Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis.

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Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings.

A concept for routine emergency-care data-based syndromic surveillance in Europe.

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Ziemann, A; Rosenkötter, N; Garcia-Castrillo Riesgo, L; Schrell, S; Kauhl, B; Vergeiner, G; Fischer, M; Lippert, F K; Krämer, A; Brand, H; Krafft, T

2014-11-01

We developed a syndromic surveillance (SyS) concept using emergency dispatch, ambulance and emergency-department data from different European countries. Based on an inventory of sub-national emergency data availability in 12 countries, we propose framework definitions for specific syndromes and a SyS system design. We tested the concept by retrospectively applying cumulative sum and spatio-temporal cluster analyses for the detection of local gastrointestinal outbreaks in four countries and comparing the results with notifiable disease reporting. Routine emergency data was available daily and electronically in 11 regions, following a common structure. We identified two gastrointestinal outbreaks in two countries; one was confirmed as a norovirus outbreak. We detected 1/147 notified outbreaks. Emergency-care data-based SyS can supplement local surveillance with near real-time information on gastrointestinal patients, especially in special circumstances, e.g. foreign tourists. It most likely cannot detect the majority of local gastrointestinal outbreaks with few, mild or dispersed cases.

Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom.

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Todkill, Dan; Loveridge, Paul; Elliot, Alex J; Morbey, Roger A; Edeghere, Obaghe; Rayment-Bishop, Tracy; Rayment-Bishop, Chris; Thornes, John E; Smith, Gillian

2017-12-01

Introduction The Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the "severe" end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England. Hypothesis/Problem Is an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems? An ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients' demographics, partial postcode of patients' location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system. The pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory

Public health in the field and the emergency operations center: methods for implementing real-time onsite syndromic surveillance at large public events.

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Pogreba-Brown, Kristen; McKeown, Kyle; Santana, Sarah; Diggs, Alisa; Stewart, Jennifer; Harris, Robin B

2013-10-01

To develop an onsite syndromic surveillance system for the early detection of public health emergencies and outbreaks at large public events. As the third largest public health jurisdiction in the United States, Maricopa County Department of Public Health has worked with academic and first-response partners to create an event-targeted syndromic surveillance (EVENTSS) system. This system complements long-standing traditional emergency department-based surveillance and provides public health agencies with rapid reporting of possible clusters of illness. At 6 high profile events, 164 patient reports were collected. Gastrointestinal and neurological syndromes were most commonly reported, followed by multisyndromic reports. Neurological symptoms were significantly increased during hot weather events. The interview rate was 2 to 7 interviews per 50 000 people per hour, depending on the ambient temperature. Discussion Study data allowed an estimation of baseline values of illness occurring at large public events. As more data are collected, prediction models can be built to determine threshold levels for public health response. EVENTSS was conducted largely by volunteer public health graduate students, increasing the response capacity for the health department. Onsite epidemiology staff could make informed decisions and take actions quickly in the event of a public health emergency.

Evaluation of the Components of the North Carolina Syndromic Surveillance System Heat Syndrome Case Definition.

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Harduar Morano, Laurel; Waller, Anna E

To improve heat-related illness surveillance, we evaluated and refined North Carolina's heat syndrome case definition. We analyzed North Carolina emergency department (ED) visits during 2012-2014. We evaluated the current heat syndrome case definition (ie, keywords in chief complaint/triage notes or International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM] codes) and additional heat-related inclusion and exclusion keywords. We calculated the positive predictive value and sensitivity of keyword-identified ED visits and manually reviewed ED visits to identify true positives and false positives. The current heat syndrome case definition identified 8928 ED visits; additional inclusion keywords identified another 598 ED visits. Of 4006 keyword-identified ED visits, 3216 (80.3%) were captured by 4 phrases: "heat ex" (n = 1674, 41.8%), "overheat" (n = 646, 16.1%), "too hot" (n = 594, 14.8%), and "heatstroke" (n = 302, 7.5%). Among the 267 ED visits identified by keyword only, a burn diagnosis or the following keywords resulted in a false-positive rate >95%: "burn," "grease," "liquid," "oil," "radiator," "antifreeze," "hot tub," "hot spring," and "sauna." After applying the revised inclusion and exclusion criteria, we identified 9132 heat-related ED visits: 2157 by keyword only, 5493 by ICD-9-CM code only, and 1482 by both (sensitivity = 27.0%, positive predictive value = 40.7%). Cases identified by keywords were strongly correlated with cases identified by ICD-9-CM codes (rho = .94, P definition through the use of additional inclusion and exclusion criteria substantially improved the accuracy of the surveillance system. Other jurisdictions may benefit from refining their heat syndrome case definition.

Regular surveillance for Li-fraumeni syndrome: advice, adherence and perceived benefits

NARCIS (Netherlands)

Lammens, C.R.M.; Bleiker, E.M.A.; Aaronson, N.K.; Wagner, A.; Sijmons, R.H.; Ausems, M.G.E.M.; Vriends, A.H.J.T.; Ruijs, M.W.G.; van Os, T.A.M.; Spruijt, L.; Gómez García, E.B.; Cats, A.; Nagtegaal, T.; Verhoef, S.

2010-01-01

Li Fraumeni Syndrome (LFS) is a hereditary cancer syndrome characterized by a high risk of developing various types of cancer from birth through late adulthood. Clinical benefits of surveillance for LFS are limited. The aim of this study is to investigate which advice for regular surveillance, if

The Frontlines of Medicine Project: a proposal for the standardized communication of emergency department data for public health uses including syndromic surveillance for biological and chemical terrorism.

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Barthell, Edward N; Cordell, William H; Moorhead, John C; Handler, Jonathan; Feied, Craig; Smith, Mark S; Cochrane, Dennis G; Felton, Christopher W; Collins, Michael A

2002-04-01

The Frontlines of Medicine Project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. This collaboration proposes to develop a nonproprietary, "open systems" approach for reporting emergency department patient data. The common element is a standard approach to sending messages from individual EDs to regional oversight entities that could then analyze the data received. ED encounter data could be used for various public health initiatives, including syndromic surveillance for chemical and biological terrorism. The interlinking of these regional systems could also permit public health surveillance at a national level based on ED patient encounter data. Advancements in the Internet and Web-based technologies could allow the deployment of these standardized tools in a rapid time frame.

Estimating the cost to U.S. health departments to conduct HIV surveillance.

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Shrestha, Ram K; Sansom, Stephanie L; Laffoon, Benjamin T; Farnham, Paul G; Shouse, R Luke; MacMaster, Karen; Hall, H Irene

2014-01-01

HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance. We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale. We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites. Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.

Mobile phone-based syndromic surveillance system, Papua New Guinea.

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Rosewell, Alexander; Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B; Ray, Pradeep; MacIntyre, C Raina

2013-11-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone-based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance.

National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

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Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

2016-01-01

Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

Mobile Phone–based Syndromic Surveillance System, Papua New Guinea

Science.gov (United States)

Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B.; Ray, Pradeep; MacIntyre, C. Raina

2013-01-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone–based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance. PMID:24188144

A methodological framework for the evaluation of syndromic surveillance systems: a case study of England.

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Colón-González, Felipe J; Lake, Iain R; Morbey, Roger A; Elliot, Alex J; Pebody, Richard; Smith, Gillian E

2018-04-24

Syndromic surveillance complements traditional public health surveillance by collecting and analysing health indicators in near real time. The rationale of syndromic surveillance is that it may detect health threats faster than traditional surveillance systems permitting more timely, and hence potentially more effective public health action. The effectiveness of syndromic surveillance largely relies on the methods used to detect aberrations. Very few studies have evaluated the performance of syndromic surveillance systems and consequently little is known about the types of events that such systems can and cannot detect. We introduce a framework for the evaluation of syndromic surveillance systems that can be used in any setting based upon the use of simulated scenarios. For a range of scenarios this allows the time and probability of detection to be determined and uncertainty is fully incorporated. In addition, we demonstrate how such a framework can model the benefits of increases in the number of centres reporting syndromic data and also determine the minimum size of outbreaks that can or cannot be detected. Here, we demonstrate its utility using simulations of national influenza outbreaks and localised outbreaks of cryptosporidiosis. Influenza outbreaks are consistently detected with larger outbreaks being detected in a more timely manner. Small cryptosporidiosis outbreaks (framework constitutes a useful tool for public health emergency preparedness in multiple settings. The proposed framework allows the exhaustive evaluation of any syndromic surveillance system and constitutes a useful tool for emergency preparedness and response.

Evaluation of the ability of standardized supports to improve public health response to syndromic surveillance for respiratory diseases in Canada

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Laura A. Rivera

2017-02-01

Full Text Available Abstract Background Despite widespread implementation of syndromic surveillance systems within public health agencies, previous studies of the implementation and use of these systems have indicated that the functions and responses taken in response to syndromic surveillance data vary widely according to local context and preferences. The objective of the Syndromic Surveillance Evaluation Study was to develop and implement standardized supports in local public health agencies in Ontario, Canada, and evaluate the ability of these supports to affect actions taken as part of public health communicable disease control programs. Methods Local public health agencies (LPHA in Ontario, which used syndromic surveillance based on emergency department visits for respiratory disease, were recruited and randomly allocated to the study intervention or control group. The intervention group health agencies received standardized supports in terms of a standardized aberrant event detection algorithm and a response protocol dictating steps to investigate and assess the public health significance of syndromic surveillance alerts. The control group continued with their pre-existing syndromic surveillance infrastructure and processes. Outcomes were assessed using logbooks, which collected quantitative and qualitative information about alerts received, investigation steps taken, and public health responses. The study was conducted prospectively for 15 months (October 2013 to February 2015. Results Fifteen LPHAs participated in the study (n = 9 intervention group, n = 6 control group. A total of 1,969 syndromic surveillance alerts were received by all LPHAs. Variations in the types and amount of responses varied by LPHA, in particularly differences were noted by the size of the health unit. Smaller health units had more challenges to both detect and mount a response to any alerts. LPHAs in the control group were more likely to declare alerts to have public

Value of syndromic surveillance within the Armed Forces for early warning during a dengue fever outbreak in French Guiana in 2006

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Jefferson Henry

2008-07-01

Full Text Available Abstract Background A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response. Methods Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants. Results It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance. Conclusion Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

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Weirong Yan

Full Text Available BACKGROUND: Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. OBJECTIVE: This study describes the design and pilot implementation of an electronic surveillance system (ISS for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. METHODS: ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP, combining with modern communication and GIS technology. ISS has four interconnected functions: 1 work group and communication group; 2 data source and collection; 3 data visualization; and 4 outbreak detection and alerting. RESULTS: As of Jan. 31(st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. CONCLUSIONS: The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: first report from the prospective Lynch syndrome database

OpenAIRE

Moller, Pal; Seppala, Toni; Bernstein, Inge; Holinski-Feder, Elke; Sala, Paola; Evans, D. Gareth; Lindblom, Annika; Macrae, Finlay; Blanco, Ignacio; Sijmons, Rolf; Jeffries, Jacqueline; Vasen, Hans; Burn, John; Nakken, Sigve; Hovig, Eivind

2017-01-01

Objective Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance.\\ud \\ud Design We undertook a multicentre study of patients carrying Lynch syndrome-associated mutations affecting MLH1, MSH2, MSH6 or PMS2. Standardised information on surveillance, cancers and outcomes were collated in an Oracle rela...

A simulation study comparing aberration detection algorithms for syndromic surveillance

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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.

Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

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Thompson, L H; Malik, M T; Gumel, A; Strome, T; Mahmud, S M

2014-11-01

We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

Signals come and go: syndromic surveillance and styles of biosecurity

OpenAIRE

Lyle Fearnley

2008-01-01

This paper follows the development of a novel biosecurity technology known as ‘syndromic surveillance’. By monitoring new sources of nondiagnostic health information (911 calls, ER triage logs, pharmaceutical sales), syndromic surveillance produces new ‘territories of intelligibility’. But the implemention of syndromic systems—and the opening up of these new territories—poses a problem of interpretation. What is significant in nondiagnostic data flows? In fact, the development of a national s...

The Impact of Law on Syndromic Disease Surveillance Implementation.

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Purtle, Jonathan; Field, Robert I; Hipper, Thomas; Nash-Arott, Jillian; Chernak, Esther; Buehler, James W

Legal environments influence how health information technologies are implemented in public health practice settings. Syndromic disease surveillance (SyS) is a relatively new approach to surveillance that depends heavily on health information technologies to achieve rapid awareness of disease trends. Evidence suggests that legal concerns have impeded the optimization of SyS. To (1) understand the legal environments in which SyS is implemented, (2) determine the perceived legal basis for SyS, and (3) identify perceived legal barriers and facilitators to SyS implementation. Multisite case study in which 35 key informant interviews and 5 focus groups were conducted with 75 SyS stakeholders. Interviews and focus groups were audio recorded, transcribed, and analyzed by 3 coders using thematic content analysis. Legal documents were reviewed. Seven jurisdictions (5 states, 1 county, and 1 city) that were purposively selected on the basis of SyS capacity and legal environment. Health department directors, SyS system administrators, legal counsel, and hospital personnel. Federal (eg, HIPAA) and state (eg, notifiable disease reporting) laws that authorize traditional public health surveillance were perceived as providing a legal basis for SyS. Financial incentives for hospitals to satisfy Meaningful Use regulations have eased concerns about the legality of SyS and increased the number of hospitals reporting SyS data. Legal issues were perceived as barriers to BioSense 2.0 (the federal SyS program) participation but were surmountable. Major legal reforms are not needed to promote more widespread use of SyS. The current legal environment is perceived by health department and hospital officials as providing a firm basis for SyS practice. This is a shift from how law was perceived when SyS adoption began and has policy implications because it indicates that major legal reforms are not needed to promote more widespread use of the technology. Beyond SyS, our study suggests that

Regular surveillance for Li-fraumeni syndrome: advice, adherence and perceived benefits

NARCIS (Netherlands)

C.R.M. Lammens (Chantal); E.M.A. Bleiker (Eveline); N.K. Aaronson (Neil); A. Wagner (Anja); R.H. Sijmons (Rolf); M.G.E.M. Ausems (Margreet); A.H.J.T. Vriends (Anette); M.W.G. Ruijs (Marielle); T.A.M. van Os (Theo); L. Spruijt (Liesbeth); E.B. Gómez García (Encarna); A. Cats (Annemieke); T. Nagtegaal; S. Verhoef

2010-01-01

textabstractLi Fraumeni Syndrome (LFS) is a hereditary cancer syndrome characterized by a high risk of developing various types of cancer from birth through late adulthood. Clinical benefits of surveillance for LFS are limited. The aim of this study is to investigate which advice for regular

Syndromic surveillance for local outbreaks of lower-respiratory infections: would it work?

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Cees C van den Wijngaard

2010-04-01

Full Text Available Although syndromic surveillance is increasingly used to detect unusual illness, there is a debate whether it is useful for detecting local outbreaks. We evaluated whether syndromic surveillance detects local outbreaks of lower-respiratory infections (LRIs without swamping true signals by false alarms.Using retrospective hospitalization data, we simulated prospective surveillance for LRI-elevations. Between 1999-2006, a total of 290762 LRIs were included by date of hospitalization and patients place of residence (>80% coverage, 16 million population. Two large outbreaks of Legionnaires disease in the Netherlands were used as positive controls to test whether these outbreaks could have been detected as local LRI elevations. We used a space-time permutation scan statistic to detect LRI clusters. We evaluated how many LRI-clusters were detected in 1999-2006 and assessed likely causes for the cluster-signals by looking for significantly higher proportions of specific hospital discharge diagnoses (e.g. Legionnaires disease and overlap with regional influenza elevations. We also evaluated whether the number of space-time signals can be reduced by restricting the scan statistic in space or time. In 1999-2006 the scan-statistic detected 35 local LRI clusters, representing on average 5 clusters per year. The known Legionnaires' disease outbreaks in 1999 and 2006 were detected as LRI-clusters, since cluster-signals were generated with an increased proportion of Legionnaires disease patients (p:<0.0001. 21 other clusters coincided with local influenza and/or respiratory syncytial virus activity, and 1 cluster appeared to be a data artifact. For 11 clusters no likely cause was defined, some possibly representing as yet undetected LRI-outbreaks. With restrictions on time and spatial windows the scan statistic still detected the Legionnaires' disease outbreaks, without loss of timeliness and with less signals generated in time (up to 42% decline.To our

An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia

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Chiu Clayton

2005-12-01

Full Text Available Abstract Background In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs. Methods Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum was used to assess the statistical significance of trends. Results During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. Conclusion We have demonstrated the feasibility and potential utility of syndromic surveillance using

Infectious disease surveillance for the London 2012 Olympic and Paralympic Games.

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Severi, E; Heinsbroek, E; Watson, C; Catchpole, M

2012-08-02

The London 2012 Olympic and Paralympic Games will be one of the largest mass gathering events in British history. In order to minimise potential infectious disease threats related to the event, the Health Protection Agency (HPA) has set up a suite of robust and multisource surveillance systems. These include enhancements of already established systems (notification of infectious diseases, local and regional reporting,laboratory surveillance, mortality surveillance, international surveillance, and syndromic surveillance in primary care), as well as new systems created for the Games (syndromic surveillance in emergency departments and out-of-hours/unscheduled care,undiagnosed serious infectious illness surveillance).Enhanced existing and newly established surveillance systems will continue after the Games or will be ready for future reactivation should the need arise. In addition to the direct improvements to surveillance, the strengthening of relationships with national and international stakeholders will constitute a major post-Games legacy for the HPA.

Pain evaluation during gynaecological surveillance in women with Lynch syndrome

NARCIS (Netherlands)

Helder-Woolderink, Jorien; de Bock, Geertruida; Hollema, Harry; van Oven, Magda; Mourits, Marian

To evaluate perceived pain during repetitive annual endometrial sampling at gynaecologic surveillance in asymptomatic women with Lynch syndrome (LS) over time and in addition to symptomatic women without LS, undergoing single endometrial sampling. In this prospective study, 52 women with LS or first

Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

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Jia, Kangbai; Mohamed, Koroma

2015-09-01

Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August

Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance : first report from the prospective Lynch syndrome database

NARCIS (Netherlands)

Moller, Pal; Seppala, Toni; Bernstein, Inge; Holinski-Feder, Elke; Sala, Paola; Evans, D. Gareth; Lindblom, Annika; Macrae, Finlay; Blanco, Ignacio; Sijmons, Rolf; Jeffries, Jacqueline; Vasen, Hans; Burn, John; Nakken, Sigve; Hovig, Eivind; Rodland, Einar Andreas; Tharmaratnam, Kukatharmini; Cappel, Wouter H. de Vos Tot Nederveen; Hill, James; Wijnen, Juul; Green, Kate; Lalloo, Fiona; Sunde, Lone; Mints, Miriam; Bertario, Lucio; Pineda, Marta; Navarro, Matilde; Morak, Monika; Renkonen-Sinisalo, Laura; Frayling, Ian M.; Plazzer, John-Paul; Pylvanainen, Kirsi; Sampson, Julian R.; Capella, Gabriel; Mecklin, Jukka-Pekka; Moslein, Gabriela

Objective Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance. Design We undertook a multicentre

Mining free-text medical records for companion animal enteric syndrome surveillance.

Science.gov (United States)

Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

2014-03-01

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.

Devising an Indicator to Detect Mid-Term Abortions in Dairy Cattle: A First Step Towards Syndromic Surveillance of Abortive Diseases

OpenAIRE

Bronner, Anne; Morignat, Eric; H?naux, Viviane; Madouasse, Aur?lien; Gay, Emilie; Calavas, Didier

2015-01-01

Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy ca...

Development and Application of Syndromic Surveillance for Severe Weather Events Following Hurricane Sandy.

Science.gov (United States)

Tsai, Stella; Hamby, Teresa; Chu, Alvin; Gleason, Jessie A; Goodrow, Gabrielle M; Gu, Hui; Lifshitz, Edward; Fagliano, Jerald A

2016-06-01

Following Hurricane Superstorm Sandy, the New Jersey Department of Health (NJDOH) developed indicators to enhance syndromic surveillance for extreme weather events in EpiCenter, an online system that collects and analyzes real-time chief complaint emergency department (ED) data and classifies each visit by indicator or syndrome. These severe weather indicators were finalized by using 2 steps: (1) key word inclusion by review of chief complaints from cases where diagnostic codes met selection criteria and (2) key word exclusion by evaluating cases with key words of interest that lacked selected diagnostic codes. Graphs compared 1-month, 3-month, and 1-year periods of 8 Hurricane Sandy-related severe weather event indicators against the same period in the following year. Spikes in overall ED visits were observed immediately after the hurricane for carbon monoxide (CO) poisoning, the 3 disrupted outpatient medical care indicators, asthma, and methadone-related substance use. Zip code level scan statistics indicated clusters of CO poisoning and increased medicine refill needs during the 2 weeks after Hurricane Sandy. CO poisoning clusters were identified in areas with power outages of 4 days or longer. This endeavor gave the NJDOH a clearer picture of the effects of Hurricane Sandy and yielded valuable state preparation information to monitor the effects of future severe weather events. (Disaster Med Public Health Preparedness. 2016;10:463-471).

Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

Directory of Open Access Journals (Sweden)

Anne Bronner

Full Text Available Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8 in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24 and 71% (n = 39 of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9% when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5% when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions.

Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

Science.gov (United States)

Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

2015-01-01

Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions.

Surveillance of construction worker injuries through an urban emergency department.

Science.gov (United States)

Hunting, K L; Nessel-Stephens, L; Sanford, S M; Shesser, R; Welch, L S

1994-03-01

To learn more about the causes of nonfatal construction worker injuries, and to identify injury cases for further work-site investigations or prevention programs, an emergency department-based surveillance program was established. Construction workers with work-related injuries or illnesses were identified by reviewing the medical records of all patients treated at the George Washington University Emergency Department between November 1, 1990 and November 31, 1992. Information regarding the worker, the injury, and the injury circumstances were abstracted from medical records. Information was obtained on 592 injured construction workers from numerous trades. Lacerations were the most commonly treated injuries among these workers, followed by strains and sprains, contusions, and eye injuries. Injuries were most commonly caused by sharp objects (n = 155, 26%), falls (n = 106, 18%), and falling objects (n = 70, 12%). Thirty-five percent of injuries were to the hands, wrists, or fingers. Among the twenty-eight injuries severe enough to require hospital admission, eighteen (64%) were caused by falls. Laborers and Hispanic workers were overrepresented among these severe cases. Emergency Department records were a useful surveillance tool for the initial identification and description of work-related injuries. Although E codes were not that useful for formulating prevention strategies, detailed review of injury circumstances from Emergency Department records was valuable and has helped to establish priorities for prevention activities.

Early detection for cases of enterovirus- and influenza-like illness through a newly established school-based syndromic surveillance system in Taipei, January 2010 ~ August 2011.

Directory of Open Access Journals (Sweden)

Ting Chia Weng

Full Text Available School children may transmit pathogens with cluster cases occurring on campuses and in families. In response to the 2009 influenza A (H1N1 pandemic, Taipei City Government officials developed a School-based Infectious Disease Syndromic Surveillance System (SID-SSS. Teachers and nurses from preschools to universities in all 12 districts within Taipei are required to daily report cases of symptomatic children or sick leave requests through the SID-SSS. The pre-diagnosis at schools is submitted firstly as common pediatric disease syndrome-groups and re-submitted after confirmation by physicians. We retrieved these data from January 2010 to August 2011 for spatio-temporal analysis and evaluated the temporal trends with cases obtained from both the Emergency Department-based Syndromic Surveillance System (ED-SSS and the Longitudinal Health Insurance Database 2005 (LHID2005. Through the SID-SSS, enterovirus-like illness (EVI and influenza-like illness (ILI were the two most reported syndrome groups (77.6% and 15.8% among a total of 19,334 cases, respectively. The pre-diagnosis judgments made by school teachers and nurses showed high consistency with physicians' clinical diagnoses for EVI (97.8% and ILI (98.9%. Most importantly, the SID-SSS had better timeliness with earlier peaks of EVI and ILI than those in the ED-SSS. Furthermore, both of the syndrome groups in these two surveillance systems had the best correlation reaching 0.98 and 0.95, respectively (p<0.01. Spatio-temporal analysis observed the patterns of EVI and ILI both diffuse from the northern suburban districts to central Taipei, with ILI spreading faster. This novel system can identify early suspected cases of two important pediatric infections occurring at schools, and clusters from schools/families. It was also cost-effective (95.5% of the operation cost reduced and 59.7% processing time saved. The timely surveillance of mild EVI and ILI cases integrated with spatial analysis may help

Public Health Surveillance Strategies for Mass Gatherings: Super Bowl XLIX and Related Events, Maricopa County, Arizona, 2015.

Science.gov (United States)

Ayala, Aurimar; Berisha, Vjollca; Goodin, Kate; Pogreba-Brown, Kristen; Levy, Craig; McKinney, Benita; Koski, Lia; Imholte, Sara

2016-01-01

Super Bowl XLIX took place on February 1, 2015, in Glendale, Arizona. In preparation for this event and associated activities, the Maricopa County Department of Public Health (MCDPH) developed methods for enhanced surveillance, situational awareness, and early detection of public health emergencies. Surveillance strategies implemented from January 22 to February 6, 2015, included enhanced surveillance alerts; animal disease surveillance; review of NFL clinic visits; syndromic surveillance for emergency room visits, urgent care facilities, and hotels; real-time onsite syndromic surveillance; all-hazards mortality surveillance; emergency medical services surveillance, review of poison control center reports; media surveillance; and aberration detection algorithms for notifiable diseases. Surveillance results included increased influenzalike illness activity reported from urgent care centers and a few influenza cases reported in the NFL clinic. A cyanide single event exposure was investigated and determined not to be a public health threat. Real-time field syndromic surveillance documented minor injuries at all events and sporadic cases of gastrointestinal and neurological (mostly headaches) disease. Animal surveillance reports included a cat suspected of carrying plague and tularemia and an investigation of highly pathogenic avian influenza in a backyard chicken flock. Laboratory results in both instances were negative. Aberration detection and syndromic surveillance detected an increase in measles reports associated with a Disneyland exposure, and syndromic surveillance was used successfully during this investigation. Coordinated enhanced epidemiologic surveillance during Super Bowl XLIX increased the response capacity and preparedness of MCDPH to make informed decisions and take public health actions in a timely manner during these mass gathering events.

Surveillance colonoscopy practice in Lynch syndrome in the Netherlands : A nationwide survey

NARCIS (Netherlands)

Koornstra, Jan J.; Vasen, Hans Fa

2007-01-01

Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), is the most common genetic disorder predisposing to colorectal cancer. As regular colonoscopic surveillance has been shown to reduce the incidence of colorectal cancer, this strategy is recommended worldwide. Recently, several

Enhancing spatial detection accuracy for syndromic surveillance with street level incidence data

Directory of Open Access Journals (Sweden)

Alemi Farrokh

2010-01-01

Full Text Available Abstract Background The Department of Defense Military Health System operates a syndromic surveillance system that monitors medical records at more than 450 non-combat Military Treatment Facilities (MTF worldwide. The Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE uses both temporal and spatial algorithms to detect disease outbreaks. This study focuses on spatial detection and attempts to improve the effectiveness of the ESSENCE implementation of the spatial scan statistic by increasing the spatial resolution of incidence data from zip codes to street address level. Methods Influenza-Like Illness (ILI was used as a test syndrome to develop methods to improve the spatial accuracy of detected alerts. Simulated incident clusters of various sizes were superimposed on real ILI incidents from the 2008/2009 influenza season. Clusters were detected using the spatial scan statistic and their displacement from simulated loci was measured. Detected cluster size distributions were also evaluated for compliance with simulated cluster sizes. Results Relative to the ESSENCE zip code based method, clusters detected using street level incidents were displaced on average 65% less for 2 and 5 mile radius clusters and 31% less for 10 mile radius clusters. Detected cluster size distributions for the street address method were quasi normal and sizes tended to slightly exceed simulated radii. ESSENCE methods yielded fragmented distributions and had high rates of zero radius and oversized clusters. Conclusions Spatial detection accuracy improved notably with regard to both location and size when incidents were geocoded to street addresses rather than zip code centroids. Since street address geocoding success rates were only 73.5%, zip codes were still used for more than one quarter of ILI cases. Thus, further advances in spatial detection accuracy are dependant on systematic improvements in the collection of individual

Collecting syndromic surveillance data by mobile phone in rural India: implementation and feasibility

Directory of Open Access Journals (Sweden)

Vishal Diwan

2015-04-01

Full Text Available Background: Infectious disease surveillance has long been a challenge for countries like India, where 75% of the health care services are private and consist of both formal and informal health care providers. Infectious disease surveillance data are regularly collected from governmental and qualified private facilities, but not from the informal sector. This study describes a mobile-based syndromic surveillance system and its application in a resource-limited setting, collecting data on patients’ symptoms from formal and informal health care providers. Design: The study includes three formal and six informal health care providers from two districts of Madhya Pradesh, India. Data collectors were posted in the clinics during the providers’ working hours and entered patient information and infectious disease symptoms on the mobile-based syndromic surveillance system. Results: Information on 20,424 patients was collected in the mobile-based surveillance system. The five most common (overlapping symptoms were fever (48%, cough (38%, body ache (38%, headache (37%, and runny nose (22%. During the same time period, the government's disease surveillance program reported around 22,000 fever cases in one district as a whole. Our data – from a very small fraction of all health care providers – thus highlight an enormous underreporting in the official surveillance data, which we estimate here to capture less than 1% of the fever cases. Additionally, we found that patients from more than 600 villages visited the nine providers included in our study. Conclusions: The study demonstrated that a mobile-based system can be used for disease surveillance from formal and informal providers in resource-limited settings. People who have not used smartphones or even computers previously can, in a short timeframe, be trained to fill out surveillance forms and submit them from the device. Technology, including network connections, works sufficiently for disease

Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural Hubei Province, China: a temporal simulation model based on healthcare-seeking behaviors.

Science.gov (United States)

Fan, Yunzhou; Wang, Ying; Jiang, Hongbo; Yang, Wenwen; Yu, Miao; Yan, Weirong; Diwan, Vinod K; Xu, Biao; Dong, Hengjin; Palm, Lars; Nie, Shaofa

2014-01-01

Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas. This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness. Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1) outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves. In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp performance of multi-stream surveillance.

Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural Hubei Province, China: a temporal simulation model based on healthcare-seeking behaviors.

Directory of Open Access Journals (Sweden)

Yunzhou Fan

Full Text Available BACKGROUND: Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas. OBJECTIVE: This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness. METHODS: Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1 outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves. RESULTS: In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp <90%. CONCLUSIONS: The temporal simulation model based on healthcare-seeking behaviors offers an accessible method for evaluating the performance of multi-stream surveillance.

Surveillance case definitions for work related upper limb pain syndromes

OpenAIRE

Harrington, J. M.; Carter, J. T.; Birrell, L.; Gompertz, D.

1998-01-01

OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project.

Science.gov (United States)

Khan, Nadeem; Pérez-Núñez, Ricardo; Shamim, Nudrat; Khan, Uzma; Naseer, Naureen; Feroze, Asher; Razzak, Junaid; Hyder, Adnan A

2015-01-01

Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments. The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire. Acute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died. Poisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem.

Monitoring data quality in syndromic surveillance: Learnings from a resource limited setting

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E Venkatarao

2012-01-01

Full Text Available Background: India is in the process of integrating all disease surveillance systems with the support of a World Bank funded program called the Integrated Disease Surveillance System. In this context the objective of the study was to evaluate the components of the Orissa Multi Disease Surveillance System. Materials and Methods: Multistage sampling was carried out, starting with four districts, followed by sequentially sampling two blocks; and in each block, two sectors and two health sub-centers were selected, all based on the best and worst performances. Two study instruments were developed for data validation, for assessing the components of the surveillance and diagnostic algorithm. The Organizational Ethics Group reviewed and approved the study. Results: In all 178 study subjects participated in the survey. The case definition of suspected meningitis in disease surveillance was found to be difficult, with only 29.94%, who could be correctly identified. Syndromic diagnosis following the diagnostic algorithm was difficult for suspected malaria (28.1%, ′unusual syndrome′ (28.1%, and simple diarrhea (62%. Only 17% could correctly answer questions on follow-up cases, but only 50% prioritized diseases. Our study showed that 54% cross-checked the data before compilation. Many (22% faltered on timeliness even during emergencies. The constraints identified were logistics (56% and telecommunication (41%. The reason for participation in surveillance was job responsibility (34.83%. Conclusions: Most of the deficiencies arose from human errors when carrying out day-to-day processes of surveillance activities, hence, should be improved by retraining. Enhanced laboratory support and electronic transmission would improve data quality and timeliness. Validity of some of the case definitions need to be rechecked. Training Programs should focus on motivating the surveillance personnel.

Human temperatures for syndromic surveillance in the emergency department: data from the autumn wave of the 2009 swine flu (H1N1) pandemic and a seasonal influenza outbreak.

Science.gov (United States)

Bordonaro, Samantha F; McGillicuddy, Daniel C; Pompei, Francesco; Burmistrov, Dmitriy; Harding, Charles; Sanchez, Leon D

2016-03-09

The emergency department (ED) increasingly acts as a gateway to the evaluation and treatment of acute illnesses. Consequently, it has also become a key testing ground for systems that monitor and identify outbreaks of disease. Here, we describe a new technology that automatically collects body temperatures during triage. The technology was tested in an ED as an approach to monitoring diseases that cause fever, such as seasonal flu and some pandemics. Temporal artery thermometers that log temperature measurements were placed in a Boston ED and used for initial triage vital signs. Time-stamped measurements were collected from the thermometers to investigate the performance a real-time system would offer. The data were summarized in terms of rates of fever (temperatures ≥100.4 °F [≥38.0 °C]) and were qualitatively compared with regional disease surveillance programs in Massachusetts. From September 2009 through August 2011, 71,865 body temperatures were collected and included in our analysis, 2073 (2.6 %) of which were fevers. The period of study included the autumn-winter wave of the 2009-2010 H1N1 (swine flu) pandemic, during which the weekly incidence of fever reached a maximum of 5.6 %, as well as the 2010-2011 seasonal flu outbreak, during which the maximum weekly incidence of fever was 6.6 %. The periods of peak fever rates corresponded with the periods of regionally elevated flu activity. Temperature measurements were monitored at triage in the ED over a period of 2 years. The resulting data showed promise as a potential surveillance tool for febrile disease that could complement current disease surveillance systems. Because temperature can easily be measured by non-experts, it might also be suitable for monitoring febrile disease activity in schools, workplaces, and transportation hubs, where many traditional syndromic indicators are impractical. However, the system's validity and generalizability should be evaluated in additional years and

U.S. Department of Energy Office of Occupational Medicine and Medical Surveillance 1995--1997 triannual report

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-08-01

From 1995 through 1997 the Office of Occupational Medicine and Medical Surveillance (EH-61) has made numerous achievements that have enhanced the performance of the office and more importantly, the Department of Energy (DOE). This report provides specific information about program activities and accomplishments, as well as individual contacts for each program. The mission of EH-61 is the prevention of worker illness by fostering outstanding occupational medicine and medical surveillance programs within the DOE complex. This mission is being realized as a result of efforts in four main business lines: (1) Surveillance; (2) Research, (3) Policy/Technical Support; and (4) Information/Communication.

Progress in Global Surveillance and Response Capacity 10 Years After Severe Acute Respiratory Syndrome

Centers for Disease Control (CDC) Podcasts

2013-04-10

Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseases' synopsis, Progress in Global Surveillance and Response Capacity 10 Years after Severe Acute Respiratory Syndrome.  Created: 4/10/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/11/2013.

The impact of thunderstorm asthma on emergency department attendances across London during July 2013.

Science.gov (United States)

Elliot, A J; Hughes, H E; Hughes, T C; Locker, T E; Brown, R; Sarran, C; Clewlow, Y; Murray, V; Bone, A; Catchpole, M; McCloskey, B; Smith, G E

2014-08-01

This study illustrates the potential of using emergency department attendance data, routinely accessed as part of a national syndromic surveillance system, to monitor the impact of thunderstorm asthma. The Emergency Department Syndromic Surveillance System (EDSSS) routinely monitors anonymised attendance data on a daily basis across a sentinel network of 35 emergency departments. Attendance data for asthma, wheeze and difficulty breathing are analysed on a daily basis. A statistically significant spike in asthma attendances in two EDSSS emergency departments in London was detected on 23 July 2013, coinciding with a series of large violent thunderstorms across southern England. There was also an increase in the reported severity of these attendances. This preliminary report illustrates the potential of the EDSSS to monitor the impact of thunderstorms on emergency department asthma attendances. Further work will focus on how this system can be used to quantify the impact on emergency departments, thus potentially improving resource planning and also adding to the thunderstorm asthma evidence-base. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Syndromic surveillance system based on near real-time cattle mortality monitoring.

Science.gov (United States)

Torres, G; Ciaravino, V; Ascaso, S; Flores, V; Romero, L; Simón, F

2015-05-01

Early detection of an infectious disease incursion will minimize the impact of outbreaks in livestock. Syndromic surveillance based on the analysis of readily available data can enhance traditional surveillance systems and allow veterinary authorities to react in a timely manner. This study was based on monitoring the number of cattle carcasses sent for rendering in the veterinary unit of Talavera de la Reina (Spain). The aim was to develop a system to detect deviations from expected values which would signal unexpected health events. Historical weekly collected dead cattle (WCDC) time series stabilized by the Box-Cox transformation and adjusted by the minimum least squares method were used to build the univariate cycling regression model based on a Fourier transformation. Three different models, according to type of production system, were built to estimate the baseline expected number of WCDC. Two types of risk signals were generated: point risk signals when the observed value was greater than the upper 95% confidence interval of the expected baseline, and cumulative risk signals, generated by a modified cumulative sum algorithm, when the cumulative sums of reported deaths were above the cumulative sum of expected deaths. Data from 2011 were used to prospectively validate the model generating seven risk signals. None of them were correlated to infectious disease events but some coincided, in time, with very high climatic temperatures recorded in the region. The harvest effect was also observed during the first week of the study year. Establishing appropriate risk signal thresholds is a limiting factor of predictive models; it needs to be adjusted based on experience gained during the use of the models. To increase the sensitivity and specificity of the predictions epidemiological interpretation of non-specific risk signals should be complemented by other sources of information. The methodology developed in this study can enhance other existing early detection

Interval colon cancer in a Lynch syndrome patient under annual colonoscopic surveillance: a case for advanced imaging techniques?

Directory of Open Access Journals (Sweden)

Oxentenko Amy S

2012-05-01

Full Text Available Abstract Background Lynch syndrome confers increased risk for various malignancies, including colorectal cancer. Colonoscopic surveillance programs have led to reduced incidence of colorectal cancer and reduced mortality from colorectal cancer. Colonoscopy every 1–2 years beginning at age 20–25, or 10 years earlier than the first diagnosis of colorectal cancer in a family, with annual colonoscopy after age 40, is the recommended management for mutation carriers. Screening programs have reduced colon cancer mortality, but interval cancers may occur. Case presentation We describe a 48-year-old woman with Lynch syndrome who was found to have an adenoma with invasive colorectal cancer within one year after a normal colonoscopy. Conclusion Our patient illustrates two current concepts about Lynch syndrome: 1 adenomas are the cancer precursor and 2 such adenomas may be “aggressive,” in the sense that the adenoma progresses more readily and more rapidly to carcinoma in this setting compared to usual colorectal adenomas. Our patient’s resected tumor invaded only into submucosa and all lymph nodes were negative; in that sense, she represents a success for annual colonoscopic surveillance. Still, this case does raise the question of whether advanced imaging techniques are advisable for surveillance colonoscopy in these high-risk patients.

A Rare Case in the Emergency Department: Holmes-Adie Syndrome

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Sahin COLAK

2015-03-01

Full Text Available SUMMARY: Holmes-Adie syndrome (HAS is a rare syndrome characterized by tonic pupil and the absence of deep tendon reflexes. HAS was first described in 1931 and is usually idiopathic, with incidences reported to be 4-7 per 100,000. Although tonic pupil is usually unilateral, it can also be bilateral. Enlarged and irregular pupil is usually noticed by the patient. Light reflex is weak or unresponsive. Another characteristic of HAS is the absence of deep tendon reflexes, and unilateral involvement is more common. This case report emphasizes that HAS should be considered in the differential diagnosis of patients presenting to the emergency department with anisocoria, and the dilute pilocarpine test can be used in diagnosis. Key words: Emergency department, Holmes-Adie syndrome, pilocarpine

Methodological challenges to multivariate syndromic surveillance: a case study using Swiss animal health data.

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Vial, Flavie; Wei, Wei; Held, Leonhard

2016-12-20

In an era of ubiquitous electronic collection of animal health data, multivariate surveillance systems (which concurrently monitor several data streams) should have a greater probability of detecting disease events than univariate systems. However, despite their limitations, univariate aberration detection algorithms are used in most active syndromic surveillance (SyS) systems because of their ease of application and interpretation. On the other hand, a stochastic modelling-based approach to multivariate surveillance offers more flexibility, allowing for the retention of historical outbreaks, for overdispersion and for non-stationarity. While such methods are not new, they are yet to be applied to animal health surveillance data. We applied an example of such stochastic model, Held and colleagues' two-component model, to two multivariate animal health datasets from Switzerland. In our first application, multivariate time series of the number of laboratories test requests were derived from Swiss animal diagnostic laboratories. We compare the performance of the two-component model to parallel monitoring using an improved Farrington algorithm and found both methods yield a satisfactorily low false alarm rate. However, the calibration test of the two-component model on the one-step ahead predictions proved satisfactory, making such an approach suitable for outbreak prediction. In our second application, the two-component model was applied to the multivariate time series of the number of cattle abortions and the number of test requests for bovine viral diarrhea (a disease that often results in abortions). We found that there is a two days lagged effect from the number of abortions to the number of test requests. We further compared the joint modelling and univariate modelling of the number of laboratory test requests time series. The joint modelling approach showed evidence of superiority in terms of forecasting abilities. Stochastic modelling approaches offer the

A cost-effectiveness analysis of three components of a syndromic surveillance system for the early warning of epidemics in rural China.

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Ding, Yan; Sauerborn, Rainer; Xu, Biao; Shaofa, Nie; Yan, Weirong; Diwan, Vinod K; Dong, Hengjin

2015-11-14

Syndromic surveillance systems (SSSs) collect non-specific syndromes in early stages of disease outbreaks. This makes an SSS a promising tool for the early detection of epidemics. An Integrated Surveillance System in rural China (ISSC project), which added an SSS to the existing Chinese surveillance system for the early warning of epidemics, was implemented from April 2012 to March 2014 in Jiangxi and Hubei Provinces. This study aims to measure the costs and effectiveness of the three components of the SSS in the ISSC project. The central measures of the cost-effectiveness analysis of the three components of the syndromic surveillance system were: 1) the costs per reported event, respectively, at the health facilities, the primary schools and the pharmacies; and 2) the operating costs per surveillance unit per year, respectively, at the health facilities, the primary schools and the pharmacies. Effectiveness was expressed by reporting outputs which were numbers of reported events, numbers of raw signals, and numbers of verified signals. The reported events were tracked through an internal data base. Signal verification forms and epidemiological investigation reports were collected from local country centers for disease control and prevention. We adopted project managers' perspective for the cost analysis. Total costs included set-up costs (system development and training) and operating costs (data collection, quality control and signal verification). We used self-designed questionnaires to collect cost data and received, respectively, 369 and 477 facility and staff questionnaires through a cross-sectional survey with a purposive sampling following the ISSC project. All data were entered into Epidata 3.02 and exported to Stata for descriptive analysis. The number of daily reported events per unit was the highest at pharmacies, followed by health facilities and finally primary schools. Variances existed within the three groups and also between Jiangxi and Hubei

Syndromic surveillance for West Nile virus using raptors in rehabilitation.

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Ana, Alba; Perez Andrés, M; Julia, Ponder; Pedro, Puig; Arno, Wünschmann; Kimberly, Vander Waal; Julio, Alvarez; Michelle, Willette

2017-11-29

Wildlife rehabilitation centers routinely gather health-related data from diverse species. Their capability to signal the occurrence of emerging pathogens and improve traditional surveillance remains largely unexplored. This paper assessed the utility for syndromic surveillance of raptors admitted to The Raptor Center (TRC) to signal circulation of West Nile Virus (WNV) in Minnesota between 1990 and 2014. An exhaustive descriptive analysis using grouping time series structures and models of interrupted times series was conducted for indicator subsets. A total of 13,080 raptors were monitored. The most representative species were red-tailed hawks, great horned owls, Cooper's hawks, American kestrels and bald eagles. Results indicated that temporal patterns of accessions at the TRC changed distinctively after the incursion of WNV in 2002. The frequency of hawks showing WNV-like signs increased almost 3 times during July and August, suggesting that monitoring of hawks admitted to TRC with WNV-like signs could serve as an indicator of WNV circulation. These findings were also supported by the results of laboratory diagnosis. This study demonstrates that monitoring of data routinely collected by wildlife rehabilitation centers has the potential to signal the spread of pathogens that may affect wild, domestic animals and humans, thus supporting the early detection of disease incursions in a region and monitoring of disease trends. Ultimately, data collected in rehabilitation centers may provide insights to efficiently allocate financial and human resources on disease prevention and surveillance.

Correcting for day of the week and public holiday effects: improving a national daily syndromic surveillance service for detecting public health threats.

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Buckingham-Jeffery, Elizabeth; Morbey, Roger; House, Thomas; Elliot, Alex J; Harcourt, Sally; Smith, Gillian E

2017-05-19

As service provision and patient behaviour varies by day, healthcare data used for public health surveillance can exhibit large day of the week effects. These regular effects are further complicated by the impact of public holidays. Real-time syndromic surveillance requires the daily analysis of a range of healthcare data sources, including family doctor consultations (called general practitioners, or GPs, in the UK). Failure to adjust for such reporting biases during analysis of syndromic GP surveillance data could lead to misinterpretations including false alarms or delays in the detection of outbreaks. The simplest smoothing method to remove a day of the week effect from daily time series data is a 7-day moving average. Public Health England developed the working day moving average in an attempt also to remove public holiday effects from daily GP data. However, neither of these methods adequately account for the combination of day of the week and public holiday effects. The extended working day moving average was developed. This is a further data-driven method for adding a smooth trend curve to a time series graph of daily healthcare data, that aims to take both public holiday and day of the week effects into account. It is based on the assumption that the number of people seeking healthcare services is a combination of illness levels/severity and the ability or desire of patients to seek healthcare each day. The extended working day moving average was compared to the seven-day and working day moving averages through application to data from two syndromic indicators from the GP in-hours syndromic surveillance system managed by Public Health England. The extended working day moving average successfully smoothed the syndromic healthcare data by taking into account the combined day of the week and public holiday effects. In comparison, the seven-day and working day moving averages were unable to account for all these effects, which led to misleading smoothing

Using real-time syndromic surveillance systems to help explore the acute impact of the air pollution incident of March/April 2014 in England.

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Smith, Gillian E; Bawa, Zharain; Macklin, Yolande; Morbey, Roger; Dobney, Alec; Vardoulakis, Sotiris; Elliot, Alex J

2015-01-01

During March and early April 2014 there was widespread poor air quality across the United Kingdom. Public Health England used existing syndromic surveillance systems to monitor community health during the period. Short lived statistically significant rises in a variety of respiratory conditions, including asthma and wheeze, were detected. This incident has demonstrated the value of real-time syndromic surveillance systems, during an air pollution episode, for helping to explore the impact of poor air quality on community health in real-time. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Pain evaluation during gynaecological surveillance in women with Lynch syndrome.

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Helder-Woolderink, Jorien; de Bock, Geertruida; Hollema, Harry; van Oven, Magda; Mourits, Marian

2017-04-01

To evaluate perceived pain during repetitive annual endometrial sampling at gynaecologic surveillance in asymptomatic women with Lynch syndrome (LS) over time and in addition to symptomatic women without LS, undergoing single endometrial sampling. In this prospective study, 52 women with LS or first degree relatives who underwent repetitive annual gynaecological surveillance including endometrial sampling of which 33 were evaluated twice or more and 50 symptomatic women without LS who had single endometrial sampling, were included. Pain intensity was registered with VAS scores. Differences in pain intensities between subsequent visits (in LS) and between the two groups were evaluated. The use of painkillers before endometrial sampling was registered. If women with LS decided for preventive surgery, the reason was recorded. The LS group reported a median VAS score of 5.0 (range 0-10) at the first surveillance (n = 52) and at the second visit (n = 24). Women who repeatedly underwent endometrial sampling more often used painkillers for this procedure. During the study period 7/52 (13 %) women with LS choose for preventive surgery, another 4/52 (8 %) refused further endometrial sampling. Painful endometrial sampling was mentioned as main reason to quit screening. The median VAS score of the 50 symptomatic women was 5.0 (range 1-9). Endometrial sampling, irrespective of indication, is a painful procedure, with a median VAS score of 5.0. During subsequent procedures in women with LS, the median pain score does not aggravate although one in five women chose an alternative for endometrial sampling.

Gerstmann's syndrome and unilateral optic ataxia in the emergency department

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Barbosa, Breno José Alencar Pires; de Brito, Marcelo Houat; Rodrigues, Júlia Chartouni; Kubota, Gabriel Taricani; Parmera, Jacy Bezerra

2017-01-01

ABSTRACT. A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke. PMID:29354229

Gerstmann's syndrome and unilateral optic ataxia in the emergency department

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Breno José Alencar Pires Barbosa

Full Text Available ABSTRACT. A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.

Correcting for day of the week and public holiday effects: improving a national daily syndromic surveillance service for detecting public health threats

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Elizabeth Buckingham-Jeffery

2017-05-01

Full Text Available Abstract Background As service provision and patient behaviour varies by day, healthcare data used for public health surveillance can exhibit large day of the week effects. These regular effects are further complicated by the impact of public holidays. Real-time syndromic surveillance requires the daily analysis of a range of healthcare data sources, including family doctor consultations (called general practitioners, or GPs, in the UK. Failure to adjust for such reporting biases during analysis of syndromic GP surveillance data could lead to misinterpretations including false alarms or delays in the detection of outbreaks. The simplest smoothing method to remove a day of the week effect from daily time series data is a 7-day moving average. Public Health England developed the working day moving average in an attempt also to remove public holiday effects from daily GP data. However, neither of these methods adequately account for the combination of day of the week and public holiday effects. Methods The extended working day moving average was developed. This is a further data-driven method for adding a smooth trend curve to a time series graph of daily healthcare data, that aims to take both public holiday and day of the week effects into account. It is based on the assumption that the number of people seeking healthcare services is a combination of illness levels/severity and the ability or desire of patients to seek healthcare each day. The extended working day moving average was compared to the seven-day and working day moving averages through application to data from two syndromic indicators from the GP in-hours syndromic surveillance system managed by Public Health England. Results The extended working day moving average successfully smoothed the syndromic healthcare data by taking into account the combined day of the week and public holiday effects. In comparison, the seven-day and working day moving averages were unable to account for all

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.

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Lee, David C; Long, Judith A; Wall, Stephen P; Carr, Brendan G; Satchell, Samantha N; Braithwaite, R Scott; Elbel, Brian

2015-09-01

We sought to improve public health surveillance by using a geographic analysis of emergency department (ED) visits to determine local chronic disease prevalence. Using an all-payer administrative database, we determined the proportion of unique ED patients with diabetes, hypertension, or asthma. We compared these rates to those determined by the New York City Community Health Survey. For diabetes prevalence, we also analyzed the fidelity of longitudinal estimates using logistic regression and determined disease burden within census tracts using geocoded addresses. We identified 4.4 million unique New York City adults visiting an ED between 2009 and 2012. When we compared our emergency sample to survey data, rates of neighborhood diabetes, hypertension, and asthma prevalence were similar (correlation coefficient = 0.86, 0.88, and 0.77, respectively). In addition, our method demonstrated less year-to-year scatter and identified significant variation of disease burden within neighborhoods among census tracts. Our method for determining chronic disease prevalence correlates with a validated health survey and may have higher reliability over time and greater granularity at a local level. Our findings can improve public health surveillance by identifying local variation of disease prevalence.

Molecular changes preceding endometrial and ovarian cancer: a study of consecutive endometrial specimens from Lynch syndrome surveillance.

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Niskakoski, Anni; Pasanen, Annukka; Lassus, Heini; Renkonen-Sinisalo, Laura; Kaur, Sippy; Mecklin, Jukka-Pekka; Bützow, Ralf; Peltomäki, Päivi

2018-03-27

Molecular alterations preceding endometrial and ovarian cancer and the sequence of events are unknown. Consecutive specimens from lifelong surveillance for Lynch syndrome provides a natural setting to address such questions. To molecularly define the multistep gynecological tumorigenesis, DNA mismatch repair gene mutation carriers with endometrial or ovarian carcinoma or endometrial hyperplasia were identified from a nation-wide registry and endometrial biopsy specimens taken from these individuals during 20 years of screening were collected. A total of 213 endometrial and ovarian specimens from Lynch syndrome individuals and 197 histology-matched (non-serous) samples from sporadic cases were available for this investigation. The specimens were profiled for markers linked to endometrial and ovarian tumorigenesis, including ARID1A protein expression, mismatch repair status, and tumor suppressor gene promoter methylation. In Lynch syndrome-associated endometrial and ovarian carcinomas, ARID1A protein was lost in 61-100% and mismatch repair was deficient in 97-100%, compared to 0-17% and 14-44% in sporadic cases (P = 0.000). ARID1A loss appeared in complex hyperplasia and deficient mismatch repair and tumor suppressor gene promoter methylation in histologically normal endometrium. Despite quantitative differences between Lynch syndrome and sporadic cases, ARID1A expression, mismatch repair, and tumor suppressor gene promoter methylation divided endometrial samples from both patient groups into three categories of increasing abnormality, comprising normal endometrium and simple hyperplasia (I), complex hyperplasia with or without atypia (II), and endometrial cancer (III). Complex hyperplasias without vs. with atypia were molecularly indistinguishable. In conclusion, surveillance specimens from Lynch syndrome identify mismatch repair deficiency, tumor suppressor gene promoter methylation, and ARID1A loss as early changes in tumor development. Our findings are

Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance

DEFF Research Database (Denmark)

Møller, Pål; Seppälä, Toni; Bernstein, Inge

2017-01-01

study of patients carrying Lynch syndrome-associated mutations affecting MLH1, MSH2, MSH6 or PMS2. Standardised information on surveillance, cancers and outcomes were collated in an Oracle relational database and analysed by age, sex and mutated gene. RESULTS: 1942 mutation carriers without previous...... carriers. Among first cancer detected in each patient the colorectal cancer cumulative incidences at 70 years by gene were 46%, 35%, 20% and 10% for MLH1, MSH2, MSH6 and PMS2 mutation carriers, respectively. The equivalent cumulative incidences for endometrial cancer were 34%, 51%, 49% and 24......%; and for ovarian cancer 11%, 15%, 0% and 0%. Ten-year crude survival was 87% after any cancer, 91% if the first cancer was colorectal, 98% if endometrial and 89% if ovarian. CONCLUSIONS: The four Lynch syndrome-associated genes had different penetrance and expression. Colorectal cancer occurred frequently despite...

Distributed data processing for public health surveillance

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Yih Katherine

2006-09-01

Full Text Available Abstract Background Many systems for routine public health surveillance rely on centralized collection of potentially identifiable, individual, identifiable personal health information (PHI records. Although individual, identifiable patient records are essential for conditions for which there is mandated reporting, such as tuberculosis or sexually transmitted diseases, they are not routinely required for effective syndromic surveillance. Public concern about the routine collection of large quantities of PHI to support non-traditional public health functions may make alternative surveillance methods that do not rely on centralized identifiable PHI databases increasingly desirable. Methods The National Bioterrorism Syndromic Surveillance Demonstration Program (NDP is an example of one alternative model. All PHI in this system is initially processed within the secured infrastructure of the health care provider that collects and holds the data, using uniform software distributed and supported by the NDP. Only highly aggregated count data is transferred to the datacenter for statistical processing and display. Results Detailed, patient level information is readily available to the health care provider to elucidate signals observed in the aggregated data, or for ad hoc queries. We briefly describe the benefits and disadvantages associated with this distributed processing model for routine automated syndromic surveillance. Conclusion For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI – a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required.

Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.

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Buehler, James W; Hopkins, Richard S; Overhage, J Marc; Sosin, Daniel M; Tong, Van

2004-05-07

The threat of terrorism and high-profile disease outbreaks has drawn attention to public health surveillance systems for early detection of outbreaks. State and local health departments are enhancing existing surveillance systems and developing new systems to better detect outbreaks through public health surveillance. However, information is limited about the usefulness of surveillance systems for outbreak detection or the best ways to support this function. This report supplements previous guidelines for evaluating public health surveillance systems. Use of this framework is intended to improve decision-making regarding the implementation of surveillance for outbreak detection. Use of a standardized evaluation methodology, including description of system design and operation, also will enhance the exchange of information regarding methods to improve early detection of outbreaks. The framework directs particular attention to the measurement of timeliness and validity for outbreak detection. The evaluation framework is designed to support assessment and description of all surveillance approaches to early detection, whether through traditional disease reporting, specialized analytic routines for aberration detection, or surveillance using early indicators of disease outbreaks, such as syndromic surveillance.

Development of an electronic emergency department-based geo-information injury surveillance system in Hong Kong.

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Chow, C B; Leung, M; Lai, Adela; Chow, Y H; Chung, Joanne; Tong, K M; Lit, Albert

2012-06-01

To describe the experience in the development of an electronic emergency department (ED)-based injury surveillance (IS) system in Hong Kong using data-mining and geo-spatial information technology (IT) for a Safe Community setup. This paper described the phased development of an emergency department-based IS system based on World Health Organization (WHO) injury surveillance Guideline to support safety promotion and injury prevention in a Safe Community in Hong Kong starting 2002. The initial ED data-based only collected data on name, sex, age, address, eight general categories of injury types (traffic, domestic, common assault, indecent assault, batter, industrial, self-harm and sports) and disposal from ED. Phase 1--manual data collection on International Classification of External Causes of Injury pre-event data; Phase 2--manual form was converted to electronic format using web-based data mining technology with built in data quality monitoring mechanism; Phase 3--integration of injury surveillance-data with in-patient hospital information; and Phase 4--geo-spatial information and body mapping were introduced to geo-code exact place of injury in an electronic map and site of injury on body map. It was feasible to develop a geo-spatial IS system at busy ED to collect valuable information for safety promotion and injury prevention at Safe Community setting. The keys for successful development and implementation involves engagement of all stakeholders at design and implementation of the system with injury prevention as ultimate goal, detail workflow planning at front end, support from the management, building on exiting system and appropriate utilisation of modern technology. Copyright © 2011 Elsevier Ltd. All rights reserved.

Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe

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Ziemann, Alexandra; Rosenkötter, Nicole; Riesgo, Luis Garcia-Castrillo

2015-01-01

BACKGROUND: The revised World Health Organization's International Health Regulations (2005) request a timely and all-hazard approach towards surveillance, especially at the subnational level. We discuss three questions of syndromic surveillance application in the European context for assessing...... public health emergencies of international concern: (i) can syndromic surveillance support countries, especially the subnational level, to meet the International Health Regulations (2005) core surveillance capacity requirements, (ii) are European syndromic surveillance systems comparable to enable cross...... effect of different types of public health emergencies in a timely manner as required by the International Health Regulations (2005)....

Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

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Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.

Syndromic surveillance using veterinary laboratory data: algorithm combination and customization of alerts.

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Dórea, Fernanda C; McEwen, Beverly J; McNab, W Bruce; Sanchez, Javier; Revie, Crawford W

2013-01-01

Syndromic surveillance research has focused on two main themes: the search for data sources that can provide early disease detection; and the development of efficient algorithms that can detect potential outbreak signals. This work combines three algorithms that have demonstrated solid performance in detecting simulated outbreak signals of varying shapes in time series of laboratory submissions counts. These are: the Shewhart control charts designed to detect sudden spikes in counts; the EWMA control charts developed to detect slow increasing outbreaks; and the Holt-Winters exponential smoothing, which can explicitly account for temporal effects in the data stream monitored. A scoring system to detect and report alarms using these algorithms in a complementary way is proposed. The use of multiple algorithms in parallel resulted in increased system sensitivity. Specificity was decreased in simulated data, but the number of false alarms per year when the approach was applied to real data was considered manageable (between 1 and 3 per year for each of ten syndromic groups monitored). The automated implementation of this approach, including a method for on-line filtering of potential outbreak signals is described. The developed system provides high sensitivity for detection of potential outbreak signals while also providing robustness and flexibility in establishing what signals constitute an alarm. This flexibility allows an analyst to customize the system for different syndromes.

Probabilistic daily ILI syndromic surveillance with a spatio-temporal Bayesian hierarchical model.

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Ta-Chien Chan

Full Text Available BACKGROUND: For daily syndromic surveillance to be effective, an efficient and sensible algorithm would be expected to detect aberrations in influenza illness, and alert public health workers prior to any impending epidemic. This detection or alert surely contains uncertainty, and thus should be evaluated with a proper probabilistic measure. However, traditional monitoring mechanisms simply provide a binary alert, failing to adequately address this uncertainty. METHODS AND FINDINGS: Based on the Bayesian posterior probability of influenza-like illness (ILI visits, the intensity of outbreak can be directly assessed. The numbers of daily emergency room ILI visits at five community hospitals in Taipei City during 2006-2007 were collected and fitted with a Bayesian hierarchical model containing meteorological factors such as temperature and vapor pressure, spatial interaction with conditional autoregressive structure, weekend and holiday effects, seasonality factors, and previous ILI visits. The proposed algorithm recommends an alert for action if the posterior probability is larger than 70%. External data from January to February of 2008 were retained for validation. The decision rule detects successfully the peak in the validation period. When comparing the posterior probability evaluation with the modified Cusum method, results show that the proposed method is able to detect the signals 1-2 days prior to the rise of ILI visits. CONCLUSIONS: This Bayesian hierarchical model not only constitutes a dynamic surveillance system but also constructs a stochastic evaluation of the need to call for alert. The monitoring mechanism provides earlier detection as well as a complementary tool for current surveillance programs.

An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

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Christian Napoli

2014-08-01

Full Text Available Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context.

Automated real time constant-specificity surveillance for disease outbreaks

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Brownstein John S

2007-06-01

Full Text Available Abstract Background For real time surveillance, detection of abnormal disease patterns is based on a difference between patterns observed, and those predicted by models of historical data. The usefulness of outbreak detection strategies depends on their specificity; the false alarm rate affects the interpretation of alarms. Results We evaluate the specificity of five traditional models: autoregressive, Serfling, trimmed seasonal, wavelet-based, and generalized linear. We apply each to 12 years of emergency department visits for respiratory infection syndromes at a pediatric hospital, finding that the specificity of the five models was almost always a non-constant function of the day of the week, month, and year of the study (p Conclusion Modeling the variance of visit patterns enables real-time detection with known, constant specificity at all times. With constant specificity, public health practitioners can better interpret the alarms and better evaluate the cost-effectiveness of surveillance systems.

Association of Mismatch Repair Mutation With Age at Cancer Onset in Lynch Syndrome: Implications for Stratified Surveillance Strategies.

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Ryan, Neil A J; Morris, Julie; Green, Kate; Lalloo, Fiona; Woodward, Emma R; Hill, James; Crosbie, Emma J; Evans, D Gareth

2017-12-01

Lynch syndrome is caused by dominantly inherited germline mutations that predispose individuals to colorectal, endometrial, ovarian, and other cancers through inactivation of the cellular mismatch repair system. Lynch syndrome–associated cancers are amenable to surveillance strategies that may improve survival. The age at which surveillance should start is disputed. To determine whether mutated gene and type of mutation influence age at onset of Lynch syndrome–associated cancers. A retrospective cohort study of individuals with Lynch syndrome–associated colorectal, endometrial, and/or ovarian cancers whose medical records were included in the clinical database of a large quaternary referral center for genomic medicine in the Northwest of England. Mutated gene (MLH1, MSH2, MSH6, and/or PMS2) and type of mutation (truncating, splicing, or large rearrangement). Age at cancer diagnosis. A total of 1063 individuals with proven Lynch syndrome were included, 495 male and 568 female (mean age 52 years; age range, 10-93 years [children were included in the database, but no children developed cancer]). There were 546 men and women with colorectal cancer, 162 women with endometrial cancer, and 49 women with ovarian cancer; mean follow-up was 68.2 months. Among MLH1 mutation carriers, mutations in MLH1 were associated with colorectal cancer in 249 (61%) of 409 men and women; endometrial cancer in 53 of 196 (27%) women; and ovarian cancer in 15 (8%) of 196 women. Among MSH2 mutation carriers, mutations in MSH2 (the most prevalent mutations overall) were most commonly associated with female-specific cancers: endometrial cancer in 83 (30%) of 279 women; ovarian cancer in 28 (10%) of 279 women; and colorectal cancer in 239 (50%) 479 men and women. Mutations in MSH6 were less prevalent, and MSH6 mutation carriers presented with colorectal and endometrial cancer at later ages than carriers of mutations in MSH2 or MLH1. When stratified by mutation type, women with truncating

Enhanced Surveillance for the Sports Festival in Tokyo 2013: Preparation for the Tokyo 2020 Olympic and Paralympic Games.

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Shimatani, Naotaka; Sugishita, Yoshiyuki; Sugawara, Tamie; Nakamura, Yuuki; Ohkusa, Yasushi; Yamagishi, Takuya; Matsui, Tamano; Kawano, Masashi; Watase, Hirotoshi; Morikawa, Yukiko; Oishi, Kazunori

2015-01-01

Enhanced surveillance was conducted during the Sports Festival in Tokyo 2013 (September 28-October 14, 2013) for early detection of outbreaks of infectious diseases and other health emergencies. Through this enhanced surveillance, 15 cases were found that required additional gathering of information outside the routine process of creating/evaluating the Daily Report. However, none of these was assessed as critical. Through the enhanced surveillance, we structured a framework that allows for earlier response when detecting aberrations. It includes the role of the Tokyo Metropolitan Government in communications and contacts with relevant parties such as public health centers, as well as in monitoring of surveillance data. However, some issues need to be further considered toward the Tokyo 2020 Olympic and Paralympic Games, such as establishing the criteria for additional response steps, increasing the number of participating bodies in syndromic surveillance, and strengthening of cooperation with related departments, including those for crisis management assuming potential biological/chemical terrorism.

Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan.

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He, Siran; Lunnen, Jeffrey C; Zia, Nukhba; Khan, Uzma; Shamim, Khusro; Hyder, Adnan A

2015-01-01

Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning

Developing syndrome definitions based on consensus and current use

Science.gov (United States)

Dowling, John N; Baer, Atar; Buckeridge, David L; Cochrane, Dennis; Conway, Michael A; Elkin, Peter; Espino, Jeremy; Gunn, Julia E; Hales, Craig M; Hutwagner, Lori; Keller, Mikaela; Larson, Catherine; Noe, Rebecca; Okhmatovskaia, Anya; Olson, Karen; Paladini, Marc; Scholer, Matthew; Sniegoski, Carol; Thompson, David; Lober, Bill

2010-01-01

Objective Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Design Clinical condition–syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Results Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. Limitations The consensus definitions have not yet been validated through implementation. Conclusion The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions. PMID:20819870

Factors associated with whole carcass condemnation rates in provincially-inspected abattoirs in Ontario 2001-2007: implications for food animal syndromic surveillance

Directory of Open Access Journals (Sweden)

Alton Gillian D

2010-08-01

Full Text Available Abstract Background Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1 describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2 identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Results Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. Conclusions The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance

A pooled analysis of the outcome of prospective colonoscopic surveillance for familial colorectal cancer

DEFF Research Database (Denmark)

Mesher, David; Dove-Edwin, Isis; Sasieni, Peter

2014-01-01

Surveillance guidelines for the management of familial colorectal cancer (FCC), a dominant family history of colorectal cancer in which the polyposis syndromes and Lynch syndrome have been excluded, are not firmly established. The outcome of colonoscopic surveillance is studied using data from six...

Performance of a Mobile Phone App-Based Participatory Syndromic Surveillance System for Acute Febrile Illness and Acute Gastroenteritis in Rural Guatemala.

Science.gov (United States)

Olson, Daniel; Lamb, Molly; Lopez, Maria Renee; Colborn, Kathryn; Paniagua-Avila, Alejandra; Zacarias, Alma; Zambrano-Perilla, Ricardo; Rodríguez-Castro, Sergio Ricardo; Cordon-Rosales, Celia; Asturias, Edwin Jose

2017-11-09

With their increasing availability in resource-limited settings, mobile phones may provide an important tool for participatory syndromic surveillance, in which users provide symptom data directly into a centralized database. We studied the performance of a mobile phone app-based participatory syndromic surveillance system for collecting syndromic data (acute febrile illness and acute gastroenteritis) to detect dengue virus and norovirus on a cohort of children living in a low-resource and rural area of Guatemala. Randomized households were provided with a mobile phone and asked to submit weekly reports using a symptom diary app (Vigilant-e). Participants reporting acute febrile illness or acute gastroenteritis answered additional questions using a decision-tree algorithm and were subsequently visited at home by a study nurse who performed a second interview and collected samples for dengue virus if confirmed acute febrile illness and norovirus if acute gastroenteritis. We analyzed risk factors associated with decreased self-reporting of syndromic data using the Vigilant-e app and evaluated strategies to improve self-reporting. We also assessed agreement between self-report and nurse-collected data obtained during home visits. From April 2015 to June 2016, 469 children in 207 households provided 471 person-years of observation. Mean weekly symptom reporting rate was 78% (range 58%-89%). Households with a poor (mobile phones for text messaging at study enrollment (61%, 35/57 vs 76.7%, 115/150; RR 0.6, 95% CI 0.4-0.9), and were less likely to access care at the local public clinic (35%, 20/57 vs 67.3%, 101/150; RR 0.4, 95% CI 0.2-0.6). Parents of female enrolled participants were more likely to have low response rate (57.1%, 84/147 vs 43.8%, 141/322; RR 1.4, 95% CI 1.1-1.9). Several external factors (cellular tower collapse, contentious elections) were associated with periods of decreased reporting. Poor response rate (mobile phone app-based participatory syndromic

National Cardiac Device Surveillance Program Database

Data.gov (United States)

Department of Veterans Affairs — The National Cardiac Device Surveillance Program Database supports the Eastern Pacemaker Surveillance Center (EPSC) staff in its function of monitoring some 11,000...

[Winter surveillance of cold exposure effects on health among the homeless population in the Paris area: data from the Coordinated Health Surveillance of Emergency Department network (Organisation de la surveillance coordonnée des urgences [Oscour(®)])].

Science.gov (United States)

Rouquette, A; Mandereau-Bruno, L; Baffert, E; Laaidi, K; Josseran, L; Isnard, H

2011-12-01

A program for helping homeless individuals in winter is implemented from November 1(st) to March 31(st) each year in France. Its aim is to prevent morbidity and mortality in this population during cold spells and periods of severe cold. A health surveillance system of the homeless population in the Paris area has been proposed to evaluate the effectiveness of the program and to alert decision-makers if an unusual increase in cold-weather effects is observed. The goal of this study was the creation of an indicator for the proposed surveillance system based on emergency department activity in the Paris area (Oscour(®) Network - Organisation de la surveillance coordonnée des urgences). The winter 2007-2008 computer medical files of 11 emergency departments in the Paris area were examined to confirm diagnosis and ascertain patient-homelessness for each patient visit which was selected from the Oscour(®) database by the patient chief-complaint or diagnosis code referring to hypothermia or frostbites. The proposed indicator is based on the maximization of three criteria: the positive predictive value, the proportion of people identified as being homeless and the number of emergency department visits. A Shewhart control chart was applied to the indicator for the four winters between 2005 and 2009 in the Paris area. Values beyond the statistical threshold would indicate a need for an adjustment to the program strategy. Two hundred and sixteen medical files were analyzed. An indicator was created, "number of emergency department visits of 15 to 69-years-old persons with chief-complaint or diagnosis code referring to hypothermia". It had a positive predictive value estimated near 85 % and identified 61.7 % people as being homeless. In the winter of 2008-2009, the statistical threshold was reached in December during the first cold spell, and again at the beginning of January during a period of severe cold. Our results support the use of this health indicator

Surface Environmental Surveillance Procedures Manual

International Nuclear Information System (INIS)

Hanf, Robert W.; Poston, Ted M.

2000-01-01

Shows and explains certain procedures needed for surface environmental surveillance. Hanford Site environmental surveillance is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE) under the Surface Environmental Surveillance Project (SESP). The basic requirements for site surveillance are set fourth in DOE Order 5400.1, General Environmental Protection Program Requirements. Guidance for the SESP is provided in DOE Order 5484.1, Environmental Protection, Safety, and Health Protection Information Reporting Requirements and DOE Order 5400.5, Radiation Protection of the Public and Environment. Guidelines for environmental surveillance activities are provided in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance. An environmental monitoring plan for the Hanford Site is outlined in DOE/RL 91-50 Rev. 2, Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office. Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual. Personnel training requirements are documented in SESP-TP-01 Rev.2, Surface Environmental Surveillance Project Training Program.

Implementation of Syndromic Surveillance Systems in Two Rural Villages in Senegal.

Science.gov (United States)

Abat, Cédric; Colson, Philippe; Chaudet, Hervé; Rolain, Jean-Marc; Bassene, Hubert; Diallo, Aldiouma; Mediannikov, Oleg; Fenollar, Florence; Raoult, Didier; Sokhna, Cheikh

2016-12-01

Infectious diseases still represent a major challenge for humanity. In this context, their surveillance is critical. From 2010 to 2016, two Point-Of-Care (POC) laboratories have been successfully implemented in the rural Saloum region of Senegal. In parallel, a homemade syndromic surveillance system called EPIMIC was implemented to monitor infectious diseases using data produced by the POC laboratory of the Timone hospital in Marseille, France. The aim of this study is to describe the steps necessary for implementing EPIMIC using data routinely produced by two POC laboratories (POC-L) established in rural Senegal villages. After improving EPIMIC, we started to monitor the 15 pathogens routinely diagnosed in the two POC-L using the same methodology we used in France. In 5 years, 2,577 deduplicated patients-samples couples from 775 different patients have been tested in the Dielmo and Ndiop POC-L. 739 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the Dielmo and Ndiop POC data with EPIMIC allowed to generate 443 alarms. Since January 2016, 316 deduplicated patients-samples couples collected from 298 different patients were processed in the Niakhar POC laboratory. 56 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the data of the Niakhar POC laboratory with EPIMIC allowed to generate 14 alarms. Although some improvements are still needed, EPIMIC has been successfully spread using data routinely produced by two rural POC-L in Senegal, West Africa.

Implementation of Syndromic Surveillance Systems in Two Rural Villages in Senegal.

Directory of Open Access Journals (Sweden)

Cédric Abat

2016-12-01

Full Text Available Infectious diseases still represent a major challenge for humanity. In this context, their surveillance is critical. From 2010 to 2016, two Point-Of-Care (POC laboratories have been successfully implemented in the rural Saloum region of Senegal. In parallel, a homemade syndromic surveillance system called EPIMIC was implemented to monitor infectious diseases using data produced by the POC laboratory of the Timone hospital in Marseille, France. The aim of this study is to describe the steps necessary for implementing EPIMIC using data routinely produced by two POC laboratories (POC-L established in rural Senegal villages. After improving EPIMIC, we started to monitor the 15 pathogens routinely diagnosed in the two POC-L using the same methodology we used in France. In 5 years, 2,577 deduplicated patients-samples couples from 775 different patients have been tested in the Dielmo and Ndiop POC-L. 739 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the Dielmo and Ndiop POC data with EPIMIC allowed to generate 443 alarms. Since January 2016, 316 deduplicated patients-samples couples collected from 298 different patients were processed in the Niakhar POC laboratory. 56 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the data of the Niakhar POC laboratory with EPIMIC allowed to generate 14 alarms. Although some improvements are still needed, EPIMIC has been successfully spread using data routinely produced by two rural POC-L in Senegal, West Africa.

Animal health syndromic surveillance: a systematic literature review of the progress in the last 5 years (2011–2016

Directory of Open Access Journals (Sweden)

Dórea FC

2016-11-01

Full Text Available Fernanda C Dórea,1 Flavie Vial2 1Department of Disease Control and Epidemiology, National Veterinary Institute (SVA, Uppsala, 2Epi-Connect, Skogås, Sweden Abstract: This review presents the current initiatives and potential for development in the field of animal health surveillance (AHSyS, 5 years on from its advent to the front of the veterinary public health scene. A systematic review approach was used to document the ongoing AHSyS initiatives (active systems and those in pilot phase and recent methodological developments. Clinical data from practitioners and laboratory data remain the main data sources for AHSyS. However, although not currently integrated into prospectively running initiatives, production data, mortality data, abattoir data, and new media sources (such as Internet searches have been the objective of an increasing number of publications seeking to develop and validate new AHSyS indicators. Some limitations inherent to AHSyS such as reporting sustainability and the lack of classification standards continue to hinder the development of automated syndromic analysis and interpretation. In an era of ubiquitous electronic collection of animal health data, surveillance experts are increasingly interested in running multivariate systems (which concurrently monitor several data streams as they are inferentially more accurate than univariate systems. Thus, Bayesian methodologies, which are much more apt to discover the interplay among multiple syndromic data sources, are foreseen to play a big part in the future of AHSyS. It has become clear that early detection of outbreaks may not be the principal expected benefit of AHSyS. As more systems will enter an active prospective phase, following the intensive development stage of the last 5 years, the study envisions AHSyS, in particular for livestock, to significantly contribute to future international-, national-, and local-level animal health intelligence, going beyond the detection and

General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

LENUS (Irish Health Repository)

Brabazon, E D

2010-01-01

The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.

Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

Science.gov (United States)

Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

2016-01-01

Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, pdisease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a single year of data and identified local hotspots of pediatric chronic diseases. PMID:28385326

Enhanced Disease Surveillance during the 2012 Republican National Convention, Tampa, FL

Science.gov (United States)

Atrubin, David; Wiese, Michael; Snider, Rebecca; Workman, Kiley; McDougle, Warren

2013-01-01

Objective To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26–30, 2012 in Tampa, FL. Introduction While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC. In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges. Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up. Methods Our normal daily analysis of the emergency department (ED) data using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) was expanded to look in detail at ED volumes and chief complaints of those patients who live outside of a 5-county Tampa Bay area. This analysis used patient zip code to determine place of residence. Additionally, ESSENCE queries were utilized to look for heat, tear gas, and RNC related exposures. The ESSENCE system also receives Poison Control data every 15 minutes. Expanded analyses of the Poison Control data were conducted as well. Two Disaster Medical Assistance Teams (DMATs) were

Enhanced syndromic surveillance for mass gatherings in the Pacific: a case study of the 11th Festival of Pacific Arts in Solomon Islands, 2012.

Science.gov (United States)

Hoy, Damian; Saketa, Salanieta T; Maraka, Roy Roger; Sio, Alison; Wanyeki, Ian; Frison, Pascal; Ogaoga, Divi; Iniakawala, Dennie; Joshua, Cynthia; Duituturaga, Sala; Lepers, Christelle; Roth, Adam; White, Paul; Souares, Yvan

2016-01-01

Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July). The ESS involved expanding on the existing syndromic surveillance parameters: from one to 15 sentinel sites, from four to eight syndromes, from aggregated to case-based reporting and from weekly to daily reporting. A web-based system was developed to enable data entry, data storage and data analysis. Towards the end of the ESS period, a focus group discussion and series of key informant interviews were conducted. The ESS was considered a success and played an important role in the early detection of possible outbreaks. For the period of the ESS, 1668 patients with syndrome presentations were received across the 15 sentinel sites. There were no major events of public health significance. Several lessons were learnt that are relevant to ESS in mass gathering scenarios, including the importance of having adequate lead in time for engagement and preparation to ensure appropriate policy and institutional frameworks are put in place.

Environmental surveillance master sampling schedule

Energy Technology Data Exchange (ETDEWEB)

Bisping, L.E.

1993-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). Samples are routinely collected and analyzed to determine the quality of air, surface water, ground water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Drinking Water Project, and Ground-Water Surveillance Project.

Quality assurance procedures for the IAEA Department of Safeguards Twin Minolta Camera Surveillance System

International Nuclear Information System (INIS)

Geoffrion, R.R.; Bussolini, P.L.; Stark, W.A.; Ahlquist, A.J.; Sanders, K.E.; Rubinstein, G.

1986-01-01

The International Atomic Energy Agency (IAEA) safeguards program provides assurance to the international community that nations are complying with nuclear safeguards treaties. In one aspect of the program, the Department of Safeguards has developed a twin Minolta camera photo surveillance systems program to assure itself and the international community that material handling is accomplished according to safeguards treaty regulations. The camera systems are positioned in strategic locations in facilities such that objective evidence can be obtained for material transactions. The films are then processed, reviewed, and used to substantiate the conclusions that nuclear material has not been diverted. Procedures have been developed to document and aid in: 1) the performance of activities involved in positioning of the camera system; 2) installation of the systems; 3) review and use of the film taken from the cameras

Long-Term Surveillance and Maintenance Plan for the U.S. Department of Energy Amchitka, Alaska, Site

Energy Technology Data Exchange (ETDEWEB)

None

2008-09-01

This Long-Term Surveillance and Maintenance Plan describes how the U.S. Department of Energy (DOE) intends to fulfill its mission to maintain protection of human health and the environment at the Amchitka, Alaska, Site1. Three underground nuclear tests were conducted on Amchitka Island. The U.S. Department of Defense, in conjunction with the U.S. Atomic Energy Commission (AEC), conducted the first nuclear test (Long Shot) to provide data that would improve the United States' capability of detecting underground nuclear explosions. The second nuclear test (Milrow) was a weapons-related test conducted by AEC as a means to study the feasibility of detonating a much larger device. The final nuclear test (Cannikin), the largest United States underground test, was a weapons-related test. Surface disturbances associated with these tests have been remediated. However, radioactivity remains deep below the surface, contained in and around the test cavities, for which no feasible remediation technology has been identified. In 2006, the groundwater model (Hassan et al. 2002) was updated using 2005 data collected by the Consortium for Risk Evaluation with Stakeholder Participation. Model simulation results indicate there is no breakthrough or seepage of radionuclides into the marine environment within 2,000 years. The Amchitka conceptual model is reasonable; the flow and transport simulation is based on the best available information and data. The simulation results are a quantitative prediction supported by the best available science and technology. This Long-Term Surveillance and Maintenance Plan is an additional step intended for the protection of human health and the environment. This plan may be modified from time to time in the future consistent with the mission to protect human health

Drinking water turbidity and emergency department visits for gastrointestinal illness in New York City, 2002-2009.

Directory of Open Access Journals (Sweden)

Jennifer L Hsieh

Full Text Available Studies have examined whether there is a relationship between drinking water turbidity and gastrointestinal (GI illness indicators, and results have varied possibly due to differences in methods and study settings.As part of a water security improvement project we conducted a retrospective analysis of the relationship between drinking water turbidity and GI illness in New York City (NYC based on emergency department chief complaint syndromic data that are available in near-real-time.We used a Poisson time-series model to estimate the relationship of turbidity measured at distribution system and source water sites to diarrhea emergency department (ED visits in NYC during 2002-2009. The analysis assessed age groups and was stratified by season and adjusted for sub-seasonal temporal trends, year-to-year variation, ambient temperature, day-of-week, and holidays.Seasonal variation unrelated to turbidity dominated (~90% deviance the variation of daily diarrhea ED visits, with an additional 0.4% deviance explained with turbidity. Small yet significant multi-day lagged associations were found between NYC turbidity and diarrhea ED visits in the spring only, with approximately 5% excess risk per inter-quartile-range of NYC turbidity peaking at a 6 day lag. This association was strongest among those aged 0-4 years and was explained by the variation in source water turbidity.Integrated analysis of turbidity and syndromic surveillance data, as part of overall drinking water surveillance, may be useful for enhanced situational awareness of possible risk factors that can contribute to GI illness. Elucidating the causes of turbidity-GI illness associations including seasonal and regional variations would be necessary to further inform surveillance needs.

Drinking water turbidity and emergency department visits for gastrointestinal illness in New York City, 2002-2009.

Science.gov (United States)

Hsieh, Jennifer L; Nguyen, Trang Quyen; Matte, Thomas; Ito, Kazuhiko

2015-01-01

Studies have examined whether there is a relationship between drinking water turbidity and gastrointestinal (GI) illness indicators, and results have varied possibly due to differences in methods and study settings. As part of a water security improvement project we conducted a retrospective analysis of the relationship between drinking water turbidity and GI illness in New York City (NYC) based on emergency department chief complaint syndromic data that are available in near-real-time. We used a Poisson time-series model to estimate the relationship of turbidity measured at distribution system and source water sites to diarrhea emergency department (ED) visits in NYC during 2002-2009. The analysis assessed age groups and was stratified by season and adjusted for sub-seasonal temporal trends, year-to-year variation, ambient temperature, day-of-week, and holidays. Seasonal variation unrelated to turbidity dominated (~90% deviance) the variation of daily diarrhea ED visits, with an additional 0.4% deviance explained with turbidity. Small yet significant multi-day lagged associations were found between NYC turbidity and diarrhea ED visits in the spring only, with approximately 5% excess risk per inter-quartile-range of NYC turbidity peaking at a 6 day lag. This association was strongest among those aged 0-4 years and was explained by the variation in source water turbidity. Integrated analysis of turbidity and syndromic surveillance data, as part of overall drinking water surveillance, may be useful for enhanced situational awareness of possible risk factors that can contribute to GI illness. Elucidating the causes of turbidity-GI illness associations including seasonal and regional variations would be necessary to further inform surveillance needs.

Syndromic Surveillance: Enhancing Detection of Disease Outbreaks in Urban China

NARCIS (Netherlands)

Pilot, E.; Schwarz, C.; Wang, L.; Krafft, T.; Wang, W.; Krafft, T.; Rosenberg, M.; Pilot, E.

2014-01-01

Recently a number of innovative surveillance approaches have been piloted or implemented in several parts of the country. Though Chinese cities have usually a sufficient health infrastructure that is included in the national surveillance system, the differences in treatment seeking behavior of a

Automated real time constant-specificity surveillance for disease outbreaks.

Science.gov (United States)

Wieland, Shannon C; Brownstein, John S; Berger, Bonnie; Mandl, Kenneth D

2007-06-13

For real time surveillance, detection of abnormal disease patterns is based on a difference between patterns observed, and those predicted by models of historical data. The usefulness of outbreak detection strategies depends on their specificity; the false alarm rate affects the interpretation of alarms. We evaluate the specificity of five traditional models: autoregressive, Serfling, trimmed seasonal, wavelet-based, and generalized linear. We apply each to 12 years of emergency department visits for respiratory infection syndromes at a pediatric hospital, finding that the specificity of the five models was almost always a non-constant function of the day of the week, month, and year of the study (p accounting for not only the expected number of visits, but also the variance of the number of visits. The expectation-variance model achieves constant specificity on all three time scales, as well as earlier detection and improved sensitivity compared to traditional methods in most circumstances. Modeling the variance of visit patterns enables real-time detection with known, constant specificity at all times. With constant specificity, public health practitioners can better interpret the alarms and better evaluate the cost-effectiveness of surveillance systems.

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...

The results of gynecologic surveillance in families with hereditary nonpolyposis colorectal cancer

DEFF Research Database (Denmark)

Ketabi, Zohreh; Gerdes, Anne-Marie; Mosgaard, Berit

2014-01-01

Objective. We aimed to estimate the incidence rate of endometrial cancer (EC) and to evaluate the results of EC-surveillance in hereditary nonpolyposis colorectal cancer (HNPCC) families. Methods. All at-risk women recommended for EC-surveillance by the HNPCC-register-2959 women (19,334 women yea...... of having Lynch syndrome. We conclude that EC surveillance should only be targeted at MMR-mutation carriers. (C) 2014 Elsevier Inc. All rights reserved....

History and evolution of surveillance in public health

Directory of Open Access Journals (Sweden)

Varun Kumar

2014-01-01

Full Text Available The modern concept of surveillance has evolved over the centuries. Public health surveillance provides the scientific database essential for decision making and appropriate public health action. It is considered as the best public health tool to prevent the occurrence of epidemics and is the backbone of public health programs and provides information so that effective action can be taken in controlling and preventing diseases of public health importance. This article reviews the history of evolution of public health surveillance from historical perspective: from Hippocrates, Black Death and quarantine, recording of vital events for the first time, first field investigation, legislations that were developed over time and modern concepts in public health surveillance. Eradication of small pox is an important achievement in public health surveillance but the recent Severe Acute Respiratory Syndrome (SARS and Influenza pandemics suggest still there is a room for improvement. Recently new global disease surveillance networks like FluNet and DengueNet were developed as internet sites for monitoring influenza and dengue information. In spite of these developments, global public health surveillance still remains unevenly distributed. There is a need for increased international cooperation to address the global needs of public health surveillance.

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

Science.gov (United States)

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

Defining syndromes using cattle meat inspection data for syndromic surveillance purposes: a statistical approach with the 2005-2010 data from ten French slaughterhouses.

Science.gov (United States)

Dupuy, Céline; Morignat, Eric; Maugey, Xavier; Vinard, Jean-Luc; Hendrikx, Pascal; Ducrot, Christian; Calavas, Didier; Gay, Emilie

2013-04-30

The slaughterhouse is a central processing point for food animals and thus a source of both demographic data (age, breed, sex) and health-related data (reason for condemnation and condemned portions) that are not available through other sources. Using these data for syndromic surveillance is therefore tempting. However many possible reasons for condemnation and condemned portions exist, making the definition of relevant syndromes challenging.The objective of this study was to determine a typology of cattle with at least one portion of the carcass condemned in order to define syndromes. Multiple factor analysis (MFA) in combination with clustering methods was performed using both health-related data and demographic data. Analyses were performed on 381,186 cattle with at least one portion of the carcass condemned among the 1,937,917 cattle slaughtered in ten French abattoirs. Results of the MFA and clustering methods led to 12 clusters considered as stable according to year of slaughter and slaughterhouse. One cluster was specific to a disease of public health importance (cysticercosis). Two clusters were linked to the slaughtering process (fecal contamination of heart or lungs and deterioration lesions). Two clusters respectively characterized by chronic liver lesions and chronic peritonitis could be linked to diseases of economic importance to farmers. Three clusters could be linked respectively to reticulo-pericarditis, fatty liver syndrome and farmer's lung syndrome, which are related to both diseases of economic importance to farmers and herd management issues. Three clusters respectively characterized by arthritis, myopathy and Dark Firm Dry (DFD) meat could notably be linked to animal welfare issues. Finally, one cluster, characterized by bronchopneumonia, could be linked to both animal health and herd management issues. The statistical approach of combining multiple factor analysis with cluster analysis showed its relevance for the detection of syndromes

SAVY-4000 Field Surveillance Plan Update for 2017

Energy Technology Data Exchange (ETDEWEB)

Kelly, Elizabeth J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stone, Timothy Amos [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Smith, Paul Herrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reeves, Kirk Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Veirs, Douglas Kirk [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Prochnow, David Adrian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-03-20

The Packaging Surveillance Program section of the Department of Energy (DOE) Manual 441.1-­1, Nuclear Material Packaging Manual (DOE 2008), requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.”This 2017 update reflects changes to the surveillance plan resulting from surveillance findings as documented in Reeves et al. 2016. These findings include observations of corrosion in SAVY and Hagan containers and the indication (in one SAVY container) of possible filter membrane thermal degradation. This surveillance plan update documents the rationale for selecting surveillance containers, specifies the containers for 2017 surveillance, and identifies a minimum set of containers for 2018 surveillance. This update contains important changes to the previous surveillance plans.

Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

Directory of Open Access Journals (Sweden)

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.

Hereditary & familial colorectal cancer : Identification, characteristics, surveillance

NARCIS (Netherlands)

Kallenberg, F.G.J.

2017-01-01

Of all colorectal cancer (CRC) cases, 15-20% is related to familial or hereditary factors. Diagnosing familial and hereditary CRC syndromes is important for several reasons. One of these is that surveillance colonoscopies can reduce CRC incidence and mortality importantly. A complete family history

Hantavirus pulmonary syndrome clinical findings: evaluating a surveillance case definition.

Science.gov (United States)

Knust, Barbara; Macneil, Adam; Rollin, Pierre E

2012-05-01

Clinical cases of hantavirus pulmonary syndrome (HPS) can be challenging to differentiate from other acute respiratory diseases, which can lead to delays in diagnosis, treatment, and disease reporting. Rapid onset of severe disease occurs, at times before diagnostic test results are available. This study's objective was to examine the clinical characteristics of patients that would indicate HPS to aid in detection and reporting. Test results of blood samples from U.S. patients suspected of having HPS submitted to the Centers for Disease Control and Prevention from 1998-2010 were reviewed. Patient information collected by case report forms was compared between HPS-confirmed and test-negative patients. Diagnostic sensitivity, specificity, predictive values, and likelihood ratios were calculated for individual clinical findings and combinations of variables. Of 567 patients included, 36% were HPS-confirmed. Thrombocytopenia, chest x-rays with suggestive signs, and receiving supplemental oxygenation were highly sensitive (>95%), while elevated hematocrit was highly specific (83%) in detecting HPS. Combinations that maximized sensitivity required the presence of thrombocytopenia. Using a national sample of suspect patients, we found that thrombocytopenia was a highly sensitive indicator of HPS and should be included in surveillance definitions for suspected HPS. Using a sensitive suspect case definition to identify potential HPS patients that are confirmed by highly specific diagnostic testing will ensure accurate reporting of this disease.

Manifestations of Gorlin-Goltz syndrome.

Science.gov (United States)

Larsen, Anne Kristine; Mikkelsen, Dorthe Bisgaard; Hertz, Jens Michael; Bygum, Anette

2014-05-01

Gorlin-Goltz syndrome is an uncommon hereditary condition caused by mutations in the PTCH1 gene causing a wide range of developmental abnormalities. Multiple basal cell carcinomas, palmoplantar pits and jaw cysts are cardinal features. Many clinicians are unfamiliar with the different manifestations and the fact that patients are especially sensitive to ionizing radiation. This was a retrospective analysis of patients with Gorlin-Goltz syndrome seen at the Department of Dermatology and Allergy Centre or at Department of Plastic Surgery, Odense University Hospital, Denmark, in the period from 1994 to 2013. A total of 17 patients from eight families fulfilled the diagnostic criteria. In all, 14 patients had basal cell carcinomas, 12 patients had jaw cysts and ten patients had calcification of the falx cerebri. Other clinical features were frontal bossing, kyphoscoliosis, rib anomalies, coalitio, cleft lip/palate, eye anomalies, milia and syndactyly. In one family, medulloblastoma and astrocytoma occurred. Traditional treatment principles of basal cell carcinomas were used including radiotherapy performed in six patients. PTCH1 mutations were identified in five families and none of these mutations had previously been described. The patient cohort illustrates classic and rare disease manifestations. It is necessary to remind clinicians that radiation therapy in Gorlin-Goltz syndrome is relatively contraindicated. Today, mutation analysis can be used for confirmation of the diagnosis and for predictive genetic testing. Patients should be offered genetic counselling and life-long surveillance. not relevant. not relevant.

Identifying emergency department patients with chest pain who are at low risk for acute coronary syndromes [digest].

Science.gov (United States)

Markel, David; Kim, Jeremy

2017-07-21

Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing. The emerging role of new technologies, such as high-sensitivity troponin assays and advanced imaging techniques, are also presented. [Points & Pearls is a digest of Emergency Medicine Practice].

Environmental surveillance master sampling schedule

International Nuclear Information System (INIS)

Bisping, L.E.

1997-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL)(a) for the US Department of Energy (DOE). This document contains the planned 1997 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. In addition, Section 3.0, Biota, also reflects a rotating collection schedule identifying the year a specific sample is scheduled for collection. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, General Environmental Protection Program, and DOE Order 5400.5, Radiation Protection of the Public and the Environment. The sampling methods will be the same as those described in the Environmental Monitoring Plan, US Department of Energy, Richland Operations Office, DOE/RL91-50, Rev. 1, US Department of Energy, Richland, Washington

Development and refinement of new statistical methods for enhanced syndromic surveillance during the 2012 Olympic and Paralympic Games.

Science.gov (United States)

Morbey, Roger A; Elliot, Alex J; Charlett, Andre; Andrews, Nick; Verlander, Neville Q; Ibbotson, Sue; Smith, Gillian E

2015-06-01

Prior to the 2012 London Olympic and Paralympic Games, new statistical methods had to be developed for the enhanced syndromic surveillance during the Games. Different methods were developed depending on whether or not historical data were available. Practical solutions were needed to cope with the required daily reporting and data quality issues. During the Games, nearly 4800 signals were tested on average each day, generating statistical alarms that were assessed to provide information on areas of potential public health concern and reassurance that no major adverse incident had occurred. spjhi;21/2/159/FIG41460458213517577 F1 fig4-1460458213517577. © The Author(s) 2013.

A review of zoonotic disease surveillance supported by the Armed Forces Health Surveillance Center.

Science.gov (United States)

Burke, R L; Kronmann, K C; Daniels, C C; Meyers, M; Byarugaba, D K; Dueger, E; Klein, T A; Evans, B P; Vest, K G

2012-05-01

The Armed Forces Health Surveillance Center (AFHSC), Division of Global Emerging Infections Surveillance and Response System conducts disease surveillance through a global network of US Department of Defense research laboratories and partnerships with foreign ministries of agriculture, health and livestock development in over 90 countries worldwide. In 2010, AFHSC supported zoonosis survey efforts were organized into four main categories: (i) development of field assays for animal disease surveillance during deployments and in resource limited environments, (ii) determining zoonotic disease prevalence in high-contact species which may serve as important reservoirs of diseases and sources of transmission, (iii) surveillance in high-risk human populations which are more likely to become exposed and subsequently infected with zoonotic pathogens and (iv) surveillance at the human-animal interface examining zoonotic disease prevalence and transmission within and between human and animal populations. These efforts have aided in the detection, identification and quantification of the burden of zoonotic diseases such as anthrax, brucellosis, Crimean Congo haemorrhagic fever, dengue fever, Hantaan virus, influenza, Lassa fever, leptospirosis, melioidosis, Q fever, Rift Valley fever, sandfly fever Sicilian virus, sandfly fever Naples virus, tuberculosis and West Nile virus, which are of military and public health importance. Future zoonotic surveillance efforts will seek to develop local capacity for zoonotic surveillance focusing on high risk populations at the human-animal interface. © 2011 Blackwell Verlag GmbH.

The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area.

Science.gov (United States)

Enanoria, Wayne T A; Crawley, Adam W; Tseng, Winston; Furnish, Jasmine; Balido, Jeannie; Aragón, Tomás J

2013-03-27

Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. Very little is known about how these functions are conducted at the local level. The purpose of the Epidemiology Networks in Action (EpiNet) Study was to describe the epidemiology and surveillance response to the 2009 pandemic influenza A (H1N1) by city and county health departments in the San Francisco Bay Area in California. The study also documented lessons learned from the response in order to strengthen future public health preparedness and response planning efforts in the region. In order to characterize the epidemiology and surveillance response, we conducted key informant interviews with public health professionals from twelve local health departments in the San Francisco Bay Area. In order to contextualize aspects of organizational response and performance, we recruited two types of key informants: public health professionals who were involved with the epidemiology and surveillance response for each jurisdiction, as well as the health officer or his/her designee responsible for H1N1 response activities. Information about the organization, data sources for situation awareness, decision-making, and issues related to surge capacity, continuity of operations, and sustainability were collected during the key informant interviews. Content and interpretive analyses were conducted using ATLAS.ti software. The study found that disease investigations were important in the first months of the pandemic, often requiring additional staff support and sometimes forcing other public health activities to be put on hold. We also found that while the Incident Command System (ICS) was used by all participating agencies to manage the response, the manner in which it was implemented and utilized varied. Each local health department (LHD) in the study collected epidemiologic data from a variety of sources, but only case reports

Evaluation of a continuous indicator for syndromic surveillance through simulation. application to vector borne disease emergence detection in cattle using milk yield.

Directory of Open Access Journals (Sweden)

Aurélien Madouasse

Full Text Available Two vector borne diseases, caused by the Bluetongue and Schmallenberg viruses respectively, have emerged in the European ruminant populations since 2006. Several diseases are transmitted by the same vectors and could emerge in the future. Syndromic surveillance, which consists in the routine monitoring of indicators for the detection of adverse health events, may allow an early detection. Milk yield is routinely measured in a large proportion of dairy herds and could be incorporated as an indicator in a surveillance system. However, few studies have evaluated continuous indicators for syndromic surveillance. The aim of this study was to develop a framework for the quantification of both disease characteristics and model predictive abilities that are important for a continuous indicator to be sensitive, timely and specific for the detection of a vector-borne disease emergence. Emergences with a range of spread characteristics and effects on milk production were simulated. Milk yields collected monthly in 48 713 French dairy herds were used to simulate 576 disease emergence scenarios. First, the effect of disease characteristics on the sensitivity and timeliness of detection were assessed: Spatio-temporal clusters of low milk production were detected with a scan statistic using the difference between observed and simulated milk yields as input. In a second step, the system specificity was evaluated by running the scan statistic on the difference between observed and predicted milk yields, in the absence of simulated emergence. The timeliness of detection depended mostly on how easily the disease spread between and within herds. The time and location of the emergence or adding random noise to the simulated effects had a limited impact on the timeliness of detection. The main limitation of the system was the low specificity i.e. the high number of clusters detected from the difference between observed and predicted productions, in the absence of

Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas

Directory of Open Access Journals (Sweden)

Webber Daniel

2008-04-01

Full Text Available Abstract Background In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments. Methods The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC, followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys, technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security. Results A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final

Enhancing Syndromic Surveillance With Online Respondent-Driven Detection

NARCIS (Netherlands)

Stein, Mart L; van Steenbergen, Jim E; Buskens, Vincent; van der Heijden, Peter G M; Koppeschaar, Carl E; Bengtsson, Linus; Thorson, Anna; Kretzschmar, MEE

OBJECTIVES: We investigated the feasibility of combining an online chain recruitment method (respondent-driven detection) and participatory surveillance panels to collect previously undetected information on infectious diseases via social networks of participants. METHODS: In 2014, volunteers from 2

Enhancing syndromic surveillance with online respondent-driven detection

NARCIS (Netherlands)

Stein, Mart L.; Van Steenbergen, Jim E.; Buskens, Vincent; Van Der Heijden, Peter G M; Koppeschaar, Carl E.; Bengtsson, Linus; Thorson, Anna; Kretzschmar, Mirjam E E

2015-01-01

Objectives. We investigated the feasibility of combining an online chain recruitment method (respondent-driven detection) and participatory surveillance panels to collect previously undetected information on infectious diseases via social networks of participants. Methods. In 2014, volunteers from 2

U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

Fraser syndrome

DEFF Research Database (Denmark)

Barisic, Ingeborg; Odak, Ljubica; Loane, Maria

2013-01-01

Fraser syndrome is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal, and urogenital malformations. We present a population-based epidemiological study using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network of...

Public involvement in environmental surveillance at Hanford

International Nuclear Information System (INIS)

Hanf, R.W. Jr.; Patton, G.W.; Woodruff, R.K.; Poston, T.M.

1994-08-01

Environmental surveillance at the Hanford Site began during the mid-1940s following the construction and start-up of the nation's first plutonium production reactor. Over the past approximately 45 years, surveillance operations on and off the Site have continued, with virtually all sampling being conducted by Hanford Site workers. Recently, the US Department of Energy Richland Operations Office directed that public involvement in Hanford environmental surveillance operations be initiated. Accordingly, three special radiological air monitoring stations were constructed offsite, near hanford's perimeter. Each station is managed and operated by two local school teaches. These three stations are the beginning of a community-operated environmental surveillance program that will ultimately involve the public in most surveillance operations around the Site. The program was designed to stimulate interest in Hanford environmental surveillance operations, and to help the public better understand surveillance results. The program has also been used to enhance educational opportunities at local schools

A comparison of data sources for the surveillance of work-related carpal tunnel syndrome in Massachusetts.

Science.gov (United States)

Davis, Letitia; Wellman, Helen; Hart, James; Cleary, Robert; Gardstein, Betsey M; Sciuchetti, Paul

2004-09-01

This study examined whether a state surveillance system for work-related carpal tunnel syndrome (WR-CTS) based on workers' compensation claims (Sentinel Event Notification System for Occupational Risks, SENSOR) and the Annual Survey of Occupational Injuries and Illnesses (SOII) identified the same industries, occupations, sources of injury, and populations for intervention. Trends in counts, rates, and female/male ratios of WR-CTS during 1994-1997, and age distributions were compared across three data sources: SENSOR, Massachusetts SOII, and National SOII. SENSOR and National SOII data on WR-CTS were compared by industry, occupation, and injury source. Due to small sample size and subsequent gaps in available information, state SOII data on WR-CTS were of little use in identifying specific industries and occupations for intervention. SENSOR and National SOII data on the frequency of WR-CTS cases identified many similar occupations and industries, and both surveillance systems pointed to computer use as a risk factor for WR-CTS. Some high rate industries identified by SENSOR were not identified using National SOII rates even when national findings were restricted to take into account the distribution of the Massachusetts workforce. Use of national SOII data on rates of WR-CTS for identifying state industry priorities for WR-CTS prevention should be undertaken with caution. Options for improving state SOII data and use of other state data systems should be pursued.

[The sociological survey of syndrome of professional burnout in physicians of obstetrics department].

Science.gov (United States)

Novgorodova, U R

2016-01-01

The syndrome of emotional burnout is a condition of emotional, psychic, physical exhaustion developed as a result of chronic unresolved stress at working place. The development of the given syndrome is specific for altruistic professions where care of people prevails (social workers, physicians, medical nurses, teachers, etc.). In ICD-10 the syndrome of burnout is described under rubric Z.73.0 as “a state of total exhaustion”. Nowadays, physicians and other medical workers found oneself least socially protected in social economic and professional aspects. This is conditioned by low level of salary, significant decreasing of quality of life, increasing of professional responsibility and also by intensification of contradictions between professional and moral duty and possibilities of rendering of medical care to population. The recent studies demonstrate that this condition can be developed in 30-50% of physicians. Also, it is established that age, marital status, had no effect on emotional burnout. The emotional burnout is developing in more degree in females than in males. Also, females are lacking relationship between motivation (satisfaction with remuneration of labor) and development of syndrome in the presence of relationship between significance of work as motivation for activities, satisfaction with professional progression. Those who experience deficiency of autonomy (“super-controlled personalities”) are more subjected to burnout. The study was carried out to determine syndrome of professional burnout in physicians of obstetrics department of large (160 beds) obstetric institution the Yakurskaia municipal clinical hospital with purpose offurther implementation of measures of prevention and correction. The presence of syndrome of burnout effects negatively on both psychophysical general state of particular workers and functioning of medical institution on the whole.

An uncommon disorder with multiple skeletal anomalies: Gorlin-Goltz syndrome.

Science.gov (United States)

Keçeli, Onur; Coskun-Benlidayı, İlke; Benlidayı, M Emre; Erdoğan, Özgür

2014-01-01

Gorlin-Goltz syndrome is an uncommon disorder transmitted through autosomal dominant inheritance. This syndrome is characterized by multiple odontogenic keratocysts, along with congenital skeletal anomalies and basal cell carcinomas. A 16-year-old girl was admitted with a complaint of swelling on the lower jaw. She had multiple basal cell nevi on both hands. Multiple lytic bone lesions on radiographs were defined as odontogenic keratocysts following the biopsy. The patient was referred to the Department of Physical Medicine and Rehabilitation for detailed musculoskeletal evaluation. Adam's forward bend test revealed a hump on the right side representing right thoracic scoliosis. Cervical kyphosis, thoracic lordosis and scoliosis, bifid rib and sacral and lumbar spina bifida on plain radiographs led to the diagnosis of Gorlin-Goltz syndrome. Since early diagnosis may provide optimum surveillance for related neoplasms, it is of paramount importance for pediatricians as well as physicians dealing with the musculoskeletal system to be aware of this rare condition.

U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

Surveillance for urinary tract cancer in Lynch syndrome

DEFF Research Database (Denmark)

Bernstein, Inge Thomsen; Myrhøj, Torben

2013-01-01

Hereditary non-polyposis colorectal cancer (HNPCC) is an inherited multiorgan cancer syndrome, which when caused by a germline mutation in the mismatch repair (MMR) genes is known as Lynch syndrome (LS). Mutation carriers are at risk for developing cancers primarily in the colon, rectum...

Emergency Department Visits Prior to Suicide and Homicide: Linking Statewide Surveillance Systems.

Science.gov (United States)

Cerel, Julie; Singleton, Michael D; Brown, Margaret M; Brown, Sabrina V; Bush, Heather M; Brancado, Candice J

2016-01-01

Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide. Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks. Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources. Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (mean = 13.6 days) and 8.3% who died by homicide (mean = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance. It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.

Immunohistochemical Pitfalls: Common Mistakes in the Evaluation of Lynch Syndrome.

Science.gov (United States)

Markow, Michael; Chen, Wei; Frankel, Wendy L

2017-12-01

At least 15% of colorectal cancers diagnosed in the United States are deficient in mismatch repair mechanisms. Most of these are sporadic, but approximately 3% of colorectal cancers result from germline alterations in mismatch repair genes and represent Lynch syndrome. It is critical to identify patients with Lynch syndrome to institute appropriate screening and surveillance for patients and their families. Exclusion of Lynch syndrome in sporadic cases is equally important because it reduces anxiety for patients and prevents excessive spending on unnecessary surveillance. Immunohistochemistry is one of the most widely used screening tools for identifying patients with Lynch syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

The other side of surveillance: Monitoring, application, and ...

African Journals Online (AJOL)

4 Department of Tuberculosis Control, National Department of Health, Pretoria, South Africa. Corresponding ... programme performance was communicated after data were reported to ..... Study strengths and limitations ... vaccinepreventable disease surveillance and response in the context of decentralization: Evidence.

Guide for: environmental radiological surveillance at US Department of Energy installations

International Nuclear Information System (INIS)

Corley, J.P.; Denham, D.H.; Jaquish, R.E.; Michels, D.E.; Olsen, A.R.; Waite, D.A.

1981-07-01

This second edition of the Guide, originally published in 1977, is presented as an interim revision and does not contain major changes in content. The original objectives and scope of the Guide have not changed. The Guide is intended to: provide recommended methods, procedures, and performance criteria to bring greater comparability to DOE environmental monitoring and reporting systems; provide DOE management, particularly the Headquarters' Operational and Environmental Safety Division (OESD) and field offices, with a broad review of accepted radiological surveillance practices for use in the evaluation of environmental surveillance programs at DOE facilities; and delineate the capabilities and limitations of the various environmental monitoring systems for radioactivity currently used at DOE sites, including technical areas where there is either an inadequate basis for procedural selection or where further development work may be warranted. The document is intended as a guide, not a manual of detailed mandatory procedure

Not in Traffic Surveillance (NiTS)

Data.gov (United States)

Department of Transportation — The Not-in-Traffic Surveillance (NiTS) system is a virtual data collection system designed to provide counts and details regarding fatalities and injuries that occur...

Validation of an electronic surveillance system for acute lung injury.

Science.gov (United States)

Herasevich, Vitaly; Yilmaz, Murat; Khan, Hasrat; Hubmayr, Rolf D; Gajic, Ognjen

2009-06-01

Early detection of acute lung injury (ALI) is essential for timely implementation of evidence-based therapies and enrollment into clinical trials. We aimed to determine the accuracy of computerized syndrome surveillance for detection of ALI in hospitalized patients and compare it with routine clinical assessment. Using a near-real time copy of the electronic medical records, we developed and validated a custom ALI electronic alert (ALI "sniffer") based on the European-American Consensus Conference Definition and compared its performance against provider-derived documentation. A total of 3,795 consecutive critically ill patients admitted to nine multidisciplinary intensive care units (ICUs) of a tertiary care teaching institution were included. ALI developed in 325 patients and was recognized by bedside clinicians in only 86 (26.5%). Under-recognition of ALI was associated with not implementing protective mechanical ventilation (median tidal volumes of 9.2 vs. 8.0 ml/kg predicted body weight, P sniffer" demonstrated excellent sensitivity of 96% (95% CI 94-98) and moderate specificity of 89% (95% CI 88-90) with a positive predictive value ranging from 24% (95% CI 13-40) in the heart-lung transplant ICU to 64% (95% CI 55-71) in the medical ICU. The computerized surveillance system accurately identifies critically ill patients who develop ALI syndrome. Since the lack of ALI recognition is a barrier to the timely implementation of best practices and enrollment into research studies, computerized syndrome surveillance could be a useful tool to enhance patient safety and clinical research.

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

Science.gov (United States)

2012-08-29

... DEPARTMENT OF DEFENSE Department of the Navy Record of Decision for Surveillance Towed Array Sensor System Low Frequency Active Sonar AGENCY: Department of the Navy, DoD. ACTION: Notice of decision... to employ up to four Surveillance Towed Array Sensor System Low Frequency Active (SURTASS LFA) sonar...

Novel public health risk assessment process developed to support syndromic surveillance for the 2012 Olympic and Paralympic Games.

Science.gov (United States)

Smith, Gillian E; Elliot, Alex J; Ibbotson, Sue; Morbey, Roger; Edeghere, Obaghe; Hawker, Jeremy; Catchpole, Mike; Endericks, Tina; Fisher, Paul; McCloskey, Brian

2017-09-01

Syndromic surveillance aims to provide early warning and real time estimates of the extent of incidents; and reassurance about lack of impact of mass gatherings. We describe a novel public health risk assessment process to ensure those leading the response to the 2012 Olympic Games were alerted to unusual activity that was of potential public health importance, and not inundated with multiple statistical 'alarms'. Statistical alarms were assessed to identify those which needed to result in 'alerts' as reliably as possible. There was no previously developed method for this. We identified factors that increased our concern about an alarm suggesting that an 'alert' should be made. Between 2 July and 12 September 2012, 350 674 signals were analysed resulting in 4118 statistical alarms. Using the risk assessment process, 122 'alerts' were communicated to Olympic incident directors. Use of a novel risk assessment process enabled the interpretation of large number of statistical alarms in a manageable way for the period of a sustained mass gathering. This risk assessment process guided the prioritization and could be readily adapted to other surveillance systems. The process, which is novel to our knowledge, continues as a legacy of the Games. © Crown copyright 2016.

Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT.

Science.gov (United States)

Gassas, A; Craig-Barnes, H; Dell, S; Doyle, J; Schechter, T; Sung, L; Egeler, M; Palaniyar, N

2013-06-01

To prospectively assess whether periodic chest health surveillance is beneficial for the early detection of bronchiolitis obliterans syndrome (BOS) in children after allo-SCT. Children up to 18 years of age receiving allo-SCT from September 2009 to September 2011 were included. Surveillance consisted of the following: a 7-item respiratory system questionnaire of cough, wheeze and shortness of breath; focused physical examination; and pulmonary function test (PFT) conducted before SCT and at 1, 3, 6, 9, 12, 18 and 24 months after SCT. Thirty-nine patients were enrolled. Five children developed BOS at a median time of 192 days (range 94-282). Positive response comparisons between the BOS group vs the non-BOS group were NS for history questionnaire (P=0.2), heart rate (P=0.3), respiratory rate (P=0.3) and oxygen saturation monitoring (P=0.8). Differences between the two groups for chest auscultation and PFT were statistically significant (P=0.03 and P=0.01, respectively). However, chest auscultation in the BOS group was only positive after BOS diagnosis. PFT reduction was evident in the asymptomatic phase (BOS group 33%; non-BOS group 4.5%, P=0.01). Changes in PFT, but not history/physical examination, allow the early detection of BOS in children after SCT. Our study is limited by the small sample size.

Bomb blast injuries: an exploration of patient characteristics and outcome using Pakistan National Emergency Departments Surveillance (Pak-NEDS) data.

Science.gov (United States)

Khan, Irum; Khan, Nadeem; Naeem, Rubaba; Kerai, Salima; Allen, Kate; Zia, Nukhba; Shahbaz, Sana; Afridi, Shiraz; Siddiqui, Emaduddin; Khan, Uzma; Hyder, Adnan A; Razzak, Junaid A

2015-01-01

Bomb blast injuries result in premature deaths and burdening of healthcare systems. The objective of this study was to explore the characteristics and outcome of patients presenting to the emergency departments in Pakistan with bomb blast injuries. Active surveillance was conducted in seven major emergency departments of Pakistan from November 2010-March 2011. All the sites are tertiary care urban centers. All the patients who presented to the hospital's emergency department (ED) following a bomb blast injury as per self-report or the ambulance personnel were included in the study. Frequency of demographics, injury pattern, and outcomes were calculated. A total of 103 patients with bomb blast injuries presented to the selected emergency departments. The median age of patients was 30 years. Around three-fourth of the patients were males (n = 74, 74.7%). Most of the bomb blast patients were seen in Peshawar (n = 41, 39.8%) and Karachi city (n = 31, 30.1%) and the most common mode of arrival was non-ambulance transport (n = 71, 76.3%). Upper limb injuries (n = 12, 40%) were common in the under 18 age group and lower limb injuries (n = 31, 39.2%) in the 18 years and above group. There were a total of 8 (7.7%) deaths reported out of these 103 patients. Bomb blast injuries in Pakistan generally affect young males. Non-ambulance transport is the most common way to access emergency departments (ED). Overall ED mortality is high and capturing data during a disaster in an emergency department is challenging.

Project Surveillance and Maintenance Plan

International Nuclear Information System (INIS)

1985-09-01

The Project Surveillance and Maintenance Plan (PSMP) describes the procedures that will be used by the US Department of Energy (DOE), or other agency as designated by the President to verify that inactive uranium tailings disposal facilities remain in compliance with licensing requirements and US Environmental Protection Agency (EPA) standards for remedial actions. The PSMP will be used as a guide for the development of individual Site Surveillance and Maintenance Plans (part of a license application) for each of the UMTRA Project sites. The PSMP is not intended to provide minimum requirements but rather to provide guidance in the selection of surveillance measures. For example, the plan acknowledges that ground-water monitoring may or may not be required and provides the [guidance] to make this decision. The Site Surveillance and Maintenance Plans (SSMPs) will form the basis for the licensing of the long-term surveillance and maintenance of each UMTRA Project site by the NRC. Therefore, the PSMP is a key milestone in the licensing process of all UMTRA Project sites. The Project Licensing Plan (DOE, 1984a) describes the licensing process. 11 refs., 22 figs., 8 tabs

Youth Risk Behavior Surveillance System (YRBSS)

Data.gov (United States)

U.S. Department of Health & Human Services — The Youth Risk Behavior Surveillance System (YRBSS) monitors 6 types of health-risk behaviors that contribute to the leading causes of death and disability among...

Cushing syndrome: update on testing.

Science.gov (United States)

Raff, Hershel

2015-03-01

Endogenous hypercortisolism (Cushing syndrome) is one of the most enigmatic diseases in clinical medicine. The diagnosis and differential diagnosis of Cushing syndrome depend on proper laboratory evaluation. In this review, an update is provided on selected critical issues in the diagnosis and differential diagnosis of Cushing syndrome: the use of late-night salivary cortisol in initial diagnosis and for postoperative surveillance, and the use of prolactin measurement to improve the performance of inferior petrosal sinus sampling to distinguish Cushing disease from ectopic adrenocorticotropic hormone (ACTH) syndrome during differential diagnosis of ACTH-dependent Cushing syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the influenza sentinel surveillance system in Madagascar, 2009-2014.

Science.gov (United States)

Rakotoarisoa, Alain; Randrianasolo, Laurence; Tempia, Stefano; Guillebaud, Julia; Razanajatovo, Norosoa; Randriamampionona, Lea; Piola, Patrice; Halm, Ariane; Heraud, Jean-Michel

2017-05-01

Evaluation of influenza surveillance systems is poor, especially in Africa. In 2007, the Institut Pasteur de Madagascar and the Malagasy Ministry of Public Health implemented a countrywide system for the prospective syndromic and virological surveillance of influenza-like illnesses. In assessing this system's performance, we identified gaps and ways to promote the best use of resources. We investigated acceptability, data quality, flexibility, representativeness, simplicity, stability, timeliness and usefulness and developed qualitative and/or quantitative indicators for each of these attributes. Until 2007, the influenza surveillance system in Madagascar was only operational in Antananarivo and the observations made could not be extrapolated to the entire country. By 2014, the system covered 34 sentinel sites across the country. At 12 sites, nasopharyngeal and/or oropharyngeal samples were collected and tested for influenza virus. Between 2009 and 2014, 177 718 fever cases were detected, 25 809 (14.5%) of these fever cases were classified as cases of influenza-like illness. Of the 9192 samples from patients with influenza-like illness that were tested for influenza viruses, 3573 (38.9%) tested positive. Data quality for all evaluated indicators was categorized as above 90% and the system also appeared to be strong in terms of its acceptability, simplicity and stability. However, sample collection needed improvement. The influenza surveillance system in Madagascar performed well and provided reliable and timely data for public health interventions. Given its flexibility and overall moderate cost, this system may become a useful platform for syndromic and laboratory-based surveillance in other low-resource settings.

2009 Pantex Plant Annual Illness and Injury Surveillance

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-12-15

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Use of emergency department electronic medical records for automated epidemiological surveillance of suicide attempts: a French pilot study.

Science.gov (United States)

Metzger, Marie-Hélène; Tvardik, Nastassia; Gicquel, Quentin; Bouvry, Côme; Poulet, Emmanuel; Potinet-Pagliaroli, Véronique

2017-06-01

The aim of this study was to determine whether an expert system based on automated processing of electronic health records (EHRs) could provide a more accurate estimate of the annual rate of emergency department (ED) visits for suicide attempts in France, as compared to the current national surveillance system based on manual coding by emergency practitioners. A feasibility study was conducted at Lyon University Hospital, using data for all ED patient visits in 2012. After automatic data extraction and pre-processing, including automatic coding of medical free-text through use of the Unified Medical Language System, seven different machine-learning methods were used to classify the reasons for ED visits into "suicide attempts" versus "other reasons". The performance of these different methods was compared by using the F-measure. In a test sample of 444 patients admitted to the ED in 2012 (98 suicide attempts, 48 cases of suicidal ideation, and 292 controls with no recorded non-fatal suicidal behaviour), the F-measure for automatic detection of suicide attempts ranged from 70.4% to 95.3%. The random forest and naïve Bayes methods performed best. This study demonstrates that machine-learning methods can improve the quality of epidemiological indicators as compared to current national surveillance of suicide attempts. Copyright © 2016 John Wiley & Sons, Ltd.

Vascular manifestations of syndromic aortopathies: role of current and emerging imaging techniques

International Nuclear Information System (INIS)

Westerland, O.; Frigiola, A.; Robert, L.; Shaw, A.; Blakeway, L.; Katsanos, K.; Kiesewetter, C.; Chung, N.; Karunanithy, N.

2015-01-01

Patients with connective tissue diseases such as Marfan's syndrome, Loeys–Dietz syndrome, and vascular Ehlers–Danlos syndrome comprise a small but important group of patients who present early with acute aortic syndrome comprising aneurysmal dilation, rupture, or aortic dissection. Cardiovascular pathologies are an important yet treatable cause of morbidity and mortality in these patients. Imaging plays an important role in initial diagnosis, surveillance, and identification of complications. Furthermore, these patients are prone to developing complications in other vascular territories. Effective screening and surveillance will allow early diagnosis and elective treatment thus reducing the morbidity and mortality associated with presentation with acute complications. In this article, we will provide an overview of the role of magnetic resonance and computed tomography angiography in the management of syndromic aortopathies.

Surveillance plan for the early detection of H5N1 highly pathogenic avian influenza virus in migratory birds in the United States: surveillance year 2009

Science.gov (United States)

Brand, Christopher J.

2009-01-01

Executive Summary: This Surveillance Plan (Plan) describes plans for conducting surveillance of wild birds in the United States and its Territories and Freely-Associated States to provide for early detection of the introduction of the H5N1 Highly Pathogenic Avian Influenza (HPAI) subtype of the influenza A virus by migratory birds during the 2009 surveillance year, spanning the period of April 1, 2009 - March 31, 2010. The Plan represents a continuation of surveillance efforts begun in 2006 under the Interagency Strategic Plan for the Early Detection of H5N1 Highly Pathogenic Avian Influenza in Wild Migratory Birds (U.S. Department of Agriculture and U.S. Department of the Interior, 2006). The Plan sets forth sampling plans by: region, target species or species groups to be sampled, locations of sampling, sample sizes, and sampling approaches and methods. This Plan will be reviewed annually and modified as appropriate for subsequent surveillance years based on evaluation of information from previous years of surveillance, changing patterns and threats of H5N1 HPAI, and changes in funding availability for avian influenza surveillance. Specific sampling strategies will be developed accordingly within each of six regions, defined here as Alaska, Hawaiian/Pacific Islands, Lower Pacific Flyway (Washington, Oregon, California, Idaho, Nevada, Arizona), Central Flyway, Mississippi Flyway, and Atlantic Flyway.

CDC Behavioral Risk Factor Surveillance System (BRFSS)

Data.gov (United States)

U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...

Was the French clinical surveillance system of bovine brucellosis influenced by the occurrence and surveillance of other abortive diseases?

Science.gov (United States)

Bronner, Anne; Morignat, Eric; Touratier, Anne; Gache, Kristel; Sala, Carole; Calavas, Didier

2015-03-01

The bovine brucellosis clinical surveillance system implemented in France aims to detect early any case of bovine brucellosis, a disease of which the country has been declared free since 2005. It relies on the mandatory notification of every bovine abortion. Following the spread of the Schmallenberg virus (SBV) in France in 2012 and 2013, and the implementation in 2012 of a clinical surveillance programme of Q fever based on abortion notifications in ten pilot départements, our objective was to study whether these two events influenced the brucellosis clinical surveillance system. The proportion of notifying farmers was analyzed over each semester from June 1, 2009 to June 30, 2013 according to the size and production type of herds, SBV status of départements and the implementation of the Q fever surveillance. Our analysis showed a slight increase in the proportion of notifying farmers as départements became infected by SBV, and after the implementation of Q fever surveillance (during the first semester of 2013). These variations might be explained by an increase in abortion occurrence (congenital deformities in newborns, due to SBV) and/or by an increase in farmers' and veterinarians' awareness (due to the spread of SBV and the implementation of the Q fever surveillance). These results highlight the difficulties in interpreting variations in the proportion of notifying farmers as a consequence of an increase in abortion occurrence. As bovine abortion surveillance can play an important role in the early warning for several diseases, there is a need to explore other ways to monitor abortions in cattle, such as syndromic surveillance using the dates of artificial insemination or calving data. Copyright © 2015 Elsevier B.V. All rights reserved.

Rinderpest surveillance

International Nuclear Information System (INIS)

2003-01-01

Rinderpest is probably the most lethal virus disease of cattle and buffalo and can destroy whole populations; damaging economies; undermining food security and ruining the livelihood of farmers and pastoralists. The disease can be eradicated by vaccination and control of livestock movement. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division to provide advice, training and materials to thirteen states through the 'Support for Rinderpest Surveillance in West Asia' project. (IAEA)

Evaluating syndromic surveillance systems at institutions of higher education (IHEs): a retrospective analysis of the 2009 H1N1 influenza pandemic at two universities.

Science.gov (United States)

Zhang, Ying; May, Larissa; Stoto, Michael A

2011-07-26

Syndromic surveillance has been widely adopted as a real-time monitoring tool for timely response to disease outbreaks. During the second wave of the pH1N1 pandemic in Fall 2009, two major universities in Washington, DC collected data that were potentially indicative of influenza-like illness (ILI) cases in students and staff. In this study, our objectives were three-fold. The primary goal of this study was to characterize the impact of pH1N1 on the campuses as clearly as possible given the data available and their likely biases. In addition, we sought to evaluate the strengths and weaknesses of the data series themselves, in order to inform these two universities and other institutions of higher education (IHEs) about real-time surveillance systems that are likely to provide the most utility in future outbreaks (at least to the extent that it is possible to generalize from this analysis). We collected a wide variety of data that covered both student ILI cases reported to medical and non-medical staff, employee absenteeism, and hygiene supply distribution records (from University A only). Communication data were retrieved from university broadcasts, university preparedness websites, and H1N1-related on campus media reports. Regional data based on the Centers for Disease Control and Prevention Outpatient Influenza-like Illness Surveillance Network (CDC ILINet) surveillance network, American College Health Association (ACHA) pandemic influenza surveillance data, and local Google Flu Trends were used as external data sets. We employed a "triangulation" approach for data analysis in which multiple contemporary data sources are compared to identify time patterns that are likely to reflect biases as well as those that are more likely to be indicative of actual infection rates. Medical personnel observed an early peak at both universities immediately after school began in early September and a second peak in early November; only the second peak corresponded to patterns in

2003 Nevada Test Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for the Nevada Test Site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Multiple Hamartoma Syndrome with Characteristic Oral and Cutaneous Manifestations

Directory of Open Access Journals (Sweden)

Prashanthi Chippagiri

2013-01-01

Full Text Available Aim. To present a case of Cowden's syndrome and emphasize the importance of continued cancer surveillance in these patients. Cowden syndrome is an inherited autosomal dominant trait with incomplete penetrance and a range of expressivity. It is characterized by multiple hamartomas and neoplasms. Mucocutaneous features include trichilemmomas, oral mucosal papillomatosis, acral keratosis, and palmoplantar keratosis. Here, we report a case of Cowdens syndrome of a 30-year-old female patient who came with a complaint of multiple growths in the oral cavity of a three-month duration. On examination, multiple skin-colored, flat-topped papules over her forehead and right malar bone and multiple papillomatous papules involving all the mucosal surfaces intraorally were observed. This syndrome is associated with the development of several types of malignancies, especially breast carcinoma and thyroid carcinoma, which is why early recognition and regular and vigilant surveillance of individuals with the syndrome are important.

Quality colonoscopy and risk of interval cancer in Lynch syndrome

NARCIS (Netherlands)

Haanstra, J. F.; Vasen, H. F. A.; Sanduleanu, S.; van der Wouden, E. J.; Koornstra, J. J.; Kleibeuker, J. H.; Cappel, W. H. de Vos Tot Nederveen

2013-01-01

Despite colonoscopic surveillance, Lynch syndrome patients develop colorectal cancer (CRC). Identification of modifiable factors has the potential to improve outcome of surveillance. The aims of this study were to determine (1) characteristics of patients with CRC, (2) endoscopic and histological

Groundwater surveillance plan for the Oak Ridge Reservation

International Nuclear Information System (INIS)

Forstrom, J.M.; Smith, E.D.; Winters, S.L.; McMaster, W.M.

1994-07-01

US Department of Energy (DOE) Order 5400.1 requires the preparation of environmental monitoring plans and implementation of environmental monitoring programs for all DOE facilities. The order identifies two distinct components of environmental monitoring, namely effluent monitoring and environmental surveillance. In general, effluent monitoring has the objectives of characterizing contaminants and demonstrating compliance with applicable standards and permit requirements, whereas environmental surveillance has the broader objective of monitoring the effects of DOE activities on on- and off-site environmental and natural resources. The purpose of this document is to support the Environmental Monitoring Plan for the Oak Ridge Reservation (ORR) by describing the groundwater component of the environmental surveillance program for the DOE facilities on the ORR. The distinctions between groundwater effluent monitoring and groundwater surveillance have been defined in the Martin Marietta Energy Systems, Inc., Groundwater Surveillance Strategy. As defined in the strategy, a groundwater surveillance program consists of two parts, plant perimeter surveillance and off-site water well surveillance. This document identifies the sampling locations, parameters, and monitoring frequencies for both of these activities on and around the ORR and describes the rationale for the program design. The program was developed to meet the objectives of DOE Order 5400.1 and related requirements in DOE Order 5400.5 and to conform with DOE guidance on environmental surveillance and the Energy Systems Groundwater Surveillance Strategy

Turner Syndrome: Care of the Patient: Birth to Late Adolescence.

Science.gov (United States)

Paolucci, Denise Gruccio; Bamba, Vaneeta

2017-06-01

Turner syndrome (TS) is a genetic condition occurring in females resulting from the loss of part or all of one of the X chromosomes. The two hallmark features of Turner syndrome include short stature and primary ovarian insufficiency. In addition, Turner syndrome can involve multiple healthcare issues including cardiac and renal anomalies, autoimmune disorders, hearing loss, ophthalmologic issues, bone anomalies, dermatologic issues and psychosocial and educational concerns. The presenting signs of Turner syndrome can vary markedly, leading to delayed or even missed diagnosis. Early identification of TS allows for appropriate screening and surveillance evaluations and more timely treatment intervention. This article will provide an overview of the healthcare issues common to patients with TS, treatments available and the screening and surveillance testing that is recommended. Copyright© of YS Medical Media ltd.

Comparing Syndromic Surveillance and Poison Center Data for Snake Bites in Missouri

OpenAIRE

Pugh, Karen H.; Kelsey, Amy; Tominack, Rebecca

2013-01-01

Objective This study intends to use two different surveillance systems available in Missouri to explore snake bite frequency and geographic distribution. Introduction In 2010, there were 4,796 snake bite exposures reported to Poison Centers nationwide (1). Health care providers frequently request help from poison centers regarding snake envenomations due to the unpredictability and complexity of prognosis and treatment. The Missouri Poison Center (MoPC) maintains a surveillance database keepi...

Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

OpenAIRE

Carpenter, Christopher R; Griffey, Richard T; Stark, Susan; Coopersmith, Craig M; Gage, Brian F

2011-01-01

Introduction: The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods: This was a single-center emergency department (ED) survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of t...

Automated Safety Incident Surveillance and Tracking System (ASISTS)

Data.gov (United States)

Department of Veterans Affairs — The Automated Safety Incident Surveillance and Tracking System (ASISTS) is a repository of Veterans Health Administration (VHA) employee accident data. Many types of...

2010 Pantex Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-29

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2009 Hanford Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-12-01

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Hanford Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety, and Security

2009-07-16

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Pantex Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-19

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Hanford Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-14

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Hanford Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-10-05

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Pantex Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-07-31

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for ORNL. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Evaluating Syndromic surveillance systems at institutions of higher education (IHEs: A retrospective analysis of the 2009 H1N1 influenza pandemic at two universities

Directory of Open Access Journals (Sweden)

May Larissa

2011-07-01

Full Text Available Abstract Background Syndromic surveillance has been widely adopted as a real-time monitoring tool for timely response to disease outbreaks. During the second wave of the pH1N1 pandemic in Fall 2009, two major universities in Washington, DC collected data that were potentially indicative of influenza-like illness (ILI cases in students and staff. In this study, our objectives were three-fold. The primary goal of this study was to characterize the impact of pH1N1 on the campuses as clearly as possible given the data available and their likely biases. In addition, we sought to evaluate the strengths and weaknesses of the data series themselves, in order to inform these two universities and other institutions of higher education (IHEs about real-time surveillance systems that are likely to provide the most utility in future outbreaks (at least to the extent that it is possible to generalize from this analysis. Methods We collected a wide variety of data that covered both student ILI cases reported to medical and non-medical staff, employee absenteeism, and hygiene supply distribution records (from University A only. Communication data were retrieved from university broadcasts, university preparedness websites, and H1N1-related on campus media reports. Regional data based on the Centers for Disease Control and Prevention Outpatient Influenza-like Illness Surveillance Network (CDC ILINet surveillance network, American College Health Association (ACHA pandemic influenza surveillance data, and local Google Flu Trends were used as external data sets. We employed a "triangulation" approach for data analysis in which multiple contemporary data sources are compared to identify time patterns that are likely to reflect biases as well as those that are more likely to be indicative of actual infection rates. Results Medical personnel observed an early peak at both universities immediately after school began in early September and a second peak in early November

Environmental surveillance master sampling schedule

Energy Technology Data Exchange (ETDEWEB)

Bisping, L E

1992-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. Samples for radiological analyses include Air-Particulate Filter, gases and vapor; Water/Columbia River, Onsite Pond, Spring, Irrigation, and Drinking; Foodstuffs/Animal Products including Whole Milk, Poultry and Eggs, and Beef; Foodstuffs/Produce including Leafy Vegetables, Vegetables, and Fruit; Foodstuffs/Farm Products including Wine, Wheat and Alfalfa; Wildlife; Soil; Vegetation; and Sediment. Direct Radiation Measurements include Terrestrial Locations, Columbia River Shoreline Locations, and Onsite Roadway, Railway and Aerial, Radiation Surveys.

Hanford Site Environmental Surveillance Master Sampling Schedule

International Nuclear Information System (INIS)

Bisping, L.E.

2000-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE). Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, General Environmental Protection Program: and DOE Order 5400.5, Radiation Protection of the Public and the Environment. The sampling design is described in the Operations Office, Environmental Monitoring Plan, United States Department of Energy, Richland DOE/RL-91-50, Rev.2, U.S. Department of Energy, Richland, Washington. This document contains the CY 2000 schedules for the routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. Each section includes sampling locations, sample types, and analyses to be performed. In some cases, samples are scheduled on a rotating basis and may not be collected in 2000 in which case the anticipated year for collection is provided. In addition, a map showing approximate sampling locations is included for each media scheduled for collection

Hanford Site Environmental Surveillance Master Sampling Schedule

International Nuclear Information System (INIS)

Bisping, L.E.

1999-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE). Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, ''General Environmental protection Program,'' and DOE Order 5400.5, ''Radiation Protection of the Public and the Environment.'' The sampling methods are described in the Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office, DOE/RL-91-50, Rev.2, U.S. Department of Energy, Richland, Washington. This document contains the CY1999 schedules for the routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. Each section includes the sampling location, sample type, and analyses to be performed on the sample. In some cases, samples are scheduled on a rotating basis and may not be collected in 1999 in which case the anticipated year for collection is provided. In addition, a map is included for each media showing approximate sampling locations

Behavioral Risk Factor Surveillance System (BRFSS) Historical Questions

Data.gov (United States)

U.S. Department of Health & Human Services — 1984-2016. Centers for Disease Control and Prevention (CDC). BRFSS Survey Data. The BRFSS is a continuous, state-based surveillance system that collects information...

A survey of core and support activities of communicable disease surveillance systems at operating-level CDCs in China.

Science.gov (United States)

Xiong, Weiyi; Lv, Jun; Li, Liming

2010-11-17

In recent years, problems like insufficient coordination, low efficiency, and heavy working load in national communicable disease surveillance systems in China have been pointed out by many researchers. To strengthen the national communicable disease surveillance systems becomes an immediate concern. Since the World Health Organization has recommended that a structured approach to strengthen national communicable disease surveillance must include an evaluation to existing systems which usually begins with a systematic description, we conducted the first survey for communicable disease surveillance systems in China, in order to understand the situation of core and support surveillance activities at province-level and county-level centers for disease control and prevention (CDCs). A nationwide survey was conducted by mail between May and October 2006 to investigate the implementation of core and support activities of the Notifiable Disease Reporting System (NDRS) and disease-specific surveillance systems in all of the 31 province-level and selected 14 county-level CDCs in Mainland China The comments on the performance of communicable disease surveillance systems were also collected from the directors of CDCs in this survey. The core activities of NDRS such as confirmation, reporting and analysis and some support activities such as supervision and staff training were found sufficient in both province-level and county-level surveyed CDCs, but other support activities including information feedback, equipment and financial support need to be strengthened in most of the investigated CDCs. A total of 47 communicable diseases or syndromes were under surveillance at province level, and 20 diseases or syndromes at county level. The activities among different disease-specific surveillance systems varied widely. Acute flaccid paralysis (AFP), measles and tuberculosis (TB) surveillance systems got relatively high recognition both at province level and county level. China has

2003 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for the East Tennessee Technology Park (K-25).The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Shifting the Paradigm: Using HIV Surveillance Data as a Foundation for Improving HIV Care and Preventing HIV Infection

Science.gov (United States)

Sweeney, Patricia; Gardner, Lytt I; Buchacz, Kate; Garland, Pamela Morse; Mugavero, Michael J; Bosshart, Jeffrey T; Shouse, R Luke; Bertolli, Jeanne

2013-01-01

Context Reducing HIV incidence in the United States and improving health outcomes for people living with HIV hinge on improving access to highly effective treatment and overcoming barriers to continuous treatment. Using laboratory tests routinely reported for HIV surveillance to monitor individuals’ receipt of HIV care and contacting them to facilitate optimal care could help achieve these objectives. Historically, surveillance-based public health intervention with individuals for HIV control has been controversial because of concerns that risks to privacy and autonomy could outweigh benefits. But with the availability of lifesaving, transmission-interrupting treatment for HIV infection, some health departments have begun surveillance-based outreach to facilitate HIV medical care. Methods Guided by ethics frameworks, we explored the ethical arguments for changing the uses of HIV surveillance data. To identify ethical, procedural, and strategic considerations, we reviewed the activities of health departments that are using HIV surveillance data to contact persons identified as needing assistance with initiating or returning to care. Findings Although privacy concerns surrounding the uses of HIV surveillance data still exist, there are ethical concerns associated with not using HIV surveillance to maximize the benefits from HIV medical care and treatment. Early efforts to use surveillance data to facilitate optimal HIV medical care illustrate how the ethical burdens may vary depending on the local context and the specifics of implementation. Health departments laid the foundation for these activities by engaging stakeholders to gain their trust in sharing sensitive information; establishing or strengthening legal, policy and governance infrastructure; and developing communication and follow-up protocols that protect privacy. Conclusions We describe a shift toward using HIV surveillance to facilitate optimal HIV care. Health departments should review the

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

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 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. PMID:24155907

Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.

Science.gov (United States)

Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

2007-06-01

We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures.

Harmful Algal Bloom-Associated Illnesses in Humans and Dogs Identified Through a Pilot Surveillance System - New York, 2015.

Science.gov (United States)

Figgatt, Mary; Hyde, James; Dziewulski, David; Wiegert, Eric; Kishbaugh, Scott; Zelin, Grant; Wilson, Lloyd

2017-11-03

Cyanobacteria, also known as blue-green algae, are photosynthetic, aquatic organisms found in fresh, brackish, and marine water around the world (1). Rapid proliferation and accumulation of potentially toxin-producing cyanobacteria characterize one type of harmful algal bloom (HAB). HABs have the potential to cause illness in humans and animals (2,3); however, the epidemiology of these illnesses has not been well characterized. Statewide in 2015, a total of 139 HABs were identified in New York, 97 (70%) of which were confirmed through laboratory analysis; 77 independent beach closures were ordered at 37 beaches on 20 different bodies of water. To better characterize HAB-associated illnesses, during June-September 2015, the New York State Department of Health (NYSDOH) implemented a pilot surveillance system in 16 New York counties. Activities included the collection of data from environmental HAB reports, illness reports, poison control centers, and syndromic surveillance, and increased outreach to the public, health care providers, and veterinarians. During June-September, 51 HAB-associated illnesses were reported, including 35 that met the CDC case definitions*; 32 of the cases occurred in humans and three in dogs. In previous years, New York never had more than 10 HAB-associated illnesses reported statewide. The pilot surveillance results from 16 counties during a 4-month period suggest that HAB-associated illnesses might be more common than previously reported.

Assessment of HIV molecular surveillance capacity in the European Union, 2016.

Science.gov (United States)

Keating, Patrick; Pharris, Anastasia; Leitmeyer, Katrin; De Angelis, Stefania; Wensing, Annemarie; Amato-Gauci, Andrew J; Broberg, Eeva

2017-12-01

IntroductionExpanding access to HIV antiretroviral treatment is expected to decrease HIV incidence and acquired immunodeficiency syndrome (AIDS) mortality. However, this may also result in increased HIV drug resistance (DR). Better monitoring and surveillance of HIV DR is required to inform treatment regimens and maintain the long term effectiveness of antiretroviral drugs. As there is currently no formal European Union (EU)-wide collection of HIV DR data, this study aimed to assess the current HIV molecular surveillance capacity in EU/European Economic Area (EEA) countries in order to inform the planning of HIV DR monitoring at EU level. Methods: Thirty EU/EEA countries were invited to participate in a survey on HIV molecular surveillance capacity, which also included laboratory aspects. Results: Among 21 responding countries, 13 reported using HIV sequence data (subtype and/or DR) for surveillance purposes at national level. Of those, nine stated that clinical, epidemiological and sequence data were routinely linked for analysis. Discussion/conclusion : We identified similarities between existing HIV molecular surveillance systems, but also found important challenges including human resources, data ownership and legal issues that would need to be addressed.Information on capacities should allow better planning of the phased introduction of HIV DR surveillance at EU/EEA level.

Correlation between national influenza surveillance data and google trends in South Korea.

Science.gov (United States)

Cho, Sungjin; Sohn, Chang Hwan; Jo, Min Woo; Shin, Soo-Yong; Lee, Jae Ho; Ryoo, Seoung Mok; Kim, Won Young; Seo, Dong-Woo

2013-01-01

In South Korea, there is currently no syndromic surveillance system using internet search data, including Google Flu Trends. The purpose of this study was to investigate the correlation between national influenza surveillance data and Google Trends in South Korea. Our study was based on a publicly available search engine database, Google Trends, using 12 influenza-related queries, from September 9, 2007 to September 8, 2012. National surveillance data were obtained from the Korea Centers for Disease Control and Prevention (KCDC) influenza-like illness (ILI) and virologic surveillance system. Pearson's correlation coefficients were calculated to compare the national surveillance and the Google Trends data for the overall period and for 5 influenza seasons. The correlation coefficient between the KCDC ILI and virologic surveillance data was 0.72 (pcorrelation was between the Google Trends query of H1N1 and the ILI data, with a correlation coefficient of 0.53 (pcorrelation with a correlation coefficient of 0.93 (pcorrelation coefficient compared with ILI data for three consecutive seasons: Tamiflu (r = 0.59, 0.86, 0.90, pcorrelated with national surveillance data in South Korea. The results of this study showed that Google Trends in the Korean language can be used as complementary data for influenza surveillance but was insufficient for the use of predictive models, such as Google Flu Trends.

1995 Annual epidemiologic surveillance report for Brookhaven National Laboratory

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

The US Department of Energy`s (DOE) conduct of epidemiologic surveillance provides an early warning system for health problems among workers. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report summarizes epidemiologic surveillance data collected from Brookhaven National Laboratory (BNL) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at BNL and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out.

2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-05-04

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-06

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-07-31

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-09-26

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-02-04

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Kansas City Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Savannah River Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-09-12

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Kansas City Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2009 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-11-24

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-10

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Savannah River Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-08-20

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Savannah River Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-05-05

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Kansas City Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-22

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Savannah River Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-29

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-10-26

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Nevada Test Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-06-30

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Idaho National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-11-23

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Nevada Test Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-24

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Kansas City Plant Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-20

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2009 Argonne National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-08-19

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-17

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Nevada Test Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-10-05

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Work-Related Lung Disease Surveillance System (eWoRLD)

Data.gov (United States)

U.S. Department of Health & Human Services — A surveillance system that provides morbidity, mortality, and workplace exposure data on work-related respiratory diseases by geographic region, industry and...

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.

Advances in the study of Lynch syndrome in China.

Science.gov (United States)

Lu, Jun-Yu; Sheng, Jian-Qiu

2015-06-14

Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, is an autosomal dominant genetic condition that has a high risk of colon cancer as well as other cancers due to inherited mutations in mismatch repair (MMR) genes. During the last decades, there have been great advances in research on Chinese Lynch syndrome. This review mainly focuses on the genetic basis, clinicopathologic features, diagnosis, intervention, chemoprevention, and surveillance of Lynch syndrome in China. In addition to frequently altered MMR genes, such as MLH1, MSH2, MSH6, and MLH3, other MMR-associated genes, such as those encoding human exonuclease 1, transforming growth factor β receptor 2, and alanine aminopeptidase, metastasis-associated protein 2, adenomatosis polyposis coli down-regulated 1, and hepatic and glial cell adhesion molecule have also been implicated in Chinese Lynch syndrome. Most Chinese researchers focused on the clinicopathologic features of Lynch syndrome, and it is noticeable that the most frequent extracolonic tumor in northeast China is lung cancer, which is different from other areas in China. The Chinese diagnostic criteria for Lynch syndrome have been established to identify gene mutation or methylation. With regard to chemoprevention, celecoxib may be effective to prevent polyps relapse in Lynch syndrome carriers. Additionally, a colonoscopy-based surveillance strategy for the prevention and early detection of neoplasms in Lynch-syndrome carriers has been proposed.

2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-24

Annual Illness and Injury Surveillance Program for 2004 for the Hanford site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Guidelines for surveillance of individuals with constitutional mismatch repair-deficiency proposed by the European Consortium "Care for CMMR-D" (C4CMMR-D).

Science.gov (United States)

Vasen, H F A; Ghorbanoghli, Z; Bourdeaut, F; Cabaret, O; Caron, O; Duval, A; Entz-Werle, N; Goldberg, Y; Ilencikova, D; Kratz, C P; Lavoine, N; Loeffen, J; Menko, F H; Muleris, M; Sebille, G; Colas, C; Burkhardt, B; Brugieres, L; Wimmer, K

2014-05-01

Lynch syndrome (LS) is an autosomal dominant disorder caused by a defect in one of the DNA mismatch repair genes: MLH1, MSH2, MSH6 and PMS2. In the last 15 years, an increasing number of patients have been described with biallelic mismatch repair gene mutations causing a syndrome referred to as 'constitutional mismatch repair-deficiency' (CMMR-D). The spectrum of cancers observed in this syndrome differs from that found in LS, as about half develop brain tumours, around half develop digestive tract cancers and a third develop haematological malignancies. Brain tumours and haematological malignancies are mainly diagnosed in the first decade of life, and colorectal cancer (CRC) and small bowel cancer in the second and third decades of life. Surveillance for CRC in patients with LS is very effective. Therefore, an important question is whether surveillance for the most common CMMR-D-associated cancers will also be effective. Recently, a new European consortium was established with the aim of improving care for patients with CMMR-D. At a workshop of this group held in Paris in June 2013, one of the issues addressed was the development of surveillance guidelines. In 1968, criteria were proposed by WHO that should be met prior to the implementation of screening programmes. These criteria were used to assess surveillance in CMMR-D. The evaluation showed that surveillance for CRC is the only part of the programme that largely complies with the WHO criteria. The values of all other suggested screening protocols are unknown. In particular, it is questionable whether surveillance for haematological malignancies improves the already favourable outcome for patients with these tumours. Based on the available knowledge and the discussions at the workshop, the European consortium proposed a surveillance protocol. Prospective collection of all results of the surveillance is needed to evaluate the effectiveness of the programme.

Mining Surveillance and Maintenance Dollars

International Nuclear Information System (INIS)

MARTINEZ, R.

2000-01-01

Accelerating site cleanup to reduce facility risks to the workers, the public and the environment during a time of declining federal budgets represents a significant technical and economic challenge to U.S. Department of Energy (DOE) Operations Offices and their respective contractors. A significant portion of a facility's recurring annual expenses are associated with routine, long-term surveillance and maintenance (S and M) activities. However, ongoing S and M activities do nothing to reduce risks and basically spend money that could be reallocated towards facility deactivation. This paper discusses the background around DOE efforts to reduce surveillance and maintenance costs, one approach used to perform cost reviews, lessons learned from field implementation and what assistance is available to assist DOE sites in performing these evaluations

Nosocomial Infections in Nuclear Medicine Departments: some considerations

International Nuclear Information System (INIS)

Metello, L.F.; Cunha, L.; Martins, M.; Isabel, O.; Ribeiro, G.

2002-01-01

Aim: Surveillance for Nosocomial Infection has become an integral part of hospital practice. Studies conducted more than 30 years ago by the Centers for Disease Control and Prevention (CDC) documented the efficacy of these surveillance activities in reducing Nosocomial Infection occurrence. It is clear that surveillance for Nosocomial Infection involves more than just documenting infection rates. However, many times the professionals involved have tended to stop at the point where rates are reported and fail to complete the task of implementing changes based on the analysis of rates or disseminating information. Moreover specific documentation regarding Nuclear Medicine Departments is not available. We therefore decided to produce this work based in the recognition of this specific need. Methods and Conclusions: Having previously defined the 'state-of-the-art' from science and technology concerning Nosocomial Infection Control and after particular study regarding technical/clinical reality of Nuclear Medicine Departments, namely introducing the radioactivity as a factor that must be taken into account with all its implications and interactions, we have obtained a group of considerations and/or recommendations to be considered in order to accomplish the maximum Quality and Efficiency regarding the Control of Nosocomial Infection in Nuclear Medicine Departments

Outcome of 24 years national surveillance in different hereditary colorectal cancer subgroups leading to more individualised surveillance

DEFF Research Database (Denmark)

Lindberg, Lars Joachim; Ladelund, Steen; Frederiksen, Birgitte Lidegaard

2017-01-01

BACKGROUND: Individuals with hereditary non-polyposis colorectal cancer (HNPCC) have a high risk of colorectal cancer (CRC). The benefits of colonic surveillance in Lynch syndrome and Amsterdam-positive (familial CRC type X familial colorectal cancer type X (FCCTX)) families are clear; only...... in the Lynch subgroup (2.0%) than in any other subgroup (0.0-0.4%, pLynch (3.6%) and non-Lynch (2.3-3.9%, p=0.28) subgroups. Non-Lynch Amsterdam-positive and Amsterdam-negative families were similar in their CRC (0.1-0.4%, p=0.......072), advanced adenoma (2.3-3.3%, p=0.32) and simple adenoma (8.4-9.9%, p=0.43) incidence. In moderate-risk families, no CRC and only one advanced adenoma was found. CONCLUSIONS: The risk of CRC in Lynch families is considerable, despite biannual surveillance. We suggest less frequent and more individualised...

The proportion of work-related emergency department visits not expected to be paid by workers' compensation: implications for occupational health surveillance, research, policy, and health equity.

Science.gov (United States)

Groenewold, Matthew R; Baron, Sherry L

2013-12-01

To examine trends in the proportion of work-related emergency department visits not expected to be paid by workers' compensation during 2003-2006, and to identify demographic and clinical correlates of such visits. A total of 3,881 work-related emergency department visit records drawn from the 2003-2006 National Hospital Ambulatory Medical Care Surveys. Secondary, cross-sectional analyses of work-related emergency department visit data were performed. Odds ratios and 95 percent confidence intervals were modeled using logistic regression. A substantial and increasing proportion of work-related emergency department visits in the United States were not expected to be paid by workers' compensation. Private insurance, Medicaid, Medicare, and workers themselves were expected to pay for 40 percent of the work-related emergency department visits with this percentage increasing annually. Work-related visits by blacks, in the South, to for-profit hospitals and for work-related illnesses were all more likely not to be paid by workers' compensation. Emergency department-based surveillance and research that determine work-relatedness on the basis of expected payment by workers' compensation systematically underestimate the occurrence of occupational illness and injury. This has important methodological and policy implications. © Health Research and Educational Trust.

Using Surveillance Camera Systems to Monitor Public Domains: Can Abuse Be Prevented

Science.gov (United States)

2006-03-01

relationship with a 16-year old girl failed. The incident was captured by a New York City Police Department surveillance camera. Although the image...administrators stated that the images recorded were “…nothing more than images of a few bras and panties .”17 The use of CCTV surveillance systems for

DASH - Youth Risk Behavior Surveillance System (YRBSS): Middle School

Data.gov (United States)

U.S. Department of Health & Human Services — 1991-2015. Middle School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

Data.gov (United States)

U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

Directory of Open Access Journals (Sweden)

Brian F Gage

2011-05-01

Full Text Available Introduction: The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods: This was a single-center emergency department (ED survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of this anonymous survey was to evaluate ED nurse and physician perceptions about the geriatric screener feasibility and barriers to implementation. In addition, as a secondary objective, respondents reported ongoing geriatric screening efforts independent of the research screeners. Results: The survey was completed by 72% of physicians and 33% of nurses. Most nurses and physicians identified geriatric technicians as beneficial to patients without impeding ED throughput. Fewer than 25% of physicians routinely screen for any geriatric syndromes. Nurses evaluated for fall risk significantly more often than physicians, but no other significant differences were noted in ongoing screening efforts. Conclusion: Dedicated geriatric technicians are perceived by nurses and physicians as beneficial to patients with the potential to improve patient safety and clinical outcomes. Most nurses and physicians are not currently screening for any geriatric syndromes. [West J Emerg Med. 2011;12(4:489–495.

[Hospital infection in the maternity department. 3 years of surveillance in 9,204 deliveries of which 1,333 were cesarean sections].

Science.gov (United States)

Tissot-Guerraz, F; Moussy, L; Agniel, F; André, A; Reverdy, M E; Miellet, C C; Audra, P; Putet, G; Sepetjan, M; Dargent, D

1990-01-01

Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

Environmental surveillance master sampling schedule

International Nuclear Information System (INIS)

Bisping, L.E.

1995-02-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program

Environmental surveillance master sampling schedule

Energy Technology Data Exchange (ETDEWEB)

Bisping, L.E.

1995-02-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program.

System specification for the integrated monitoring and surveillance system

International Nuclear Information System (INIS)

1997-09-01

This System Specification establishes the requirements for the Plutonium Focus Area (PFA) Integrated Monitoring and Surveillance System (IMSS). In this document, ''Integrated Monitoring and Surveillance System'' is used to describe the concept of integrated sensors, computers, personnel, and systems that perform the functions of sensing conditions, acquiring data, monitoring environmental safety and health, controlling and accounting for materials, monitoring material stability, monitoring container integrity, transferring data, and analyzing, reporting, and storing data. This concept encompasses systems (e.g. sensors, personnel, databases, etc.) that are already in place at the sites but may require modifications or additions to meet all identified surveillance requirements. The purpose of this System Specification is to provide Department of Energy (DOE) sites that store plutonium materials with a consolidation of all known requirements for the storage and surveillance of 3013 packages of stabilized plutonium metals and oxides. This compilation may be used (1) as a baseline for surveillance system design specifications where 3013 packages of stabilized plutonium metals and oxides will be stored and monitored; (2) as a checklist for evaluating existing surveillance systems to ensure that all requirements are met for the storage and surveillance of 3013 packages of stabilized plutonium metals and oxides; and (3) as a baseline for preparing procurement specifications tailored for site specific storage and surveillance of 3013 packages of stabilized plutonium metals and oxides

Understanding unintentional childhood home injuries: pilot surveillance data from Karachi, Pakistan.

Science.gov (United States)

Zia, Nukhba; Khan, Uzma R; Razzak, Junaid A; Puvanachandra, Prasanthi; Hyder, Adnan A

2012-01-19

Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment. This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan. The surveillance included 566 injured children of which 409 (72%) injuries had taken place at/around home. Of 409 children, 66% were males and mostly between 5 and 11 years of age. Injuries commonly occurred during play time (51%). Fall (59%), dog bites (11%) and burns (9%) were the commonest mechanisms of injury. The majority of the children (78%) were directly discharged from the emergency room with predicted short term disability (42%). There were 2 deaths in the emergency department both due to falls. Childhood injury surveillance system provides valuable in-depth information on child injuries. The majority of these unintentional childhood injuries occur at home; with falls, dog bites and burns being the most common types of unintentional childhood home injuries. Specific surveillance systems for child injuries can provide new and valuable information for countries like Pakistan.

Hantavirus Pulmonary Syndrome in Santa Cruz, Bolivia: Outbreak Investigation and Antibody Prevalence Study

Science.gov (United States)

Montgomery, Joel M.; Blair, Patrick J.; Carroll, Darin S.; Mills, James N.; Gianella, Alberto; Iihoshi, Naomi; Briggiler, Ana M.; Felices, Vidal; Salazar, Milagros; Olson, James G.; Glabman, Raisa A.; Bausch, Daniel G.

2012-01-01

We report the results of an investigation of a small outbreak of hantavirus pulmonary syndrome in 2002 in the Department of Santa Cruz, Bolivia, where the disease had not previously been reported. Two cases were initially reported. The first case was a physician infected with Laguna Negra virus during a weekend visit to his ranch. Four other persons living on the ranch were IgM antibody-positive, two of whom were symptomatic for mild hantavirus pulmonary syndrome. The second case was a migrant sugarcane worker. Although no sample remained to determine the specific infecting hantavirus, a virus 90% homologous with Río Mamoré virus was previously found in small-eared pygmy rice rats (Oligoryzomys microtis) trapped in the area. An antibody prevalence study conducted in the region as part of the outbreak investigation showed 45 (9.1%) of 494 persons to be IgG positive, illustrating that hantavirus infection is common in Santa Cruz Department. Precipitation in the months preceding the outbreak was particularly heavy in comparison to other years, suggesting a possible climatic or ecological influence on rodent populations and risk of hantavirus transmission to humans. Hantavirus infection appears to be common in the Santa Cruz Department, but more comprehensive surveillance and field studies are needed to fully understand the epidemiology and risk to humans. PMID:23094116

SKIV2L Mutations Cause Syndromic Diarrhea, or Trichohepatoenteric Syndrome

Science.gov (United States)

Fabre, Alexandre; Charroux, Bernard; Martinez-Vinson, Christine; Roquelaure, Bertrand; Odul, Egritas; Sayar, Ersin; Smith, Hilary; Colomb, Virginie; Andre, Nicolas; Hugot, Jean-Pierre; Goulet, Olivier; Lacoste, Caroline; Sarles, Jacques; Royet, Julien; Levy, Nicolas; Badens, Catherine

2012-01-01

Syndromic diarrhea (or trichohepatoenteric syndrome) is a rare congenital bowel disorder characterized by intractable diarrhea and woolly hair, and it has recently been associated with mutations in TTC37. Although databases report TTC37 as being the human ortholog of Ski3p, one of the yeast Ski-complex cofactors, this lead was not investigated in initial studies. The Ski complex is a multiprotein complex required for exosome-mediated RNA surveillance, including the regulation of normal mRNA and the decay of nonfunctional mRNA. Considering the fact that TTC37 is homologous to Ski3p, we explored a gene encoding another Ski-complex cofactor, SKIV2L, in six individuals presenting with typical syndromic diarrhea without variation in TTC37. We identified mutations in all six individuals. Our results show that mutations in genes encoding cofactors of the human Ski complex cause syndromic diarrhea, establishing a link between defects of the human exosome complex and a Mendelian disease. PMID:22444670

A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.

Science.gov (United States)

Fuller, Brian M; Ferguson, Ian T; Mohr, Nicholas M; Drewry, Anne M; Palmer, Christopher; Wessman, Brian T; Ablordeppey, Enyo; Keeperman, Jacob; Stephens, Robert J; Briscoe, Cristopher C; Kolomiets, Angelina A; Hotchkiss, Richard S; Kollef, Marin H

2017-04-01

To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. Quasi-experimental, before-after trial. Emergency department and ICUs of an academic center. Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU. An emergency department ventilator protocol which targeted variables in need of quality improvement, as identified by prior work: 1) lung-protective tidal volume, 2) appropriate setting of positive end-expiratory pressure, 3) oxygen weaning, and 4) head-of-bed elevation. A total of 229 patients (186 preintervention group, 43 intervention group) were studied. In the emergency department, the intervention was associated with significant changes (p protective ventilation from 11.1% to 61.5%, p value of less than 0.01. The intervention was associated with a reduction in mortality from 54.8% to 39.5% (odds ratio, 0.38; 95% CI, 0.17-0.83; p = 0.02) and a 3.9 day increase in ventilator-free days, p value equals to 0.01. This before-after study of mechanically ventilated patients with acute respiratory distress syndrome demonstrates that implementing a mechanical ventilator protocol in the emergency department is feasible and associated with improved clinical outcomes.

Sleep apnea syndrome: experience of the pulmonology department in Ibn Sina Hospital, Rabat, Morocco.

Science.gov (United States)

Jniene, Asmaa; el Ftouh, Mustapha; Fihry, Mohamed Tawfiq el Fassy

2012-01-01

Sleep apnea syndrome is a highly prevalent disorder that is still underdiagnosed and undertreated and whose obstructive form is the most common. The diagnosis is suspected on clinical signs collected by interrogation and questionnaires (Berlin questionnaire and Epworth sleepiness scale), then confirmed by objective sleep study findings (polygraphy or polysomnography). It is necessary to conduct studies in each context on the characteristics and management of sleep apnea syndrome comprising the testing of reliability of the questionnaires. Prospective and descriptive study of 104 patients addressed to sleep consultation at pulmononology Department of Ibn Sina Hospital, Morocco over a period of 5 years (January 2006 to December 2010), agreed to participate in the study, responded to a predetermined questionnaire, and benefited from clinical examination and paraclinical tests including a polygraphy or a polysomnography 59(56.7%) patients had an obstructive sleep apnea-hypopnea syndrome with a similar prevalence in both sexes. 32.2% of patients were obese and 28,8% had cardio-vascular diseases. Snoring, excessive daytime sleepiness and witnessed apnea were found in respectively 79.7%, 50.8% and 16.9%. Berlin questionnaire and Epworth sleepiness scale had an acceptable internal consistency against apnea hypopnea index with a Cronbach's alpha coefficient respectively 0.79 and 0.78. Depending on severity, clinical impact and results of investigations, the adequate treatment has been proposed based on the 2010 recommendations for clinical practice. This study has provided an idea about the profile and the management of patients having an obstructive sleep apnea-hypopnea syndrome and showed that both Berlin questionnaire and Epworth sleepiness scale are two simple and reliable methods in our context. A larger and further study across the country should be considered.

Surveillance for Health Protection in England and Wales: An analysis of NHS Direct syndromic data

NARCIS (Netherlands)

Cooper, D. L.

2008-01-01

Disease surveillance is the collection and analysis health data to provide information for action and to inform decisions relating to public health policy. Surveillance systems in the UK typically rely on data about diagnoses made by clinicians, or laboratory confirmations of specific disease

2010 Nevada National Security Site Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-20

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-16

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-06-30

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-14

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-27

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety, and Security

2009-07-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-09-21

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-03-04

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Idaho National Engineering and Environmental Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for Idaho National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Hanford Site Environmental Surveillance Master Sampling Schedule for Calendar Year 2008

Energy Technology Data Exchange (ETDEWEB)

Bisping, Lynn E.

2008-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by Pacific Northwest National Laboratory for the U.S. Department of Energy. Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 450.1, "Environmental Protection Program," and DOE Order 5400.5, "Radiation Protection of the Public and the Environment." The environmental surveillance sampling design is described in the "Hanford Site Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office." This document contains the calendar year 2008 schedule for the routine collection of samples for the Surface Environmental Surveillance Project and Drinking Water Monitoring Project. Each section includes sampling locations, sampling frequencies, sample types, and analyses to be performed. In some cases, samples are scheduled on a rotating basis. If a sample will not be collected in 2008, the anticipated year for collection is provided. Maps showing approximate sampling locations are included for media scheduled for collection in 2008.

75 FR 41872 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance...

Science.gov (United States)

2010-07-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance, Natural History... evaluation of ``Surveillance, Natural History, Quality of Care and Outcomes of Diabetes Mellitus with Onset...

75 FR 13560 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance...

Science.gov (United States)

2010-03-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance, Natural History... evaluation of ``Surveillance, Natural History, Quality of Care and Outcomes of Diabetes Mellitus With Onset...

Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters.

Science.gov (United States)

Magruder, Steven F; Henry, J; Snyde, M

2005-08-26

Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

Hanford Site ground-water surveillance for 1989

International Nuclear Information System (INIS)

Evans, J.C.; Bryce, R.W.; Bates, D.J.; Kemner, M.L.

1990-06-01

This annual report of ground-water surveillance activities provides discussions and listings of results for ground-water monitoring at the Hanford Site during 1989. The Pacific Northwest Laboratory (PNL) assesses the impacts of Hanford operations on the environment for the US Department of Energy (DOE). The impact Hanford operations has on ground water is evaluated through the Hanford Site Ground-Water Surveillance program. Five hundred and sixty-seven wells were sampled during 1989 for Hanford ground-water monitoring activities. This report contains a listing of analytical results for calendar year (CY) 1989 for species of importance as potential contaminants. 30 refs., 29 figs,. 4 tabs

75 FR 48349 - Agency Forms Undergoing Paperwork Reduction Act review

Science.gov (United States)

2010-08-10

... monitor syndrome-based (e.g., case information collected in emergency departments (EDs) and diagnostic... syndromic surveillance systems. EARS has been designed and used to monitor syndromic data from emergency... events such as the Beijing Summer Olympics; multiple Superbowls (football) and World Series (baseball...

Revised surveillance case definition for HIV infection--United States, 2014.

Science.gov (United States)

2014-04-11

Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

Neurological manifestations of influenza infection in children and adults: results of a National British Surveillance Study.

Science.gov (United States)

Goenka, Anu; Michael, Benedict D; Ledger, Elizabeth; Hart, Ian J; Absoud, Michael; Chow, Gabriel; Lilleker, James; Lunn, Michael; McKee, David; Peake, Deirdre; Pysden, Karen; Roberts, Mark; Carrol, Enitan D; Lim, Ming; Avula, Shivaram; Solomon, Tom; Kneen, Rachel

2014-03-01

The emergence of influenza A(H1N1) 2009 was met with increased reports of associated neurological manifestations. We aimed to describe neurological manifestations of influenza in adults and children in the United Kingdom that presented at this time. A 2-year surveillance study was undertaken through the British adult and pediatric neurological surveillance units from February 2011. Patients were included if they met clinical case definitions within 1 month of proven influenza infection. Twenty-five cases were identified: 21 (84%) in children and 4 (16%) in adults. Six (29%) children had preexisting neurological disorders. Polymerase chain reaction of respiratory secretions identified influenza A in 21 (81%; 20 of which [95%] were H1N1) and influenza B in 4 (15%). Twelve children had encephalopathy (1 with movement disorder), 8 had encephalitis, and 1 had meningoencephalitis. Two adults had encephalopathy with movement disorder, 1 had encephalitis, and 1 had Guillain-Barré syndrome. Seven individuals (6 children) had specific acute encephalopathy syndromes (4 acute necrotizing encephalopathy, 1 acute infantile encephalopathy predominantly affecting the frontal lobes, 1 hemorrhagic shock and encephalopathy, 1 acute hemorrhagic leukoencephalopathy). Twenty (80%) required intensive care, 17 (68%) had poor outcome, and 4 (16%) died. This surveillance study described a cohort of adults and children with neurological manifestations of influenza. The majority were due to H1N1. More children than adults were identified; many children had specific encephalopathy syndromes with poor outcomes. None had been vaccinated, although 8 (32%) had indications for this. A modified classification system is proposed based on our data and the increasing spectrum of recognized acute encephalopathy syndromes.

Determinants of Pseudogymnoascus destructans within bat hibernacula: Implications for surveillance and management of white-nose syndrome

Science.gov (United States)

Verant, Michelle L.; Bohuski, Elizabeth A.; Richgels, Katherine L. D.; Olival, Kevin J.; Epstein, Jonathan H.; Blehert, David

2018-01-01

Fungal diseases are an emerging global problem affecting human health, food security and biodiversity. Ability of many fungal pathogens to persist within environmental reservoirs can increase extinction risks for host species and presents challenges for disease control. Understanding factors that regulate pathogen spread and persistence in these reservoirs is critical for effective disease management.White-nose syndrome (WNS) is a disease of hibernating bats caused by Pseudogymnoascus destructans (Pd), a fungus that establishes persistent environmental reservoirs within bat hibernacula, which contribute to seasonal disease transmission dynamics in bats. However, host and environmental factors influencing distribution of Pdwithin these reservoirs are unknown.We used model selection on longitudinally collected field data to test multiple hypotheses describing presence–absence and abundance of Pd in environmental substrates and on bats within hibernacula at different stages of WNS.First detection of Pd in the environment lagged up to 1 year after first detection on bats within that hibernaculum. Once detected, the probability of detecting Pd within environmental samples from a hibernaculum increased over time and was higher in sediment compared to wall surfaces. Temperature had marginal effects on the distribution of Pd. For bats, prevalence and abundance of Pd were highest on Myotis lucifugus and on bats with visible signs of WNS.Synthesis and applications. Our results indicate that distribution of Pseudogymnoascus destructans (Pd) within a hibernaculum is driven primarily by bats with delayed establishment of environmental reservoirs. Thus, collection of samples from Myotis lucifugus, or from sediment if bats cannot be sampled, should be prioritized to improve detection probabilities for Pd surveillance. Long-term persistence of Pd in sediment suggests that disease management for white-nose syndrome should address risks of sustained

Determinants of Pseudogymnoascus destructans within bat hibernacula: implications for surveillance and management of white-nose syndrome.

Science.gov (United States)

Verant, Michelle L; Bohuski, Elizabeth A; Richgels, Katherine L D; Olival, Kevin J; Epstein, Jonathan H; Blehert, David S

2018-01-01

1. Fungal diseases are an emerging global problem affecting human health, food security and biodiversity. Ability of many fungal pathogens to persist within environmental reservoirs can increase extinction risks for host species and presents challenges for disease control. Understanding factors that regulate pathogen spread and persistence in these reservoirs is critical for effective disease management. 2. White-nose syndrome (WNS) is a disease of hibernating bats caused by Pseudogymnoascus destructans ( Pd ), a fungus that establishes persistent environmental reservoirs within bat hibernacula, which contribute to seasonal disease transmission dynamics in bats. However, host and environmental factors influencing distribution of Pd within these reservoirs are unknown. 3. We used model selection on longitudinally collected field data to test multiple hypotheses describing presence-absence and abundance of Pd in environmental substrates and on bats within hibernacula at different stages of WNS. 4. First detection of Pd in the environment lagged up to one year after first detection on bats within that hibernaculum. Once detected, the probability of detecting Pd within environmental samples from a hibernaculum increased over time and was higher in sediment compared to wall surfaces. Temperature had marginal effects on the distribution of Pd . For bats, prevalence and abundance of Pd were highest on Myotis lucifugus and on bats with visible signs of WNS. 5. Synthesis and applications . Our results indicate that distribution of Pseudogymnoascus destructans ( Pd ) within a hibernaculum is driven primarily by bats with delayed establishment of environmental reservoirs. Thus, collection of samples from Myotis lucifugus , or from sediment if bats cannot be sampled, should be prioritized to improve detection probabilities for Pd surveillance. Long-term persistence of Pd in sediment suggests that disease management for white-nose syndrome should address risks of sustained

Hanford Site Environmental Surveillance Master Sampling Schedule for Calendar Year 2005

Energy Technology Data Exchange (ETDEWEB)

Bisping, Lynn E.

2005-01-19

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE). Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs. This document contains the calendar year 2005 schedules for the routine and non-routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project.

Evaluation of a commercial rubella IgM assay for use on oral fluid samples for diagnosis and surveillance of congenital rubella syndrome and postnatal rubella.

Science.gov (United States)

Vijaylakshmi, P; Muthukkaruppan, V R; Rajasundari, A; Korukluoglu, G; Nigatu, W; L A Warrener; Samuel, D; Brown, D W G

2006-12-01

Clinical diagnosis (surveillance) of rubella is unreliable and laboratory confirmation is essential. Detection of virus specific IgM in serum is the most commonly used method. However, the use of serum necessitates the drawing of blood, either through venipuncture or finger/heel prick, which can be difficult in young babies. Oral fluid samples have proved useful as an alternative, less invasive sample for virus specific IgM detection however until recently no commercial rubella IgM tests were available, restricting the usefulness of this approach. To evaluate the performance of the Microimmune Rubella IgM capture EIA using oral fluid samples from outbreaks as well as in cases of suspected congenital rubella syndrome (CRS). Paired serum and oral fluids were collected from cases during a rubella outbreak in three provinces in Turkey. Matched serum and oral fluid samples were collected from children with suspected CRS in an active surveillance programme at the Aravind Eye Hospital in South India. Serum samples were collected as part of the measles surveillance programme in Ethiopia. On serum samples the sensitivity and specificity of the Microimmune Rubella IgM capture EIA compared to Behring Enzygnost rubella IgM test was 96.9% (62/64; 95% CI 94.2-100%) and 100% (53/53; 95% CI 93.2-100%). On oral fluids compared to matched Behring results on serum the sensitivity was 95.5% (42/44; 95% CI 84.5-99.4%). The sensitivity and specificity of Microimmune Rubella IgM capture EIA on oral fluids from suspected CRS cases compared to serum results using Behring Enzygnost IgM assay was 100% (95% CI 84.5-100%) and 100% (95% CI 95.8-100.0%) respectively. Microimmune Rubella IgM capture EIA has adequate performance for diagnosis and surveillance of rubella in outbreak using either serum or oral fluid specimens.

1995 annual epidemiologic surveillance report for Fernald Environmental Management Project

International Nuclear Information System (INIS)

1995-01-01

The US Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. During the past several years, a number of DOE sites have participated in the Epidemiologic Surveillance Program. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report provides a summary of epidemiologic surveillance data collected from the Fernald Environmental Management Project (FEMP) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at FEMP and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out

1995 annual epidemiologic surveillance report for Fernald Environmental Management Project

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

The US Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. During the past several years, a number of DOE sites have participated in the Epidemiologic Surveillance Program. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report provides a summary of epidemiologic surveillance data collected from the Fernald Environmental Management Project (FEMP) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at FEMP and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out.

Global Tobacco Surveillance System (GTSS) - Global Adult Tobacco Survey (GATS)

Data.gov (United States)

U.S. Department of Health & Human Services — 2008-2012. Centers for Disease Control and Prevention (CDC). Office on Smoking and Health (OSH) – Global Tobacco Surveillance System (GTSS) - Global Adult Tobacco...

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 (YRBSS). This data is used for...

1995 annual epidemiologic surveillance report for Hanford Site

International Nuclear Information System (INIS)

1995-01-01

The US Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. A number of DOE sites participate in the Epidemiologic Surveillance Program. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, disabilities and deaths among current workers. This report provides a summary of epidemiologic surveillance data collected from the Hanford Site from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at Hanford and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out. The information in the main body of the report provides a descriptive analysis of the data collected from the site, and the appendices provides additional detail. The report also contains an expanded Glossary and an Explanation of Diagnostic Categories which gives examples of health conditions in each of the diagnostic categories

1995 annual epidemiologic surveillance report for Hanford Site

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

The US Department of Energy`s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. A number of DOE sites participate in the Epidemiologic Surveillance Program. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, disabilities and deaths among current workers. This report provides a summary of epidemiologic surveillance data collected from the Hanford Site from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at Hanford and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out. The information in the main body of the report provides a descriptive analysis of the data collected from the site, and the appendices provides additional detail. The report also contains an expanded Glossary and an Explanation of Diagnostic Categories which gives examples of health conditions in each of the diagnostic categories.

Hanford site environmental surveillance master sampling schedule

International Nuclear Information System (INIS)

Bisping, L.E.

1998-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE). Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1 open-quotes General Environmental Protection Program,close quotes and DOE Order 5400.5, open-quotes Radiation Protection of the Public and the Environment.close quotes The sampling methods are described in the Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office, DOE/RL91-50, Rev. 2, U.S. Department of Energy, Richland, Washington. This document contains the 1998 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. Each section of this document describes the planned sampling schedule for a specific media (air, surface water, biota, soil and vegetation, sediment, and external radiation). Each section includes the sample location, sample type, and analyses to be performed on the sample. In some cases, samples are scheduled on a rotating basis and may not be planned for 1998 in which case the anticipated year for collection is provided. In addition, a map is included for each media showing sample locations

Small-bowel cancer in Lynch syndrome : is it time for surveillance?

NARCIS (Netherlands)

Koornstra, Jan J.; Kleibeuker, Jan H.; Vasen, Hans F. A.

Small-bowel cancer is part of the tumour spectrum of Lynch syndrome. Lynch syndrome, or hereditary non-polyposis colorectal cancer, is caused by germline mutations in one of the mismatch repair genes. Mutation carriers have an estimated lifetime risk for the development of small-bowel cancer of

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....

Symptom-triggered benzodiazepine therapy for alcohol withdrawal syndrome in the emergency department: a comparison with the standard fixed dose benzodiazepine regimen.

LENUS (Irish Health Repository)

Cassidy, Eugene M

2012-10-01

The aim of the study was to compare symptom-triggered and standard benzodiazepine regimens for the treatment of alcohol withdrawal syndrome in an emergency department clinical decision unit. The authors found that the symptom-triggered approach reduced cumulative benzodiazepine dose and length of stay.

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,...

2009 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2010-07-09

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2008 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-12-11

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-01

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-31

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-17

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

Science.gov (United States)

Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

2006-01-01

During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

The Lynch syndrome: a management dilemma.

Science.gov (United States)

Palumbo, Piergaspare; Amatucci, Chiara; Perotti, Bruno; Dezzi, Claudia; Girolami, Marco; Illuminati, Giulio; Angelici, Alberto M

2013-05-01

The case of a familial Lynch syndrome is reported. The criteria for early diagnosis, management and surveillance are briefly reviewed. A germline mutation of genes responsible for mismatch repair is at the basis of the Lynch syndrome. Carriers are predisposed to colorectal cancer and other tumors. Two members of the presently reported family developed colorectal cancer, whereas two others developed other neoplasms. The syndrome was confirmed in members of the same family with appropriate genetic workup. Clinical examination and endoscopy were consequently scheduled once-a-year. Given the high risk of neoplastic disease, such yearly controls can be proposed as the standard follow-up of this condition.

Automated data extraction from general practice records in an Australian setting: trends in influenza-like illness in sentinel general practices and emergency departments.

Science.gov (United States)

Liljeqvist, Gösta T H; Staff, Michael; Puech, Michele; Blom, Hans; Torvaldsen, Siranda

2011-06-06

Influenza intelligence in New South Wales (NSW), Australia is derived mainly from emergency department (ED) presentations and hospital and intensive care admissions, which represent only a portion of influenza-like illness (ILI) in the population. A substantial amount of the remaining data lies hidden in general practice (GP) records. Previous attempts in Australia to gather ILI data from GPs have given them extra work. We explored the possibility of applying automated data extraction from GP records in sentinel surveillance in an Australian setting.The two research questions asked in designing the study were: Can syndromic ILI data be extracted automatically from routine GP data? How do ILI trends in sentinel general practice compare with ILI trends in EDs? We adapted a software program already capable of automated data extraction to identify records of patients with ILI in routine electronic GP records in two of the most commonly used commercial programs. This tool was applied in sentinel sites to gather retrospective data for May-October 2007-2009 and in real-time for the same interval in 2010. The data were compared with that provided by the Public Health Real-time Emergency Department Surveillance System (PHREDSS) and with ED data for the same periods. The GP surveillance tool identified seasonal trends in ILI both retrospectively and in near real-time. The curve of seasonal ILI was more responsive and less volatile than that of PHREDSS on a local area level. The number of weekly ILI presentations ranged from 8 to 128 at GP sites and from 0 to 18 in EDs in non-pandemic years. Automated data extraction from routine GP records offers a means to gather data without introducing any additional work for the practitioner. Adding this method to current surveillance programs will enhance their ability to monitor ILI and to detect early warning signals of new ILI events.

2003 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for Lawrence Livermore National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Sandia National Laboratories--Albuquerque Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for Sandia National Laboratories-Albuquerque. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Multimodality cardiac imaging in Turner syndrome.

Science.gov (United States)

Mortensen, Kristian H; Gopalan, Deepa; Nørgaard, Bjarne L; Andersen, Niels H; Gravholt, Claus H

2016-06-01

Congenital and acquired cardiovascular diseases contribute significantly to the threefold elevated risk of premature death in Turner syndrome. A multitude of cardiovascular anomalies and disorders, many of which deleteriously impact morbidity and mortality, is frequently left undetected and untreated because of poor adherence to screening programmes and complex clinical presentations. Imaging is essential for timely and effective primary and secondary disease prophylaxis that may alleviate the severe impact of cardiovascular disease in Turner syndrome. This review illustrates how cardiovascular disease in Turner syndrome manifests in a complex manner that ranges in severity from incidental findings to potentially fatal anomalies. Recommendations regarding the use of imaging for screening and surveillance of cardiovascular disease in Turner syndrome are made, emphasising the key role of non-invasive and invasive cardiovascular imaging to the management of all patients with Turner syndrome.

Targeted surveillance for postnatal hearing loss: a program evaluation.

Science.gov (United States)

Beswick, Rachael; Driscoll, Carlie; Kei, Joseph; Glennon, Shirley

2012-07-01

The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss. All children who were born in Queensland, Australia between September 2004 and December 2009, received a bilateral 'pass' on newborn hearing screening, and had at least one risk factor, were referred for targeted surveillance and were included in this study. The cohort was assessed throughout early childhood in accordance with Queensland's diagnostic assessment protocols. During the study period, 7320 (2.8% of 261,328) children were referred for targeted surveillance, of which 56 were identified with a postnatal hearing loss (0.77%). Of these, half (50.0%) were identified with a mild hearing loss, and 64.3% were identified with a sensorineural hearing loss. In regards to risk factors, syndrome, craniofacial anomalies, and severe asphyxia had the highest yield of positive cases of postnatal hearing loss for children referred for targeted surveillance, whereas, low birth weight, bacterial meningitis, and professional concern had a particularly low yield. Limitations of the targeted surveillance program were noted and include: (1) a lost contact rate of 32.4%; (2) delays in first surveillance assessment; (3) a large number of children who required on-going monitoring; and (4) extensive diagnostic assessments were completed on children with normal hearing. Examination of the lost contact rate revealed indigenous children were more likely to be documented as lost contact. In addition, children with one risk factor only were significantly more likely to not attend a surveillance appointment. Positive cases of postnatal hearing loss were detected through the targeted surveillance program. However, the

Global invasive bacterial vaccine-preventable diseases surveillance--2008-2014.

Science.gov (United States)

Murray, Jillian; Agócs, Mary; Serhan, Fatima; Singh, Simarjit; Deloria-Knoll, Maria; O'Brien, Katherine; Mwenda, Jason M; Mihigo, Richard; Oliveira, Lucia; Teleb, Nadia; Ahmed, Hinda; Wasley, Annemarie; Videbaek, Dovile; Wijesinghe, Pushpa; Thapa, Arun Bhadra; Fox, Kimberly; Paladin, Fem Julia; Hajjeh, Rana; Schwartz, Stephanie; Van Beneden, Chris; Hyde, Terri; Broome, Claire; Cherian, Thomas

2014-12-12

Meningitis and pneumonia are leading causes of morbidity and mortality in children globally infected with Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis, and Haemophilus influenzae causing a large proportion of disease. Vaccines are available to prevent many of the common types of these infections. S. pneumoniae was estimated to have caused 11% of deaths in children aged Organization (WHO) has recommended inclusion of PCV in childhood immunization programs worldwide, especially in countries with high child mortality. As of November 26, 2014, a total of 112 (58%) of all 194 WHO member states and 44 (58%) of the 76 member states ever eligible for support from Gavi, the Vaccine Alliance (Gavi), have introduced PCV. Invasive pneumococcal disease (IPD) surveillance that includes data on serotypes, along with meningitis and pneumonia syndromic surveillance, provides important data to guide decisions to introduce PCV and monitor its impact.

Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Vanderbruggen Nathalie

2009-11-01

Full Text Available Abstract Munchausen syndrome is a rare psychiatric disorder in which patients inflict on themselves an illness or injury for the primary purpose of assuming the sick role. Because these patients can present with many different complaints and clinical symptoms, diagnosis is often made at a later stage of hospitalisation. In contrast we report a case of a 40-year old woman very easy to diagnose with Munchausen syndrome. This trained nurse presented at our emergency department (ED complaining of abdominal pain. Interviewed by the medical trainee, she immediately confessed having put a knitting needle into her urethra four days earlier. She was not able to remove it anymore because it was beyond her reach. Abdominal X-ray confirmed the presence of the needle and a median laparotomy was performed to remove it. The diagnosis of Munchausen syndrome seemed immediately obvious in this case.

Cumulative query method for influenza surveillance using search engine data.

Science.gov (United States)

Seo, Dong-Woo; Jo, Min-Woo; Sohn, Chang Hwan; Shin, Soo-Yong; Lee, JaeHo; Yu, Maengsoo; Kim, Won Young; Lim, Kyoung Soo; Lee, Sang-Il

2014-12-16

Internet search queries have become an important data source in syndromic surveillance system. However, there is currently no syndromic surveillance system using Internet search query data in South Korea. The objective of this study was to examine correlations between our cumulative query method and national influenza surveillance data. Our study was based on the local search engine, Daum (approximately 25% market share), and influenza-like illness (ILI) data from the Korea Centers for Disease Control and Prevention. A quota sampling survey was conducted with 200 participants to obtain popular queries. We divided the study period into two sets: Set 1 (the 2009/10 epidemiological year for development set 1 and 2010/11 for validation set 1) and Set 2 (2010/11 for development Set 2 and 2011/12 for validation Set 2). Pearson's correlation coefficients were calculated between the Daum data and the ILI data for the development set. We selected the combined queries for which the correlation coefficients were .7 or higher and listed them in descending order. Then, we created a cumulative query method n representing the number of cumulative combined queries in descending order of the correlation coefficient. In validation set 1, 13 cumulative query methods were applied, and 8 had higher correlation coefficients (min=.916, max=.943) than that of the highest single combined query. Further, 11 of 13 cumulative query methods had an r value of ≥.7, but 4 of 13 combined queries had an r value of ≥.7. In validation set 2, 8 of 15 cumulative query methods showed higher correlation coefficients (min=.975, max=.987) than that of the highest single combined query. All 15 cumulative query methods had an r value of ≥.7, but 6 of 15 combined queries had an r value of ≥.7. Cumulative query method showed relatively higher correlation with national influenza surveillance data than combined queries in the development and validation set.

Diagnosis of antenatal Bartter syndrome.

Science.gov (United States)

Narayan, R; Peres, M; Kesby, G

2016-01-01

Bartter syndrome is a rare heterogeneous group of autosomal-recessive salt-losing renal tubular disorders that can present in fetal life (antenatal Bartter syndrome; ABS) as "unexplained" early-onset polyhydramnios, often associated with growth restriction. Prenatal diagnosis of the condition involves assessment of amniotic fluid biochemistry in a setting of polyuric polyhydramnios; with elevated chloride levels considered a consistent and diagnostic finding. Other amniotic fluid biochemical markers have been described, notably increased aldosterone levels, and low total protein levels. NOVEL INSIGHT: Antenatal Bartter syndrome is a heterogeneous group of renal disorders. While certain biochemical features in amniotic fluid might heighten suspicion, final diagnosis can only be made in the postnatal setting. In the setting of unexplained severe polyhydramnios, clinicians should continue to entertain the diagnosis of antenatal Bartter Syndrome and maintain neonatal surveillance, even if amniotic fluid markers do not support the diagnosis.

Effectiveness and Cost Efficiency of Different Surveillance Components for Proving Freedom and Early Detection of Disease: Bluetongue Serotype 8 in Cattle as Case Study for Belgium, France and the Netherlands.

Science.gov (United States)

Welby, S; van Schaik, G; Veldhuis, A; Brouwer-Middelesch, H; Peroz, C; Santman-Berends, I M; Fourichon, C; Wever, P; Van der Stede, Y

2017-12-01

Quick detection and recovery of country's freedom status remain a constant challenge in animal health surveillance. The efficacy and cost efficiency of different surveillance components in proving the absence of infection or (early) detection of bluetongue serotype 8 in cattle populations within different countries (the Netherlands, France, Belgium) using surveillance data from years 2006 and 2007 were investigated using an adapted scenario tree model approach. First, surveillance components (sentinel, yearly cross-sectional and passive clinical reporting) within each country were evaluated in terms of efficacy for substantiating freedom of infection. Yearly cross-sectional survey and passive clinical reporting performed well within each country with sensitivity of detection values ranging around 0.99. The sentinel component had a sensitivity of detection around 0.7. Secondly, how effective the components were for (early) detection of bluetongue serotype 8 and whether syndromic surveillance on reproductive performance, milk production and mortality data available from the Netherlands and Belgium could be of added value were evaluated. Epidemic curves were used to estimate the timeliness of detection. Sensitivity analysis revealed that expected within-herd prevalence and number of herds processed were the most influential parameters for proving freedom and early detection. Looking at the assumed direct costs, although total costs were low for sentinel and passive clinical surveillance components, passive clinical surveillance together with syndromic surveillance (based on reproductive performance data) turned out most cost-efficient for the detection of bluetongue serotype 8. To conclude, for emerging or re-emerging vectorborne disease that behaves such as bluetongue serotype 8, it is recommended to use passive clinical and syndromic surveillance as early detection systems for maximum cost efficiency and sensitivity. Once an infection is detected and eradicated

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

Regulatory standards applicable or relevant to the independent Hanford environmental surveillance and oversight program

International Nuclear Information System (INIS)

King, S.E.; Hendrickson, P.L.; Siegel, M.R.; Woodruff, M.G.; Belfiglio, J.; Elliott, R.W.

1990-03-01

The authors reviewed federal and state statutes and regulations, as well as Department of Energy (DOE) orders and other guidance material, for potential applicability to the environmental surveillance program conducted for the Hanford site by the Pacific Northwest Laboratory (PNL). There are no federal or state statutes or regulations which are directly applicable to the environmental surveillance program. However, other regulatory schemes, while not directly applicable to the environmental surveillance program, are important insofar as they are indicative of regulatory concern and direction. Because of the evolving nature of environmental regulations, this area needs to be closely monitored for future impact on environmental surveillance activities. 9 refs.,

Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data (2011 to present)

Data.gov (United States)

U.S. Department of Health & Human Services — 2011 to present. BRFSS combined land line and cell phone prevalence data. BRFSS is a continuous, state-based surveillance system that collects information about...

Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data (2010 and prior)

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2010. BRFSS land line only prevalence data. BRFSS is a continuous, state-based surveillance system that collects information about modifiable risk factors for...

Comparing national infectious disease surveillance systems: China and the Netherlands.

Science.gov (United States)

Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

2017-05-08

Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks. A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts. The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals. Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.

Evaluation of self-swabbing coupled with a telephone health helpline as an adjunct tool for surveillance of influenza viruses in Ontario

Directory of Open Access Journals (Sweden)

D. McGolrick

2016-09-01

Full Text Available Abstract Background Calls to a telephone health helpline (THHL have been previously evaluated for the ability to monitor specific syndromes, such as fever and influenza-like-illness or gastrointestinal illness. This method of surveillance has been shown to be highly correlated with traditional surveillance methods, and to have potential for early detection of community-based illness. Self-sampling, or having a person take his/her own nasal swab, has also proven successful as a useful method for obtaining a specimen, which may be used for respiratory virus detection. Methods This study describes a self-swabbing surveillance system mediated by a nurse-led THHL in Ontario whereby syndromic surveillance concepts are used to recruit and monitor participants with influenza-like illness. Once recruited, participants collect a nasal specimen obtained by self-swabbing and submit for testing and laboratory confirmation. Enumeration of weekly case counts was used to evaluate the timeliness of the self-swabbing surveillance system through comparison to other respiratory virus and influenza surveillance systems in Ontario. The operational efficiency of the system was also evaluated. Results The mean and median number of days between the day that a participant called the THHL, to the day a package was received at the laboratory for testing were approximately 10.4 and 8.6 days, respectively. The time between self-swab collection and package reception was 4.9 days on average, with a median of 4 days. The self-swabbing surveillance system adequately captured the 2014 influenza B season in a timely manner when compared to other Ontario-based sources of influenza surveillance data from the same year; however, the emergence of influenza B was not detected any earlier than with these other surveillance systems. Influenza A surveillance was also evaluated. Using the THHL self-swabbing system, a peak in the number of cases for influenza A was observed approximately

Long-term surveillance plan for the Lowman, Idaho, disposal site

International Nuclear Information System (INIS)

1993-09-01

The long-term surveillance plan (LTSP) for the Lowman, Idaho, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Lowman disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This preliminary final LTSP is being submitted to the US Nuclear Regulatory Commission (NRC) as a requirement for issuance of a general license for custody and long-term care for the disposal site. The general license requires that the disposal cell be cared for in accordance with the provisions of this LTSP. The LTSP documents whether the land and interests are owned by the United States or an Indian tribe, and describes, in detail, how the long-term care of the disposal site will be carried out through the UMTRA Project long-term surveillance program. The Lowman, Idaho, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program, (DOE, 1992)

Indsigter og udfordringer i danske Lynch-syndrom-familier

DEFF Research Database (Denmark)

Therkildsen, Christina; Timshel, Susanne; Nilbert, Mef

2008-01-01

identified 88 unique mutations in 164 Danish families delineated as Lynch syndrome families. Predictive genetic diagnostics enables the identification of high risk individuals, who are offered participation in surveillance programmes that effectively reduce morbidity and mortality in colorectal cancer....

Timeliness of syndromic influenza surveillance through work and school absenteeism

OpenAIRE

Bollaerts, K; Antoine, J; Robesyn, E; Van Proeyen, L; Vomberg, J; Feys, E; De Decker, E; Catry, B

2010-01-01

In this paper, we investigate the usefulness of work and school absenteeism surveillance as an early warning system for influenza. In particular, time trends in daily absenteeism rates collected during the A(H1N1)2009 pandemic are compared with weekly incidence rates of influenza-like illness (ILI) obtained from the Belgian Sentinel General Practitioner (SGP) network. The results indicate a rise in absenteeism rates prior to the onset of the influenza epidemic, suggesting that absenteeism sur...

Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment

Science.gov (United States)

2016-09-01

outside the formal programs. Population-based data suggest limited lifestyle modifications after diagnosis and potentially a reduction in exercise ...periodic surveillance prostate biopsies. There were no lifestyle or behavioral components as part of the protocol. 1Department of Urology, University of...management strategy. Our broad objective is two-fold: [1] to improve the ability to select candidates who safely choose active surveillance as a

2004 Hanford Site Annual Illness and Injury Surveillance Report, Revised October 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-24

Annual Illness and Injury Surveillance Program report for 2004 for the Hanford site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for Y-12. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Revising rates of asymptomatic Zika virus infection based on sentinel surveillance data from French Overseas Territories

Directory of Open Access Journals (Sweden)

Lorenzo Subissi

2017-12-01

Full Text Available French Polynesia and the French Territories of the Americas (FTAs have experienced outbreaks of Zika virus (ZIKV infection. These territories used similar sentinel syndromic surveillance to follow the epidemics. However, the surveillance system only takes into account consulting patients diagnosed with ZIKV disease, while non-consulting cases, as well as asymptomatic cases, are not taken into account. In the French territories under study, the ratio of consulting to non-consulting patients was found to likely be as low as 1/3 to 1/4, and rough estimates of the ZIKV asymptomatic infections indicated a lower rate than previously reported (i.e., not more than half. Keywords: Zika virus, Sentinel surveillance, Asymptomatic infections, Pacific islands, Caribbean region, Vector-borne infections

1995 annual epidemiologic surveillance report for Idaho National Engineering and Environmental Laboratory

International Nuclear Information System (INIS)

1995-01-01

The US Department of Energy's (DOE) conduct of epidemiologic surveillance provides an early warning system for health problems among workers. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report summarizes epidemiologic surveillance data collected from the Idaho National Engineering and Environmental Laboratory (INEEL) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at INEEL and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out

1995 annual epidemiologic surveillance report for Idaho National Engineering and Environmental Laboratory

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

The US Department of Energy's (DOE) conduct of epidemiologic surveillance provides an early warning system for health problems among workers. This program monitors illnesses and health conditions that result in an absence of five or more consecutive workdays, occupational injuries and illnesses, and disabilities and deaths among current workers. This report summarizes epidemiologic surveillance data collected from the Idaho National Engineering and Environmental Laboratory (INEEL) from January 1, 1995 through December 31, 1995. The data were collected by a coordinator at INEEL and submitted to the Epidemiologic Surveillance Data Center, located at Oak Ridge Institute for Science and Education, where quality control procedures and data analyses were carried out.

Tank farm surveillance and waste status summary report for October 1992

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-01-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for January 1993

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-03-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for November 1992

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-02-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank Farm surveillance and waste status summary report for September 1993

International Nuclear Information System (INIS)

Hanlon, B.M.

1994-01-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for October 1992

Energy Technology Data Exchange (ETDEWEB)

Hanlon, B.M.

1993-01-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks.

Tank farm surveillance and waste status summary report for May 1994

Energy Technology Data Exchange (ETDEWEB)

Hanlon, B.M.

1994-08-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks.

Tank farm surveillance and waste status summary report for June 1993

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-10-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for May 1994

International Nuclear Information System (INIS)

Hanlon, B.M.

1994-08-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter 1, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for December 1992

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-02-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank Farm surveillance and waste status summary report for March 1993

International Nuclear Information System (INIS)

Hanlon, B.M.

1993-05-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are Contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding flank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks

Tank farm surveillance and waste status summary report for December 1993

Energy Technology Data Exchange (ETDEWEB)

Hanlon, B.M.

1994-05-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special 9 surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of U.S. Department of Energy-Richland Operations Office Order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, U.S. Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks.

Tank farm surveillance and waste status summary report for December 1992

Energy Technology Data Exchange (ETDEWEB)

Hanlon, B.M.

1993-02-01

This report is the official inventory for radioactive waste stored in underground tanks in the 200 Areas at the Hanford Site. Data that depict the status of stored radioactive waste and tank vessel integrity are contained within the report. This report provides data on each of the existing 177 large underground waste storage tanks and 49 smaller catch tanks and special surveillance facilities, and supplemental information regarding tank surveillance anomalies and ongoing investigations. This report is intended to meet the requirement of US Department of Energy-Richland Operations Office Order 5820.2A, Chapter I, Section 3.e. (3) (DOE-RL, 1990, Radioactive Waste Management, US Department of Energy-Richland Operation Office, Richland, Washington) requiring the reporting of waste inventories and space utilization for Hanford Tank Farm Tanks.

Surveillance guidelines for smallpox vaccine (vaccinia) adverse reactions.

Science.gov (United States)

Casey, Christine; Vellozzi, Claudia; Mootrey, Gina T; Chapman, Louisa E; McCauley, Mary; Roper, Martha H; Damon, Inger; Swerdlow, David L

2006-02-03

CDC and the U.S. Food and Drug Administration rely on state and local health departments, health-care providers, and the public to report the occurrence of adverse events after vaccination to the Vaccine Adverse Event Reporting System. With such data, trends can be accurately monitored, unusual occurrences of adverse events can be detected, and the safety of vaccination intervention activities can be evaluated. On January 24, 2003, the U.S. Department of Health and Human Services (DHHS) implemented a preparedness program in which smallpox (vaccinia) vaccine was administered to federal, state, and local volunteers who might be first responders during a biologic terrorism event. As part of the DHHS Smallpox Preparedness and Response Program, CDC in consultation with experts, established surveillance case definitions for adverse events after smallpox vaccination. Adverse reactions after smallpox vaccination identified during the 1960s surveillance activities were classified on the basis of clinical description and included eczema vaccinatum; fetal vaccinia; generalized vaccinia; accidental autoinoculation, nonocular; ocular vaccinia; progressive vaccinia; erythema multiforme major; postvaccinial encephalitis or encephalomyelitis; and pyogenic infection of the vaccination site. This report provides uniform criteria used for the surveillance case definition and classification for these previously recognized adverse reactions used during the DHHS Smallpox Preparedness and Response Program. Inadvertent inoculation was changed to more precisely describe this event as inadvertent autoinoculation and contact transmission, nonocular and ocular vaccinia. Pyogenic infection also was renamed superinfection of the vaccination site or regional lymph nodes. Finally, case definitions were developed for a new cardiac adverse reaction (myo/pericarditis) and for a cardiac adverse event (dilated cardiomyopathy) and are included in this report. The smallpox vaccine surveillance case

Emergency Medical Service (EMS) Data for Syndromic Surveillance in Andhra Pradesh, India

NARCIS (Netherlands)

Pilot, E.; Rao, R.; Jena, B.; Krafft, T.; Wang, W.; Krafft, T.; Rosenberg, M.; Pilot, E.

2014-01-01

Infectious disease outbreaks like H1N1 and more recently Ebola, have once more highlighted that health surveillance and early detection are critical core functions to improve the capacity, preparedness and responsiveness of the Indian public health system. The systematic use of routinely collected

Using automated medical records for rapid identification of illness syndromes (syndromic surveillance: the example of lower respiratory infection

Directory of Open Access Journals (Sweden)

Dashevsky Inna

2001-10-01

Full Text Available Abstract Background Gaps in disease surveillance capacity, particularly for emerging infections and bioterrorist attack, highlight a need for efficient, real time identification of diseases. Methods We studied automated records from 1996 through 1999 of approximately 250,000 health plan members in greater Boston. Results We identified 152,435 lower respiratory infection illness visits, comprising 106,670 episodes during 1,143,208 person-years. Three diagnoses, cough (ICD9CM 786.2, pneumonia not otherwise specified (ICD9CM 486 and acute bronchitis (ICD9CM 466.0 accounted for 91% of these visits, with expected age and sex distributions. Variation of weekly occurrences corresponded closely to national pneumonia and influenza mortality data. There was substantial variation in geographic location of the cases. Conclusion This information complements existing surveillance programs by assessing the large majority of episodes of illness for which no etiologic agents are identified. Additional advantages include: a sensitivity, uniformity and efficiency, since detection of events does not depend on clinicians' to actively report diagnoses, b timeliness, the data are available within a day of the clinical event; and c ease of integration into automated surveillance systems. These features facilitate early detection of conditions of public health importance, including regularly occurring events like seasonal respiratory illness, as well as unusual occurrences, such as a bioterrorist attack that first manifests as respiratory symptoms. These methods should also be applicable to other infectious and non-infectious conditions. Knowledge of disease patterns in real time may also help clinicians to manage patients, and assist health plan administrators in allocating resources efficiently.

Attaching Hollywood to a Surveillant Assemblage: Normalizing Discourses of Video Surveillance

Directory of Open Access Journals (Sweden)

Randy K Lippert

2015-10-01

Full Text Available This article examines video surveillance images in Hollywood film. It moves beyond previous accounts of video surveillance in relation to film by theoretically situating the use of these surveillance images in a broader “surveillant assemblage”. To this end, scenes from a sample of thirty-five (35 films of several genres are examined to discern dominant discourses and how they lend themselves to normalization of video surveillance. Four discourses are discovered and elaborated by providing examples from Hollywood films. While the films provide video surveillance with a positive associative association it is not without nuance and limitations. Thus, it is found that some forms of resistance to video surveillance are shown while its deterrent effect is not. It is ultimately argued that Hollywood film is becoming attached to a video surveillant assemblage discursively through these normalizing discourses as well as structurally to the extent actual video surveillance technology to produce the images is used.

The applicability of animal health surveillance systems for post-market monitoring of potential adverse effects of genetically modified (GM) feed.

Science.gov (United States)

Vince, L; Kleter, G A; Kostov, K; Pfeiffer, D U; Guitian, J

2018-04-20

A facultative post market monitoring of potential health impacts of genetically modified (GM) feedstuffs on livestock consuming these feeds after pre-market risk assessment is under ongoing consideration. Within the IPAFEED database, scientific studies on health effects beyond performance in livestock and the results of a systematic search for evidence of outcome effects due to GM feed are consolidated. These outcomes were reviewed and checked for consistency in order to identify plausible syndromes suitable for conducting surveillance. The 24 selected studies showed no consistent changes in any health parameter. There were no repeated studies in any species by GM crop type and animal species. As such, there is insufficient evidence to inform the design of surveillance systems for detecting known adverse effects. Animal health surveillance systems have been proposed for the post market monitoring of potential adverse effects in animals. Such systems were evaluated for their applicability to the detection of hypothetical adverse effects and their strengths and weaknesses to detect syndromes of concern are presented. For known adverse effects, applied controlled post-market studies may yield conclusive and high-quality evidence. For detecting unknown adverse effects, the use of existing surveillance systems may still be of interest. A simulation tool developed within the project can be adapted and applied to existing surveillance systems to explore their applicability to the detection of potential adverse effects of GM feed. Copyright © 2018. Published by Elsevier Ltd.

Cannabis Hyperemesis Syndrome in the Emergency Department: How Can a Specialized Addiction Team Be Useful? A Pilot Study.

Science.gov (United States)

Pélissier, Fanny; Claudet, Isabelle; Gandia-Mailly, Peggy; Benyamina, Amine; Franchitto, Nicolas

2016-11-01

Chronic cannabis users may experience cyclical episodes of nausea and vomiting and learned behavior of hot bathing. This clinical condition, known as cannabis hyperemesis syndrome, was first reported in 2004. Our aim was to promote early recognition of this syndrome in emergency departments (EDs) and to increase referral to addiction specialists. Cannabis abusers were admitted to the ED for vomiting or abdominal pain from June 1, 2014 to January 1, 2015 and diagnosed with cannabis hyperemesis syndrome by a specialized addiction team. Then, medical records were examined retrospectively. Seven young adults were included. Their mean age was 24.7 years (range 17-39 years) and the majority were men (male-to-female ratio 1.2). Biological and toxicological blood samples were taken in all patients. Tetrahydrocannabinol blood level was measured in 4 patients, with a mean blood concentration of 11.6 ng/mL. Radiographic examination including abdominal computed tomography and brain imaging were negative, as was upper endoscopy. Five patients compulsively took hot baths in an attempt to decrease the symptoms. Treatment was symptomatic. Five patients have started follow-up with the specialized addiction team. Cannabis hyperemesis syndrome is still under-diagnosed 10 years after it was first described. Physicians should be aware of this syndrome to avoid repeated hospitalizations or esophageal complications. Greater awareness should lead to prompt treatment and prevention of future recurrence through cannabis cessation. Addiction specialists, as well as medical toxicologists, are experts in the management of cannabis abusers and can help re-establish the role of medical care in this population in collaboration with emergency physicians. Copyright © 2016 Elsevier Inc. All rights reserved.

Role of new endoscopic techniques in Lynch syndrome

NARCIS (Netherlands)

Haanstra, Jasmijn F.; Kleibeuker, Jan H.; Koornstra, Jan J.

Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), is the most common hereditary condition predisposing for colorectal cancer. International guidelines recommend surveillance of the colorectum by colonoscopy every 1-2 years starting at the age of 20-25 years. This has been shown

DASH - Youth Risk Behavior Surveillance System (YRBSS): High School - Excluding Sexual Identity

Data.gov (United States)

U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

Cushing's syndrome in childhood: update on genetics, treatment, and outcomes.

Science.gov (United States)

Lodish, Maya

2015-02-01

To provide an update on the genes associated with Cushing's syndrome in children, as well as to familiarize the clinician with recent treatment guidelines and outcome data for children with Cushing's syndrome. The list of genes associated with Cushing's syndrome continues to grow. In addition, treatment for childhood Cushing's syndrome is evolving. As long-term follow-up data on children becomes available, clinicians need to be aware of the issues that require attention. Knowledge of the specific genetic causes of Cushing's syndrome has potential implications for treatment, surveillance, and counseling. Advances in surgical technique, radiation modalities, and medical therapies offer the potential for additional treatment options in Cushing's syndrome. Early identification and management of post-treatment morbidities in children treated for Cushing's syndrome is crucial in order to optimize care.

Lynch syndrome and Lynch syndrome mimics: The growing complex landscape of hereditary colon cancer

Science.gov (United States)

Carethers, John M; Stoffel, Elena M

2015-01-01

Hereditary non-polyposis colorectal cancer (HNPCC) was previously synonymous with Lynch syndrome; however, identification of the role of germline mutations in the DNA mismatch repair (MMR) genes has made it possible to differentiate Lynch syndrome from other conditions associated with familial colorectal cancer (CRC). Broadly, HNPCC may be dichotomized into conditions that demonstrate defective DNA MMR and microsatellite instability (MSI) vs those conditions that demonstrate intact DNA MMR. Conditions characterized by MMR deficient CRCs include Lynch syndrome (germline MMR mutation), Lynch-like syndrome (biallelic somatic MMR mutations), constitutional MMR deficiency syndrome (biallelic germline MMR mutations), and sporadic MSI CRC (somatic biallelic methylation of MLH1). HNPCC conditions with intact DNA MMR associated with familial CRC include polymerase proofreading associated polyposis and familial colorectal cancer type X. Although next generation sequencing technologies have elucidated the genetic cause for some HNPCC conditions, others remain genetically undefined. Differentiating between Lynch syndrome and the other HNPCC disorders has profound implications for cancer risk assessment and surveillance of affected patients and their at-risk relatives. Clinical suspicion coupled with molecular tumor analysis and testing for germline mutations can help differentiate the clinical mimicry within HNPCC and facilitate diagnosis and management. PMID:26309352

Lynch syndrome and Lynch syndrome mimics: The growing complex landscape of hereditary colon cancer.

Science.gov (United States)

Carethers, John M; Stoffel, Elena M

2015-08-21

Hereditary non-polyposis colorectal cancer (HNPCC) was previously synonymous with Lynch syndrome; however, identification of the role of germline mutations in the DNA mismatch repair (MMR) genes has made it possible to differentiate Lynch syndrome from other conditions associated with familial colorectal cancer (CRC). Broadly, HNPCC may be dichotomized into conditions that demonstrate defective DNA MMR and microsatellite instability (MSI) vs those conditions that demonstrate intact DNA MMR. Conditions characterized by MMR deficient CRCs include Lynch syndrome (germline MMR mutation), Lynch-like syndrome (biallelic somatic MMR mutations), constitutional MMR deficiency syndrome (biallelic germline MMR mutations), and sporadic MSI CRC (somatic biallelic methylation of MLH1). HNPCC conditions with intact DNA MMR associated with familial CRC include polymerase proofreading associated polyposis and familial colorectal cancer type X. Although next generation sequencing technologies have elucidated the genetic cause for some HNPCC conditions, others remain genetically undefined. Differentiating between Lynch syndrome and the other HNPCC disorders has profound implications for cancer risk assessment and surveillance of affected patients and their at-risk relatives. Clinical suspicion coupled with molecular tumor analysis and testing for germline mutations can help differentiate the clinical mimicry within HNPCC and facilitate diagnosis and management.

Laboratory of environmental radiological surveillance

International Nuclear Information System (INIS)

Mendez G, A.; Marcial M, F.; Giber F, J.; Montiel R, E.; Leon del V, E.; Rivas C, I.; Leon G, M.V.; Lagunas G, E.; Aragon S, R.; Juarez N, A.; Alfaro L, M.M.

1991-12-01

The department of radiological protection of the ININ requests the collaboration of the Engineering Unit for the elaboration of the work project of the laboratory of environmental radiological surveillance. The emission of radioactive substances to the atmosphere like consequence of the normal operation of the Nuclear Center, constitutes an exhibition source from the man to the radiations that it should be appropriately watched over and controlled to be able to determine the population's potential exhibition that it lives in the area of influence of the installation. (Author)

Child Maltreatment Surveillance Improvement Opportunities: A Wake County, North Carolina Pilot Project.

Science.gov (United States)

Shanahan, Meghan E; Fliss, Mike D; Proescholdbell, Scott K

2018-01-01

BACKGROUND As child maltreatment often occurs in private, child welfare numbers underestimate its true prevalence. Child maltreatment surveillance systems have been used to ascertain more accurate counts of children who experience maltreatment. This manuscript describes the results from a pilot child maltreatment surveillance system in Wake County, North Carolina. METHODS We linked 2010 and 2011 data from 3 sources (Child Protective Services, Raleigh Police Department, and Office of the Chief Medical Examiner) to obtain rates of definite and possible child maltreatment. We separately analyzed emergency department visits from 2010 and 2011 to obtain counts of definite and possible child maltreatment. We then compared the results from the surveillance systems to those obtained from Child Protective Services (CPS) data alone. RESULTS In 2010 and 2011, rates of definite child maltreatment were 11.7 and 11.3 per 1,000 children, respectively, when using the linked data, compared to 10.0 and 9.5 per 1,000 children using CPS data alone. The rates of possible maltreatment were 25.3 and 23.8 per 1,000, respectively. In the 2010 and 2011 emergency department data, there were 68 visits and 84 visits, respectively, that met the case definition for maltreatment. LIMITATIONS While 4 data sources were analyzed, only 3 were linked in the current surveillance system. It is likely that we would have identified more cases of maltreatment had more sources been included. CONCLUSION While the surveillance system identified more children who met the case definition of maltreatment than CPS data alone, the rates of definite child maltreatment were not considerably higher than official reports. Rates of possible child maltreatment were much higher than both the definite case definition and child welfare records. Tracking both definite and possible case definitions and using a variety of data sources provides a more complete picture of child maltreatment in North Carolina. ©2018 by the

Role for Genetic Anticipation in Lynch Syndrome

DEFF Research Database (Denmark)

Nilbert, Mef; Timshel, Susanne; Bernstein, Inge

2009-01-01

PURPOSE: Anticipation (ie, an earlier age at onset in successive generations) is linked to repeat expansion in neurodegenerative syndromes, whereas its role in hereditary cancer is unclear. We assessed anticipation in Lynch syndrome (hereditary nonpolyposis colorectal cancer [HNPCC]), in which DNA...... mismatch repair (MMR) defects cause early and accelerated tumor development with a broad tumor spectrum. PATIENTS AND METHODS: In the population-based Danish HNPCC registry, 407 MMR gene mutation carriers who had developed cancer associated with Lynch syndrome, were identified. These individuals formed 290....... The effect remained when cancers diagnosed at surveillance were excluded, applied to maternal as well as paternal inheritance, and was independent of the MMR gene mutated. CONCLUSION: The effect from anticipation demonstrated in this large, population-based Lynch syndrome cohort underscores the need...

The U.S. Department of Veterans' Affairs depleted uranium exposed cohort at 25 Years: Longitudinal surveillance results

Energy Technology Data Exchange (ETDEWEB)

McDiarmid, Melissa A.; Gaitens, Joanna M.; Hines, Stella [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201 (United States); Condon, Marian, E-mail: mcondon@medicine.umaryland.edu [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Roth, Tracy; Oliver, Marc; Gucer, Patricia [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201 (United States); Brown, Lawrence [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Department of Pathology, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201 (United States); Centeno, Jose A. [US Food and Drug Administration, Center for Devices and Radiological Health Office of Science and Engineering Laboratories, Silver Spring, MD 20993 (United States); Dux, Moira [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Squibb, Katherine S. [Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201 (United States); Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201 (United States)

2017-01-15

Background: A small group of Gulf War I veterans wounded in depleted uranium (DU) friendly-fire incidents have been monitored for health changes in a clinical surveillance program at the Veterans Affairs Medical Center, Baltimore since 1994. Methods: During the spring of 2015, an in-patient clinical surveillance protocol was performed on 36 members of the cohort, including exposure monitoring for total and isotopic uranium concentrations in urine and a comprehensive assessment of health outcomes. Results: On-going mobilization of U from embedded fragments is evidenced by elevated urine U concentrations. The DU isotopic signature is observed principally in participants possessing embedded fragments. Those with only an inhalation exposure have lower urine U concentration and a natural isotopic signature. Conclusions: At 25 years since first exposure to DU, an aging cohort of military veterans continues to show no U-related health effects in known target organs of U toxicity. As U body burden continues to accrue from in-situ mobilization from metal fragment depots, and increases with exposure duration, critical tissue-specific U concentration thresholds may be reached, thus recommending on-going surveillance of this veteran cohort. - Highlights: • Gulf War I veterans wounded with depleted uranium are monitored for health changes. • In 2015 in-patient clinical surveillance was performed on 36 members of the cohort. • Mobilization of U from embedded fragments is evidenced by elevated U in urine. • This cohort of continues to show no U-related health effects.

The U.S. Department of Veterans' Affairs depleted uranium exposed cohort at 25 Years: Longitudinal surveillance results

International Nuclear Information System (INIS)

McDiarmid, Melissa A.; Gaitens, Joanna M.; Hines, Stella; Condon, Marian; Roth, Tracy; Oliver, Marc; Gucer, Patricia; Brown, Lawrence; Centeno, Jose A.; Dux, Moira; Squibb, Katherine S.

2017-01-01

Background: A small group of Gulf War I veterans wounded in depleted uranium (DU) friendly-fire incidents have been monitored for health changes in a clinical surveillance program at the Veterans Affairs Medical Center, Baltimore since 1994. Methods: During the spring of 2015, an in-patient clinical surveillance protocol was performed on 36 members of the cohort, including exposure monitoring for total and isotopic uranium concentrations in urine and a comprehensive assessment of health outcomes. Results: On-going mobilization of U from embedded fragments is evidenced by elevated urine U concentrations. The DU isotopic signature is observed principally in participants possessing embedded fragments. Those with only an inhalation exposure have lower urine U concentration and a natural isotopic signature. Conclusions: At 25 years since first exposure to DU, an aging cohort of military veterans continues to show no U-related health effects in known target organs of U toxicity. As U body burden continues to accrue from in-situ mobilization from metal fragment depots, and increases with exposure duration, critical tissue-specific U concentration thresholds may be reached, thus recommending on-going surveillance of this veteran cohort. - Highlights: • Gulf War I veterans wounded with depleted uranium are monitored for health changes. • In 2015 in-patient clinical surveillance was performed on 36 members of the cohort. • Mobilization of U from embedded fragments is evidenced by elevated U in urine. • This cohort of continues to show no U-related health effects.

Surveillance of the exposure to ionizing radiations of the University health staff

International Nuclear Information System (INIS)

Tomasina, F.; Sponton, F.; Pintado, C.; Laborde, A.; Blanco, D.; Stolovas, N.; Satragno, N.

2011-01-01

Introduction The surveillance program for the workers exposed to ionizing radiations involves personal dosemeters of exposed workers, and their assessment and comparison with the reference values, which allow prioritizing and taking effective preventive action. Objectives To present the occupational health surveillance program for university workers exposed to ionizing radiations during the 2003-2006 period.Methods Longitudinal and descriptive study. Dosimetric data were obtained from secondary source, on the basis of the dosimetric surveillance program in the University of the Republic. The exposure was evaluated through film dosimetry. The personal dosimetric value records were analyzed within the surveillance program in 2003, 2004, 2005 and 2006.Results It was observed that the dosimetric values did not exceed the reference values accepted as annual maximum figures. The annual maximum dose received was 15,72 milisieverts in the diagnosis and specialized treatment areas of the university hospital. Conclusions Surveillance of exposure to radiations allowed directing the specific systematic medical check-ups as well as stretching the taking of radioprotective measures. In this regard, the Department of Occupational Health is carrying out educational tasks and disseminating the surveillance program in order to reinforce preventive measures.

2003 Kansas City Plant Annual Illness and Injury Surveillance Report, Revised September 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

Annual Illness and Injury Surveillance Program report for 2003 for the Kansas City Plant. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-02

Annual Illness and Injury Surveillance Program report for 2003 for Brookhaven National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Holt Oram syndrome : a registry-based study in Europe

NARCIS (Netherlands)

Barisic, Ingeborg; Boban, Ljubica; Greenlees, Ruth; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Addor, Marie-Claude; Arriola, Larraitz; Bergman, Jorieke E. H.; Braz, Paula; Budd, Judith L. S.; Gatt, Miriam; Haeusler, Martin; Khoshnood, Babak; Klungsoyr, Kari; McDonnell, Bob; Nelen, Vera; Pierini, Anna; Queisser-Wahrendorf, Annette; Rankin, Judith; Rissmann, Anke; Rounding, Catherine; Tucker, David; Verellen-Dumoulin, Christine; Dolk, Helen

2014-01-01

Background: Holt-Oram syndrome (HOS) is an autosomal dominant disorder characterised by upper limb anomalies and congenital heart defects. We present epidemiological and clinical aspects of HOS patients using data from EUROCAT (European Surveillance of Congenital Anomalies) registries. Methods: The

PRKAR1A-negative familial Cushing's syndrome: two case reports.

Science.gov (United States)

Lim, Lee Ling; Kitan, Normayah; Paramasivam, Sharmila Sunita; Ratnasingam, Jeyakantha; Ibrahim, Luqman; Chan, Siew Pheng; Tan, Alexander Tong Boon; Vethakkan, Shireene Ratna

2015-12-01

Determining the etiology of Cushing's syndrome is very challenging to endocrinologists, with most of the difficulty arising from subtype differentiation of adrenocorticotropic hormone-dependent Cushing's syndrome. We present the pitfalls of evaluating a rare cause of adrenocorticotropic hormone-independent Cushing's syndrome in the transition period between adolescence and adulthood. A sibling pair with familial isolated primary pigmented nodular adrenocortical disease is described. The index case, a 20-year-old Chinese woman, presented with premenopausal osteoporosis with T12 compression fracture and young hypertension. Biochemical analysis confirmed adrenocorticotropic hormone-independent Cushing's syndrome (elevated 0800 h plasma cortisol 808 nmol/L with suppressed adrenocorticotropic hormone level Cushing's syndrome at age 18 years, with typical cushingoid habitus, but no osteoporosis or hypertension. His adrenal computed tomographic scans showed micronodularities over bilateral adrenal glands. He was successfully treated with bilateral adrenalectomy. Screening for Carney's complex and PRKAR1A gene mutation was negative. Signs and symptoms of Cushing's syndrome resolved after bilateral adrenalectomy for both patients. They were placed on lifelong glucocorticoid and mineralocorticoid replacement therapy and long-term surveillance for Carney's complex. The cases of these two patients illustrate the difficulties involved in diagnosing primary pigmented nodular adrenocortical disease, a variant of adrenocorticotropic hormone-independent Cushing's syndrome that is managed with bilateral adrenalectomy. A high index of suspicion for this disease is needed, especially in adolescents with adrenocorticotropic hormone-independent Cushing's syndrome who have a significant family history, features of Carney's complex, and no resolution of Cushing's syndrome after unilateral adrenalectomy. Patients with primary pigmented nodular adrenocortical disease can either have

Cardiac imaging in RASopathies/mitogen activated protein kinase syndromes

Directory of Open Access Journals (Sweden)

Rita Gravino

2014-07-01

Full Text Available RASopathies include a spectrum of disorders due to dysregulation of RAS/mitogen activated protein kinase pathway that plays an essential role in the control of the cell cycle and differentiation. As a consequence, its dysregulation has profound developmental consequences, in particular cardiac malformations. RASopathies with cardiac features are: Noonan syndrome, multiple lentigines syndrome, cardio-faciocutaneous syndrome, Costello syndrome, neurofibromatosis- 1, Legius syndrome, neurofibromatosis- Noonan syndrome. The former syndromes are associated with a high rate of cardiac involvement (60-85% and 12 genes: PTPN11, SOS1, RAF1, KRAS, HRAS, BRAF, MEK1/MAP2K1, MEK2/MAP2K2, NRAS, SHOC2, CBL and SPRED1. Although the majority of these diseases are readily distinguishable in clinical terms, an integrated imaging study of the cardiac condition associated to RASopathies helps to better define risk assessment, surveillance, and management of these patients.

Sleep apnea syndrome: experience of the pulmonology department ...

African Journals Online (AJOL)

Introduction Sleep apnea syndrome is a highly prevalent disorder that is still underdiagnosed and undertreated and whose obstructive form is the most common. The diagnosis is suspected on clinical signs collected by interrogation and questionnaires (Berlin questionnaire and Epworth sleepiness scale), then confirmed by ...

Validation of a Syndromic Case Definition for Detecting Emergency Department Visits Potentially Related to Marijuana.

Science.gov (United States)

DeYoung, Kathryn; Chen, Yushiuan; Beum, Robert; Askenazi, Michele; Zimmerman, Cali; Davidson, Arthur J

Reliable methods are needed to monitor the public health impact of changing laws and perceptions about marijuana. Structured and free-text emergency department (ED) visit data offer an opportunity to monitor the impact of these changes in near-real time. Our objectives were to (1) generate and validate a syndromic case definition for ED visits potentially related to marijuana and (2) describe a method for doing so that was less resource intensive than traditional methods. We developed a syndromic case definition for ED visits potentially related to marijuana, applied it to BioSense 2.0 data from 15 hospitals in the Denver, Colorado, metropolitan area for the period September through October 2015, and manually reviewed each case to determine true positives and false positives. We used the number of visits identified by and the positive predictive value (PPV) for each search term and field to refine the definition for the second round of validation on data from February through March 2016. Of 126 646 ED visits during the first period, terms in 524 ED visit records matched ≥1 search term in the initial case definition (PPV, 92.7%). Of 140 932 ED visits during the second period, terms in 698 ED visit records matched ≥1 search term in the revised case definition (PPV, 95.7%). After another revision, the final case definition contained 6 keywords for marijuana or derivatives and 5 diagnosis codes for cannabis use, abuse, dependence, poisoning, and lung disease. Our syndromic case definition and validation method for ED visits potentially related to marijuana could be used by other public health jurisdictions to monitor local trends and for other emerging concerns.

Secure Video Surveillance System (SVSS) for unannounced safeguards inspections

International Nuclear Information System (INIS)

Galdoz, Erwin G.; Pinkalla, Mark

2010-01-01

The Secure Video Surveillance System (SVSS) is a collaborative effort between the U.S. Department of Energy (DOE), Sandia National Laboratories (SNL), and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The joint project addresses specific requirements of redundant surveillance systems installed in two South American nuclear facilities as a tool to support unannounced inspections conducted by ABACC and the International Atomic Energy Agency (IAEA). The surveillance covers the critical time (as much as a few hours) between the notification of an inspection and the access of inspectors to the location in facility where surveillance equipment is installed. ABACC and the IAEA currently use the EURATOM Multiple Optical Surveillance System (EMOSS). This outdated system is no longer available or supported by the manufacturer. The current EMOSS system has met the project objective; however, the lack of available replacement parts and system support has made this system unsustainable and has increased the risk of an inoperable system. A new system that utilizes current technology and is maintainable is required to replace the aging EMOSS system. ABACC intends to replace one of the existing ABACC EMOSS systems by the Secure Video Surveillance System. SVSS utilizes commercial off-the shelf (COTS) technologies for all individual components. Sandia National Laboratories supported the system design for SVSS to meet Safeguards requirements, i.e. tamper indication, data authentication, etc. The SVSS consists of two video surveillance cameras linked securely to a data collection unit. The collection unit is capable of retaining historical surveillance data for at least three hours with picture intervals as short as 1sec. Images in .jpg format are available to inspectors using various software review tools. SNL has delivered two SVSS systems for test and evaluation at the ABACC Safeguards Laboratory. An additional 'proto-type' system remains

LLNL Livermore site Groundwater Surveillance Plan

International Nuclear Information System (INIS)

1992-04-01

Department of Energy (DOE) Order 5400.1 establishes environ-mental protection program requirements, authorities, and responsibilities for DOE operations to assume compliance with federal, state, and local environmental protection laws and regulations; Federal Executive Orders; and internal DOE policies. ne DOE Order contains requirements and guidance for environmental monitoring programs, the objectives of which are to demonstrate compliance with legal and regulatory requirements imposed by federal, state, and local agencies; confirm adherence to DOE environmental protection polices; and support environmental management decisions. The environmental monitoring programs consist of two major activities: (1) measurement and monitoring of effluents from DOE operations, and (2) surveillance through measurement, monitoring, and calculation of the effects of those operations on the environment and public health. The latter concern, that of assessing the effects, if any, of Lawrence Livermore National Laboratory (LLNL) operations and activities on on-site and off-site surface waters and groundwaters is addressed by an Environmental Surveillance Program being developed by LLNL. The Groundwater Surveillance Plan presented here has been developed on a sitespecific basis, taking into consideration facility characteristics, applicable regulations, hazard potential, quantities and concentrations of materials released, the extent and use of local water resources, and specific local public interest and concerns

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 developm......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...

Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

Science.gov (United States)

Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

2012-10-01

Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance.

Science.gov (United States)

Wassilak, Steven G F; Williams, Cheryl L; Murrill, Christopher S; Dahl, Benjamin A; Ohuabunwo, Chima; Tangermann, Rudolf H

2017-07-01

Surveillance for acute flaccid paralysis (AFP) is a fundamental cornerstone of the global polio eradication initiative (GPEI). Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. Because of the extensive resources devoted to AFP surveillance, multiple opportunities exist for additional diseases to be added using GPEI assets, particularly because there is generally 1 district officer responsible for all disease surveillance. For this reason, integrated surveillance has become a standard practice in many countries, ranging from adding surveillance for measles and rubella to integrated disease surveillance for outbreak-prone diseases (integrated disease surveillance and response). This report outlines the current level of disease surveillance integration in 3 countries (Nepal, India, and Nigeria) and proposes that resources continue for long-term maintenance in resource-poor countries of AFP surveillance as a platform for surveillance of vaccine-preventable diseases and other outbreak-prone diseases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Feasibility and acceptability of workers' health surveillance for fire fighters

NARCIS (Netherlands)

Plat, Marie-Christine J.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2011-01-01

The objective of this study was to test the feasibility and acceptability of a new workers' health surveillance (WHS) for fire fighters in a Dutch pilot-implementation project. In three fire departments, between November 2007 and February 2009, feasibility was tested with respect to i) worker intent

A Hidden Markov Model for Analysis of Frontline Veterinary Data for Emerging Zoonotic Disease Surveillance

Science.gov (United States)

Robertson, Colin; Sawford, Kate; Gunawardana, Walimunige S. N.; Nelson, Trisalyn A.; Nathoo, Farouk; Stephen, Craig

2011-01-01

Surveillance systems tracking health patterns in animals have potential for early warning of infectious disease in humans, yet there are many challenges that remain before this can be realized. Specifically, there remains the challenge of detecting early warning signals for diseases that are not known or are not part of routine surveillance for named diseases. This paper reports on the development of a hidden Markov model for analysis of frontline veterinary sentinel surveillance data from Sri Lanka. Field veterinarians collected data on syndromes and diagnoses using mobile phones. A model for submission patterns accounts for both sentinel-related and disease-related variability. Models for commonly reported cattle diagnoses were estimated separately. Region-specific weekly average prevalence was estimated for each diagnoses and partitioned into normal and abnormal periods. Visualization of state probabilities was used to indicate areas and times of unusual disease prevalence. The analysis suggests that hidden Markov modelling is a useful approach for surveillance datasets from novel populations and/or having little historical baselines. PMID:21949763

Oak Ridge Research reactor shutdown maintenance and surveillance

International Nuclear Information System (INIS)

Coleman, G.H.; Laughlin, D.L.

1991-05-01

The Department of Energy ordered the Oak Ridge Research Reactor to be placed in permanent shutdown on July 14, 1987. The paper outlines routine maintenance activities and surveillance tests performed April through September, 1990, on the reactor instrumentation and controls, process system, and the gaseous waste filter system. Preparations are being made to transfer the facility to the Remedial Action Program. 6 tabs

The Great East Japan Earthquake: a need to plan for post-disaster surveillance in developed countries

Directory of Open Access Journals (Sweden)

Jeffrey Partridge

2011-12-01

Full Text Available After a devastating earthquake and tsunami struck north-eastern Japan in March 2011, the public health system, including the infectious disease surveillance system, was severely compromised. While models for post-disaster surveillance exist, they focus predominantly on developing countries during the early recovery phase. Such models do not necessarily apply to developed countries, which differ considerably in their baseline surveillance systems. Furthermore, there is a need to consider the process by which a surveillance system recovers post-disaster. The event in Japan has highlighted a need to address these concerns surrounding post-disaster surveillance in developed countries.In May 2011, the World Health Organization convened a meeting where post-disaster surveillance was discussed by experts and public health practitioners. In this paper, we describe a post-disaster surveillance approach that was discussed at the meeting, based on what had actually occurred and what may have been, or would be, ideal. Briefly, we describe the evolution of a surveillance system as it returns to the pre-existing system, starting from an event-based approach during the emergency relief phase, a syndromic approach during the early recovery phase, an enhanced sentinel approach during the late recovery phase and a return to baseline during the development phase. Our aim is not to recommend a specific model but to encourage other developed countries to initiate their own discussions on post-disaster surveillance and develop plans according to their needs and capacities. As natural disasters will continue to occur, we hope that developing such plans during the “inter-disaster” period will help mitigate the surveillance challenges that will arise post-disaster.

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,

Timeliness of Surveillance during Outbreak of Shiga Toxin–producing Escherichia coli Infection, Germany, 2011

OpenAIRE

Altmann, Mathias; Wadl, Maria; Altmann, Doris; Benzler, Justus; Eckmanns, Tim; Krause, Gérard; Spode, Anke; an der Heiden, Matthias

2011-01-01

In the context of a large outbreak of Shiga toxin–producing Escherichia coli O104:H4 in Germany, we quantified the timeliness of the German surveillance system for hemolytic uremic syndrome and Shiga toxin–producing E. coli notifiable diseases during 2003–2011. Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain.

Long-term surveillance plan for the Shiprock Disposal site, Shiprock, New Mexico

International Nuclear Information System (INIS)

1994-09-01

The long-term surveillance plan (LTSP) for the Shiprock, New Mexico, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Shiprock disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents the land ownership interests and details how the long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Association syndrome de Gougerot Sjogren et maladie coeliaque ...

African Journals Online (AJOL)

association avec un syndrome de Gougerot Sjogren (SGS) a rarement été rapportée, mais une association due au simple hasard ne peut être exclue. Dans ce cas, le risque d'oncogenèse est double et une surveillance régulière s'impose.

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.

Long-term surveillance plan for the Mexican Hat Disposal Site, Mexican Hat, Utah

International Nuclear Information System (INIS)

1996-02-01

This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSP (based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program), documents the land ownership interests and details how the long-term care of the disposal site will be accomplished

Behavioral Risk Factor Surveillance System (BRFSS) Age-Adjusted Prevalence Data (2011 to present)

Data.gov (United States)

U.S. Department of Health & Human Services — 2011 to present. BRFSS combined land line and cell phone age-adjusted prevalence data. The BRFSS is a continuous, state-based surveillance system that collects...

2003 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report, Revised September 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

Annual Illness and Injury Surveillance Program report for 2003 for Los Alamos National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Using Deep Learning Algorithm to Enhance Image-review Software for Surveillance Cameras

Energy Technology Data Exchange (ETDEWEB)

Cui, Yonggang

2018-05-07

We propose the development of proven deep learning algorithms to flag objects and events of interest in Next Generation Surveillance System (NGSS) surveillance to make IAEA image review more efficient. Video surveillance is one of the core monitoring technologies used by the IAEA Department of Safeguards when implementing safeguards at nuclear facilities worldwide. The current image review software GARS has limited automated functions, such as scene-change detection, black image detection and missing scene analysis, but struggles with highly cluttered backgrounds. A cutting-edge algorithm to be developed in this project will enable efficient and effective searches in images and video streams by identifying and tracking safeguards relevant objects and detect anomalies in their vicinity. In this project, we will develop the algorithm, test it with the IAEA surveillance cameras and data sets collected at simulated nuclear facilities at BNL and SNL, and implement it in a software program for potential integration into the IAEA’s IRAP (Integrated Review and Analysis Program).

Ideology, Critique and Surveillance

Directory of Open Access Journals (Sweden)

Heidi Herzogenrath-Amelung

2013-11-01

Full Text Available The 2013 revelations concerning global surveillance programmes demonstrate in unprecedented clarity the need for Critical Theory of information and communication technologies (ICTs to address the mechanisms and implications of increasingly global, ubiquitous surveillance. This is all the more urgent because of the dominance of the “surveillance ideology” (the promise of security through surveillance that supports the political economy of surveillance. This paper asks which theoretical arguments and concepts can be useful for philosophically grounding a critique of this surveillance ideology. It begins by examining how the surveillance ideology works through language and introduces the concept of the ‘ideological packaging’ of ICTs to show how rhetoric surrounding the implementation of surveillance technologies reinforces the surveillance ideology. It then raises the problem of how ideology-critique can work if it relies on language itself and argues that Martin Heidegger’s philosophy can make a useful contribution to existing critical approaches to language.

Sport and active recreation injuries in Australia: evidence from emergency department presentations

OpenAIRE

Finch, C.; Valuri, G.; Ozanne-Smith, J.

1998-01-01

OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Dat...

Birth prevalence of Prader-Willi syndrome in Australia.

Science.gov (United States)

Smith, A; Egan, J; Ridley, G; Haan, E; Montgomery, P; Williams, K; Elliott, E

2003-03-01

This is the first population based study to estimate the birth prevalence of DNA proven Prader-Willi syndrome. Thirty infants were reported to the Australian Paediatric Surveillance Unit between 1998 and 2000, a prevalence of 4 per 100,000 live births or approximately 1/25,000 live births per annum.

Malware and Disease: Lessons from Cyber Intelligence for Public Health Surveillance.

Science.gov (United States)

Smith, Frank L

2016-01-01

Malicious software and infectious diseases are similar is several respects, as are the functional requirements for surveillance and intelligence to defend against these threats. Given these similarities, this article compares and contrasts the actors, relationships, and norms at work in cyber intelligence and disease surveillance. Historical analysis reveals that civilian cyber defense is more decentralized, private, and voluntary than public health in the United States. Most of these differences are due to political choices rather than technical necessities. In particular, political resistance to government institutions has shaped cyber intelligence over the past 30 years, which is a troubling sign for attempts to improve disease surveillance through local, state, and federal health departments. Information sharing about malware is also limited, despite information technology being integral to cyberspace. Such limits suggest that automation through electronic health records will not automatically improve public health surveillance. Still, certain aspects of information sharing and analysis for cyber defense are worth emulating or, at the very least, learning from to help detect and manage health threats.

Sezary syndrome after successful treatment of Hodgkin's Disease

International Nuclear Information System (INIS)

Buechner, S.A.

1981-01-01

A patient had a cutaneous T-cell lymphoma, appearing clinically as Sezary syndrome, that developed two years after successful treatment of Hodgkin's disease with combined radiotherapy and chemotherapy. Clinical, histologic, and electron microscopic observations were made during the course of the Sezary syndrome. The malignant cells in the cell infiltrates and in the peripheral blood were characterized as T cells. There is a possible relationship of the cutaneous T-cell lymphoma to impaired immune surveillance in this patient and to the potential carcinogenicity of combined radiotherapy and chemotherapy

FINAL REPORT FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

Energy Technology Data Exchange (ETDEWEB)

Joe M. Aldrich

2004-11-01

The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004.

FINAL REPORT. FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

International Nuclear Information System (INIS)

Aldrich, Joe M.

2004-01-01

The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC--05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004

Long-term surveillance plan for the Green River, Utah, disposal site

International Nuclear Information System (INIS)

1997-06-01

The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Annual Surveillance Summary: Escherichia coli (E. coli) Infections in the Military Health System (MHS), 2015

Science.gov (United States)

2017-03-01

Annual Surveillance Summary: Escherichia coli ( E . coli ) Infections in the Military Health System (MHS...or position of the Department of the Navy, Department of Defense, nor the U.S. Government. i i E . coli in the MHS: Annual Summary 2015 Prepared...March 2017 EpiData Center Department NMCPHC-EDC-TR-187-2017 ii ii E . coli in the MHS: Annual Summary 2015 Prepared March 2017 EpiData

Who is Surveilling Whom?

DEFF Research Database (Denmark)

Mortensen, Mette

2014-01-01

This article concerns the particular form of counter-surveillance termed “sousveillance”, which aims to turn surveillance at the institutions responsible for surveillance. Drawing on the theoretical perspectives “mediatization” and “aerial surveillance,” the article studies WikiLeaks’ publication...

A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports.

Science.gov (United States)

Quade, Patrick; Nsoesie, Elaine Okanyene

2017-07-05

Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne disease outbreaks. ©Patrick Quade, Elaine Okanyene

Timeliness of Surveillance during Outbreak of Shiga Toxin–producing Escherichia coli Infection, Germany, 2011

Science.gov (United States)

Wadl, Maria; Altmann, Doris; Benzler, Justus; Eckmanns, Tim; Krause, Gérard; Spode, Anke; an der Heiden, Matthias

2011-01-01

In the context of a large outbreak of Shiga toxin–producing Escherichia coli O104:H4 in Germany, we quantified the timeliness of the German surveillance system for hemolytic uremic syndrome and Shiga toxin–producing E. coli notifiable diseases during 2003–2011. Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain. PMID:22000368

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

2003 Fernald Environmental Management Project Annual Illness and Injury Surveillance Report, Revised September 2007

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-04

Annual Illness and Injury Surveillance Program report for 2003 for the Fernald Environmental Management Project. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The IISP monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Long-term surveillance plan for the Collins Ranch disposal site, Lakeview, Oregon

International Nuclear Information System (INIS)

1994-08-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Collins Ranch disposal site, Lakeview, Oregon, describes the surveillance activities for the disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Long-term surveillance plan for the Bodo Canyon Disposal Site, Durango, Colorado

Energy Technology Data Exchange (ETDEWEB)

1994-03-01

This long-term surveillance plan (LTSP) for the Durango, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Durango (Bodo Canyon) disposal site, which will be referred to as the disposal site throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). RRMs include tailings and other uranium ore processing wastes still at the site, which the DOE determines to be radioactive. This LTSP is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992).

Long-term surveillance plan for the Bodo Canyon Disposal Site, Durango, Colorado

International Nuclear Information System (INIS)

1994-03-01

This long-term surveillance plan (LTSP) for the Durango, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Durango (Bodo Canyon) disposal site, which will be referred to as the disposal site throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). RRMs include tailings and other uranium ore processing wastes still at the site, which the DOE determines to be radioactive. This LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992)

Monitoring the multi-faceted problem of youth violence: the Asian/Pacific Islander Youth Violence Prevention Center's surveillance system.

Science.gov (United States)

Sugimoto-Matsuda, Jeanelle J; Hishinuma, Earl S; Momohara, Christie-Brianna K; Rehuher, Davis; Soli, Fa'apisa M; Bautista, Randy Paul M; Chang, Janice Y

2012-10-01

Youth violence (YV) is a complex public health issue that spans geographic, ethnic, and socioeconomic lines. The Asian/Pacific Islander Youth Violence Prevention Center conducts qualitative and quantitative research on YV in Hawai'i. A critical element in YV prevention involves measuring YV and its risk-protective factors to determine the scope of the problem and to monitor changes across time. Under the Asian/Pacific Islander Youth Violence Prevention Center's (APIYVPC's) surveillance umbrella, a variety of methodologies are utilized. The major forms of active surveillance are a School-Wide Survey for youth, and a Safe Community Household Survey for adults. A variety of secondary data sources are accessed, such as the Centers for Disease Control and Prevention (Youth Risk Behavior Surveillance System), the Hawai'i State Department of the Attorney General, the Hawai'i State Department of Education, and the Hawai'i State Department of Health. State data are especially important for the Center, because most of these sources disaggregate ethnicity data for Asian Americans/Pacific Islanders. This paper details the surveillance methodologies utilized by the APIYVPC to monitor YV in one specific community and in Hawai'i, in comparison to the rest of the State and nation. Empirical results demonstrate the utility of each methodology and how they complement one another. Individually, each data source lends valuable information to the field of YV prevention; however, collectively, the APIYVPC's surveillance methods help to paint a more complete picture regarding violence rates and the relationship between YV and its risk-protective factors, particularly for minority communities.

Hepatitis E as a cause of acute jaundice syndrome in northern Uganda, 2010-2012.

Science.gov (United States)

Gerbi, Gemechu B; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D; Teshale, Eyasu H

2015-02-01

Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7-24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda. © The American Society of Tropical Medicine and Hygiene.

Managing the risk of cancer in Cowden syndrome: a case report

Directory of Open Access Journals (Sweden)

Hammami Sonia

2012-07-01

Full Text Available Abstract Introduction Cowden syndrome is a rare cancer predisposition syndrome inherited in an autosomal-dominant fashion. The syndrome is characterized by hamartomatous polyps that affect multiple organs: skin, mucous membranes, thyroid, breast, gastrointestinal tract, endometrium and brain. It is also associated with an increased risk of developing malignancy in many tissues but especially breast, thyroid and endometrium. Case presentation We present the case of a 30-year-old Tunisian woman with mental retardation who presented to our facility with rectal hamartomatous polyps. Her medical history included fibrocystic disease of the breast over the last three years. A physical examination revealed macrocephaly, hyperkeratotic papules on the mid-facial skin, palmoplantar keratosis and oral mucosal papillomatosis. A breast examination revealed nodular breast tissue bilaterally and a diffuse thyroid goiter. Our patient was clinically euthyroid. A total thyroidectomy was performed. A histopathologic examination revealed thyroid papillary carcinoma. A gastrointestinal evaluation revealed esophageal and gastric polyps. Biopsies showed hyperplastic and adenomatous lesions associated with Helicobacter pylori. A final diagnosis of Cowden syndrome was made according to the syndrome testing criteria adapted by the US National Comprehensive Cancer Network. A prophylactic bilateral mastectomy was proposed but refused by our patient. Our patient was kept under surveillance for breast and colorectal malignancies. Conclusions Early and accurate diagnosis of Cowden syndrome is essential because it is a cancer predisposition syndrome that carries an increased risk for developing malignancy in many tissues, especially breast and thyroid. For this reason, education regarding the signs and symptoms of cancer is important. All patients must be screened for malignancies and options for prophylactic mastectomy should be discussed. Guidelines for cancer screening

The first nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan.

Science.gov (United States)

Watanabe, Shinichi; Ohnishi, Takamitsu; Yuasa, Akira; Kiyota, Hiroshi; Iwata, Satoshi; Kaku, Mitsuo; Watanabe, Akira; Sato, Junko; Hanaki, Hideaki; Manabe, Motomu; Suzuki, Tamio; Otsuka, Fujio; Aihara, Michiko; Iozumi, Ken; Tamaki, Takeshi; Funada, Yuichi; Shinozaki, Mikio; Kobayashi, Motoko; Okuda, Masaru; Kikyo, Go; Kikuchi, Kumi; Okada, Yoshitane; Takeshima, Masanori; Kaneko, Osamu; Ogawa, Natsuki; Ito, Rie; Okuyama, Ryuhei; Shimada, Shinji; Shimizu, Tadamichi; Hatta, Naohito; Manabu, Maeda; Tsutsui, Kiyohiro; Tanaka, Toshihiro; Miyachi, Yoshiki; Asada, Hideo; Furukawa, Fukumi; Kurokawa, Ichiro; Iwatsuki, Keiji; Hide, Michihiro; Muto, Masahiko; Yamamoto, Osamu; Niihara, Hiroyuki; Takagaki, Kenji; Kubota, Yasuo; Sayama, Koji; Sano, Shigetoshi; Furue, Masutaka; Kanekura, Takuro

2017-08-01

To investigate the trends of antimicrobial resistance in pathogens isolated from skin and soft-tissue infections (SSTI) at dermatology departments in Japan, a Japanese surveillance committee conducted the first nationwide survey in 2013. Three main organisms were collected from SSTI at 30 dermatology departments in medical centers and 10 dermatology clinics. A total of 860 strains - 579 of Staphylococcus aureus, 240 of coagulase-negative Staphylococci, and 41 of Streptococcus pyogenes - were collected and shipped to a central laboratory for antimicrobial susceptibility testing. The patient profiles were also studied. Among all 579 strains of S. aureus, 141 (24.4%) were methicillin-resistant (MRSA). Among 97 Staphylococcus epidermidis strains, 54 (55.7%) were methicillin-resistant (MRSE). MRSA and MRSE were more frequently isolated from inpatients than from outpatients. Furthermore, these methicillin-resistant strains were also isolated more frequently from patients with histories of taking antibiotics within 4 weeks and hospitalization within 1 year compared to those without. However, there were no significant differences in MIC values and susceptibility patterns of the MRSA strains between patients with a history of hospitalization within 1 year and those without. Therefore, most of the isolated MRSA cases at dermatology departments are not healthcare-acquired, but community-acquired MRSA. S. pyogenes strains were susceptible to most antibiotics except macrolides. The information in this study is not only important in terms of local public health but will also contribute to an understanding of epidemic clones of pathogens from SSTI. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Surveillance of healthcare-associated infection in hospitalised South African children: Which method performs best?

Directory of Open Access Journals (Sweden)

A Dramowski

2017-01-01

Full Text Available Background. In 2012, the South African (SA National Department of Health mandated surveillance of healthcare-associated infection (HAI, but made no recommendations of appropriate surveillance methods. Methods. Prospective clinical HAI surveillance (the reference method was conducted at Tygerberg Children’s Hospital, Cape Town, from 1 May to 31 October 2015. Performance of three surveillance methods (point prevalence surveys (PPSs, laboratory surveillance and tracking of antimicrobial prescriptions was compared with the reference method using surveillance evaluation guidelines. Factors associated with failure to detect HAI were identified by logistic regression analysis. Results. The reference method detected 417 HAIs among 1 347 paediatric hospitalisations (HAI incidence of 31/1000 patient days; 95% confidence interval (CI 28.2 - 34.2. Surveillance methods had variable sensitivity (S and positive predictive value (PPV: PPS S = 24.9% (95% CI 21 - 29.3, PPV = 100%; laboratory surveillance S = 48.4% (95% CI 43.7 - 53.2, PPV = 55.2% (95% CI 50.1 - 60.2; and antimicrobial prescriptions S = 66.4% (95% CI 61.8 - 70.8%, PPV = 88.5% (95% CI 84.5 - 91.6. Combined laboratory-antimicrobial surveillance achieved superior HAI detection (S = 84.7% (95% CI 80.9 - 87.8%, PPV = 97% (95% CI 94.6 - 98.4%. Factors associated with failure to detect HAI included patient transfer (odds ratio (OR 2.0, single HAI event (OR 2.8, age category 1 - 5 years (OR 2.1 and hospitalisation in a general ward (OR 2.3. Conclusions. Repeated PPSs, laboratory surveillance and/or antimicrobial prescription tracking are feasible HAI surveillance methods for low-resource settings. Combined laboratory-antimicrobial surveillance achieved the best sensitivity and PPV. SA paediatric healthcare facilities should individualise HAI surveillance, selecting a method suited to available resources and practice context.

Cushing’s syndrome in childhood: update on genetics, treatment, and outcomes

Science.gov (United States)

Lodish, Maya

2015-01-01

Purpose of review To provide an update on the genes associated with Cushing’s syndrome in children, as well as to familiarize the clinician with recent treatment guidelines and outcome data for children with Cushing’s syndrome. Recent findings The list of genes associated with Cushing’s syndrome continues to grow. In addition, treatment for childhood Cushing’s syndrome is evolving. As long-term follow-up data on children becomes available, clinicians need to be aware of the issues that require attention. Summary Knowledge of the specific genetic causes of Cushing’s syndrome has potential implications for treatment, surveillance, and counseling. Advances in surgical technique, radiation modalities, and medical therapies offer the potential for additional treatment options in Cushing’s syndrome. Early identification and management of post-treatment morbidities in children treated for Cushing’s syndrome is crucial in order to optimize care. PMID:25517021

The stress ulcer syndrome

NARCIS (Netherlands)

H.A. van Essen

1986-01-01

textabstractThe stress ulcer syndrome is described in this thesis. This syndrome is seen in patients admitted to intensive care departments or being treated in field hospitals, in disaster areas, or battle fields. Acute mucosal lesions associated with burns (Curling's ulcers) and central nervous

Ground-water sample collection and analysis plan for the ground-water surveillance project

International Nuclear Information System (INIS)

Bryce, R.W.; Evans, J.C.; Olsen, K.B.

1991-12-01

The Pacific Northwest Laboratory performs ground-water sampling activities at the US Department of Energy's (DOE's) Hanford Site in support of DOE's environmental surveillance responsibilities. The purpose of this document is to translate DOE's General Environmental Protection Program (DOE Order 5400.1) into a comprehensive ground-water sample collection and analysis plan for the Hanford Site. This sample collection and analysis plan sets forth the environmental surveillance objectives applicable to ground water, identifies the strategy for selecting sample collection locations, and lists the analyses to be performed to meet those objectives

Long-term surveillance plan for the South Clive disposal site Clive, Utah

International Nuclear Information System (INIS)

1997-09-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project South Clive disposal site in Clive, Utah. This LSTP describes the long-term surveillance program the DOE will implement to ensure the South Clive disposal site performs as designed and is cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed for custody and long-term care, the Nuclear Regulatory Commission (NRC) requires the DOE to submit such a site-specific LTSP

Environmental surveillance master sampling schedule

International Nuclear Information System (INIS)

Bisping, L.E.

1991-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. The routine sampling plan for the SESP has been revised this year to reflect changing site operations and priorities. Some sampling previously performed at least annually has been reduced in frequency, and some new sampling to be performed at a less than annual frequency has been added. Therefore, the SESP schedule reflects sampling to be conducted in calendar year 1991 as well as future years. The ground-water sampling schedule is for 1991. This schedule is subject to modification during the year in response to changes in Site operation, program requirements, and the nature of the observed results. Operational limitations such as weather, mechanical failures, sample availability, etc., may also require schedule modifications. Changes will be documented in the respective project files, but this plan will not be reissued. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford evirons

Environmental surveillance master sampling schedule

Energy Technology Data Exchange (ETDEWEB)

Bisping, L.E.

1991-01-01

Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. The routine sampling plan for the SESP has been revised this year to reflect changing site operations and priorities. Some sampling previously performed at least annually has been reduced in frequency, and some new sampling to be performed at a less than annual frequency has been added. Therefore, the SESP schedule reflects sampling to be conducted in calendar year 1991 as well as future years. The ground-water sampling schedule is for 1991. This schedule is subject to modification during the year in response to changes in Site operation, program requirements, and the nature of the observed results. Operational limitations such as weather, mechanical failures, sample availability, etc., may also require schedule modifications. Changes will be documented in the respective project files, but this plan will not be reissued. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford evirons.

Overview of environmental surveillance of waste management activities at the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

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

1986-02-01

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 US 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 and Environmental Sciences Laboratory (RESL), the US Geological Survey (USGS), the National Oceanic and Atmospheric Administration (NOAA), EG and G Idaho, Inc., and Westinghouse Idaho Nuclear Company (WINCO). Surveillance of waste management facilities is integrated with the overall INEL Site surveillance program. Air, water, soil, biota, and environmental radiation are monitored or sampled routinely at the INEL. Results to date indicate very small or no impacts from the INEL on the surrounding environment. Environmental surveillance activities are currently underway to address key environmental issues at the INEL. 7 refs., 6 figs., 2 tabs

Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome

Directory of Open Access Journals (Sweden)

Sivaraman KR

2013-03-01

Full Text Available Kavitha R Sivaraman, Chirag G Patel, Thasarat S Vajaranant, Ahmad A ArefDepartment of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago School of Medicine, Chicago, IL, USAAbstract: Primary pigment dispersion syndrome (PPDS is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more often unilateral and acquired as a result of surgery, trauma, or intraocular tumor, but can likewise lead to pigmentary glaucoma. We report two cases of patients with bilateral PPDS who developed secondary pigment dispersion and pigmentary glaucoma in one eye. Patients with PPDS who acquire a secondary mechanism of pigment dispersion may be at an increased risk of progression to pigmentary glaucoma, presumably due to an increased burden of liberated pigment. In addition to regular surveillance for progression to glaucoma from PPDS, secondary causes of pigmentary dispersion in these eyes should be considered when patients present with grossly asymmetric findings. When secondary pigment dispersion is identified in eyes with PPDS, we recommend prompt intervention to alleviate the cause of secondary pigment dispersion and/or aggressive control of intraocular pressure to limit glaucomatous damage.Keywords: primary pigment dispersion syndrome, pigmentary glaucoma

Hepatitis E as a Cause of Acute Jaundice Syndrome in Northern Uganda, 2010–2012

Science.gov (United States)

Gerbi, Gemechu B.; Williams, Roxanne; Bakamutumaho, Barnabas; Liu, Stephen; Downing, Robert; Drobeniuc, Jan; Kamili, Saleem; Xu, Fujie; Holmberg, Scott D.; Teshale, Eyasu H.

2015-01-01

Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7–24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda. PMID:25448237

The Argentine remote monitoring and surveillance system

International Nuclear Information System (INIS)

Bonino, A.; Roca, J.L.; Perez, A.; Pizarro, L.; Krimer, M.; Teira, R.; Higa, Z.; Saettone, S.; Monzon, J.; Moroni, D.

1996-01-01

The Scientific and Technical Support Department of the Argentine National Board of Nuclear Regulation (ENREN) has developed a Remote Monitoring and Surveillance System (RMSS) that provides a media to verify state of variables related to the monitoring and surveillance activities of nuclear facilities, mainly safeguard applications. RMSS includes a variety of on site installed sensors, an authenticated radiofrequency communication link, a receiver processing unit, an active vision set and a user friendly personal computer interface to collect, view and store pertinent histories of events. A real time data base allows consulting, maintenance, updating and checking activities. RMSS could be integrated into a LAN or WAN via modem for use in a remote operation scheme. In this paper a description of the RMSS is provided. Also, an overview of the RMSS operation at one facility under safeguards belonging to the National Commission of Atomic Energy (CNEA) is presented. Results and conclusions of the system associated with this facility are given. (author). 37 figs

The Argentine remote monitoring and surveillance system

Energy Technology Data Exchange (ETDEWEB)

Bonino, A; Roca, J L; Perez, A; Pizarro, L; Krimer, M; Teira, R; Higa, Z; Saettone, S; Monzon, J; Moroni, D [Ente Nacional Regulador Nuclear, Buenos Aires (Argentina). Dept. Apoyo Cientifico y Tecnico

1997-12-31

The Scientific and Technical Support Department of the Argentine National Board of Nuclear Regulation (ENREN) has developed a Remote Monitoring and Surveillance System (RMSS) that provides a media to verify state of variables related to the monitoring and surveillance activities of nuclear facilities, mainly safeguard applications. RMSS includes a variety of on site installed sensors, an authenticated radiofrequency communication link, a receiver processing unit, an active vision set and a user friendly personal computer interface to collect, view and store pertinent histories of events. A real time data base allows consulting, maintenance, updating and checking activities. RMSS could be integrated into a LAN or WAN via modem for use in a remote operation scheme. In this paper a description of the RMSS is provided. Also, an overview of the RMSS operation at one facility under safeguards belonging to the National Commission of Atomic Energy (CNEA) is presented. Results and conclusions of the system associated with this facility are given. (author). 37 figs.

Emergency Department Chief Complaint and Diagnosis Data to Detect Influenza-Like Illness with an Electronic Medical Record

Science.gov (United States)

May, Larissa S.; Griffin, Beth Ann; Bauers, Nicole Maier; Jain, Arvind; Mitchum, Marsha; Sikka, Neal; Carim, Marianne; Stoto, Michael A.

2010-01-01

Background: The purpose of syndromic surveillance is early detection of a disease outbreak. Such systems rely on the earliest data, usually chief complaint. The growing use of electronic medical records (EMR) raises the possibility that other data, such as emergency department (ED) diagnosis, may provide more specific information without significant delay, and might be more effective in detecting outbreaks if mechanisms are in place to monitor and report these data. Objective: The purpose of this study is to characterize the added value of the primary ICD-9 diagnosis assigned at the time of ED disposition compared to the chief complaint for patients with influenza-like illness (ILI). Methods: The study was a retrospective analysis of the EMR of a single urban, academic ED with an annual census of over 60, 000 patients per year from June 2005 through May 2006. We evaluate the objective in two ways. First, we characterize the proportion of patients whose ED diagnosis is inconsistent with their chief complaint and the variation by complaint. Second, by comparing time series and applying syndromic detection algorithms, we determine which complaints and diagnoses are the best indicators for the start of the influenza season when compared to the Centers for Disease Control regional data for Influenza-Like Illness for the 2005 to 2006 influenza season using three syndromic surveillance algorithms: univariate cumulative sum (CUSUM), exponentially weighted CUSUM, and multivariate CUSUM. Results: In the first analysis, 29% of patients had a different diagnosis at the time of disposition than suggested by their chief complaint. In the second analysis, complaints and diagnoses consistent with pneumonia, viral illness and upper respiratory infection were together found to be good indicators of the start of the influenza season based on temporal comparison with regional data. In all examples, the diagnosis data outperformed the chief-complaint data. Conclusion: Both analyses

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.

Metabolic Syndrome: Systems Thinking in Heart Disease.

Science.gov (United States)

Dommermuth, Ron; Ewing, Kristine

2018-03-01

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors. MetS is associated with approximately 4-fold increase in the likelihood of developing type 2 diabetes mellitus (T2DM) and a 2-fold increase in the incidence of cardiovascular disease complications. MetS is a progressive, proinflammatory, prothrombotic condition that manifests itself along a broad spectrum of disease. It is associated with hypertension, obstructive sleep apnea, fatty liver disease, gout, and polycystic ovarian syndrome. Intervening in and reversing the pathologic process become more difficult as the disease progresses, highlighting the needs for increased individual and community surveillance and primary prevention. Copyright © 2017 Elsevier Inc. All rights reserved.

A model-based assessment of the cost-utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients.

Science.gov (United States)

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2015-04-25

Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost-utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could outweigh

Patient-reported disease knowledge and educational needs in Lynch syndrome: findings of an interactive multidisciplinary patient conference.

Science.gov (United States)

Bannon, Sarah A; Mork, Maureen; Vilar, Eduardo; Peterson, Susan K; Lu, Karen; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; You, Yiqian Nancy

2014-02-05

Patients with Lynch Syndrome, the most common hereditary colorectal cancer syndrome, benefit from genetic education and family counseling regarding diagnostic testing and cancer surveillance/prevention recommendations. Although genetic counseling is currently the most common venue where such education and counseling takes place, little is known about the level of disease knowledge and education needs as directly reported by patients and families with Lynch Syndrome. Furthermore, experiences with forums for larger-scale knowledge transfer have been limited in the current literature. We conducted a one-day interactive multidisciplinary patient conference, designed to complement individual genetic counseling for updating disease knowledge, supportive networking and needs assessment among Lynch Syndrome patients and their family members. The patient conference was designed utilizing the conceptual framework of action research. Paired pre- and post-conference surveys were administered to 44 conference participants anonymously to assess patient-reported disease knowledge and education needs. A multidisciplinary team of expert providers utilized a variety of educational formats during the one-day conference. Four main focus areas were: genetic testing, surveillance/prevention, living with Lynch Syndrome, and update on research. Thirty-two participants (73%) completed the pre-conference, and 28 (64%) participants completed the post-conference surveys. Nineteen respondents were affected and the remaining were unaffected. The scores of the disease-knowledge items significantly increased from 84% pre- to 92% post-conference (p = 0.012). Patients reported a high level of satisfaction and identified further knowledge needs in nutrition (71%), surveillance/prevention options (71%), support groups (36%), cancer risk assessment (32%), active role in medical care (32%), and research opportunities (5%). Our experience with a dedicated patient education conference focused on

Incidence of refeeding syndrome in internal medicine patients.

Science.gov (United States)

Kraaijenbrink, B V C; Lambers, W M; Mathus-Vliegen, E M H; Siegert, C E H

2016-03-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to a department of internal medicine. All patients acutely admitted to the department of internal medicine of a teaching community hospital in Amsterdam, the Netherlands, between 22 February 2011 and 29 April 2011, were included. We applied the National Institute for Health and Care Excellence (NICE) criteria for determining people at risk of refeeding syndrome and took hypophosphataemia as the main indicator for the presence of this syndrome. Of 178 patients included in the study, 97 (54%) were considered to be at risk of developing refeeding syndrome and 14 patients actually developed the syndrome (14% of patients at risk and 8% of study population). Patients with a malignancy or previous malignancy were at increased risk of developing refeeding syndrome (p refeeding syndrome. The Short Nutritional Assessment Questionnaire score had a positive and negative predictive value of 13% and 95% respectively. The incidence of refeeding syndrome was relatively high in patients acutely admitted to the department of internal medicine. Oncology patients are at increased risk of developing refeeding syndrome. When taking the occurrence of hypophosphataemia as a hallmark, no other single clinical or composite parameter could be identified that accurately predicts the development of refeeding syndrome.

Skin symptoms in four ectodermal dysplasia syndromes including two case reports of Rapp-Hodgkin-Syndrome.

Science.gov (United States)

Knaudt, Björn; Volz, Thomas; Krug, Markus; Burgdorf, Walter; Röcken, Martin; Berneburg, Mark

2012-01-01

The skin, hair and nail changes in four distinct ectodermal dysplasia syndromes are compared and reviewed. These syndromes comprise Christ-Siemens-Touraine syndrome; ectrodactyly, ectodermal dysplasia and cleft lip/palate syndrome; ankyloblepharon-ectodermal defects-cleft lip/palate syndrome and Rapp-Hodgkin syndrome. A comprehensive overview of the dermatological signs and symptoms in these syndromes was generated from the database of the Ectodermal Dysplasia Network Germany, the clinical findings in the patients seen in our department and an extensive review of the literature. The findings included abnormalities of skin, sweating, hair and nails. These clinical findings are discussed in relation to the underlying molecular defects known to play a role in these four ectodermal dysplasia syndromes.

Characteristics of patients patch tested in the European Surveillance System on Contact Allergies (ESSCA) network, 2009-2012

DEFF Research Database (Denmark)

Uter, Wolfgang; Gefeller, Olaf; Giménez-Arnau, Ana

2015-01-01

from 63 530 consultations collected by 53 departments from 12 countries participating in the European Surveillance System on Contact Allergies (ESSCA) ( www.essca-dc.org) between 2009 and 2012. RESULTS: Considerable variation in the prevalence of the MOAHLFA factors between departments was found...... one department per country give valuable insights into the spectrum of contact allergy prevalence rates in that country, but are not as representative as national data pooled from several departments....

Hazelwood Interim Storage Site environmental surveillance report for calendar year 1993

International Nuclear Information System (INIS)

1994-06-01

This report summarizes the results of environmental surveillance activities conducted at the Hazelwood Interim Storage Site (HISS) during calendar year 1993. It includes an overview of site operations, the basis for monitoring for radioactive and non-radioactive parameters, summaries of environmental program at HISS, a summary of the results, and the calculated hypothetical radiation dose to the offsite population. Environmental surveillance activities were conducted in accordance with the site environmental monitoring plan, which describes the rationale and design criteria for the surveillance program, the frequency of sampling and analysis, specific sampling and analysis procedures, and quality assurance requirements. The US Department of Energy (DOE) began environmental monitoring of HISS in 1984, when the site was assigned to DOE by Congress through the energy and Water Development Appropriations Act and subsequent to DOE's Formerly Utilized Sites Remediation Action Program (FUSRAP). Contamination at HISS originated from uranium processing work conducted at Mallinckrodt Chemical Works at the St. Louis Downtown Site (SLDS) from 1942 through 1957

Surveillance Culture

DEFF Research Database (Denmark)

2017-01-01

What does it mean to live in a world full of surveillance? In this documentary film, we take a look at everyday life in Denmark and how surveillance technologies and practices influence our norms and social behaviour. Researched and directed by Btihaj Ajana and Anders Albrechtslund....

Pediatric imaging in DICER1 syndrome

International Nuclear Information System (INIS)

Bueno, Marta Tijerin; Martinez-Rios, Claudia; Ahyad, Rayan A.; Greer, Mary-Louise C.; Puente Gregorio, Alejandro de la; Villani, Anita; Malkin, David; Druker, Harriet; Van Engelen, Kalene; Gallinger, Bailey; Aronoff, Laura; Grant, Ronald

2017-01-01

DICER1 syndrome, arising from a mutation in the DICER1 gene mapped to chromosome 14q32, is associated with an increased risk of a range of benign and malignant neoplasms. To determine the spectrum of abnormalities and imaging characteristics in patients with DICER1 syndrome at a tertiary pediatric hospital. This retrospective analysis evaluated imaging in patients ≤18 years with DICER1 germline variants between January 2004 and July 2016. An imaging database search including keywords pleuropulmonary blastoma, cystic nephroma, pineoblastoma, embryonal rhabdomyosarcoma, ovarian sex cord-stromal tumor, ovarian Sertoli-Leydig cell tumor and DICER1 syndrome, was cross-referenced against the institutional Cancer Genetics Program database, excluding patients with negative/unknown DICER1 gene testing. Sixteen patients were included (12 females; mean age at presentation: 4.2 years, range: 14 days to 17 years), with surveillance imaging encompassing the following modalities: chest X-ray and CT; abdominal, pelvic and neck US; and brain and whole-body MRI. Malignant lesions (68.8% of patients) included pleuropulmonary blastoma (5), pineoblastoma (3), ovarian Sertoli-Leydig cell tumor (1), embryonal rhabdomyosarcoma (1) and renal sarcoma (1); benign lesions (37.5% of patients) included thyroid cysts (2), thyroid nodules (2), cystic nephroma (2), renal cysts (1) and pineal cyst (1). A common lesional appearance observed across modalities and organs was defined as the ''cracked windshield'' sign. The spectrum of DICER1-related tumors and the young age at presentation suggest early surveillance of at-risk patients is critical, while minimizing exposure to ionizing radiation. (orig.)

Pediatric imaging in DICER1 syndrome

Energy Technology Data Exchange (ETDEWEB)

Bueno, Marta Tijerin; Martinez-Rios, Claudia; Ahyad, Rayan A.; Greer, Mary-Louise C. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, Ontario (Canada); University of Toronto, Department of Medical Imaging, Toronto, Ontario (Canada); Puente Gregorio, Alejandro de la [Hospital Son Espases, Radiotherapy Department, Palma de Mallorca (Spain); Villani, Anita; Malkin, David [University of Toronto, Department of Pediatrics, Toronto, Ontario (Canada); The Hospital for Sick Children, Division of Hematology/Oncology, Toronto, Ontario (Canada); The Hospital for Sick Children, Genetics and Genomic Biology Program, Toronto, Ontario (Canada); Druker, Harriet [The Hospital for Sick Children, Division of Hematology/Oncology, Toronto, Ontario (Canada); The Hospital for Sick Children, Department of Genetic Counselling, Toronto, Ontario (Canada); The Hospital for Sick Children, Department of Molecular Genetics, Toronto, Ontario (Canada); Van Engelen, Kalene [The Hospital for Sick Children, Genetics and Genomic Biology Program, Toronto, Ontario (Canada); Gallinger, Bailey [The Hospital for Sick Children, Genetics and Genomic Biology Program, Toronto, Ontario (Canada); The Hospital for Sick Children, Department of Genetic Counselling, Toronto, Ontario (Canada); The Hospital for Sick Children, Department of Molecular Genetics, Toronto, Ontario (Canada); Aronoff, Laura [The Hospital for Sick Children, Division of Hematology/Oncology, Toronto, Ontario (Canada); Grant, Ronald [University of Toronto, Department of Pediatrics, Toronto, Ontario (Canada); The Hospital for Sick Children, Division of Hematology/Oncology, Toronto, Ontario (Canada)

2017-09-15

DICER1 syndrome, arising from a mutation in the DICER1 gene mapped to chromosome 14q32, is associated with an increased risk of a range of benign and malignant neoplasms. To determine the spectrum of abnormalities and imaging characteristics in patients with DICER1 syndrome at a tertiary pediatric hospital. This retrospective analysis evaluated imaging in patients ≤18 years with DICER1 germline variants between January 2004 and July 2016. An imaging database search including keywords pleuropulmonary blastoma, cystic nephroma, pineoblastoma, embryonal rhabdomyosarcoma, ovarian sex cord-stromal tumor, ovarian Sertoli-Leydig cell tumor and DICER1 syndrome, was cross-referenced against the institutional Cancer Genetics Program database, excluding patients with negative/unknown DICER1 gene testing. Sixteen patients were included (12 females; mean age at presentation: 4.2 years, range: 14 days to 17 years), with surveillance imaging encompassing the following modalities: chest X-ray and CT; abdominal, pelvic and neck US; and brain and whole-body MRI. Malignant lesions (68.8% of patients) included pleuropulmonary blastoma (5), pineoblastoma (3), ovarian Sertoli-Leydig cell tumor (1), embryonal rhabdomyosarcoma (1) and renal sarcoma (1); benign lesions (37.5% of patients) included thyroid cysts (2), thyroid nodules (2), cystic nephroma (2), renal cysts (1) and pineal cyst (1). A common lesional appearance observed across modalities and organs was defined as the ''cracked windshield'' sign. The spectrum of DICER1-related tumors and the young age at presentation suggest early surveillance of at-risk patients is critical, while minimizing exposure to ionizing radiation. (orig.)

Surveillance Recommendations for Children with Overgrowth Syndromes and Predisposition to Wilms Tumors and Hepatoblastoma

NARCIS (Netherlands)

Kalish, Jennifer M.; Doros, Leslie; Helman, Lee J.; Hennekam, Raoul C.; Kuiper, Roland P.; Maas, Saskia M.; Maher, Eamonn R.; Nichols, Kim E.; Plon, Sharon E.; Porter, Christopher C.; Rednam, Surya; Schultz, Kris Ann P.; States, Lisa J.; Tomlinson, Gail E.; Zelley, Kristin; Druley, Todd E.

2017-01-01

A number of genetic syndromes have been linked to increased risk for Wilms tumor (WT), hepatoblastoma (HB), and other embryonal tumors. Here, we outline these rare syndromes with at least a 1% risk to develop these tumors and recommend uniform tumor screening recommendations for North America.

Annual report for Hanford Site: Epidemiologic surveillance - 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-01-01

Epidemiologic surveillance at U.S. Department of Energy (DOE) facilities consists of regular and systematic collection, analysis, and interpretation of data on absences due to illness and injury in the work force. Its purpose is to provide an early warning system for health problems occurring among employees at participating sites. Data are collected by coordinators at each site and submitted to the Epidemiologic Surveillance Data Center, located at the Oak Ridge Institute for Science and Education, where quality control procedures and analyses are carried out. Rates of absences and rates of diagnoses associated with absences are analyzed by occupational and other relevant variables. They may be compared with the disease experience of different groups within the DOE work force and with populations that do not work for DOE to identify disease patterns or clusters that may be associated with work activities.This report provides the final summary for the Hanford Reservation.

Uncertainties in the Management of a Lynch Syndrome Patient: A Case Report

OpenAIRE

Campos, Sara; Amaro, Pedro; Cunha, Inês; Fraga, João; Cipriano, Maria Augusta; Tomé, Luís

2017-01-01

Introduction: Lynch syndrome (LS), the most common hereditary colorectal cancer syndrome, is characterized by mutations in mismatch repair (MMR) genes leading to an increased cancer risk, namely colorectal cancer. Case: In the context of surveillance colonoscopy, a 40-mm flat lesion (0-IIa+b, Paris classification) was identified and submitted to piecemeal mucosal endoscopic resection in a 64-year-old LS patient with an MLH1 germline mutation (262delATC) and two previous segmental resections d...

A Systematic Review on the Existing Screening Pathways for Lynch Syndrome Identification

OpenAIRE

Tognetto, Alessia; Michelazzo, Maria Benedetta; Calabró, Giovanna Elisa; Unim, Brigid; Di Marco, Marco; Ricciardi, Walter; Pastorino, Roberta; Boccia, Stefania

2017-01-01

Background Lynch syndrome (LS) is the most common hereditary colon cancer syndrome, accounting for 3–5% of colorectal cancer (CRC) cases, and it is associated with the development of other cancers. Early detection of individuals with LS is relevant, since they can take advantage of life-saving intensive care surveillance. The debate regarding the best screening policy, however, is far from being concluded. This prompted us to conduct a systematic review of the existing screening pathways for ...

Emergence of Epidemic Zika Virus Transmission and Congenital Zika Syndrome: Are Recently Evolved Traits to Blame?

Directory of Open Access Journals (Sweden)

Scott C. Weaver

2017-01-01

Full Text Available The mechanisms responsible for the dramatic emergence of Zika virus (ZIKV, accompanied by congenital Zika syndrome and Guillain-Barré syndrome (GBS, remain unclear. However, two hypotheses are prominent: (i evolution for enhanced urban transmission via adaptation to mosquito vectors, or for enhanced human infection to increase amplification, or (ii the stochastic introduction of ZIKV into large, naive human populations in regions with abundant Aedes aegypti populations, leading to enough rare, severe infection outcomes for their first recognition. Advances in animal models for human infection combined with improvements in serodiagnostics, better surveillance, and reverse genetic approaches should provide more conclusive evidence of whether mosquito transmission or human pathogenesis changed coincidentally with emergence in the South Pacific and the Americas. Ultimately, understanding the mechanisms of epidemic ZIKV emergence, and its associated syndromes, is critical to predict future risks as well as to target surveillance and control measures in key locations.

Long-term surveillance plan for the Collins Ranch Disposal Site, Lakeview, Oregon

International Nuclear Information System (INIS)

1993-12-01

This long-term surveillance plan (LTSP) for the Lakeview, Oregon, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Lakeview (Collins Ranch) disposal cell, which will be referred to as the Collins Ranch disposal cell throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States or an Indian tribe, and details how the long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

European Surveillance System on Contact Allergies (ESSCA)

DEFF Research Database (Denmark)

Uter, W; Amario-Hita, J C; Balato, A

2017-01-01

BACKGROUND: Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, such as introduction of new substances, new products or formulations and regulatory intervention, the spectrum of contact sensitization changes....... OBJECTIVE: To evaluate the current spectrum of contact allergy to allergens present in the European baseline series (EBS) across Europe. METHODS: Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (ESSCA, www.essca-dc.org) in consecutively patch-tested patients......, 2013/14, in 46 departments in 12 European countries. RESULTS: Altogether, 31 689 patients were included in the analysis. Compared to a similar analysis in 2004, the prevalence of contact allergy to methylisothiazolinone went up to around 20% in several departments. In comparison, contact allergy...

Long-term surveillance plan for the Burro Canyon disposal cell, Slick Rock, Colorado

International Nuclear Information System (INIS)

1996-11-01

This long-term surveillance plant (LTSP) describes the US Department of energy's (DOE) long-term care program for the Uranium Mill Tailings Remediation Action (UMTRA) Project's burro Canyon disposal cell in San Miguel County, Colorado. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Burro Canyon disposal cell performs as designed. The program is based on site inspections to identify threats to disposal cell integrity. No ground water monitoring will be required at the Burro Canyon disposal cell because the ground water protection strategy is supplemental standards based on low-yield from the upper-most aquifer

Long-term surveillance plan for the Mexican Hat disposal site Mexican Hat, Utah

International Nuclear Information System (INIS)

1997-06-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Mexican Hat, Utah, disposal site. This LSTP describes the long-term surveillance program the DOE will implement to ensure the Mexican Hat disposal site performs as designed and is cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed for custody and long-term care, the Nuclear Regulatory Commission (NRC) requires the DOE to submit such a site-specific LTSP

Long-term surveillance plan for the Mexican Hat disposal site, Mexican Hat, Utah

International Nuclear Information System (INIS)

1996-01-01

This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSPC documents the land ownership interests and details how the long-term care of the disposal site will be accomplished

Long-term surveillance plan for the Estes Gulch disposal site near Rifle, Colorado

International Nuclear Information System (INIS)

1997-07-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Estes Gulch disposal site near Rifle, Colorado. This LSTP describes the long-term surveillance program the DOE will implement to ensure the Estes Gulch disposal site performs as designed and is cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed for custody and long-term care, the Nuclear Regulatory Commission (NRC) requires the DOE to submit such a site-specific LTSP

Long-term surveillance plan for the Cheney disposal site near Grand Junction, Colorado

International Nuclear Information System (INIS)

1997-07-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Cheney Disposal Site near Grand Junction, Colorado. This LSTP describes the long-term surveillance program the DOE will implement to ensure the Cheney Disposal Site performs as designed and is cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed for custody and long-term care, the Nuclear Regulatory Commission (NRC) requires the DOE to submit such a site-specific LTSP

[Analysis of the risk factors of acute respiratory distress syndrome of Berlin new definition in patients with sepsis in emergency department].

Science.gov (United States)

Qiao, Liang; Liu, Zhi

2015-07-01

To discuss the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis in emergency department. 312 patients with sepsis admitted to Department of Emergency of China Medical University Affiliated First Hospital were retrospectively analyzed, and they were divided into two groups according to development of ARDS, which was defined according to the Berlin new definition. The age, gender, vital signs, laboratory results, underlying disease, the mortality in emergency department sepsis (MEDS) score and lung injury prediction score (LIPS) were collected. Univariate analysis was done for each parameter. Statistical significance results were evaluated by multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of the parameter for ARDS. The incidence of sepsis-related ARDS was 11.2% (35/312). Within 35 cases of ARDS, there were 10 cases of mild ARDS, 18 cases of moderate ARDS, and 7 cases of severe ARDS. Univariate analysis showed that age (t=-2.134, P=0.035), oxygenation index (t=-4.245, P=0.001), arterial lactate (Lac, t=6.245, Pemergency department, which may be a reference for the early clinical diagnosis of ARDS.

Long-term surveillance plan for the Green River, Utah disposal site. Revision 1

International Nuclear Information System (INIS)

1994-08-01

The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Creutzfeldt-Jakob disease surveillance in Australia, update to December 2013.

Science.gov (United States)

Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona A; Masters, Collin L; Collins, Stephen J

2014-12-31

Nation-wide surveillance of transmissible spongiform encephalopathies including Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Surveillance has been undertaken since 1993. Over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements, the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness and understanding of Creutzfeldt-Jakob disease and other transmissible spongiform encephalopathies in the health care setting. In 2013, routine surveillance continued and this brief report provides an update of the surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2013, and retrospectively to 1970. The report highlights the recent multi-national collaborative study published that has verified the correlation between surveillance intensity and reported disease incidence. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of

Remote-Reading Safety and Safeguards Surveillance System for 3013 Containers

International Nuclear Information System (INIS)

Lechelt, W. M.; Skorpik, J. R.; Silvers, K. L.; Szempruch, R. W.; Douglas, D. G.; Fein, K. O.

2002-01-01

At Hanford's Plutonium Finishing Plant (PFP), plutonium oxide is being loaded into stainless steel containers for long-term storage on the Hanford Site. These containers consist of two weld-sealed stainless steel cylinders nested one within the other. A third container holds the plutonium within the inner cylinder. This design meets the U.S. Department of Energy (DOE) storage standard, DOE-STD- 3013-2000, which anticipates a 50-year storage lifetime. The 3013 standard also requires a container surveillance program to continuously monitor pressure and to assure safeguards are adequate. However, the configuration of the container system makes using conventional measurement and monitoring methods difficult. To better meet the 3013 monitoring requirements, a team from Fluor Hanford (who manages the PFP), Pacific Northwest National Laboratory (PNNL), and Vista Engineering Technologies, LLC, developed a safer, cost-efficient, remote PFP 3013 container surveillance system. This new surveillance system is a combination of two successfully deployed technologies: (1) a magnetically coupled pressure gauge developed by Vista Engineering and (2) a radio frequency (RF) tagging device developed by PNNL. This system provides continuous, 100% monitoring of critical parameters with the containers in place, as well as inventory controls. The 3013 container surveillance system consists of three main elements: (1) an internal magnetic pressure sensor package, (2) an instrument pod (external electronics package), and (3) a data acquisition storage and display computer. The surveillance system described in this paper has many benefits for PFP and DOE in terms of cost savings and reduced personnel exposure. In addition, continuous safety monitoring (i.e., internal container pressure and temperature) of every container is responsible nuclear material stewardship and fully meets and exceeds DOE's Integrated Surveillance Program requirements

National Status and Trends, Benthic Surveillance Project Sites, 1984-1992, National Centers for Coastal Ocean Science

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set reports information regarding the nominal sampling locations for the National Status and Trends Benthic Surveillance Project sites. One record is...

Programmatic Impact of 5 Years of Mortality Surveillance of New York City Homeless Populations

Science.gov (United States)

Marder, Dova; Begier, Elizabeth; Gutkovich, Alexander; Mos, Robert; Griffin, Angela; Zimmerman, Regina; Madsen, Ann

2013-01-01

A homeless mortality surveillance system identifies emerging trends in the health of the homeless population and provides this information to key stakeholders in a timely and ongoing manner to effect evidence-based, programmatic change. We describe the first 5 years of the New York City homeless mortality surveillance system and, for the first time in peer-reviewed literature, illustrate the impact of key elements of sustained surveillance (i.e., timely dissemination of aggregate mortality data and real-time sharing of information on individual homeless decedents) on the programs of New York City’s Department of Homeless Services. These key elements had a positive impact on the department’s programs that target sleep-related infant deaths and hypothermia, drug overdose, and alcohol-related deaths among homeless persons. PMID:24148068

Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj.

Science.gov (United States)

Alotaibi, Badriah M; Yezli, Saber; Bin Saeed, Abdul-Aziz A; Turkestani, Abdulhafeez; Alawam, Amnah H; Bieh, Kingsley L

2017-05-01

Hajj is one of the largest and the most ethnically and culturally diverse mass gatherings worldwide. The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. The literature describes infectious diseases prevention and control strategies for Hajj but with limited information on the operations and characteristics of the existing Hajj infectious diseases surveillance systems. We reviewed documents, including guidelines and reports from the Saudi Ministry of Health's database, to describe the characteristics of the infectious diseases surveillance systems that were operational during the 2015 Hajj, highlighting best practices and gaps and proposing strategies for strengthening and improvement. Using Pubmed and Embase online search engines and a combination of search terms including, 'mass gatherings' 'Olympics' 'surveillance' 'Hajj' 'health security', we explored the existing literature and highlighted some lessons learnt from other international mass gatherings. A regular indicator-based infectious disease surveillance system generates routine reports from health facilities within the Kingdom to the regional and central public health directorates all year round. During Hajj, enhanced indicator-based notifiable diseases surveillance systems complement the existing surveillance tool to ensure timely reporting of event information for appropriate action by public health officials. There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security. © International Society of Travel Medicine, 2017. Published by Oxford University

Long-term Surveillance Plan for the Falls City Disposal Site, Falls City, Texas. Revision 1

International Nuclear Information System (INIS)

1995-08-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Hanford Site surface environmental surveillance

International Nuclear Information System (INIS)

Dirkes, R.L.

1998-01-01

Environmental surveillance of the Hanford Site and the surrounding region is conducted to demonstrate compliance with environmental regulations, confirm adherence to US Department of Energy (DOE) environmental protection policies, support DOE environmental management decisions, and provide information to the public. The Surface Environmental Surveillance Project (SESP) is a multimedia environmental monitoring program conducted to measure the concentrations of radionuclides and chemical contaminants in the environment and assess the integrated effects of these contaminants on the environment and the public. The monitoring program includes sampling air, surface water, sediments, soil, natural vegetation, agricultural products, fish, and wildlife. Functional elements inherent in the operation of the SESP include project management, quality assurance/control, training, records management, environmental sampling network design and implementation, sample collection, sample analysis, data management, data review and evaluation, exposure assessment, and reporting. The SESP focuses on those contaminant/media combinations calculated to have the highest potential for contributing to off-site exposure. Results of the SESP indicate that contaminant concentrations in the Hanford environs are very low, generally below environmental standards, at or below analytical detection levels, and indicative of environmental levels. However, areas of elevated contaminant concentrations have been identified at Hanford. The extent of these areas is generally limited to past operating areas and waste disposal sites

Active surveillance for influenza vaccine adverse events: the integrated vaccine surveillance system.

Science.gov (United States)

Newes-Adeyi, Gabriella; Greece, Jacey; Bozeman, Sam; Walker, Deborah Klein; Lewis, Faith; Gidudu, Jane

2012-02-01

We conducted a pilot study of the Integrated Vaccine Surveillance System (IVSS), a novel active surveillance system for monitoring influenza vaccine adverse events that could be used in mass vaccination settings. We recruited 605 adult vaccinees from a convenience sample of 12 influenza vaccine clinics conducted by public health departments of two U.S. metropolitan regions. Vaccinees provided daily reports on adverse reactions following immunization (AEFI) using an interactive voice response system (IVR) or the internet for 14 consecutive days following immunization. Followup with nonrespondents was conducted through computer-assisted telephone interviewing (CATI). Data on vaccinee reports were available real-time through a dedicated secure website. 90% (545) of vaccinees made at least one daily report and 49% (299) reported consecutively for the full 14-day period. 58% (315) used internet, 20% (110) IVR, 6% (31) CATI, and 16% (89) used a combination for daily reports. Of the 545 reporters, 339 (62%) reported one or more AEFI, for a total of 594 AEFIs reported. The majority (505 or 85%) of these AEFIs were mild symptoms. It is feasible to develop a system to obtain real-time data on vaccine adverse events. Vaccinees are willing to provide daily reports for a considerable time post vaccination. Offering multiple modes of reporting encourages high response rates. Study findings on AEFIs showed that the IVSS was able to exhibit the emerging safety profile of the 2008 seasonal influenza vaccine. Copyright © 2011 Elsevier Ltd. All rights reserved.

Limits on surveillance: frictions, fragilities and failures in the operation of camera surveillance.

NARCIS (Netherlands)

Dubbeld, L.

2004-01-01

Public video surveillance tends to be discussed in either utopian or dystopian terms: proponents maintain that camera surveillance is the perfect tool in the fight against crime, while critics argue that the use of security cameras is central to the development of a panoptic, Orwellian surveillance

Radar sensor technology developments as CSIR DPSS in support of persistent, ubiquitous surveillance systems

CSIR Research Space (South Africa)

Anderson, F

2008-11-01

Full Text Available of an S&T capability based on international technology trends in persistent, ubiquitous surveillance. The ultimate aim of this programme is to develop and produce a series of South African innovations that can be used by departments and agencies...

Surveillance of environmental radiation in Finland. Annual Report 2000

International Nuclear Information System (INIS)

Mustonen, R.

2001-01-01

The main goal of the surveillance of environmental radioactivity is to be always aware of levels of radiation to which the public is exposed. Another goal is to detect all remarkable changes in levels of environmental radiation and radioactivity. Compliance with the basic safety standards laid down for protection of the health of the general public against dangers arising from ionising radiation can be ensured with environmental radiation surveillance. Running of surveillance programmes on continuous basis also maintains and develops competence and readiness to respond to radiological emergencies. Surveillance of environmental radioactivity in Finland is one of the official obligations of the Radiation and Nuclear Safety Authority (STUK). This obligation is based on the national and the European Communities' legislation. The Finnish radiation protection legislation appoints STUK as the national authority responsible for surveillance of environmental radioactivity, and the Euratom Treaty assumes continuous monitoring of levels of radioactivity in the air, water and soil in the Member States. In Finland, also the Finnish Meteorological Institute (FMI) and the Defence Forces are monitoring environmental radiation at their own stations. This report summarises the results of environmental radiation surveillance in 2000. The report also contains some comparisons with results from the previous years. The results are collected from monitoring programmes of STUK, FMI and the Defence Forces Research Institute of Technology. Nuclear power plant licensees are responsible for environmental surveillance in the vicinity of nuclear power plants in Finland. Those results are reported elsewhere. STUK's partners in surveillance of environmental radioactivity are collecting and delivering samples for laboratory analyses, or are participating in whole-body counting. STUK would like to express its gratitude to the following institutions for the successful co-operation: Defence Forces

Surveillance of environmental radiation in Finland. Annual Report 2001

International Nuclear Information System (INIS)

Mustonen, R.

2002-01-01

The main goal of the surveillance of environmental radioactivity is to be always aware of levels of radiation to which the public is exposed. Another goal is to detect all remarkable changes in levels of environmental radiation and radioactivity. Compliance with the basic safety standards laid down for protection of health of the general public against dangers arising from ionising radiation can be ensured with environmental radiation surveillance. Running of surveillance programmes on continuous basis also maintains and develops competence and readiness to respond to radiological emergencies. Surveillance of environmental radioactivity in Finland is one of the official obligations of the Radiation and Nuclear Safety Authority (STUK). This obligation is based on the national and the European Communities' legislation. The Finnish radiation protection legislation appoints STUK as the national authority responsible for surveillance of environmental radioactivity, and the Euratom Treaty assumes continuous monitoring of levels of radioactivity in the air, water and soil in the Member States. In Finland, also the Finnish Meteorological Institute (FMI) and the Defence Forces are monitoring environmental radiation at their own stations. This report summarises the results of environmental radiation surveillance in 2001. The report also contains some comparisons with results from the previous years. The results are collected from monitoring programmes of STUK, FMI and the Defence Forces Research Institute of Technology. Nuclear power plant licensees are responsible for environmental surveillance in the vicinity of nuclear power plants in Finland. Those results are reported elsewhere. STUK's partners in surveillance of environmental radioactivity are collecting and delivering environmental samples for laboratory analyses, or are participating in whole-body counting. STUK would like to express its gratitude to the following institutions for the successful co-operation: Defence

Handbook of surveillance technologies

CERN Document Server

Petersen, JK

2012-01-01

From officially sanctioned, high-tech operations to budget spy cameras and cell phone video, this updated and expanded edition of a bestselling handbook reflects the rapid and significant growth of the surveillance industry. The Handbook of Surveillance Technologies, Third Edition is the only comprehensive work to chronicle the background and current applications of the full-range of surveillance technologies--offering the latest in surveillance and privacy issues.Cutting-Edge--updates its bestselling predecessor with discussions on social media, GPS circuits in cell phones and PDAs, new GIS s

Containment and surveillance devices

International Nuclear Information System (INIS)

Campbell, J.W.; Johnson, C.S.; Stieff, L.R.

The growing acceptance of containment and surveillance as a means to increase safeguards effectiveness has provided impetus to the development of improved surveillance and containment devices. Five recently developed devices are described. The devices include one photographic and two television surveillance systems and two high security seals that can be verified while installed

Case based rubella surveillance in Abia State, South East Nigeria, 2007-2011.

Science.gov (United States)

Umeh, Chukwuemeka Anthony; Onyi, Stella Chioma

2014-01-01

Introduction. Rubella infection has the potential of causing severe fetal birth defects collectively called congenital rubella syndrome (CRS) if the mother is infected early in pregnancy. However, little is known about rubella and CRS epidemiology in Nigeria and rubella vaccines are still not part of routine childhood immunization in Nigeria. Methods. Analysis of confirmed cases of rubella in Abia State, Nigeria from 2007 to 2011 detected through Abia State Integrated Disease Surveillance and Response system. Results. Of the 757 febrile rash cases, 81(10.7%) tested positive for rubella immunoglobulin M (IgM). New rubella infection decreased from 6.81/1,000,000 population in 2007 to 2.28/1,000,000 in 2009 and increased to 6.34/1,000,000 in 2011. The relative risk of rubella was 1.5 (CI [0.98-2.28]) times as high in females compared to males and 1.6 times (CI [0.90-2.91]) as high in rural areas compared to urban areas. Eighty six percent of rubella infections occurred in children less than 15 years with a high proportion of cases occurring between 5 and 14 years. Conclusion. Rubella infection in Abia State, Nigeria is predominantly in those who are younger than 15 years old. It is also more prevalent in females and in those living in rural areas of the state. Unfortunately, there is no surveillance of CRS in Nigeria and so the public health impact of rubella infection in the state is not known. Efforts should be made to expand the rubella surveillance in Nigeria to incorporate surveillance for CRS.

Surveillance and vaccine effectiveness of an influenza epidemic predominated by vaccine-mismatched influenza B/Yamagata-lineage viruses in Taiwan, 2011-12 season.

Directory of Open Access Journals (Sweden)

Yi-Chun Lo

Full Text Available INTRODUCTION: The 2011-12 trivalent influenza vaccine contains a strain of influenza B/Victoria-lineage viruses. Despite free provision of influenza vaccine among target populations, an epidemic predominated by influenza B/Yamagata-lineage viruses occurred during the 2011-12 season in Taiwan. We characterized this vaccine-mismatched epidemic and estimated influenza vaccine effectiveness (VE. METHODS: Influenza activity was monitored through sentinel viral surveillance, emergency department (ED and outpatient influenza-like illness (ILI syndromic surveillance, and case-based surveillance of influenza with complications and deaths. VE against laboratory-confirmed influenza was evaluated through a case-control study on ILI patients enrolled into sentinel viral surveillance. Logistic regression was used to estimate VE adjusted for confounding factors. RESULTS: During July 2011-June 2012, influenza B accounted for 2,382 (72.5% of 3,285 influenza-positive respiratory specimens. Of 329 influenza B viral isolates with antigen characterization, 287 (87.2% were B/Yamagata-lineage viruses. Proportions of ED and outpatient visits being ILI-related increased from November 2011 to January 2012. Of 1,704 confirmed cases of influenza with complications, including 154 (9.0% deaths, influenza B accounted for 1,034 (60.7% of the confirmed cases and 103 (66.9% of the deaths. Reporting rates of confirmed influenza with complications and deaths were 73.5 and 6.6 per 1,000,000, respectively, highest among those aged ≥65 years, 50-64 years, 3-6 years, and 0-2 years. Adjusted VE was -31% (95% CI: -80, 4 against all influenza, 54% (95% CI: 3, 78 against influenza A, and -66% (95% CI: -132, -18 against influenza B. CONCLUSIONS: This influenza epidemic in Taiwan was predominated by B/Yamagata-lineage viruses unprotected by the 2011-12 trivalent vaccine. The morbidity and mortality of this vaccine-mismatched epidemic warrants careful consideration of introducing a

Use of diagnosis codes for detection of clinically significant opioid poisoning in the emergency department: A retrospective analysis of a surveillance case definition.

Science.gov (United States)

Reardon, Joseph M; Harmon, Katherine J; Schult, Genevieve C; Staton, Catherine A; Waller, Anna E

2016-02-08

Although fatal opioid poisonings tripled from 1999 to 2008, data describing nonfatal poisonings are rare. Public health authorities are in need of tools to track opioid poisonings in near real time. We determined the utility of ICD-9-CM diagnosis codes for identifying clinically significant opioid poisonings in a state-wide emergency department (ED) surveillance system. We sampled visits from four hospitals from July 2009 to June 2012 with diagnosis codes of 965.00, 965.01, 965.02 and 965.09 (poisoning by opiates and related narcotics) and/or an external cause of injury code of E850.0-E850.2 (accidental poisoning by opiates and related narcotics), and developed a novel case definition to determine in which cases opioid poisoning prompted the ED visit. We calculated the percentage of visits coded for opioid poisoning that were clinically significant and compared it to the percentage of visits coded for poisoning by non-opioid agents in which there was actually poisoning by an opioid agent. We created a multivariate regression model to determine if other collected triage data can improve the positive predictive value of diagnosis codes alone for detecting clinically significant opioid poisoning. 70.1 % of visits (Standard Error 2.4 %) coded for opioid poisoning were primarily prompted by opioid poisoning. The remainder of visits represented opioid exposure in the setting of other primary diseases. Among non-opioid poisoning codes reviewed, up to 36 % were reclassified as an opioid poisoning. In multivariate analysis, only naloxone use improved the positive predictive value of ICD-9-CM codes for identifying clinically significant opioid poisoning, but was associated with a high false negative rate. This surveillance mechanism identifies many clinically significant opioid overdoses with a high positive predictive value. With further validation, it may help target control measures such as prescriber education and pharmacy monitoring.

An integrated national mortality surveillance system for death registration and mortality surveillance, China.

Science.gov (United States)

Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

2016-01-01

In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

Manifestations of Gorlin-Goltz syndrome

DEFF Research Database (Denmark)

Larsen, Anne Kristine; Mikkelsen, Dorthe; Hertz, Jens Michael

2014-01-01

INTRODUCTION: Gorlin-Goltz syndrome is an uncommon hereditary condition caused by mutations in the PTCH1 gene causing a wide range of developmental abnormalities. Multiple basal cell carcinomas, palmoplantar pits and jaw cysts are cardinal features. Many clinicians are unfamiliar with the different...... manifestations and the fact that patients are especially sensitive to ionizing radiation. MATERIAL AND METHODS: This was a retrospective analysis of patients with Gorlin-Goltz syndrome seen at the Department of Dermatology and Allergy Centre or at Department of Plastic Surgery, Odense University Hospital...... families and none of these mutations had previously been described. CONCLUSION: The patient cohort illustrates classic and rare disease manifestations. It is necessary to remind clinicians that radiation therapy in Gorlin-Goltz syndrome is relatively contraindicated. Today, mutation analysis can be used...

A model-based assessment of the cost–utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients

International Nuclear Information System (INIS)

Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

2015-01-01

Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost–utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could

Hanford Site Environmental Surveillance Master Sampling Schedule for Calendar Year 2010

Energy Technology Data Exchange (ETDEWEB)

Bisping, Lynn E.

2010-01-08

Environmental surveillance of the Hanford Site and surrounding areas is conducted by Pacific Northwest National Laboratory for the U.S. Department of Energy (DOE). Sampling is conducted to evaluate levels of radioactive and nonradioactive pollutants in the Hanford Site environs per regulatory requirements. This document contains the calendar year 2010 schedule for the routine collection of samples for the Surface Environmental Surveillance Project and the Drinking Water Monitoring Project. Each section includes sampling locations, sampling frequencies, sample types, and analyses to be performed. In some cases, samples are scheduled on a rotating basis. If a sample will not be collected in 2010, the anticipated year for collection is provided. Maps showing approximate sampling locations are included for media scheduled for collection in 2010.

Digital dashboard design using multiple data streams for disease surveillance with influenza surveillance as an example.

Science.gov (United States)

Cheng, Calvin K Y; Ip, Dennis K M; Cowling, Benjamin J; Ho, Lai Ming; Leung, Gabriel M; Lau, Eric H Y

2011-10-14

Great strides have been made exploring and exploiting new and different sources of disease surveillance data and developing robust statistical methods for analyzing the collected data. However, there has been less research in the area of dissemination. Proper dissemination of surveillance data can facilitate the end user's taking of appropriate actions, thus maximizing the utility of effort taken from upstream of the surveillance-to-action loop. The aims of the study were to develop a generic framework for a digital dashboard incorporating features of efficient dashboard design and to demonstrate this framework by specific application to influenza surveillance in Hong Kong. Based on the merits of the national websites and principles of efficient dashboard design, we designed an automated influenza surveillance digital dashboard as a demonstration of efficient dissemination of surveillance data. We developed the system to synthesize and display multiple sources of influenza surveillance data streams in the dashboard. Different algorithms can be implemented in the dashboard for incorporating all surveillance data streams to describe the overall influenza activity. We designed and implemented an influenza surveillance dashboard that utilized self-explanatory figures to display multiple surveillance data streams in panels. Indicators for individual data streams as well as for overall influenza activity were summarized in the main page, which can be read at a glance. Data retrieval function was also incorporated to allow data sharing in standard format. The influenza surveillance dashboard serves as a template to illustrate the efficient synthesization and dissemination of multiple-source surveillance data, which may also be applied to other diseases. Surveillance data from multiple sources can be disseminated efficiently using a dashboard design that facilitates the translation of surveillance information to public health actions.

Uncertainties in the Management of a Lynch Syndrome Patient: A Case Report

Science.gov (United States)

Campos, Sara; Amaro, Pedro; Cunha, Inês; Fraga, João; Cipriano, Maria Augusta; Tomé, Luís

2017-01-01

Introduction Lynch syndrome (LS), the most common hereditary colorectal cancer syndrome, is characterized by mutations in mismatch repair (MMR) genes leading to an increased cancer risk, namely colorectal cancer. Case In the context of surveillance colonoscopy, a 40-mm flat lesion (0-IIa+b, Paris classification) was identified and submitted to piecemeal mucosal endoscopic resection in a 64-year-old LS patient with an MLH1 germline mutation (262delATC) and two previous segmental resections due to metachronous colorectal cancer. Pathology raised the suspicion of superficial submucosal invasive carcinoma with poor differentiation. Immunochemistry showed heterogeneous MLH1 expression and PMS2 loss. In a short-term follow-up colonoscopy, another 30-mm advanced carcinoma was identified. The patient was referred to surgery. Conclusion This case raises several issues: (1) the potentially fast tumorigenesis and progression to carcinoma in LS and implications for endoscopic screening and surveillance; (2) pitfalls in the interpretation of MMR proteins immunochemistry; (3) the role of endoscopic resection in LS. PMID:29255760

Uncertainties in the Management of a Lynch Syndrome Patient: A Case Report

Directory of Open Access Journals (Sweden)

Sara Campos

2017-03-01

Full Text Available Introduction: Lynch syndrome (LS, the most common hereditary colorectal cancer syndrome, is characterized by mutations in mismatch repair (MMR genes leading to an increased cancer risk, namely colorectal cancer. Case: In the context of surveillance colonoscopy, a 40-mm flat lesion (0-IIa+b, Paris classification was identified and submitted to piecemeal mucosal endoscopic resection in a 64-year-old LS patient with an MLH1 germline mutation (262delATC and two previous segmental resections due to metachronous colorectal cancer. Pathology raised the suspicion of superficial submucosal invasive carcinoma with poor differentiation. Immunochemistry showed heterogeneous MLH1 expression and PMS2 loss. In a short-term follow-up colonoscopy, another 30-mm advanced carcinoma was identified. The patient was referred to surgery. Conclusion: This case raises several issues: (1 the potentially fast tumorigenesis and progression to carcinoma in LS and implications for endoscopic screening and surveillance; (2 pitfalls in the interpretation of MMR proteins immunochemistry; (3 the role of endoscopic resection in LS.

Influenza surveillance

Directory of Open Access Journals (Sweden)

Karolina Bednarska

2016-04-01

Full Text Available Influenza surveillance was established in 1947. From this moment WHO (World Health Organization has been coordinating international cooperation, with a goal of monitoring influenza virus activity, effective diagnostic of the circulating viruses and informing society about epidemics or pandemics, as well as about emergence of new subtypes of influenza virus type A. Influenza surveillance is an important task, because it enables people to prepare themselves for battle with the virus that is constantly mutating, what leads to circulation of new and often more virulent strains of influenza in human population. As vaccination is the most effective method of fighting the virus, one of the major tasks of GISRS is developing an optimal antigenic composition of the vaccine for the current epidemic season. European Influenza Surveillance Network (EISN has also developed over the years. EISN is running integrated epidemiological and virological influenza surveillance, to provide appropriate data to public health experts in member countries, to enable them undertaking relevant activities based on the current information about influenza activity. In close cooperation with GISRS and EISN are National Influenza Centres - national institutions designated by the Ministry of Health in each country.

Using health and demographic surveillance for the early detection of cholera outbreaks: analysis of community- and hospital-based data from Matlab, Bangladesh.

Science.gov (United States)

Saulnier, Dell D; Persson, Lars-Åke; Streatfield, Peter Kim; Faruque, A S G; Rahman, Anisur

2016-01-01

Cholera outbreaks are a continuing problem in Bangladesh, and the timely detection of an outbreak is important for reducing morbidity and mortality. In Matlab, the ongoing Health and Demographic Surveillance System (HDSS) data records symptoms of diarrhea in children under the age of 5 years at the community level. Cholera surveillance in Matlab currently uses hospital-based data. The objective of this study is to determine whether increases in cholera in Matlab can be detected earlier by using HDSS diarrhea symptom data in a syndromic surveillance analysis, when compared to hospital admissions for cholera. HDSS diarrhea symptom data and hospital admissions for cholera in children under 5 years of age over a 2-year period were analyzed with the syndromic surveillance statistical program EARS (Early Aberration Reporting System). Dates when significant increases in either symptoms or cholera cases occurred were compared to one another. The analysis revealed that there were 43 days over 16 months when the cholera cases or diarrhea symptoms increased significantly. There were 8 months when both data sets detected days with significant increases. In 5 of the 8 months, increases in diarrheal symptoms occurred before increases of cholera cases. The increases in symptoms occurred between 1 and 15 days before the increases in cholera cases. The results suggest that the HDSS survey data may be able to detect an increase in cholera before an increase in hospital admissions is seen. However, there was no direct link between diarrheal symptom increases and cholera cases, and this, as well as other methodological weaknesses, should be taken into consideration.

Surveillance of environmental radiation in Finland. Annual Report 2004

International Nuclear Information System (INIS)

Mustonen, R.

2005-07-01

previous years. The results are collected from monitoring programmes of STUK, FMI and the Defence Forces Research Institute of Technology. Nuclear power plant licensees are responsible for environmental surveillance in the vicinity of nuclear power plants in Finland. Those results are reported elsewhere. STUK's partners in surveillance of environmental radioactivity are collecting and delivering environmental samples for laboratory analyses, or are participating in whole-body counting. STUK would like to express its gratitude to the following institutions for the successful co-operation: Defence Forces, Finnish Meteorological Institute, Arctic Research Centre, Southeast Finland Regional Environment Centre, North Ostrobothnia Regional Environment Centre, Lapland Regional Environment Centre, Southeast Finland Frontier Guard District, Lapland Frontier Guard District, Jyvaeskylae Airport, Rescue Centre of Kotka, Water supply plants of Oulu and Turku, Valio Ltd., Health Department of Helsinki/Maria Hospital, Tampere University Central Hospital, Lapland Central Hospital, Secondary school of Helsingin yhteislyseo, Secondary school of Hatanpaeae in Tampere, and Secondary school of Korkalovaara in Rovaniemi. This report is addressed to all who are interested in environmental radioactivity in Finland. STUK delivers monitoring data also to the European Commission on regular basis, and this report is a summary of the results delivered to the Commission. The report is also available on the STUK's home pages www.stuk.fi. (orig.)

Acute coronary syndrome associated with Churg-Strauss syndrome

Directory of Open Access Journals (Sweden)

Annette Doris Wagner

2007-11-01

Full Text Available Annette Doris Wagner1, Gerd Peter Meyer2, Markus Rihl3, Anke Rathmann2, Ulrike Wittkop1, Henning Zeidler4, Hermann Haller1, Joachim Lotz51Department Internal Medicine, Division of Nephrology; 2Division of Cardiology; 3Division of Rheumatology; 4Rheumatologikum Hannover; 5Department of Diagnostic Radiology; Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, GermanyAbstract: A 41-year old female patient was admitted with acute onset of dyspnea and chest pain. Previous history revealed asthma, chronic sinusitis and eosinophilic proctitis. Electrocardiogram showed anterior ST-segment elevations and inferior ST-segment depression. Immediate heart catheterization revealed a distally occluded left anterior descending coronary artery, the occlusion being reversible after nitroglycerine. Cardiac magnetic resonance imaging was consistent with perimyocarditis. Hypereosinophilia and IgE elevation were present and Churg-strauss syndrome was diagnosed.Keywords: Churg-Strauss syndrome (CSS, carditis, cardiac MRI

Comparison of the HEART and TIMI Risk Scores for Suspected Acute Coronary Syndrome in the Emergency Department.

Science.gov (United States)

Sun, Benjamin C; Laurie, Amber; Fu, Rongwei; Ferencik, Maros; Shapiro, Michael; Lindsell, Christopher J; Diercks, Deborah; Hoekstra, James W; Hollander, Judd E; Kirk, J Douglas; Peacock, W Frank; Anantharaman, Venkataraman; Pollack, Charles V

2016-03-01

The emergency department evaluation for suspected acute coronary syndrome (ACS) is common, costly, and challenging. Risk scores may help standardize clinical care and screening for research studies. The Thrombolysis in Myocardial Infarction (TIMI) and HEART are two commonly cited risk scores. We tested the null hypothesis that the TIMI and HEART risk scores have equivalent test characteristics. We analyzed data from the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS) from 9 EDs on patients with suspected ACS, 1999-2001. We excluded patients with an emergency department diagnosis consistent with ACS, or without sufficient data to calculate TIMI and HEART scores. The primary outcome was 30-day major adverse cardiovascular events, including all-cause death, acute myocardial infarction, and urgent revascularization. We describe test characteristics of the TIMI and HEART risk scores. The study cohort included 8255 patients with 508 (6.2%) 30-day major adverse cardiovascular events. Receiver operating curve and reclassification analyses favored HEART [c statistic: 0.753, 95% confidence interval (CI): 0.733-0.773; continuous net reclassification improvement: 0.608, 95% CI: 0.527-0.689] over TIMI (c statistic: 0.678, 95% CI: 0.655-0.702). A HEART score 0-3 [negative predictive value (NPV) 0.982, 95% CI: 0.978-0.986; positive predictive value (PPV) 0.103, 95% CI: 0.094-0.113; likelihood ratio (LR) positive 1.76; LR negative 0.28] demonstrates similar or superior NPV/PPV/LR compared with TIMI = 0 (NPV 0.978, 95% CI: 0.971-0.983; PPV 0.077, 95% CI: 0.071-0.084; LR positive 1.28; LR negative 0.35) and TIMI = 0-1 (NPV 0.963, 95% CI: 0.958-0.968; PPV 0.102, 95% CI: 0.092-0.113; LR positive 1.73; LR negative 0.58). The HEART score has better discrimination than TIMI and outperforms TIMI within previously published "low-risk" categories.