLANCE AND ANTIBIOTIC STEWARDSHIP IN VENTILATOR ASSOCIATED PNEUMONIA

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2016-04-01

    Full Text Available BACKGROUND Ventilator-Associated Pneumonia (VAP continues to be a major problem in critically ill patients. The objective of this research was to know the burden of ventilator-associated pneumonia and effectiveness of antibiotic stewardship in Medical Intensive Care Unit (MICU of our institution. METHODS This prospective observational study was carried out for one year at our institution. It included all patients more than 18 years of age admitted to MICU who underwent invasive mechanical ventilation for more than 48 hours. Among these, patients who developed VAP as per the CPIS score were identified. Laboratory results were correlated with the patient’s clinical condition and adjunct investigations. The presumptive therapy for treatment of hospital acquired pneumonia was based on surveillance by hospital infection control unit. All patients who received empiric antimicrobial therapy were analysed against bacterial sensitivity. RESULTS The VAP rate was 67 cases per 1000 ventilator days. The incidence of early VAP was 47.5% and incidence of late VAP was 52.5%. Gram negative isolates in particular Acinetobacter baumannii were more frequent than the Gram positive isolates in early and late VAP; 95% Acinetobacter baumannii isolates were resistant to Carbapenem and sensitive to only Colistin in 67.6% cases, Colistin and Tigecycline in 24.3% cases and to other antibiotics in 8.1% cases. There were inappropriate empirical antibiotic prescriptions in 80% of instances and required a change of antibiotics after the culture and sensitivity report. CONCLUSIONS In conclusion, this work demonstrates the importance of an active surveillance program in multi-drug resistance outbreak recognition in our ICU and review of antimicrobial use to prevent emergence of antibiotic resistance strains and to preserve existing therapeutic option for caring for such infections.

  2. Active surveillance for prostate cancer: current evidence and contemporary state of practice.

    Science.gov (United States)

    Tosoian, Jeffrey J; Carter, H Ballentine; Lepor, Abbey; Loeb, Stacy

    2016-04-01

    Prostate cancer remains one of the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment seem to improve survival in men with unfavourable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favourable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate-cancer-specific mortality are exceedingly low in the intermediate term (5-10 years). Such outcomes seem to be closely associated with programme-specific criteria for selection, monitoring, and intervention, suggesting that AS--like other management strategies--could be individualized based on the level of risk acceptable to patients in light of their personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis.

  3. Implementation of an integrated information system for the management of swine vesicular disease surveillance activities in Italy.

    Science.gov (United States)

    Bellini, Silvia; Ferrarini, Nicola; Santucci, Ugo

    2007-01-01

    In Europe in the last decade, swine vesicular disease (SVD) outbreaks have been steadily reported in Italy where surveillance and eradication activities are in place. To collect and analyse data gathered during SVD surveillance activities, the Italian reference centre for vesicular diseases (CERVES) has implemented an integrated information system for the management of the national surveillance plan. The system was developed using Web-based technology and open source software. It was designed to gather, integrate and manage data generated by the activities of the Veterinary Services, the laboratory information system, herd and animal registers and the relevant technical and scientific information. A geographic information system provides an interface for the system, which facilitates the planning, implementation and evaluation of disease control actions. Access to the system is feasible through a second level domain.

  4. Surveillance-activated defenses block the ROS-induced mitochondrial unfolded protein response.

    Directory of Open Access Journals (Sweden)

    Eva D Runkel

    Full Text Available Disturbance of cellular functions results in the activation of stress-signaling pathways that aim at restoring homeostasis. We performed a genome-wide screen to identify components of the signal transduction of the mitochondrial unfolded protein response (UPR(mt to a nuclear chaperone promoter. We used the ROS generating complex I inhibitor paraquat to induce the UPR(mt, and we employed RNAi exposure post-embryonically to allow testing genes whose knockdown results in embryonic lethality. We identified 54 novel regulators of the ROS-induced UPR(mt. Activation of the UPR(mt, but not of other stress-signaling pathways, failed when homeostasis of basic cellular mechanisms such as translation and protein transport were impaired. These mechanisms are monitored by a recently discovered surveillance system that interprets interruption of these processes as pathogen attack and depends on signaling through the JNK-like MAP-kinase KGB-1. Mutation of kgb-1 abrogated the inhibition of ROS-induced UPR(mt, suggesting that surveillance-activated defenses specifically inhibit the UPR(mt but do not compromise activation of the heat shock response, the UPR of the endoplasmic reticulum, or the SKN-1/Nrf2 mediated response to cytosolic stress. In addition, we identified PIFK-1, the orthologue of the Drosophila PI 4-kinase four wheel drive (FWD, and found that it is the only known factor so far that is essential for the unfolded protein responses of both mitochondria and endoplasmic reticulum. This suggests that both UPRs may share a common membrane associated mechanism.

  5. The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

    Science.gov (United States)

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Aedo, Socrates; Jacob, Omar

    2017-01-01

    Active surveillance (AS) is a considered treatment option for men with low or very low-risk prostate cancer. However, on repeat biopsy some 25% were upgraded and recommended for active treatment. We compare the presence or absence of primary circulating prostate cells (CPCs) with the clinical pathological findings after radical prostatectomy in men fulfilling the criteria for active surveillance and the risk of reclassification for active observation (AO). Methods and patients A single centre observational study was done involving 102 men who fulfilled the Epstein criteria for AS and underwent radical prostatectomy as mono-therapy for prostate cancer. The patients were classified according to the presence or absence of CPCs detected immediately before the prostate biopsy. Mononuclear cells were obtained by differential gel centrifugation of 8 mL of venous blood and CPCs identified using immunocytochemistry with anti-PSA and anti-P504S. A positive CPC test was defined as at least 1 PSA (+), P504S (+) cell detected/blood sample. The surgical specimen was analysed for Gleason score and pathological stage. Results A total of 25 out of 102 (24.5%) men were upgraded based on the pathological findings of the surgical specimen. Among which 45 (44%) men were positive for CPCs. They were younger, 63.9 versus 68.1 years (p = 0.0148), had a lower frequency of pT2 or lower disease (64.4% versus 91.2% p <0.001), higher median Gleason scores (6 versus 5 p < 0.001) in both the biopsy and surgical specimens, and a higher frequency of upgrading 44% versus 9% (p < 0.001) Conclusions In men fulfilling the criteria for AS, the presence of primary CPCs suggests a high risk for disease upgrade and therefore these men may not be ideal for observational therapy. Further studies with a larger population are warranted. PMID:28144285

  6. A Kindergarten Cardiovascular Risk Surveillance Study: CARDIAC-Kinder

    Science.gov (United States)

    Cottrell, Lesley; Spangler-Murphy, Emily; Minor, Valerie; Downes, Amia; Nicholson, Paula; Neal, William A.

    2005-01-01

    Objective: To evaluate an intervention aimed at increasing family physical activity and parent education about diet and activity for kindergarten students and issues related to their children's BMI. Methods: A randomized, controlled trial design was used to assess intervention impact in parental report of child diet and physical activity, and step…

  7. Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

    Science.gov (United States)

    Turkbey, Baris; Mani, Haresh; Aras, Omer; Ho, Jennifer; Hoang, Anthony; Rastinehad, Ardeshir R.; Agarwal, Harsh; Shah, Vijay; Bernardo, Marcelino; Pang, Yuxi; Daar, Dagane; McKinney, Yolanda L.; Linehan, W. Marston; Kaushal, Aradhana; Merino, Maria J.; Wood, Bradford J.; Pinto, Peter A.

    2013-01-01

    Purpose: To determine whether multiparametric magnetic resonance (MR) imaging can help identify patients with prostate cancer who would most appropriately be candidates for active surveillance (AS) according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D’Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy. Materials and Methods: This institutional review board–approved HIPAA-compliant retrospectively designed study included 133 patients (mean age, 59.3 years) with a mean prostate-specific antigen level of 6.73 ng/mL (median, 4.39 ng/mL) who underwent multiparametric MR imaging at 3.0 T before radical prostatectomy. Informed consent was obtained from all patients. Patients were then retrospectively classified as to whether they would have met AS eligibility criteria or were better served by surgery. AS eligibility criteria for prostatectomy specimens were a dominant tumor smaller than 0.5 mL without Gleason 4 or 5 patterns or extracapsular or seminal vesicle invasion. Conventional clinical assessment scores (the D’Amico, Epstein, and CAPRA scoring systems) were compared with multiparametric MR imaging findings for predicting AS candidates. The level of significance of difference between scoring systems was determined by using the χ2 test for categoric variables with the level of significance set at P < .05. Results: Among 133 patients, 14 were eligible for AS on the basis of prostatectomy results. The sensitivity, positive predictive value (PPV), and overall accuracy, respectively, were 93%, 25%, and 70% for the D’Amico system, 64%, 45%, and 88% for the Epstein criteria, and 93%, 20%, and 59% for the CAPRA scoring system for predicting AS candidates (P < .005 for all, χ2 test), while multiparametric MR imaging had a sensitivity of 93%, a PPV of 57%, and an overall accuracy of 92% (P < .005). Conclusion

  8. Rugby World Cup 2015: World Rugby injury surveillance study.

    Science.gov (United States)

    Fuller, Colin W; Taylor, Aileen; Kemp, Simon P T; Raftery, Martin

    2017-01-01

    To determine the incidence, severity and nature of injuries sustained during the Rugby World Cup (RWC) 2015 together with the inciting events leading to the injuries. A prospective, whole population study. 639 international rugby players representing 20 countries. The study protocol followed the definitions and procedures recommended in the consensus statement for epidemiological studies in rugby union; output measures included players' age (years), stature (cm), body mass (kg) and playing position, and the group-level incidence (injuries/1000 player-hours), mean and median severity (days-absence), location (%), type (%) and inciting event (%) for match and training injuries. Incidence of injury was 90.1 match injuries/1000 player-match-hours (backs: 100.4; forwards: 81.1) and 1.0 training injuries/1000 player-training-hours (backs: 0.9; forwards: 1.2). The mean severity of injuries was 29.8 days-absence (backs: 30.4; forwards: 29.1) during matches and 14.4 days-absence (backs: 6.3; forwards: 19.8) during training. During matches, head/face (22.0%), knee (16.2%), muscle-strain (23.1%) and ligament-sprain (23.1%) and, during training, lower limb (80.0%) and muscle-strain (60.0%) injuries were the most common locations and types of injury. Being-tackled (24.7%) was the most common inciting event for injury during matches and rugby-skills-contact activities (70.0%) the most common during training. While the incidence, nature and inciting events associated with match injuries at RWC 2015 were similar to those reported previously for RWCs 2007 and 2011, there were increasing trends in the mean severity and total days-absence through injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. The value of community participation in disease surveillance: a case study from Niger.

    Science.gov (United States)

    Ndiaye, Serigne M; Quick, Linda; Sanda, Ousmane; Niandou, Seydou

    2003-06-01

    A team of researchers, including one behavioral scientist (S.M.N.) and three epidemiologists (L.Q., O.S. and S.N.) conducted community analyses to assess the social and cultural factors that affect the detection and reporting of disease cases in a surveillance system, using acute flaccid paralysis (AFP) surveillance in Niger as a case study. Over a 60-day period in the country, the research team reviewed written field reports and interviewed epidemiologists, nurses, community members and persons in governmental and non-governmental organizations. Overall, we found that the logistical difficulties of travel and communication, which are common in developing countries, constrain the conventional surveillance system that relies on epidemiologists visiting sites to discover and investigate cases, particularly in rural areas. Other challenges include: community members' lack of knowledge about the possible link between a case of paralysis and a dangerous, communicable disease; lack of access to health care, including the low number of clinics and health care workers; cultural beliefs that favor seeking a local healer before consulting a nurse or physician; and health workers' lack of training in AFP surveillance. The quality of surveillance in developing countries can improve if a community-based approach is adopted. Such a system has been used successfully in Niger during smallpox-eradication and guinea worm-control campaigns. In a community-based system, community members receive basic education or more extensive training to motivate and enable them to notify health care staff about possible cases of disease in a timely fashion. Local organizations, local projects and local leaders must be included to ensure the success of such a program. In Niger we found sufficient quantities of this type of social capital, along with enough local experience of past health campaigns, to suggest that a community-based approach can improve the level of comprehensiveness and sensitivity

  10. Five years of Kawasaki disease in the Netherlands a national surveillance study

    NARCIS (Netherlands)

    Tacke, C.E.; Breunis, W.B.; Pereira, R.R.; Breur, J.M.; Kuipers, I.M.; Kuijpers, T.W.

    2014-01-01

    Background: The aim of this study was to evaluate the incidence, disease presentation, treatment and cardiac outcome of Kawasaki disease (KD) in The Netherlands. Methods: The national Dutch Pediatric Surveillance Unit was used to prospectively register new KD cases from 2008 through 2012.

  11. Fluoxetine and infantile hypertrophic pylorus stenosis : a signal from a birth defects drug exposure surveillance study

    NARCIS (Netherlands)

    Bakker, M.K.; de Walle, H.E.K.; Wilffert, B.; de Jong-van den Berg, L.T.W.

    2010-01-01

    Purpose We report an association found in a surveillance study which systematically evaluated combinations of specific birth defects and drugs used in the first trimester of pregnancy. Method The database of a population-based birth defects registry (birth years 1997-2007) was systematically screene

  12. Evaluating Social Media Networks in Medicines Safety Surveillance: Two Case Studies

    NARCIS (Netherlands)

    P.M. Coloma (Preciosa); B. Becker (Benedikt); M.C.J.M. Sturkenboom (Miriam); E.M. Van Mulligen (Erik M.); J.A. Kors (Jan)

    2015-01-01

    textabstractIntroduction: There is growing interest in whether social media can capture patient-generated information relevant for medicines safety surveillance that cannot be found in traditional sources. Objective: The aim of this study was to evaluate the potential contribution of mining social m

  13. Results of a market surveillance study in The Netherlands on break-mark tablets

    NARCIS (Netherlands)

    Barends, D.M.; Groot, D.W.; van der Steen, J.C.; de Kaste, D.; Frijlink, H.W.

    2006-01-01

    A representative market surveillance study on break-mark tablets for human use, having a marketing authorization (MA) in The Netherlands (NL), was carried out. The uniformity of mass of subdivided break-mark tablets into halves was assessed according to Ph.Eur.5.5, now current; and for comparison al

  14. NIH State-of-the-Science Conference Statement: Role of active surveillance in the management of men with localized prostate cancer.

    Science.gov (United States)

    Ganz, Patricia A; Barry, John M; Burke, Wylie; Col, Nananda F; Corso, Phaedra S; Dodson, Everett; Hammond, M Elizabeth; Kogan, Barry A; Lynch, Charles F; Newcomer, Lee; Seifter, Eric J; Tooze, Janet A; Viswanath, Kasisomayajula Vish; Wessells, Hunter

    cancer in the United States are candidates for this approach. However, there are many unanswered questions about active surveillance strategies and prostate cancer that require further research and clarification. These include: • Improvements in the accuracy and consistency of pathologic diagnosis of prostate cancer • Consensus on which men are the most appropriate candidates for active surveillance • The optimal protocol for active surveillance and the potential for individualizing the approach based on clinical and patient factors • Optimal ways to communicate the option of active surveillance to patients • Methods to assist patient decisionmaking • Reasons for acceptance or rejection of active surveillance as a treatment strategy • Short- and long-term outcomes of active surveillance. Well-designed studies to address these questions and others raised in this statement represent an important health research priority. Qualitative, observational, and interventional research designs are needed. Due to the paucity of evidence about this important public health problem, all patients being considered for active surveillance should be offered participation in multicenter research studies that incorporate community settings and partners.

  15. Surveillance and threat detection prevention versus mitigation

    CERN Document Server

    Kirchner, Richard

    2014-01-01

    Surveillance and Threat Detection offers readers a complete understanding of the terrorist/criminal cycle, and how to interrupt that cycle to prevent an attack. Terrorists and criminals often rely on pre-attack and pre-operational planning and surveillance activities that can last a period of weeks, months, or even years. Identifying and disrupting this surveillance is key to prevention of attacks. The systematic capture of suspicious events and the correlation of those events can reveal terrorist or criminal surveillance, allowing security professionals to employ appropriate countermeasures and identify the steps needed to apprehend the perpetrators. The results will dramatically increase the probability of prevention while streamlining protection assets and costs. Readers of Surveillance and Threat Detection will draw from real-world case studies that apply to their real-world security responsibilities. Ultimately, readers will come away with an understanding of how surveillance detection at a high-value, f...

  16. Prostatic intraepithelial neoplasia-like ductal prostatic adenocarcinoma: A case suitable for active surveillance?

    Directory of Open Access Journals (Sweden)

    Soroush Rais-Bahrami

    2017-01-01

    Full Text Available In contrast to typical prostatic ductal adenocarcinoma, prostatic intraepithelial neoplasia (PIN-like ductal adenocarcinoma is a rare variant of prostate cancer with low-grade clinical behavior. We report a case of a 66-year-old African-American male with an elevated serum prostate-specific antigen who underwent multiparametric prostate magnetic resonance imaging (MRI and MRI/ultrasound fusion-guided biopsies. Pathology demonstrated low-volume Gleason score 3 + 3 = 6 (Grade Group 1, acinar adenocarcinoma involving one core and PIN-like ductal adenocarcinoma on a separate core. Herein, we discuss the potential role of active surveillance for patients with this rare variant of prostate cancer found in the era of advanced imaging with multiparametric MRI for prostate cancer.

  17. Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer

    DEFF Research Database (Denmark)

    Kayser, Lars; Hansen-Nord, Nete S; Osborne, Richard H

    2015-01-01

    responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework...... and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores...... and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related...

  18. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

    Science.gov (United States)

    Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

    2016-12-01

    There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. First report on entomological field activities for the surveillance of West Nile disease in Italy

    Directory of Open Access Journals (Sweden)

    Maria Goffredo

    2008-09-01

    Full Text Available West Nile virus (WNV is neuropathogenic for birds, horses and humans and is maintained in natural cycles between birds and mosquitoes, particularly the Culex genus; horses and humans are considered to be incidental hosts. A surveillance plan was implemented in Italy in 1998, following a limited outbreak of WNV equine encephalomyelitis and a WNV outbreak in France very close to the Italian border. This plan to assess the risks of the virus being introduced again included entomological surveillance performed in 15 study areas considered ‘at risk’ of WNV introduction in the country. Entomological surveys conducted in Italy from 2003 to 2007 resulted in the capture of a total of 28 798 mosquitoes, of which there were 14 765 adults and 14 033 larvae belonging to 22 species. According to the literature, eight of the species identified have been found to be naturally infected with WNV or were successfully infected in the laboratory in some parts of Europe and in the United States, namely: Aedes albopictus (Skuse, 1897 (= Stegomiya albopicta, Aedes vexans (Meigen, 1830, Anopheles maculipennis Meigen, 1818, Coquillettidia richiardii (Ficalbi, 1889, Culex modestus Ficalbi, 1889, Culex pipiens Linnaeus, 1758, Culex theileri Theobald, 1903 and Ochlerotatus caspius (Pallas, 1771 (= Aedes caspius.

  20. Active surveillance of American tegumentary leishmaniasis in endemic areas in rural Bolivia

    Directory of Open Access Journals (Sweden)

    Vladimir Luna Tedesqui

    2012-02-01

    Full Text Available INTRODUCTION: American tegumentary leishmaniasis (ATL, including mucocutaneous leishmaniasis (MCL and localized cutaneous leishmaniasis (LCL, is endemic in Bolivia. We describe the results of active surveillance of ATL from 2001 to 2006 and assess demographic data related to ATL epidemiology in the Yungas valleys. METHODS: Community-based active ATL surveillance was performed by the institutions SERVIR, CÁRITAS, and the Health Services Department of La Paz, whose files were reviewed retrospectively. A cross-sectional survey was carried out to assess demographic data in two communities. RESULTS: Two thousand nine hundred nine cases of ATL were detected from 2001 to 2006: 2,488 (85.5% corresponded to LCL and 421 (14.5% to MCL. A reduction in the proportion of mucosal cases was observed between 2001 and 2006. The proportion of MCL cases increased with age and was higher among males (15.5% versus 12.1%, p=0.018. The rate of positivity via direct observation of the parasite in dermal scrapings and in parasite cultivation was significantly higher for LCL than for MCL (p<0.001 and p=0.009, respectively. The rate of reactivity in the leishmanin skin test was higher in the group with mucosal lesions (p=0.012. The cross-sectional survey showed that 40% of the families had emigrated from the Altiplano. CONCLUSIONS: It is necessary to undertake continuous case detection of ATL in the area, where the disease presents a high rate of mucosal cases. Increasing incidence seems to be associated with immigration and continuous deforestation to expand the crop-growing areas.

  1. Which surveillance systems were operational after Typhoon Haiyan

    Directory of Open Access Journals (Sweden)

    Sheila Tante

    2015-11-01

    Full Text Available Introduction: Effective disease surveillance is vital for a successful disaster response. This study assessed the functionality of the three disease surveillance systems used post-Haiyan: Philippine Integrated Disease Surveillance and Response (PIDSR, Event-based Surveillance and Response (ESR and Surveillance in Post Extreme Emergencies and Disasters (SPEED. Methods: A survey of 45 government health officers from affected areas was conducted in March 2014. The survey documented when each of the systems was operational and included questions that ranked the functionality of the three surveillance systems and whether they complemented each other. Results: Two of 11 (18% surveillance units had an operational SPEED system pre-event. PIDSR and ESR remained operational in five of 11 (45% surveillance units without interruption of reporting. Ten surveillance units (91% rated PIDSR as functional post-Typhoon; eight (72.7% considered ESR functional. SPEED was rated as functional by three (27% surveillance units. Seven of 11 (63.6% surveillance units rated the three systems as being complementary to each other. Discussion: In most of the areas affected by Typhoon Haiyan, the routine surveillance systems (PIDSR and ESR were not disrupted; although, in Leyte it took seven weeks for these to be operational. Although SPEED is recommended for activation within 48 hours after a disaster, this did not occur in most of the surveyed areas. Most of the surveillance units rated PIDSR, ESR and SPEED to be complementary to each other.

  2. Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration.

    Science.gov (United States)

    Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène; Balestre, Eric; Kouakou, Martial; Akakpo, Jocelyn; Ahouada, Carin; de Rekeneire, Nathalie; Dabis, François; Lewden, Charlotte; Minga, Albert

    2015-04-09

    The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities. Within the International epidemiological Database to Evaluate AIDS (IeDEA)--West Africa collaboration, we conducted a prospective, multicenter data collection that involved two facilities in Abidjan, Côte d'Ivoire and one in Cotonou, Benin. Among HIV-infected adults receiving ART, events were recorded using a standardized form. A simple case-definition of severe morbidity (death, hospitalization, fever>38°5C, Karnofsky indexART in ambulatory HIV care facilities in West Africa. Meanwhile, additional studies are needed due to the undiagnosed aspect of severe morbidity in substantial proportion.

  3. Surveillance of healthcare acquired infections in hospital and community: a retrospective study in Local Healthcare Organization of Rovigo

    Directory of Open Access Journals (Sweden)

    Francesca Ronzani

    2013-03-01

    Full Text Available Background: antimicrobial resistance is recognized as one of the greatest threats to human health worldwide. Infections caused by multidrug-resistant bacteria are associated with higher incidences of mortality, morbidity, prolonged hospital stay and increase of costs. Surveillance of alert organism/conditions and bacterial resistance to antimicrobials is a systematic and dynamic system of data collection that analyses and monitors trends of bacterial resistance. This study was conducted to detect antimicrobial susceptibility patterns in order to inform treatment choices and generate hospital-wide baseline data.Methods: the Local Healtcare Oganization of Rovigo has started a program of surveillance on antimicrobial resistance in hospital and community. In this work some results of the surveillance of microorganism isolated and related antimicrobial resistance are reported, collected in the period 2009-2010 in Rovigo and Trecenta Hospitals, Territorial Nursing Homes (TNH and community from patients’ blood, urine and respiratory samples.Results: data show a significant difference in the level of antibiotic resistance between the two Hospitals. High rates of extended-spectrum β-lactamase (ESBL-producing organisms are detected and carbapenems are the only reliable agents for the treatment of many infections in the Hospital of Trecenta and TNH.Conclusions: because ESBL producing bacteria are emerging pathogens in the community, the rational use of available antibiotics or the appropriate antimicrobial prescribing are imperative. Local surveillance is a powerful tool to detect and monitor hospital and community infections and provides information useful as a guide to medical practice, including therapeutics and disease-control activities.

  4. Weighted Activity and Costing of Surveillance and Control in Animal Epidemiology

    Directory of Open Access Journals (Sweden)

    Duboz Raphaël

    2013-01-01

    Full Text Available Activity based modeling and simulation is a very promising field. It has recently demonstrated its potential from modeling software development methods [9] to the design of low energy sensors. In this position paper, I would like to initiate a reflexion on the use of the weighted activity in the context of financial costing using the formulation recently proposed by X. Hu and B.P. Zeigler [5]. I propose here to formalize a recent approach of costing, the Time-Driven Activity Based Costing [3], using the theoretical modeling framework initiated by B.P. Zeigler [6]. I argue that this specification can potentially improve the traditional model of Time-Driven Activity Based Costing. I illustrate the approach in the context of surveillance and control in animal epidemiology. The demonstration of its effectiveness is not done in this position paper. Nevertheless, as the existing costing systems are designed to support decision making in business management, the scenario based approach proposed in this paper should be very useful to support decisions in complex management situations.

  5. Quality of life of nursing-home residents with dementia subject to surveillance technology versus physical restraints: an explorative study.

    NARCIS (Netherlands)

    Boekhorst, S. te; Depla, M.F.I.A.; Francke, A.L.; Twisk, J.W.R.; Zwijsen, S.A.; Hertogh, C.M.P.M.

    2013-01-01

    Objective: As physical restraints should only be used in exceptional cases, there is an urgent need for alternatives to restraint use. Surveillance technology could be such an alternative. This study explored whether nursing-home residents with dementia subjected to surveillance technology had

  6. [Active surveillance of adverse drug reaction in the era of big data: challenge and opportunity for control selection].

    Science.gov (United States)

    Wang, S F; Zhan, S Y

    2016-07-01

    Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China.

  7. Association Between User-Generated Commuting Data and Population-Representative Active Commuting Surveillance Data - Four Cities, 2014-2015.

    Science.gov (United States)

    Whitfield, Geoffrey P; Ussery, Emily N; Riordan, Brian; Wendel, Arthur M

    2016-09-16

    Creating environments that support all types of physical activity, including active transportation, is a public health priority (1). Public health surveillance that identifies the locations where community members walk and bicycle (i.e., engage in active transportation) can inform such efforts. Traditional population-representative active transportation surveillance incurs a considerable time lag between data collection and dissemination, and often lacks geographic specificity (2). Conversely, user-generated active transportation data from Global Positioning System (GPS)-based activity tracking devices and mobile applications can provide near real-time information, but might be subject to self-selection bias among users. CDC analyzed the association between GPS-based commuting data from a company that allows tracking of activity with a mobile application (Strava, Inc., San Francisco, California) and population-representative commuting data from the U.S. Census Bureau's American Community Survey (ACS) (3) for four U.S. cities. The level of analysis was the Census block group. The number of GPS-tracked commuters in Strava was associated with the number of ACS active commuters (Spearman's rho = 0.60), suggesting block groups were ranked similarly based on these distinct but related measurements. The correlation was higher in high population density areas. User-generated active transportation data might complement traditional surveillance systems by providing near real-time, location-specific information on where active transportation occurs.

  8. Georgia's collaborative approach to expanding mosquito surveillance in response to Zika virus: a case study.

    Science.gov (United States)

    Rustin, R Christopher; Martin, Deonte; Sevilimedu, Varadan; Pandeya, Sarbesh; Rochani, Haresh; Kelly, Rosmarie

    2017-01-01

    Zika virus (ZIKV) was declared an international public health emergency by the World Health Organization on February 1, 2016. Due to the known and estimated range of the ZIKV mosquito vectors, southern and central US states faced increased risk of ZIKV transmission. With the state of Georgia hosting the world's busiest international airport, a climate that supports the ZIKV vectors, and limited surveillance (13 counties) and response capacity, the Department of Public Health (DPH) was challenged to respond and prevent ZIKV transmission. This case study describes and evaluates the state's surveillance capacity before and after the declaration of ZIKV as a public health emergency. We analyzed surveillance data from the DPH to compare the geographical distribution of counties conducting surveillance, total number, and overall percentage of mosquito species trapped in 2015 to 2016. Counties conducting surveillance before and after the identification of the ZIKV risk were mapped using ArcMap 10.4.1. Using SAS (version 9.2) (SAS Institute, Inc, Cary, NC), we performed the independent 2 sample t test to test for differences in prevalence in both years, and a χ² analysis to test for differences between numbers of species across the 13 counties. In addition, weighted frequency counts of mosquitoes were used to test (χ²) an association between major mosquito vector species and 7 urban counties. Lastly, using data from 2012-2016, a time-trend analysis was conducted to evaluate temporal trends in species prevalence. From 2015 to 2016, surveillance increased from 13 to 57 (338% increase) counties geographically dispersed across Georgia. A total of 76,052 mosquitoes were trapped and identified in 2015 compared to 144,731 (90.3% increase) in 2016. Significant differences between species (Psurveillance footprint. Existing and new partnerships were developed with the military and local health departments to expand and share data. This additional surveillance data allowed DPH to

  9. Detection of Activities by Wireless Sensors for Daily Life Surveillance: Eating and Drinking

    Directory of Open Access Journals (Sweden)

    Chen Khong Tham

    2009-03-01

    Full Text Available This paper introduces a two-stage approach to the detection of people eating and/or drinking for the purposes of surveillance of daily life. With the sole use of wearable accelerometer sensor attached to somebody’s (man or a woman wrists, this two-stage approach consists of feature extraction followed by classification. At the first stage, based on the limb’s three dimensional kinematics movement model and the Extended Kalman Filter (EKF, the realtime arm movement features described by Euler angles are extracted from the raw accelerometer measurement data. In the latter stage, the Hierarchical Temporal Memory (HTM network is adopted to classify the extracted features of the eating/drinking activities based on the space and time varying property of the features, by making use of the powerful modelling capability of HTM network on dynamic signals which is varying with both space and time. The proposed approach is tested through the real eating and drinking activities using the three dimensional accelerometers. Experimental results show that the EKF and HTM based two-stage approach can perform the activity detection successfully with very high accuracy.

  10. New Method for Real Time Influenza Surveillance in Primary Care: A Wisconsin Research and Education Network (WREN) Supported Study.

    Science.gov (United States)

    Temte, Jonathan L; Barlow, Shari; Schemmel, Amber; Temte, Emily; Hahn, David L; Reisdorf, Erik; Shult, Peter; Tamerius, John

    2017-01-01

    The goal of public health infectious disease surveillance systems is to provide accurate laboratory results in near-real time. When it comes to influenza surveillance, most current systems are encumbered with inherent delays encountered in the real-life chaos of medical practice. To combat this, we implemented and tested near-real-time surveillance using a rapid influenza detection test (RIDT) coupled with immediate, wireless transmission of results to public health entities. A network of 19 primary care clinics across Wisconsin were recruited, including 4 sites already involved in ongoing influenza surveillance and 15 sites that were new to surveillance activities. Each site was provided with a Quidel Sofia Influenza A+B RIDT analyzer attached to a wireless router. Influenza test results, along with patient age, were transmitted immediately to a cloud-based server, automatically compiled, and forwarded to the surveillance team daily. Weekly counts of positive influenza A and B cases were compared with positive polymerase chain reaction (PCR) detections from an independent surveillance system within the state. Following Institutional Review Board (IRB) and institutional approvals, we recruited 19 surveillance sites, installed equipment, and trained staff within 4 months. Of the 1119 cases tested between September 15, 2013 and June 28, 2014, 316 were positive for influenza. The system provided early detection of the influenza outbreak in Wisconsin. The influenza peak between January 12 and 25, 2014, as well as the epidemic curve, closely matched that derived from the established PCR laboratory network (r = 0.927; P surveillance. Results from the initial year strongly support this approach to highly accurate and timely influenza surveillance. © Copyright 2017 by the American Board of Family Medicine.

  11. Occupational injury surveillance: A study in a metal smelting industry

    Directory of Open Access Journals (Sweden)

    Saha Asim

    2007-01-01

    Full Text Available An investigation of occupational injury was undertaken in a metal smelting industry to examine the occurrence and nature of occupational accidents where analysis of occupational injury records was carried out. At the same time, all the workers were interviewed to collect data in relation to personal and occupational characteristics. With this information, the study aimed to examine the role of different factors in the causation of occupational accidents. High incidence of superficial injuries of limbs due mostly to stepping / striking against objects and overexertion / wrong movements of the workers and the frequent association of handling of small tools with work injuries, observed in this study indicated the role of human error in these accidents and highlighted the necessity of proper safety training of the workers. This study also highlighted the need of elevated safety status during summer months and in evening and night shifts (more so in the second half. Moreover, this study could categorize some high-risk groups e.g. young workers, less-experienced workers, obese workers, workers having smoking / chewing habits etc, who need special attention so far as workplace safety is concerned.

  12. Development and application of the active surveillance of pathogens microarray to monitor bacterial gene flux

    Directory of Open Access Journals (Sweden)

    Hinds Jason

    2008-10-01

    Full Text Available Abstract Background Human and animal health is constantly under threat by emerging pathogens that have recently acquired genetic determinants that enhance their survival, transmissibility and virulence. We describe the construction and development of an Active Surveillance of Pathogens (ASP oligonucleotide microarray, designed to 'actively survey' the genome of a given bacterial pathogen for virulence-associated genes. Results The microarray consists of 4958 reporters from 151 bacterial species and include genes for the identification of individual bacterial species as well as mobile genetic elements (transposons, plasmid and phage, virulence genes and antibiotic resistance genes. The ASP microarray was validated with nineteen bacterial pathogens species, including Francisella tularensis, Clostridium difficile, Staphylococcus aureus, Enterococcus faecium and Stenotrophomonas maltophilia. The ASP microarray identified these bacteria, and provided information on potential antibiotic resistance (eg sufamethoxazole resistance and sulfonamide resistance and virulence determinants including genes likely to be acquired by horizontal gene transfer (e.g. an alpha-haemolysin. Conclusion The ASP microarray has potential in the clinic as a diagnostic tool, as a research tool for both known and emerging pathogens, and as an early warning system for pathogenic bacteria that have been recently modified either naturally or deliberately.

  13. First record of Stegomyia albopicta in Turkey determined by active ovitrap surveillance and DNA barcoding.

    Science.gov (United States)

    Oter, Kerem; Gunay, Filiz; Tuzer, Erkut; Linton, Yvonne-Marie; Bellini, Romeo; Alten, Bulent

    2013-10-01

    Despite its confirmed establishment in neighboring Greece and Bulgaria, the presence of the Oriental invasive species Stegomyia albopicta (Skuse) (=Aedes albopictus) has never been confirmed in Turkey. Active surveillance for this container-breeding species was carried out using oviposition traps at 15 discrete sites in the towns of Ipsala (n=8 sites), Kesan (n=5) (Edirne District), and Malkara (n=2) (Tekirdag District) in the Thrace region of northwestern Turkey, from May 23 through November 10, 2011. Eggs collected were reared to the fourth larval instar and adult stages where possible to facilitate integrated morphological and molecular species identification. DNA barcodes (658 bp of the mitochondrial cytochrome c oxidase I [COI] gene) were compared with all four potentially invasive Stegomyia species: St. aegypti, St. albopicta, St. cretina, and St. japonica. Sequences generated for samples collected in Thrace Region were herein confirmed as St. albopicta, the first record of this vector species in Turkey. Eggs of St. albopicta were detected in two discrete localities: (1) In the grounds of a restaurant in Kesan (in week 36), and (2) in the customs area of the Turkish-Greek border at Ipsala (in weeks 32 and 38). Multiple detection of St. albopicta eggs indicates the possible establishment of the species in northwestern Turkey. Finding this important disease vector has implications for public health and requires the implementation of active vector monitoring programs and targeted vector suppression strategies to limit the spread of this invasive vector species in Turkey.

  14. A nationwide cohort study of stage I seminoma patients followed on a surveillance program.

    Science.gov (United States)

    Mortensen, Mette Saksø; Lauritsen, Jakob; Gundgaard, Maria Gry; Agerbæk, Mads; Holm, Niels Vilstrup; Christensen, Ib Jarle; von der Maase, Hans; Daugaard, Gedske

    2014-12-01

    Increasing concerns about late effects after adjuvant treatment for stage I seminoma have made surveillance an attractive alternative. To evaluate the surveillance strategy in a nationwide cohort study. A retrospective, population-based study of Danish patients diagnosed with stage I seminoma between 1984 and 2008 and followed for 5 yr (n=1954). Patient data were linked with national registries on November 30, 2012, to obtain information on late relapse, vital status, and cause of death. Disease-specific survival (DSS), overall survival, relapse rates, time to relapse, detection of relapse, and prognostic factors for relapse were described for the cohort. The Kaplan-Meier method was used to determine survival probabilities. A Cox proportional hazards model was used for multivariate analysis of prognostic factors. Median follow-up time was 15.1 yr. In total, 369 patients relapsed after a median 13.7 mo. DSS after 15 yr was 99.3%. Tumor size was a significant factor for relapse. Either vascular invasion or invasion of epididymis was significant if the other factor was excluded from analysis. Limitations include the retrospective nature of the study and the number of missing values in analysis. In the world's largest study of stage I seminoma patients, we found surveillance to be a safe alternative to adjuvant therapies. Tumor size was a significant factor for relapse, together with either invasion of epididymis or vascular invasion. In this nationwide study, we looked at the outcomes of patients with stage I seminoma followed for 5 yr. We found that surveillance is a safe alternative to adjuvant treatment. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  15. The cost-utility of open prostatectomy compared with active surveillance in early localised prostate cancer

    Science.gov (United States)

    2014-01-01

    Background There is an on-going debate about whether to perform surgery on early stage localised prostate cancer and risk the common long term side effects such as urinary incontinence and erectile dysfunction. Alternatively these patients could be closely monitored and treated only in case of disease progression (active surveillance). The aim of this paper is to develop a decision-analytic model comparing the cost-utility of active surveillance (AS) and radical prostatectomy (PE) for a cohort of 65 year old men with newly diagnosed low risk prostate cancer. Methods A Markov model comparing PE and AS over a lifetime horizon was programmed in TreeAge from a German societal perspective. Comparative disease specific mortality was obtained from the Scandinavian Prostate Cancer Group trial. Direct costs were identified via national treatment guidelines and expert interviews covering in-patient, out-patient, medication, aids and remedies as well as out of pocket payments. Utility values were used as factor weights for age specific quality of life values of the German population. Uncertainty was assessed deterministically and probabilistically. Results With quality adjustment, AS was the dominant strategy compared with initial treatment. In the base case, it was associated with an additional 0.04 quality adjusted life years (7.60 QALYs vs. 7.56 QALYs) and a cost reduction of €6,883 per patient (2011 prices). Considering only life-years gained, PE was more effective with an incremental cost-effectiveness ratio of €96,420/life year gained. Sensitivity analysis showed that the probability of developing metastases under AS and utility weights under AS are a major sources of uncertainty. A Monte Carlo simulation revealed that AS was more likely to be cost-effective even under very high willingness to pay thresholds. Conclusion AS is likely to be a cost-saving treatment strategy for some patients with early stage localised prostate cancer. However, cost-effectiveness is

  16. Provocative dietary factors in geriatric hypertension: A surveillance study.

    Science.gov (United States)

    Jagtap, Madhavi V; Deole, Yogesh S; Chandola, Harimohan; Ravishankar, B

    2012-10-01

    Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ≤180 mm Hg and diastolic blood pressure >90 mm Hg and ≤110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension.

  17. [Poliomyelitis surveillance: seroepidemiologic study on a Piedmont population sample].

    Science.gov (United States)

    Maiello, A; Ossola, O; Guidetti, A; Zotti, C; Moiraghi Ruggenini, A

    1995-01-01

    In order to assess the immunity/receptivity towards the three poliovirus strains, a sample representative of the sex and age composition of the resident population in Piedmont at census 1981, was examined. For each subject data were collected in order to identify the population from social-ambient point of view. For the evaluation of antibodie's title to poliovirus 1, 2, 3, the serums were analyzed with the neutralization method using the microtitolation plates and epithelial larynx cancer cells (HEp-2), like revealing system. The samples with > or = 2 title were considered positives for specific antibodies. To determine the relation between presence/absence of specific poliovirus antibodies and the other variables, a multiple logistic regression was fitted and the odds ratio was calculated. The results of our study show an immunity in all age groups, underlying a herd immunity condition. Furthermore the incomplete antibodies response to the three poliovirus strains seems to be influenced by age only.

  18. OptisampleTM: Open web-based application to optimize sampling strategies for active surveillance activities at the herd level illustrated using Porcine Respiratory Reproductive Syndrome (PRRS).

    Science.gov (United States)

    Alba, Anna; Morrison, Robert E; Cheeran, Ann; Rovira, Albert; Alvarez, Julio; Perez, Andres M

    2017-01-01

    Porcine reproductive and respiratory syndrome virus (PRRSv) infection causes a devastating economic impact to the swine industry. Active surveillance is routinely conducted in many swine herds to demonstrate freedom from PRRSv infection. The design of efficient active surveillance sampling schemes is challenging because optimum surveillance strategies may differ depending on infection status, herd structure, management, or resources for conducting sampling. Here, we present an open web-based application, named 'OptisampleTM', designed to optimize herd sampling strategies to substantiate freedom of infection considering also costs of testing. In addition to herd size, expected prevalence, test sensitivity, and desired level of confidence, the model takes into account the presumed risk of pathogen introduction between samples, the structure of the herd, and the process to select the samples over time. We illustrate the functionality and capacity of 'OptisampleTM' through its application to active surveillance of PRRSv in hypothetical swine herds under disparate epidemiological situations. Diverse sampling schemes were simulated and compared for each herd to identify effective strategies at low costs. The model results show that to demonstrate freedom from disease, it is important to consider both the epidemiological situation of the herd and the sample selected. The approach illustrated here for PRRSv may be easily extended to other animal disease surveillance systems using the web-based application available at http://stemma.ahc.umn.edu/optisample.

  19. Association between the location of colon polyps at baseline and surveillance colonoscopy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ana Oliveira

    Full Text Available Introduction: Several factors are used to stratify the probability of polyp recurrence. However, there are no studies correlating the location of the initial polyps and the recurrent ones. The aim of this study was to verify whether the polyp location at the surveillance colonoscopy was correlated with the location of the previously excised polyps at the baseline colonoscopy. Methods: A retrospective study of patients submitted to colonoscopy with presence and excision of all polyps, followed by a surveillance colonoscopy. Polyp location was divided into proximal/distal to splenic flexure and rectum. Characteristics and recurrent rates at the same colon location were also evaluated. Results: Out of the 346 patients who underwent repeated colonoscopy, 268 (77.4% had at least 1 polyp detected. For all the segments there was an increased risk of recurrent polyps in the same location and it was about four times higher in proximal (OR 3.5; CI 2.1-6.0 and distal colon segments (OR 3.8; CI 2.1-6.8, followed by three times higher in the rectum (OR 2.6; CI 1.5-4.6. No difference was found between the rates of recurrence at the same segment, taking into consideration the polyp morphology, size, polypectomy technique employed and histological classification. Conclusion: There seems to be a significant association between polyp location at baseline and surveillance colonoscopy.

  20. Report on HPAI Surveillance Activities for 2007-08 on Pocosin Lakes National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Pungo Unit in Pocosin Lakes NWR hosts large populations of waterfowl species that have been identified for live bird or mortality surveillance for the Highly...

  1. Prostate Cancer: Multi-Parametric Magnetic Resonance Imaging of the Prostate re- classifies patients eligible for Active Surveillance

    DEFF Research Database (Denmark)

    Elkjær, Maria; Pedersen, Bodil Ginnerup; Høyer, Søren

    2015-01-01

    Introduction and Objectives: Pathological examination of the extracted prostate after radical prostatectomy often reveals that trans-rectal ultrasound (TRUS) and TRUS-guided biopsy (TRUS-bx) underestimated the tumor’s true size and aggressiveness. This clinical problem seems to defy a satisfactory...... solution to the dilemma of whether to enroll patients in active surveillance (AS) or to offer the patient active treatment. We present the preliminary results of an on-going trial in which we investigate if multi-parametric magnetic resonance imaging (mpMRI) of the prostate detects significant prostate...... cancer (PC) better than TRUS and TRUS-bx, and if we may in this way make selection of patients for active surveillance safer. Materials and Methods: From November 2014 patients enrolled in an AS program at Aarhus University Hospital, Denmark, were offered an mpMRI 8 weeks after TRUS-bx. All patients were...

  2. Design study for a 16x zoom lens system for visible surveillance camera

    Science.gov (United States)

    Vella, Anthony; Li, Heng; Zhao, Yang; Trumper, Isaac; Gandara-Montano, Gustavo A.; Xu, Di; Nikolov, Daniel K.; Chen, Changchen; Brown, Nicolas S.; Guevara-Torres, Andres; Jung, Hae Won; Reimers, Jacob; Bentley, Julie

    2015-09-01

    *avella@ur.rochester.edu Design study for a 16x zoom lens system for visible surveillance camera Anthony Vella*, Heng Li, Yang Zhao, Isaac Trumper, Gustavo A. Gandara-Montano, Di Xu, Daniel K. Nikolov, Changchen Chen, Nicolas S. Brown, Andres Guevara-Torres, Hae Won Jung, Jacob Reimers, Julie Bentley The Institute of Optics, University of Rochester, Wilmot Building, 275 Hutchison Rd, Rochester, NY, USA 14627-0186 ABSTRACT High zoom ratio zoom lenses have extensive applications in broadcasting, cinema, and surveillance. Here, we present a design study on a 16x zoom lens with 4 groups (including two internal moving groups), designed for, but not limited to, a visible spectrum surveillance camera. Fifteen different solutions were discovered with nearly diffraction limited performance, using PNPX or PNNP design forms with the stop located in either the third or fourth group. Some interesting patterns and trends in the summarized results include the following: (a) in designs with such a large zoom ratio, the potential of locating the aperture stop in the front half of the system is limited, with ray height variations through zoom necessitating a very large lens diameter; (b) in many cases, the lens zoom motion has significant freedom to vary due to near zero total power in the middle two groups; and (c) we discuss the trade-offs between zoom configuration, stop location, packaging factors, and zoom group aberration sensitivity.

  3. Economic Analysis of Classical Swine Fever Surveillance in the Netherlands.

    Science.gov (United States)

    Guo, X; Claassen, G D H; Oude Lansink, A G J M; Loeffen, W; Saatkamp, H W

    2016-06-01

    Classical swine fever (CSF) is a highly contagious pig disease that causes economic losses and impaired animal welfare. Improving the surveillance system for CSF can help to ensure early detection of the virus, thereby providing a better initial situation for controlling the disease. Economic analysis is required to compare the benefits of improved surveillance with the costs of implementing a more intensive system. This study presents a comprehensive economic analysis of CSF surveillance in the Netherlands, taking into account the specialized structure of Dutch pig production, differences in virulence of CSF strains and a complete list of possible surveillance activities. The starting point of the analysis is the current Dutch surveillance system (i.e. the default surveillance-setup scenario), including the surveillance activities 'daily clinical observation by the farmer', 'veterinarian inspection after a call', 'routine veterinarian inspection', 'pathology in AHS', 'PCR on tonsil in AHS', 'PCR on grouped animals in CVI' and 'confirmatory PCR by NVWA'. Alternative surveillance-setup scenarios were proposed by adding 'routine serology in slaughterhouses', 'routine serology on sow farms' and 'PCR on rendered animals'. The costs and benefits for applying the alternative surveillance-setup scenarios were evaluated by comparing the annual mitigated economic losses because of intensified CSF surveillance with the annual additional surveillance costs. The results of the cost-effectiveness analysis show that the alternative surveillance-setup scenarios with 'PCR on rendered animals' are effective for the moderately virulent CSF strain, whereas the scenarios with 'routine serology in slaughterhouses' or 'routine serology on sow farms' are effective for the low virulent strain. Moreover, the current CSF surveillance system in the Netherlands is cost-effective for both moderately virulent and low virulent CSF strains. The results of the cost-benefit analysis for the

  4. Using Hospital Inpatient Discharge Data to Supplement Active Surveillance for Invasive Pneumococcal Disease: Is the Extract Worth the Exertion?

    Science.gov (United States)

    Nichols, Megin C; Bareta, Joseph; Coyle, Alexander; Landen, Michael

    2016-01-01

    Invasive pneumococcal disease (IPD) surveillance systems monitor morbidity, mortality, and vaccine impact; accurate surveillance is important to detect changes in epidemiology. We evaluated completeness of IPD reporting in New Mexico by comparing data from the Hospital Inpatient Discharge Database (HIDD) and the New Mexico Active Bacterial Core Surveillance (ABCs) program. We linked data from the HIDD and the ABCs program. We defined cases of IPD in the HIDD among New Mexico residents with hospitalizations during 2007-2009 as specific (320.1 or 038.2) or nonspecific (481, 320.2, or 041.2) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. To validate if HIDD records that could not be matched to ABCs data were true IPD cases, we reviewed laboratory data and determined if Streptococcus pneumoniae (S. pneumoniae) had been isolated from a sterile body site. We examined 732 HIDD records for cases that were not matched in the ABCs database; of such records, S. pneumoniae was isolated from a sterile body site in 10 HIDD records. ABCs data detected the majority of IPD cases in New Mexico. Laboratory and medical record review is essential when using HIDD data because ICD-9-CM coding alone does not ensure data accuracy. The addition of IPD cases to the ABCs program from the HIDD was minimally beneficial to active surveillance and reporting completeness in New Mexico. States that rely exclusively on passive reporting and that have access to HIDD data might use linkages of pneumococcal and IPD-specific ICD-9-CM-coded HIDD data to improve IPD surveillance and case ascertainment.

  5. A focused ethnographic study of Sri Lankan government field veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance.

    Directory of Open Access Journals (Sweden)

    Kate Sawford

    Full Text Available The global public health community is facing the challenge of emerging infectious diseases. Historically, the majority of these diseases have arisen from animal populations at lower latitudes where many nations experience marked resource constraints. In order to minimize the impact of future events, surveillance of animal populations will need to enable prompt event detection and response. Many surveillance systems targeting animals rely on veterinarians to submit cases to a diagnostic laboratory or input clinical case data. Therefore understanding veterinarians' decision-making process that guides laboratory case submission and their perceptions of infectious disease surveillance is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance initiatives. A focused ethnographic study was conducted with twelve field veterinary surgeons that participated in a mobile phone-based surveillance pilot project in Sri Lanka. Each participant agreed to an individual in-depth interview that was recorded and later transcribed to enable thematic analysis of the interview content. Results found that field veterinarians in Sri Lanka infrequently submit cases to laboratories--so infrequently that common case selection principles could not be described. Field veterinarians in Sri Lanka have a diagnostic process that operates independently of laboratories. Participants indicated a willingness to take part in surveillance initiatives, though they highlighted a need for incentives that satisfy a range of motivations that vary among field veterinarians. This study has implications for the future of animal health surveillance, including interpretation of disease patterns reported, system design and implementation, and engagement of data providers.

  6. A focused ethnographic study of Sri Lankan government field veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance.

    Science.gov (United States)

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2012-01-01

    The global public health community is facing the challenge of emerging infectious diseases. Historically, the majority of these diseases have arisen from animal populations at lower latitudes where many nations experience marked resource constraints. In order to minimize the impact of future events, surveillance of animal populations will need to enable prompt event detection and response. Many surveillance systems targeting animals rely on veterinarians to submit cases to a diagnostic laboratory or input clinical case data. Therefore understanding veterinarians' decision-making process that guides laboratory case submission and their perceptions of infectious disease surveillance is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance initiatives. A focused ethnographic study was conducted with twelve field veterinary surgeons that participated in a mobile phone-based surveillance pilot project in Sri Lanka. Each participant agreed to an individual in-depth interview that was recorded and later transcribed to enable thematic analysis of the interview content. Results found that field veterinarians in Sri Lanka infrequently submit cases to laboratories--so infrequently that common case selection principles could not be described. Field veterinarians in Sri Lanka have a diagnostic process that operates independently of laboratories. Participants indicated a willingness to take part in surveillance initiatives, though they highlighted a need for incentives that satisfy a range of motivations that vary among field veterinarians. This study has implications for the future of animal health surveillance, including interpretation of disease patterns reported, system design and implementation, and engagement of data providers.

  7. A Focused Ethnographic Study of Sri Lankan Government Field Veterinarians’ Decision Making about Diagnostic Laboratory Submissions and Perceptions of Surveillance

    Science.gov (United States)

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2012-01-01

    The global public health community is facing the challenge of emerging infectious diseases. Historically, the majority of these diseases have arisen from animal populations at lower latitudes where many nations experience marked resource constraints. In order to minimize the impact of future events, surveillance of animal populations will need to enable prompt event detection and response. Many surveillance systems targeting animals rely on veterinarians to submit cases to a diagnostic laboratory or input clinical case data. Therefore understanding veterinarians’ decision-making process that guides laboratory case submission and their perceptions of infectious disease surveillance is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance initiatives. A focused ethnographic study was conducted with twelve field veterinary surgeons that participated in a mobile phone-based surveillance pilot project in Sri Lanka. Each participant agreed to an individual in-depth interview that was recorded and later transcribed to enable thematic analysis of the interview content. Results found that field veterinarians in Sri Lanka infrequently submit cases to laboratories – so infrequently that common case selection principles could not be described. Field veterinarians in Sri Lanka have a diagnostic process that operates independently of laboratories. Participants indicated a willingness to take part in surveillance initiatives, though they highlighted a need for incentives that satisfy a range of motivations that vary among field veterinarians. This study has implications for the future of animal health surveillance, including interpretation of disease patterns reported, system design and implementation, and engagement of data providers. PMID:23133542

  8. Scientific Opinion on the evaluation of molecular typing methods for major food-borne microbiological hazards and their use for attribution modelling, outbreak investigation and scanning surveillance: Part 2 (surveillance and data management activities

    Directory of Open Access Journals (Sweden)

    EFSA Panel on Biological Hazards (BIOHAZ

    2014-07-01

    Full Text Available Surveillance programmes based on active and harmonised sampling are considered the most suitable for food-borne outbreak investigations, hypothesis generation, early detection of emerging pathogen subtypes, attribution modelling and genetic studies of bacterial populations. Currently, prototype molecular databases are not widely linked and contain limited epidemiological data, therefore development of linkage mechanisms is a priority. A key technical requirement is determination of an agreed threshold value for the level of genetic variation amongst isolates that can still be regarded as epidemiologically-related. Molecular typing data should be coupled with a minimum required set of epidemiological data and datasets should be comparable to facilitate joint analyses in conjunction with human case data. Rules for assembling strain collections and associated provenance data should be agreed and introduced as EU standards. The data collection process and the characteristics of the data repository should ensure reproducibility and maximise compatibility and interoperability between different datasets. Molecular bacterial characterisation developments, particularly Whole Genome Sequencing (WGS, should be harmonised with those used for surveillance in the human population and food industry. Reference methods and materials, including sequence data, should be adopted for typing of food-borne pathogens. Upload of molecular data should only be allowed for approved laboratories and should be subject to External Quality Assessment. Ongoing international oversight is required to ensure a consensual ‘one-health’ approach. The establishment of a joint EFSA-ECDC-EU-RLs committee for the support of cross-sectoral molecular surveillance, with a balance of public health and veterinary expertise and including both epidemiologists and microbiologists is strongly recommended. Revision of the legal basis of programmes for pathogen reduction based on historic

  9. Internet surveillance, regulation, and chilling effects online: a comparative case study

    Directory of Open Access Journals (Sweden)

    Jonathon W. Penney

    2017-05-01

    Full Text Available With internet regulation and censorship on the rise, states increasingly engaging in online surveillance, and state cyber-policing capabilities rapidly evolving globally, concerns about regulatory “chilling effects” online—the idea that laws, regulations, or state surveillance can deter people from exercising their freedoms or engaging in legal activities on the internet have taken on greater urgency and public importance. But just as notions of “chilling effects” are not new, neither is skepticism about their legal, theoretical, and empirical basis; in fact, the concept remains largely un-interrogated with significant gaps in understanding, particularly with respect to chilling effects online. This work helps fill this void with a first-of-its-kind online survey that examines multiple dimensions of chilling effects online by comparing and analyzing responses to hypothetical scenarios involving different kinds of regulatory actions—including an anti-cyberbullying law, public/private sector surveillance, and an online regulatory scheme, based on the Digital Millennium Copyright Act (DMCA, enforced through personally received legal threats/notices. The results suggest not only the existence and significance of regulatory chilling effects online across these different scenarios but also evidence a differential impact—with personally received legal notices and government surveillance online consistently having the greatest chilling effect on people’s activities online—and certain online activities like speech, search, and personal sharing also impacted differently. The results also offer, for the first time, insights based on demographics and other similar factors about how certain people and groups may be more affected than others, including findings that younger people and women are more likely to be chilled; younger people and women are less likely to take steps to resist regulatory actions and defend themselves; and anti

  10. Surveillance of tobacco industry retail marketing activities of reduced harm products.

    Science.gov (United States)

    Slater, Sandy; Giovino, Gary; Chaloupka, Frank

    2008-01-01

    With the introduction of potential reduced exposure products (PREPs) and the interest in studying tobacco harm reduction, sound research and surveillance are needed to examine and understand the distribution and availability of PREPs in communities, as well as the tobacco industry's marketing practices surrounding these products. We examined the availability and marketing of PREPs in a national sample of tobacco retail stores. We also compared the price of PREPs to those of premium brand cigarettes and examined the distribution of PREPs in comparison with premium brand cigarettes by store type, urbanization, region, and race/ethnicity. We found that PREPs are not widely available, are priced similarly to leading cigarette brands, and have few promotional offers. We also found some significant differences in the distribution of PREPs and cigarettes, as well as in the distribution of Ariva and Omni, by store type and community demographics. The fact that this study used data collected nationally emphasizes the importance of these findings and helps shed some light on the tobacco industry's PREP marketing strategies. This study's national sample provides a unique perspective that needs to be replicated if and when other PREPs are widely marketed.

  11. Child development surveillance: intervention study with nurses of the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Altamira Pereira da Silva Reichert

    2015-10-01

    Full Text Available Objective: to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care.Methods: interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated.Results: after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children's development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development.Conclusions: the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care.

  12. Child development surveillance: intervention study with nurses of the Family Health Strategy1

    Science.gov (United States)

    Reichert, Altamira Pereira da Silva; Collet, Neusa; Eickmann, Sophie Helena; Lima, Marília de Carvalho

    2015-01-01

    Objective: to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care. Methods: interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated. Results: after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children's development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development. Conclusions: the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care. PMID:26487147

  13. A study on assessment methodology of surveillance test interval and allowed outage time

    Energy Technology Data Exchange (ETDEWEB)

    Che, Moo Seong; Cheong, Chang Hyeon; Lee, Byeong Cheol [Seoul Nationl Univ., Seoul (Korea, Republic of)] (and others)

    1996-07-15

    The objectives of this study is the development of methodology by which assessing the optimizes Surveillance Test Interval(STI) and Allowed Outage Time(AOT) using PSA method that can supplement the current deterministic methods and the improvement of Korea nuclear power plants safety. In the first year of this study, the survey about the assessment methodologies, modeling and results performed by domestic and international researches is performed as the basic step before developing the assessment methodology of this study. The assessment methodology that supplement the revealed problems in many other studies is presented and the application of new methodology into the example system assures the feasibility of this method.

  14. Implementation and utilisation of community-based mortality surveillance: a case study from Chad

    Directory of Open Access Journals (Sweden)

    Bowden Sarah

    2012-11-01

    Full Text Available Abstract Background Prospective surveillance is a recognised approach for measuring death rates in humanitarian emergencies. However, there is limited evidence on how such surveillance should optimally be implemented and on how data are actually used by agencies. This case study investigates the implementation and utilisation of mortality surveillance data by Médecins Sans Frontières (MSF in eastern Chad. We aimed to describe and analyse the community-based mortality surveillance system, trends in mortality data and the utilisation of these data to guide MSF’s operational response. Methods The case study included 5 MSF sites including 2 refugee camps and 3 camps for internally displaced persons (IDPs. Data were obtained through key informant interviews and systematic review of MSF operational reports from 2004–2008. Results Mortality data were collected using community health workers (CHWs. Mortality generally decreased progressively. In Farchana and Breidjing refugee camps, crude death rates (CDR decreased from 0.9 deaths per 10,000 person-days in 2004 to 0.2 in 2008 and from 0.7 to 0.1, respectively. In Gassire, Ade and Kerfi IDP camps, CDR decreased from 0.4 to 0.04, 0.3 to 0.04 and 1.0 to 0.3. Death rates among children under 5 years (U5DR followed similar trends. CDR and U5DR crossed emergency thresholds in one site, Kerfi, where CDR rapidly rose to 2.1 and U5DR to 7.9 in July 2008 before rapidly decreasing to below emergency levels by September 2008. Discussion Mortality data were used regularly to monitor population health status and on two occasions as a tool for advocacy. Lessons learned included the need for improved population estimates and standardized reporting procedures for improved data quality and dissemination; the importance of a simple and flexible model for data collection; and greater investment in supervising CHWs. Conclusions This model of community based mortality surveillance can be adapted and used by

  15. A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs.

    Directory of Open Access Journals (Sweden)

    Kate Sawford

    Full Text Available The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.

  16. A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs.

    Science.gov (United States)

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2013-01-01

    The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.

  17. A Focused Ethnographic Study of Alberta Cattle Veterinarians’ Decision Making about Diagnostic Laboratory Submissions and Perceptions of Surveillance Programs

    Science.gov (United States)

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2013-01-01

    The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance. PMID:23741397

  18. Cognitive and Affective Representations of Active Surveillance as a Treatment Option for Low-Risk Prostate Cancer.

    Science.gov (United States)

    Lyons, Kathleen D; Li, Hsin H; Mader, Emily M; Stewart, Telisa M; Morley, Christopher P; Formica, Margaret K; Perrapato, Scott D; Seigne, John D; Hyams, Elias S; Irwin, Brian H; Mosher, Terry; Hegel, Mark T

    2016-06-29

    Benefits of early diagnosis and treatment remain debatable for men with low-risk prostate cancer. Active surveillance (AS) is an alternative to treatment. The goal of AS is to identify patients whose cancer is progressing rapidly while avoiding treatment in the majority of patients. The purpose of this study was to explore cognitive and affective representations of AS within a clinical environment that promotes AS a viable option for men with low-risk prostate cancer. Participants included patients for whom AS and active treatment were equally viable options, as well as practitioners who were involved in consultations for prostate cancer. Data were generated from semistructured interviews and audits of consultation notes and were analyzed using thematic analysis. Nineteen patients and 16 practitioners completed a semistructured interview. Patients generally viewed AS as a temporary strategy that was largely equated with inaction. There was variation in the degree to which inaction was viewed as warranted or favorable. Patient perceptions of AS were generally malleable and able to be influenced by information from trusted sources. Encouraging slow deliberation and multiple consultations may facilitate greater understanding and acceptance of AS as a viable treatment option for low-risk prostate cancer.

  19. Towards data justice? The ambiguity of anti-surveillance resistance in political activism

    Directory of Open Access Journals (Sweden)

    Lina Dencik

    2016-11-01

    Full Text Available The Snowden leaks, first published in June 2013, provided unprecedented insights into the operations of state-corporate surveillance, highlighting the extent to which everyday communication is integrated into an extensive regime of control that relies on the ‘datafication’ of social life. Whilst such data-driven forms of governance have significant implications for citizenship and society, resistance to surveillance in the wake of the Snowden leaks has predominantly centred on techno-legal responses relating to the development and use of encryption and policy advocacy around privacy and data protection. Based on in-depth interviews with a range of social justice activists, we argue that there is a significant level of ambiguity around this kind of anti-surveillance resistance in relation to broader activist practices, and critical responses to the Snowden leaks have been confined within particular expert communities. Introducing the notion of ‘data justice’, we therefore go on to make the case that resistance to surveillance needs to be (reconceptualized on terms that can address the implications of this data-driven form of governance in relation to broader social justice agendas. Such an approach is needed, we suggest, in light of a shift to surveillance capitalism in which the collection, use and analysis of our data increasingly comes to shape the opportunities and possibilities available to us and the kind of society we live in.

  20. Towards data justice? The ambiguity of anti-surveillance resistance in political activism

    Directory of Open Access Journals (Sweden)

    Lina Dencik

    2016-11-01

    Full Text Available The Snowden leaks, first published in June 2013, provided unprecedented insights into the operations of state-corporate surveillance, highlighting the extent to which everyday communication is integrated into an extensive regime of control that relies on the ‘datafication’ of social life. Whilst such data-driven forms of governance have significant implications for citizenship and society, resistance to surveillance in the wake of the Snowden leaks has predominantly centred on techno-legal responses relating to the development and use of encryption and policy advocacy around privacy and data protection. Based on in-depth interviews with a range of social justice activists, we argue that there is a significant level of ambiguity around this kind of anti-surveillance resistance in relation to broader activist practices, and critical responses to the Snowden leaks have been confined within particular expert communities. Introducing the notion of ‘data justice’, we therefore go on to make the case that resistance to surveillance needs to be (reconceptualized on terms that can address the implications of this data-driven form of governance in relation to broader social justice agendas. Such an approach is needed, we suggest, in light of a shift to surveillance capitalism in which the collection, use and analysis of our data increasingly comes to shape the opportunities and possibilities available to us and the kind of society we live in.

  1. Minimal residual disease surveillance in chronic lymphocytic leukemia by fluorescence-activated cell sorting.

    Science.gov (United States)

    Ringelstein-Harlev, Shimrit; Fineman, Riva

    2014-10-01

    Achievement of complete response (CR) to therapy in chronic lymphocytic leukemia (CLL) has become a feasible goal, directly correlating with prolonged survival. It has been established that the classic definition of CR actually encompasses a variety of disease loads, and more sensitive multiparameter flow cytometry and polymerase chain reaction methods can detect the disease burden with a much higher sensitivity. Detection of malignant cells with a sensitivity of 1 tumor cell in 10,000 cells (10(-4)), using the abovementioned sophisticated techniques, is the current cutoff for minimal residual disease (MRD). Tumor burdens lower than 10(-4) are defined as MRD-negative. Several studies in CLL have determined the achievement of MRD negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Minimal residual disease evaluation using flow cytometry is a sensitive and applicable approach which is expected to become an integral part of future prospective trials in CLL designed to assess the role of MRD surveillance in treatment tailoring.

  2. Minimal Residual Disease Surveillance in Chronic Lymphocytic Leukemia by Fluorescence-Activated Cell Sorting

    Directory of Open Access Journals (Sweden)

    Shimrit Ringelstein-Harlev

    2014-10-01

    Full Text Available Achievement of complete response (CR to therapy in chronic lymphocytic leukemia (CLL has become a feasible goal, directly correlating with prolonged survival. It has been established that the classic definition of CR actually encompasses a variety of disease loads, and more sensitive multiparameter flow cytometry and polymerase chain reaction methods can detect the disease burden with a much higher sensitivity. Detection of malignant cells with a sensitivity of 1 tumor cell in 10,000 cells (10–4, using the abovementioned sophisticated techniques, is the current cutoff for minimal residual disease (MRD. Tumor burdens lower than 10–4 are defined as MRD-negative. Several studies in CLL have determined the achievement of MRD negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Minimal residual disease evaluation using flow cytometry is a sensitive and applicable approach which is expected to become an integral part of future prospective trials in CLL designed to assess the role of MRD surveillance in treatment tailoring.

  3. Passive Surveillance of Ixodes scapularis (Say), Their Biting Activity, and Associated Pathogens in Massachusetts

    Science.gov (United States)

    Xu, Guang; Mather, Thomas N.; Hollingsworth, Craig S.

    2016-01-01

    Abstract A passive surveillance of tick-borne pathogens was conducted over a 7-year period (2006–2012), in which a total of 3551 ticks were submitted to the University of Massachusetts for PCR testing. The vast majority of these ticks were Ixodes scapularis from Massachusetts (N = 2088) and hence were the focus of further analysis. Two TaqMan duplex qPCR assays were developed to test I. scapularis ticks for the presence of three human pathogens: Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti. I. scapularis submissions were concentrated from Cape Cod, the eastern half of the state outside of the Boston metropolitan area, parts of Franklin and Hampshire counties along the Quabbin Reservoir watershed, and southwestern Berkshire county. Differences in seasonal activity pattern were observed for different developmental stages of I. scapularis. The largest proportion of tick bite victims were age 9 years and under. Nymphal ticks were found more often on lower extremities of their hosts, while more adult ticks were found on the head. Overall infection rate of B. burgdorferi, A. phagocytophilum, and B. microti in human-biting ticks was 29.6%, 4.6%, and 1.8%, respectively. B. burgdorferi-infected ticks were widely distributed, but A. phagocytophilum- and B. microti-infected I. scapularis were found mainly in the eastern half of the state. We found that 1.8%, 1.0%, and 0.4% of ticks were coinfected by B. burgdorferi and A. phagocytophilum, B. burgdorferi and B. microti, and A. phagocytophilum and B. microti, respectively, and 0.3% of ticks had triple coinfection. PMID:27248292

  4. Patient Perspective on Watchful Waiting/Active Surveillance for Localized Prostate Cancer

    Science.gov (United States)

    Xu, Jinping; Neale, Anne Victoria; Dailey, Rhonda K.; Eggly, Susan; Schwartz, Kendra L.

    2014-01-01

    Objective To describe prostate cancer treatment decision making, focusing on knowledge and attitudes toward observation, known as watchful waiting (WW) or active surveillance (AS), and reasons for not choosing WW/AS. Methods Semistructured in-person interviews were conducted with 21 men (14 black; 7 white) with recently diagnosed localized prostate cancer. Results All cancers were detected by prostate-specific antigen screening; 14 men had low-risk disease. Nineteen chose surgery or radiation treatment. The majority wanted to “get rid of” or “cure” the cancer by undergoing aggressive therapy, even with awareness of the potential for significant side effects. Most men seemed unaware of the uncertainty/controversies that aggressive treatment may not cure their cancer or improve their survival. Limited knowledge about WW/AS was common, and few remembered WW/AS being presented as a viable option. Rather, many men perceived it as “doing nothing.” Some men, who initially were inclined toward WW/AS, yielded to pressure from family, physicians, or both to choose aggressive treatment. Lack of physician support was a significant barrier to WW/AS. Conclusions The observational strategy (WW/AS) was not viewed as a reasonable approach, even for those with low-risk cancer. The desire for aggressive therapy may reflect the complex psychology associated with receiving a diagnosis of cancer and the limited supportive counseling received. Further efforts to better understand and educate patients and physicians may help men make informed and appropriate treatment decisions to maximize quality of life without compromising survival. PMID:23136314

  5. Evaluation of models predicting insignificant prostate cancer to select men for active surveillance of prostate cancer.

    Science.gov (United States)

    Wong, L M; Neal, D E; Finelli, A; Davis, S; Bonner, C; Kapoor, J; Trachtenberg, J; Thomas, B; Hovens, C M; Costello, A J; Corcoran, N M

    2015-06-01

    In an era of personalized medicine, individualized risk assessment using easily available tools on the internet and the literature are appealing. However, uninformed use by clinicians and the public raises potential problems. Herein, we assess the performance of published models to predict insignificant prostate cancer (PCa), using a multi-national low-risk population that may be considered for active surveillance (AS) based on contemporary practice. Data on men suitable for AS but undergoing upfront radical prostatectomy were pooled from three international academic institutions in Cambridge (UK), Toronto (Canada) and Melbourne (Australia). Four predictive models identified from literature review were assessed for their ability to predict the presence of four definitions of insignificant PCa. Evaluation was performed using area under the curve (AUC) of receiver operating characteristic curves and Brier scores for discrimination, calibration curves and decision curve analysis. A cohort of 460 men meeting the inclusion criteria of all four nomograms was identified. The highest AUCs calculated for any of the four models ranged from 0.618 to 0.664, suggesting weak positive discrimination at best. Models had best discriminative ability for a definition of insignificant disease characterized by organ-confined Gleason score ⩽6 with a total volume ⩽0.5 ml or 1.3 ml. Calibration plots showed moderate range of predictive ability for the Kattan model though this model did not perform well at decision curve analysis. External assessment of models predicting insignificant PCa showed moderate performance at best. Uninformed interpretation may cause undue anxiety or false reassurance and they should be used with caution.

  6. [Integration of health surveillance and women's health care: a study on comprehensiveness in the Unified National Health System].

    Science.gov (United States)

    Maia, Christiane; Guilhem, Dirce; Lucchese, Geraldo

    2010-04-01

    Comprehensiveness is a key principle in Brazil's Unified National Health System (SUS), approached from various perspectives, including linkage between services. The debate on this principle appears in health care, especially in the area of Women's Health, and in Health Surveillance guidelines. Since both areas target quality of health services, the aim of this study is to analyze the integration between Health Surveillance and Women's Health Care. This is a qualitative case study that interviewed Health Surveillance staff in health services and coordinators of Women's Health services. The findings point to the isolation of Health Surveillance within the health secretariats. The importance of integrating the two areas is cited by Women's Health administrators, but it is difficult to implement. Collaborative relations only occur in emergency situations. The Health Surveillance professionals believe that this lack of integration is due to the fact that women's health issues do not require their participation, and that at any rate they collaborate with the area through health inspections and talks. The study detected difficulties in achieving integration between the two areas, with the persistent challenge of linking health actions, especially with Health Surveillance.

  7. How Can We Identify the Elimination of Infectious Diseases? Experience From an Active Measles Laboratory Surveillance System in the Republic of Korea.

    Science.gov (United States)

    Yang, Tae Un; Kang, Hae Ji; Eom, Hye Eun; Park, Young-Joon; Park, Ok; Kim, Su Jin; Nam, Jeong-Gu; Kim, Sung Soon; Jeong, Eun Kyeong

    2015-11-01

    Global efforts have markedly decreased the disease burden of vaccine-preventable diseases. Many countries have made considerable progress toward the elimination of measles. As elimination is approached, the very low incidence achieved by high vaccination coverage has underscored the need for a sensitive and timely surveillance system. In the Republic of Korea, an active laboratory surveillance system (ALSS) was implemented to supplement the existing passive surveillance system in 2006. The ALSS connects 5 major commercial laboratories and the national measles reference laboratory, where referred samples with positive or equivocal results are retested. Annually, from 2009 to 2013, 3714 suspected cases were detected through the ALSS, an expansion of 8- to 57-fold, compared with only the passive surveillance system. The ALSS, with its sensitivity and timeliness, is a reasonable strategy to supplement the existing measles surveillance system and to help identify the elimination of measles.

  8. Pharmacotherapy follow-up: Role in active malaria surveillance in a travel medicine centre outside the transmission area in Brazil.

    Science.gov (United States)

    Pedro, R S; Brasil, P; Pina-Costa, A; Machado, C R; Damasceno, L S; Daniel-Ribeiro, C T; Guaraldo, L

    2017-06-13

    (87.1%) cure occurred less than 72 hours after treatment initiation. Pharmacotherapy follow-up of malaria treatment by surveillance activities is therefore important regarding information about treatment outcomes as well as patient safety, resulting in better patient care and reducing the chance of relapses. The results underscore its use as a tool for monitoring adherence and drug resistance outside an endemic area. Pharmacotherapy follow-up should be considered a useful malaria surveillance tool that can be developed by reference centres for comprehensive health care assistance and monitoring of therapeutic resistance. © 2017 John Wiley & Sons Ltd.

  9. Disease Burden of Dengue in the Philippines: Adjusting for Underreporting by Comparing Active and Passive Dengue Surveillance in Punta Princesa, Cebu City.

    Science.gov (United States)

    Undurraga, Eduardo A; Edillo, Frances E; Erasmo, Jonathan Neil V; Alera, Maria Theresa P; Yoon, In-Kyu; Largo, Francisco M; Shepard, Donald S

    2017-04-01

    AbstractDengue virus (DENV) is a serious threat to public health. Having reliable estimates of the burden of dengue is important to inform policy and research, but surveillance systems are not designed to capture all symptomatic DENV infections. We derived the rate of reporting of dengue by comparing active surveillance of symptomatic DENV infections in a prospective community-based seroepidemiological cohort study (N = 1008) of acute febrile illness in Punta Princesa, Cebu City, Philippines, with passive surveillance data from the Cebu City Health Department. Febrile episodes detected in a weekly follow-up of participants were tested for serotype-specific DENV by hemi-nested reverse transcription-polymerase chain reaction (nested RT-PCR) and acute/convalescent blood samples tested by dengue IgM/IgG enzyme immunoassay. We estimated the burden of dengue in the Philippines in disability-adjusted life years (DALYs), and conducted a probabilistic sensitivity analysis using Monte-Carlo simulations to address uncertainty. The results showed a 21% cumulative reporting rate of symptomatic DENV infections, equivalent to an expansion factor of 4.7 (95% certainty level [CL]: 2.2-15.1). Based on surveillance data in the Philippines for 2010-2014, we estimated 794,255 annual dengue episodes (95% CL: 463,000-2,076,000) and a disease burden of 535 (95% CL: 380-994) DALYs per million population using age weights and time discounting and 997 (95% CL: 681-1,871) DALYs per million population without age and time adjustments. Dengue imposes a substantial burden in the Philippines; almost 10 times higher than estimated for rabies, about twice the burden of intestinal fluke infections, and about 10% of the burden of tuberculosis. Our estimates should inform policy makers and raise awareness among the public.

  10. Reassembling Surveillance Creep

    DEFF Research Database (Denmark)

    Bøge, Ask Risom; Lauritsen, Peter

    2017-01-01

    We live in societies in which surveillance technologies are constantly introduced, are transformed, and spread to new practices for new purposes. How and why does this happen? In other words, why does surveillance “creep”? This question has received little attention either in theoretical...... development or in empirical analyses. Accordingly, this article contributes to this special issue on the usefulness of Actor-Network Theory (ANT) by suggesting that ANT can advance our understanding of ‘surveillance creep’. Based on ANT’s model of translation and a historical study of the Danish DNA database......, we argue that surveillance creep involves reassembling the relations in surveillance networks between heterogeneous actors such as the watchers, the watched, laws, and technologies. Second, surveillance creeps only when these heterogeneous actors are adequately interested and aligned. However...

  11. [Cost estimation of an epidemiological surveillance network for animal diseases in Central Africa: a case study of the Chad network].

    Science.gov (United States)

    Ouagal, M; Berkvens, D; Hendrikx, P; Fecher-Bourgeois, F; Saegerman, C

    2012-12-01

    In sub-Saharan Africa, most epidemiological surveillance networks for animal diseases were temporarily funded by foreign aid. It should be possible for national public funds to ensure the sustainability of such decision support tools. Taking the epidemiological surveillance network for animal diseases in Chad (REPIMAT) as an example, this study aims to estimate the network's cost by identifying the various costs and expenditures for each level of intervention. The network cost was estimated on the basis of an analysis of the operational organisation of REPIMAT, additional data collected in surveys and interviews with network field workers and a market price listing for Chad. These costs were then compared with those of other epidemiological surveillance networks in West Africa. The study results indicate that REPIMAT costs account for 3% of the State budget allocated to the Ministry of Livestock. In Chad in general, as in other West African countries, fixed costs outweigh variable costs at every level of intervention. The cost of surveillance principally depends on what is needed for surveillance at the local level (monitoring stations) and at the intermediate level (official livestock sectors and regional livestock delegations) and on the cost of the necessary equipment. In African countries, the cost of surveillance per square kilometre depends on livestock density.

  12. Perceived usefulness of a distributed community-based syndromic surveillance system: a pilot qualitative evaluation study

    Directory of Open Access Journals (Sweden)

    Olson Donald R

    2011-06-01

    Full Text Available Abstract Background We conducted a pilot utility evaluation and information needs assessment of the Distribute Project at the 2010 Washington State Public Health Association (WSPHA Joint Conference. Distribute is a distributed community-based syndromic surveillance system and network for detection of influenza-like illness (ILI. Using qualitative methods, we assessed the perceived usefulness of the Distribute system and explored areas for improvement. Nine state and local public health professionals participated in a focus group (n = 6 and in semi-structured interviews (n = 3. Field notes were taken, summarized and analyzed. Findings Several emergent themes that contribute to the perceived usefulness of system data and the Distribute system were identified: 1 Standardization: a common ILI syndrome definition; 2 Regional Comparability: views that support county-by-county comparisons of syndromic surveillance data; 3 Completeness: complete data for all expected data at a given time; 4 Coverage: data coverage of all jurisdictions in WA state; 5 Context: metadata incorporated into the views to provide context for graphed data; 6 Trusted Data: verification that information is valid and timely; and 7 Customization: the ability to customize views as necessary. As a result of the focus group, a new county level health jurisdiction expressed interest in contributing data to the Distribute system. Conclusion The resulting themes from this study can be used to guide future information design efforts for the Distribute system and other syndromic surveillance systems. In addition, this study demonstrates the benefits of conducting a low cost, qualitative evaluation at a professional conference.

  13. CARRS Surveillance study: design and methods to assess burdens from multiple perspectives

    Directory of Open Access Journals (Sweden)

    Nair Manisha

    2012-08-01

    Full Text Available Abstract Background Cardio-metabolic diseases (CMDs are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011. Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries. Methods Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort. Sites: Three urban settings (Chennai and New Delhi in India; Karachi in Pakistan, 4000 participants in each site stratified by gender and age. Sampling methodology: Multi-stage cluster random sampling; followed by within-household participant selection through a combination of Health Information National Trends Study (HINTS and Kish methods. Culturally-appropriate and methodologically-relevant data collection instruments were developed to gather information on CMDs and their risk factors; quality of life, health-care utilisation and costs, along with objective measures of anthropometric, clinical and biochemical parameters. The cohort follow-up is designed as a pilot study to understand the feasibility of estimating incidence of risk factors, disease events, morbidity, and mortality. Results The overall participant response rate in the first cross-sectional survey was 94.1% (Chennai 92.4%, n = 4943; Delhi 95.7%, n = 4425; Karachi 94.3%, n = 4016. 51.8% of the participants were females, 61.6% 60 years. Discussion This surveillance model will generate data on prevalence and trends; help study the complex life-course patterns of CMDs, and provide a platform for developing and testing interventions and tools for prevention and control of CMDs in South-Asia. It will also help understanding the

  14. Diffusion-weighted magnetic resonance imaging for prediction of insignificant prostate cancer in potential candidates for active surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Heon; Jeong, Jae Yong; Lee, Sin Woo; Sung, Hyun Hwan; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Lee, Hyun Moo; Choi, Han Yong; Jeon, Seong Soo [Sungkyunkwan University School of Medicine, Department of Urology, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Chan Kyo; Park, Byung Kwan [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of)

    2015-06-01

    To investigate whether the apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) could help improve the prediction of insignificant prostate cancer in candidates for active surveillance (AS). Enrolled in this retrospective study were 287 AS candidates who underwent DW-MRI before radical prostatectomy. Patients were stratified into two groups; Group A consisted of patients with no visible tumour or a suspected tumour ADC value > 0.830 x 10{sup -3} mm{sup 2}/sec and Group B consisted of patients with a suspected tumour ADC value < 0.830 x 10{sup -3} mm{sup 2}/sec. We compared pathological outcomes in each group. Group A had 243 (84.7 %) patients and Group B had 44 (15.3 %) patients. The proportion of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer was significantly higher in Group A than Group B (61.3 % vs. 38.6 %, p = 0.005 and 47.7 % vs. 25.0 %, p = 0.005, respectively). On multivariate analysis, a high ADC value was the independent predictor of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer (odds ratio = 2.43, p = 0.011 and odds ratio = 2.74, p = 0.009, respectively). Tumour ADC values may be a useful marker for predicting insignificant prostate cancer in candidates for AS. (orig.)

  15. A pilot study for targeted surveillance of bovine spongiform encephalopathy in Nigeria.

    Science.gov (United States)

    Nwankiti, O O; Ikeh, E I; Asala, O; Seuberlich, T

    2013-06-01

    Bovine spongiform encephalopathy (BSE), popularly known as 'mad cow disease', led to an epidemic in Europe that peaked in the mid-1990s. Its impact on developing countries, such as Nigeria, has not been fully established as information on livestock and surveillance has eluded those in charge of this task. The BSE risk to Nigeria's cattle population currently remains undetermined, which has resulted in international trade restrictions on commodities from the cattle population. This is mainly because of a lack of updated BSE risk assessments and disease surveillance data. To evaluate the feasibility of BSE surveillance in Nigeria, we carried out a pilot study targeting cattle that were presented for emergency or casualty slaughter. In total, 1551 cattle of local breeds, aged 24 months and above were clinically examined. Ataxia, recumbency and other neurological signs were topmost on our list of criteria. A total of 96 cattle, which correspond to 6.2%, presented clinical signs that supported a suspect of BSE. The caudal brainstem tissues of these animals were collected post-mortem and analysed for the disease-specific form of the prion protein using a rapid test approved by the International Animal Health Organization (OIE). None of the samples were positive for BSE. Although our findings do not exclude the presence of BSE in Nigeria, they do demonstrate that targeted sampling of clinically suspected cases of BSE is feasible in developing countries. In addition, these findings point to the possibility of implementing clinical monitoring schemes for BSE and potentially other diseases with grave economic and public health consequences.

  16. Age- and influenza activity-stratified case definitions of influenza-like illness: experience from hospital-based influenza surveillance in South Korea.

    Directory of Open Access Journals (Sweden)

    Tae Un Yang

    Full Text Available OBJECTIVES: This study aims to identify clinical case definitions of influenza with higher accuracy in patients stratified by age group and influenza activity using hospital-based surveillance system. METHODS: In seven tertiary hospitals across South Korea during 2011-2012 influenza season, respiratory specimens were obtained from patients presenting an influenza-like illness (ILI, defined as having fever plus at least one of following symptoms: cough, sore throat or rhinorrhea. Influenza was confirmed by reverse transcriptase-polymerase chain reaction. We performed multivariate logistic regression analyses to identify clinical variables with better relation with laboratory-confirmed influenza, and compared the accuracy of combinations. RESULTS: Over the study period, we enrolled 1417 patients, of which 647 had laboratory-confirmed influenza. Patients with cough, rhinorrhea, sore throat or headache were more likely to have influenza (p<0.05. The most accurate criterion across the study population was the combination of cough, rhinorrhea, sore throat and headache (sensitivity 71.3%, specificity 60.1% and AUROC 0.66. The combination of rhinorrhea, sore throat and sputum during the peak influenza activity period in the young age group showed higher accuracy than that using the whole population (sensitivity 89.3%, specificity 72.1%, and AUROC 0.81. CONCLUSIONS: The accuracy of clinical case definitions of influenza differed across age groups and influenza activity periods. Categorizing the entire population into subgroups would improve the detection of influenza patients in the hospital-based surveillance system.

  17. Age- and Influenza Activity-Stratified Case Definitions of Influenza-Like Illness: Experience from Hospital-Based Influenza Surveillance in South Korea

    Science.gov (United States)

    Yang, Tae Un; Cheong, Hee Jin; Song, Joon Young; Lee, Jin Soo; Wie, Seong-Heon; Kim, Young Keun; Choi, Won Suk; Lee, Jacob; Jeong, Hye Won; Kim, Woo Joo

    2014-01-01

    Objectives This study aims to identify clinical case definitions of influenza with higher accuracy in patients stratified by age group and influenza activity using hospital-based surveillance system. Methods In seven tertiary hospitals across South Korea during 2011–2012 influenza season, respiratory specimens were obtained from patients presenting an influenza-like illness (ILI), defined as having fever plus at least one of following symptoms: cough, sore throat or rhinorrhea. Influenza was confirmed by reverse transcriptase-polymerase chain reaction. We performed multivariate logistic regression analyses to identify clinical variables with better relation with laboratory-confirmed influenza, and compared the accuracy of combinations. Results Over the study period, we enrolled 1417 patients, of which 647 had laboratory-confirmed influenza. Patients with cough, rhinorrhea, sore throat or headache were more likely to have influenza (p<0.05). The most accurate criterion across the study population was the combination of cough, rhinorrhea, sore throat and headache (sensitivity 71.3%, specificity 60.1% and AUROC 0.66). The combination of rhinorrhea, sore throat and sputum during the peak influenza activity period in the young age group showed higher accuracy than that using the whole population (sensitivity 89.3%, specificity 72.1%, and AUROC 0.81). Conclusions The accuracy of clinical case definitions of influenza differed across age groups and influenza activity periods. Categorizing the entire population into subgroups would improve the detection of influenza patients in the hospital-based surveillance system. PMID:24475034

  18. Economics of zoonoses surveillance in a 'One Health' context: an assessment of Campylobacter surveillance in Switzerland.

    Science.gov (United States)

    Babo Martins, S; Rushton, J; Stärk, K D C

    2017-04-01

    Cross-sectorial surveillance and general collaboration between the animal and the public health sectors are increasingly recognized as needed to better manage the impacts of zoonoses. From 2009, the Swiss established a Campylobacter mitigation system that includes human and poultry surveillance data-sharing within a multi-sectorial platform, in a 'One Health' approach. The objective of this study was to explore the economics of this cross-sectorial approach, including surveillance and triggered interventions. Costs and benefits of the One Health and of the uni-sectorial approach to Campylobacter surveillance were identified using an economic assessment framework developed earlier. Cost information of surveillance activities and interventions was gathered and disability-adjusted life years (DALYs) associated with the disease estimated for 2008 and 2013. In the first 5 years of this One Health approach to Campylobacter mitigation, surveillance contributed with information mainly used to perform risk assessments, monitor trends and shape research efforts on Campylobacter. There was an increase in costs associated with the mitigation activities following integration, due mainly to the allocation of additional resources to research and implementation of poultry surveillance. The overall burden of campylobacteriosis increased by 3·4-8·8% to 1751-2852 DALYs in 2013. In the timing of the analysis, added value associated with this cross-sectorial approach to surveillance of Campylobacter in the country was likely generated through non-measurable benefits such as intellectual capital and social capital.

  19. Changes in Gleason score grading on serial follow-up biopsies in prostate cancer patients undergoing active surveillance.

    Science.gov (United States)

    Guijarro, A; Hernández, V; López, B; Capitán, C; Pérez-Fernández, E; de la Peña, E; de la Morena, J M; Llorente, C

    2015-04-01

    Active surveillance for prostate cancer has grown systematically in the recent years with more robust mid-term outcomes. However, changes in Gleason score during serial biopsies are not detailed in many of these reports. To evaluate changes in Gleason score on follow-up biopsies in low-risk prostate cancer in patients undergoing AS program in our center. Series of patients diagnosed of prostate cancer between 2004 and 2013 have been analyzed. The inclusion criteria were: PSA ≤ 10 ng/ml + Gleason ≤ 6 + T1c/T2a + ≤ 2 positive cores, and no more than 50% of affected core. The pathology of each of the biopsies was analyzed. We studied a series of 175 patients undergoing AS. Mean follow-up was 3.96 years (SD 2.4). Follow-up biopsies with Gleason scores ≥ 7 were: 5.72% in the first biopsy, 7.39% and 7.41% in subsequent biopsies. By contrast, in 42.03% of cases did not show evident tumor involvement in the first biopsy, 40.74% and 51.85% in the second and third biopsies respectively. Median stay in the AS program was: 90.99 months (95% CI: 53.53-128.46) in patients with first positive biopsy vs. 96.66 months (95% CI: 63.19-130.13) in those without evidence of tumor. In our series the pathological data of the first 3 biopsies remain stable in terms of the positive biopsy rate, Gleason score, or indication of active treatment proportions. Those patients who do not show evidence of malignancy in the first follow-up biopsy are less likely to need active treatment than the other patients in the series. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Experience and lessons from surveillance and studies of the 2009 pandemic in Europe.

    Science.gov (United States)

    Nicoll, A; Ammon, A; Amato Gauci, A; Amato, A; Ciancio, B; Zucs, P; Devaux, I; Plata, F; Mazick, A; Mølbak, K; Asikainen, T; Kramarz, P

    2010-01-01

    Surveillance and studies in a pandemic is a complex topic including four distinct components: (1) early detection and investigation; (2) comprehensive early assessment; (3) monitoring; and (4) rapid investigation of the effectiveness and impact of countermeasures, including monitoring the safety of pharmaceutical countermeasures. In the 2009 pandemic, the prime early detection and investigation took place in the Americas, but Europe needed to undertake the other three components while remaining vigilant to new phenomenon such as the emergence of antiviral resistance and important viral mutation. Laboratory-based surveillance was essential and also integral to epidemiological and clinical surveillance. Early assessment was especially vital because of the many important strategic parameters of the pandemic that could not be anticipated (the 'known unknowns'). Such assessment did not need to be undertaken in every country, and was done by the earliest affected European countries, particularly those with stronger surveillance. This was more successful than requiring countries to forward primary data for central analysis. However, it sometimes proved difficult to get even those analyses from European counties, and information from Southern hemisphere countries and North America proved equally valuable. These analyses informed which public health and clinical measures were most likely to be successful, and were summarized in a European risk assessment that was updated repeatedly. The estimate of the severity of the pandemic by the World Health Organization (WHO), and more detailed description by the European Centre for Disease Prevention and Control in the risk assessment along with revised planning assumptions were essential, as most national European plans envisaged triggering more disruptive interventions in the event of a severe pandemic. Setting up new surveillance systems in the midst of the pandemic and getting information from them was generally less successful

  1. Postmarketing Safety Surveillance and Reevaluation of Danhong Injection: Clinical Study of 30888 Cases

    Directory of Open Access Journals (Sweden)

    Xue-Lin Li

    2015-01-01

    Full Text Available Traditional Chinese medicine injections (TCMIs have played an irreplaceable role for treating some clinical emergency, severe illness, and infectious diseases in China. In recent years, the incidence rates of adverse drug reactions (ADRs of TCMIs have increased year by year. Danhong injection (DHI is one representative TCMI comprised of Danshen and Honghua for treating cardiovascular and cerebrovascular diseases in clinic. In present study, the postmarketing safety surveillance and reevaluation of DHI were reported. Total 30888 patients in 37 hospitals from 6 provinces participated in the study. The results showed that the ADR incidence rate of DHI was 3.50‰. Seventeen kinds of new adverse reactions of DHI were found. The main type of ADRs of DHI was type A (including sweating, dizziness, headache, flushing, vasodilation, eye hemorrhage, faintness, chest pain, palpitations, breathlessness, anxious, nausea, flatulence, vomiting, hypotension, hypertension, local numbness, dyspnea, joint disease, and tinnitus accounting for 57.75%. The severities of most ADRs of DHI were mild and moderate reactions accounting for 25.93% and 66.67%, respectively. The main disposition of ADRs of DHI was drug withdrawal and without any treatments. The results can provide basis for amendment and improvement of the instructions of DHI, as well as demonstration and reference for the postmarketing safety surveillance and reevaluation of other TCMIs. And the rationality, scientificity, and safety of clinical applications of TCMIs could be improved.

  2. Postmarketing Safety Surveillance and Reevaluation of Danhong Injection: Clinical Study of 30888 Cases.

    Science.gov (United States)

    Li, Xue-Lin; Tang, Jin-Fa; Li, Wei-Xia; Li, Chun-Xiao; Zhao, Tao; Zhao, Bu-Chang; Wang, Yong; Zhang, Hui; Chen, Xiao-Fei; Xu, Tao; Zhu, Ming-Jun

    2015-01-01

    Traditional Chinese medicine injections (TCMIs) have played an irreplaceable role for treating some clinical emergency, severe illness, and infectious diseases in China. In recent years, the incidence rates of adverse drug reactions (ADRs) of TCMIs have increased year by year. Danhong injection (DHI) is one representative TCMI comprised of Danshen and Honghua for treating cardiovascular and cerebrovascular diseases in clinic. In present study, the postmarketing safety surveillance and reevaluation of DHI were reported. Total 30888 patients in 37 hospitals from 6 provinces participated in the study. The results showed that the ADR incidence rate of DHI was 3.50‰. Seventeen kinds of new adverse reactions of DHI were found. The main type of ADRs of DHI was type A (including sweating, dizziness, headache, flushing, vasodilation, eye hemorrhage, faintness, chest pain, palpitations, breathlessness, anxious, nausea, flatulence, vomiting, hypotension, hypertension, local numbness, dyspnea, joint disease, and tinnitus) accounting for 57.75%. The severities of most ADRs of DHI were mild and moderate reactions accounting for 25.93% and 66.67%, respectively. The main disposition of ADRs of DHI was drug withdrawal and without any treatments. The results can provide basis for amendment and improvement of the instructions of DHI, as well as demonstration and reference for the postmarketing safety surveillance and reevaluation of other TCMIs. And the rationality, scientificity, and safety of clinical applications of TCMIs could be improved.

  3. Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum.

    Science.gov (United States)

    Herdiana, Herdiana; Cotter, Chris; Coutrier, Farah N; Zarlinda, Iska; Zelman, Brittany W; Tirta, Yusrifar Kharisma; Greenhouse, Bryan; Gosling, Roly D; Baker, Peter; Whittaker, Maxine; Hsiang, Michelle S

    2016-09-13

    As malaria transmission declines, it becomes more geographically focused and more likely due to asymptomatic and non-falciparum infections. To inform malaria elimination planning in the context of this changing epidemiology, local assessments on the risk factors for malaria infection are necessary, yet challenging due to the low number of malaria cases. A population-based, cross-sectional study was performed using passive and active surveillance data collected in Aceh Besar District, Indonesia from 2014 to 2015. Malaria infection was defined as symptomatic polymerase chain reaction (PCR)-confirmed infection in index cases reported from health facilities, and asymptomatic or symptomatic PCR-confirmed infection identified in reactive case detection (RACD). Potential risk factors for any infection, species-specific infection, or secondary-case detection in RACD were assessed through questionnaires and evaluated for associations. Nineteen Plasmodium knowlesi, 12 Plasmodium vivax and six Plasmodium falciparum cases were identified passively, and 1495 community members screened in RACD, of which six secondary cases were detected (one P. knowlesi, three P. vivax, and two P. falciparum, with four being asymptomatic). Compared to non-infected subjects screened in RACD, cases identified through passive or active surveillance were more likely to be male (AOR 12.5, 95 % CI 3.0-52.1), adult (AOR 14.0, 95 % CI 2.2-89.6 for age 16-45 years compared to malaria infection in index and RACD identified cases was associated with forest exposure, particularly overnights in the forest for work. In low-transmission settings, utilization of data available through routine passive and active surveillance can support efforts to target individuals at high risk.

  4. The European surveillance activities EARSS and ESAC in the context of ABS International.

    Science.gov (United States)

    Metz-Gercek, Sigrid; Mittermayer, Helmut

    2008-01-01

    Development of resistance obstructs the successful use of antimicrobial drugs, since shortly after each and every introduction of a new antibiotic resistant pathogens have emerged. The hope of being able to reverse or at least slow down the occurrence of antibiotic resistance has led to a number of actions and initiatives. The project "ABS International - Implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the European Union", together with the European Antimicrobial Resistance Surveillance System (EARSS) and the European Surveillance on Antimicrobial Consumption (ESAC), covers a large proportion of possible actions against antibiotic resistance. The data generated by EARSS and ESAC are an essential prerequisite for targeted interventions to cope with the problem of antibiotic resistance. The project ABS International constitutes an impressive initiative to optimize the situation in hospitals in nine European member states.

  5. Visual Sensor Technology for Advanced Surveillance Systems: Historical View, Technological Aspects and Research Activities in Italy

    Directory of Open Access Journals (Sweden)

    Lauro Snidaro

    2009-03-01

    Full Text Available The paper is a survey of the main technological aspects of advanced visual-based surveillance systems. A brief historical view of such systems from the origins to nowadays is given together with a short description of the main research projects in Italy on surveillance applications in the last twenty years. The paper then describes the main characteristics of an advanced visual sensor network that (a directly processes locally acquired digital data, (b automatically modifies intrinsic (focus, iris and extrinsic (pan, tilt, zoom parameters to increase the quality of acquired data and (c automatically selects the best subset of sensors in order to monitor a given moving object in the observed environment.

  6. Surveillance of Australian Hajj pilgrims for carriage of potentially pathogenic bacteria: Data from two pilot studies

    Science.gov (United States)

    Azeem, Mohammad Irfan; Tashani, Mohamed; Badahdah, Al-Mamoon; Heron, Leon; Pedersen, Kristen; Jeoffreys, Neisha; Kok, Jen; Haworth, Elizabeth; Dwyer, Dominic E; Hill-Cawthorne, Grant; Rashid, Harunor; Booy, Robert

    2017-01-01

    AIM To estimate the pharyngeal carriage rate of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) among Australian Hajj pilgrims. METHODS In 2014, surveillance was conducted in two phases among Australian Hajj pilgrims: The first phase during Hajj in Mina, and the second phase soon after returning home to Australia. Nasopharyngeal or oropharyngeal swabs were taken from participants then tested, firstly by nucleic acid testing, and also by standard culture. RESULTS Of 183 participants recruited in the first phase, 26 (14.2%) tested positive for S. pneumoniae; 4 had received pneumococcal conjugate vaccine (PCV13). Only one tested positive for N. meningitidis (W). Of 93 2nd phase samples cultured, 17 (18.3%) grew S. aureus, all methicillin sensitive, 2 (2.2%) grew N. meningitidis (on subculture; one serotype B, one negative), and 1 (1%), from an unvaccinated pilgrim, grew S. pneumoniae. CONCLUSION Relatively high carriage of S. pneumoniae and little meningococcal carriage was found. This indicates the importance of a larger study for improved infection surveillance and possible vaccine evaluation. PMID:28352634

  7. Surveillance of dengue and chikungunya infection in Dong Thap, Vietnam:A 13-month study

    Institute of Scientific and Technical Information of China (English)

    Pham Thi Kim Lien; Phan Thi Nga; Laurence Briant; Truong Ba Tang; Bui Minh Trang; Laurent Gavotte; Emmanuel Cornillot; Vu Trong Duoc; Tran Nhu Duong; Roger Frutos

    2016-01-01

    Objective: To establish a surveillance in Dong Thap, at the border with Cambodia by assessing the presence of DENV serotypes and CHIKV among patients hospitalized at Dong Thap general hospital. Methods: Cross-sectional descriptive analysis was conducted on a cohort of 131 patients hospitalized with acute fever and symptoms compatible with dengue or chikungunya. The study was conducted from January 2012 to February 2013. The full clinical picture was established as well as serological and molecular detection. Serological analysis was sequentially performed on blood samples collected on admission and an average of seven days after admission. The detection of IgM antibody to DENV was performed by IgM capture ELISA and the detection of DENV and CHIKV RNA was done by reverse-transcription multiplex PCR. Results: 101 patients out of 131 (77%) were confirmed with dengue. All four dengue serotypes were detected with a predominance of DENV2 and DENV4. No chikungunya infection was detected although reported in neighboring Cambodia. A differential efficiency of serological dengue detection was observed. Efficiency was 29% upon admission and 53% after seven days on the same patients. 30 patients out of 131 (23%) were negative with both DENV and CHIKV. Conclusions: Dengue is at risk of being underestimated and chikungunya is not systematically detected. Changes in detection and surveillance procedures are therefore discussed to increase efficiency of dengue detection and continue the monitoring the emergence of CHIKV in Dong Thap province and in Vietnam.

  8. Tracking Dabbing Using Search Query Surveillance: A Case Study in the United States

    Science.gov (United States)

    Zhang, Zhu; Zeng, Daniel Dajun; Leischow, Scott J

    2016-01-01

    Background Dabbing is an emerging method of marijuana ingestion. However, little is known about dabbing owing to limited surveillance data on dabbing. Objective The aim of the study was to analyze Google search data to assess the scope and breadth of information seeking on dabbing. Methods Google Trends data about dabbing and related topics (eg, electronic nicotine delivery system [ENDS], also known as e-cigarettes) in the United States between January 2004 and December 2015 were collected by using relevant search terms such as “dab rig.” The correlation between dabbing (including topics: dab and hash oil) and ENDS (including topics: vaping and e-cigarette) searches, the regional distribution of dabbing searches, and the impact of cannabis legalization policies on geographical location in 2015 were analyzed. Results Searches regarding dabbing increased in the United States over time, with 1,526,280 estimated searches during 2015. Searches for dab and vaping have very similar temporal patterns, where the Pearson correlation coefficient (PCC) is .992 (Poil and e-cigarette, in which the corresponding PCC is .931 (Pcannabis surveillance, and these findings can help enhance the understanding of the popularity of dabbing and provide insights for future research and informed policy making on dabbing. PMID:27637361

  9. Intraclass correlation coefficients in the Brazilian network for surveillance of severe maternal morbidity study

    Directory of Open Access Journals (Sweden)

    Haddad Samira M

    2012-09-01

    Full Text Available Abstract Background The purpose of the study was to evaluate intraclass correlation coefficients (ICC of variables concerning personal characteristics, structure, outcome and process in the Brazilian Network for Surveillance of Severe Maternal Morbidity study conducted to identify severe maternal morbidity/near miss cases using the World Health Organization criteria. Method It was a cross-sectional, multicenter study involving 27 hospitals providing care for pregnant women in Brazil. Cluster size and the mean size of the primary sampling unit were described. Estimated prevalence rates, ICC, their respective 95% confidence intervals, the design effect and the mean cluster size were presented for each variable. Results Overall, 9,555 cases of severe maternal morbidity (woman admitted with potentially life-threatening conditions, near miss events or death were included in the study. ICC ranged from Conclusions These results may be used to design new cluster trials in maternal and perinatal health and to help calculate sample sizes.

  10. Health environmental risks surveillance systems: toxicological surveillance

    OpenAIRE

    Ana Ferrer Dufol; Santiago Nogué Xarau; Francisco Vargas Marcos; Olivia Castillo Soria; Pilar Gascó Alberich; Ana de la Torre Reoyo; Eduardo de la Peña de Torres

    2004-01-01

    A study of the Clinical Toxicological Section, about the Epidemiological Surveillance in Emergency Services, in relation to chemical products intoxications during the 1999-2003 period, is presented. This work is a result of an agreement between the Spanish Toxicological Association (AETOX) and the Spanish Ministry of Health and Consumption, and was presented in the National Congress of Environment (CONAMA) within the “Health Environmental Risks Surveillance Systems” working group.

  11. Regional Epidemiology of Methicillin-Resistant Staphylococcus aureus Among Critically Ill Children in a State With Mandated Active Surveillance.

    Science.gov (United States)

    Lyles, Rosie D; Trick, William E; Hayden, Mary K; Lolans, Karen; Fogg, Louis; Logan, Latania K; Shulman, Stanford T; Weinstein, Robert A; Lin, Michael Y

    2016-12-01

    In theory, active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) reduces MRSA spread by identifying all MRSA-colonized patients and placing them under contact precautions. In October 2007, Illinois mandated active MRSA surveillance in all intensive care units, including neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs). We evaluated MRSA trends in a large metropolitan region in the wake of this law. Chicago hospitals with a NICU or PICU were recruited for 8 single-day point prevalence surveys that occurred twice-yearly between June 2008 and July 2011 and then yearly in 2012 to 2013. Samples from all patients were cultured for MRSA (nose and umbilicus for neonates, nose and groin for pediatric patients). Hospital-reported admission MRSA-screening results also were obtained. Point prevalence cultures were screened for MRSA by using broth enrichment, chromogenic agar, and standard confirmatory methods. All eligible hospitals (N = 10) participated (10 NICUs, 6 PICUs). Hospital-reported adherence to state-mandated MRSA screening at admission was high (95% for NICUs, 94% for PICUs). From serial point prevalence surveys, overall MRSA prevalences in the NICUs and PICUs were 4.2% (89 of 2101) and 5.7% (36 of 632), respectively. MRSA colonization prevalences were unchanged in the NICUs (year-over-year risk ratio [RR], 0.93 [95% confidence interval (CI), 0.78-1.12]; P = .45) and trended toward an increase in the PICUs (RR, 1.25 [95% CI, 0.72-2.12]; P = .053). We estimated that 81% and 40% of MRSA-positive patients in the NICUs and PICUs, respectively, had newly acquired MRSA. In a region with mandated active MRSA surveillance, we found ongoing unchanged rates of MRSA colonization and acquisition among NICU and PICU patients. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Can a general health surveillance between birth and 10 months identify children with mental disorder at 1(1/2) year? A case-control study nested in cohort CCC 2000

    DEFF Research Database (Denmark)

    Skovgaard, Anne Mette; Houmann, Tine; Christiansen, Eva Storgaard;

    2008-01-01

    Mental health surveillance in infancy was studied in an existing child health surveillance programme with child psychiatric disorder at 1(1/2) year as the outcome.......Mental health surveillance in infancy was studied in an existing child health surveillance programme with child psychiatric disorder at 1(1/2) year as the outcome....

  13. Market-Based Approach to Mobile Surveillance Systems

    Directory of Open Access Journals (Sweden)

    Ahmed M. Elmogy

    2012-01-01

    Full Text Available The active surveillance of public and private sites is increasingly becoming a very important and critical issue. It is, therefore, imperative to develop mobile surveillance systems to protect these sites. Modern surveillance systems encompass spatially distributed mobile and static sensors in order to provide effective monitoring of persistent and transient objects and events in a given area of interest (AOI. The realization of the potential of mobile surveillance requires the solution of different challenging problems such as task allocation, mobile sensor deployment, multisensor management, cooperative object detection and tracking, decentralized data fusion, and interoperability and accessibility of system nodes. This paper proposes a market-based approach that can be used to handle different problems of mobile surveillance systems. Task allocation and cooperative target tracking are studied using the proposed approach as two challenging problems of mobile surveillance systems. These challenges are addressed individually and collectively.

  14. Family history and stroke outcome in a bi-ethnic, population-based stroke surveillance study

    Directory of Open Access Journals (Sweden)

    Uchino Ken

    2005-10-01

    Full Text Available Background The genetic epidemiology of ischemic stroke remains relatively unstudied, and information about the genetic epidemiology of ischemic stroke in populations with significant minority representation is currently unavailable. Methods The Brain Attack Surveillance in Corpus Christi project (BASIC is a population-based stroke surveillance study conducted in the bi-ethnic community of Nueces County, Texas, USA. Completed ischemic strokes were identified among patients 45 years or older seen at hospitals in the county between January 1, 2000 – December 31, 2002. A random sample of ischemic stroke patients underwent an in-person interview and detailed medical record abstraction (n = 400. Outcomes, including initial stroke severity (NIH stroke scale, age at stroke onset, 90-day mortality and functional outcome (modified Rankin scale ≥2, were studied for their association with family history of stroke among a first degree relative using multivariable logistic and linear regression. A chi-square test was used to test the association between family history of stroke and ischemic stroke subtype. Results The study population was 53.0% Mexican American and 58.4% female. Median age was 73.2 years. Forty percent reported a family history of stroke among a first degree relative. Family history of stroke was borderline significantly associated with stroke subtype (p = 0.0563. Family history was associated with poor functional outcome in the multivariable model (OR = 1.87; 95% CI: 1.14–3.09. Family history was not significantly related to initial stroke severity, age at stroke onset, or 90-day mortality. Conclusion Family history of stroke was related to ischemic stroke subtype and to functional status at discharge. More research is needed to understand whether stroke subtype would be a useful selection criterion for genetic association studies and to hypothesize about a possible genetic link to recovery following ischemic stroke.

  15. Surveillance of febrile patients in a district and evaluation of their spatiotemporal associations: a pilot study

    Directory of Open Access Journals (Sweden)

    Lee Lap-yip

    2010-02-01

    Full Text Available Abstract Background Fever is an undifferentiated clinical feature that may enhance the sensitivity of syndromic surveillance systems. By studying the spatiotemporal associations of febrile patients, it may allow early detection of case clustering that indicates imminent threat of infectious disease outbreaks in the community. Methods We captured consecutive emergency department visits that led to hospitalization in a district hospital in Hong Kong during the period of 12 Sep 2005 to 14 Oct 2005. We recorded demographic data, provisional diagnoses, temperature on presentation and residential location for each patient-episode, and geocoded the residential addresses. We applied Geographical Information System technology to study the geographical distribution these cases, and their associations within a 50-m buffer zone spatially. A case cluster was defined by three or more spatially associated febrile patients within each three consecutive days. Results One thousand and sixty six patient-episodes were eligible for analysis; 42% of them had fever (>37°C; oral temperature on presentation. Two hundred and four patient-episodes (19.1% came from residential care homes for elderly (RCHE. We detected a total of 40 case clusters during the study period. Clustered cases were of older age; 57 (33.3% were residents of RCHE. We found a median of 3 patients (range: 3 - 8 and time span of 3 days (range: 2 - 8 days in each cluster. Twenty five clusters had 2 or more patients living in the same building block; 18 of them were from RCHE. Conclusions It is technically feasible to perform surveillance on febrile patients and studying their spatiotemporal associations. The information is potentially useful for early detection of impending infectious disease threats.

  16. Physical activity surveillance in the European Union: reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ).

    Science.gov (United States)

    Baumeister, Sebastian E; Ricci, Cristian; Kohler, Simone; Fischer, Beate; Töpfer, Christine; Finger, Jonas D; Leitzmann, Michael F

    2016-05-23

    The current study examined the reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ), a novel questionnaire for the surveillance of physical activity (PA) during work, transportation, leisure time, sports, health-enhancing and muscle-strengthening activities over a typical week. Reliability was assessed by administering the 8-item questionnaire twice to a population-based sample of 123 participants aged 15-79 years at a 30-day interval. Concurrent (inter-method) validity was examined in 140 participants by comparisons with self-report (International Physical Activity Questionnaire-Long Form (IPAQ-LF), 7-day Physical Activity Record (PAR), and objective criterion measures (GT3X+ accelerometer, physical work capacity at 75% (PWC(75%)) from submaximal cycle ergometer test, hand grip strength). The EHIS-PAQ showed acceptable reliability, with a median intraclass correlation coefficient across PA domains of 0.55 (range 0.43-0.73). Compared to the GT3X+ (counts/minutes/day), the EHIS-PAQ underestimated moderate-to-vigorous PA (median difference -11.7, p-value = 0.054). Spearman correlation coefficients (ρ) for validity were moderate-to-strong (ρ's > 0.41) for work-related PA (IPAQ = 0.64, GT3X + =0.43, grip strength = 0.48), transportation-related PA (IPAQ = 0.62, GT3X + =0.43), walking (IPAQ = 0.58), and health-enhancing PA (IPAQ = 0.58, PAR = 0.64, GT3X + =0.44, PWC(75%) = 0.48), and fair-to-poor (ρ's measurement of PA levels at work, during transportation and health-enhancing PA.

  17. A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer

    DEFF Research Database (Denmark)

    Eriksen, Anne Kirstine; Hansen, Rikke Dalgaard; Borre, Michael;

    2017-01-01

    BACKGROUND: The prognosis for men with non-aggressive prostate cancer is good, and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis. Despite positive results in animal studies and a few human interventions with whole-grain rye...... on markers of prostate cancer progression, the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied. The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6......-grain rye and 3 × 45 minutes/week of vigorous physical activity. The duration of the intervention was 6 months and end of follow-up 12 months after baseline. Clinic visits were scheduled at baseline and 3, 6 and 12 months after baseline. Compliance with the intervention was evaluated by diaries, food...

  18. A qualitative study of state-level zoonotic disease surveillance in new England.

    Science.gov (United States)

    Scotch, M; Mattocks, K; Rabinowitz, P; Brandt, C

    2011-03-01

    Zoonotic diseases are infectious diseases transmittable between animals and humans and outbreaks of these diseases in animals can signify that humans are also infected (or vice versa). Thus, communication between animal and human health agencies is critical for surveillance. Understanding how these agencies conduct surveillance and share information is important for the development of successful automated zoonotic monitoring systems. Individual interviews were conducted with 13 professionals who perform animal or human zoonotic disease surveillance in one of the New England states. Questions centred on existing surveillance methods, collaborations between animal and human health agencies, and technological and data needs. The results showed that agencies routinely communicate over suspected zoonotic disease cases, yet there are barriers preventing automated electronic linking of health data of animals and humans. These include technological barriers and barriers due to sensitivity and confidentiality of information. Addressing these will facilitate the development of electronic systems for integrating animal and human zoonotic disease surveillance data.

  19. Serial prostate biopsy and risk of lower urinary tract symptoms: results from a large, single-institution active surveillance cohort.

    Science.gov (United States)

    Glass, Allison S; Hilton, Joan F; Cowan, Janet E; Washington, Samuel L; Carroll, Peter R

    2014-01-01

    To describe the effect of serial prostate biopsy on lower urinary tract symptoms (LUTS) in men who undergo active surveillance (AS) at a large academic institution. This is a retrospective study of men enrolled in AS for ≥6 months who underwent ≥1 biopsy and completed ≥1 International Prostate Symptom Score (IPSS) questionnaire. In additional to total IPSS, we report the mean difference between the first and last questionnaires for patients who completed ≥2 questionnaires. Multivariate models, adjusting for disease features, age, race, prostate volume and baseline, or incident benign prostatic hypertrophy (BPH), were used to assess relationships between IPSS and total biopsy exposure. Four hundred eighty-two men were eligible, and 291 completed ≥2 IPSS questionnaires. Overall, mean (standard deviation) age was 61.7 (7.8) years, and median prostate volume (interquartile range) was 42 (34-61) mL. At baseline, 11% provided history of BPH. Among men who completed multiple questionnaires, 25% experienced clinically significant worsening (IPSS increase ≥4 points). In regression model, total IPSS was not significantly associated with greater biopsy exposure (P = .25). IPSS change from initial and the latest questionnaire was not significantly associated with initial or interval biopsy exposure in an adjusted longitudinal model (P = .64 and .50, respectively), but a trend was observed with greater age decade (+4.07 points, 95% CI -0.30 to 8.4; P = .07). Repeated prostate biopsy does not appear to independently pose additional risk of LUTS in an AS population. In unadjusted analyses, greater biopsy exposure is a surrogate for increasing follow-up time, age, and BPH risk, and thus, risk of LUTS onset and progression. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. The importance of gender-stratified antibiotic resistance surveillance of unselected uropathogens: a Dutch nationwide extramural surveillance study.

    NARCIS (Netherlands)

    Heijer, C.D.J. den; Penders, J.; Donker, G.A.; Bruggeman, C.A.; Stobberingh, E.E.

    2013-01-01

    Few studies have been performed on urinary tract infections (UTIs) in men. In the present study, general practitioners (n = 42) from the Dutch Sentinel General Practice Network collected urinary samples from 560 male patients (≥18 years) suspected of UTI and recorded prescribed antibiotic treatment.

  1. Using Google Trends for influenza surveillance in South China.

    Science.gov (United States)

    Kang, Min; Zhong, Haojie; He, Jianfeng; Rutherford, Shannon; Yang, Fen

    2013-01-01

    Google Flu Trends was developed to estimate influenza activity in many countries; however there is currently no Google Flu Trends or other Internet search data used for influenza surveillance in China. Influenza surveillance data from 2008 through 2011 were obtained from provincial CDC influenza-like illness and virological surveillance systems of Guangdong, a province in south China. Internet search data were downloaded from the website of Google Trends. Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data and internet search trends. The correlation between CDC ILI surveillance and CDC virus surveillance was 0.56 (95% CI: 0.43, 0.66). The strongest correlation was between the Google Trends term of Fever and ILI surveillance with a correlation coefficient of 0.73 (95% CI: 0.66, 0.79). When compared with influenza virological surveillance, the Google Trends term of Influenza A had the strongest correlation with a correlation coefficient of 0.64 (95% CI: 0.43, 0.79) in the 2009 H1N1 influenza pandemic period. This study shows that Google Trends in Chinese can be used as a complementary source of data for influenza surveillance in south China. More research in the future should develop new models using search trends in Chinese language to estimate local disease activity and detect early signals of outbreaks.

  2. Lasting treatment effects in a postmarketing surveillance study of prolonged-release melatonin.

    Science.gov (United States)

    Hajak, Göran; Lemme, Kathrin; Zisapel, Nava

    2015-01-01

    Surveillance studies are useful to evaluate how a new medicinal product performs in everyday treatment and how the patient who takes it feels and functions, thereby determining the benefit/risk ratio of the drug under real-life conditions. Prolonged-release melatonin (PRM; Circadin) was approved in Europe for the management of primary insomnia patients age 55 years or older suffering from poor quality of sleep. With traditional hypnotics (e.g. benzodiazepine-receptor agonists), there are concerns about rebound insomnia and/or withdrawal symptoms. We report data from a postmarketing surveillance study in Germany on the effects of 3 weeks of treatment with PRM on sleep in patients with insomnia during treatment and at early (1-2 days) and late (around 2 weeks) withdrawal. In total, 653 patients (597 evaluable) were recruited at 204 sites (mean age 62.7 years, 68% previously treated with hypnotics, 65% women). With PRM treatment, the mean sleep quality (on a scale of 1-5 on which 1 is very good and 5 is very bad) improved from 4.2 to 2.6 and morning alertness improved from 4.0 to 2.5. The improvements persisted over the post-treatment observation period. Rebound insomnia, defined as a one-point deterioration in sleep quality below baseline values, was found in 3.2% (early withdrawal) and 2.0% (late withdrawal). Most of the patients (77%) who used traditional hypnotics before PRM treatment had stopped using them and only 5.6% of naive patients started such drugs after PRM discontinuation. PRM was well tolerated during treatment and the most frequently reported adverse events were nausea (10 patients, 1.5%), dizziness, restlessness and headache (five patients each, insomnia.

  3. [Activity of sanitary surveillances in Vilnius at the time of the Second Republic of Poland].

    Science.gov (United States)

    Berner, Włodzimierz

    2009-01-01

    At the time of the Second Republic of Poland, in March 1922, the city of Vilnius together with the Vilnius Region was incorporated into Poland. Sanitary and health negligence was one of the main problems of the city. The genesis of that situation dates back to the 120-year national bondage, when the city was under the Russian rule. Since 1915 it was occupied by the German invader, and from January to April 1919 it belonged to Soviet Russia. The legacy left by this epoch concerned bad housing conditions, problems with removal of impurities, scarcity of fresh water supply, uneven and dirt roads, which along with other bionegative factors resulted in dissemination of contagious diseases and occurrence of other health risks. In Vilnius of the interwar period, similarly to other big cities in Poland, sanitary surveillances played a significant role in controlling acute contagious diseases, inspecting sanitary conditions of living quarters, service outlets, industrial plants, sites of production and selling food articles, as well as surveillance of food. Municipal doctors supervised the work of sanitary inspectors in each sanitary office.

  4. Study on the post-closure surveillance methods at low- and intermediate-level radioactive waste disposal facility

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Joo Ho; Shin, Jin Seong; Lee, Jae Min; Choi, Won Cheol; Cheon, Tae Hoon [Kyunghee Univ., Seoul (Korea, Republic of)

    1996-02-15

    Presidential decree, of atomic energy act of Korea, number 233.3.9 requires that the repository, after closure, of low- and intermediate-level radioactive waste be controlled and monitored an Ministry of Science and Technology decides. This study emphasizes on establishing a direction of technical guides, considering rock cavern disposal as a domestic project. Other types of repositories will also be referred to for their technical matter. Review of domestic and foreign requirements, review of the objectives of post-closure surveillance, suggestion of surveillance methods and technical guides.

  5. Real-time monitoring of school absenteeism to enhance disease surveillance: a pilot study of a mobile electronic reporting system.

    Science.gov (United States)

    Lawpoolsri, Saranath; Khamsiriwatchara, Amnat; Liulark, Wongwat; Taweeseneepitch, Komchaluch; Sangvichean, Aumnuyphan; Thongprarong, Wiraporn; Kaewkungwal, Jaranit; Singhasivanon, Pratap

    2014-05-12

    School absenteeism is a common source of data used in syndromic surveillance, which can eventually be used for early outbreak detection. However, the absenteeism reporting system in most schools, especially in developing countries, relies on a paper-based method that limits its use for disease surveillance or outbreak detection. The objective of this study was to develop an electronic real-time reporting system on school absenteeism for syndromic surveillance. An electronic (Web-based) school absenteeism reporting system was developed to embed it within the normal routine process of absenteeism reporting. This electronic system allowed teachers to update students' attendance status via mobile tablets. The data from all classes and schools were then automatically sent to a centralized database for further analysis and presentation, and for monitoring temporal and spatial patterns of absent students. In addition, the system also had a disease investigation module, which provided a link between absenteeism data from schools and local health centers, to investigate causes of fever among sick students. The electronic school absenteeism reporting system was implemented in 7 primary schools in Bangkok, Thailand, with total participation of approximately 5000 students. During May-October 2012 (first semester), the percentage of absentees varied between 1% and 10%. The peak of school absenteeism (sick leave) was observed between July and September 2012, which coincided with the peak of dengue cases in children aged 6-12 years being reported to the disease surveillance system. The timeliness of a reporting system is a critical function in any surveillance system. Web-based application and mobile technology can potentially enhance the use of school absenteeism data for syndromic surveillance and outbreak detection. This study presents the factors that determine the implementation success of this reporting system.

  6. Guidelines to site selection for population surveillance and mosquito control trials: a case study from Mauritius.

    Science.gov (United States)

    Iyaloo, Diana P; Elahee, Khouaildi B; Bheecarry, Ambicadutt; Lees, Rosemary Susan

    2014-04-01

    Many novel approaches to controlling mosquito vectors through the release of sterile and mass reared males are being developed in the face of increasing insecticide resistance and other limitations of current methods. Before full scale release programmes can be undertaken there is a need for surveillance of the target population, and investigation of parameters such as dispersal and longevity of released, as compared to wild males through mark-release-recapture (MRR) and other experiments, before small scale pilot trials can be conducted. The nature of the sites used for this field work is crucial to ensure that a trial can feasibly collect sufficient and relevant information, given the available resources and practical limitations, and having secured the correct regulatory, community and ethical approvals and support. Mauritius is considering the inclusion of the sterile insect technique (SIT), for population reduction of Aedes albopictus, as a component of the Ministry of Health and Quality of Life's 'Operational Plan for Prevention and Control of Chikungunya and Dengue'. As part of an investigation into the feasibility of integrating the SIT into the Integrated Vector Management (IVM) scheme in Mauritius a pilot trial is planned. Two potential sites have been selected for this purpose, Pointe des Lascars and Panchvati, villages in the North East of the country, and population surveillance has commenced. This case study will here be used to explore the considerations which go into determining the most appropriate sites for mosquito field research. Although each situation is unique, and an ideal site may not be available, this discussion aims to help researchers to consider and balance the important factors and select field sites that will meet their needs.

  7. The rationale for integrated childhood meningoencephalitis surveillance: a case study from Cambodia

    Science.gov (United States)

    Touch, Sok; Hills, Susan; Rani, Manju; Samnang, Chham; Khalakdina, Asheena; Jacobson, Julie

    2009-01-01

    Abstract Problem Recent progress in vaccine availability and affordability has raised prospects for reducing death and disability from neurological infections in children. In many Asian countries, however, the epidemiology and public health burden of neurological diseases such as Japanese encephalitis and bacterial meningitis are poorly understood. Approach A sentinel surveillance system for Japanese encephalitis was developed and embedded within the routine meningoencephalitis syndromic surveillance system in Cambodia in 2006. The sentinel surveillance system was designed so surveillance and laboratory testing for other etiologies of neurological infection could be incorporated. Local setting The Communicable Disease Control department of the Ministry of Health in Cambodia worked with partners to establish the sentinel surveillance system. Relevant changes The sentinel surveillance system has provided important information on the disease burden of Japanese encephalitis in Cambodia and is now providing a platform for expansion to incorporate laboratory testing for other vaccine-preventable neurological infections in children. Lessons learned Sentinel surveillance systems, when linked to syndromic reporting systems, can characterize the epidemiology of meningoencephalitis and identify the proportion of hospital-based neurological infection in children that is vaccine preventable. Integrated systems enable consistency in data collection, analysis and information dissemination, and they enhance the capacity of public health managers to provide more credible and integrated information to policy-makers. This will assist decision-making about the potential role of immunization in reducing the incidence of childhood neurological infections. PMID:19551241

  8. Establishing a web-based integrated surveillance system for early detection of infectious disease epidemic in rural China: a field experimental study

    Directory of Open Access Journals (Sweden)

    Yan Wei-rong

    2012-02-01

    Full Text Available Abstract Background A crucial goal of infectious disease surveillance is the early detection of epidemics, which is essential for disease control. In China, the current surveillance system is based on confirmed case reports. In rural China, it is not practical for health units to perform laboratory tests to confirm disease and people are more likely to get 'old' and emerging infectious diseases due to poor living conditions and closer contacts with wild animals and poultry. Syndromic surveillance, which collects non-specific syndromes before diagnosis, has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation. It will be especially effective for surveillance in resource poor settings. Methods/Design This is a field experimental study. The experimental tool is an innovative electronic surveillance system, combining syndromic surveillance with the existing case report surveillance in four selected counties in China. In the added syndromic surveillance, three types of data are collected including patients' major symptoms from health clinics, pharmaceutical sales from pharmacies and absenteeism information from primary school. In order to evaluate the early warning capability of the new added syndromic surveillance, the timelines and validity of the alert signals will be analyzed in comparison with the traditional case reporting system. The acceptability, feasibility and economic evaluation of the whole integrated surveillance system will be conducted in a before and after study design. Discussions Although syndromic surveillance system has mostly been established in developed areas, there are opportunities and advantages of developing it in rural China. The project will contribute to knowledge, experience and evidence on the establishment of an integrated surveillance system, which aims to provide early warning of disease epidemics in developing countries.

  9. Position surveillance using one active ranging satellite and time-of-arrival of a signal from an independent satellite

    Science.gov (United States)

    Anderson, R. E.; Frey, R. L.; Lewis, J. R.

    1980-01-01

    Position surveillance using one active ranging/communication satellite and the time-of-arrival of signals from an independent satellite was shown to be feasible and practical. A towboat on the Mississippi River was equipped with a tone-code ranging transponder and a receiver tuned to the timing signals of the GOES satellite. A similar transponder was located at the office of the towing company. Tone-code ranging interrogations were transmitted from the General Electric Earth Station Laboratory through ATS-6 to the towboat and to the ground truth transponder office. Their automatic responses included digital transmissions of time-of-arrival measurements derived from the GOES signals. The Earth Station Laboratory determined ranges from the satellites to the towboat and computed position fixes. The ATS-6 lines-of-position were more precise than 0.1 NMi, 1 sigma, and the GOES lines-of-position were more precise than 1.6 NMi, 1 sigma. High quality voice communications were accomplished with the transponders using a nondirectional antenna on the towboat. The simple and effective surveillance technique merits further evaluation using operational maritime satellites.

  10. Continuous active surveillance of adverse events following immunisation using SMS technology.

    Science.gov (United States)

    Westphal, Darren W; Williams, Stephanie A; Leeb, Alan; Effler, Paul V

    2016-06-17

    On-going post-licensure surveillance of adverse events following immunisation (AEFI) is critical to detecting and responding to potentially serious adverse events in a timely manner. SmartVax is a vaccine safety monitoring tool that uses automated data extraction from existing practice management software and short message service (SMS) technology to follow-up vaccinees in real-time. We report on childhood vaccine safety surveillance using SmartVax at a medical practice in Perth, Western Australia. Parents of all children under age five years who were vaccinated according to the Australian National Immunisation Schedule between November 2011 and June 2015 were sent an SMS three days post administration to enquire whether the child had experienced a suspected vaccine reaction. Affirmative replies triggered a follow-up SMS requesting details of the reaction(s) via a link to a survey that could be completed using a smartphone or the web. Rates of reported AEFI including fever, headache, fatigue, rash, vomiting, diarrhoea, rigours, seizures, and local reactions were calculated by vaccination time point. Overall, 239 (8.2%; 95% CI 7.2-9.2%) possible vaccine reactions were reported for 2897 vaccination visits over the 44 month time period. The proportion of children experiencing a possible AEFI, mostly local reactions, was significantly greater following administration of diphtheria-tetanus-pertussis-poliomyelitis vaccine at 4 years of age (77/441; 17.5%; 95% CI 13.9-21.0%) compared to the vaccinations given at 2-18 months (p<0.001). Across all time points, local reactions and fatigue were the most frequently reported AEFI. Automated SMS-based reporting can facilitate sustainable, real-time, monitoring of adverse reactions and contribute to early identification of potential vaccine safety issues. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. A study on assessment methodology of surveillance test interval and Allowed Outage Time

    Energy Technology Data Exchange (ETDEWEB)

    Che, Moo Seong; Cheong, Chang Hyeon; Ryu, Yeong Woo; Cho, Jae Seon; Heo, Chang Wook; Kim, Do Hyeong; Kim, Joo Yeol; Kim, Yun Ik; Yang, Hei Chang [Seoul National Univ., Seoul (Korea, Republic of)

    1997-07-15

    Objectives of this study is the development of methodology by which assesses the optimization of Surveillance Test Interval(STI) and Allowed Outage Time(AOT) using PSA method that can supplement the current deterministic methods and the improvement of Korean nuclear power plants safety. In the first year of this study, the survey about the assessment methodologies, modeling and results performed by domestic and international researches are performed as the basic step before developing the assessment methodology of this study. The assessment methodology that supplement the revealed problems in many other studies is presented and the application of new methodology into the example system assures the feasibility of this method. In the second year of this study, the sensitivity analyses about the failure factors of the components are performed in the bases of the assessment methodologies of the first study, the interaction modeling of the STI and AOT is quantified. And the reliability assessment methodology about the diesel generator is reviewed and applied to the PSA code.

  12. 76 FR 40736 - NIH State-of-the-Science Conference on the Role of Active Surveillance in the Management of Men...

    Science.gov (United States)

    2011-07-11

    ... HUMAN SERVICES National Institutes of Health NIH State-of-the-Science Conference on the Role of Active Surveillance in the Management of Men With Localized Prostate Cancer ACTION: Notice. Notice is hereby given of the National Institutes of Health (NIH), ``State-of-the-Science Conference on the Role of Active...

  13. A study on assessment methodology of surveillance test interval and allowed outage time

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Chang Hyun; You, Young Woo; Cho, Jae Seon; Huh, Chang Wook; Kim, Do Hyoung; Kim, Ju Youl; Kim, Yoon Ik; Yang, Hui Chang; Park, Kang Min [Seoul National Univ., Seoul (Korea, Republic of)

    1998-03-15

    The objectives of this study is the development of methodology by which assesses the optimization of Surveillance Test Internal(STI) and Allowed Outage Time(AOT) using PSA method that can supplement the current deterministic methods and the improvement of Korean nuclear power plant safety. In this study, the survey about the assessment methodologies, modelings and results performed by domestic and international researches are performed as the basic step before developing the assessment methodology of this study. The assessment methodology that supplement the revealed problems in many other studies is presented and the application of new methodology into the example system assures the feasibility of this method. The sensitivity analyses about the failure factors of the components are performed in the bases of the and AOT is quantified. And the reliability assessment methodology about the diesel generator is reviewed and applied to the PSA code. The qualitative assessment for the STI/AOR of RPS/ESFAS assured safety the most important system in the nuclear power plant are performed.

  14. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

    Directory of Open Access Journals (Sweden)

    Antonios Douros

    2016-01-01

    Full Text Available Herb-induced liver injury (HILI has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once. Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed.

  15. Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study

    Science.gov (United States)

    Douros, Antonios; Bronder, Elisabeth; Andersohn, Frank; Klimpel, Andreas; Kreutz, Reinhold; Garbe, Edeltraut; Bolbrinker, Juliane

    2016-01-01

    Herb-induced liver injury (HILI) has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb) or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once). Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed. PMID:26784183

  16. Invasive pneumococcal disease in children aged younger than 5 years in India: a surveillance study.

    Science.gov (United States)

    Manoharan, Anand; Manchanda, Vikas; Balasubramanian, Sundaram; Lalwani, Sanjay; Modak, Meera; Bai, Sushama; Vijayan, Ajith; Shet, Anita; Nagaraj, Savitha; Karande, Sunil; Nataraj, Gita; Yewale, Vijay N; Joshi, Shrikrishna A; Iyer, Ranganathan N; Santosham, Mathuram; Kahn, Geoffrey D; Knoll, Maria Deloria

    2017-03-01

    Invasive pneumococcal disease continues to be a major cause of morbidity and mortality among children younger than 5 years of age in India. We aimed to provide nationally representative data for the pattern of disease due to Streptococcus pneumoniae, trends in the serotype of invasive pneumococci, and invasive pneumococci antimicrobial resistance patterns, in India. In this prospective hospital-based and retrospective laboratory-based surveillance study, we prospectively enrolled children aged younger than 5 years with suspected or proven invasive pneumococcal disease from 18 hospitals or institutional centres and retrospectively included laboratory-confirmed pneumococcal isolates from ten sentinel laboratories, together representing 11 states in India. Eligibility criteria were fever higher than 38°C without localising symptoms, clinical presentation of suspected meningitis or pneumonia, and evidence of radiographic pneumonia. We cultured blood and other normally sterile body fluids, reconfirmed and serotyped pneumococcal isolates, and established antimicrobial susceptibility using standard study protocols. Between Jan 1, 2011, and June 30, 2015, we enrolled 4377 patients. Among 361 (8%) patients with culture-proven pneumococcal disease, all clinical data were known for 226 (63%); among these patients, 132 (58%) presented with pneumonia, 78 (35%) presented with meningitis, and 16 (7%) had other clinical conditions. 131 (3%) died overall and 29 (8%) patients with invasive pneumococcal disease died. Serotypes 14 (52 [14%] of 361), 1 (49 [14%]), 5 (37 [10%]), and 19F (33 [9%]) were the most common. Penicillin non-susceptibility occurred in isolates from 29 (8%) patients, co-trimoxazole resistance occurred in 239 (66%), erythromycin resistance occurred in 132 (37%), and chloramphenicol resistance occurred in 33 (9%). We found multidrug resistance in 33 (9%) of 361 patients. The proportion of positive blood cultures, number of isolates, geographical representation

  17. Nosocomial infection characteristics in a burn intensive care unit: analysis of an eleven-year active surveillance.

    Science.gov (United States)

    Öncül, Oral; Öksüz, Sinan; Acar, Ali; Ülkür, Ersin; Turhan, Vedat; Uygur, Fatih; Ulçay, Asım; Erdem, Hakan; Özyurt, Mustafa; Görenek, Levent

    2014-08-01

    The objective of this study was to describe nosocomial infection (NI) rates, risk factors, etiologic agents, antibiotic susceptibility, invasive device utilization and invasive device associated infection rates in a burn intensive care unit (ICU) in Turkey. Prospective surveillance of nosocomial infections was performed according to Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) criteria between 2001 and 2012. The data was analyzed retrospectively. During the study period 658 burn patients were admitted to our burn ICU. 469 cases acquired 602 NI for an overall NI rate of 23.1 per 1000 patient days. 109 of all the cases (16.5%) died. Pseudomonas aeruginosa (241), Acinetobacter baumannii (186) and Staphylococcus aureus (69) were the most common identified bacteria in 547 strains. Total burn surface area, full thickness burn, older age, presence of inhalation injury were determined to be the significant risk factors for acquisition of NI. Determining the NI profile at a certain burn ICU can lead the medical staff apply the appropriate treatment regimen and limit the drug resistance. Eleven years surveillance report presented here provides a recent data about the risk factors of NI in a Turkish burn ICU. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  18. Colorectal cancer surveillance in Hodgkin lymphoma survivors at increased risk of therapy-related colorectal cancer: study design.

    Science.gov (United States)

    Rigter, Lisanne S; Spaander, Manon C W; Moons, Leon M; Bisseling, Tanya M; Aleman, Berthe M P; de Boer, Jan Paul; Lugtenburg, Pieternella J; Janus, Cecile P M; Petersen, Eefke J; Roesink, Judith M; Raemaekers, John M M; van der Maazen, Richard W M; Cats, Annemieke; Bleiker, Eveline M A; Snaebjornsson, Petur; Carvalho, Beatriz; Lansdorp-Vogelaar, Iris; Jóźwiak, Katarzyna; Te Riele, Hein; Meijer, Gerrit A; van Leeuwen, Flora E; van Leerdam, Monique E

    2017-02-07

    Second primary malignancies are a major cause of excess morbidity and mortality in cancer survivors. Hodgkin lymphoma survivors who were treated with infradiaphragmatic radiotherapy and/or high-dose procarbazine have an increased risk to develop colorectal cancer. Colonoscopy surveillance plays an important role in colorectal cancer prevention by removal of the precursor lesions (adenomas) and early detection of cancer, resulting in improved survival rates. Therefore, Hodgkin lymphoma survivors treated with infradiaphragmatic radiotherapy and/or high-dose procarbazine could benefit from colonoscopy, or other surveillance modalities, which are expected to reduce colorectal cancer incidence and mortality. Current knowledge on clinicopathological and molecular characteristics of therapy-related colorectal cancer is limited. The pathogenesis of such colorectal cancers might be different from the pathogenesis in the general population and therefore these patients might require a different clinical approach. We designed a study with the primary aim to assess the diagnostic yield of a first surveillance colonoscopy among Hodgkin lymphoma survivors at increased risk of colorectal cancer and to compare these results with different screening modalities in the general population. Secondary aims include assessment of the test characteristics of stool tests and evaluation of burden, acceptance and satisfaction of CRC surveillance through two questionnaires. This prospective multicenter cohort study will include Hodgkin lymphoma survivors who survived ≥8 years after treatment with infradiaphragmatic radiotherapy and/or procarbazine (planned inclusion of 259 participants). Study procedures will consist of a surveillance colonoscopy with removal of precursor lesions (adenomas) and 6-8 normal colonic tissue biopsies, a fecal immunochemical test and a stool DNA test. All neoplastic lesions encountered will be classified using relevant histomorphological, immunohistochemical and

  19. A 6-year surveillance study of "Stingers" in NCAA American Football.

    Science.gov (United States)

    Green, James; Zuckerman, Scott L; Dalton, Sara L; Djoko, Aristarque; Folger, Dustin; Kerr, Zachary Y

    2017-01-01

    This study describes the epidemiology of "stinger" injuries in National Collegiate Athletic Association (NCAA) Men's Football. About 57 NCAA Men's Football programmes provided 153 team-seasons of injury data to the NCAA Injury Surveillance Programme (NCAA-ISP) during the 2009/2010-2014/2015 academic years. In the study period, 229 "stingers" were reported for an injury rate of 2.04/10,000 athlete-exposures (AE). Most "stingers" were reported during competitions (55.5%) and the preseason (80.3%) and resulted in time loss less than 24 hours (63.8%). One in five (18.8%) were recurrent. Most "stingers" were due to player contact (93.0%), particularly while tackling (36.7%) and blocking (25.8%) and occurred to defensive ends/linebackers (25.8%) and offensive linemen (23.6%). Although previous research reports a large prevalence of "stingers" among football players, the NCAA-ISP reported a relatively low injury rate. The transient nature of pain associated with "stingers" may have contributed to under-reporting, highlighting the need to deduce manners to increase reporting.

  20. Surveillance of hantaviruses in Poland: a study of animal reservoirs and human hantavirus disease in Subcarpathia.

    Science.gov (United States)

    Michalski, Aleksander; Niemcewicz, Marcin; Bielawska-Drózd, Agata; Nowakowska, Anna; Gaweł, Jerzy; Pitucha, Grzegorz; Joniec, Justyna; Zielonka, Katarzyna; Marciniak-Niemcewicz, Anna; Kocik, Janusz

    2014-07-01

    The first cluster of hemorrhagic fever with renal syndrome (HFRS) in Poland was identified in 2007 in the Subcarpathian region. The natural environment of this area is a key habitat for hantavirus vectors. The animal reservoir of existing human HFRS clusters was studied to assess the occurrence of viruses (including Tula virus, Puumala virus, and Dobrava-Belgrade virus) among rodents. We examined 70 suspected human cases with symptoms corresponding to the clinical picture of HFRS. Serological analysis (indirect immunofluorescence assay and immunoblot) confirmed the presence of anti-hantavirus antibodies in 18 patients, which were surveyed with regard to developed symptoms and presumed rodent contact. Seroepidemiological analysis of newly confirmed human cases was performed, putative areas of human exposure were studied, and 194 rodents were subsequently captured from identified areas. Internal organs (lungs, heart, spleen, bladder, and kidneys) were collected from 64 Apodemus flavicollis, 55 Apodemus agrarius, 40 Myodes glareolus, 21 Mus musculus, and 14 Microtus arvalis and tested for the presence of hantavirus RNA by reverse transcription and subsequent real-time PCR. Positive samples were also tested by indirect immunofluorescence. Animal reservoir surveillance enabled the first detection of Puumala virus and Dobrava-Belgrade virus among animals in Poland. Furthermore, some places where rodents were captured correlated with areas of residence of laboratory-confirmed human cases and likely detected virus species. Moreover, three species of hantaviruses coexisting in a relatively small area were identified.

  1. Tuberculosis among Healthcare Workers in Southeastern China: A Retrospective Study of 7-Year Surveillance Data

    Directory of Open Access Journals (Sweden)

    Bin Chen

    2014-11-01

    Full Text Available The baseline prevalence and characteristics of tuberculosis (TB among general healthcare workers (HCWs in southeastern China remains unknown. We conducted a retrospective study based on the TB surveillance data in Zhejiang Province from 2005 to 2011, which were extracted from the national Tuberculosis Information Management System (TIMS. We calculated and compared annual notification rates of different occupational groups and analyzed the epidemiological and clinical characteristics. The annual TB notification rates among general HCWs declined steadily from 2005 to 2011. On average, HCWs showed annual TB notification rates lower than the general population but higher than teachers. Recorded HCW TB patients averaged 35.5 years of age, with females outnumbering males (58.0% > 42.0%. The proportion of pulmonary tuberculosis (PTB was higher among male than in the female patients (88.5% > 83.4%, P = 0.031. Our study suggested that general HCWs run a higher occupational risk than teachers although the two groups are socioeconomically comparable and that the priority should be given to the young female HCWs for TB prevention in healthcare institutions.

  2. Systematic, active surveillance for Middle East respiratory syndrome coronavirus in camels in Egypt

    Science.gov (United States)

    Ali, Mohamed A; Shehata, Mahmoud M; Gomaa, Mokhtar R; Kandeil, Ahmed; El-Shesheny, Rabeh; Kayed, Ahmed S; El-Taweel, Ahmed N; Atea, Mohamed; Hassan, Nagla; Bagato, Ola; Moatasim, Yassmin; Mahmoud, Sara H; Kutkat, Omnia; Maatouq, Asmaa M; Osman, Ahmed; McKenzie, Pamela P; Webby, Richard J; Kayali, Ghazi

    2017-01-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe human infections and dromedary camels are considered an intermediary host. The dynamics of natural infection in camels are not well understood. Through systematic surveillance in Egypt, nasal, rectal, milk, urine and serum samples were collected from camels between June 2014 and February 2016. Locations included quarantines, markets, abattoirs, free-roaming herds and farmed breeding herds. The overall seroprevalence was 71% and RNA detection rate was 15%. Imported camels had higher seroprevalence (90% vs 61%) and higher RT-PCR detection rates (21% vs 12%) than locally raised camels. Juveniles had lower seroprevalence than adults (37% vs 82%) but similar RT-PCR detection rates (16% vs 15%). An outbreak in a breeding herd, showed that antibodies rapidly wane, that camels become re-infected, and that outbreaks in a herd are sustained for an extended time. Maternal antibodies titers were very low in calves regardless of the antibody titers of the mothers. Our results support the hypothesis that camels are a reservoir for MERS-CoV and that camel trade is an important route of introducing the virus into importing countries. Findings related to waning antibodies and re-infection have implications for camel vaccine development, disease management and zoonotic threat. PMID:28050021

  3. Initial Experience with Electronic Tracking of Specific Tumor Sites in Men Undergoing Active Surveillance of Prostate Cancer

    Science.gov (United States)

    Sonn, Geoffrey A.; Filson, Christopher P.; Chang, Edward; Natarajan, Shyam; Margolis, Daniel J.; Macairan, Malu; Lieu, Patricia; Huang, Jiaoti; Dorey, Frederick J.; Reiter, Robert E.; Marks, Leonard S.

    2014-01-01

    Objectives Targeted biopsy, using magnetic resonance (MR) – ultrasound (US) fusion, may allow tracking of specific cancer sites in the prostate. We aimed to evaluate initial use of the technique to follow tumor sites in men on active surveillance of prostate cancer. Methods and Materials Fifty-three men with prostate cancer (all T1c) underwent re-biopsy of 74 positive biopsy sites, which were tracked and targeted using the Artemis MR-US fusion device (Eigen, Grass Valley, CA, USA) from March 2010 through January 2013. The initial biopsy included 12 cores from a standard template (mapped by software) and directed biopsies from regions of interest seen on MRI. In the repeat biopsy, samples were taken from sites containing cancer at the initial biopsy. Outcomes of interest at second MR-US biopsy included (a) presence of any cancer and (b) presence of clinically significant cancer. Results All cancers on initial biopsy were either Gleason score 3+3=6 (N=63) or 3+4=7 (N=11). At initial biopsy, 23 cancers were within an MRI target, and 51 were found on systematic biopsy. Cancer detection rate on repeat biopsy (29/74, 39%) was independent of Gleason score on initial biopsy (p=NS) but directly related to initial cancer core length (CCL) (pbiopsies were positive. An increase of Gleason score was uncommon (9/74, 12%). Conclusions Monitoring of specific prostate cancer-containing sites may be achieved in some men using an electronic tracking system. The chances of finding tumor on repeat specific-site sampling was directly related to the length of tumor in the initial biopsy core and presence of tumor within an MRI target; upgrading of Gleason score was uncommon. Further research is required to evaluate the potential utility of site-specific biopsy tracking for prostate cancer patients on active surveillance. PMID:25027689

  4. Routine active surveillance for carbapenemase-producing Enterobacteriaceae from rectal swabs: diagnostic implications of multiplex polymerase chain reaction.

    Science.gov (United States)

    Lowman, W; Marais, M; Ahmed, K; Marcus, L

    2014-10-01

    Screening for carriage of carbapenemase-producing Enterobacteriaceae (CPE) is considered an important infection prevention and control strategy. To date, screening has relied primarily on culture although polymerase chain reaction (PCR)-based screening is gaining momentum. Currently there is no gold standard screening method and consequently it is important to consider the implications of different diagnostic strategies used in active surveillance. To assess the utility of a multiplex PCR screening strategy, as a component of active surveillance, for detection of CPE in patients admitted to various hospitals. A single rectal swab was collected from patients at various hospitals, considered to be at risk of colonization with CPE. Comparison of a modified US Centers for Disease Control and Prevention culture protocol with a PCR-based assay for the detection of the blaNDM, blaKPC, blaOxA-48-like, blaVIM, blaIMP, and blaGES genes was performed. Of the 251 consecutive rectal swabs collected, 30 were PCR positive for one or more carbapenemase genes. Fifteen (50%) were culture positive and CPE only accounted for six isolates. PCR demonstrated excellent sensitivity (100%), specificity (89.8%), and negative predictive value (100%) for detection of CPE, but a positive predictive value of only 46.6% and 16.6% for detection of carbapenemase-producing Gram-negatives and CPE, respectively. The apparent excellent performance characteristics of PCR for detection of CPE from rectal swabs must be tempered by knowledge of CPE prevalence and be interpreted within a defined epidemiological context. Further comparative research with culture, evaluating the clinical utility of PCR-based assays as a screening tool, is needed. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. A single centre experience of active surveillance as management strategy for low-risk prostate cancer in Ireland.

    Science.gov (United States)

    Forde, J C; Daly, P J; White, S; Morrin, M; Smyth, G P; O'Neill, B D P; Power, R E

    2014-09-01

    Active surveillance (AS) is a management strategy for addressing the widely acknowledged problem of over diagnosis and over treatment of clinically indolent prostate cancer. A total of 80 patients were enrolled on the AS program in our institution between January 2008 and June 2012. All data were collected prospectively in a secure database. The mean age of patients enrolled was 62.7 years (range 50-72). Median PSA at enrolment was 5.6 ng/mL (range 1.2-13.4). The mean follow-up was 32 months (range 2-54). In total, 85 % of patients had a repeat biopsy after 1-year with 30 % having another biopsy after 3 years. Overall, 45 % of patients remain on AS. In the remainder; 42.5 % of patients have been removed from AS for definitive treatment, while 8.75 % of patients are now on watchful waiting, 2.5 % of patients self discharged from the program and one patient died of cardiovascular disease. The prostate cancer specific survival rate is 100 %. Reasons for removal from AS and referral for treatment were; 67.6 % of patients had upgrade of disease on repeat biopsy, 17.6 % of patients had PSA progression, 11.8 % patients had progression of disease on MRI, and one patient developed a palpable nodule. Regarding definitive treatment; 52.9 % of patients have been for referred for external beam radiotherapy, 14.7 % have been referred for brachytherapy, 29.4 % have been referred for surgery and one patient has refused definitive treatment. Our findings to date support active surveillance as a valid strategy for early, localised prostate cancer.

  6. Use of wildlife rehabilitation centres in pathogen surveillance: A case study in white storks (Ciconia ciconia).

    Science.gov (United States)

    Camacho, MariaCruz; Hernández, Jose Manuel; Lima-Barbero, Jose Francisco; Höfle, Ursula

    2016-08-01

    More than 70% of new human pathogens are zoonotic and many originate from the wildlife reservoir. Wildlife rehabilitation centres (WRC) are an easily accessible source for sample and data collection for preventive surveillance, but data collected this way may be biased. We use white storks (Ciconia ciconia) as a model to compare pathogen prevalence obtained in the field and WRC. We address factors that may affect disease prevalence data like origin, the age group and the "diseased" state of WRC admissions. In this study we compared prevalence of Escherichia coli and Salmonella spp. in the digestive tract; antibodies against West Nile virus, avian influenza and Newcastle disease virus, and antimicrobial resistance patterns of E. coli between nestling and adult wild storks established in different habitats (n=90) and storks admitted to two different WRC (n=30) in the same region. When age groups and colonies of origin were disregarded, the mean enterobacteria (E. coli, Salmonella) and viral antibody prevalence of the wild population (n=90) were similar to prevalence observed in the individuals admitted to WRC (n=30). However, in fledgling juvenile storks admitted to WRC, the prevalence of Salmonella spp. (13.3%), E. coli showing resistance to cefotaxime (37.9%) and against two antimicrobials at once (41.4%) were more similar to the prevalence in stork nestlings from landfill-associated colonies (7.9%, 37.1% and 48.6%, respectively for prevalence of Salmonella spp. and E. coli displaying, cefotaxime resistance and resistance against two antimicrobials), and significantly higher than in colonies located in natural habitats (0%; 10.5% and 15.8%, respectively). Thus, pathogen surveillance in individuals from an abundant species admitted to WRC is useful to monitor overall mean prevalence, but for certain pathogens may not be sufficient to detect differences between local populations. In addition, the ecology of the tested species and the specific temporal, spatial and

  7. Understanding young adult physical activity, alcohol and tobacco use in community colleges and 4-year post-secondary institutions: A cross-sectional analysis of epidemiological surveillance data

    Directory of Open Access Journals (Sweden)

    Lust Katherine

    2010-04-01

    Full Text Available Abstract Background Young adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students. Methods Cross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions. The 2007 surveillance data included 9,931 respondents. Results The prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations. Conclusions These findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.

  8. Murder followed by suicide: a newspaper surveillance study using the New York Times Index.

    Science.gov (United States)

    Warren-Gordon, Kiesha; Byers, Bryan D; Brodt, Stephen J; Wartak, Melissa; Biskupski, Brian

    2010-11-01

    Murder–suicide is a relatively uncommon event but as reported by the New York Times, it has occurred and continues to occur yearly. Previous research has indicated that those who commit murder–suicides tend to be men, are in or have been in an intimate relationship with the victim, victims tend to be women, and a firearm is most likely to be used. This study uses a newspaper surveillance methodology to examine such cases. Articles from the New York Times as found in the New York Times Index were coded, analyzed, and examined. The cases, 166 in total, support the findings from prior research. The trend data was examined by cross tabulations and chi-square analysis. The findings suggest that murder–suicides are rare events and when they occur they usually involve a male perpetrator and an intimate partner victim who is either a wife or girlfriend with the event occurring in a private home. A firearm is the most commonly used method for both murders and suicides, particularly if there was more than one murder victim. The authors conclude by suggesting that future research should focus on using the forthcoming data resource in the CDC’s National Violent Death Reporting System (NVDRS) to examine the occurrence of murder–suicide.

  9. Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2013-2016.

    Science.gov (United States)

    Marder, Ellyn P; Cieslak, Paul R; Cronquist, Alicia B; Dunn, John; Lathrop, Sarah; Rabatsky-Ehr, Therese; Ryan, Patricia; Smith, Kirk; Tobin-D'Angelo, Melissa; Vugia, Duc J; Zansky, Shelley; Holt, Kristin G; Wolpert, Beverly J; Lynch, Michael; Tauxe, Robert; Geissler, Aimee L

    2017-04-21

    Foodborne diseases represent a substantial public health concern in the United States. CDC's Foodborne Diseases Active Surveillance Network (FoodNet) monitors cases reported from 10 U.S. sites* of laboratory-diagnosed infections caused by nine enteric pathogens commonly transmitted through food. This report describes preliminary surveillance data for 2016 on the nine pathogens and changes in incidences compared with 2013-2015. In 2016, FoodNet identified 24,029 infections, 5,512 hospitalizations, and 98 deaths caused by these pathogens. The use of culture-independent diagnostic tests (CIDTs) by clinical laboratories to detect enteric pathogens has been steadily increasing since FoodNet began surveying clinical laboratories in 2010 (1). CIDTs complicate the interpretation of FoodNet surveillance data because pathogen detection could be affected by changes in health care provider behaviors or laboratory testing practices (2). Health care providers might be more likely to order CIDTs because these tests are quicker and easier to use than traditional culture methods, a circumstance that could increase pathogen detection (3). Similarly, pathogen detection could also be increasing as clinical laboratories adopt DNA-based syndromic panels, which include pathogens not often included in routine stool culture (4,5). In addition, CIDTs do not yield isolates, which public health officials rely on to distinguish pathogen subtypes, determine antimicrobial resistance, monitor trends, and detect outbreaks. To obtain isolates for infections identified by CIDTs, laboratories must perform reflex culture(†); if clinical laboratories do not, the burden of culturing falls to state public health laboratories, which might not be able to absorb that burden as the adoption of these tests increases (2). Strategies are needed to preserve access to bacterial isolates for further characterization and to determine the effect of changing trends in testing practices on surveillance.

  10. The effect of surveillance and appreciative inquiry on puerperal infections: a longitudinal cohort study in India.

    Directory of Open Access Journals (Sweden)

    Julia Hussein

    Full Text Available OBJECTIVE: To evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India. METHODS: This longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups. FINDINGS: Of the 8,124 women followed up, puerperal infections were reported in 319 women (3.9% over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001 but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR = 0.94 95% CI 0.91-0.97. Risk factors like delivery type, complications or delivery attendant showed no association with infection. CONCLUSION: Interruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN03513186.

  11. Using Social Media to Perform Local Influenza Surveillance in an Inner-City Hospital: A Retrospective Observational Study.

    Science.gov (United States)

    Broniatowski, David Andre; Dredze, Mark; Paul, Michael J; Dugas, Andrea

    2015-01-01

    Public health officials and policy makers in the United States expend significant resources at the national, state, county, and city levels to measure the rate of influenza infection. These individuals rely on influenza infection rate information to make important decisions during the course of an influenza season driving vaccination campaigns, clinical guidelines, and medical staffing. Web and social media data sources have emerged as attractive alternatives to supplement existing practices. While traditional surveillance methods take 1-2 weeks, and significant labor, to produce an infection estimate in each locale, web and social media data are available in near real-time for a broad range of locations. The objective of this study was to analyze the efficacy of flu surveillance from combining data from the websites Google Flu Trends and HealthTweets at the local level. We considered both emergency department influenza-like illness cases and laboratory-confirmed influenza cases for a single hospital in the City of Baltimore. This was a retrospective observational study comparing estimates of influenza activity of Google Flu Trends and Twitter to actual counts of individuals with laboratory-confirmed influenza, and counts of individuals presenting to the emergency department with influenza-like illness cases. Data were collected from November 20, 2011 through March 16, 2014. Each parameter was evaluated on the municipal, regional, and national scale. We examined the utility of social media data for tracking actual influenza infection at the municipal, state, and national levels. Specifically, we compared the efficacy of Twitter and Google Flu Trends data. We found that municipal-level Twitter data was more effective than regional and national data when tracking actual influenza infection rates in a Baltimore inner-city hospital. When combined, national-level Twitter and Google Flu Trends data outperformed each data source individually. In addition, influenza

  12. Recognizing suspicious activities in infrared imagery using appearance-based features and the theory of hidden conditional random fields for outdoor perimeter surveillance

    Science.gov (United States)

    Rogotis, Savvas; Palaskas, Christos; Ioannidis, Dimosthenis; Tzovaras, Dimitrios; Likothanassis, Spiros

    2015-11-01

    This work aims to present an extended framework for automatically recognizing suspicious activities in outdoor perimeter surveilling systems based on infrared video processing. By combining size-, speed-, and appearance-based features, like the local phase quantization and the histograms of oriented gradients, actions of small duration are recognized and used as input, along with spatial information, for modeling target activities using the theory of hidden conditional random fields (HCRFs). HCRFs are used to classify an observation sequence into the most appropriate activity label class, thus discriminating high-risk activities like trespassing from zero risk activities, such as loitering outside the perimeter. The effectiveness of this approach is demonstrated with experimental results in various scenarios that represent suspicious activities in perimeter surveillance systems.

  13. What is the optimal definition of misclassification in patients with very low-risk prostate cancer eligible for active surveillance? Results from a multi-institutional series.

    NARCIS (Netherlands)

    Gandaglia, G.; Ploussard, G.; Isbarn, H.; Suardi, N.; Visschere, P.J. De; Futterer, J.J.; Ghadjar, P.; Massard, C.; Ost, P.; Sooriakumaran, P.; Surcel, C.I.; Bergh, R.C. van den; Montorsi, F.; Ficarra, V.; Giannarini, G.; Briganti, A.

    2015-01-01

    BACKGROUND: The risk of unfavorable prostate cancer in active surveillance (AS) candidates is nonnegligible. However, what represents an adverse pathologic outcome in this setting is unknown. We aimed at assessing the optimal definition of misclassification and its effect on recurrence in AS candida

  14. Utilizing harmonization and common surveillance methods to consolidate 4 cohorts: the Western Alaska Tribal Collaborative for Health (WATCH study

    Directory of Open Access Journals (Sweden)

    Kathryn R. Koller

    2013-05-01

    Full Text Available Background. According to health status reports, chronic disease prevalence appears to be rising in western Alaska Native (AN people, and accurate population-based data are needed. Four cohort studies of western AN people were conducted in the Norton Sound and Yukon-Kuskokwim regions, but none have been large enough to allow reliable estimates of rates of chronic diseases and evaluate their risk factors. Objective. In this article, the methods used to combine 4 major cohort studies of rural western AN people are described and the benefits and challenges encountered in combining data and standardizing surveillance methods for these studies are discussed. Design. Tribal permission was obtained for each cohort study and the consolidated study. Data from baseline exams were directly combined or harmonized into new variables. Common surveillance methods were developed and implemented to identify incidence and risk factors for cardiovascular disease (CVD events and type 2 diabetes. Results. A cohort of 4,569 western AN participants (2,116 men and 2,453 women, aged 18–95 years, was established to study CVD and diabetes prevalence. Prospective surveillance data over an average 6.7-year follow-up can now be used to study CVD and diabetes incidence and associated risk factors in a subset of 2,754 western AN participants (1,218 men and 1,536 women who consented to initial surveillance. Conclusions. The combined cohort provides statistical power to examine incidence rates and risk factors for CVD and diabetes and allows for analyses by geographic region. The data can be used to develop intervention programmes in these populations and others.

  15. The Increasing Challenge of Multidrug-Resistant Gram-Negative Bacilli: Results of a 5-Year Active Surveillance Program in a Neonatal Intensive Care Unit.

    Science.gov (United States)

    Giuffrè, Mario; Geraci, Daniela M; Bonura, Celestino; Saporito, Laura; Graziano, Giorgio; Insinga, Vincenzo; Aleo, Aurora; Vecchio, Davide; Mammina, Caterina

    2016-03-01

    Colonization and infection by multidrug-resistant gram-negative bacilli (MDR GNB) in neonatal intensive care units (NICUs) are increasingly reported.We conducted a 5-year prospective cohort surveillance study in a tertiary NICU of the hospital "Paolo Giaccone," Palermo, Italy. Our objectives were to describe incidence and trends of MDR GNB colonization and the characteristics of the most prevalent organisms and to identify the risk factors for colonization. Demographic, clinical, and microbiological data were prospectively collected. Active surveillance cultures (ASCs) were obtained weekly. Clusters of colonization by extended spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae were analyzed by conventional and molecular epidemiological tools.During the study period, 1152 infants were enrolled in the study. Prevalences of colonization by MDR GNB, ESBL-producing GNB and multiple species/genera averaged, respectively, 28.8%, 11.7%, and 3.7%. Prevalence and incidence density of colonization by MDR GNB and ESBL-producing GNB showed an upward trend through the surveillance period. Rates of ESBL-producing E coli and K pneumoniae colonization showed wide fluctuations peaking over the last 2 years. The only independent variables associated with colonization by MDR GNB and ESBL-producing organisms and multiple colonization were, respectively, the days of NICU stay (odds ratio [OR] 1.041), the days of exposure to ampicillin-sulbactam (OR 1.040), and the days of formula feeding (OR 1.031). Most clusters of E coli and K pneumoniae colonization were associated with different lineages. Ten out of 12 clusters had an outborn infant as their index case.Our study confirms that MDR GNB are an increasing challenge to NICUs. The universal once-a-week approach allowed us to understand the epidemiology of MDR GNB, to timely detect new clones and institute contact precautions, and to assess risk factors. Collection of these data can be an important tool to

  16. Childhood TB Surveillance: Bridging the Knowledge Gap to Inform Policy

    Directory of Open Access Journals (Sweden)

    Andrew J. Brent

    2012-01-01

    Full Text Available Tuberculosis (TB is a leading cause of death globally. Natural history studies show that young children are at particularly high risk of progression to active TB and severe, disseminated disease following infection. Despite this, high-quality regional and global surveillance data on the burden of childhood TB are lacking. We discuss the unique aspects of TB in children that make diagnosis and therefore surveillance challenging; the limitations of available surveillance data; other data which provide insights into the true burden of childhood TB. Improved surveillance is among the key research priorities identified for childhood TB, but progress to date has been slow. Recent advances in TB diagnostics, and standardized clinical diagnostic guidelines and case definitions, all provide opportunities for new strategies to improve surveillance. Better-quality data on the burden and trends of childhood TB will inform and improve both public health policy and clinical practice.

  17. Transparency and surveillance as sociotechnical accountability a house of mirrors

    CERN Document Server

    Johnson, Deborah G

    2014-01-01

    Surveillance and transparency are both significant and increasingly pervasive activities in neoliberal societies. Surveillance is taken up as a means to achieving security and efficiency; transparency is seen as a mechanism for ensuring compliance or promoting informed consumerism and informed citizenship. Indeed, transparency is often seen as the antidote to the threats and fears of surveillance. This book adopts a novel approach in examining surveillance practices and transparency practices together as parallel systems of accountability. It presents the house of mirrors as a new framework for understanding surveillance and transparency practices instrumented with information technology. The volume centers around five case studies: Campaign Finance Disclosure, Secure Flight, American Red Cross, Google, and Facebook. A series of themed chapters draw on the material and provide cross-case analysis. The volume ends with a chapter on policy implications.

  18. A novel method of surgical site infection surveillance after cardiac surgery by active participation of stake holders.

    Science.gov (United States)

    Noman, Fatima; Mahmood, Syed Faisal; Asif, Shaheen; Rahim, Noureen; Khan, Ghufranullah; Hanif, Bashir

    2012-06-01

    We describe a comprehensive surveillance system involving infection control practitioners, surgeons, administrative staff, and patients aimed at improving the postdischarge surveillance of surgical site infections. The system was able to detect 22 infections out of 538 procedures, 95% of which were detected during the postdischarge period.

  19. Implementing maternal death surveillance and response: a review of lessons from country case studies.

    Science.gov (United States)

    Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

    2017-07-17

    Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in

  20. A Comparative Assessment of Observational Medical Outcomes Partnership and Mini-Sentinel Common Data Models and Analytics: Implications for Active Drug Safety Surveillance.

    Science.gov (United States)

    Xu, Yihua; Zhou, Xiaofeng; Suehs, Brandon T; Hartzema, Abraham G; Kahn, Michael G; Moride, Yola; Sauer, Brian C; Liu, Qing; Moll, Keran; Pasquale, Margaret K; Nair, Vinit P; Bate, Andrew

    2015-08-01

    An often key component to coordinating surveillance activities across distributed networks is the design and implementation of a common data model (CDM). The purpose of this study was to evaluate two drug safety surveillance CDMs from an ecosystem perspective to better understand how differences in CDMs and analytic tools affect usability and interpretation of results. Humana claims data from 2007 to 2012 were mapped to Observational Medical Outcomes Partnership (OMOP) and Mini-Sentinel CDMs. Data were described and compared at the patient level by source code and mapped concepts. Study cohort construction and effect estimates were also compared using two different analytical methods--one based on a new user design implementing a high-dimensional propensity score (HDPS) algorithm and the other based on univariate self-controlled case series (SCCS) design--across six established positive drug-outcome pairs to learn how differences in CDMs and analytics influence steps in the database analytic process and results. Claims data for approximately 7.7 million Humana health plan members were transformed into the two CDMs. Three health outcome cohorts and two drug cohorts showed differences in cohort size and constituency between Mini-Sentinel and OMOP CDMs, which was a result of multiple factors. Overall, the implementation of the HDPS procedure on Mini-Sentinel CDM detected more known positive associations than that on OMOP CDM. The SCCS method results were comparable on both CDMs. Differences in the implementation of the HDPS procedure between the two CDMs were identified; analytic model and risk period specification had a significant impact on the performance of the HDPS procedure on OMOP CDM. Differences were observed between OMOP and Mini-Sentinel CDMs. The analysis of both CDMs at the data model level indicated that such conceptual differences had only a slight but not significant impact on identifying known safety associations. Our results show that differences at

  1. A Qualitative Study Investigating Experiences, Perceptions, and Healthcare System Performance in Relation to the Surveillance of Typhoid Fever in Madagascar.

    Science.gov (United States)

    Pach, Alfred; Warren, Michelle; Chang, Irene; Im, Justin; Nichols, Chelsea; Meyer, Christian G; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; von Kalckreuth, Vera; Baker, Stephen; Rabezanahary, Henintsoa; Rakotondrainiarivelo, Jean Philibert; Raminosoa, Tiana Mirana; Rakotozandrindrainy, Raphaël; Marks, Florian

    2016-03-15

    The burden of typhoid fever (TF) in sub-Saharan Africa is largely unknown but is increasingly thought to be high, given that water and sanitary conditions remain unimproved in many countries. To address this gap in information, the Typhoid Fever Surveillance in Africa Program (TSAP) founded a surveillance system for TF in 10 African countries. This study was a component of the TSAP surveillance project in Madagascar. The study entailed a qualitative assessment of patients' experiences and perceptions of services for febrile symptoms at the studies' rural and urban sentinel public health clinics. The study examined influences on the use of these facilities, alternative sources of care, and providers' descriptions of medical consultations and challenges in providing services. Data were collected through semistructured and open-ended individual interviews and a focus group with patients, caregivers, and medical personnel. Thirty-three patients and 12 healthcare providers participated in the data collection across the 2 healthcare facilities. The quality of services, cost, and travel distance were key factors that enabled access to and use of these clinics. Divergent healthcare-seeking patterns were related to variability in the care utilized, socioeconomic status, and potential distance from the facilities : These factors influenced delivery of care, patient access, and the health facilities' capacity to identify cases of febrile illness such as TF. This approach provided an in-depth investigation and understanding of healthcare-seeking behavior at the study facilities, and factors that facilitated or acted as barriers to their use. Our findings demonstrate the relevance of these public health clinics as sites for the surveillance of TF in their role as central healthcare sources for families and communities within these rural and urban areas of Madagascar. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All

  2. Global Assessment of the Activity of Tigecycline against Multidrug-Resistant Gram-Negative Pathogens between 2004 and 2014 as Part of the Tigecycline Evaluation and Surveillance Trial.

    Science.gov (United States)

    Giammanco, Anna; Calà, Cinzia; Fasciana, Teresa; Dowzicky, Michael J

    2017-01-01

    Multidrug-resistant (MDR) Gram-negative organisms are a burden on the global health care system. The Tigecycline Evaluation and Surveillance Trial (TEST) is an ongoing global study designed to monitor the in vitro activities of tigecycline and a panel of marketed antimicrobials against a range of clinically significant pathogens. In this study, in vitro data are presented for MDR Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, and Enterobacter cloacae isolates collected from 2004 to 2014. In total, 13% (21,967/170,759) of isolates displayed multidrug resistance globally, with the highest rates recorded among A. baumannii (overall rate, 44% [8,294/18,741], increasing from 23% [309/1,323] in 2004 to 63% [447/712] in 2014). Other multidrug resistance rates ranged from 2.5% for K. oxytoca (203/8,000) to 12% for P. aeruginosa and K. pneumoniae (3,951/32,786 and 3,895/32,888, respectively), and rates among these pathogens remained stable during the study period. Against MDR E. coli, Klebsiella spp., and E. aerogenes, the lowest rates of resistance were to tigecycline (0.2%, 6%, and 12%, respectively), and the lowest MIC90 value against A. baumannii was observed for tigecycline (2 mg/liter; MIC range, ≤0.008 to ≥32 mg/liter). The only significant change in resistance to tigecycline during the study period was for MDR E. coli (P negative organisms presented here, but the rising rates of MDR A. baumannii highlight the need for the continued monitoring of global multidrug resistance. IMPORTANCE Multidrug resistance among bacterial pathogens is an ongoing global problem and renders antimicrobial agents ineffective at treating bacterial infections. In the health care setting, infections caused by multidrug-resistant (MDR) Gram-negative bacteria can cause increased mortality, longer hospital stays, and higher treatments costs. The aim of the Tigecycline Evaluation and

  3. A stepwise approach to stroke surveillance in Brazil: the EMMA (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral) study.

    Science.gov (United States)

    Goulart, Alessandra C; Bustos, Iara R; Abe, Ivana M; Pereira, Alexandre C; Fedeli, Ligia M; Benseñor, Isabela M; Lotufo, Paulo A

    2010-08-01

    Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. To verify stroke mortality rates and morbidity in an area of São Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-health-programme neighbourhood (Step 3). A total of 682 patients 18 years and above, including 472 incident cases, presented with cerebrovascular disease and were enrolled in Step 1 during April-May 2009. Cerebral infarction (84.3%) and first-ever stroke (85.2%) were the most frequent. In Step 2, 256 deaths from stroke were identified during 2006-2007. Forty-four per cent of deaths were classified as unspecified stroke, 1/3 as ischaemic stroke, and 1/4 due to haemorrhagic subtype. In Step 3, 577 subjects over 35 years old were evaluated at home, and 244 cases of stroke survival were diagnosed via a questionnaire, validated by a board-certified neurologist. The population demographic characteristics were similar in the three steps, except in terms of age and gender. By including data from all settings, World Health Organization stroke surveillance can provide data to help plan future resources that meet the needs of the public-health system.

  4. Think regionally, act locally: metals in honeybee workers in the Netherlands (surveillance study 2008).

    Science.gov (United States)

    van der Steen, J J M; Cornelissen, B; Blacquière, T; Pijnenburg, J E M L; Severijnen, M

    2016-08-01

    In June 2008, a surveillance study for metals in honeybees was performed in the Netherlands. Randomly, 150 apiaries were selected. In each apiary, five colonies were sampled. Per apiary, the hive samples were pooled. The apiary sample was analysed for Al, As, Ba, Cd, Co, Cr, Cu, Li, Mn, Mo, Ni, Sb, Se, Sn, Sr, Ti, V and Zn. All metals could be detected in all apiaries. As, Li, Sb, Sn and V were detected in part of the apiaries. The overall picture showed a regional pattern. In apiaries in the east of the Netherlands, Al, Ba, Cr, Mn, Mo, Ni, Se and Ti are found in higher concentrations compared to the west. In-region variation was demonstrated, indicating local effects. The vicinity of the apiaries was mapped afterwards and characterised as land uses of >50 % agricultural area, >50 % wooded area, >50 % urban area and mixed land use within a circle of 28 km(2) around the apiary. The results indicated that in apiaries located in >50 % wooded areas, significantly higher concentrations of Al, Ba, Cd, Cr, Cu, Li, Mn, Mo, Ni, Sb, Sr, Ti and Zn were found compared to agricultural, urban and mixed land use areas. We conclude that (1) the ratio between metal concentrations varies per region, demonstrating spatial differences, and (2) there is in-region local variation per metal. The results indicate the impact of land use on metal concentrations in honeybees. For qualitative bioindication studies, regional, local and land use effects should be taken into account.

  5. Environmental Surveillance of Polioviruses in Rio de Janeiro, Brazil, in Support to the Activities of Global Polio Eradication Initiative.

    Science.gov (United States)

    de Oliveira Pereira, Joseane Simone; da Silva, Lidiane Rodrigues; de Meireles Nunes, Amanda; de Souza Oliveira, Silas; da Costa, Eliane Veiga; da Silva, Edson Elias

    2016-03-01

    Wild polioviruses still remain endemic in three countries (Afghanistan, Pakistan, and Nigeria) and re-emergency of wild polio has been reported in previously polio-free countries. Environmental surveillance has been used as a supplementary tool in monitoring the circulation of wild poliovirus (PVs) and/or vaccine-derived PVs even in the absence of acute flaccid paralysis cases. This study aimed to monitor the presence of polioviruses in wastewater samples collected at one wastewater treatment plant located in the municipality of Rio de Janeiro, Brazil. From December 2011 to June 2012 and from September to December 2012, 31 samples were collected and processed. RD and L20B cell cultures were able to isolate PVs and non-polio enteroviruses in 27/31 samples. Polioviruses were isolated in eight samples (type 1 Sabin = 1, type 2 Sabin = 5, and type 3 Sabin = 2). Vaccine-derived polioviruses were not detected nor evidence of recombination with other PVs or non-polio enterovirus serotypes were observed among the isolates. The Sabin-related serotypes 2 and 3 presented nucleotide substitutions in positions associated with the neurovirulent phenotype at the 5'-UTR. Changes in important Amino acid residues at VP1 were also observed in the serotypes 2 and 3. Environmental surveillance has been used successfully in monitoring the circulation of PVs and non-polio enteroviruses and it is of crucial importance in the final stages of the WHO global polio eradication initiative. Our results show the continuous circulation of Sabin-like PVs and non-polio enteroviruses in the analyzed area during the study period.

  6. Liminal Surveillance. An ethnographic control room study during a local event

    NARCIS (Netherlands)

    Boersma, F.K.

    2013-01-01

    This article is about the targeted, temporarily intensified use of an already existing, permanently installed surveillance system for the safety and security management during a local event at the campus of the University of Illinois, USA. In particular it is the CCTV system that is analyzed after

  7. Salmonella surveillance and control for finisher pigs and pork in Denmark — A case study

    DEFF Research Database (Denmark)

    Alban, L.; Baptista, F.M.; Møgelmose, V.

    2012-01-01

    Salmonella can either be controlled pre-harvest, post-harvest or by a combination of both approaches. This paper describes the lessons learned in Danish Salmonella surveillance and control programme for finisher pigs and pork. Initially, main focus was on pre-harvest initiatives and correct ident...

  8. Computerized surveillance of opioid-related adverse drug events in perioperative care: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gattis Katherine G

    2009-08-01

    events. Conclusion A small investment of resources into a pharmacist-driven surveillance model gave great gains in organizational adverse drug event detection. The patients who experienced multiple events are particularly relevant to future studies seeking risk factors for opioid induced respiratory depression. Computerized surveillance is an efficient, impactful, and sustainable model for ongoing capture and analysis of these rare, but potentially serious events.

  9. Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices.

    Science.gov (United States)

    Zhang, B-C; Hou, L; Lv, B; Xu, Y-W

    2014-02-01

    To determine the incidence of immediate and delayed adverse drug reactions (ADRs), and to assess patient discomfort following administration of iodixanol during imaging examinations in routine clinical practice. A total of 20 185 patients across 95 clinical centres were enrolled in a prospective post-marketing surveillance registry with iodixanol. Patients were monitored for occurrence of ADRs immediately following iodixanol administration and for up to 7 days after administration. The overall rate of ADRs was 1.52%, of which 0.58% was immediate and 0.97% was delayed onset. Two patients had non-fatal serious ADRs (0.01%). The ADRs were significantly more common in patients who underwent contrast-enhanced CT/coronary CT angiography vs others (p Multivariate analysis showed that female gender, intravenous route of contrast injection, body weight ≥ 80 kg, age less than 65 years, contrast flow rate ≥ 4 ml s⁻¹ and prior reaction to iodinated contrast medium were all significant and independent contributors to ADRs. Pre-treatment contrast volume and history of cardiac disease, gout, hypertension, diabetes mellitus or asthma did not affect the rate of ADRs. Discomfort was generally mild, with 94.8% of patients reporting a composite score of 0-3. The safety of iodixanol in routine clinical practice was shown to be similar to the published safety profiles of other non-ionic iodinated contrast agents. Patient discomfort during administration was mild or absent in most patients. The major strength of this study is that it included 20 185 patients enrolled in various types of imaging examinations. The safety profile of iodixanol was comparable to previously published work.

  10. Surveillance Angels

    NARCIS (Netherlands)

    Rothkrantz, L.J.M.

    2014-01-01

    The use of sensor networks has been proposed for military surveillance and environmental monitoring applications. Those systems are composed of a heterogeneous set of sensors to observe the environment. In centralised systems the observed data will be conveyed to the control room to process the

  11. Surveillance Angels

    NARCIS (Netherlands)

    Rothkrantz, L.J.M.

    2014-01-01

    The use of sensor networks has been proposed for military surveillance and environmental monitoring applications. Those systems are composed of a heterogeneous set of sensors to observe the environment. In centralised systems the observed data will be conveyed to the control room to process the data

  12. Activity of ceftaroline and comparators against pathogens isolated from skin and soft tissue infections in Latin America - results of AWARE surveillance 2012

    Directory of Open Access Journals (Sweden)

    Daryl Hoban

    Full Text Available ABSTRACT As part of the Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE surveillance program in 2012 the in vitro activity of ceftaroline and relevant comparator antimicrobials was evaluated in six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico and Venezuela against pathogens isolated from patients with hospital associated skin and soft tissue infections (SSTIs. The study documented that ceftaroline was highly active (MIC90 0.25 mg/L/% susceptible 100% against methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus (MIC90 2 mg/L/% susceptible 83.3% and ß-hemolytic streptococci (MIC90 0.008-0.015 mg/L/% susceptible 100%. The activity of ceftaroline against selected species of Enterobacteriaceae was dependent upon the presence or absence of extended-spectrum ß-lactamases (ESBLs. Against ESBL screen-negativeEscherichia coli, Klebsiella pneumoniae, andKlebsiella oxytoca the MIC90 and percent susceptible for ceftaroline were (0.5 mg/L/94.1%, (0.5 mg/L/99.0% and (0.5 mg/L/91.5%, respectively. Ceftaroline demonstrated potent activity against a recent collection of pathogens associated with SSTI in six Latin American countries in 2012.

  13. Multiview human activity recognition system based on spatiotemporal template for video surveillance system

    Science.gov (United States)

    Kushwaha, Alok Kumar Singh; Srivastava, Rajeev

    2015-09-01

    An efficient view invariant framework for the recognition of human activities from an input video sequence is presented. The proposed framework is composed of three consecutive modules: (i) detect and locate people by background subtraction, (ii) view invariant spatiotemporal template creation for different activities, (iii) and finally, template matching is performed for view invariant activity recognition. The foreground objects present in a scene are extracted using change detection and background modeling. The view invariant templates are constructed using the motion history images and object shape information for different human activities in a video sequence. For matching the spatiotemporal templates for various activities, the moment invariants and Mahalanobis distance are used. The proposed approach is tested successfully on our own viewpoint dataset, KTH action recognition dataset, i3DPost multiview dataset, MSR viewpoint action dataset, VideoWeb multiview dataset, and WVU multiview human action recognition dataset. From the experimental results and analysis over the chosen datasets, it is observed that the proposed framework is robust, flexible, and efficient with respect to multiple views activity recognition, scale, and phase variations.

  14. Efficacy and safety of oral citicoline in acute ischemic stroke: drug surveillance study in 4,191 cases.

    Science.gov (United States)

    Cho, H-J; Kim, Y J

    2009-04-01

    Citicoline is an essential precursor in the synthesis of phosphatidylcholine, a key cell membrane phospholipid, and is known to have neuroprotective effects in acute ischemic stroke. The aim of this study was to determine the efficacy and safety of oral citicoline in Korean patients with acute ischemic stroke. A drug surveillance study was carried out in 4,191 patients with a diagnosis of acute ischemic stroke. Oral citicoline (500-4000 mg/day) was administered within less than 24 h after acute ischemic stroke in 3,736 patients (early group) and later than 24 h after acute ischemic stroke in 455 patients (late group) for at least 6 weeks. For efficacy assessment, primary outcomes were patients' scores obtained with a short form of the National Institutes of Health Stroke Scale (s-NIHSS), a short form of the Barthel Index of activities of daily living (s-BI) and a modified Rankin Scale (mRS) at enrollment, after 6 weeks and at the end of therapy for those patients with extended treatment. All adverse reactions were monitored during the study period for safety assessment. All measured outcomes, including s-NIHSS, s-BI and mRS, were improved after 6 weeks of therapy (P citicoline therapy for more than 12 weeks when compared with those who ended therapy at week 6. Improvements were more significant in the higher dose group (> or = 2000 mg/day) (P Citicoline safety was excellent; 37 side effects were observed in 31 patients (0.73%). The most frequent findings were nervous system-related symptoms (8 of 37, 21.62%), followed by gastrointestinal symptoms (5 of 37, 13.5%). Oral citicoline improved neurological, functional and global outcomes in patients with acute ischemic stroke without significant safety concerns.

  15. Comparative study on the effectiveness of different mosquito traps in arbovirus surveillance with a focus on WNV detection.

    Science.gov (United States)

    Pezzin, Alex; Sy, Victoria; Puggioli, Arianna; Veronesi, Rodolfo; Carrieri, Marco; Maccagnani, Bettina; Bellini, Romeo

    2016-01-01

    The selection of the ideal trap for arbovirus surveillance is an issue of primary importance to increase the sensitivity of virus detection and the cost-effectiveness of the entomological surveillance. During the summer 2011, the effectiveness of five types of mosquito traps (CDC gravid trap, CO2(-)baited trap, BG-Sentinel™ and two experimental prototypes) to attract females potentially infected with West Nile virus were assessed. The study was carried out in three natural wetland sites located in the Emilia-Romagna Region (Northern Italy), using a Latin square scheme. Single night collections of adult females were performed and determination of species and physiological state (gravid, nulliparous or parous) was made upon return to the laboratory. The species most frequently collected in the gravid trap was Culex pipiens sl. L., being gravid females the large majority of the individuals. Species diversity was much higher in CO2(-)baited traps, which may therefore enable a more comprehensive description of the vector species composition and their role in arboviruses circulation. Our findings indicate that gravid traps can be a valid tool and should be integrated in the West Nile virus surveillance system in the Emilia-Romagna region, mainly based on collections made with CO2-baited traps.

  16. A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

    Science.gov (United States)

    Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

    2017-08-04

    Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

  17. Surveillance of infection severity: a registry study of laboratory diagnosed Clostridium difficile.

    Directory of Open Access Journals (Sweden)

    Iryna Schlackow

    Full Text Available BACKGROUND: Changing clinical impact, as virulent clones replace less virulent ones, is a feature of many pathogenic bacterial species and can be difficult to detect. Consequently, innovative techniques monitoring infection severity are of potential clinical value. METHODS AND FINDINGS: We studied 5,551 toxin-positive and 20,098 persistently toxin-negative patients tested for Clostridium difficile infection between February 1998 and July 2009 in a group of hospitals based in Oxford, UK, and investigated 28-day mortality and biomarkers of inflammation (blood neutrophil count, urea, and creatinine concentrations collected at diagnosis using iterative sequential regression (ISR, a novel joinpoint-based regression technique suitable for serial monitoring of continuous or dichotomous outcomes. Among C. difficile toxin-positive patients in the Oxford hospitals, mean neutrophil counts on diagnosis increased from 2003, peaked in 2006-2007, and then declined; 28-day mortality increased from early 2006, peaked in late 2006-2007, and then declined. Molecular typing confirmed these changes were likely due to the ingress of the globally distributed severe C. difficile strain, ST1. We assessed the generalizability of ISR-based severity monitoring in three ways. First, we assessed and found strong (p<0.0001 associations between isolation of the ST1 severe strain and higher neutrophil counts at diagnosis in two unrelated large multi-centre studies, suggesting the technique described might be useful elsewhere. Second, we assessed and found similar trends in a second group of hospitals in Birmingham, UK, from which 5,399 cases were analysed. Third, we used simulation to assess the performance of this surveillance system given the ingress of future severe strains under a variety of assumptions. ISR-based severity monitoring allowed the detection of the severity change years earlier than mortality monitoring. CONCLUSIONS: Automated electronic systems providing

  18. Levodopa therapy with entacapone in daily clinical practice: results of a post-marketing surveillance study.

    Science.gov (United States)

    Kupsch, Andreas; Trottenberg, Thomas; Bremen, Dirk

    2004-01-01

    The catechol-O-methyl transferase inhibitor entacapone is given in combination with levodopa/dopa decarboxylase inhibitor for Parkinson's disease (PD) patients experiencing end-of-dose wearing-off. This 4-week post-marketing surveillance study was undertaken to assess patients' responses to levodopa combined with entacapone in a real clinical practice setting. Overall, 466 patients with idiopathic PD treated with levodopa and experiencing symptoms of wearing-off were recruited. Both physicians and patients recorded the response to therapy, including improvements and side-effects. Following initiation of entacapone treatment, the average daily levodopa dose was reduced from 510 to 453 mg. Physician assessment of entacapone efficacy was judged to be "very good" or "good" in 77.6% of the patients, and tolerability was considered to be "very good" or "good" in 92.4% of patients, with only 12 patients (2.6%) withdrawing from the study. Compared with baseline, there was a decrease in the mean duration of daily 'off' time from 3.0 to 1.3 h per day during the treatment period. Adverse events were in line with those previously reported, with diarrhoea being the most frequent event. The percentage of patients suffering from dyskinesia decreased from 46 to 34%, and of those patients still suffering from dyskinesia, the average daily duration of dyskinesia was reduced from 2.2 to 1.7 h. The use of adjunct dopamine agonists decreased from 67 to 59%. At study end, the percentage of patients who rated their quality of life (QoL) as "very good" or "good" increased from 12.1 to 51.7% and the percentage of patients who rated their QoL as "bad" or "very bad" decreased from 40 to 10.7%. In summary, the results of this survey conducted in real clinical practice support the findings of previous clinical trials demonstrating the efficacy and tolerability of entacapone, as well as the benefits of improved QoL, for patients achieved with entacapone.

  19. A Post-Marketing Surveillance Study to Evaluate Performance of the EXIMO™ Blood Glucose Monitoring System.

    Science.gov (United States)

    Chandnani, Sonia R; Ramakrishna, C D; Dave, Bhargav A; Kothavade, Pankaj S; Thakkar, Ashok S

    2017-05-01

    The performance of Blood Glucose Monitoring System (BGMS) is critical as the information provided by the system guide the patient or health care professional in making treatment decisions. However, besides evaluating accuracy of the BGMS in laboratory setting, it is equally important that the intended users (healthcare professionals and patients) should be able to achieve blood glucose measurements with similar level of high accuracy. To assess the performance of EXIMO™ (Meril Diagnostics Pvt. Ltd., Vapi, Gujarat, India) BGMS as per International Organization for Standardization (ISO) 15197:2013 section 8 user performance criteria. This was a non-randomized and post-marketing study conducted at a tertiary care centre of India. A total of 1005 patients with diabetes themselves performed fingertip blood glucose measurement using EXIMO™ BGMS. Immediately after capillary blood glucose measurement using the blood glucose monitoring system, venous blood sample from each patient was obtained by a trained technician which was assessed by reference laboratory method- Cobas Integra 400 plus (Roche Instrument Centre, Rotkreuz, Switzerland). All the blood glucose measurements assessed by EXIMO™ were compared with laboratory results. Performance of the system was assessed as per ISO 15197:2013 criteria using Bland-Altman plot, Parkes-Consensus Error Grid (CEG) and Surveillance Error Grid analyses (SEG). A total of 1005 patients participated in the study. Average age of the patients was 44.93±14.65 years. Evaluation of capillary fingertip blood glucose measurements demonstrated that 95.82% measurements fulfilled ISO 15197:2013 section 8 user performance criteria. All the results lie within clinically non-critical zones; Zone A (99.47%; n=1000) and Zone B (0.53%; n=05) of the CEG analysis. As per SEG analysis, majority of the results fell within "no-risk" zone (risk score 0 to 0.5; 90.42%). The result of the study confirmed that intended users are able to obtain accurate

  20. Automatic Association of Chats and Video Tracks for Activity Learning and Recognition in Aerial Video Surveillance

    Directory of Open Access Journals (Sweden)

    Riad I. Hammoud

    2014-10-01

    Full Text Available We describe two advanced video analysis techniques, including video-indexed by voice annotations (VIVA and multi-media indexing and explorer (MINER. VIVA utilizes analyst call-outs (ACOs in the form of chat messages (voice-to-text to associate labels with video target tracks, to designate spatial-temporal activity boundaries and to augment video tracking in challenging scenarios. Challenging scenarios include low-resolution sensors, moving targets and target trajectories obscured by natural and man-made clutter. MINER includes: (1 a fusion of graphical track and text data using probabilistic methods; (2 an activity pattern learning framework to support querying an index of activities of interest (AOIs and targets of interest (TOIs by movement type and geolocation; and (3 a user interface to support streaming multi-intelligence data processing. We also present an activity pattern learning framework that uses the multi-source associated data as training to index a large archive of full-motion videos (FMV. VIVA and MINER examples are demonstrated for wide aerial/overhead imagery over common data sets affording an improvement in tracking from video data alone, leading to 84% detection with modest misdetection/false alarm results due to the complexity of the scenario. The novel use of ACOs and chat Sensors 2014, 14 19844 messages in video tracking paves the way for user interaction, correction and preparation of situation awareness reports.

  1. Thermal surveillance of active volcanoes. [infrared scanner recordings of thermal anomalies of Mt. Baker volcano

    Science.gov (United States)

    Friedman, J. D. (Principal Investigator)

    1974-01-01

    The author has identified the following significant results. By the end of 1973, aerial infrared scanner traverses for thermal anomaly recordings of all Cascade Range volcanoes were essentially completed. Amplitude level slices of the Mount Baker anomalies were completed and compiled at a scale of 1:24,000, thus producing, for the first time, an accurate map of the distribution and intensity of thermal activity on Mount Baker. The major thermal activity is concentrated within the crater south of the main summit and although it is characterized by intensive solfataric activity and warm ground, it is largely subglacial, causing the development of sizable glacier perforation features. The outgoing radiative flux from the east breach anomalies is sufficient to account for the volume of ice melted to form the glacier perforations. DCP station 6251 has been monitoring a thermally anomalous area on the north slope of Mount Baker. The present thermal activity of Mount Baker accounts for continuing hydrothermal alteration in the crater south of the main summit and recurrent debris avalanches from Sherman Peak on its south rim. The infrared anomalies mapped as part of the experiment SR 251 are considered the basic evidence of the subglacial heating which was the probable triggering mechanism of an avalanche down Boulder Glacier on August 20-21, 1973.

  2. Annual Assessment of Longitudinal Studies and Injury Surveillance for Gender Integration in the Army, 2016

    Science.gov (United States)

    2017-03-01

    health problems. This annual assessment meets the requirement described in Headquarters, Department of the Army (HQDA) Execution Order (EXORD) 097-16...AUTHOR(S) Keith Hauret and Dr. Bruce Jones (Army Public Health Center) Cindy Bush, Steve Rossi, and Melissa Richardson (contractors for the Armed Forces... Health Surveillance Branch, Defense Health Agency) 5d. PROJECT NUMBER WBS 0047783 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING

  3. Methodology and early findings of the fifth survey of childhood and adolescence surveillance and prevention of adult noncommunicable disease: The caspian-v study

    Directory of Open Access Journals (Sweden)

    Mohammad Esmaeil Motlagh

    2017-01-01

    Full Text Available Background: This paper presents the methodology and early findings of the fifth survey of a school-based surveillance program in Iran. Methods: This nationwide study was conducted in 2015 as the fifth survey of a surveillance program entitled "Childhood and Adolescence Surveillance and PreventIon of Adult Non- communicable disease" (CASPIAN-V study. The protocol was mainly based on the World Health Organization-Global School student Health Survey. We studied 14400 students, aged 7-18 years, and their parents living in 30 provinces in Iran. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. Results: The participation rate for the whole study and for blood sampling were 99% and 91.5%, respectively. The mean (SD age of participants was 12.3 (3.2 years, consisting of 49.4% girls and 71.4% urban residents. Overall, 16.1% were underweight (17.4% of boys and 14.8% of girls, and 20.8% had excess weight consisting of 9.4% (8.7% of boys and 10.2% of girls of overweight and 11.4% (12.5% of boys and 10.3% of girls of obesity. Abdominal obesity was documented in 21.1% of students (21.6% of boys and 20.5% of girls. Low HDL-C was the most prevalent abnormality of the lipid profile (29.5% followed by high serum triglycerides (27.7%. Of students, 59.9% consumed whole wheat bread; and 57% reported that they never or rarely added salt to table. The reported daily consumption of fresh fruits, vegetables, and milk was about 60%, 32% and 40%, respectively. 13.7% of participants had at least 30-min daily leisure-time physical activity. Conclusions: The current findings provide an overview of the current health status and lifestyle habits of children and adolescents. This surveillance program would help planning preventive programs at individual and community levels.

  4. Methodology and Early Findings of the Fifth Survey of Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease: The CASPIAN-V Study

    Science.gov (United States)

    Motlagh, Mohammad Esmaeil; Ziaodini, Hasan; Qorbani, Mostafa; Taheri, Majzoubeh; Aminaei, Tahereh; Goodarzi, Azam; Ataie-Jafari, Asal; Rezaei, Fatemeh; Ahadi, Zeinab; Shafiee, Gita; Shahsavari, Ali; Heshmat, Ramin; Kelishadi, Roya

    2017-01-01

    Background: This paper presents the methodology and early findings of the fifth survey of a school-based surveillance program in Iran. Methods: This nationwide study was conducted in 2015 as the fifth survey of a surveillance program entitled “Childhood and Adolescence Surveillance and PreventIon of Adult Non- communicable disease” (CASPIAN-V) study. The protocol was mainly based on the World Health Organization-Global School student Health Survey. We studied 14400 students, aged 7-18 years, and their parents living in 30 provinces in Iran. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. Results: The participation rate for the whole study and for blood sampling were 99% and 91.5%, respectively. The mean (SD) age of participants was 12.3 (3.2) years, consisting of 49.4% girls and 71.4% urban residents. Overall, 16.1% were underweight (17.4% of boys and 14.8% of girls), and 20.8% had excess weight consisting of 9.4% (8.7% of boys and 10.2% of girls) of overweight and 11.4% (12.5% of boys and 10.3% of girls) of obesity. Abdominal obesity was documented in 21.1% of students (21.6% of boys and 20.5% of girls). Low HDL-C was the most prevalent abnormality of the lipid profile (29.5%) followed by high serum triglycerides (27.7%). Of students, 59.9% consumed whole wheat bread; and 57% reported that they never or rarely added salt to table. The reported daily consumption of fresh fruits, vegetables, and milk was about 60%, 32% and 40%, respectively. 13.7% of participants had at least 30-min daily leisure-time physical activity. Conclusions: The current findings provide an overview of the current health status and lifestyle habits of children and adolescents. This surveillance program would help planning preventive programs at individual and community levels. PMID:28217266

  5. Information and communication technology in disease surveillance, India: a case study

    Directory of Open Access Journals (Sweden)

    Krishnan Sampath K

    2010-12-01

    Full Text Available Abstract India has made appreciable progress and continues to demonstrate a strong commitment for establishing and operating a disease surveillance programme responsive to the requirements of the International Health Regulations (IHR[2005]. Within five years of its launch, India has effectively used modern information and communication technology for collection, storage, transmission and management of data related to disease surveillance and effective response. Terrestrial and/or satellite based linkages are being established within all states, districts, state-run medical colleges, infectious disease hospitals, and public health laboratories. This network enables speedy data transfer, video conferencing, training and e-learning for outbreaks and programme monitoring. A 24x7 call centre is in operation to receive disease alerts. To complement these efforts, a media scanning and verification cell functions to receive reports of early warning signals. During the 2009 H1N1 outbreak, the usefulness of the information and communication technology (ICT network was well appreciated. India is using ICT as part of its Integrated Disease Surveillance Project (IDSP to help overcome the challenges in further expansion in hard-to-reach populations, to increase the involvement of the private sector, and to increase the use of other modes of communication like e-mail and voicemail.

  6. Information and communication technology in disease surveillance, India: a case study.

    Science.gov (United States)

    Kant, Lalit; Krishnan, Sampath K

    2010-12-03

    India has made appreciable progress and continues to demonstrate a strong commitment for establishing and operating a disease surveillance programme responsive to the requirements of the International Health Regulations (IHR[2005]). Within five years of its launch, India has effectively used modern information and communication technology for collection, storage, transmission and management of data related to disease surveillance and effective response. Terrestrial and/or satellite based linkages are being established within all states, districts, state-run medical colleges, infectious disease hospitals, and public health laboratories. This network enables speedy data transfer, video conferencing, training and e-learning for outbreaks and programme monitoring. A 24x7 call centre is in operation to receive disease alerts. To complement these efforts, a media scanning and verification cell functions to receive reports of early warning signals. During the 2009 H1N1 outbreak, the usefulness of the information and communication technology (ICT) network was well appreciated. India is using ICT as part of its Integrated Disease Surveillance Project (IDSP) to help overcome the challenges in further expansion in hard-to-reach populations, to increase the involvement of the private sector, and to increase the use of other modes of communication like e-mail and voicemail.

  7. Intraprostatic locations of tumor foci of higher grade missed by diagnostic prostate biopsy among potential candidates for active surveillance

    Science.gov (United States)

    Kim, Kwangmo; Lee, Jung Keun; Choe, Gheeyoung; Hong, Sung Kyu

    2016-01-01

    To establish optimal biopsy scheme for selection of candidates for active surveillance (AS) among prostate cancer (PCa) patients, information on topographical distribution of tumor foci of higher grade missed by contemporary biopsy amongst potential candidates of AS would certainly be useful. Thus we analyzed topographic distribution of tumor foci by examining prostatectomy specimens in 444 patients who underwent radical prostatectomy for low risk PCa. Anterior and posterior prostate areas were demarcated by a horizontal line drawn at midpoint of prostatic urethra. Among 444 subjects, patients with upgrading showed relatively higher prevalence of index tumor foci in anterior prostate than those without upgrading, though not reaching statistical significance (p = 0.252). Meanwhile, among 135 (30.4%) patients with very low risk PCa, patients with upgrading showed significantly higher prevalence of index tumor foci in anterior prostate than those without upgrading (52.2% vs 33.8%; p = 0.031). In conclusions, tumor foci of higher grade missed by diagnostic biopsy were mostly located in anterior prostate among very low risk PCa patients. Such finding would be concrete evidence to support the notion that more efforts are needed to increase accuracy in detecting tumor foci in anterior prostate among potential candidates for AS. PMID:27827421

  8. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Directory of Open Access Journals (Sweden)

    Florian Wagenlehner

    2016-01-01

    Full Text Available The Global Prevalence of Infections in Urology (GPIU study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI. Investigators registered data through a web-based application (http://gpiu.esiu.org/. Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.

  9. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Science.gov (United States)

    Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Köves, Béla; Naber, Kurt; Perepanova, Tamara; Tenke, Peter; Wullt, Björn; Bogenhard, Florian; Johansen, Truls Erik Bjerklund

    2016-01-01

    The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI). Investigators registered data through a web-based application (http://gpiu.esiu.org/). Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years. PMID:26797640

  10. Surveillance of waste disposal activity at sea using satellite ocean color imagers: GOCI and MODIS

    Science.gov (United States)

    Hong, Gi Hoon; Yang, Dong Beom; Lee, Hyun-Mi; Yang, Sung Ryull; Chung, Hee Woon; Kim, Chang Joon; Kim, Young-Il; Chung, Chang Soo; Ahn, Yu-Hwan; Park, Young-Je; Moon, Jeong-Eon

    2012-09-01

    Korean Geostationary Ocean Color Imager (GOCI) and Moderate Resolution Imaging Spectroradiometer (MODIS) Aqua observations of the variation in ocean color at the sea surface were utilized to monitor the impact of nutrient-rich sewage sludge disposal in the oligotrophic area of the Yellow Sea. MODIS revealed that algal blooms persisted in the spring annually at the dump site in the Yellow Sea since year 2000 to the present. A number of implications of using products of the satellite ocean color imagers were exploited here based on the measurements in the Yellow Sea. GOCI observes almost every hour during the daylight period, every day since June 2011. Therefore, GOCI provides a powerful tool to monitor waste disposal at sea in real time. Tracking of disposal activity from a large tanker was possible hour by hour from the GOCI timeseries images compared to MODIS. Smaller changes in the color of the ocean surface can be easily observed, as GOCI resolves images at smaller scales in space and time in comparison to polar orbiting satellites, e.g., MODIS. GOCI may be widely used to monitor various marine activities in the sea, including waste disposal activity from ships.

  11. Air surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Patton, G.W.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  12. Autonomous soaring and surveillance in wind fields with an unmanned aerial vehicle

    Science.gov (United States)

    Gao, Chen

    Small unmanned aerial vehicles (UAVs) play an active role in developing a low-cost, low-altitude autonomous aerial surveillance platform. The success of the applications needs to address the challenge of limited on-board power plant that limits the endurance performance in surveillance mission. This thesis studies the mechanics of soaring flight, observed in nature where birds utilize various wind patterns to stay airborne without flapping their wings, and investigates its application to small UAVs in their surveillance missions. In a proposed integrated framework of soaring and surveillance, a bird-mimicking soaring maneuver extracts energy from surrounding wind environment that improves surveillance performance in terms of flight endurance, while the surveillance task not only covers the target area, but also detects energy sources within the area to allow for potential soaring flight. The interaction of soaring and surveillance further enables novel energy based, coverage optimal path planning. Two soaring and associated surveillance strategies are explored. In a so-called static soaring surveillance, the UAV identifies spatially-distributed thermal updrafts for soaring, while incremental surveillance is achieved through gliding flight to visit concentric expanding regions. A Gaussian-process-regression-based algorithm is developed to achieve computationally-efficient and smooth updraft estimation. In a so-called dynamic soaring surveillance, the UAV performs one cycle of dynamic soaring to harvest energy from the horizontal wind gradient to complete one surveillance task by visiting from one target to the next one. A Dubins-path-based trajectory planning approach is proposed to maximize wind energy extraction and ensure smooth transition between surveillance tasks. Finally, a nonlinear trajectory tracking controller is designed for a full six-degree-of-freedom nonlinear UAV dynamics model and extensive simulations are carried to demonstrate the effectiveness of

  13. Catheter-related infection in Irish intensive care units diagnosed with HELICS criteria: a multi-centre surveillance study.

    LENUS (Irish Health Repository)

    Conrick-Martin, I

    2013-03-01

    Catheter-related infection (CRI) surveillance is advocated as a healthcare quality indicator. However, there is no national CRI surveillance programme or standardized CRI definitions in Irish intensive care units (ICUs).

  14. Padeliporfin vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial.

    Science.gov (United States)

    Azzouzi, Abdel-Rahmène; Vincendeau, Sébastien; Barret, Eric; Cicco, Antony; Kleinclauss, François; van der Poel, Henk G; Stief, Christian G; Rassweiler, Jens; Salomon, Georg; Solsona, Eduardo; Alcaraz, Antonio; Tammela, Teuvo T; Rosario, Derek J; Gomez-Veiga, Francisco; Ahlgren, Göran; Benzaghou, Fawzi; Gaillac, Bertrand; Amzal, Billy; Debruyne, Frans M J; Fromont, Gaëlle; Gratzke, Christian; Emberton, Mark

    2017-02-01

    Vascular-targeted photodynamic therapy, a novel tissue-preserving treatment for low-risk prostate cancer, has shown favourable safety and efficacy results in single-arm phase 1 and 2 studies. We compared this treatment with the standard of care, active surveillance, in men with low-risk prostate cancer in a phase 3 trial. This randomised controlled trial was done in 47 European university centres and community hospitals. Men with low-risk, localised prostate cancer (Gleason pattern 3) who had received no previous treatment were randomly assigned (1:1) to vascular-targeted photodynamic therapy (4 mg/kg padeliporfin intravenously over 10 min and optical fibres inserted into the prostate to cover the desired treatment zone and subsequent activation by laser light 753 nm with a fixed power of 150 mW/cm for 22 min 15 s) or active surveillance. Randomisation was done by a web-based allocation system stratified by centre with balanced blocks of two or four patients. Best practice for active surveillance at the time of study design was followed (ie, biopsy at 12-month intervals and prostate-specific antigen measurement and digital rectal examination at 3-month intervals). The co-primary endpoints were treatment failure (histological progression of cancer from low to moderate or high risk or death during 24 months' follow-up) and absence of definite cancer (absence of any histology result definitely positive for cancer at month 24). Analysis was by intention to treat. Treatment was open-label, but investigators assessing primary efficacy outcomes were masked to treatment allocation. This trial is registered with ClinicalTrials.gov, number NCT01310894. Between March 8, 2011, and April 30, 2013, we randomly assigned 206 patients to vascular-targeted photodynamic therapy and 207 patients to active surveillance. Median follow-up was 24 months (IQR 24-25). The proportion of participants who had disease progression at month 24 was 58 (28%) of 206 in the vascular

  15. 9975 SHIPPING PACKAGE LIFE EXTENSION SURVEILLANCE PROGRAM RESULTS SUMMARY

    Energy Technology Data Exchange (ETDEWEB)

    Daugherty, W.; Dunn, K.; Hackney, B.; Hoffman, E.; Skidmore, E.

    2011-01-06

    Results from the 9975 Surveillance Program at the Savannah River Site (SRS) are summarized for justification to extend the life of the 9975 packages currently stored in the K-Area Materials Storage (KAMS) facility from 10 years to 15 years. This justification is established with the stipulation that surveillance activities will continue throughout this extended time to ensure the continued integrity of the 9975 materials of construction and to further understand the currently identified degradation mechanisms. The current 10 year storage life was developed prior to storage. A subsequent report was later used to extend the qualification of the 9975 shipping packages for 2 years for shipping plus 10 years for storage. However the qualification for the storage period was provided by the monitoring requirements of the Storage and Surveillance Program. This report summarizes efforts to determine a new safe storage limit for the 9975 shipping package based on the surveillance data collected since 2005 when the surveillance program began. KAMS is a zero-release facility that depends upon containment by the 9975 to meet design basis storage requirements. Therefore, to confirm the continued integrity of the 9975 packages while stored in KAMS, a 9975 Storage and Surveillance Program was implemented alongside the DOE required Integrated Surveillance Program (ISP) for 3013 plutonium-bearing containers. The 9975 Storage and Surveillance Program performs field surveillance as well as accelerated aging tests to ensure any degradation due to aging, to the extent that could affect packaging performance, is detected in advance of such degradation occurring in the field. The Program has demonstrated that the 9975 package has a robust design that can perform under a variety of conditions. As such the primary emphasis of the on-going 9975 Surveillance Program is an aging study of the 9975 Viton(reg.sign) GLT containment vessel O-rings and the Celotex(reg.sign) fiberboard thermal

  16. Moxonidine in the treatment of overweight and obese patients with the metabolic syndrome: a postmarketing surveillance study.

    Science.gov (United States)

    Sharma, A M; Wagner, T; Marsalek, P

    2004-09-01

    Moxonidine is a centrally active imidazoline receptor agonist that effectively lowers blood pressure and has been shown to have beneficial effects on lipid and carbohydrate metabolism. We assessed the efficacy of moxonidine in a postmarketing surveillance study (CAMUS) conducted in 772 practices in Germany, documenting 4005 patients with hypertension, who were overweight and/or suffered from metabolic syndrome. Patients were treated with moxonidine (Cynt) for the first time following the baseline visit for 8 weeks. Mean blood pressure decreased from 168/97 to 141/83 mmHg for all patients and from 168/96 to 141/83 mmHg for patients with metabolic syndrome. Blood pressure reduction was particularly pronounced in patients with severe hypertension at baseline. The response rate (DBP or =10 mmHg) of antihypertensive treatment with moxonidine was 94.0% for all patients and 93.8% for patients with metabolic syndrome. The recommended targets for antihypertensive treatment of the German Diabetes Society/German Hypertension Society were reached by 30.5% of nondiabetics (goal: <140/90 mmHg) and by 3.6% of diabetics (goal: <130/80 mmHg) observed. After 8 weeks of treatment, patients achieved a mean weight loss of 1.4 kg, which was particularly pronounced in obese patients. The rate of patients receiving antihypertensive combination therapy was 81.1% for those with metabolic syndrome, and 63.3% for all other patients. Patients with metabolic syndrome were preferentially treated with ACE inhibitors and diuretics. We conclude that moxonidine effectively reduces blood pressure in patients with metabolic syndrome while simultaneously reducing body weight in obese patients.

  17. Estimation of hand hygiene opportunities on an adult medical ward using 24-hour camera surveillance: validation of the HOW2 Benchmark Study.

    Science.gov (United States)

    Diller, Thomas; Kelly, J William; Blackhurst, Dawn; Steed, Connie; Boeker, Sue; McElveen, Danielle C

    2014-06-01

    We previously published a formula to estimate the number of hand hygiene opportunities (HHOs) per patient-day using the World Health Organization's "Five Moments for Hand Hygiene" methodology (HOW2 Benchmark Study). HHOs can be used as a denominator for calculating hand hygiene compliance rates when product utilization data are available. This study validates the previously derived HHO estimate using 24-hour video surveillance of health care worker hand hygiene activity. The validation study utilized 24-hour video surveillance recordings of 26 patients' hospital stays to measure the actual number of HHOs per patient-day on a medicine ward in a large teaching hospital. Statistical methods were used to compare these results to those obtained by episodic observation of patient activity in the original derivation study. Total hours of data collection were 81.3 and 1,510.8, resulting in 1,740 and 4,522 HHOs in the derivation and validation studies, respectively. Comparisons of the mean and median HHOs per 24-hour period did not differ significantly. HHOs were 71.6 (95% confidence interval: 64.9-78.3) and 73.9 (95% confidence interval: 69.1-84.1), respectively. This study validates the HOW2 Benchmark Study and confirms that expected numbers of HHOs can be estimated from the unit's patient census and patient-to-nurse ratio. These data can be used as denominators in calculations of hand hygiene compliance rates from electronic monitoring using the "Five Moments for Hand Hygiene" methodology. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Oral selenium supplementation has no effect on prostate-specific antigen velocity in men undergoing active surveillance for localized prostate cancer.

    Science.gov (United States)

    Stratton, M Suzanne; Algotar, Amit M; Ranger-Moore, James; Stratton, Steven P; Slate, Elizabeth H; Hsu, Chiu-Hsieh; Thompson, Patricia A; Clark, Larry C; Ahmann, Frederick R

    2010-08-01

    The Nutritional Prevention of Cancer trial showed a 52% lower incidence of prostate cancer in men supplemented with selenium. As a result, our study was designed to assess whether selenium supplementation attenuates the progression of prostate cancer. A phase 2 randomized, double-blind, placebo-controlled clinical trial was conducted in men with localized nonmetastatic prostate cancer who had elected to forgo active treatment and be followed by active surveillance. A total of 140 men were randomized to placebo (n = 46), 200 microg/d (n = 47), or 800 microg/d (n = 47) selenium p.o. (as selenized yeast) and followed every 3 months for up to 5 years. Prostate-specific antigen (PSA) velocity was used as a marker of prostate cancer progression and was estimated using mixed-effects regression. Adjusting for age, body mass index, baseline selenium, smoking, baseline PSA, race, PSA method, and Gleason score, PSA velocities for the 200 microg/d and 800 microg/d treatment groups were not statistically significantly different from placebo (P = 0.32 and P = 0.61, respectively). In the highest quartile of baseline selenium, men supplemented with 800 microg selenium showed statistically significantly higher PSA velocity as compared with placebo (P = 0.018). Selenium supplementation did not show a protective effect on PSA velocity in subjects with localized prostate cancer. On the contrary, supplementation with high-dose selenium was observed to be a risk factor for increased PSA velocity in men with high baseline plasma selenium concentrations.

  19. Surveillance of broad-spectrum antibiotic prescription in Singaporean hospitals: a 5-year longitudinal study.

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    Yi-Xin Liew

    Full Text Available BACKGROUND: Inappropriate prescription of antibiotics may contribute towards higher levels antimicrobial resistance. A key intervention for improving appropriate antibiotic prescription is surveillance of prescription. This paper presents the results of a longitudinal surveillance of broad-spectrum antibiotic prescription in 5 public-sector hospitals in Singapore from 2006 to 2010. METHODOLOGY/PRINCIPAL FINDINGS: Quarterly antibiotic prescription data were obtained and converted to defined daily doses (DDDs per 1,000 inpatient-days. The presence of significant trends in antibiotic prescription over time for both individual and combined hospitals was tested by regression analysis and corrected for autocorrelation between time-points. Excluding fluoroquinolones, there was a significant increase in prescription of all monitored antibiotics from an average of 233.12 defined daily doses (DDD/1,000 inpatient-days in 2006 to 254.38 DDD/1,000 inpatient-days in 2010 (Coefficient = 1.13, 95%CI: 0.16-2.09, p = 0.025. Increasing utilization of carbapenems, piperacillin/tazobactam, and Gram-positive agents were seen in the majority of the hospitals, while cephalosporins were less prescribed over time. The combined expenditure for 5 hospitals increased from USD9.9 million in 2006 to USD16.7 million in 2010. CONCLUSIONS/SIGNIFICANCE: The rate of prescription of broad-spectrum antibiotics in Singaporean hospitals is much higher compared to those of European hospitals. This may be due to high rates of antimicrobial resistance. The increase in expenditure on monitored antibiotics over the past 5 years outstripped the actual increase in DDD/1,000 inpatient-days of antibiotics prescribed. Longitudinal surveillance of antibiotic prescription on a hospital and countrywide level is important for detecting trends for formulating interventions or policies. Further research is needed to understand the causes for the various prescription trends and to act on these where

  20. Satellite relay telemetry in the surveillance of active volcanoes and major fault zones

    Science.gov (United States)

    Eaton, J. P.; Ward, P. L.

    1972-01-01

    A review was made of efforts to develop a dense telemetered microearthquake network to study earthquake mechanics along the San Andreas fault and the strain mechanics of the Kilauea Volcano. The principle elements and objectives of the ERTS-A proposal are outlined. Some of the aspects of the earthquake network and the results obtained from it as well as some promising experiments in computerized record processing are discussed.

  1. Prefer Parameters of Occupational Health Surveillance System (OSS in Expert Opinions of Occupational Staffs: A Qualitative Study

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    Amir Bahrami-Ahmadi

    2017-07-01

    Full Text Available Occupational Health Surveillance System (OHSS provides a critical opportunity to monitor and evaluate occupational disorders and injuries over the time. Among more than 21 million employees in Iran, 62.08% and 38.03% had been worked in the industrial and private sections respectively. Present qualitative study was designed for collection of expert opinion of staffs in this field and determined proper characters of suitable Iranian OHSS. Present qualitative study was performed on an interview based on data from occupational medicine staffs. Some questions about OHSS definition, temporary accompaniment of occupational diseases and injuries surveillance system, OHSS promoters and consumers, type of requested data for OHSS and rewarding and controlling systems to prepare qualitative and valid OHSS data. Interview answers were read, summarized and presented. Most of study participants’ staff believed that OHSS in the scientific base must cover all of essentially its parts including disorders, hazards and accidents together. They believed that this combination was made by a team working with occupational medicine staffs and other specialties such as occupational hygienist and information technologists. They emphasized that the Iranian ministry of health had the capacity to promote OHSS and organizing executive committee with all of OHSS involved as team working in this field. Occupational staff had been focused on this fact that OHSS data must cover all of needed data of Iranian working population and their relatives. Iranian occupational registry system must be change and develop as Occupational Health Surveillance system according the main parameters which were found in occupational staff interview.

  2. Global Surveillance of In Vitro Activity of Micafungin against Candida: a Comparison with Caspofungin by CLSI-Recommended Methods

    Science.gov (United States)

    Pfaller, M. A.; Boyken, L.; Hollis, R. J.; Messer, S. A.; Tendolkar, S.; Diekema, D. J.

    2006-01-01

    Micafungin is an echinocandin antifungal agent that has recently been approved for the prevention of invasive fungal infection and the treatment of esophageal candidiasis. Prospective sentinel surveillance for the emergence of in vitro resistance to micafungin among invasive Candida sp. isolates is indicated. We determined the in vitro activity of micafungin against 2,656 invasive (bloodstream or sterile site) unique patient isolates of Candida spp. collected from 60 medical centers worldwide in 2004 and 2005. We performed antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) M27-A2 method and used a 24-hour prominent inhibition endpoint for determination of the MIC. Caspofungin was tested in parallel against all isolates. Of 2,656 invasive Candida sp. isolates, species distribution was 55.6% Candida albicans, 14.4% Candida parapsilosis, 13.4% Candida glabrata, 10.1% Candida tropicalis, 2.4% Candida krusei, 1.7% Candida guilliermondii, 0.9% Candida lusitaniae, 0.6% Candida kefyr, and 0.9% other Candida species. Overall, micafungin was very active against Candida (MIC50/MIC at which 90% of the isolates tested are inhibited [MIC90], 0.015/1 μg/ml; 96% inhibited at a MIC of ≤1 μg/ml, 100% inhibited at a MIC of ≤2 μg/ml) and comparable to caspofungin (MIC50/MIC90, 0.03/0.25 μg/ml; 99% inhibited at a MIC of ≤2 μg/ml). Results by species, expressed as MIC50/MIC90 (micrograms per milliliter), were as follows: C. albicans, 0.015/0.03; C. glabrata, 0.015/0.015; C. tropicalis, 0.03/0.06; C. krusei, 0.06/0.12; C. kefyr, 0.06/0.06; C. parapsilosis, 1/2; C. guilliermondii, 0.5/1; C. lusitaniae, 0.12/0.25; other Candida spp., 0.25/1. Although the species distribution varied considerably among the different geographic regions, there was no difference in micafungin activity across the regions. Micafungin has excellent in vitro activity against invasive clinical isolates of Candida from centers worldwide. PMID:17021079

  3. Improving the modeling of disease data from the government surveillance system: a case study on malaria in the Brazilian Amazon.

    Directory of Open Access Journals (Sweden)

    Denis Valle

    Full Text Available The study of the effect of large-scale drivers (e.g., climate of human diseases typically relies on aggregate disease data collected by the government surveillance network. The usual approach to analyze these data, however, often ignores a changes in the total number of individuals examined, b the bias towards symptomatic individuals in routine government surveillance, and; c the influence that observations can have on disease dynamics. Here, we highlight the consequences of ignoring the problems listed above and develop a novel modeling framework to circumvent them, which is illustrated using simulations and real malaria data. Our simulations reveal that trends in the number of disease cases do not necessarily imply similar trends in infection prevalence or incidence, due to the strong influence of concurrent changes in sampling effort. We also show that ignoring decreases in the pool of infected individuals due to the treatment of part of these individuals can hamper reliable inference on infection incidence. We propose a model that avoids these problems, being a compromise between phenomenological statistical models and mechanistic disease dynamics models; in particular, a cross-validation exercise reveals that it has better out-of-sample predictive performance than both of these alternative models. Our case study in the Brazilian Amazon reveals that infection prevalence was high in 2004-2008 (prevalence of 4% with 95% CI of 3-5%, with outbreaks (prevalence up to 18% occurring during the dry season of the year. After this period, infection prevalence decreased substantially (0.9% with 95% CI of 0.8-1.1%, which is due to a large reduction in infection incidence (i.e., incidence in 2008-2010 was approximately one fifth of the incidence in 2004-2008.We believe that our approach to modeling government surveillance disease data will be useful to advance current understanding of large-scale drivers of several diseases.

  4. EPS Biomarkers Improve Stratification of NCCN Active Surveillance Candidates: Performance of Secretion Capacity and TMPRSS2:ERG Models

    Science.gov (United States)

    Whelan, Christopher; Kawachi, Mark; Smith, David D.; Linehan, Jennifer; Babilonia, Gail; Mejia, Rosa; Wilson, Timothy; Smith, Steven

    2014-01-01

    Purpose Active surveillance (AS) is a viable patient option for prostate cancer where a clinical determination of low-risk and presumably organ-confined disease can be made. In an effort to standardize risk stratification schemes, the National Comprehensive Cancer Network (NCCN) has provided guidelines for the AS option. Our purpose was to determine the effectiveness of expressed prostatic secretion (EPS) biomarkers in detecting occult risk factors in NCCN AS candidates. Materials and Methods EPS specimens were obtained prior to Robot-Assisted Radical Prostatectomy (RARP). Secretion capacity biomarkers: total RNA and EPS specimen volume were measured by standard techniques. RNA expression biomarkers: TXNRD1-mRNA, PSA-mRNA, TMPRSS2:ERG fusion mRNA and PCA3-mRNAs were measured by quantitative reverse-transcription PCR. Results Of the 528 patients from whom EPS was collected, 216 were eligible for AS under NCCN guidelines. Variable Selection in logistic regression identified two models, one featuring Type III and Type VI TMPRSS2:ERG variants, and one featuring two secretion capacity biomarkers. Of the two high performing models, the secretion capacity model was the most effective in detecting patients within this group that were upstaged or both upstaged and upgraded. It reduced the risk of upstaging in patients with a negative test by nearly 8 fold, and reduced the risk of being both upstaged and upgraded by about 5 fold, while doubling the prevalence upstaging in the positive test group. Conclusions Non-invasive EPS testing may improve patient acceptance of AS by dramatically reducing the presence of occult risk factors among patients eligible for AS under NCCN guidelines. PMID:23669563

  5. Towards One Health Knowledge Networks: A Southern African Centre of Infectious Disease Surveillance case study

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    Eric Beda

    2012-06-01

    Full Text Available The dynamic nature of new information and/or knowledge is a big challenge for information systems. Early knowledge management systems focused entirely on technologies for storing, searching and retrieving data; these systems have proved a failure. Juirsica and Mylopoulos1 suggested that in order to build effective technologies for knowledge management, we need to further our understanding of how individuals, groups and organisations use knowledge. As the focus on knowledge management for organisations and consortia alike is moving towards a keen appreciation of how deeply knowledge is embedded in people’s experiences, there is a general realisation that knowledge cannot be stored or captured digitally. This puts more emphasis in creating enabling environments for interactions that stimulate knowledge sharing.Our work aims at developing an un-obtrusive intelligent system that glues together effective contemporary and traditional technologies to aid these interactions and manage the information captured. In addition this system will include tools to aid propagating a repository of scientific information relevant to surveillance of infectious diseases to complement knowledge shared and/or acts as a point of reference.This work is ongoing and based on experiences in developing a knowledge network management system for the Southern African Centre of Infectious Disease Surveillance (SACIDS, A One Health consortium of southern African academic and research institutions involved with infectious diseases of humans and animals in partnership with world-renowned centres of research in industrialised countries.

  6. Utility of dried blood spots for measurement of cholesterol and triglycerides in a surveillance study.

    Science.gov (United States)

    Lakshmy, Ramakrishnan; Gupta, Ruby; Prabhakaran, Dorairaj; Snehi, Uma; Reddy, K Srinath

    2010-03-01

    Developing countries are facing a rise in noncommunicable diseases (NCD), which is a cause for concern. The World Health Organization has recommended a stepwise approach for NCD risk factor surveillance. Screening for risk factors in remote populations is difficult due to lack of resources and technical expertise, including standardized laboratory facilities. The collection of samples on filter paper for the assessment of risk factors circumvents the need for blood processing, storage, and shipment at ultralow temperatures. Samples were collected on 3-mm Whatman filter paper from one industry (National Thermal Power Corporation) located in the periphery of Delhi as part of a surveillance carried out in industries from different parts of India. Total cholesterol was measured in serum and dried blood by the cholesterol oxidase/p-aminophenazone method and triglycerides by the glycerophosphate oxidase-peroxidase/aminophenazone method. Values obtained by the two methods were compared using Pearson correlation, and Bland-Altman plots were prepared to assess bias. The correlation coefficient "r" was 0.78 for cholesterol and 0.94 for triglycerides between dried blood spots and serum. Bland-Altman plots suggest that differences in values obtained by the two methods were within two standard deviations for most of the samples. Blood samples dried on filter paper can be a successful option for population screening in remote areas, provided preanalytical variations arising due to the method of blood spot preparation and storage are well controlled. (c) 2010 Diabetes Technology Society.

  7. Defining 'surveillance' in drug safety.

    Science.gov (United States)

    Aronson, Jeffrey K; Hauben, Manfred; Bate, Andrew

    2012-05-01

    The concept of surveillance in pharmacovigilance and pharmacoepidemiology has evolved from the concept of surveillance in epidemiology, particularly of infectious diseases. We have surveyed the etymology, usages, and previous definitions of 'surveillance' and its modifiers, such as 'active' and 'passive'. The following essential definitional features of surveillance emerge: (i) surveillance and monitoring are different--surveillance involves populations, while monitoring involves individuals; (ii) surveillance can be performed repeatedly and at any time during the lifetime of a medicinal product or device; (iii) although itself non-interventional, it can adduce any types of evidence (interventional, observational, or anecdotal, potentially at different times); (iv) it encompasses data collection, management, analysis, and interpretation; (v) it includes actions to be taken after signal detection, including initial evaluation and communication; and (vi) it should contribute to the classification of adverse reactions and their prevention or mitigation and/or to the harnessing of beneficial effects. We conclude that qualifiers add ambiguity and uncertainty without enhancing the idea of surveillance. We propose the following definition of surveillance of health-care products, which embraces all the surveyed ideas and reflects real-world pharmacovigilance processes: 'a form of non-interventional public health research, consisting of a set of processes for the continued systematic collection, compilation, interrogation, analysis, and interpretation of data on benefits and harms (including relevant spontaneous reports, electronic medical records, and experimental data).' As a codicil, we note that the purposes of surveillance are to identify, evaluate, understand, and communicate previously unknown effects of health-care products, or new aspects of known effects, in order to harness such effects (if beneficial) or prevent or mitigate them (if harmful).

  8. Impact of active surveillance, chlorambucil, and other therapy on health-related quality of life in patients with CLL/SLL in the Netherlands.

    Science.gov (United States)

    van den Broek, Esther C; Oerlemans, Simone; Nijziel, Marten R; Posthuma, Eduardus F M; Coebergh, Jan Willem W; van de Poll-Franse, Lonneke V

    2015-01-01

    As survival of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) increases and the number of patients who live long rises, health-related quality of life (HRQoL) becomes a relevant endpoint. Few studies investigated this, mainly as a secondary endpoint in randomized clinical trials where patients with early stage CLL/SLL, and elderly/frail patients were underrepresented. The aim of our study was to assess HRQoL in a population-based setting, including these previously underrepresented patients. Out of 175 patients diagnosed with CLL/SLL between 2004 and 2011, 136 (78 %) returned the HRQoL questionnaire. The outcomes were compared to an age- and sex-matched norm population. Detailed data on stage and treatment were extracted from a population-based hematological registry (PHAROS). Patients ever treated for CLL/SLL reported significantly poorer HRQoL than the norm population (p chlorambucil reported the lowest HRQoL scores. Drastic, long-lasting negative effects of starting treatment on HRQoL cannot be excluded, whereas active surveillance does not seem to provoke worrying, anxiety, or depressive symptoms. Further elaborate research into the impact of starting therapy on HRQoL is needed, especially in patients that are underrepresented in most clinical trials, and thoroughly consider its results during revision of treatment guidelines.

  9. Building up a collaborative network for the surveillance of HIV genetic diversity in Italy: A pilot study

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    Nunzia Sanarico

    2015-12-01

    Full Text Available INTRODUCTION: Prevalence of infection with HIV-1 non-B subtypes in Italy has been reported to raise, due to increased migration flows and travels. HIV-1 variants show different biological and immunological properties that impact on disease progression rate, response to antiretroviral therapy (ART and sensitivity of diagnostic tests with important implications for public health. Therefore, a constant surveillance of the dynamics of HIV variants in Italy should be a high public health priority. Organization of surveillance studies requires building up a platform constituted of a network of clinical centers, laboratories and institutional agencies, able to properly collect samples for the investigation of HIV subtypes heterogeneity and to provide a database with reliable demographic, clinical, immunological and virological data. AIM: We here report our experience in building up such a platform, co-ordinated by the National AIDS Center of the Istituto Superiore di Sanita, taking advantage of a pilot study aimed at evaluating HIV subtypes diversity in populations of HIV-infected migrant people in Italy. MATERIALS AND METHODS: Four hundred and thirty four HIV-infected migrants were enrolled in 9 Italian clinical centers located throughout the Italian territory. Standard Operating Procedures (SOPs for sample collection were provided by the National AIDS Center to each clinical center. In addition, clinical centers were required to fill up a case report form (crf for each patient, which included demographic, clinical, immunological and virological information. RESULTS: All centers properly collected and stored samples from each enrolled individual. Overall, the required information was correctly provided for more than 90% of the patients. However, some fields of the crf, particularly those including information on the last HIV-negative antibody test and presence of co-infections, were properly filled up in less than 80% of the enrolled migrants. Centers

  10. Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report.

    Science.gov (United States)

    Gómez-Reino, Juan J; Carmona, Loreto; Valverde, Vicente Rodríguez; Mola, Emilio Martín; Montero, Maria Dolores

    2003-08-01

    The long-term safety of therapeutic agents that neutralize tumor necrosis factor (TNF) is uncertain. Recent evidence based on spontaneous reporting shows an association with active tuberculosis (TB). We undertook this study to determine and describe the long-term safety of 2 of these agents, infliximab and etanercept, in rheumatic diseases based on a national active-surveillance system following the commercialization of the drugs. We analyzed the safety data actively collected in the BIOBADASER (Base de Datos de Productos Biológicos de la Sociedad Española de Reumatología) database, which was launched in February 2000 by the Spanish Society of Rheumatology. For the estimation of TB risk, the annual incidence rate in patients treated with these agents was compared with the background rate and with the rate in a cohort of patients with rheumatoid arthritis (RA) assembled before the era of anti-TNF treatment. Seventy-one participating centers sent data on 1,578 treatments with infliximab (86%) or etanercept (14%) in 1,540 patients. Drug survival rates (reported as the cumulative percentage of patients still receiving medication) for infliximab and etanercept pooled together were 85% and 81% at 1 year and 2 years, respectively. Instances of discontinuation were essentially due to adverse events. Seventeen cases of TB were found in patients treated with infliximab. The estimated incidence of TB associated with infliximab in RA patients was 1,893 per 100,000 in the year 2000 and 1,113 per 100,000 in the year 2001. These findings represent a significant increased risk compared with background rates. In the first 5 months of 2002, after official guidelines were established for TB prevention in patients treated with biologics, only 1 new TB case was registered (in January). Therapy with infliximab is associated with an increased risk of active TB. Proper measures are needed to prevent and manage this adverse event.

  11. Global Assessment of the Activity of Tigecycline against Multidrug-Resistant Gram-Negative Pathogens between 2004 and 2014 as Part of the Tigecycline Evaluation and Surveillance Trial

    Science.gov (United States)

    Calà, Cinzia; Fasciana, Teresa; Dowzicky, Michael J.

    2017-01-01

    ABSTRACT Multidrug-resistant (MDR) Gram-negative organisms are a burden on the global health care system. The Tigecycline Evaluation and Surveillance Trial (TEST) is an ongoing global study designed to monitor the in vitro activities of tigecycline and a panel of marketed antimicrobials against a range of clinically significant pathogens. In this study, in vitro data are presented for MDR Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, and Enterobacter cloacae isolates collected from 2004 to 2014. In total, 13% (21,967/170,759) of isolates displayed multidrug resistance globally, with the highest rates recorded among A. baumannii (overall rate, 44% [8,294/18,741], increasing from 23% [309/1,323] in 2004 to 63% [447/712] in 2014). Other multidrug resistance rates ranged from 2.5% for K. oxytoca (203/8,000) to 12% for P. aeruginosa and K. pneumoniae (3,951/32,786 and 3,895/32,888, respectively), and rates among these pathogens remained stable during the study period. Against MDR E. coli, Klebsiella spp., and E. aerogenes, the lowest rates of resistance were to tigecycline (0.2%, 6%, and 12%, respectively), and the lowest MIC90 value against A. baumannii was observed for tigecycline (2 mg/liter; MIC range, ≤0.008 to ≥32 mg/liter). The only significant change in resistance to tigecycline during the study period was for MDR E. coli (P < 0.01), among which eight resistant isolates were identified globally from 2009 to 2013. In summary, these results show that tigecycline retained in vitro activity against the majority of MDR Gram-negative organisms presented here, but the rising rates of MDR A. baumannii highlight the need for the continued monitoring of global multidrug resistance. IMPORTANCE Multidrug resistance among bacterial pathogens is an ongoing global problem and renders antimicrobial agents ineffective at treating bacterial infections. In the health care setting

  12. Influenza surveillance in the Pacific Island countries and territories during the 2009 pandemic: an observational study

    Directory of Open Access Journals (Sweden)

    Kool Jacobus Leen

    2013-01-01

    Full Text Available Abstract Background Historically, Pacific island countries and territories (PICTs have been more severely affected by influenza pandemics than any other part of the world. We herein describe the emergence and epidemiologic characteristics of pandemic influenza H1N1 in PICTs from 2009 to 2010. Methods The World Health Organization gathered reports of influenza-like-illness and laboratory-confirmed pandemic H1N1 cases from all 23 Pacific island countries and territories, from April 2009 through August 2010. Data were gathered through weekly email reports from Pacific island countries and territories and through email or telephone follow-up. Results Pacific island countries and territories started detecting pandemic H1N1 cases in June 2009, firstly in French Polynesia, with the last new detection occurring in August 2009 in Tuvalu. Nineteen Pacific island countries and territories reported 1,972 confirmed cases, peaking in August 2009. No confirmed pandemic H1N1 cases were identified in Niue, Pitcairn and Tokelau; the latter instituted strict maritime quarantine. Influenza-like-illness surveillance showed trends similar to surveillance of confirmed cases. Seven Pacific island countries and territories reported 21 deaths of confirmed pandemic H1N1. Case-patients died of acute respiratory distress syndrome or multi-organ failure, or both. The most reported pre-existing conditions were obesity, lung disease, heart disease, and pregnancy. Pacific island countries and territories instituted a variety of mitigation measures, including arrival health screening. Multiple partners facilitated influenza preparedness planning and outbreak response. Conclusions Pandemic influenza spread rapidly throughout the Pacific despite enormous distances and relative isolation. Tokelau and Pitcairn may be the only jurisdictions to have remained pandemic-free. Despite being well-prepared, Pacific island countries and territories experienced significant morbidity and

  13. European recommendations for antimicrobial resistance surveillance.

    Science.gov (United States)

    Cornaglia, G; Hryniewicz, W; Jarlier, V; Kahlmeter, G; Mittermayer, H; Stratchounski, L; Baquero, F

    2004-04-01

    The problem of antimicrobial resistance surveillance in Europe has been debated extensively in many excellent documents issued by national committees that often assume the value of national guidelines. However, a comprehensive document addressing the whole matter from a European perspective, as well as reviewing its present status and drafting future perspectives, has been lacking. The present recommendations have been produced by the ESCMID Study Group for Antimicrobial Resistance Surveillance (ESGARS) through a consensus process involving all members of the Study Group. The recommendations focus on the detection of bacterial resistance and its reporting to clinicians, public health officers and a wider-and ever-increasing-audience. The leading concept is that the basis for resistance monitoring is microbiological diagnostics. The prerequisites for resistance monitoring are findings of adequate quality and quantity, which have been recorded properly and evaluated correctly. Different types of surveillance studies should fulfil different requirements with regard to data collection and reporting, the expected use of data, and the prerequisites for networking such activities. To generate relevant indicators, bacterial resistance data should be reported using adequate denominators and stratification. Reporting of antimicrobial resistance data is necessary for selection of empirical therapy at the local level, for assessing the scale of the resistance problem at the local, national or international levels, for monitoring changes in resistance rates, and for detecting the emergence and spread of new resistances types. Any type of surveillance study should conclude, where appropriate, with a proposal for intervention based on the data obtained.

  14. [Evaluation of epidemiologic surveillance systems: analysis of different approaches in a study in Ecuador].

    Science.gov (United States)

    Briand, S

    2000-12-01

    Based on the experience of the assessment of public health surveillance systems, this paper explores the relationship between knowledge and action. Like research, evaluation is a cognitive process however oriented to a specific aim. Thus it is possible to compare the various approaches of evaluating these systems using the frame of paradigms in sciences (positivism, post positivism, critical theory and constructivism). In addition, evaluation aims to improve the functioning of the system, to introduce changes in it. The fourth generation evaluation, as it has been done in Ecuador, is an interesting way of acquiring understanding of the system while solving its malfunctionings. In this experience, the evaluator seeks the participation of the actors of the system at each steps of the evaluation process. He searches to involved them through three levels: intellectual, affective and ontological.

  15. Pre-harvest surveillance of Campylobacter and Salmonella in Danish broiler flocks: a 2-year study

    DEFF Research Database (Denmark)

    Wedderkopp, A.; Gradel, K.O.; Jorgensen, J.C.

    2001-01-01

    In national surveillance programmes of broiler flocks carried out in Denmark during 1998 and 1999, 89,110 samples for Campylobacter representing 8911 broiler flocks were taken at 10 different abattoirs, and 44,550 samples for Salmonella were taken from the same flocks in the broiler houses...... at the farms. Of the swabs, 42.5% were Campylobacter positive. Most positive samples were found during July, August and September, while the lowest number of positive samples were found during January, February, March and April. Of the flocks, 5.5% were Salmonella positive, but no seasonal variation...... was observed. For each flock, the presence of Campylobacter and Salmonella was recorded in order to estimate the possible correlation between colonisation with the two pathogens. In conclusion, no significant effects on intensive cleaning and disinfection procedures on Campylobacter occurrence could...

  16. HIV surveillance in complex emergencies.

    Science.gov (United States)

    Salama, P; Dondero, T J

    2001-04-01

    Many studies have shown a positive association between both migration and temporary expatriation and HIV risk. This association is likely to be similar or even more pronounced for forced migrants. In general, HIV transmission in host-migrant or host-forced-migrant interactions depends on the maturity of the HIV epidemic in both the host and the migrant population, the relative seroprevalence of HIV in the host and the migrant population, the prevalence of other sexually transmitted infections (STIs) that may facilitate transmission, and the level of sexual interaction between the two communities. Complex emergencies are the major cause of mass population movement today. In complex emergencies, additional factors such as sexual interaction between forced-migrant populations and the military; sexual violence; increasing commercial sex work; psychological trauma; and disruption of preventive and curative health services may increase the risk for HIV transmission. Despite recent success in preventing HIV infection in stable populations in selected developing countries, internally displaced persons and refugees (or forced migrants) have not been systematically included in HIV surveillance systems, nor consequently in prevention activities. Standard surveillance systems that rely on functioning health services may not provide useful data in many complex emergency settings. Secondary sources can provide some information in these settings. Little attempt has been made, however, to develop innovative HIV surveillance systems in countries affected by complex emergencies. Consequently, data on the HIV epidemic in these countries are scarce and HIV prevention programs are either not implemented or interventions are not effectively targeted. Second generation surveillance methods such as cross-sectional, population-based surveys can provide rapid information on HIV, STIs, and sexual behavior. The risks for stigmatization and breaches of confidentiality must be recognized

  17. Potential for the Australian and New Zealand paediatric intensive care registry to enhance acute flaccid paralysis surveillance in Australia: a data-linkage study

    OpenAIRE

    Hobday, Linda K; Thorley, Bruce R; Alexander, Janet; Aitken, Thomas; Peter D Massey; Cretikos, Michelle; Slater, Anthony; DURRHEIM, DAVID N.

    2013-01-01

    Background Australia uses acute flaccid paralysis (AFP) surveillance to monitor its polio-free status. The World Health Organization criterion for a sensitive AFP surveillance system is the annual detection of at least one non-polio AFP case per 100,000 children aged less than 15 years, a target Australia has not consistently achieved. Children exhibiting AFP are likely to be hospitalised and may be admitted to an intensive care unit. This provides a potential opportunity for active AFP surve...

  18. Antimicrobial activity of ceftobiprole, a novel anti-methicillin-resistant Staphylococcus aureus cephalosporin, tested against contemporary pathogens: results from the SENTRY Antimicrobial Surveillance Program (2005-2006).

    Science.gov (United States)

    Fritsche, Thomas R; Sader, Helio S; Jones, Ronald N

    2008-05-01

    Ceftobiprole is a 1st-in-class anti-methicillin-resistant Staphylococcus aureus (MRSA) extended-spectrum cephalosporin currently in clinical trials for the treatment of complicated skin and skin structure infections (cSSSIs) and nosocomial pneumonia. This agent is also active against other prominent Gram-positive and Gram-negative pathogens, making it an attractive candidate for broad-spectrum therapy. We evaluated the in vitro potency of ceftobiprole tested against the most commonly occurring bacterial pathogens as part of a global surveillance study for the years 2005 to 2006 (>60 medical centers in North America, Latin America, and Europe). All isolates (40 675) were susceptibility tested using reference broth microdilution methods. Ceftobiprole inhibited 100% and >99% of tested S. aureus and coagulase-negative staphylococci at Ceftobiprole was also broadly active against Streptococcus pneumoniae, beta-hemolytic and viridans group streptococci, inhibiting >98% of isolates at ceftobiprole was generally inactive against Enterococcus faecium, the majority of Enterococcus faecalis strains (95.7%) were inhibited at ceftobiprole and ceftazidime), ceftobiprole and cefepime were superior to ceftazidime against Enterobacter spp. and Citrobacter spp. Against Pseudomonas aeruginosa, ceftobiprole was equal in potency to ceftazidime (MIC50, 2 microg/mL) and 2-fold more potent than cefepime. None of these agents inhibited >45% of Acinetobacter spp. at 8 mug/mL. Ceftobiprole is a new anti-MRSA beta-lactam with recognized activity against the most commonly occurring Enterobacteriaceae and P. aeruginosa, similar to that of extended-spectrum cephems. These characteristics warrant continued evaluation of the agent as empiric therapy for cSSSIs, and in pneumonia, especially in those institutions/regions where MRSA and P. aeruginosa may be prevalent.

  19. High dengue case capture rate in four years of a cohort study in Nicaragua compared to national surveillance data.

    Directory of Open Access Journals (Sweden)

    Katherine Standish

    Full Text Available Dengue is a major public health problem in tropical and subtropical regions; however, under-reporting of cases to national surveillance systems hinders accurate knowledge of disease burden and costs. Laboratory-confirmed dengue cases identified through the Nicaraguan Pediatric Dengue Cohort Study (PDCS were compared to those reported from other health facilities in Managua to the National Epidemiologic Surveillance (NES program of the Nicaraguan Ministry of Health. Compared to reporting among similar pediatric populations in Managua, the PDCS identified 14 to 28 (average 21.3 times more dengue cases each year per 100,000 persons than were reported to the NES. Applying these annual expansion factors to national-level data, we estimate that the incidence of confirmed pediatric dengue throughout Nicaragua ranged from 300 to 1000 cases per 100,000 persons. We have estimated a much higher incidence of dengue than reported by the Ministry of Health. A country-specific expansion factor for dengue that allows for a more accurate estimate of incidence may aid governments and other institutions calculating disease burden, costs, resource needs for prevention and treatment, and the economic benefits of drug and vaccine development.

  20. A Focused Ethnographic Study of Alberta Cattle Veterinarians’ Decision Making about Diagnostic Laboratory Submissions and Perceptions of Surveillance Programs

    OpenAIRE

    Kate Sawford; Ardene Robinson Vollman; Craig Stephen

    2013-01-01

    The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemen...

  1. A postmarketing surveillance study of dexrabeprazole in the treatment of acid peptic disorders.

    Science.gov (United States)

    Jain, S C

    2009-02-01

    Dexrabeprazole [R(+) rabeprazole] is a novel proton-pump inhibitor which has recently become available in India for the treatment of acid peptic diseases. Experimental and clinical studies have shown superiority of dexrabeprazole (at half the recommended rabeprazole dose) over rabeprazole in terms of favourable pharmacokinetics, better efficacy and faster and greater healing activity. Results of present study in a large population of 4931 patients of acid peptic disorders, reconfirmed safety and efficacy of dexrabeprazole 10 mg once daily in the treatment of gastro-oesophageal reflux disease and also showed its effectiveness in the treatment of patients with peptic ulcers (gastric/duodenal).

  2. Multiple Hypothesis Tracking (MHT) for Space Surveillance: Results and Simulation Studies

    Science.gov (United States)

    Singh, N.; Poore, A.; Sheaff, C.; Aristoff, J.; Jah, M.

    2013-09-01

    With the anticipated installation of more accurate sensors and the increased probability of future collisions between space objects, the potential number of observable space objects is likely to increase by an order of magnitude within the next decade, thereby placing an ever-increasing burden on current operational systems. Moreover, the need to track closely-spaced objects due, for example, to breakups as illustrated by the recent Chinese ASAT test or the Iridium-Kosmos collision, requires new, robust, and autonomous methods for space surveillance to enable the development and maintenance of the present and future space catalog and to support the overall space surveillance mission. The problem of correctly associating a stream of uncorrelated tracks (UCTs) and uncorrelated optical observations (UCOs) into common objects is critical to mitigating the number of UCTs and is a prerequisite to subsequent space catalog maintenance. Presently, such association operations are mainly performed using non-statistical simple fixed-gate association logic. In this paper, we report on the salient features and the performance of a newly-developed statistically-robust system-level multiple hypothesis tracking (MHT) system for advanced space surveillance. The multiple-frame assignment (MFA) formulation of MHT, together with supporting astrodynamics algorithms, provides a new joint capability for space catalog maintenance, UCT/UCO resolution, and initial orbit determination. The MFA-MHT framework incorporates multiple hypotheses for report to system track data association and uses a multi-arc construction to accommodate recently developed algorithms for multiple hypothesis filtering (e.g., AEGIS, CAR-MHF, UMAP, and MMAE). This MHT framework allows us to evaluate the benefits of many different algorithms ranging from single- and multiple-frame data association to filtering and uncertainty quantification. In this paper, it will be shown that the MHT system can provide superior

  3. Surface-water surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Saldi, K.A.; Dirkes, R.L.; Blanton, M.L.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the Surface water on and near the Hanford Site is monitored to determine the potential effects of Hanford operations. Surface water at Hanford includes the Columbia River, riverbank springs, ponds located on the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site. Columbia River sediments are also included in this discussion. Tables 5.3.1 and 5.3.2 summarize the sampling locations, sample types, sampling frequencies, and sample analyses included in surface-water surveillance activities during 1994. Sample locations are also identified in Figure 5.3.1. This section describes the surveillance effort and summarizes the results for these aquatic environments. Detailed analytical results are reported by Bisping (1995).

  4. Defense Health Care: DOD Needs to Clarify Policies Related to Occupational and Environmental Health Surveillance and Monitor Risk Mitigation Activities

    Science.gov (United States)

    2015-05-01

    and environmental health surveillance OEHSA Occupational and Environmental Health Site Assessment POEMS Periodic Occupational and...inhalation from burn pits in Iraq and Afghanistan, the Institute of Medicine was unable to determine whether long -term health effects are likely to result...Washington, D.C.: May 1, 2012). 5See Institute of Medicine for the Department of Veterans’ Affairs. Long -Term Health Consequences of Exposure to Burn

  5. Descriptive review of tuberculosis surveillance systems across the circumpolar regions

    Directory of Open Access Journals (Sweden)

    Annie-Claude Bourgeois

    2016-04-01

    baseline knowledge on similarities and differences among circumpolar tuberculosis surveillance systems. The similarity in case definitions will allow for description of the epidemiology of TB based on surveillance data in circumpolar regions, further study of tuberculosis trends across regions, and recommendation of best practices to improve surveillance activities.

  6. Health disparities experienced by people with disabilities in the United States: a Behavioral Risk Factor Surveillance System study.

    Science.gov (United States)

    Pharr, Jennifer R; Bungum, Tim

    2012-09-09

    The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all chronic diseases, for physical inactivity, obesity and smoking. They were significantly more likely to participate in some preventive services (flu/pneumonia vaccination, HIV test) and significantly less likely to participate in other preventive services (mammogram, Pap test). Our findings suggest that people with disabilities are less able to fully participate in all preventive services offered.

  7. Malaria in pregnancy: a passive surveillance study of pregnant women in low transmission areas of Colombia, Latin America

    DEFF Research Database (Denmark)

    Lopez-Perez, Mary; Pacheco, M Andreína; Buriticá, Lucía

    2016-01-01

    2011 and 2013. Trained physicians confirmed the pregnancy status and recorded clinical and epidemiological information. Haematological parameters, as well as hepatic and renal function, anti-malarial antibodies and parasite genotypes were evaluated. RESULTS: A total of 582 women presented with malaria......BACKGROUND: Malaria causes a significant burden in highly endemic areas where children and pregnant women are more susceptible to severe disease and death, however, in low transmission settings malaria in pregnant women is less frequent. The aim of this study was to provide information of clinical...... profile, anti-parasite host immune responses and parasite genotyping of pregnant women with malaria in low endemic areas of Colombia. METHODS: This was a descriptive study conducted through passive surveillance in 1328 individuals from three endemic areas of Córdoba, Nariño and Chocó departments between...

  8. [Activity of sanitary surveillances/offices in Warsaw at the time of the second republic of Poland].

    Science.gov (United States)

    Berner, Włodzimierz

    2006-01-01

    At the time of the Second Republic of Poland, Warsaw, the capital of the rebirth country, was a neglected town as regards sanitary conditions. The genesis of this situation dates back to the period of the national bondage by the Russian partitioner, and since 1915 by the German invader who did not care about the problems associated with public health. The sanitary and hygienic conditions worsened significantly in 1916, after incorporating into Warsaw large out-of-town regions whose housing was of the rural character with numerous wooden cottages, field roads, without any sanitary sewage system. Poor municipal sanitary-maintenance conditions and infectious diseases spreading in Warsaw made the Town Authorities implement preventive action and entrust sanitary surveillances with this difficult task. These surveillances were set up at the time of the First World War, and after 1920 were changed into sanitary offices. Their duties included control of acute infectious diseases, sanitary inspection of living quarters, sites of production and selling of food articles, plants, service outlets, shops of a different character, as well as surveillance of food purchased by the inhabitants. In each sanitary office a doctor was employed who supervised the work of one, two or three sanitary inspectors.

  9. Evaluation of Multiplex-Based Antibody Testing for Use in Large-Scale Surveillance for Yaws: a Comparative Study.

    Science.gov (United States)

    Cooley, Gretchen M; Mitja, Oriol; Goodhew, Brook; Pillay, Allan; Lammie, Patrick J; Castro, Arnold; Moses, Penias; Chen, Cheng; Ye, Tun; Ballard, Ronald; Martin, Diana L

    2016-05-01

    WHO has targeted yaws for global eradication by 2020. The program goals are to interrupt the transmission in countries where yaws is endemic and to certify countries as yaws free where yaws was endemic in the past. No new rapid plasmin reagin (RPR) seroreactivity in young children is required for certification of elimination at a country level. We sought to evaluate whether antibody responses to specific treponemal antigens measured in a high-throughput multiplex bead array (MBA) assay differentiate past versus current infection and whether a nontreponemal lipoidal antigen test can be incorporated into the MBA. Serum and dried blood spot specimens collected for yaws surveillance projects in Ghana, Vanuatu, and Papua New Guinea (PNG) were run on MBA to measure antibodies against recombinant p17 (rp17) and treponemal membrane protein A (TmpA) treponemal antigens. Results were compared to standard treponemal laboratory (TPPA or TPHA [TPP(H)A]) and quantitative RPR test data. Of 589 specimens, 241 were TPP(H)A(+)/RPR(+), 88 were TPP(H)A(+)/RPR(-), 6 were TPP(H)A(-)/RPR(+), and 254 were negative for both tests. Compared to TPP(H)A, reactive concordance of rp17 was 93.7%, while reactive concordance of TmpA was only 81.9%. TmpA-specific reactivity showed good correlation with RPR titers (R(2) = 0.41; P RPR testing (cardiolipin) were not detected in the MBA. Our results suggest that TmpA can be used as a treponemal antigen marker for recent or active infection and potentially replace RPR in a high-throughput multiplex tool for large-scale yaws surveillance.

  10. Detection and Isolation of Swine Influenza A Virus in Spiked Oral Fluid and Samples from Individually Housed, Experimentally Infected Pigs: Potential Role of Porcine Oral Fluid in Active Influenza A Virus Surveillance in Swine.

    Directory of Open Access Journals (Sweden)

    Inge Decorte

    Full Text Available The lack of seasonality of swine influenza A virus (swIAV in combination with the capacity of swine to harbor a large number of co-circulating IAV lineages, resulting in the risk for the emergence of influenza viruses with pandemic potential, stress the importance of swIAV surveillance. To date, active surveillance of swIAV worldwide is barely done because of the short detection period in nasal swab samples. Therefore, more sensitive diagnostic methods to monitor circulating virus strains are requisite.qRT-PCR and virus isolations were performed on oral fluid and nasal swabs collected from individually housed pigs that were infected sequentially with H1N1 and H3N2 swIAV strains. The same methods were also applied to oral fluid samples spiked with H1N1 to study the influence of conservation time and temperature on swIAV infectivity and detectability in porcine oral fluid.All swIAV infected animals were found qRT-PCR positive in both nasal swabs and oral fluid. However, swIAV could be detected for a longer period in oral fluid than in nasal swabs. Despite the high detectability of swIAV in oral fluid, virus isolation from oral fluid collected from infected pigs was rare. These results are supported by laboratory studies showing that the PCR detectability of swIAV remains unaltered during a 24 h incubation period in oral fluid, while swIAV infectivity drops dramatically immediately upon contact with oral fluid (3 log titer reduction and gets lost after 24 h conservation in oral fluid at ambient temperature.Our data indicate that porcine oral fluid has the potential to replace nasal swabs for molecular diagnostic purposes. The difficulty to isolate swIAV from oral fluid could pose a drawback for its use in active surveillance programs.

  11. Conjoined Twins: A Worldwide Collaborative Epidemiological Study of the International Clearinghouse for Birth Defects Surveillance and Research

    Science.gov (United States)

    MUTCHINICK, OSVALDO M.; LUNA-MUÑOZ, LEONORA; AMAR, EMMANUELLE; BAKKER, MARIAN K.; CLEMENTI, MAURIZIO; COCCHI, GUIDO; DUTRA, MARIA DA GRAÇA; FELDKAMP, MARCIA L.; LANDAU, DANIELLE; LEONCINI, EMANUELE; LI, ZHU; LOWRY, BRIAN; MARENGO, LISA K.; MARTÍNEZ-FRÍAS, MARÍA-LUISA; MASTROIACOVO, PIERPAOLO; MÉTNEKI, JULIA; MORGAN, MARGERY; PIERINI, ANNA; RISSMAN, ANKE; RITVANEN, ANNUKKA; SCARANO, GIOACCHINO; SIFFEL, CSABA; SZABOVA, ELENA; ARTEAGA-VÁZQUEZ, JAZMÍN

    2015-01-01

    Conjoined twins (CT) are a very rare developmental accident of uncertain etiology. Prevalence has been previously estimated to be 1 in 50,000 to 1 in 100,000 births. The process by which monozygotic twins do not fully separate but form CT is not well understood. The purpose of the present study was to analyze diverse epidemiological aspects of CT, including the different variables listed in the Introduction Section of this issue of the Journal. The study was made possible using the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR) structure. This multicenter worldwide research includes the largest sample of CT ever studied. A total of 383 carefully reviewed sets of CT obtained from 26,138,837 births reported by 21 Clearinghouse Surveillance Programs (SP) were included in the analysis. Total prevalence was 1.47 per 100,000 births (95% CI: 1.32–1.62). Salient findings including an evident variation in prevalence among SPs: a marked variation in the type of pregnancy outcome, a similarity in the proportion of CT types among programs: a significant female predominance in CT: particularly of the thoracopagus type and a significant male predominance in parapagus and parasitic types: significant differences in prevalence by ethnicity and an apparent increasing prevalence trend in South American countries. No genetic, environmental or demographic significant associated factors were identified. Further work in epidemiology and molecular research is necessary to understand the etiology and pathogenesis involved in the development of this fascinating phenomenon of nature. PMID:22002822

  12. The surveillant assemblage.

    Science.gov (United States)

    Haggerty, K D; Ericson, R V

    2000-12-01

    George Orwell's 'Big Brother' and Michel Foucault's 'panopticon' have dominated discussion of contemporary developments in surveillance. While such metaphors draw our attention to important attributes of surveillance, they also miss some recent dynamics in its operation. The work of Gilles Deleuze and Felix Guattari is used to analyse the convergence of once discrete surveillance systems. The resultant 'surveillant assemblage' operates by abstracting human bodies from their territorial settings, and separating them into a series of discrete flows. These flows are then reassembled in different locations as discrete and virtual 'data doubles'. The surveillant assemblage transforms the purposes of surveillance and the hierarchies of surveillance, as well as the institution of privacy.

  13. The Influence of Psychosocial Constructs on the Adherence to Active Surveillance for Localized Prostate Cancer in a Prospective, Population-based Cohort.

    Science.gov (United States)

    Lang, Maximilian F; Tyson, Mark D; Alvarez, JoAnn Rudd; Koyama, Tatsuki; Hoffman, Karen E; Resnick, Matthew J; Cooperberg, Matthew R; Wu, Xiao-Cheng; Chen, Vivien; Paddock, Lisa E; Hamilton, Ann S; Hashibe, Mia; Goodman, Michael; Greenfield, Sheldon; Kaplan, Sherrie H; Stroup, Antoinette; Penson, David F; Barocas, Daniel A

    2017-05-01

    To evaluate the influence of psychosocial factors such as prostate cancer (PCa) anxiety, social support, participation in medical decision-making (PDM), and educational level on patient decisions to discontinue PCa active surveillance (AS) in the absence of disease progression. The Comparative Effectiveness Analysis of Surgery and Radiation study is a prospective, population-based cohort study of men with localized PCa diagnosed in 2011-2012. PCa anxiety, social support, PDM, educational level, and patient reasons for discontinuing AS were assessed through patient surveys. A Cox proportional hazards model examined the relationship between psychosocial variables and time to discontinuation of AS. Of 531 patients on AS, 165 (30.9%) underwent treatment after median follow-up of 37 months. Whereas 69% of patients cited only medical reasons for discontinuing AS, 31% cited at least 1 personal reason, and 8% cited personal reasons only. Patients with some college education discontinued AS significantly earlier (hazard ratio: 2.0, 95% confidence interval: 1.2, 3.2) than patients with less education. PCa anxiety, social support, and PDM were not associated with seeking treatment. We found that 31% of men who choose AS for PCa discontinue AS within 3 years. Eight percent of men who sought treatment did so in the absence of disease progression. Education, but not psychosocial factors, seems to influence definitive treatment-seeking. Future research is needed to understand how factors unrelated to disease severity influence treatment decisions among patients on AS to identify opportunities to improve adherence to AS. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. 9975 SHIPPING PACKAGE LIFE EXTENSION SURVEILLANCE PROGRAM RESULTS SUMMARY

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, K.; Daugherty, W.; Hackney, B.; Hoffman, E.; Skidmore, E.

    2011-05-27

    Results from the 9975 shipping package Storage and Surveillance Program at the Savannah River Site (SRS) are summarized for justification to extend the life of the 9975 packages currently stored in the K-Area Complex (KAC). This justification is established with the stipulation that surveillance activities will continue throughout the extended time to ensure the continued integrity of the 9975 materials of construction and to further understand the currently identified degradation mechanisms. The 10 year storage life justification was developed prior to storage. A subsequent report was later used to validate the qualification of the 9975 shipping packages for 10 years in storage. However the qualification for the storage period was provided by the monitoring requirements of the 9975 Storage and Surveillance Program. This report summarizes efforts to determine a new safe storage limit for the 9975 shipping package based on the surveillance data collected since 2005 when the 9975 Storage and Surveillance Program began. The Program has demonstrated that the 9975 package has a robust design that can perform under a variety of conditions. The primary emphasis of the on-going 9975 Storage and Surveillance Program is an aging study of the 9975 Viton{reg_sign} containment vessel O-rings and the Celotex{reg_sign} fiberboard thermal insulation at bounding conditions of radiation, elevated temperatures and/or elevated humidity.

  15. Revisiting typhoid fever surveillance in low and middle income countries: lessons from systematic literature review of population-based longitudinal studies.

    Science.gov (United States)

    Mogasale, Vittal; Mogasale, Vijayalaxmi V; Ramani, Enusa; Lee, Jung Seok; Park, Ju Yeon; Lee, Kang Sung; Wierzba, Thomas F

    2016-01-29

    The control of typhoid fever being an important public health concern in low and middle income countries, improving typhoid surveillance will help in planning and implementing typhoid control activities such as deployment of new generation Vi conjugate typhoid vaccines. We conducted a systematic literature review of longitudinal population-based blood culture-confirmed typhoid fever studies from low and middle income countries published from 1(st) January 1990 to 31(st) December 2013. We quantitatively summarized typhoid fever incidence rates and qualitatively reviewed study methodology that could have influenced rate estimates. We used meta-analysis approach based on random effects model in summarizing the hospitalization rates. Twenty-two papers presented longitudinal population-based and blood culture-confirmed typhoid fever incidence estimates from 20 distinct sites in low and middle income countries. The reported incidence and hospitalizations rates were heterogeneous as well as the study methodology across the sites. We elucidated how the incidence rates were underestimated in published studies. We summarized six categories of under-estimation biases observed in these studies and presented potential solutions. Published longitudinal typhoid fever studies in low and middle income countries are geographically clustered and the methodology employed has a potential for underestimation. Future studies should account for these limitations.

  16. Fast and low-cost decentralized surveillance of transmission of tuberculosis based on strain-specific PCRs tailored from whole genome sequencing data: a pilot study.

    Science.gov (United States)

    Pérez-Lago, L; Martínez Lirola, M; Herranz, M; Comas, I; Bouza, E; García-de-Viedma, D

    2015-03-01

    Molecular epidemiology has transformed our knowledge of how tuberculosis (TB) is transmitted. Whole genome sequencing (WGS) has reached unprecedented levels of accuracy. However, it has increased technical requirements and costs, and analysis of data delays results. Our objective was to find a way to reconcile speed and ease of implementation with the high resolution of WGS. The targeted regional allele-specific oligonucleotide PCR (TRAP) assay presented here is based on allele-specific PCR targeting strain-specific single nucleotide polymorphisms, identified from WGS, and makes it possible to track actively transmitted Mycobacterium tuberculosis strains. A TRAP assay was optimized to track the most actively transmitted strains in a population in Almería, Southeast Spain, with high rates of TB. TRAP was transferred to the local laboratory where transmission was occurring. It performed well from cultured isolates and directly from sputa, enabling new secondary cases of infection from the actively transmitted strains to be detected. TRAP constitutes a fast, simple and low-cost tool that could modify surveillance of TB transmission. This pilot study could help to define a new model to survey TB transmission based on a decentralized multinodal network of local laboratories applying fast and low-cost TRAPs, which are developed by central reference centres, tailored to the specific demands of transmission at each local node.

  17. Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study.

    Directory of Open Access Journals (Sweden)

    Siobhan Langford

    2015-12-01

    Full Text Available Plasmodium malariae is a slow-growing parasite with a wide geographic distribution. Although generally regarded as a benign cause of malaria, it has been associated with nephrotic syndrome, particularly in young children, and can persist in the host for years. Morbidity associated with P. malariae infection has received relatively little attention, and the risk of P. malariae-associated nephrotic syndrome is unknown.We used data from a very large hospital-based surveillance system incorporating information on clinical diagnoses, blood cell parameters and treatment to describe the demographic distribution, morbidity and mortality associated with P. malariae infection in southern Papua, Indonesia. Between April 2004 and December 2013 there were 1,054,674 patient presentations to Mitra Masyarakat Hospital of which 196,380 (18.6% were associated with malaria and 5,097 were with P. malariae infection (constituting 2.6% of all malaria cases. The proportion of malaria cases attributable to P. malariae increased with age from 0.9% for patients under one year old to 3.1% for patients older than 15 years. Overall, 8.5% of patients with P. malariae infection required admission to hospital and the median length of stay for these patients was 2.5 days (Interquartile Range: 2.0-4.0 days. Patients with P. malariae infection had a lower mean hemoglobin concentration (9.0 g/dL than patients with P. falciparum (9.5 g/dL, P. vivax (9.6g/dL and mixed species infections (9.3g/dL. There were four cases of nephrotic syndrome recorded in patients with P. malariae infection, three of which were in children younger than 5 years old, giving a risk in this age group of 0.47% (95% Confidence Interval; 0.10% to 1.4%. Overall, 2.4% (n = 16 of patients hospitalized with P. malariae infection subsequently died in hospital, similar to the proportions for the other endemic Plasmodium species (range: 0% for P. ovale to 1.6% for P. falciparum.Plasmodium malariae infection is

  18. A multi-sensor scenario for coastal surveillance

    NARCIS (Netherlands)

    Broek, A.C. van den; Broek, S.P. van den; Heuvel, J.C. van den; Schwering, P.B.W.; Heijningen, A.W.P. van

    2007-01-01

    Maritime borders and coastal zones are susceptible to threats such as drug trafficking, piracy, undermining economical activities. At TNO Defence, Security and Safety various studies aim at improving situational awareness in a coastal zone. In this study we focus on multi-sensor surveillance of the

  19. Quali-quantitative analysis of best selling drugs from pharmacy, street market and traditional herbal medicine: a pilot study of market surveillance in Senegal.

    Science.gov (United States)

    Pichini, Simona; Rotolo, Maria Concetta; Bellotti, Pasquale; Minutillo, Adele; Mastrobattista, Luisa; Pacifici, Roberta

    2015-02-01

    A pilot study of market surveillance in Senegal has been performed analyzing best selling drugs from an official pharmacy and a street market in two principal cities of Senegal and some traditional preparations from herbal medicine from the same market. A simple and rapid gas chromatography method with mass spectrometry detection has been applied after a liquid-liquid extraction of pharmaceutical products and traditional preparations at acidic, neutral and basic pH with chloroform-isopropanol (9:1, v/v). The assay was validated in the range from 10mg to 250 mg/g powder preparations with good determination coefficients (r(2)≥ 0.99) for the calibration curves. At three concentrations spanning the linear dynamic ranges of the calibration curves, mean recoveries of substances under investigation were always higher than 90% and intra-assay and inter-assay precision and accuracy were always better than 15%. The four best selling drugs purchased from a Dakar local pharmacy exactly contained the amount of active principles reported in the respective labels while the best selling drugs freely purchased from Kaolack market contained an amount of active ingredients lower than that declared on the label. No pharmacological active compound, but salicylic acid was found in one of the traditional herbal preparations. This pilot study showed that whereas official drugs sold in pharmacies at prices accessible for a very few portion of the population contained the amount of active principles as reported in the labels, those from street market bought by the majority of population contained an amount of active ingredients lower than that declared on the label and finally traditional herbal preparations seldom contain pharmacological active principles.

  20. A preliminary study for the development of indices and the current state of surgical site infections (SSIs) in Korea: the Korean Surgical Site Infection Surveillance (KOSSIS) program.

    Science.gov (United States)

    Park, Sun Jin; Lee, Kil Yeon; Park, Ji Won; Lee, Jae Gil; Choi, Hee Jung; Chun, Hee Kyung; Kang, Jung Gu

    2015-03-01

    We aimed to develop an effective system for surgical site infection (SSI) surveillance and examine the current domestic state of SSIs for common abdominal surgeries in Korea. The Korean Surgical Site Infection Surveillance (KOSSIS) program was developed as an SSI surveillance system. A prospective multicenter study in nine university-affiliated or general hospitals was conducted for patients who underwent gastrectomy, cholecystectomy, appendectomy, colectomy, or proctectomy between August 16 and September 30 in 2012. Patients were monitored for up to 30 days by combining direct observation and a postdischarge surgeon survey. Data on SSIs were prospectively collected with KOSSIS secretarial support according to a common protocol. Operation-specific SSI rates were stratified according to risk factors and compared with data from the Korean Nosocomial Infections Surveillance System (KONIS) and National Healthcare Safety Network. A focus group interview was conducted with participating hospitals for feedback. A total of 1,088 operations were monitored: 207 gastrectomies, 318 cholecystectomies, 270 appendectomies, 197 colectomies, and 96 proctectomies. Operation-specific SSI rates determined by the KOSSIS program were substantially higher than those found in KONIS (7.73% [95% confidence interval, 4.5%-12.3%] vs. 3.4% for gastrectomies, 10.15% [95% confidence interval, 6.1%-15.2%] vs. 4.0% for colectomy, and 13.5% [95% confidence interval, 7.4%-22.0%] vs. 4.2% for proctectomy). Despite a short surveillance period and heterogenous group of hospitals, our results suggest that KOSSIS could be a useful program to enhance SSI surveillance in Korea.

  1. Implementation of a Multimodal Mobile System for Point-of-Sale Surveillance: Lessons Learned From Case Studies in Washington, DC, and New York City.

    Science.gov (United States)

    Cantrell, Jennifer; Ganz, Ollie; Ilakkuvan, Vinu; Tacelosky, Michael; Kreslake, Jennifer; Moon-Howard, Joyce; Aidala, Angela; Vallone, Donna; Anesetti-Rothermel, Andrew; Kirchner, Thomas R

    2015-01-01

    In tobacco control and other fields, point-of-sale surveillance of the retail environment is critical for understanding industry marketing of products and informing public health practice. Innovations in mobile technology can improve existing, paper-based surveillance methods, yet few studies describe in detail how to operationalize the use of technology in public health surveillance. The aims of this paper are to share implementation strategies and lessons learned from 2 tobacco, point-of-sale surveillance projects to inform and prepare public health researchers and practitioners to implement new mobile technologies in retail point-of-sale surveillance systems. From 2011 to 2013, 2 point-of-sale surveillance pilot projects were conducted in Washington, DC, and New York, New York, to capture information about the tobacco retail environment and test the feasibility of a multimodal mobile data collection system, which included capabilities for audio or video recording data, electronic photographs, electronic location data, and a centralized back-end server and dashboard. We established a preimplementation field testing process for both projects, which involved a series of rapid and iterative tests to inform decisions and establish protocols around key components of the project. Important components of field testing included choosing a mobile phone that met project criteria, establishing an efficient workflow and accessible user interfaces for each component of the system, training and providing technical support to fieldworkers, and developing processes to integrate data from multiple sources into back-end systems that can be utilized in real-time. A well-planned implementation process is critical for successful use and performance of multimodal mobile surveillance systems. Guidelines for implementation include (1) the need to establish and allow time for an iterative testing framework for resolving technical and logistical challenges; (2) developing a streamlined

  2. Verification of Neonatal Tetanus Surveillance Systems in Katsina State, Nigeria.

    Science.gov (United States)

    Nass, Shafique Sani; Danawi, Hadi; Cain, Loretta; Sharma, Monoj

    2017-01-01

    The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. The goal of the study was to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina State, Nigeria. The study is a retrospective record review using extracted data from NNT records and analyzed using descriptive statistics. The prevalence of NNT and mortality rate were 336 cases and 3.4 deaths per 100 000 population, respectively, whereas the prevalence of NNT and mortality rate reported through the Integrated Disease Surveillance and Response (IDSR) system were 111 cases and 1.0 death per 100 000 population, respectively. The study shows underreporting of NNT in the existing IDSR system. Active surveillance is a good strategy for verifying underreporting of NNT in the surveillance system. The IDSR system should be strengthened with the capacity to detect events associated with a disease toward global elimination.

  3. Sirenomelia : An Epidemiologic Study in a Large Dataset From the International Clearinghouse of Birth Defects Surveillance and Research, and Literature Review

    NARCIS (Netherlands)

    Orioli, Ieda M.; Amar, Emmanuelle; Arteaga-Vazquez, Jazmin; Bakker, Marian K.; Bianca, Sebastiano; Botto, Lorenzo D.; Clementi, Maurizio; Correa, Adolfo; Csaky-Szunyogh, Melinda; Leoncini, Emanuele; Li, Zhu; Lopez-Camelo, Jorge S.; Lowry, R. Brian; Marengo, Lisa; Martinez-Frias, Maria-Luisa; Mastroiacovo, Pierpaolo; Morgan, Margery; Pierini, Anna; Ritvanen, Annukka; Scarano, Gioacchino; Szabova, Elena; Castilla, Eduardo E.

    2011-01-01

    Sirenomelia is a very rare limb anomaly in which the normally paired lower limbs are replaced by a single midline limb. This study describes the prevalence, associated malformations, and maternal characteristics among cases with sirenomelia. Data originated from 19 birth defect surveillance system m

  4. Priorities for antibiotic resistance surveillance in Europe

    DEFF Research Database (Denmark)

    Fluit, A. C.; van der Bruggen, J. T.; Aarestrup, Frank Møller

    2006-01-01

    Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. To achieve this, surveillance studies must have standardised methodologies...... to the various reservoirs of antibiotic-resistant bacteria, such as hospitalised patients, nursing homes, the community, animals and food. Two studies that could serve as examples of tailored programmes are the European Antimicrobial Resistance Surveillance System (EARSS), which collects resistance data during...... of antibiotic resistance....

  5. PREDICT-CP: study protocol of implementation of comprehensive surveillance to predict outcomes for school-aged children with cerebral palsy.

    Science.gov (United States)

    Boyd, Roslyn N; Davies, Peter Sw; Ziviani, Jenny; Trost, Stewart; Barber, Lee; Ware, Robert; Rose, Stephen; Whittingham, Koa; Sakzewski, Leanne; Bell, Kristie; Carty, Christopher; Obst, Steven; Benfer, Katherine; Reedman, Sarah; Edwards, Priya; Kentish, Megan; Copeland, Lisa; Weir, Kelly; Davenport, Camilla; Brooks, Denise; Coulthard, Alan; Pelekanos, Rebecca; Guzzetta, Andrea; Fiori, Simona; Wynter, Meredith; Finn, Christine; Burgess, Andrea; Morris, Kym; Walsh, John; Lloyd, Owen; Whitty, Jennifer A; Scuffham, Paul A

    2017-07-12

    Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8-12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity). This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006-2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models. The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5-5 then 8-12 years of direct clinical assessment to enable prediction of outcomes

  6. GSFC Supplier Surveillance

    Science.gov (United States)

    Kelly, Michael P.

    2011-01-01

    Topics covered include: Develop Program/Project Quality Assurance Surveillance Plans The work activities performed by the developer and/or his suppliers are subject to evaluation and audit by government-designated representatives. CSO supports project by selecting on-site supplier representative s by one of several methods: (1) a Defense Contract Management Agency (DCMA) person via a Letter Of Delegation (LOD), (2) an independent assurance contractor (IAC) via a contract Audits, Assessments, and Assurance (A3) Contract Code 300 Mission Assurance Support Contract (MASC)

  7. Ocean surveillance satellites

    Science.gov (United States)

    Laurent, D.

    Soviet and U.S. programs involving satellites for surveillance of ships and submarines are discussed, considering differences in approaches. The Soviet program began with the Cosmos 198 in 1967 and the latest, the Cosmos 1400 series, 15 m long and weighing 5 tons, carry radar for monitoring ships and a nuclear reactor for a power supply. Other Soviet spacecraft carrying passive microwave sensors and ion drives powered by solar panels have recently been detonated in orbit for unknown reasons. It has also been observed that the Soviet satellites are controlled in pairs, with sequential orbital changes for one following the other, and both satellites then overflying the same points. In contrast, U.S. surveillance satellites have been placed in higher orbits, thus placing greater demands on the capabilities of the on-board radar and camera systems. Project White Cloud and the Clipper Bow program are described, noting the continued operation of the White Cloud spacecraft, which are equipped to intercept radio signals from surface ships. Currently, the integrated tactical surveillance system program has completed its study and a decision is expected soon.

  8. How the surveillance system may bias the results of analytical epidemiological studies on BSE: prevalence among dairy versus beef suckler cattle breeds in France.

    Science.gov (United States)

    Ducrot, Christian; Roy, Pascal; Morignat, Eric; Baron, Thierry; Calavas, Didier

    2003-01-01

    Until recently, epidemiological studies on Bovine Spongiform Encephalopathy (BSE) were based on Mandatory Reporting Systems (MRS) of clinically suspect bovines only, but rapid diagnostic tests were validated in 1999 and are used for targeted surveillance in Switzerland, France and other countries, as a complementary and secondary tool. Data on 30491 cattle issued from a French pilot program targeted at cattle having died on the farm, subjected to euthanasia or sent for emergency slaughter, did not show any significant difference in BSE risk between dairy and beef suckler breeds. The data also revealed that part of the clinical cases of BSE escaped the MRS, which permitted to detect more dairy than beef suckler affected cattle compared to the targeted surveillance in the same period (from August to December 2000) and region (Bretagne, Pays de la Loire and Basse Normandie regions). Analyzing together the data of the targeted surveillance and mandatory reporting system programs with a non-conditional logistic regression, we found that the odds of a dead cow being a BSE case among all dead cattle was 3.2 times higher for dairy breeds compared to beef suckler breeds. This confirmed British findings but points out to the fact that considering either MRS or targeted surveillance data alone may possibly create biases in epidemiological studies on BSE.

  9. Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland

    Directory of Open Access Journals (Sweden)

    Rutkowski Stefan

    2008-05-01

    Full Text Available Abstract Background Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI. To date, no prospective multicenter studies have been published on this topic. Methods Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO with specific case definitions and standardized surveillance methods. Results 7 pediatric oncology centers (university facilities participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36% were HAIs in 181 patients, for an incidence density (ID (number of events per 1,000 inpatient days of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P Conclusion Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

  10. Rare disease surveillance: An international perspective

    NARCIS (Netherlands)

    Elliott, E.J.; Nicoll, A.; Lynn, R.; Marchessault, V.; Hirasing, R.A.; Ridley, G.

    2001-01-01

    Background: The International Network of Paediatric Surveillance Units (INoPSU) was established in 1998 and met formally for the first time in Ottawa, Ontario in June 2000. Objectives: To document the methodology and activities of existing national paediatric surveillance units; the formation of

  11. Rare disease surveillance: An international perspective

    NARCIS (Netherlands)

    Elliott, E.J.; Nicoll, A.; Lynn, R.; Marchessault, V.; Hirasing, R.A.; Ridley, G.

    2001-01-01

    Background: The International Network of Paediatric Surveillance Units (INoPSU) was established in 1998 and met formally for the first time in Ottawa, Ontario in June 2000. Objectives: To document the methodology and activities of existing national paediatric surveillance units; the formation of INo

  12. THE LONG-TERM ONCOLOGICAL RESULTS OF RADICAL PROSTATECTOMY IN PATIENTS WITH A MAXIMUM FOLLOW-UP OF UP TO 15 YEARS, WHO MEET THE ERSPC (PRIAS CRITERIA FOR ACTIVE SURVEILLANCE

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2014-07-01

    Full Text Available No consensus on how to select patients is one of the factors restricting the wide acceptance of active surveillance (AS. The frequency of unfavorable histological findings and long-term overall and relapse-free survival rates were studied in 152 patients who met the ERSPC [European Randomized Study of Screening for Prostate Cancer] (PRIAS criteria for AS and had undergone retropubic prostatectomy (RPE in the period 1997 to 2010. Negative histological characteristics were found in more than 10 % of the patients, with the median postoperative followup of 67 months biochemical recurrence developed in 3 (2 % patients. Five- and ten-year relapse-free survival rates were 97 and 88.2 %, respectively. Histological and long-term oncological results after RPE are suboptimal in the patients meeting the PRIAS criteria. There is a need for additional studies of the safety and efficiency of AS under conditions of Russian public health.

  13. Multi locus variable-number tandem repeat (MLVA typing tools improved the surveillance of Salmonella enteritidis: a 6 years retrospective study.

    Directory of Open Access Journals (Sweden)

    Sophie Bertrand

    Full Text Available Surveillance of Salmonella enterica subsp. enterica serovar Enteritidis is generally considered to benefit from molecular techniques like multiple-locus variable-number of tandem repeats analysis (MLVA, which allow early detection and confinement of outbreaks. Here, a surveillance study, including phage typing, antimicrobial susceptibility testing and MLVA on 1,535 S. Enteritidis isolates collected between 2007 and 2012, was used to evaluate the added value of MLVA for public health surveillance in Belgium. Phage types PT4, PT8, PT21, PT1, PT6, PT14b, PT28 and PT13 dominate the Belgian S. Enteritidis population. The isolates of S. Enteritidis were most frequently susceptible to all antibiotics tested. 172 different MLVA profiles were detected, of which 9 frequent profiles included 67.2% of the S. Enteritidis population. During a serial passage experiment on selected isolates to investigate the in vitro stability of the 5 MLVA loci, no variations over time were observed indicating that the MLVA profiles were stable. The MLVA profile of isolates originating from different outbreaks in the Democratic Republic of the Congo (DRC between 2010 and 2011 were distinct from any of the MLVA profiles found in Belgian isolates throughout the six year observational period and demonstrates that MLVA improves public health surveillance of S. Enteritidis. However, MLVA should be complemented with other subtyping methods when investigating outbreaks is caused by the most common MLVA profile.

  14. Multi locus variable-number tandem repeat (MLVA) typing tools improved the surveillance of Salmonella enteritidis: a 6 years retrospective study.

    Science.gov (United States)

    Bertrand, Sophie; De Lamine de Bex, Guillaume; Wildemauwe, Christa; Lunguya, Octavie; Phoba, Marie France; Ley, Benedikt; Jacobs, Jan; Vanhoof, Raymond; Mattheus, Wesley

    2015-01-01

    Surveillance of Salmonella enterica subsp. enterica serovar Enteritidis is generally considered to benefit from molecular techniques like multiple-locus variable-number of tandem repeats analysis (MLVA), which allow early detection and confinement of outbreaks. Here, a surveillance study, including phage typing, antimicrobial susceptibility testing and MLVA on 1,535 S. Enteritidis isolates collected between 2007 and 2012, was used to evaluate the added value of MLVA for public health surveillance in Belgium. Phage types PT4, PT8, PT21, PT1, PT6, PT14b, PT28 and PT13 dominate the Belgian S. Enteritidis population. The isolates of S. Enteritidis were most frequently susceptible to all antibiotics tested. 172 different MLVA profiles were detected, of which 9 frequent profiles included 67.2% of the S. Enteritidis population. During a serial passage experiment on selected isolates to investigate the in vitro stability of the 5 MLVA loci, no variations over time were observed indicating that the MLVA profiles were stable. The MLVA profile of isolates originating from different outbreaks in the Democratic Republic of the Congo (DRC) between 2010 and 2011 were distinct from any of the MLVA profiles found in Belgian isolates throughout the six year observational period and demonstrates that MLVA improves public health surveillance of S. Enteritidis. However, MLVA should be complemented with other subtyping methods when investigating outbreaks is caused by the most common MLVA profile.

  15. Using Administrative Data to Ascertain True Cases of Muscular Dystrophy: Rare Disease Surveillance.

    Science.gov (United States)

    Smith, Michael G; Royer, Julie; Mann, Joshua R; McDermott, Suzanne

    2017-01-12

    Administrative records from insurance and hospital discharge data sources are important public health tools to conduct passive surveillance of disease in populations. Identifying rare but catastrophic conditions is a challenge since approaches for maximizing valid case detection are not firmly established. The purpose of our study was to explore a number of algorithms in which International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and other administrative variables could be used to identify cases of muscular dystrophy (MD). We used active surveillance to identify possible cases of MD in medical practices in neurology, genetics, and orthopedics in 5 urban South Carolina counties and to identify the cases that had diagnostic support (ie, true cases). We then developed an algorithm to identify cases based on a combination of ICD-9-CM codes and administrative variables from a public (Medicaid) and private insurer claims-based system and a statewide hospital discharge dataset (passive surveillance). Cases of all types of MD and those with Duchenne or Becker MD (DBMD) that were common to both surveillance systems were examined to identify the most specific administrative variables for ascertainment of true cases. Passive statewide surveillance identified 3235 possible cases with MD in the state, and active surveillance identified 2057 possible cases in 5 actively surveilled counties that included 2 large metropolitan areas where many people seek medical care. There were 537 common cases found in both the active and passive systems, and 260 (48.4%) were confirmed by active surveillance to be true cases. Of the 260 confirmed cases, 70 (26.9%) were recorded as DBMD. Accuracy of finding a true case in a passive surveillance system was improved substantially when specific diagnosis codes, number of times a code was used, age of the patient, and specialty provider variables were used.

  16. Economic Assessment of Zoonoses Surveillance in a 'One Health' Context: A Conceptual Framework.

    Science.gov (United States)

    Babo Martins, S; Rushton, J; Stärk, K D C

    2016-08-01

    Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross-sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross-sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non-monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision-making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.

  17. The importance of active surveillance in the intensive care unit of Galliera Hospital in Genoa. Analysis of bacterial strains isolated in 2006-2007

    Directory of Open Access Journals (Sweden)

    Maurizio Dallera

    2009-09-01

    Full Text Available Introduction. The risk of infection is higher in intensive care units than in other hospital departments for a number of reasons: the often serious condition of the patients, the invasive diagnostic and therapeutic procedures performed, the indiscriminate use of broad-spectrum antibiotics and the administration of immunosuppressive drugs. Aims. The present study aimed, on the one hand, to assess the importance of surveillance in the intensive care unit as a means of evaluating healthcare and management procedures and detecting epidemics and “sentinel” microorganisms, and, on the other, to gather up-to-date information on resistance to antibiotics in order to guide proper empirical therapy. Materials and methods.We conducted a retrospective analysis of the microbiological examinations carried out in the period 2006-2007 in the intensive care unit of Galliera Hospital in Genoa. Microbiological surveillance reports and those with antibiograms were picked out.The microorganisms most frequently isolated in the total of samples were listed and then subdivided according to the sample type (respiratory or blood from which they were isolated. The antibiotic resistance of these microorganisms was subsequently evaluated. Results. Data analysis revealed that S. aureus was the microorganism most frequently isolated in the total of samples (15.6%, followed by S. epidermidis (11.6% and E. coli (11.1%.With regard to the respiratory samples, S. aureus again proved to be the most frequently isolated strain (18.7%, while S. epidermidis was isolated from a higher percentage of blood cultures (36.7%. Conclusions. The results obtained confirm the utility of infection surveillance procedures in departments at risk, such as intensive care units.

  18. Value of Surveillance Studies for Patients With Stage I to II Diffuse Large B-Cell Lymphoma in the Rituximab Era

    Energy Technology Data Exchange (ETDEWEB)

    Hiniker, Susan M.; Pollom, Erqi L. [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Khodadoust, Michael S. [Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford, California (United States); Kozak, Margaret M. [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Xu, Guofan; Quon, Andrew [Division of Nuclear Medicine, Department of Radiology, Stanford Cancer Institute, Stanford, California (United States); Advani, Ranjana H. [Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford, California (United States); Hoppe, Richard T., E-mail: rhoppe@stanford.edu [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States)

    2015-05-01

    Background: The role of surveillance studies in limited-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era has not been well defined. We sought to evaluate the use of imaging (computed tomography [CT] and positron emission tomography [PET]-CT) scans and lactate dehydrogenase (LDH) in surveillance of patients with stage I to II DLBCL. Methods: A retrospective analysis was performed of patients who received definitive treatment between 2000 and 2013. Results: One hundred sixty-two consecutive patients with stage I to II DLBCL were treated with chemotherapy +/− rituximab, radiation, or combined modality therapy. The 5-year rates of overall survival (OS) and freedom from progression (FFP) were 81.2% and 80.8%, respectively. Of the 162 patients, 124 (77%) were followed up with at least 1 surveillance PET scan beyond end-of-treatment scans; of those, 94 of 124 (76%) achieved a complete metabolic response on PET scan after completion of chemotherapy, and this was associated with superior FFP (P=.01, HR=0.3) and OS (P=.01, HR 0.3). Eighteen patients experienced relapse after initial response to therapy. Nine relapses were initially suspected by surveillance imaging studies (8 PET, 1 CT), and 9 were suspected clinically (5 by patient-reported symptoms and 4 by symptoms and physical examination). No relapses were detected by surveillance LDH. The median duration from initiation of treatment to relapse was 14.3 months among patients with relapses suspected by imaging, and 59.8 months among patients with relapses suspected clinically (P=.077). There was no significant difference in OS from date of first therapy or OS after relapse between patients whose relapse was suspected by imaging versus clinically. Thirteen of 18 patients underwent successful salvage therapy after relapse. Conclusions: A complete response on PET scan immediately after initial chemotherapy is associated with superior FFP and OS in stage I to II DLBCL. The use of PET scans as

  19. Evaluation of multivariate surveillance

    OpenAIRE

    Frisén,Marianne; Andersson, Eva; Schiöler, Linus

    2009-01-01

    Multivariate surveillance is of interest in many areas such as industrial production, bioterrorism detection, spatial surveillance, and financial transaction strategies. Some of the suggested approaches to multivariate surveillance have been multivariate counterparts to the univariate Shewhart, EWMA, and CUSUM methods. Our emphasis is on the special challenges of evaluating multivariate surveillance methods. Some new measures are suggested and the properties of several measures are demonstrat...

  20. [Infectious disease surveillance in Miyagi after the Great East Japan Earthquake].

    Science.gov (United States)

    Kim, Mihyun; Kamigaki, Taro; Mimura, Satoshi; Oshitani, Hitoshi

    2013-10-01

    The Great East Japan Earthquake, which occurred on March 11, 2011, damaged many health facilities and compelled many inhabitants to live in evacuation centers. For the purpose of monitoring infectious disease outbreaks, infectious disease surveillance targeted at evacuation centers was established in Miyagi Prefecture. In this study, we summarized the monitoring activities of infectious diseases through this surveillance after the earthquake. Infectious disease surveillance was implemented from March 18 to November 6, 2011. The surveillance consisted of two phases (hereafter, surveillance 1 and 2) reflecting the difference in frequencies of reporting as well as the number of targeted diseases. Surveillance 1 operated between March 18 and May 13, 2011, and Surveillance 2 operated between May 10 and November 6, 2011. We reviewed the number of cases reported, the number of evacuation centers, and demographic information of evacuees with the surveillance. In Surveillance 1, there were 8,737 reported cases; 84% of them were acute respiratory symptoms, and 16% were acute digestive symptoms. Only 4.4% of evacuation centers were covered by the surveillance one week after the earthquake. In Surveillance 2, 1,339 cases were reported; 82% of them were acute respiratory symptoms, and 13% were acute digestive symptoms. Surveillance 2 revealed that the proportion of children aged 5 years and younger was lower than that of other age groups in all targeted diseases. No particular outbreaks were detected through those surveillances. Infectious disease surveillance operated from one week after the earthquake to the closure of all evacuation centers in Miyagi Prefecture. No outbreaks were detected in that period. However, low coverage of evacuation centers just after the earthquake as well as skewed frequencies of reported syndromes draw attention to the improvement of the early warning system. It is important to coordinate with the medical aid team that visits the evacuation centers

  1. [HIV and syphilis coinfection in pregnancy and vertical HIV transmission: a study based on epidemiological surveillance data].

    Science.gov (United States)

    Acosta, Lisiane M W; Gonçalves, Tonantzin Ribeiro; Barcellos, Nêmora Tregnago

    2016-12-01

    To estimate the rate of HIV and syphilis coinfection among pregnant women living in Porto Alegre, Brazil, as well as the association of coinfection with vertical HIV transmission and socioeconomic variables. This analytical retrospective cross-sectional study employed data from the regular epidemiological surveillance system for the period from 2010 to 2013. Data were obtained regarding pregnant women with HIV and exposed children, syphilis in pregnancy, and congenital syphilis. The study population included 1 500 HIV-positive women with deliveries from 2010 to 2013. Of these, 155 (10.3%) were also infected with syphilis, corresponding to an HIV and syphilis coinfection rate of 10.2% (± 1.5%). The coinfected group had lower education levels, higher prevalence of black women, and greater HIV exposure related to drug use by the woman or a partner. Coinfected women had more delayed HIV diagnosis (for example, during childbirth) and greater prevalence of lacking prenatal care (44%). Crude analysis showed an association between vertical HIV transmission and HIV and syphilis co-infection (PR = 2.1; 95%CI: 1.21-3.74; P = 0.01) that persisted in the adjusted analysis. A profile of increased vulnerability was identified among pregnant women with HIV and syphilis coinfection. A positive impact of the treatment to reduce congenital syphilis and eliminate vertical transmission of HIV depends on enhanced access to qualified health care.

  2. A Seventeen-Year Epidemiological Surveillance Study of Borrelia burgdorferi Infections in Two Provinces of Northern Spain

    Directory of Open Access Journals (Sweden)

    Lourdes Lledó

    2014-01-01

    Full Text Available This paper reports a 17-year seroepidemiological surveillance study of Borrelia burgdorferi infection, performed with the aim of improving our knowledge of the epidemiology of this pathogen. Serum samples (1,179 from patients (623, stratified with respect to age, sex, season, area of residence and occupation bitten by ticks in two regions of northern Spain were IFA-tested for B. burgdorferi antibodies. Positive results were confirmed by western blotting. Antibodies specific for B. burgdorferi were found in 13.3% of the patients; 7.8% were IgM positive, 9.6% were IgG positive, and 4.33% were both IgM and IgG positive. Five species of ticks were identified in the seropositive patients: Dermacentor marginatus (41.17% of such patients Dermacentor reticulatus (11.76%, Rhiphicephalus sanguineus (17.64%, Rhiphicephalus turanicus (5.88% and Ixodes ricinus (23.52%. B. burgdorferi DNA was sought by PCR in ticks when available. One tick, a D. reticulatus male, was found carrying the pathogen. The seroprevalence found was similar to the previously demonstrated in similar studies in Spain and other European countries.

  3. Safety and efficacy of adapalene gel 0.1% in acne vulgaris: Results of a post-marketing surveillance study

    Directory of Open Access Journals (Sweden)

    Percy S

    2003-07-01

    Full Text Available Introduction: Adapalene is a novel retinoid indicated for the topical treatment of acne vulgaris. The drug was introduced in India in 2001. Aims: A post-marketing surveillance study was conducted to assess the safety and efficacy of adapalene gel 0.1% when used as monotherapy or in combination with other anti-acne agents in Indian patients of acne vulgaris. Material and Methods: A 12-week, multicentre, open-label, non-comparative study involving 571 patients from 21 centers across India was conducted between January and September of 2002. Concomitant prescription of other anti-acne drugs was permitted, if needed. Results: Of the 571 patients, 441 completed the treatment as per protocol. At the end of therapy, 96.3% of patients showed an improvement in their acne from baseline, with greater than 75% improvement seen in two-thirds of patients. Adverse events were reported in 24% of the patients, none of which were serious. The tolerability of therapy was rated as excellent/good in 81% of patients by physicians and in 78% by the patients. Conclusion: Adapalene gel 0.1% is a safe and effective topical agent in the treatment of mild to moderate acne vulgaris in Indian patients. It may be safely combined with other topical and oral anti-acne agents.

  4. GEIS Surveillance Network Program

    Science.gov (United States)

    2013-10-01

    resistance surveillance, diarrhea etiology and antimicrobial resistance surveillance, sexually transmitted illness surveillance, and capacity building...vomiting, diarrhea , joint pains, general malaise. Of the samples analyzed, only 53.7% had an associated etiology: Malaria (47.0%, EBV (39.7...immunity to the disease. Many adults in those situations are reservoirs, facilitating continuing disease transmission to those without immunity. In Kenya

  5. SOA-surveillance Nederland

    NARCIS (Netherlands)

    Rijlaarsdam J; Bosman A; Laar MJW van de; CIE

    2000-01-01

    In May 1999 a working group was started to evaluate the current surveillance systems for sexually transmitted diseases (STD) and to make suggestions for a renewed effective and efficient STD surveillance system in the Netherlands. The surveillance system has to provide insight into the prevalence an

  6. SOA-surveillance Nederland

    NARCIS (Netherlands)

    Rijlaarsdam J; Bosman A; Laar MJW van de; CIE

    2000-01-01

    In May 1999 a working group was started to evaluate the current surveillance systems for sexually transmitted diseases (STD) and to make suggestions for a renewed effective and efficient STD surveillance system in the Netherlands. The surveillance system has to provide insight into the prevalence

  7. Tuberculosis in newly arrived asylum seekers: A prospective 12 month surveillance study at Friedland, Germany.

    Science.gov (United States)

    Meier, Volker; Artelt, Tanja; Cierpiol, Stefanie; Gossner, Johannes; Scheithauer, Simone

    2016-11-01

    In the European Union tuberculosis prevalence-rates are among the lowest in the world. The prevalence of active tuberculosis in migrant populations has to be analyzed to get valid data on the risk of tuberculosis and for the decision of screening activities. Therefore, we prospectively quantified the risk of active tuberculosis among asylum seekers at time of arrival. Investigation was performed as regular part of the admission screenings for people arriving at Friedland, Germany, a primary major receiving center during one year. In 11.773 newly arrived asylum seekers 16 X-ray investigations gave the suspicion of active tuberculosis, thereof 11 cases could be verified by culture, thereof 9 cases were classified as microscopically positive. These data translate into rates of 136 per 100.000 suspected cases, 93 per 100.000 verified cases, and finally 76 per 100.000 infectious cases, respectively. Prevalence was higher in asylum seekers coming from Eritrea and Russia compared to the main origins of current migration Syria, Afghanistan, Iraq, Iran, and Lebanon. One case of MDR-tuberculosis could be detected in a migrant from Russia. Prevalence rates of tuberculosis in newly arrived asylum seekers are higher than in native European populations. Rates seem to reflect the prevalence in the home countries. X-ray investigation during first examination may help identifying people needing further tests for detecting infectious tuberculosis and therefore may prevent transmission. However due to the low prevalence rates screening procedures have to be reviewed. Copyright © 2016 Elsevier GmbH. All rights reserved.

  8. Platforms for Persistent Communications, Surveillance and Reconnaissance

    Science.gov (United States)

    2008-09-01

    Membership Study Manager Ms. Anorme Anim – ASB Communications (Comms) Team Dr. Allen Adler Dr. Pete Swan BG(Ret) Bob Wynn Ms. Madhu Beriwal Surveillance...Pete Swan BG(Ret) Bob Wynn Dr. Madhu Beriwal Surveillance & Reconnaissance (SR) Team Dr. Darrell Collier Mr. Herb Gallagher Mr. Gary Glaser Mr. Steve...ASB Communications (Comms) Team Dr. Allen Adler Dr. Pete Swan BG(Ret) Bob Wynn Ms. Madhu Beriwal Surveillance & Reconnaissance (SR) Team Dr

  9. Anomaly detection for internet surveillance

    NARCIS (Netherlands)

    Bouma, H.; Raaijmakers, S.A.; Halma, A.H.R.; Wedemeijer, H.

    2012-01-01

    Many threats in the real world can be related to activity of persons on the internet. Internet surveillance aims to predict and prevent attacks and to assist in finding suspects based on information from the web. However, the amount of data on the internet rapidly increases and it is time consuming

  10. Anomaly detection for internet surveillance

    NARCIS (Netherlands)

    Bouma, H.; Raaijmakers, S.A.; Halma, A.H.R.; Wedemeijer, H.

    2012-01-01

    Many threats in the real world can be related to activity of persons on the internet. Internet surveillance aims to predict and prevent attacks and to assist in finding suspects based on information from the web. However, the amount of data on the internet rapidly increases and it is time consuming

  11. The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance

    Directory of Open Access Journals (Sweden)

    Sue Smith

    2016-01-01

    Full Text Available We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH, out of hours (GPOOH and emergency department (ED syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013 and non-heatwave years (2012, 2014. Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI, there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65–74 years age group (and over 75 years in ED attendances. These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather.

  12. [Risk profiling in cancer surveillance in contaminated sites: an example from the ISS-AIRTUM collaborative study].

    Science.gov (United States)

    Catelan, Dolores; Buzzoni, Carlotta; Coviello, Enzo; Crocetti, Emanuele; Pasetto, Roberto; Pirastu, Roberta; Biggeri, Annibale

    2014-01-01

    Epidemiological surveillance on high risk environmental areas or areas covered by cancer registration yields long inventories of relative risks. Summaries of the results' tables must be produced to identify priorities and tailor public health actions. The aim is, therefore, to draw conclusions from each area's disease profile, or from the area signature of each disease.With this inmind, we used data on cancer incidence from 17 Cancer Registries that participated in the ISS-AIRTUM (National Institute of Health-Italian Network of Cancer Registries) study, and we produced conditional and marginal rankings of areas/diseases using a multivariate hierarchical Bayesian model. In this context, it is important to obtain an uncertainty evaluation by calculating the credibility intervals of ranks. The areas marginal ranking shows a large overlapping of credibility intervals, such that it is not possible to speak of a limited number of ISS-AIRTUM areas as being particularly affected. Every ISS-AIRTUMarea, therefore,must be considered individually and ordering themby ranking of cancer incidence wouldn't be appropriate. Instead,marginal ranking of diseases highlights the impact of asbestos exposure in all the analyzed areas.

  13. Prevalence of antimicrobial resistance among clinical isolates of Bacteroides fragilis group in Canada in 2010-2011: CANWARD surveillance study.

    Science.gov (United States)

    Karlowsky, James A; Walkty, Andrew J; Adam, Heather J; Baxter, Melanie R; Hoban, Daryl J; Zhanel, George G

    2012-03-01

    Clinical isolates of the Bacteroides fragilis group (n = 387) were collected from patients attending nine Canadian hospitals in 2010-2011 and tested for susceptibility to 10 antimicrobial agents using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. B. fragilis (59.9%), Bacteroides ovatus (16.3%), and Bacteroides thetaiotaomicron (12.7%) accounted for ~90% of isolates collected. Overall rates of percent susceptibility were as follows: 99.7%, metronidazole; 99.5%, piperacillin-tazobactam; 99.2%, imipenem; 97.7%, ertapenem; 92.0%, doripenem; 87.3%, amoxicillin-clavulanate; 80.9%, tigecycline; 65.9%, cefoxitin; 55.6%, moxifloxacin; and 52.2%, clindamycin. Percent susceptibility to cefoxitin, clindamycin, and moxifloxacin was lowest for B. thetaiotaomicron (n = 49, 24.5%), Parabacteroides distasonis/P. merdae (n = 11, 9.1%), and B. ovatus (n = 63, 31.8%), respectively. One isolate (B. thetaiotaomicron) was resistant to metronidazole, and two isolates (both B. fragilis) were resistant to both piperacillin-tazobactam and imipenem. Since the last published surveillance study describing Canadian isolates of B. fragilis group almost 20 years ago (A.-M. Bourgault et al., Antimicrob. Agents Chemother. 36:343-347, 1992), rates of resistance have increased for amoxicillin-clavulanate, from 0.8% (1992) to 6.2% (2010-2011), and for clindamycin, from 9% (1992) to 34.1% (2010-2011).

  14. Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

    Directory of Open Access Journals (Sweden)

    Nghia Ho Dang Trung

    Full Text Available BACKGROUND: Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen. METHODS: We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology. RESULTS: We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children. CONCLUSIONS: Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

  15. Methods for observational post-licensure medical product safety surveillance.

    Science.gov (United States)

    Nelson, Jennifer C; Cook, Andrea J; Yu, Onchee; Zhao, Shanshan; Jackson, Lisa A; Psaty, Bruce M

    2015-04-01

    Post-licensure medical product safety surveillance is important for detecting adverse events potentially not identified pre-licensure. Historically, post-licensure safety monitoring has been accomplished using passive reporting systems and by conducting formal Phase IV randomized trials or large epidemiological studies, also known as safety surveillance or pharmacovigilance studies. However, crucial gaps in the safety evidence base provided by these approaches have led to high profile product withdrawals and growing public concern about unknown health risks associated with licensed products. To address the limitations of existing surveillance systems and to facilitate more accurate and rapid detection of safety problems, new systems involving active surveillance of large, population-based cohorts using observational health care databases are being developed. In this article, we review common statistical methods that have been employed previously for post-licensure safety monitoring, including data mining and sequential hypothesis testing, and assess which methods may be promising for potential use within this newly proposed prospective observational cohort monitoring framework. We discuss gaps in existing approaches and identify areas where methodological development is needed to improve the success of safety surveillance efforts in this setting.

  16. Sensors for Desert Surveillance

    Directory of Open Access Journals (Sweden)

    B. S. Chauhan

    2005-10-01

    Full Text Available Various types of sensors-visible, passive night vision, infrared, synthetic aperture radar, etc can be used for desert surveillance. The surveillance capability of these sensors depends to a large extent, on various atmospheric effects, viz., absorption, scattering, aerosol, turbulence, and optical mirage. In this paper, effects of various atmospheric phenomena on the transmission of signals, merits and demerits of different means of surveillance under desert environmental conditions are discussed. Advanced surveillance techniques, ie, multisensor fusion, multi and hyperspectral imaging, having special significance for desert surveillance, have also been discussed.

  17. Surveillance of acute respiratory infections among outpatients: A pilot study in Isfahan city

    Directory of Open Access Journals (Sweden)

    Abbasali Javadi

    2015-01-01

    Full Text Available Background: Considering that there was not any regional survey in Isfahan, Iran regarding the epidemiology of acute respiratory tract infections (ARTI in different age groups of general population, the aim of this study was to determine the epidemiologic feature of ARTIs in Isfahan using multiplex polymerase chain reaction (PCR method. Materials and Methods: In this cross-sectional study, patients aged 15 years old. Rhinovirus was the most common cause of ARTI in patients aged 50 years. Influenza virus B was the most common cause of ARTI in patients aged 5-50 years. Conclusion: Our study provides baseline information on the epidemiologic and clinical feature of outpatients with ARTIs in Isfahan city. Though our findings in this pilot study could be helpful in diagnosis, treatment, and prevention of ARTI, planning preventive interventional.

  18. Cross-sectional small intestinal surveillance of maintenance hemodialysis patients using video capsule endoscopy: SCHEMA study

    Science.gov (United States)

    Hosoe, Naoki; Matsukawa, Shigeaki; Kanno, Yoshihiko; Naganuma, Makoto; Imaeda, Hiroyuki; Ida, Yosuke; Tsuchiya, Yoshitsugu; Hibi, Toshifumi; Ogata, Haruhiko; Kanai, Takanori

    2016-01-01

    Background and study aims: Small intestinal pathology in hemodialysis (HD) patients has been studied in only a small number of retrospective case series. One method for noninvasively surveying small intestinal disorders is video capsule endoscopy (VCE). The primary aim of this study was to investigate the prevalence of small intestinal abnormalities among asymptomatic maintenance HD outpatients using VCE. The secondary aim was to assess the clinical impact of these abnormalities. Patients and methods: This study consisted of two phases. In phase I, a cross-sectional study, a cohort of patients who received maintenance HD three times weekly at an outpatient hemodialysis clinic were studied using VCE. Phase II was a prospective cohort study with follow up for 1 year after VCE. Results: Fifty-six patients were enrolled in this study, and two were excluded from analysis due to capsule retention in the stomach. The prevalence of small bowel abnormalities in HD patients was 64.8 % (35/54) (95 % confidential interval 52.1 % – 77.6 %). Of 54 patients, 21 (38.9 %) had mucosal lesions, 10 (18.5 %) had vascular lesions, and 4 (7.4 %) had both lesion types. During the 1-year follow-up period, events occurred in four patients. A small bowel-associated event was observed in one patient, who underwent laparoscopy-assisted small intestinal partial resection 3 months after diagnosis by VCE. All patients in whom events were seen had small bowel abnormalities; no events were observed in the VCE-negative group. Conclusions: Although asymptomatic maintenance HD patients had a high prevalence of small bowel abnormalities (64.8 %), they did not have a high incidence of small bowel-associated events during the 1-year follow-up. PMID:27227120

  19. PTEN loss and chromosome 8 alterations in Gleason grade 3 prostate cancer cores predicts the presence of un-sampled grade 4 tumor: implications for active surveillance.

    Science.gov (United States)

    Trock, Bruce J; Fedor, Helen; Gurel, Bora; Jenkins, Robert B; Knudsen, B S; Fine, Samson W; Said, Jonathan W; Carter, H Ballentine; Lotan, Tamara L; De Marzo, Angelo M

    2016-07-01

    Men who enter active surveillance because their biopsy exhibits only Gleason grade 3 (G3) frequently have higher grade tumor missed by biopsy. Thus, biomarkers are needed that, when measured on G3 tissue, can predict the presence of higher grade tumor in the whole prostate. We evaluated whether PTEN loss, chromosome 8q gain (MYC) and/or 8p loss (LPL) measured only on G3 cores is associated with un-sampled G4 tumor. A tissue microarray was constructed of prostatectomy tissue from patients whose prostates exhibited only Gleason score 3+3, only 3+4 or only 4+3 tumor (n=50 per group). Cores sampled only from areas of G3 were evaluated for PTEN loss by immunohistochemistry, and PTEN deletion, LPL/8p loss and MYC/8q gain by fluorescence in situ hybridization. Biomarker results were compared between Gleason score 6 vs 7 tumors using conditional logistic regression. PTEN protein loss, odds ratio=4.99, P=0.033; MYC/8q gain, odds ratio=5.36, P=0.010; and LPL/8p loss, odds ratio=3.96, P=0.003 were significantly more common in G3 cores derived from Gleason 7 vs Gleason 6 tumors. PTEN gene deletion was not statistically significant. Associations were stronger comparing Gleason 4+3 vs 6 than for Gleason 3+4 vs 6. MYC/8q gain, LPL/8p loss and PTEN protein loss measured in G3 tissue microarray cores strongly differentiate whether the core comes from a Gleason 6 or Gleason 7 tumor. If validated to predict upgrading from G3 biopsy to prostatectomy these biomarkers could reduce the likelihood of enrolling high-risk men and facilitate safe patient selection for active surveillance.

  20. DATA SHARING REPORT CHARACTERIZATION OF POPULATION 7: PERSONAL PROTECTIVE EQUIPMENT, DRY ACTIVE WASTE, AND MISCELLANEOUS DEBRIS, SURVEILLANCE AND MAINTENANCE PROJECT OAK RIDGE NATIONAL LABORATORY OAK RIDGE, TENNESSEE

    Energy Technology Data Exchange (ETDEWEB)

    Harpenau, Evan M

    2013-10-10

    The U.S. Department of Energy (DOE) Oak Ridge Office of Environmental Management (EM-OR) requested that Oak Ridge Associated Universities (ORAU), working under the Oak Ridge Institute for Science and Education (ORISE) contract, provide technical and independent waste management planning support under the American Recovery and Reinvestment Act (ARRA). Specifically, DOE EM-OR requested that ORAU plan and implement a sampling and analysis campaign targeting certain URS|CH2M Oak Ridge, LLC (UCOR) surveillance and maintenance (S&M) process inventory waste. Eight populations of historical and reoccurring S&M waste at the Oak Ridge National Laboratory (ORNL) have been identified in the Waste Handling Plan for Surveillance and Maintenance Activities at the Oak Ridge National Laboratory, DOE/OR/01-2565&D2 (WHP) (DOE 2012) for evaluation and processing to determine a final pathway for disposal. Population 7 (POP 7) consists of 56 containers of aged, low-level and potentially mixed S&M waste that has been staged in various locations around ORNL. Several of these POP 7 containers primarily contain personal protective equipment (PPE) and dry active waste (DAW), but may contain other miscellaneous debris. This data sharing report addresses the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) specified waste in a 13-container subpopulation (including eight steel boxes, three 55-gal drums, one sealand, and one intermodal) that lacked sufficient characterization data for possible disposal at the Environmental Management Waste Management Facility (EMWMF) using the approved Waste Lot (WL) 108.1 profile.

  1. Data sharing report characterization of population 7: Personal protective equipment, dry active waste, and miscellaneous debris, surveillance and maintenance project Oak Ridge National Laboratory Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Harpenau, Evan M. [Oak Ridge Inst. for Science and Education (ORISE), Oak Ridge, TN (United States)

    2013-10-10

    The U.S. Department of Energy (DOE) Oak Ridge Office of Environmental Management (EM-OR) requested that Oak Ridge Associated Universities (ORAU), working under the Oak Ridge Institute for Science and Education (ORISE) contract, provide technical and independent waste management planning support under the American Recovery and Reinvestment Act (ARRA). Specifically, DOE EM-OR requested that ORAU plan and implement a sampling and analysis campaign targeting certain URS|CH2M Oak Ridge, LLC (UCOR) surveillance and maintenance (S&M) process inventory waste. Eight populations of historical and reoccurring S&M waste at the Oak Ridge National Laboratory (ORNL) have been identified in the Waste Handling Plan for Surveillance and Maintenance Activities at the Oak Ridge National Laboratory, DOE/OR/01-2565&D2 (WHP) (DOE 2012) for evaluation and processing to determine a final pathway for disposal. Population 7 (POP 7) consists of 56 containers of aged, low-level and potentially mixed S&M waste that has been staged in various locations around ORNL. Several of these POP 7 containers primarily contain personal protective equipment (PPE) and dry active waste (DAW), but may contain other miscellaneous debris. This data sharing report addresses the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) specified waste in a 13-container subpopulation (including eight steel boxes, three 55-gal drums, one sealand, and one intermodal) that lacked sufficient characterization data for possible disposal at the Environmental Management Waste Management Facility (EMWMF) using the approved Waste Lot (WL) 108.1 profile.

  2. Epidemiology of accidents among users of two-wheeled motor vehicles. A surveillance study in two Italian cities.

    Science.gov (United States)

    LaTorre, Giuseppe; Bertazzoni, Giuliano; Zotta, Donato; van Beeck, Edward; Ricciardi, Gualtiero

    2002-06-01

    This paper describes a study on the epidemiology of accidents among users of two-wheeled motor vehicles in two Italian cities, Rome and Naples. A surveillance study was conducted, recruiting the victims of accidents among users of two-wheeled motor vehicles, visiting the emergency departments of two Italian hospitals. The registration form includes personal data of the involved person, circumstances of the accident, means of arrival at the hospital, type of vehicles involved, helmet use, and eventually third parties involved, and data on the specific injury diagnosis. 736 injured drivers of two-wheeled motor vehicles were investigated for the study (65.1% males, 34.9% females). The mean age of the victims was 22.92 years; 42.9% of the injuries were the result of a single accident. In 35.5% of the injuries cars were involved and in 8.6% of the cases there was a passenger included. Only 12% of the injured people were wearing a helmet. Most of the lesions concerns the knee or lower leg (27.5%), followed by the head (17.5%), elbow and forearm (8.8%), wrist and hand (8.6%), shoulder and upper arm (8.4%) and ankle and foot (6.9%). Helmet use has a protective effect (OR = 0.23), whereas accidents in Naples and during dark hours are associated with an increased risk of head injury (respectively OR = 1.93, and OR = 1.46). In this study the lower injury risk due to the use of the helmet on the frequency and severity of head trauma was confirmed. Moreover, the results confirm that Emergency Departments can provide essential epidemiological information, and they have already provided clear arguments in favour of extending the compulsory use of helmets to people above 18 years in Italy.

  3. Atividade antimicrobiana in vitro de quinupristina/dalfopristina para cocos gram-positivos isolados de cinco centros brasileiros: resultado do estudo de vigilância L-SMART Antimicrobial in vitro activity of quinupristin/dalfopristin against gram-positive cocci isolated from 5 Brazilian centers: results from the local smart (L-SMART surveillance study

    Directory of Open Access Journals (Sweden)

    Caio Mendes

    2002-07-01

    /ml, sendo que 45% das cepas testadas foram sensíveis e 55% apresentaram sensibilidade intermediária à associação. Desta forma, pode-se afirmar que a associação Q/D representa uma nova opção para o tratamento endovenoso de infecções causadas por cocos gram-positivos, principalmente para as cepas multirresistentes, sendo também uma alternativa ao uso de glicopeptídeos.A progressive increase of resistance among Gram-positive cocci (GPC towards some antimicrobial agents has been observed for the past few years. This rise of resistance, most often seen in Staphylococcus spp., and Enterococcus spp., has mainly been noticed in hospital environments. Due to these recent patterns of resistance, newly developed antimicrobial agents need to be evaluated for the treatment of infections caused by these multi-resistant microorganisms. Quinupristin/dalfopristin (Q/D, also known as Synercid®, is an antimicrobial agent of intravenous administration, composed of two semi-synthetic derivatives of pristinomycin belonging to the group of streptogramins. The combination of streptogramins B and A at 3:7 ratio has an antimicrobial activity against gram-positive cocci. This combination has potent activity against gram-positive cocci such as Staphylococcus spp., Streptococcus spp. including Streptococcus pneumoniae, and Enterococcus faecium. However, strains of E. faecalis are usually resistant to this compound. The aim of this study was to evaluate the in vitro activity of Q/D and other eight antibiotics against 631 strains of GPC isolated from five Brazilian centers. Additionally, 20 vancomycin-resistant strains of E. faecium provided by a reference center from the United States were also included in this study. Minimal Inhibitory Concentrations (MICs were determined by E-test methodology (AB Biodisk, Solna, Sweden, using standardized and controlled procedures. The evaluated strains were as follows: Staphylococcus aureus (267, coagulase negative Staphylococcus (131, Streptococcus

  4. European surveillance study on antimicrobial susceptibility of Gram-positive anaerobic cocci

    DEFF Research Database (Denmark)

    Brazier, J; Chmelar, D; Dubreuil, L

    2008-01-01

    Gram-positive anaerobic cocci (GPAC) are a heterogeneous group of microorganisms frequently isolated from local and systemic infections. In this study, the antimicrobial susceptibilities of clinical strains isolated in 10 European countries were investigated. After identification of 299 GPAC to s...

  5. Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study.

    NARCIS (Netherlands)

    Hak, E.; Loon, S. van; Buskens, E.; Essen, G.A. van; Bakker, D. de; Tacken, M.A.J.B.; Hout, B.A. van; Grobbee, D.E.; Verheij, T.J.M.

    2003-01-01

    Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis media

  6. Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study

    NARCIS (Netherlands)

    Hak, E; van Loon, S; Buskens, E; van Essen, G A; de Bakker, D; Tacken, M A J B; van Hout, B A; Grobbee, D E; Verheij, Th J M

    2003-01-01

    Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis media

  7. Surveillance for Enteric Pathogens in a Case-Control Study of Acute Diarrhea in Western Kenya

    Science.gov (United States)

    2012-11-01

    parasites, two wet mounts were prepared for each specimen (one stained with iodine ) and analyzed by two laboratory technicians. For C. parvum identification...questionnaires completed at the time of study enrollment. However, a disproportionate amount of the Table 1. Enteric pathogens in patients and controls from

  8. Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study

    NARCIS (Netherlands)

    Hak, E; van Loon, S; Buskens, E; van Essen, G A; de Bakker, D; Tacken, M A J B; van Hout, B A; Grobbee, D E; Verheij, Th J M

    2003-01-01

    Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis media

  9. Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study.

    NARCIS (Netherlands)

    Hak, E.; Loon, S. van; Buskens, E.; Essen, G.A. van; Bakker, D. de; Tacken, M.A.J.B.; Hout, B.A. van; Grobbee, D.E.; Verheij, T.J.M.

    2003-01-01

    Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis media

  10. Effectiveness and satisfaction with zolmitriptan 5 mg nasal spray for treatment of migraine in real-life practice: results of a postmarketing surveillance study.

    Science.gov (United States)

    Diener, Hans-Christoph; Evers, Stefan

    2007-01-01

    Addressing the needs of migraineurs by actively seeking patient feedback on disease-related disability and treatment satisfaction may lead to improved management and treatment outcomes. Patient feedback can be collected in postmarketing surveillance (PMS) studies. The objective of this PMS study was to evaluate the efficacy and tolerability of zolmitriptan 5 mg nasal spray in the acute treatment of migraine attacks. Patients received zolmitriptan 5 mg nasal spray to treat migraine attacks of any severity and were followed up after a maximum of 4 months. Patients evaluated the efficacy and tolerability of zolmitriptan nasal spray, and were asked whether they wished to continue using zolmitriptan nasal spray and their preference compared with previous treatments. Physicians also assessed the efficacy and tolerability of zolmitriptan nasal spray. A total of 1838 patients (84.8% females) participated in the study. Within 30 minutes of administration of zolmitriptan nasal spray, 85.0% of patients reported improvements in headache pain, with 25.1% reporting an improvement within 10 minutes. At 1 hour post-dose, 57.9% of patients were pain free and 61.7% were able to resume usual daily activities. Most patients (72.9%) rated zolmitriptan nasal spray as 'better' than previous therapy. The majority (88.8%) expressed a wish to continue using zolmitriptan nasal spray. Physicians evaluated the efficacy of zolmitriptan nasal spray as 'excellent' or 'good' in 89.4% of patients. Tolerability was evaluated as 'excellent' or 'good' in 91.6% of patients. Zolmitriptan 5 mg nasal spray provides favourable efficacy and tolerability in the acute treatment of migraine attacks. Most patients assessed zolmitriptan nasal spray as 'better' than previous treatment, with nearly all wishing to continue using it.

  11. Value of surveillance {sup 18}F FDG PET/CT in colorectal cancer:comparison with conventional imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Kyoung; Yoo, Ie Ryung; Park, Hye Lim; Choi, Hyun Su; Han, Eun Ji; Kim, Sung Hoon; Chung, Soo Kyo; O, Joo Hyun [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-09-15

    To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC)and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS). Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph)were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow up imaging. The final diagnosis was based on at least 6 months of follow up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels. A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland. PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan.

  12. [Comparative study of larval and ovitrap efficacy for surveillance of dengue and yellow fever vectors].

    Science.gov (United States)

    Marques, C C; Marques, G R; de Brito, M; dos Santos Neto, L G; Ishibashi, V de C; Gomes, F de A

    1993-08-01

    A comparative study of the efficiency of ovitraps and larval-traps was undertaken with a view to improving the entomological survey of vectors of Dengue and Yellow Fever-Aedes aegypti and Aedes albopictus-in S. Paulo State, Brazil. The region studied is infected only by Aedes albopictus, a species that keeps to wild habitats but colonizes artificial breeding grounds as well. The first part of the study was located in a periurban area of Tremembé county were 3 hollon trees, 23 ovitraps and 5 larval-traps were compared. The second part of these experiments took place in Lavrinhas county (Pinheiros district), where 20 ovitraps and 5 larval-traps were tested. The results showed that the ovitrap was more efficient than larval-traps and were positive even in the presence of natural breeding grounds. It was also observed un the evaluation of the results of "thermonebulization (fog)" that the ovitraps showed strong reduction in the average number of eggs, but this was not observed in the Breteau Index.

  13. Surveillance or Adjuvant Treatment With Chemotherapy or Radiotherapy in Stage I Seminoma: A Systematic Review and Meta-Analysis of 13 Studies.

    Science.gov (United States)

    Petrelli, Fausto; Coinu, Andrea; Cabiddu, Mary; Ghilardi, Mara; Borgonovo, Karen; Lonati, Veronica; Barni, Sandro

    2015-10-01

    Testicular stage I seminoma has a remarkable cure rate with orchiectomy alone. The benefit of adjuvant therapy is questionable, and a direct comparison with active surveillance is lacking. We performed a meta-analysis to evaluate the benefit of adjuvant radiotherapy (RT) or chemotherapy (CT) compared with surveillance alone on relapse-free survival (RFS), overall survival (OS), and noncancer-related mortality in patients with stage I seminoma. We performed a systematic search of PubMed, EMBASE, Web of Science, SCOPUS, and the Cochrane Register of Controlled Trials. Meta-analysis was performed using the fixed- or random-effects models. The primary endpoint was 5-year RFS, and secondary endpoints were 5-year OS and 5-year noncancer-related mortality, reported as odds ratios (ORs) and 95% confidence intervals (CIs). A total of 13 trials (11 retrospective and 2 prospective cohort series), including 12,075 patients with stage I seminoma, were analyzed. The relapse rates were 3.9% versus 14.8% in the adjuvant therapy and surveillance arms, respectively. Overall, adjuvant therapy significantly improved 5-year RFS (OR, 0.17; 95% CI, 0.1-0.29; P seminoma. However, they do not increase OS or noncancer-related mortality. Both treatment options can be offered to patients with stage I seminoma, taking into consideration the side effects and high cure rate of testicular cancer at relapse. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Head lice surveillance on a deregulated OTC-sales market: a study using web query data.

    Directory of Open Access Journals (Sweden)

    Johan Lindh

    Full Text Available The head louse, Pediculus humanus capitis, is an obligate ectoparasite that causes infestations of humans. Studies have demonstrated a correlation between sales figures for over-the-counter (OTC treatment products and the number of humans with head lice. The deregulation of the Swedish pharmacy market on July 1, 2009, decreased the possibility to obtain complete sale figures and thereby the possibility to obtain yearly trends of head lice infestations. In the presented study we wanted to investigate whether web queries on head lice can be used as substitute for OTC sales figures. Via Google Insights for Search and Vårdguiden medical web site, the number of queries on "huvudlöss" (head lice and "hårlöss" (lice in hair were obtained. The analysis showed that both the Vårdguiden series and the Google series were statistically significant (p<0.001 when added separately, but if the Google series were already included in the model, the Vårdguiden series were not statistically significant (p = 0.5689. In conclusion, web queries can detect if there is an increase or decrease of head lice infested humans in Sweden over a period of years, and be as reliable a proxy as the OTC-sales figures.

  15. Head lice surveillance on a deregulated OTC-sales market: a study using web query data.

    Science.gov (United States)

    Lindh, Johan; Magnusson, Måns; Grünewald, Maria; Hulth, Anette

    2012-01-01

    The head louse, Pediculus humanus capitis, is an obligate ectoparasite that causes infestations of humans. Studies have demonstrated a correlation between sales figures for over-the-counter (OTC) treatment products and the number of humans with head lice. The deregulation of the Swedish pharmacy market on July 1, 2009, decreased the possibility to obtain complete sale figures and thereby the possibility to obtain yearly trends of head lice infestations. In the presented study we wanted to investigate whether web queries on head lice can be used as substitute for OTC sales figures. Via Google Insights for Search and Vårdguiden medical web site, the number of queries on "huvudlöss" (head lice) and "hårlöss" (lice in hair) were obtained. The analysis showed that both the Vårdguiden series and the Google series were statistically significant (pGoogle series were already included in the model, the Vårdguiden series were not statistically significant (p = 0.5689). In conclusion, web queries can detect if there is an increase or decrease of head lice infested humans in Sweden over a period of years, and be as reliable a proxy as the OTC-sales figures.

  16. Biological specimens for community-based surveillance studies: Method of recruitment matters

    Directory of Open Access Journals (Sweden)

    Brenda L. Coleman

    2011-12-01

    Full Text Available Studies requiring the collection of biological specimens are often difficult to perform and costly. We compare face-to-face and telephone interviews to determine which is more effective for return of self-collected rectal swabs from subjects living in rural and semi-rural areas of Ontario, Canada. People interviewed face-to-face in 2006-2007 were asked to provide a rectal swab while the interviewer waited. Those interviewed by telephone were sent a package and asked to return the swab by mail, with one follow-up reminder call. Telephone interviewing resulted in a higher response rate for the completion of household and individual-level questionnaires. However, face-to-face interviews resulted in a significantly higher proportion of interviewees who returned swabs making the participation rate higher for this mode of contact (33.7 versus 25.0 percent. Using multivariable logistic regression, higher rates of rectal swab return were associated with face-to-face interviewing while adjusting for the impact of household size and respondent age and sex. For studies requiring the submission of intimate biological samples, face-to-face interviews can be expected to provide a higher rate of return than telephone interviews.

  17. Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study

    Directory of Open Access Journals (Sweden)

    M. Süsskind

    2012-01-01

    Full Text Available Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs caused by anthroposophical medicines (AMEDs in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code, causality (according to the Uppsala Monitoring Centre WHO criteria, and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6% experienced 211 ADRs (CTCAE grade 2/3 n=191, 90.5%, CTCAE grade 4/5 n=20, 9.5% of which 57 ADRs (27.0% were serious. The median age of patients with ADRs (62.1% females was 72.0 (IQR: 61.0; 80.0. Six patients (0.2% experienced six ADRs (2.8% of ADRs caused by eight suspected AMEDs, all of which were mild reactions (grade 2. Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms.

  18. Health Consequences of Typhoon Haiyan in the Eastern Visayas Region Using a Syndromic Surveillance Database

    OpenAIRE

    Salazar, Miguel Antonio; Law, Ronald; Pesigan, Arturo; Winkler, Volker

    2017-01-01

    Introduction: Typhoon Haiyan was the strongest storm recorded in Philippine history. Surveillance in Post Extreme Emergencies and Disasters (SPEED) was activated during the typhoon response. This study analyzes the health impact of different diseases during different timeframes post-disaster during Typhoon Haiyan in 2013 using a syndromic surveillance database. Methods: SPEED reports medical consultations based on 21 syndromes covering a range of conditions from three syndrome groups: communi...

  19. Population-Based Surveillance of Invasive Group A Streptococcal Disease in British Columbia: 1996-1998

    OpenAIRE

    Gordean L Bjornson; Scheifele, David W; Alison Bell; Arlene King

    2001-01-01

    OBJECTIVE: To identify and describe all cases of invasive group A streptococcal (GAS) infection occurring in British Columbia during a two-year period.DESIGN: Active, laboratory-based surveillance with supplemental case description.SETTING: Forty community and regional hospitals and the provincial laboratory participated, encompassing all health regions.POPULATION STUDIED: Entire provincial population from April 1, 1996 to March 31, 1998.MAIN RESULTS: Over the 24-month surveillance period, 18...

  20. Efficacy, tolerability and safety of nebivolol in patients with hypertension and diabetes: a post-marketing surveillance study.

    Science.gov (United States)

    Van Bortel, L M

    2010-09-01

    Hypertension is a widely prevalent condition of elevated blood pressure (BP) and is the leading risk factor for the development of cardiovascular disease (CVD). Many patients have additional risk factors such as diabetes mellitus (DM) or previous history of CVD. Nebivolol is a third-generation beta (beta)-blockers which has been shown not to influence metabolic parameters in patients with DM. This postmarketing surveillance study aimed to collect information on the efficacy, safety and tolerability of nebivolol in hypertensive patients with concomitant DM. Hypertensive patients with DM followed by 52 cardiologists, internal medicine specialists and general practitioners, between 24 August 2003 and 9 January 2007 in The Netherlands were included in this study. Physicians were asked to survey nebivolol treatment for 6 months. A total of 510 patients were enrolled. Overall, 93.3% of patients were diagnosed with essential hypertension and 6.7% with secondary hypertension. All patients were co-diagnosed with DM. Nebivolol therapy was associated with a significant reduction in both systolic blood pressure (BP) and diastolic BP versus baseline (p hypertension, resistance or intolerance to previous antihypertensive medication, or other reasons). A significant improvement in blood glucose was seen at 4 months (-0.6 mmol/L; p = 0.021). Significant reductions in total cholesterol (-1.45 mmol/L; p = 0.006), low density lipoprotein (LDL) cholesterol (-1.32 mmol/L; p = 0.003) and LDL/high density lipoprotein (HDL) cholesterol ratio (-0.77; p = 0.011) were observed at 2 months. No significant changes were seen in HDL cholesterol and triglycerides. Nebivolol treatment was associated with a significantly reduced BP, improved blood glucose and LDL cholesterol levels and was well tolerated in hypertensive patients with concomitant DM.

  1. Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study.

    Science.gov (United States)

    Westwick, Harrison J; Shamji, Mohammed F

    2015-09-01

    Most spinal meningiomas are intradural lesions in the thoracic spine that present with both local pain and myelopathy. By using the large prospective Surveillance, Epidemiology, and End Results (SEER) database, the authors studied the incidence of spinal meningiomas and examined demographic and treatment factors predictive of death. Using SEER*Stat software, the authors queried the SEER database for cases of spinal meningioma between 2000 and 2010. From the results, tumor incidence and demographic statistics were computed; incidence was analyzed as a function of tumor location, pathology, age, sex, and malignancy code. Survival was analyzed by using a Cox proportional hazards ratio in SPSS for age, sex, marital status, primary site, size quartile, treatment modality, and malignancy code. In this analysis, significance was set at a p value of 0.05. The 1709 spinal meningiomas reported in the SEER database represented 30.7% of all primary intradural spinal tumors and 7.9% of all meningiomas. These meningiomas occurred at an age-adjusted incidence of 0.193 (95% CI 0.183-0.202) per 100,000 population and were closely related to sex (337 [19.7%] male patients and 1372 [80.3%] female patients). The Cox hazard function for mortality in males was higher (2.4 [95% CI1.7-3.5]) and statistically significant, despite the lower lesion incidence in males. All-cause survival was lowest in patients older than 80 years. Primary site and treatment modality were not significant predictors of mortality. Spinal meningiomas represent a significant fraction of all primary intradural spinal tumors and of all meningiomas. The results of this study establish the association of lesion incidence and survival with sex, with a less frequent incidence in but greater mortality among males.

  2. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

    Directory of Open Access Journals (Sweden)

    Enserink Remko

    2012-10-01

    Full Text Available Abstract Background Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network. The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. Methods/design The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff, medical consumption, absenteeism and circulating enteric pathogens (children are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. Discussion The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (biodatabases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.

  3. Surveillance of tedizolid activity and resistance: In vitro susceptibility of Gram-positive pathogens collected over 5 years from the United States and Europe.

    Science.gov (United States)

    Bensaci, Mekki; Sahm, Daniel

    2017-02-01

    In vitro activity of tedizolid and comparators against 11,231 Gram-positive clinical isolates from the United States (84 centers) and Europe (115 centers) were summarized as part of the Surveillance of Tedizolid Activity and Resistance program between 2009 and 2013. Susceptibility testing was performed according to Clinical Laboratory and Standards Institute (CLSI) guidelines. Minimum inhibitory concentration (MIC) interpretations were based on CLSI and European Committee on Antimicrobial Susceptibility Testing criteria. Tedizolid inhibited 99.7% of all isolates at MIC ≤0.5 mg/L; activity was similar regardless of methicillin or vancomycin resistance phenotypes of Staphylococcus aureus and enterococci, respectively. Tedizolid MIC >1 mg/L was reported for 3 S. aureus, 4 coagulase-negative staphylococci, and 2 enterococcal isolates; all streptococci were inhibited at MIC ≤0.5 mg/L. Tedizolid was ≥4-fold more potent than linezolid against all groups, including resistant phenotypes. Tedizolid had potent/stable activity against a large, contemporary collection of Gram-positive clinical isolates, with low rates of resistance.

  4. Clinical, environmental, and serologic surveillance studies of melioidosis in Gabon, 2012-2013.

    Science.gov (United States)

    Wiersinga, W Joost; Birnie, Emma; Weehuizen, Tassili A F; Alabi, Abraham S; Huson, Michaëla A M; Huis in 't Veld, Robert A G; Mabala, Harry K; Adzoda, Gregoire K; Raczynski-Henk, Yannick; Esen, Meral; Lell, Bertrand; Kremsner, Peter G; Visser, Caroline E; Wuthiekanun, Vanaporn; Peacock, Sharon J; van der Ende, Arie; Limmathurotsakul, Direk; Grobusch, Martin P

    2015-01-01

    Burkholderia pseudomallei, an environmental gram-negative bacillus, is the causative agent of melioidosis and a bio-threat agent. Reports of B. pseudomallei isolation from soil and animals in East and West Africa suggest that melioidosis might be more widely distributed than previously thought. Because it has been found in equatorial areas with tropical climates, we hypothesized that B. pseudomallei could exist in Gabon. During 2012-2013, we conducted a seroprevalance study in which we set up microbiology facilities at a large clinical referral center and prospectively screened all febrile patients by conducting blood cultures and testing for B. pseudomallei and related species; we also determined whether B. pseudomallei could be isolated from soil. We discovered a novel B. pseudomallei sequence type that caused lethal septic shock and identified B. pseudomallei and B. thailandensis in the environment. Our data suggest that melioidosis is emerging in Central Africa but is unrecognized because of the lack of diagnostic microbiology facilities.

  5. Observed Prevalence of Congenital Heart Defects From a Surveillance Study in China

    Science.gov (United States)

    Zhang, Yali; Riehle-Colarusso, Tiffany; Correa, Adolfo; Li, Song; Feng, Xinheng; Gindler, Jacqueline; Lin, Hui; Webb, Catherine; Li, Wei; Trines, Jean; Berry, Robert J.; Yeung, Lorraine; Luo, Ying; Jiang, Meifang; Chen, Hua; Sun, Xiamei; Li, Zhu

    2015-01-01

    Objectives The purpose of this study was to estimate the prevalence of major and minor congenital heart defects among fetuses and neonates using sonography in a general population of 4 areas surrounding Shanghai, China. Methods Pregnant women were recruited between April 2004 and December 2005 in Jiaxing City, Suzhou City, Changshu County, and Haining County. All participants could have 3 sonographic examinations performed by specially trained physicians regardless of medical indication: a fetal sonographic screen and fetal echocardiography between 20 and 28 weeks’ gestation and neonatal echocardiography. Diagnoses of congenital heart defects were made on the basis of review of all available scans by an international group of experts in pediatric cardiology. Prevalence rates were calculated per 1000 births. Results Among 4006 scanned fetuses and neonates, there were 75 congenital heart defects, including 12 major defects. The observed prevalence for all congenital heart defects was 18.7 (95% confidence interval, 14.8–23.5) per 1000 births, and the prevalence for major defects was 3.0 (95% confidence interval, 1.6–5.2) per 1000 births. The most common defects were ventricular septal defects (n = 47 [62.7%]), atrial septal defects (n = 14 [18.7%]), tetralogy of Fallot (n = 4 [5.3%]), and hypoplastic left heart syndrome (n = 3 [4.0%]). Conclusions The prevalence of all congenital heart defects in the 4 areas of China studied was higher than that reported in other countries, with ventricular septal defects being the most frequent defects. Our data likely reflect a better estimate of the total prevalence of congenital heart defects in China than reported previously. PMID:21705732

  6. The U.S.-Mexico Border Infectious Disease Surveillance Project: Establishing Binational Border Surveillance

    Science.gov (United States)

    Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin

    2003-01-01

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California–Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS. PMID:12533288

  7. Atrial Fibrillation Screening in Nonmetropolitan Areas Using a Telehealth Surveillance System With an Embedded Cloud-Computing Algorithm: Prospective Pilot Study.

    Science.gov (United States)

    Chen, Ying-Hsien; Hung, Chi-Sheng; Huang, Ching-Chang; Hung, Yu-Chien; Hwang, Juey-Jen; Ho, Yi-Lwun

    2017-09-26

    Atrial fibrillation (AF) is a common form of arrhythmia that is associated with increased risk of stroke and mortality. Detecting AF before the first complication occurs is a recognized priority. No previous studies have examined the feasibility of undertaking AF screening using a telehealth surveillance system with an embedded cloud-computing algorithm; we address this issue in this study. The objective of this study was to evaluate the feasibility of AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm. We conducted a prospective AF screening study in a nonmetropolitan area using a single-lead electrocardiogram (ECG) recorder. All ECG measurements were reviewed on the telehealth surveillance system and interpreted by the cloud-computing algorithm and a cardiologist. The process of AF screening was evaluated with a satisfaction questionnaire. Between March 11, 2016 and August 31, 2016, 967 ECGs were recorded from 922 residents in nonmetropolitan areas. A total of 22 (2.4%, 22/922) residents with AF were identified by the physician's ECG interpretation, and only 0.2% (2/967) of ECGs contained significant artifacts. The novel cloud-computing algorithm for AF detection had a sensitivity of 95.5% (95% CI 77.2%-99.9%) and specificity of 97.7% (95% CI 96.5%-98.5%). The overall satisfaction score for the process of AF screening was 92.1%. AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm is feasible.

  8. The potential of the European network of congenital anomaly registers (EUROCAT) for drug safety surveillance : a descriptive study

    NARCIS (Netherlands)

    Meijer, Willemijn M.; Cornel, Martina C.; Dolk, Helen; de Walle, Hermien E. K.; Armstrong, Nicola C.; de Jong-van den Berg, Lolkje T. W.

    Background European Surveillance of Congenital Anomalies (EUROCAT) is a network of population-based congenital anomaly registries in Europe surveying more than I million births per year, or 25% of the births in the European Union. This paper describes the potential of the EUROCAT collaboration for

  9. Timing of Identification among Children with an Autism Spectrum Disorder: Findings from a Population-Based Surveillance Study

    Science.gov (United States)

    Shattuck, Paul T.; Durkin, Maureen; Maenner, Matthew; Newschaffer, Craig; Mandell, David S.; Wiggins, Lisa; Lee, Li-Ching; Rice, Catherine; Giarelli, Ellen; Kirby, Russell; Baio, Jon; Pinto-Martin, Jennifer; Cuniff, Christopher

    2009-01-01

    Analysis of the data from Center for Disease Control's autism surveillance program found that the median age of identification of children with autism is 5.7 years. Being male, having an IQ of 70 or lower, and having developmental regression are the factors linked to a younger age of identification. There is a need for research, innovation, and…

  10. Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwide surveillance study.

    Directory of Open Access Journals (Sweden)

    Simone Lanini

    Full Text Available Bacterial infections remain a challenge to solid organ transplantation. Due to the alarming spread of carbapenem-resistant gram negative bacteria, these organisms have been frequently recognized as cause of severe infections in solid organ transplant recipients.Between 15 May and 30 September 2012 we enrolled 887 solid organ transplant recipients in Italy with the aim to describe the epidemiology of gram negative bacteria spreading, to explore potential risk factors and to assess the effect of early isolation of gram negative bacteria on recipients' mortality during the first 90 days after transplantation. During the study period 185 clinical isolates of gram negative bacteria were reported, for an incidence of 2.39 per 1000 recipient-days. Positive cultures for gram negative bacteria occurred early after transplantation (median time 26 days; incidence rate 4.33, 1.67 and 1.14 per 1,000 recipient-days in the first, second and third month after SOT, respectively. Forty-nine of these clinical isolates were due to carbapenem-resistant gram negative bacteria (26.5%; incidence 0.63 per 1000 recipient-days. Carbapenems resistance was particularly frequent among Klebsiella spp. isolates (49.1%. Recipients with longer hospital stay and those who received either heart or lung graft were at the highest risk of testing positive for any gram negative bacteria. Moreover recipients with longer hospital stay, lung recipients and those admitted to hospital for more than 48h before transplantation had the highest probability to have culture(s positive for carbapenem-resistant gram negative bacteria. Forty-four organ recipients died (0.57 per 1000 recipient-days during the study period. Recipients with at least one positive culture for carbapenem-resistant gram negative bacteria had a 10.23-fold higher mortality rate than those who did not.The isolation of gram-negative bacteria is most frequent among recipient with hospital stays >48 hours prior to transplant

  11. Effectiveness and tolerability of parenteral testosterone undecanoate: a post-marketing surveillance study.

    Science.gov (United States)

    Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis

    2017-08-16

    This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.

  12. A study on surveillance of environmental factors affecting the variation of indoor radon concentration

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Shin Ae; Kim, Ok Ja; Lee, Mi Kyeong; Cho, Eun Ok; Choi, Yun Sun; Choi, Jin Kyeong; Park, Seon Hye; Han, Hyeon Sun [Hankook Research, Seoul (Korea, Republic of)

    2000-03-15

    Before the main survey, a preliminary survey was carried out to decide the most suitable type of a radon detector the most appropriate places to install such a radon detector. To this end, three types of detectors were set up in 108 locations, approximately 3% of 3,000 to measure the radon levels, and 102 detectors(94%) were collected. As a result of the preliminary survey, Radtrack was chosen as a radon detector for the main survey, and bedrooms on the first floor of houses and the first floor of public buildings were decided to be the places for the first installment of detectors. It is most desirable to survey the radon concentrations in all houses nationwide. Considering the survey period and budgets, however, 3,000 spots were targeted for the main survey at the recommendation of the Korea Institute of Nuclear Safety in charge of this study. As it is important to maintain the same panels for a year to measure the radon concentrations at 3,000 locations, a total of 3,237 panels, 10% more than the target sample number, were surveyed considering the possible loss of panels during the survey period. The first radon detector was installed in each of 3,237 spots in December 1999, and collected three months later in March 2000, followed by the installment of the second detector.

  13. [Post-marketing surveillance of Tanreqing injection in children: a real world study].

    Science.gov (United States)

    Li, X X; Zhuo, L; Yang, Y H; Zhan, S Y; Zhai, S D

    2017-02-10

    Objective: To evaluate the safety of Tanreqing injection among children in the real world. Methods: A multicenter, large sample, ambispective cohort study, with registration-type clinical safety monitoring. A total of 6 188 inpatients and patients from the emergency units, aged ≤ 14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China, were recruited between January, 2014 and May, 2015. The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection. Univariate analysis was used to explain the risk factors of ADR. Results: The overall incidence of ADE was 4.20‰ (26 cases), including 4 serious ones. The incidence of ADR was 3.07‰ (19 cases), including 17 cases of general ADR and 2 cases of new ADR. All the ADR cases were mild or moderate, mostly showing damages in skin and appendages. The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured. Having histories of allergies to drugs or foods would increase the incidence of ADR. Conclusion:Tanreqing injection caused low incidence of ADR in children. Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.

  14. Presence, distribution, and molecular epidemiology of methicillin-resistant Staphylococcus aureus in a small animal teaching hospital: a year-long active surveillance targeting dogs and their environment.

    Science.gov (United States)

    van Balen, Joany; Kelley, Christina; Nava-Hoet, Rocio C; Bateman, Shane; Hillier, Andrew; Dyce, Jonathan; Wittum, Thomas E; Hoet, Armando E

    2013-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is known to be present in small animal veterinary clinical environments. However, a better understanding of the ecology and dynamics of MRSA in these environments is necessary for the development of effective infectious disease prevention and control programs. To achieve this goal, a yearlong active MRSA surveillance program was established at The Ohio State University (OSU) Veterinary Medical Center to describe the spatial and molecular epidemiology of this bacterium in the small animal hospital. Antimicrobial susceptibility testing, staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) typing, and dendrogram analysis were used to characterize and analyze the 81 environmental and 37 canine-origin MRSA isolates obtained during monthly sampling events. Overall, 13.5% of surfaces were contaminated with MRSA at 1 or more sampling times throughout the year. The majority of the environmental and canine isolates were SCCmec type II (93.8% and 86.5%, respectively) and USA100 (90.1% and 86.5%, respectively). By PFGE analysis, these isolates were found to be closely related, which reflects a low diversity of MRSA strains circulating in the hospital. For 5 consecutive months, 1 unique pulsotype was the most prevalent across the medical services and was recovered from a variety of surfaces and hospital locations. Carts/gurneys, doors, and examination tables/floors were the most frequently contaminated surfaces. Some surfaces maintained the same pulsotypes for 3 consecutive months. Molecular analysis found that incoming MRSA-positive dogs were capable of introducing a new pulsotype into the hospital environment during the surveillance period. Our results suggest that once a MRSA strain is introduced into the hospital environment, it can be maintained and spread for extended periods of time. These findings can aid in the development of biosecurity and biocontainment protocols aimed at

  15. ACTIVITIES OF THE ADMINISTRATION OF FEDERAL SERVICE FOR SURVEILLANCE ON CONSUMER RIGHTS PROTECTION AND HUMAN WELL-BEING IN KHABAROVSKY KRAI IN CONDITIONS OF THE FUKUSHIMA ACCIDENT AND MEASURES UNDERTAKEN TO PROTECT THE TERRITORY AND POPULATION THE REGION

    Directory of Open Access Journals (Sweden)

    V. A. Ott

    2011-01-01

    Full Text Available The article analyzes activities of the Administration of Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in Khabarovsky Krai and the Federal Health Organization "Center of Hygiene and Epidemiology in Khabarovsky Krai" in the situation related to the Fukushima accident in Japan

  16. Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates.

    Science.gov (United States)

    van der Zwet, W C; Kaiser, A M; van Elburg, R M; Berkhof, J; Fetter, W P F; Parlevliet, G A; Vandenbroucke-Grauls, C M J E

    2005-12-01

    The incidence of nosocomial infection in neonatal intensive care units (NICUs) is high compared with other wards. However, no definitions for hospital-acquired infection are available for NICUs. The aim of this study was to measure the incidence of such infections and to identify risk factors in the NICU of the VU University Medical Center, which serves as a level III regional NICU. For this purpose, a prospective surveillance was performed in 1998-2000. We designed definitions by adjusting the current definitions of the Centers for Disease Control and Prevention (CDC) for children risk factors were dichotomized. Analysis of risk factors was performed by Cox regression with time-dependent variables. The relationship between the Clinical Risk Index for Babies (CRIB) and nosocomial infection was investigated. Furthermore, for a random sample of cases, we determined whether bloodstream infection and pneumonia would also have been identified with the CDC definitions. Seven hundred and forty-two neonates were included in the study. One hundred and ninety-one neonates developed 264 infections. Bloodstream infection (N=138, 14.9/1000 patient-days) and pneumonia (N=69, 7.5/1000 patient-days) were the most common infections. Of bloodstream infections, 59% were caused by coagulase-negative staphylococci; in 21% of neonates, blood cultures remained negative. In 25% of pneumonias, Enterobacteriaceae were the causative micro-organisms; 26% of cultures remained negative. Compared with the Nosocomial Infections Surveillance System (NNIS) of the CDC, our device utilization ratios and device-associated nosocomial infection rates were high. The main risk factors for bloodstream infection were birth weight [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.45-2.17] and parenteral feeding with hospital-pharmacy-produced, all-in-one mixture 'Minimix' (HR 3.69, 95%CI 2.03-6.69); administration of intravenous antibiotics (HR 0.39, 95%CI 0.26-0.56) was a protective risk factor. The

  17. Species distribution and antifungal susceptibility of bloodstream fungal isolates in paediatric patients in Mexico: a nationwide surveillance study.

    Science.gov (United States)

    González, Gloria M; Treviño-Rangel, Rogelio de J; Palma-Nicolás, José P; Martínez, César; González, J Gerardo; Ayala, Jacobo; Caballero, Amílcar; Morfín-Otero, Rayo; Rodríguez-Noriega, E; Velarde, Fernando; Ascencio, Elba P; Tinoco, Juan C; Vázquez, Jorge A; Cano, Manuel A; León-Sicairos, Nidia; González, Rocío; Rincón, Joaquín; Elías, Miguel A; Bonifaz, Alexandro

    2013-12-01

    To establish the species distribution and in vitro susceptibilities of 358 bloodstream fungal isolates from paediatric patients in Mexico. Isolates were collected during a 2 year surveillance programme in 14 medical centres in 10 Mexican states. A molecular approach was used to determine the Candida parapsilosis species complex. In vitro susceptibility to amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, anidulafungin and micafungin was determined according to CLSI procedures. Species-specific clinical breakpoints for fluconazole, voriconazole and echinocandins were applied. Candida spp. accounted for 98.33% of fungaemias, including 127 Candida albicans isolates, 127 C. parapsilosis complex isolates (121 C. parapsilosis sensu stricto, 4 Candida orthopsilosis and 2 Candida metapsilosis strains) and 72 Candida tropicalis isolates. C. albicans and C. parapsilosis complex were the species predominant in neonates (48 cases each; 41.02%). C. parapsilosis complex was also the predominant species in patients 1 month to <2 years of age (P = 0.007). In contrast, C. albicans was the most frequent species in patients aged 2 to <12 years (P = 0.003). Antifungal resistance was rare among the subset of isolates. Candida glabrata showed the highest resistance rate to amphotericin B (1/9 isolates), fluconazole (1/9 isolates) and itraconazole (2/9 isolates). The species distribution differed with the age of the patients, with C. albicans and C. parapsilosis complex being the most commonly isolated species. C. glabrata showed the highest resistance rate to amphotericin B, fluconazole and itraconazole. This is the first study of fungaemia episodes in Mexican children.

  18. Cyclopia: An Epidemiologic Study in a Large Dataset From the International Clearinghouse of Birth Defects Surveillance and Research

    Science.gov (United States)

    Orioli, Iêda M.; Amar, Emmanuelle; Bakker, Marian K.; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Canfield, Mark A.; Clementi, Maurizio; Correa, Adolfo; Csáky-Szunyogh, Melinda; Feldkamp, Marcia L.; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Morgan, Margery; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Szabova, Elena; Castilla, Eduardo E.

    2015-01-01

    Cyclopia is characterized by the presence of a single eye, with varying degrees of doubling of the intrinsic ocular structures, located in the middle of the face. It is the severest facial expression of the holoprosencephaly (HPE) spectrum. This study describes the prevalence, associated malformations, and maternal characteristics among cases with cyclopia. Data originated in 20 Clearinghouse (ICBDSR) affiliated birth defect surveillance systems, reported according to a single pre-established protocol. A total of 257 infants with cyclopia were identified. Overall prevalence was 1 in 100,000 births (95%CI: 0.89–1.14), with only one program being out of range. Across sites, there was no correlation between cyclopia prevalence and number of births (r = 0.08; P=0.75) or proportion of elective termination of pregnancy (r= −0.01; P=0.97). The higher prevalence of cyclopia among older mothers (older than 34) was not statistically significant. The majority of cases were liveborn (122/200; 61%) and females predominated (male/total: 42%). A substantial proportion of cyclopias (31%) were caused by chromosomal anomalies, mainly trisomy 13. Another 31% of the cases of cyclopias were associated with defects not typically related to HPE, with more hydrocephalus, heterotaxia defects, neural tube defects, and preaxial reduction defects than the chromosomal group, suggesting the presence of ciliopathies or other unrecognized syndromes. Cyclopia is a very rare defect without much variability in prevalence by geographic location. The heterogeneous etiology with a high prevalence of chromosomal abnormalities, and female predominance in HPE, were confirmed, but no effect of increased maternal age or association with twinning was observed. PMID:22006661