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Sample records for active population-based surveillance

  1. The uptake of active surveillance for the management of prostate cancer: A population-based analysis

    PubMed Central

    Richard, Patrick O.; Alibhai, Shabbir M.H.; Panzarella, Tony; Klotz, Laurence; Komisarenko, Maria; Fleshner, Neil E.; Urbach, David; Finelli, Antonio

    2016-01-01

    Introduction: Active surveillance (AS) is a strategy for the management of low-risk prostate cancer (PCa). However, few studies have assessed the uptake of AS at a population level and none of these were based on a Canadian population. Therefore, our objectives were to estimate the proportion of men being managed by AS in Ontario and to assess the factors associated with its uptake. Methods: This was a retrospective, population-based study using administrative databases from the province of Ontario to identify men ≤75 years diagnosed with localized PCa between 2002 and 2010. Descriptive statistics were used to estimate the proportion of men managed by AS, whereas mixed models were used to assess the factors associated with the uptake of AS. Results: 45 691 men met our inclusion criteria. Of these, 18% were managed by AS. Over time, the rates of AS increased significantly from 11% to 21% (p<0.001). Older age, residing in an urban centre, being diagnosed in the later years of the study period, having a neighborhood income in the highest quintile, and being managed by urologists were all associated with greater odds of receiving AS. Conclusions: There has been a steady increase in the uptake of AS between 2002 and 2010. However, only 18% of men diagnosed with localized PCa were managed by AS during the study period. The decisions to adopt AS were influenced by several individual and physician characteristics. The data suggest that there is significant opportunity for more widespread adoption of AS. PMID:27800055

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

    PubMed Central

    2012-01-01

    Background There are few studies on the epidemiology of epilepsy in large populations in Low and Middle Income Countries (LMIC). Most studies in these regions use two-stage population-based screening surveys, which are time-consuming and costly to implement in large populations required to generate accurate estimates. We examined the sensitivity and specificity of a three-stage cross-sectional screening methodology in detecting active convulsive epilepsy (ACE), which can be embedded within on-going census of demographic surveillance systems. We validated a three-stage cross-sectional screening methodology on a randomly selected sample of participants of a three-stage prevalence survey of epilepsy. Diagnosis of ACE by an experienced clinician was used as ‘gold standard’. We further compared the expenditure of this method with the standard two-stage methodology. Results We screened 4442 subjects in the validation and identified 35 cases of ACE. Of these, 18 were identified as false negatives, most of whom (15/18) were missed in the first stage and a few (3/18) in the second stage of the three-stage screening. Overall, this methodology had a sensitivity of 48.6% and a specificity of 100%. It was 37% cheaper than a two-stage survey. Conclusion This was the first study to evaluate the performance of a multi-stage screening methodology used to detect epilepsy in demographic surveillance sites. This method had poor sensitivity attributed mainly to stigma-related non-response in the first stage. This method needs to take into consideration the poor sensitivity and the savings in expenditure and time as well as validation in target populations. Our findings suggest the need for continued efforts to develop and improve case-ascertainment methods in population-based epidemiological studies of epilepsy in LMIC. PMID:23171721

  3. Population based mortality surveillance in carbon products manufacturing plants.

    PubMed Central

    Teta, M J; Ott, M G; Schnatter, A R

    1987-01-01

    The utility of a population based, corporate wide mortality surveillance system was evaluated after a 10 year observation period of one of the company's divisions. The subject population, 2219 white male, long term employees from Union Carbide Corporation's carbon based electrode and specialty products operations, was followed up for mortality from 1974 to 1983. External comparisons with the United States male population were supplemented with internal comparisons among subgroups of the study population, defined by broad job categories and time related variables, adjusting for important correlates of the healthy worker effect. Significant deficits of deaths were observed for all causes and the major non-cancer causes of death. The numbers of deaths due to malignant neoplasms and respiratory cancer were less than, but not statistically different from, expected. There was a non-significant excess of deaths from lymphopoietic cancer, occurring predominantly among salaried employees. When specific locations were examined, operations with potential exposure to coal tar products exhibited a mortality pattern similar to that of the total cohort. The risk for lung cancer was significantly raised (five observed, 1.4 expected) in one small, but older, location which did not involve coal tar products during the period of employment of these individuals, but which historically used asbestos materials for several unique applications. Although these findings are limited by small numbers and a short observation period, the population based surveillance strategy has provided valuable information regarding the mortality experience of the population, directions for future research, and the allocation of epidemiological resources. PMID:3593661

  4. Development and use of a population based injury surveillance system: the All Wales Injury Surveillance System (AWISS)

    PubMed Central

    Lyons, R; Jones, S; Kemp, A; Sibert, J; Shepherd, J; Richmond, P; Bartlett, C; Palmer, S

    2002-01-01

    This report details the development and use of a population based emergency room surveillance system in the UK. Despite some difficulties in accessing high quality data the system has stimulated a considerable number of research and intervention projects. While surveillance systems with high quality data collection and coding parameters remain the gold standard, imperfect systems, particularly if population based, can play a substantial part in stimulating injury prevention initiatives. PMID:11928983

  5. Big data for population-based cancer research: the integrated cancer information and surveillance system.

    PubMed

    Meyer, Anne-Marie; Olshan, Andrew F; Green, Laura; Meyer, Adrian; Wheeler, Stephanie B; Basch, Ethan; Carpenter, William R

    2014-01-01

    The Integrated Cancer Information and Surveillance System (ICISS) facilitates population-based cancer research by developing extensive information technology systems that can link and manage large data sets. Taking an interdisciplinary 'team science' approach, ICISS has developed data, systems, and methods that allow researchers to better leverage the power of big data to improve population health.

  6. Participation Dynamics in Population-Based Longitudinal HIV Surveillance in Rural South Africa

    PubMed Central

    Larmarange, Joseph; Mossong, Joël; Bärnighausen, Till; Newell, Marie Louise

    2015-01-01

    Population-based HIV surveillance is crucial to inform understanding of the HIV pandemic and evaluate HIV interventions, but little is known about longitudinal participation patterns in such settings. We investigated the dynamics of longitudinal participation patterns in a high HIV prevalence surveillance setting in rural South Africa between 2003 and 2012, taking into account demographic dynamics. At any given survey round, 22,708 to 30,495 persons were eligible. Although the yearly participation rates were relatively modest (26% to 46%), cumulative rates increased substantially with multiple recruitment opportunities: 68% of eligible persons participated at least once, 48% at least twice and 31% at least three times after five survey rounds. We identified two types of study fatigue: at the individual level, contact and consent rates decreased with multiple recruitment opportunities and, at the population level, these rates also decreased over calendar time, independently of multiple recruitment opportunities. Using sequence analysis and hierarchical clustering, we identified three broad individual participation profiles: consenters (20%), switchers (43%) and refusers (37%). Men were over represented among refusers, women among consenters, and temporary non-residents among switchers. The specific subgroup of persons who were systemically not contacted or refusers constitutes a challenge for population-based surveillance and interventions. PMID:25875851

  7. Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination.

    PubMed

    Gomez, E; Peguero, M; Sanchez, J; Castellanos, P L; Feris, J; Peña, C; Brudzinski-LaClaire, L; Levine, O S

    2000-12-01

    Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100,000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness.

  8. Estimating the burden of shigellosis in Thailand: 36-month population-based surveillance study.

    PubMed Central

    Chompook, Pornthip; Samosornsuk, Seksun; von Seidlein, Lorenz; Jitsanguansuk, Supot; Sirima, Nunta; Sudjai, Sanit; Mangjit, Prasitchai; Kim, Deok Ryun; Wheeler, Jeremy G.; Todd, Jim; Lee, Hyejon; Ali, Mohammad; Clemens, John; Tapchaisri, Pramuan; Chaicumpa, Wanpen

    2005-01-01

    OBJECTIVE: To estimate incidence of shigellosis in the Kaengkhoi district, Saraburi Province, Thailand. METHODS: Population-based surveillance of shigellosis based in treatment centres. The detected rates of treated shigellosis were corrected for the number of cases missed due to the low sensitivity of microbiological culture methods and participants' use of health-care providers not participating in the study. FINDINGS: The overall uncorrected incidence of shigellosis was 0.6/1000 population per year (95% confidence interval (CI) = 0.5-0.8). The unadjusted incidence of treated shigellosis was highest among children less than 5 years old (4/1000 children per year; 95% CI = 3-6) and significantly lower among people aged > 5 years (0.3/1000 population per year; 95% CI = 0.2-0.5; P < 0.001). Adjusting for cases likely to be missed as a result of culture and surveillance methods increased estimates approximately five times. The majority of Shigella isolates (122/146; 84%) were S. sonnei; the rest were S. flexneri. Of the 22 S. flexneri isolates, the three most frequently encountered serotypes were 2a (36%), 1b (23%) and 3b (28%). A total of 90-95% of S. sonnei and S. flexneri isolates were resistant to tetracycline and co-trimoxazole. In contrast to S. sonnei isolates, more than 90% of the S. flexneri isolates were also resistant to ampicillin and chloramphenicol (P < 0.0001). CONCLUSION: Estimates of incidence of Shigella infection in the community are 10-fold to 100-fold greater than those found from routine government surveillance. The high prevalence of Shigella strains resistant to multiple antibiotics adds urgency to the development of a vaccine to protect against shigellosis in this region of Thailand. PMID:16283050

  9. Developmental Regression in Children with an Autism Spectrum Disorder Identified by a Population-Based Surveillance System

    ERIC Educational Resources Information Center

    Wiggins, Lisa D.; Rice, Catherine E.; Baio, Jon

    2009-01-01

    This study evaluated the phenomenon of autistic regression using population-based data. The sample comprised 285 children who met the autism spectrum disorder (ASD) case definition within an ongoing surveillance program. Results indicated that children with a previously documented ASD diagnosis had higher rates of autistic regression than children…

  10. Active surveillance for prostate cancer.

    PubMed

    Romero-Otero, Javier; García-Gómez, Borja; Duarte-Ojeda, José M; Rodríguez-Antolín, Alfredo; Vilaseca, Antoni; Carlsson, Sigrid V; Touijer, Karim A

    2016-03-01

    It is worth distinguishing between the two strategies of expectant management for prostate cancer. Watchful waiting entails administering non-curative androgen deprivation therapy to patients on development of symptomatic progression, whereas active surveillance entails delivering curative treatment on signs of disease progression. The objectives of the two management strategies and the patients enrolled in either are different: (i) to review the role of active surveillance as a management strategy for patients with low-risk prostate cancer; and (ii) review the benefits and pitfalls of active surveillance. We carried out a systematic review of active surveillance for prostate cancer in the literature using the National Center for Biotechnology Information's electronic database, PubMed. We carried out a search in English using the terms: active surveillance, prostate cancer, watchful waiting and conservative management. Selected studies were required to have a comprehensive description of the demographic and disease characteristics of the patients at the time of diagnosis, inclusion criteria for surveillance, and a protocol for the patients' follow up. Review articles were included, but not multiple papers from the same datasets. Active surveillance appears to reduce overtreatment in patients with low-risk prostate cancer without compromising cancer-specific survival at 10 years. Therefore, active surveillance is an option for select patients who want to avoid the side-effects inherent to the different types of immediate treatment. However, inclusion criteria for active surveillance and the most appropriate method of monitoring patients on active surveillance have not yet been standardized.

  11. EUROCOURSE recipe for cancer surveillance by visible population-based cancer RegisTrees in Europe: From roots to fruits.

    PubMed

    Coebergh, Jan Willem; van den Hurk, Corina; Louwman, Marieke; Comber, Harry; Rosso, Stefano; Zanetti, Roberto; Sacchetto, Lidia; Storm, Hans; van Veen, Evert-Ben; Siesling, Sabine; van den Eijnden-van Raaij, Janny

    2015-06-01

    provide only incidence and survival data. If they are unable to do so because POs and stakeholders do not demand it, they might also be inhibited by data protection restrictions, especially in German and French speaking countries. The value of population-based studies of quality of oncologic care and mass screening and the flawless reputation with regard to data protection of intensively used CRs in the northwest of Europe offered a sharp contrast, although they also follow the 1995 EU guideline on data protection. CRs thus offer a perfect example of what can be done with sensitive and minimal data, also when enriched by linkages to other databases. Intensive use of the data has allowed CR research departments to take on a visible expertise-based profile but a neutral in many public controversies in preventive oncology. Their management and fundability also appeared to benefit from externally classifying the wide array of tumour- or tract-specific intelligence and research activities for the various users in oncology and public health and also patients - who are the source of the data - are better informed. Transparency on what CRs enable may also improve through programmes of research have been deemed essential to our funding POs (ministries, cancer charities, cancer centres or public health institutes) who might benefit from some guidance to - often suboptimal -governance. Therefore, a metaphoric RegisTree has been developed for self-assessment and to clarify CR working methods and domain-specific performance to stakeholders and funding agencies, showing much room for development in many CRs. All in all, CRs are likely to remain unique sources of independent expert information on the burden of cancer, indispensable for cancer surveillance, with increased attention to cancer survivors, up to 4% of the population. Investments in the expanding CR network across Europe offer an excellent way forward for comparative future cancer surveillance with so many epidemiologic and

  12. EUROCOURSE recipe for cancer surveillance by visible population-based cancer RegisTrees in Europe: From roots to fruits.

    PubMed

    Coebergh, Jan Willem; van den Hurk, Corina; Louwman, Marieke; Comber, Harry; Rosso, Stefano; Zanetti, Roberto; Sacchetto, Lidia; Storm, Hans; van Veen, Evert-Ben; Siesling, Sabine; van den Eijnden-van Raaij, Janny

    2015-06-01

    provide only incidence and survival data. If they are unable to do so because POs and stakeholders do not demand it, they might also be inhibited by data protection restrictions, especially in German and French speaking countries. The value of population-based studies of quality of oncologic care and mass screening and the flawless reputation with regard to data protection of intensively used CRs in the northwest of Europe offered a sharp contrast, although they also follow the 1995 EU guideline on data protection. CRs thus offer a perfect example of what can be done with sensitive and minimal data, also when enriched by linkages to other databases. Intensive use of the data has allowed CR research departments to take on a visible expertise-based profile but a neutral in many public controversies in preventive oncology. Their management and fundability also appeared to benefit from externally classifying the wide array of tumour- or tract-specific intelligence and research activities for the various users in oncology and public health and also patients - who are the source of the data - are better informed. Transparency on what CRs enable may also improve through programmes of research have been deemed essential to our funding POs (ministries, cancer charities, cancer centres or public health institutes) who might benefit from some guidance to - often suboptimal -governance. Therefore, a metaphoric RegisTree has been developed for self-assessment and to clarify CR working methods and domain-specific performance to stakeholders and funding agencies, showing much room for development in many CRs. All in all, CRs are likely to remain unique sources of independent expert information on the burden of cancer, indispensable for cancer surveillance, with increased attention to cancer survivors, up to 4% of the population. Investments in the expanding CR network across Europe offer an excellent way forward for comparative future cancer surveillance with so many epidemiologic and

  13. Monitoring the introduction of pneumococcal conjugate vaccines into West Africa: design and implementation of a population-based surveillance system.

    PubMed

    Mackenzie, Grant A; Plumb, Ian D; Sambou, Sana; Saha, Debasish; Uchendu, Uchendu; Akinsola, Bolanle; Ikumapayi, Usman N; Baldeh, Ignatius; Usuf, Effua; Touray, Kebba; Jasseh, Momodou; Howie, Stephen R C; Wattiaux, Andre; Lee, Ellen; Knoll, Maria Deloria; Levine, Orin S; Greenwood, Brian M; Adegbola, Richard A; Hill, Philip C

    2012-01-01

    Routine use of pneumococcal conjugate vaccines (PCVs) in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD) and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.

  14. Declining HIV Prevalence in Parallel With Safer Sex Behaviors in Burkina Faso: Evidence From Surveillance and Population-Based Surveys

    PubMed Central

    Kirakoya-Samadoulougou, Fati; Nagot, Nicolas; Samadoulougou, Sekou; Sokey, Mamadou; Guiré, Abdoulaye; Sombié, Issiaka; Meda, Nicolas

    2016-01-01

    ABSTRACT Objective: To investigate trends in HIV prevalence and changes in reported sexual behaviors between 1998 and 2014 in Burkina Faso. Methods: We obtained data on HIV prevalence from antenatal care (ANC) surveillance sites (N = 9) that were consistently included in surveillance between 1998 and 2014. We also analyzed data on HIV prevalence and reported sex behaviors from 3 population-based surveys from the Demographic and Health Surveys (DHS), conducted in 1998–99, 2003, and 2010. Sex behavior indicators comprised never-married youth who have never had sex; sex with more than 1 partner; sex with a nonmarital, non-cohabiting partner; condom use at last sex with a nonmarital, non-cohabiting partner; and sex before age 15. We calculated survey-specific HIV prevalence with 95% confidence intervals (CIs) and used the chi-square test or chi-square test for trend to compare HIV prevalence across survey years and to analyze trends in reported sex behaviors. Results: HIV prevalence among pregnant women ages 15–49 decreased by 72% in urban areas, from 7.1% in 1998 to 2.0% in 2014, and by 75% in rural areas, from 2.0% in 2003 to 0.5% in 2014. HIV declined most in younger age groups, which is a good reflection of recent incidence, with declines of 55% among 15–19-year-olds, 72% among 20–24-year-olds, 40% among 25–29-year-olds, and 7% among those ≥30 years old (considering urban and rural data combined). Data reported in the DHS corroborated these declines in HIV prevalence: between 2003 and 2010, HIV prevalence dropped significantly—by 89% among girls ages 15–19, from 0.9% (95% CI, 0.2 to 1.6) to 0.1% (95% CI, 0.0 to 0.4), and by 78% among young women ages 20–24, from 1.8% (95% CI, 1.6 to 3.0) to 0.4% (95% CI, 0.0 to 0.7). During the same time period, people reported safer sex behaviors. For example, significantly higher percentages of never-married youth reported they had never had sex, lower percentages of sexually active youth reported multiple

  15. Identification of Streptococcus suis Meningitis through Population-Based Surveillance, Togo, 2010–2014

    PubMed Central

    Tall, Haoua; Njanpop-Lafourcade, Berthe-Marie; Mounkoro, Didier; Tidjani, Loukoumane; Agbenoko, Kodjo; Alassani, Issifou; Amidou, Moussa; Tamekloe, Stanislas; Laing, Kenneth G.; Witney, Adam A.; Hinds, Jason; van der Linden, Mark P.G.; Gessner, Bradford D.

    2016-01-01

    During 2010–2014, we enrolled 511 patients with suspected bacterial meningitis into surveillance in 2 districts of northern Togo. We identified 15 persons with Streptococcus suis infection; 10 had occupational contact with pigs, and 12 suffered neurologic sequelae. S. suis testing should be considered in rural areas of the African meningitis belt. PMID:27314251

  16. Identification of Streptococcus suis Meningitis through Population-Based Surveillance, Togo, 2010-2014.

    PubMed

    Tall, Haoua; Njanpop-Lafourcade, Berthe-Marie; Mounkoro, Didier; Tidjani, Loukoumane; Agbenoko, Kodjo; Alassani, Issifou; Amidou, Moussa; Tamekloe, Stanislas; Laing, Kenneth G; Witney, Adam A; Hinds, Jason; van der Linden, Mark P G; Gessner, Bradford D; Moïsi, Jennifer C

    2016-07-01

    During 2010-2014, we enrolled 511 patients with suspected bacterial meningitis into surveillance in 2 districts of northern Togo. We identified 15 persons with Streptococcus suis infection; 10 had occupational contact with pigs, and 12 suffered neurologic sequelae. S. suis testing should be considered in rural areas of the African meningitis belt. PMID:27314251

  17. Population-based Surveillance for Medically Attended Human Parainfluenza Viruses From the Influenza Incidence Surveillance Project, 2010–2014

    PubMed Central

    Finelli, Lyn; Whitaker, Brett; Fowlkes, Ashley

    2016-01-01

    Background: Parainfluenza viruses (PIV) have been shown to contribute substantially to pediatric hospitalizations in the United States. However, to date, there has been no systematic surveillance to estimate the burden among pediatric outpatients. Methods: From August 2010 through July 2014, outpatient health care providers with enumerated patient populations in 13 states and jurisdictions participating in the Influenza Incidence Surveillance Project conducted surveillance of patients with influenza-like illness (ILI). Respiratory specimens were collected from the first 10 ILI patients each week with demographic and clinical data. Specimens were tested for multiple respiratory viruses, including PIV1–4, using reverse transcriptase–polymerase chain reaction assays. Cumulative incidence was calculated using provider patient population size as the denominator. Results: PIVs 1–3 were detected in 8.0% of 7716 ILI-related outpatient specimens: 30% were PIV1, 26% PIV2 and 44% PIV3. PIV circulation varied noticeably by year and type, with PIV3 predominating in 2010–2011 (incidence 110 per 100,000 children), PIV1 in 2011–2012 (89 per 100,000), dual predominance of PIV2 and PIV3 (88 and 131 per 100,000) in 2012–2013 and PIV3 (100 per 100,000) in 2013–2014. The highest incidence of PIV detections was among patients aged <5 years (259–1307 per 100,000). The median age at detection for PIV3 (3.4 years) was significantly lower than the median ages for PIV1 (4.5 years) and PIV2 (7.0 years; P < 0.05). Conclusions: PIVs 1–3 comprise a substantial amount of medically attended pediatric ILI, particularly among children aged <5 years. Distinct seasonal circulation patterns as well as significant differences in rates by age were observed between PIV types. PMID:26974891

  18. Preventing young children's injuries: analysis of data from a population-based surveillance.

    PubMed

    Toblin, Robin L; Brenner, Ruth A; Taneja, Gitanjali S; Rossi, Maryann W; Collins, Millicent; Mickalide, Angela D; Overpeck, Mary D; Clinton-Reid, Yvette; Dever, Jill A; Boyle, Kerrie; Trumble, Ann C; Scheidt, Peter C

    2011-12-01

    The objective of this study is to determine prevention strategies for potentially serious injury events among children younger than 3 years of age based upon circumstances surrounding injury events. Surveillance was conducted on all injuries to District of Columbia (DC) residents less than 3 years old that resulted in an Emergency Department (ED) visit, hospitalization, or death for 1 year. Data were collected through abstraction of medical records and interviews with a subset of parents of injured children. Investigators coded injury-related events for the potential for death or disability. Potential prevention strategies were then determined for all injury events that had at least a moderate potential for death or disability and sufficient detail for coding (n = 425). Injury-related events included 10 deaths, 163 hospitalizations, and 2,868 ED visits (3,041 events in total). Of the hospitalizations, 88% were coded as moderate or high potential for disability or death, versus only 21% of the coded ED visits. For potentially serious events, environmental change strategies were identified for 47%, behavior change strategies for 77%, and policy change strategies for 24%. For 46% of the events more than one type of prevention strategy was identified. Only 8% had no identifiable prevention strategy. Prevention strategies varied by specific cause of injury. Potential prevention strategies were identifiable for nearly all potentially serious injury events, with multiple potential prevention strategies identified for a large fraction of the events. These findings support developing multifaceted prevention approaches informed by community-based injury surveillance.

  19. Preventing young children's injuries: analysis of data from a population-based surveillance.

    PubMed

    Toblin, Robin L; Brenner, Ruth A; Taneja, Gitanjali S; Rossi, Maryann W; Collins, Millicent; Mickalide, Angela D; Overpeck, Mary D; Clinton-Reid, Yvette; Dever, Jill A; Boyle, Kerrie; Trumble, Ann C; Scheidt, Peter C

    2011-12-01

    The objective of this study is to determine prevention strategies for potentially serious injury events among children younger than 3 years of age based upon circumstances surrounding injury events. Surveillance was conducted on all injuries to District of Columbia (DC) residents less than 3 years old that resulted in an Emergency Department (ED) visit, hospitalization, or death for 1 year. Data were collected through abstraction of medical records and interviews with a subset of parents of injured children. Investigators coded injury-related events for the potential for death or disability. Potential prevention strategies were then determined for all injury events that had at least a moderate potential for death or disability and sufficient detail for coding (n = 425). Injury-related events included 10 deaths, 163 hospitalizations, and 2,868 ED visits (3,041 events in total). Of the hospitalizations, 88% were coded as moderate or high potential for disability or death, versus only 21% of the coded ED visits. For potentially serious events, environmental change strategies were identified for 47%, behavior change strategies for 77%, and policy change strategies for 24%. For 46% of the events more than one type of prevention strategy was identified. Only 8% had no identifiable prevention strategy. Prevention strategies varied by specific cause of injury. Potential prevention strategies were identifiable for nearly all potentially serious injury events, with multiple potential prevention strategies identified for a large fraction of the events. These findings support developing multifaceted prevention approaches informed by community-based injury surveillance. PMID:21904860

  20. Active Surveillance of Candidemia, Australia

    PubMed Central

    Slavin, Monica; Nguyen, Quoc; Marriott, Deborah; Playford, E. Geoffrey; Ellis, David; Sorrell, Tania

    2006-01-01

    Population-based surveillance for candidemia in Australia from 2001 to 2004 identified 1,095 cases. Annual overall and hospital-specific incidences were 1.81/100,000 and 0.21/1,000 separations (completed admissions), respectively. Predisposing factors included malignancy (32.1%), indwelling vascular catheters (72.6%), use of antimicrobial agents (77%), and surgery (37.1%). Of 919 episodes, 81.5% were inpatient healthcare associated (IHCA), 11.6% were outpatient healthcare associated (OHCA), and 6.9% were community acquired (CA). Concomitant illnesses and risk factors were similar in IHCA and OHCA candidemia. IHCA candidemia was associated with sepsis at diagnosis (p<0.001), death <30 days after infection (p<0.001), and prolonged hospital admission (p<0.001). Non–Candida albicans species (52.7%) caused 60.5% of cases acquired outside hospitals and 49.9% of IHCA candidemia (p = 0.02). The 30-day death rate was 27.7% in those >65 years of age. Adult critical care stay, sepsis syndrome, and corticosteroid therapy were associated with the greatest risk for death. Systematic epidemiologic studies that use standardized definitions for IHCA, OHCA, and CA candidemia are indicated. PMID:17176564

  1. A Population-Based Acute Meningitis and Encephalitis Syndromes Surveillance in Guangxi, China, May 2007- June 2012

    PubMed Central

    Chongsuvivatwong, Virasakdi; Wu, Xinghua; Bi, Fuyin; Hadler, Stephen C.; Jiraphongsa, Chuleeporn; Sornsrivichai, Vorasith; Lin, Mei; Quan, Yi

    2015-01-01

    Objectives Acute meningitis and encephalitis (AME) are common diseases with the main pathogens being viruses and bacteria. As specific treatments are different, it is important to develop clinical prediction rules to distinguish aseptic from bacterial or fungal infection. In this study we evaluated the incidence rates, seasonal variety and the main etiologic agents of AME, and identified factors that could be used to predict the etiologic agents. Methods A population-based AME syndrome surveillance system was set up in Guigang City, Guangxi, involving 12 hospitals serving the study communities. All patients meeting the case definition were investigated. Blood and/or cerebrospinal fluid were tested for bacterial pathogens using culture or RT-PCR and serological tests for viruses using enzyme-linked immunosorbent assays. Laboratory testing variables were grouped using factor analysis. Multinomial logistic regression was used to predict the etiology of AME. Results From May 2007 to June 2012, the annual incidence rate of AME syndrome, and disease specifically caused by Japanese encephalitis (JE), other viruses, bacteria and fungi were 12.55, 0.58, 4.57, 0.45 and 0.14 per 100,000 population, respectively. The top three identified viral etiologic agents were enterovirus, mumps virus, and JE virus, and for bacteria/fungi were Streptococcus sp., Cryptococcus neoformans and Staphylococcus sp. The incidence of JE and other viruses affected younger populations and peaked from April to August. Alteration of consciousness and leukocytosis were more likely to be caused by JE, bacteria and fungi whereas CSF inflammation was associated with bacterial/fungal infection. Conclusions With limited predictive validity of symptoms and signs and routine laboratory tests, specific tests for JE virus, mumps virus and enteroviruses are required to evaluate the immunization impact and plan for further intervention. CSF bacterial culture cannot be omitted in guiding clinical decisions

  2. Development of web-based geocoding applications for the population-based Birth Defects Surveillance System in New York state.

    PubMed

    Wang, Ying; Le, Linh H; Wang, Xiaohang; Tao, Zhen; Druschel, Charlotte D; Cross, Philip K; Hwang, Syni-An

    2010-01-01

    Geographic information systems (GIS) have been widely used in mapping health data and analyzing the geographic distribution of disease. Mapping and spatially analyzing data normally begins with geocoding, a process of assigning geographic coordinates to an address so that it can be displayed and analyzed on a map. The objectives of this project were to develop Web-based geocoding applications for the New York State birth defects surveillance system to geocode, both automatically and interactively, the birth defect cases of the Congenital Malformations Registry (CMR) and evaluate the geocoding results. Geocoding software, in conjunction with a Java-based development tool (J Server), was used to develop the Web-based applications on the New York State Department of Health's Health Commerce System. The Web-based geocoding applications have been developed and implemented for the New York State birth defects surveillance system. These menu-driven applications empower users to conduct geocoding activities using only a PC and a Web browser without the installation of any GIS software. These powerful tools provide automatic, real-time, street-level geocoding of the routinely collected birth defects records in the CMR. Up to 92% of the CMR records have been geocoded with addresses exactly matched to the reference addresses on house number, street name, and city or zip code. PMID:20795565

  3. Guillain-Barre syndrome during the 2009-2010 H1N1 influenza vaccination campaign: population-based surveillance among 45 million Americans.

    PubMed

    Wise, Matthew E; Viray, Melissa; Sejvar, James J; Lewis, Paige; Baughman, Andrew L; Connor, Walter; Danila, Richard; Giambrone, Greg P; Hale, Christa; Hogan, Brenna C; Meek, James I; Murphree, Rendi; Oh, John Y; Reingold, Arthur; Tellman, Norisse; Conner, Susan M; Singleton, James A; Lu, Peng-Jun; DeStefano, Frank; Fridkin, Scott K; Vellozzi, Claudia; Morgan, Oliver W

    2012-06-01

    Because of widespread distribution of the influenza A (H1N1) 2009 monovalent vaccine (pH1N1 vaccine) and the prior association between Guillain-Barré syndrome (GBS) and the 1976 H1N1 influenza vaccine, enhanced surveillance was implemented to estimate the magnitude of any increased GBS risk following administration of pH1N1 vaccine. The authors conducted active, population-based surveillance for incident cases of GBS among 45 million persons residing at 10 Emerging Infections Program sites during October 2009-May 2010; GBS was defined according to published criteria. The authors determined medical and vaccine history for GBS cases through medical record review and patient interviews. The authors used vaccine coverage data to estimate person-time exposed and unexposed to pH1N1 vaccine and calculated age- and sex-adjusted rate ratios comparing GBS incidence in these groups, as well as age- and sex-adjusted numbers of excess GBS cases. The authors received 411 reports of confirmed or probable GBS. The rate of GBS immediately following pH1N1 vaccination was 57% higher than in person-time unexposed to vaccine (adjusted rate ratio = 1.57, 95% confidence interval: 1.02, 2.21), corresponding to 0.74 excess GBS cases per million pH1N1 vaccine doses (95% confidence interval: 0.04, 1.56). This excess risk was much smaller than that observed during the 1976 vaccine campaign and was comparable to some previous seasonal influenza vaccine risk assessments.

  4. Epidemiology of meningitis due to Haemophilus influenzae type b in children in Bulgaria: a prospective, population-based surveillance study.

    PubMed Central

    Kojouharova, Mira; Gatcheva, Nina; Setchanova, Lena; Robertson, Susan E.; Wenger, Jay D.

    2002-01-01

    OBJECTIVE: To assess the incidence of meningitis caused by Haemophilus influenzae type b (Hib) among children in Bulgaria and to provide evidence for an informed decision on the use of Hib vaccines in Bulgaria. METHODS: From 1 July 1997 to 31 December 1999, active surveillance for meningitis was conducted in six regions. For children with suspected meningitis, a cerebrospinal fluid (CSF) specimen was sent for cytology, chemistry, latex agglutination testing, culture and sensitivity. FINDINGS: During the 2.5-year study period, surveillance was conducted among 138 249 children aged <5 years - a sample representing 40% of all Bulgarian children in this age group. Overall, 285 children with suspected meningitis were identified. In eight children, clinical symptoms of meningitis resolved rapidly before a CSF specimen could be obtained. Of the remaining 277 children, 121 (44%) were classified as having probable bacterial meningitis on the basis of a CSF examination. An organism was identified for 88 (73%) of the 121 cases with probable bacterial meningitis. There were 21 cases of Hib, giving a mean annual incidence of 6.1 Hib meningitis cases per 100 000 children <5 years; the case-fatality rate was 10%. Nearly 60% of Hib isolates were resistant to one or more antibiotics, but they were not resistant to third-generation cephalosporins. CONCLUSION: On the basis of these findings, Hib conjugate vaccines have been included in the list of vaccines recommended for children by the Bulgarian Ministry of Health. The recommended initial treatment for paediatric bacterial meningitis has been changed to third-generation cephalosporins. PMID:12378285

  5. Healthcare and Guidelines: A Population-Based Survey of Recorded Medical Problems and Health Surveillance for People with Down syndrome

    ERIC Educational Resources Information Center

    Maatta, Tuomo; Maatta, Joonas; Tervo-Maatta, Tuula; Taanila, Anja; Kaski, Markus; Iivanainen, Matti

    2011-01-01

    Background: Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method: Case records from the specialised and primary healthcare and disability services were analysed. Results: A wide spectrum of age-specific medical and surgical problems was…

  6. Timing of Identification among Children with an Autism Spectrum Disorder: Findings from a Population-Based Surveillance Study

    ERIC Educational Resources Information Center

    Shattuck, Paul T.; Durkin, Maureen; Maenner, Matthew; Newschaffer, Craig; Mandell, David S.; Wiggins, Lisa; Lee, Li-Ching; Rice, Catherine; Giarelli, Ellen; Kirby, Russell; Baio, Jon; Pinto-Martin, Jennifer; Cuniff, Christopher

    2009-01-01

    Analysis of the data from Center for Disease Control's autism surveillance program found that the median age of identification of children with autism is 5.7 years. Being male, having an IQ of 70 or lower, and having developmental regression are the factors linked to a younger age of identification. There is a need for research, innovation, and…

  7. Toward a population-based approach to end-of-life care surveillance in Canada: initial efforts and lessons.

    PubMed

    Lau, Francis; Downing, Michael; Tayler, Carolyn; Fassbender, Konrad; Lesperance, Mary; Barnett, Jeff

    2013-01-01

    This paper describes a project undertaken by the Hospice Palliative End-of-Life Care Surveillance Team Network--one of four Cancer Surveillance and Epidemiology Networks established by the Canadian Partnership Against Cancer in 2009 to create information products that can be used to inform cancer control. The project was designed to improve the quality and use of existing electronic patient databases in its member organizations. The project's intent was to better understand terminally ill cancer patients in their final year of life, with noncancer as comparison. The network created an early design for a Web-based end-of-life care surveillance system prototype. Using a flagging process, anonymized data sets on cancer/ noncancer palliative patients and those who died in 2008-2009 were extracted and analyzed. The Australian palliative approach was adapted as the conceptual model based on the data sets available. Common data elements were defined then mapped to local data sets to create a common data set. Information products were created as online reports. Throughout the project, members were engaged in knowledge translation. Overall, the project was well received by network members. There are still major data-quality and linkage issues that require further work.

  8. Increasing HIV-1 Drug Resistance Between 2010 and 2012 in Adults Participating in Population-Based HIV Surveillance in Rural KwaZulu-Natal, South Africa

    PubMed Central

    Danaviah, Siva; Lessells, Richard; Elshareef, Muna; Tanser, Frank; Wilkinson, Eduan; Pillay, Sureshnee; Mthiyane, Hloniphile; Mwambi, Henry; Pillay, Deenan; de Oliveira, Tulio

    2016-01-01

    Abstract As more human immunodeficiency virus (HIV)–infected patients access combination antiretroviral therapy (cART), higher proportions of newly infected patients may be infected with drug-resistant viruses. Regular surveillance of transmitted drug resistance (TDR) is required in southern Africa where high rates of transmission persist despite rapid expansion of ART. Dried blood spot samples from cART-naive participants from two rounds of an annual population-based HIV surveillance program in rural KwaZulu-Natal were tested for HIV RNA, and samples with HIV RNA >10,000 copies/ml were genotyped for drug resistance. The 2009 surveillance of drug resistance mutation (SDRM) list was used for drug resistance interpretation. The data were added to previously published data from the same program, and the χ2 test for trend was used to test for trend in estimated prevalence of any TDR. Seven hundred and one participants' data were analyzed: 67 (2010), 381 (2011), and 253 (2012). No TDR was detected in 2010. Years 2011 and 2012 had 18 participants with SDRMs 4.7% and 7.1%, respectively (p = .02, χ2 test for trend). The nonnucleoside reverse transcriptase inhibitor mutation, K103N, was the most common mutation, occurring in 27 (3.8%) of the participants, while nucleoside reverse transcriptase inhibitor (NRTI) SDRMs were detected in 10 (1.4%) of the participants, of whom eight had only a single NRTI SDRM. The increase in levels of drug resistance observed in this population could be a signal of increasing transmission of drug-resistant HIV. Thus, continued surveillance is critical to inform public health policies around HIV treatment and prevention. PMID:27002368

  9. Increasing HIV-1 Drug Resistance Between 2010 and 2012 in Adults Participating in Population-Based HIV Surveillance in Rural KwaZulu-Natal, South Africa.

    PubMed

    Manasa, Justen; Danaviah, Siva; Lessells, Richard; Elshareef, Muna; Tanser, Frank; Wilkinson, Eduan; Pillay, Sureshnee; Mthiyane, Hloniphile; Mwambi, Henry; Pillay, Deenan; de Oliveira, Tulio

    2016-08-01

    As more human immunodeficiency virus (HIV)-infected patients access combination antiretroviral therapy (cART), higher proportions of newly infected patients may be infected with drug-resistant viruses. Regular surveillance of transmitted drug resistance (TDR) is required in southern Africa where high rates of transmission persist despite rapid expansion of ART. Dried blood spot samples from cART-naive participants from two rounds of an annual population-based HIV surveillance program in rural KwaZulu-Natal were tested for HIV RNA, and samples with HIV RNA >10,000 copies/ml were genotyped for drug resistance. The 2009 surveillance of drug resistance mutation (SDRM) list was used for drug resistance interpretation. The data were added to previously published data from the same program, and the χ(2) test for trend was used to test for trend in estimated prevalence of any TDR. Seven hundred and one participants' data were analyzed: 67 (2010), 381 (2011), and 253 (2012). No TDR was detected in 2010. Years 2011 and 2012 had 18 participants with SDRMs 4.7% and 7.1%, respectively (p = .02, χ(2) test for trend). The nonnucleoside reverse transcriptase inhibitor mutation, K103N, was the most common mutation, occurring in 27 (3.8%) of the participants, while nucleoside reverse transcriptase inhibitor (NRTI) SDRMs were detected in 10 (1.4%) of the participants, of whom eight had only a single NRTI SDRM. The increase in levels of drug resistance observed in this population could be a signal of increasing transmission of drug-resistant HIV. Thus, continued surveillance is critical to inform public health policies around HIV treatment and prevention. PMID:27002368

  10. Active surveillance for nonmuscle invasive bladder cancer.

    PubMed

    Miyake, Makito; Fujimoto, Kiyohide; Hirao, Yoshihiko

    2016-06-01

    Nonmuscle invasive bladder cancer (NMIBC) is known to be a heterogeneous malignancy that requires varying treatment modalities and follow-up schedules. Low-grade Ta papillary tumors are categorized as low-risk NMIBC because of their favorable prognosis. There is an expanding movement that overdiagnosis and overtreatment should be avoided considering the economic impact and the patients' quality of life. It has been over 10 years since the initial assessment of active surveillance for low-risk NMIBC suggested its feasibility and safety. However, urologists are still unfamiliar with this treatment option, which can be ideal in appropriately selected patients. In this review article, we focus on active surveillance for low-risk NMIBC and discuss the evidence and rationale for this treatment option. There are several issues to resolve in order to advocate active surveillance as a standard option in selected patients. A specific follow-up protocol including intervals of cystoscopy, urine cytology, urine markers, and other radiographic examinations need to be optimized and validated. Finally, we integrate the available data into the follow-up strategy and propose a new surveillance protocol for active surveillance of recurrent low-risk bladder cancer. PMID:27326406

  11. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones.

  12. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. PMID:26378390

  13. Nationwide population-based cohort study of uterine rupture in Belgium: results from the Belgian Obstetric Surveillance System

    PubMed Central

    Vandenberghe, G; De Blaere, M; Van Leeuw, V; Roelens, K; Englert, Y; Hanssens, M; Verstraelen, H

    2016-01-01

    Objectives We aimed to assess the prevalence of uterine rupture in Belgium and to evaluate risk factors, management and outcomes for mother and child. Design Nationwide population-based prospective cohort study. Setting Emergency obstetric care. Participation of 97% of maternity units covering 98.6% of the deliveries in Belgium. Participants All women with uterine rupture in Belgium between January 2012 and December 2013. 8 women were excluded because data collection forms were not returned. Results Data on 90 cases of confirmed uterine rupture were obtained, of which 73 had a previous Caesarean section (CS), representing an estimated prevalence of 3.6 (95% CI 2.9 to 4.4) per 10 000 deliveries overall and of 27 (95% CI 21 to 33) and 0.7 (95% CI 0.4 to 1.2) per 10 000 deliveries in women with and without previous CS, respectively. Rupture occurred during trial of labour after caesarean section (TOLAC) in 57 women (81.4%, 95% CI 68% to 88%), with a high rate of augmented (38.5%) and induced (29.8%) labour. All patients who underwent induction of labour had an unfavourable cervix at start of induction (Bishop Score ≤7 in 100%). Other uterine surgery was reported in the history of 22 cases (24%, 95% CI 17% to 34%), including 1 case of myomectomy, 3 cases of salpingectomy and 2 cases of hysteroscopic resection of a uterine septum. 14 cases ruptured in the absence of labour (15.6%, 95% CI 9.5% to 24.7%). No mothers died; 8 required hysterectomy (8.9%, 95% CI 4.6% to 16.6%). There were 10 perinatal deaths (perinatal mortality rate 117/1000 births, 95% CI 60 to 203) and perinatal asphyxia was observed in 29 infants (34.5%, 95% CI 25.2% to 45.1%). Conclusions The prevalence of uterine rupture in Belgium is similar to that in other Western countries. There is scope for improvement through the implementation of nationally adopted guidelines on TOLAC, to prevent use of unsafe procedures, and thereby reduce avoidable morbidity and mortality. PMID:27188805

  14. Methods in HPV Surveillance: Experiences from a Population-Based Study of HPV Infection among Women in the San Juan Metropolitan Area of Puerto Rico.

    PubMed

    Ortiz, Ana Patricia; Marrero, Edmir; Muñoz, Cristina; Pérez, Cynthia M; Tortolero-Luna, Guillermo; Romaguera, Josefina; Rodríguez, Nahir; González-Falero, Andrea; Palefsky, Joel; Suárez, Erick

    2015-09-01

    This article describes the methodology of the first population-based study of human papillomavirus (HPV) infection among women aged 16-64 years residing in the San Juan Metropolitan Area of Puerto Rico (PR). The sample was identified through a complex sampling design of households. The sampling frame was selected in four stages, using census tracts maps from the Census Bureau. Women completed a face-to-face interview and a computer-assisted self-interview using the Audio CASI system, for the collection of demographic, clinical, and lifestyle variables, and sampling acceptability. Anal, cervical, and oral specimens were collected through self-collection methods for HPV DNA testing using a modified pool of MY09/MY11 consensus HPV L1 and human ß-globin amplification primers. Anthropometric measurements were taken using the Third National Health and Nutrition Examination Survey methodology. Blood samples were collected to create a bio-repository for future HPV-related studies. Fifty census tract blocks were randomly selected. We recruited 566 women, with a response rate of 83.4%. Response rates did not vary by age-group (p>0.05); although they varied by socioeconomic (SES) census block stratums (p<0.05), response rates were good (>75%) in all SES strata. All participants agreed to respond to the surveys and provide the requested anogenital and oral samples. Overall, more than 98% understood and more than 50% felt comfortable with the cervical, anal, and oral self-collection methods used. This article documents the feasibility of performing population-based studies for HPV surveillance in women in PR. PMID:26356735

  15. Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

    PubMed Central

    Breiman, Robert F.; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M.; Olack, Beatrice; Ochieng, John B.; Wamola, Newton; Montgomery, Joel M.; Williamson, John; Parashar, Umesh D.; Burton, Deron C.; Tate, Jacqueline E.; Feikin, Daniel R.

    2015-01-01

    Background Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. Methods We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Results Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Conclusions Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission. PMID:24343615

  16. Foodborne Diseases Active Surveillance Network—2 Decades of Achievements, 1996–2015

    PubMed Central

    Jones, Timothy F.; Vugia, Duc J.; Griffin, Patricia M.

    2015-01-01

    The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States. FoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome. Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet’s major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care–seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues. The importance of FoodNet’s ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly. PMID:26292181

  17. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

    PubMed Central

    Allemani, Claudia; Weir, Hannah K; Carreira, Helena; Harewood, Rhea; Spika, Devon; Wang, Xiao-Si; Bannon, Finian; Ahn, Jane V; Johnson, Christopher J; Bonaventure, Audrey; Marcos-Gragera, Rafael; Stiller, Charles; Silva, Gulnar Azevedo e; Chen, Wan-Qing; Ogunbiyi, Olufemi J; Rachet, Bernard; Soeberg, Matthew J; You, Hui; Matsuda, Tomohiro; Bielska-Lasota, Magdalena; Storm, Hans; Tucker, Thomas C; Coleman, Michel P

    2015-01-01

    Summary Background Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Methods Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15–99 years) and 75 000 children (age 0–14 years) diagnosed with cancer during 1995–2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005–09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15–19% in North America, and as low as 7–9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10–20% between 1995–99 and 2005–09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer

  18. Epidemiology and outcome of candidaemia in patients with oncological and haematological malignancies: results from a population-based surveillance in Spain.

    PubMed

    Puig-Asensio, M; Ruiz-Camps, I; Fernández-Ruiz, M; Aguado, J M; Muñoz, P; Valerio, M; Delgado-Iribarren, A; Merino, P; Bereciartua, E; Fortún, J; Cuenca-Estrella, M; Almirante, B

    2015-05-01

    A prospective, population-based surveillance on candidaemia was implemented in five metropolitan areas of Spain from May 2010 to April 2011. We aimed to describe the distribution and susceptibility pattern of Candida species, and to evaluate risk factors for mortality in patients with oncological (solid tumours) and haematological malignancies. Adults (≥ 16 years) with cancer were included in the present report. Impact of therapeutic strategies on 7- and 30-day mortality were analysed by logistic regression, adjusting for propensity score by inverse weighting probability of receiving early antifungal treatment and catheter removal. We included 238 (32.6%) patients (195 oncological, 43 haematological). Compared with oncological patients, haematological patients were more likely to have received chemotherapy (53.5% versus 17.4%, p < 0.001) or corticosteroids (41.9% versus 21%, p < 0.001), and have neutropenia (44.2% versus 1.5%, p < 0.001). Overall, 14.8% of patients developed breakthrough candidaemia. Non-albicans Candida species (71.1% versus 55.6%, p 0.056) and Candida tropicalis (22.2% versus 7.6%, p 0.011) were more frequent in haematological patients. Based on EUCAST breakpoints, 27.6% of Candida isolates were non-susceptible to fluconazole. Resistance to echinocandins was negligible. Mortality at 7 and 30 days was 12.2% and 31.5%, respectively, and did not differ significantly between the patient groups. Prompt antifungal therapy together with catheter removal (≤ 48 hours) was associated with lower mortality at 7 days (adjusted OR 0.05; 95% CI 0.01-0.42) and 30 days (adjusted OR 0.27; 95% CI 0.16-0.46). In conclusion, non-albicans species are emerging as the predominant isolates, particularly in haematological patients. Prompt, adequate antifungal treatment plus catheter removal may lead to a reduction in mortality.

  19. Physical activity and subarachnoid haemorrhage: a population based case-control study

    PubMed Central

    Fann, J; Kukull, W; Katon, W; Longstreth, W

    2000-01-01

    OBJECTIVE—To evaluate physical activity as a risk factor for subarachnoid haemorrhage.
METHODS—A population based case-control study in King County, Washington. A standardised, personal interview was used to determine physical activity during the past year and at the onset of the bleed for case patients and a similar reference time for control subjects. Conditional logistic regression and a case cross over analysis were performed in which each case patient served as his or her own control. Subjects were 149 men and women with incident, spontaneous subarachnoid haemorrhage and two control subjects per case patient. Control subjects were identified through random digit dialing and matched on age, sex, and respondent type.
RESULTS—Four of the 149 (2.7%) case patients were engaged in vigorous physical activity at the time of their subarachnoid haemorrhage. With those who were engaged in non-vigorous or no physical activity serving as the reference group, the relative risk of sustaining a subarachnoid haemorrhage for those engaged in vigorous physical activity was 11.6 (95% confidence interval (95% CI) 1.2-113.2). In the case cross over analysis, the relative risk was 15.0 (95% CI 4.3-52.2). Higher levels of long term regular physical activity over the past year were associated with a lower, but not statistically significant, risk of subarachnoid haemorrhage (test for trend, p=0.3).
CONCLUSION—The risk of subarachnoid haemorrhage is increased during vigorous physical activity, although only a few result from this mechanism.

 PMID:11080229

  20. Sexual activity and concerns in people with coronary heart disease from a population-based study

    PubMed Central

    Steptoe, Andrew; Jackson, Sarah E; Wardle, Jane

    2016-01-01

    Objective Sexual activity is a central component of intimate relationships, but sexual function may be impaired by coronary heart disease (CHD). There have been few representative population-based comparisons of sexual behaviour and concerns in people with and without CHD. We therefore investigated these issues in a large nationally representative sample of older people. Methods We analysed cross-sectional data from 2979 men and 3711 women aged 50 and older from the English Longitudinal Study of Ageing. Sexual behaviour and concerns were assessed by validated self-completion questionnaire and analyses were weighted for non-response. Covariates included age, partnerships status and comorbidities. Results There were 376 men and 279 women with CHD. Men with CHD were less likely to be sexually active (68.7% vs 80.0%, adjusted OR 0.62, 95% CI 0.47 to 0.81), thought less about sex (74.7% vs 81.9%, OR 0.72, CI 0.54 to 0.95), and reported more erectile difficulties (47.4% vs 38.1%, OR 1.46, CI 1.10 to 1.93) than men without CHD. Effects were more pronounced among those diagnosed within the past 4 years. Women diagnosed <4 years ago were also less likely to be sexually active (35.4% vs 55.6%, OR 0.44, CI 0.23 to 0.84). There were few differences in concerns about sexual activity. Cardiovascular medication showed weak associations with erectile dysfunction. Conclusions There is an association between CHD and sexual activity, particularly among men, but the impact of CHD is limited. More effective advice after diagnosis might reverse the reduction in sexual activity, leading to improved quality of life. PMID:27126394

  1. Epidemiology and Predictors of Mortality in Cases of Candida Bloodstream Infection: Results from Population-Based Surveillance, Barcelona, Spain, from 2002 to 2003

    PubMed Central

    Almirante, Benito; Rodríguez, Dolors; Park, Benjamin J.; Cuenca-Estrella, Manuel; Planes, Ana M.; Almela, Manuel; Mensa, Jose; Sanchez, Ferran; Ayats, Josefina; Gimenez, Montserrat; Saballs, Pere; Fridkin, Scott K.; Morgan, Juliette; Rodriguez-Tudela, Juan L.; Warnock, David W.; Pahissa, Albert

    2005-01-01

    We conducted population-based surveillance for Candida bloodstream infections in Spain to determine its incidence, the extent of antifungal resistance, and risk factors for mortality. A case was defined as the first positive blood culture for any Candida spp. in a resident of Barcelona, from 1 January 2002 to 31 December 2003. We defined early mortality as occurring between days 3 to 7 after candidemia and late mortality as occurring between days 8 to 30. We detected 345 cases of candidemia, for an average annual incidence of 4.3 cases/100,000 population, 0.53 cases/1,000 hospital discharges, and 0.73 cases/10,000 patient-days. Outpatients comprised 11% of the cases, and 89% had a central venous catheter (CVC) at diagnosis. Overall mortality was 44%. Candida albicans was the most frequent species (51% of cases), followed by Candida parapsilosis (23%), Candida tropicalis (10%), Candida glabrata (8%), Candida krusei (4%), and other species (3%). Twenty-four isolates (7%) had decreased susceptibility to fluconazole (MIC ≥ 16 μg/ml). On multivariable analysis, early death was independently associated with hematological malignancy (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.1 to 10.4). Treatment with antifungals (OR, 0.05; 95% CI, 0.01 to 0.2) and removal of CVCs (OR, 0.3; 95% CI, 0.1 to 0.9) were protective factors for early death. Receiving adequate treatment, defined as having CVCs removed and administration of an antifungal medication (OR, 0.2; 95% CI, 0.08 to 0.8), was associated with lower odds of late mortality; intubation (OR, 7.5; 95% CI, 2.6 to 21.1) was associated with higher odds. The incidence of candidemia and prevalence of fluconazole resistance are similar to other European countries, indicating that routine antifungal susceptibility testing is not warranted. Antifungal medication and catheter removal are critical in preventing mortality. PMID:15815004

  2. Increased Risk of Active Tuberculosis following Acute Kidney Injury: A Nationwide, Population-Based Study

    PubMed Central

    Chang, Chia-Hsui; Huang, Hui-Yu; Huang, Tao-Min; Lai, Chun-Fu; Lin, Meng-Chun; Ko, Wen-Je; Wu, Kwan-Dun; Yu, Chong-Jen; Shu, Chin-Chung; Lee, Chih-Hsin; Wang, Jann-Yuan

    2013-01-01

    Background Profound alterations in immune responses associated with uremia and exacerbated by dialysis increase the risk of active tuberculosis (TB). Evidence of the long-term risk and outcome of active TB after acute kidney injury (AKI) is limited. Methods This population-based-cohort study used claim records retrieved from the Taiwan National Health Insurance database. We retrieved records of all hospitalized patients, more than 18 years, who underwent dialysis for acute kidney injury (AKI) during 1999–2008 and validated using the NSARF data. Time-dependent Cox proportional hazards model to adjust for the ongoing effect of end-stage renal disease (ESRD) was conducted to predict long-term de novo active TB after discharge from index hospitalization. Results Out of 2,909 AKI dialysis patients surviving 90 days after index discharge, 686 did not require dialysis after hospital discharge. The control group included 11,636 hospital patients without AKI, dialysis, or history of TB. The relative risk of active TB in AKI dialysis patients, relative to the general population, after a mean follow-up period of 3.6 years was 7.71. Patients who did (hazard ratio [HR], 3.84; p<0.001) and did not (HR, 6.39; p<0.001) recover from AKI requiring dialysis had significantly higher incidence of TB than patients without AKI. The external validated data also showed nonrecovery subgroup (HR = 4.37; p = 0.049) had high risk of developing active TB compared with non-AKI. Additionally, active TB was associated with long-term all-cause mortality after AKI requiring dialysis (HR, 1.34; p = 0.032). Conclusions AKI requiring dialysis seems to independently increase the long-term risk of active TB, even among those who weaned from dialysis at discharge. These results raise concerns that the increasing global burden of AKI will in turn increase the incidence of active TB. PMID:23936044

  3. Active surveillance for congenital rubella syndrome in Yangon, Myanmar.

    PubMed Central

    Thant, Kyaw-Zin; Oo, Win-Mar; Myint, Thein-Thein; Shwe, Than-Nu; Han, Aye-Maung; Aye, Khin-Mar; Aye, Kay-Thi; Moe, Kyaw; Thein, Soe; Robertson, Susan E.

    2006-01-01

    OBJECTIVE: Rubella vaccine is not included in the immunization schedule in Myanmar. Although surveillance for outbreaks of measles and rubella is conducted nationwide, there is no routine surveillance for congenital rubella syndrome (CRS). Therefore, we organized a study to assess the burden of CRS. METHODS: From 1 December 2000 to 31 December 2002 active surveillance for CRS was conducted among children aged 0-17 months at 13 hospitals and 2 private clinics in Yangon, the capital city. Children with suspected CRS had a standard examination and a blood sample was obtained. All serum samples were tested for rubella-specific IgM; selected samples were tested for rubella-specific IgG and for rubella RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). FINDINGS: A total of 81 children aged 0-17 months were suspected of having CRS. Of these, 18 children had laboratory-confirmed CRS (7 were IgM positive; 7 were RT-PCR positive; and 10 were IgG positive at > 6 months of age). One additional child who tested positive by RT-PCR and whose mother had had rubella during pregnancy but who had a normal clinical examination was classified as having congenital rubella infection. During 2001-02 no rubella outbreaks were detected in Yangon Division. In the 31 urban townships of Yangon Division, the annual incidence was 0.1 laboratory-confirmed cases of CRS per 1000 live births. CONCLUSION: This is the first population-based study of CRS incidence from a developing country during a rubella-endemic period; the incidence of CRS is similar to endemic rates found in industrialized countries during the pre-vaccine era. Rubella-specific IgG tests proved practical for diagnosing CRS in children aged > 6 months. This is one of the first studies to report on the use of rubella-specific RT-PCR directly on serum samples; further studies are warranted to confirm the utility of this method as an additional means of diagnosing CRS. PMID:16501710

  4. [Active surveillance for dengue and dengue hemorrhagic fever].

    PubMed

    Gubler, D J

    1989-07-01

    Dengue and dengue hemorrhagic fever are emerging as major public health problems in most tropical countries. Effective prevention and control programs will depend on improved surveillance. A new approach to active surveillance is outlined with emphasis on the interepidemic period. The objective is to develop an early warning surveillance system than can predict epidemic dengue. Virologic surveillance is the most important in an early warning system. Dengue virus transmission should be monitored to provide information on which serotypes are present, their distribution, and the type of illness associated with each serotype. Other components of the active surveillance system include fever alert and clinical surveillance for severe and fatal disease associated with viral syndrome. Individually, each component is not very sensitive, but collectively, they provide an early warning capability that allows detection of newly introduced dengue virus serotypes well in advance of epidemic transmission. With such information, emergency mosquito control can be implemented and major epidemics averted.

  5. Long Term Activity Analysis in Surveillance Video Archives

    ERIC Educational Resources Information Center

    Chen, Ming-yu

    2010-01-01

    Surveillance video recording is becoming ubiquitous in daily life for public areas such as supermarkets, banks, and airports. The rate at which surveillance video is being generated has accelerated demand for machine understanding to enable better content-based search capabilities. Analyzing human activity is one of the key tasks to understand and…

  6. All Wales Injury Surveillance System revised: development of a population-based system to evaluate single-level and multilevel interventions

    PubMed Central

    Lyons, Ronan A; Turner, Samantha; Lyons, Jane; Walters, Angharad; Snooks, Helen A; Greenacre, Judith; Humphreys, Ciaran; Jones, Sarah J

    2016-01-01

    Background Injury surveillance has been established since the 1990s, but is still largely based upon single-source data from sentinel sites. The growth of electronic health records and developments in privacy protecting linkage technologies provide an opportunity for more sophisticated surveillance systems. Objective To describe the evolution of an injury surveillance system to support the evaluation of interventions, both simple and complex in terms of organisation. Methods The paper describes the evolution of the system from one that relied upon data only from emergency departments to one that include multisource data and are now embedded in a total population privacy protecting data linkage system. Injury incidence estimates are compared by source and data linkage used to aid understanding of data quality issues. Examples of applications, challenges and solutions are described. Results The age profile and estimated incidence of injuries recorded in general practice, emergency departments and hospital admissions differ considerably. Data linkage has enabled the evaluation of complex interventions and measurement of longer-term impact of a wide range of exposures. Conclusions Embedding injury surveillance within privacy protecting data linkage environment can transform the utility of a traditional single-source surveillance system to a multisource system. It also facilitates greater involvement in the evaluation of simple and complex healthcare and non-healthcare interventions and contributes to the growing evidence basis underlying the science of injury prevention and control. PMID:26658339

  7. Impact of 13-Valent Pneumococcal Conjugate Vaccine Used in Children on Invasive Pneumococcal Disease in Children and Adults in the United States: Analysis of Multisite, Population-based Surveillance

    PubMed Central

    Moore, Matthew R.; Link-Gelles, Ruth; Schaffner, William; Lynfield, Ruth; Lexau, Catherine; Bennett, Nancy M.; Petit, Susan; Zansky, Shelley M.; Harrison, Lee H.; Reingold, Arthur; Miller, Lisa; Scherzinger, Karen; Thomas, Ann; Farley, Monica M.; Zell, Elizabeth R.; Taylor, Thomas H.; Pondo, Tracy; Rodgers, Loren; McGee, Lesley; Beall, Bernard; Jorgensen, James H.; Whitney, Cynthia G.

    2016-01-01

    SUMMARY Background In 2000, 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in the U.S. and resulted in dramatic reductions in invasive pneumococcal disease (IPD) and modest increases in non-PCV7-type IPD. In 2010, a 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 in the U.S. immunization schedule. We evaluated the effect of PCV13 use in children on IPD in children and adults in the U.S. Methods We used laboratory- and population-based data on incidence of IPD from CDC’s Emerging Infections Program / Active Bacterial Core surveillance in a time-series model to estimate the impact of vaccination. Cases of IPD during July 2004–June 2013 were classified as being caused by the PCV13 serotypes against which PCV7 has no effect (PCV13/nonPCV7). Findings Compared with incidence expected among children <5 years old if PCV7 alone had been continued, incidence of IPD overall and IPD caused by PCV13/nonPCV7 serotypes declined by 64% (95% interval estimate [IE] 59–68 %) and 93% (95%IE 91–94), respectively, by July 2012–June 2013. Among adults, incidence of IPD overall and PCV13/nonPCV7-type IPD also declined by 12–32% and 58–72%, respectively, depending on age. In all age groups, reductions were driven principally by changes in incidence of serotypes 19A and 7F. We estimate that over 30,000 cases of IPD and 3,000 deaths were averted in the first 3 years following PCV13 introduction. Interpretation PCV13 has reduced IPD among all ages when used routinely in children in the U.S. Serotypes 19A and 7F, which emerged after PCV7 introduction, have been effectively controlled. PMID:25656600

  8. Comparison between active and passive surveillance within the network of epidemiological surveillance of animal diseases in Chad.

    PubMed

    Ouagal, Mahamat; Hendrikx, Pascal; Saegerman, Claude; Berkvens, Dirk

    2010-11-01

    A comparative study between passive and active surveillance based on herd visits (villages) was conducted over a period of 24 months. It included 106 surveillance stations of the animal disease epidemiological surveillance network in Chad distributed randomly into 52 stations of active surveillance and 54 stations of passive surveillance. Nine diseases of various vaccination and expected prevalence status were monitored. The active surveillance stations carried out four herd visits monthly to look for the diseases under surveillance and organised four farmers awareness-raising meetings to stimulate them to make disease notifications. The passive surveillance stations held each month four farmer awareness-raising meetings. The suspicions recorded by the stations were consigned to a suspicion form specific to each disease, indicating whether a call from the farmer, a visit to the herd or a awareness-raising meeting was the source. The results showed that, irrespective of surveillance type, all diseases under surveillance, except the rare diseases (Rinderpest and Rift Valley Fever) were reported by the surveillance agents. However, suspicions recorded following farmer calls are significantly more important than suspicions carried out during herd visits or meetings. Nevertheless, a considerable number of suspicions is recorded during awareness-raising meetings. Finally approximately 83% of the herd visits realised by the active surveillance stations showed negative results (no suspicion identified). Passive surveillance stimulated by awareness-raising meetings appears to be better adapted to Chads conditions and less expensive for the surveillance of existing diseases. However, for the rare diseases, other methods of specific active surveillance (such as for example sentinel herds) remain important to complete passive surveillance.

  9. Prostate Active Surveillance Study — EDRN Public Portal

    Cancer.gov

    Primary Objective: To discover and confirm biomarkers that predict aggressive disease as defined by pre-specified histological, PSA, clinical criteria, or outcomes based on these variables. Secondary Objectives: To determine the proportion of patients on active surveillance who progress based on the above criteria. To determine the clinical predictors of disease progression. To measure the recurrence-free, disease-specific, and overall survival of men on active surveillance for clinically localized prostate cancer.

  10. A comparison of active adverse event surveillance systems worldwide.

    PubMed

    Huang, Yu-Lin; Moon, Jinhee; Segal, Jodi B

    2014-08-01

    Post-marketing drug surveillance for adverse drug events (ADEs) has typically relied on spontaneous reporting. Recently, regulatory agencies have turned their attention to more preemptive approaches that use existing data for surveillance. We conducted an environmental scan to identify active surveillance systems worldwide that use existing data for the detection of ADEs. We extracted data about the systems' structures, data, and functions. We synthesized the information across systems to identify common features of these systems. We identified nine active surveillance systems. Two systems are US based-the FDA Sentinel Initiative (including both the Mini-Sentinel Initiative and the Federal Partner Collaboration) and the Vaccine Safety Datalink (VSD); two are Canadian-the Canadian Network for Observational Drug Effect Studies (CNODES) and the Vaccine and Immunization Surveillance in Ontario (VISION); and two are European-the Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR) Alliance and the Vaccine Adverse Event Surveillance and Communication (VAESCO). Additionally, there is the Asian Pharmacoepidemiology Network (AsPEN) and the Shanghai Drug Monitoring and Evaluative System (SDMES). We identified two systems in the UK-the Vigilance and Risk Management of Medicines (VRMM) Division and the Drug Safety Research Unit (DSRU), an independent academic unit. These surveillance systems mostly use administrative claims or electronic medical records; most conduct pharmacovigilance on behalf of a regulatory agency. Either a common data model or a centralized model is used to access existing data. The systems have been built using national data alone or via partnership with other countries. However, active surveillance systems using existing data remain rare. North America and Europe have the most population coverage; with Asian countries making good advances. PMID:25022829

  11. Population based study of social and productive activities as predictors of survival among elderly Americans

    PubMed Central

    Glass, Thomas A; de Leon, Carlos Mendes; Marottoli, Richard A; Berkman, Lisa F

    1999-01-01

    Objectives To examine any association between social, productive, and physical activity and 13 year survival in older people. Design Prospective cohort study with annual mortality follow up. Activity and other measures were assessed by structured interviews at baseline in the participants’ homes. Proportional hazards models were used to model survival from time of initial interview. Setting City of New Haven, Connecticut, United States. Participants 2761 men and women from a random population sample of 2812 people aged 65 and older. Main outcome measure Mortality from all causes during 13 years of follow up. Results All three types of activity were independently associated with survival after age, sex, race/ethnicity, marital status, income, body mass index, smoking, functional disability, and history of cancer, diabetes, stroke, and myocardial infarction were controlled for. Conclusions Social and productive activities that involve little or no enhancement of fitness lower the risk of all cause mortality as much as fitness activities do. This suggests that in addition to increased cardiopulmonary fitness, activity may confer survival benefits through psychosocial pathways. Social and productive activities that require less physical exertion may complement exercise programmes and may constitute alternative interventions for frail elderly people. Key messagesLittle is known about predictors of survival among elderly peoplePhysical activity is clearly good for health, but the potential benefits of social activities have not been studiedSocial and productive activities are as effective as fitness activities in lowering the risk of deathEnhanced social activities may help to increase the quality and length of life PMID:10454399

  12. Physical Activity and Influenza-Coded Outpatient Visits, a Population-Based Cohort Study

    PubMed Central

    Siu, Eric; Campitelli, Michael A.; Kwong, Jeffrey C.

    2012-01-01

    Background Although the benefits of physical activity in preventing chronic medical conditions are well established, its impacts on infectious diseases, and seasonal influenza in particular, are less clearly defined. We examined the association between physical activity and influenza-coded outpatient visits, as a proxy for influenza infection. Methodology/Principal Findings We conducted a cohort study of Ontario respondents to Statistics Canada’s population health surveys over 12 influenza seasons. We assessed physical activity levels through survey responses, and influenza-coded physician office and emergency department visits through physician billing claims. We used logistic regression to estimate the risk of influenza-coded outpatient visits during influenza seasons. The cohort comprised 114,364 survey respondents who contributed 357,466 person-influenza seasons of observation. Compared to inactive individuals, moderately active (OR 0.83; 95% CI 0.74–0.94) and active (OR 0.87; 95% CI 0.77–0.98) individuals were less likely to experience an influenza-coded visit. Stratifying by age, the protective effect of physical activity remained significant for individuals <65 years (active OR 0.86; 95% CI 0.75–0.98, moderately active: OR 0.85; 95% CI 0.74–0.97) but not for individuals ≥65 years. The main limitations of this study were the use of influenza-coded outpatient visits rather than laboratory-confirmed influenza as the outcome measure, the reliance on self-report for assessing physical activity and various covariates, and the observational study design. Conclusion/Significance Moderate to high amounts of physical activity may be associated with reduced risk of influenza for individuals <65 years. Future research should use laboratory-confirmed influenza outcomes to confirm the association between physical activity and influenza. PMID:22737242

  13. Activity Limitations among Young Adults with Developmental Disabilities: A Population-Based Follow-Up Study

    ERIC Educational Resources Information Center

    Braun, Kim Van Naarden; Yeargin-Allsopp, Marshalyn; Lollar, Donald

    2009-01-01

    Developmental disabilities are a heterogeneous group of chronic conditions that may result in substantial activity limitations. The type and number of limitations may vary by impairment characteristics. Economic and social constraints may impact activity limitations beyond those attributable to their impairment. Using the International…

  14. Adherence to Physical Activity Recommendations and Its Associated Factors: An Interregional Population-Based Study

    PubMed Central

    Alkerwi, Ala’a; Schuh, Barbara; Sauvageot, Nicolas; Zannad, Faiez; Olivier, Arnaud; Guillaume, Michèle; Albert, Adelin; Larsson, Charlotte A.

    2015-01-01

    Background Though the influence of physical activity in preventing cardiovascular diseases is well documented, only a few comparative studies have determined the degree of adherence to physical activity recommendations among populations and identified the demographic, socioeco-nomic, behavioural and health-related factors associated with good compliance. Design and methods Cross-sectional interregional NESCaV survey of 3133 subjects compared three populations, Luxembourg, Lorraine (France) and Wallonia (Belgium), by using the International Physical Activity Questionnaire. Age and gender prevalence rates of physical activity were standardized to the European population. Results The likelihood to meet the recommendations was higher in Luxembourg, after adjustment for age, gender, education, employment, weight status, morbidity score, health perception and level of importance attributed to the practice of physical activity (P<0.0001). The odds for meeting the recommendations were significantly higher among those with secondary than tertiary education. Compared to good self-health perception, subjects with poor or fair self-perceived health were less likely to meet the recommendations; this also applied to those attributing little or enough importance to physical activity compared with great importance. Conclusions Region, education, self-perceived health and perception of importance of physical activity were emerged as independent determinants of meeting the recommendations. Awareness of the positive health effects of physical activity might thus be crucial for motivating the people to become more active. Further research is needed to explore potential region-specific factors which might explain the difference in population behaviours with respect to physical activity. Significance for public health This manuscript describes the prevalence of physical activity level of adult population from three European regions, Luxembourg, Wallonia and Lorraine, based on the

  15. Surveillance of Hospital Contacts among Danish Seafarers and Fishermen with Focus on Skin and Infectious Diseases—A Population-Based Cohort Study

    PubMed Central

    Kaerlev, Linda; Jensen, Anker; Hannerz, Harald

    2014-01-01

    Objectives: A systematic overview of time trends in hospital contacts among Danish seafarers and fishermen by job title and analyses on skin and infectious diseases. Methods: Occupational cohorts with hospital contacts 1994–1998 and 1999–2003. Standardized hospital contact ratios (SHCR) were estimated using national rates and ranked by SHCR size. Results: For non-officers in 1994–1998, infectious diseases had the highest SHCR, followed by neoplastic and endocrinal diseases; in 1999–2003 skin diseases were followed by endocrinal and gastrointestinal diseases. For fishermen in 1994–1998, nervous system, gastrointestinal, and skin diseases had the highest SHCRs; in 1999–2003 it was nervous system, skin, and lymphohematopoietic diseases. As for skin diseases, male fishermen and non-officer seamen generally had increased SHCRs, but engine room personnel specifically had a low SHCR for eczema (eight cases). Fishermen had high SHCRs for tuberculosis in both time periods (six and nine cases, respectively). Non-officer seamen on cargo ships had increased SHCRs for HIV in both time periods and for hepatitis in 1994–1999. Extending the follow-up until 2000 or 2005 showed similar results. Conclusions: Surveillance of seamen’s health gives useful information. The elevated SHCR for HIV infection among non-officers has not declined despite preventive information campaigns. Tuberculosis among fishermen may be due to infection on shore. Skin diseases had very high SHCRs, not due to cutaneous oil exposure. PMID:25411726

  16. Breast Cancer by Age at Diagnosis in the Gharbiah, Egypt, Population-Based Registry Compared to the United States Surveillance, Epidemiology, and End Results Program, 2004–2008

    PubMed Central

    Schlichting, Jennifer A.; Soliman, Amr S.; Schairer, Catherine; Harford, Joe B.; Hablas, Ahmed; Ramadan, Mohamed; Seifeldin, Ibrahim; Merajver, Sofia D.

    2015-01-01

    Objective. Although breast cancers (BCs) in young women often display more aggressive features, younger women are generally not screened for early detection. It is important to understand the characteristics of young onset breast cancer to increase awareness in this population. This analysis includes all ages, with emphasis placed on younger onset BC in Egypt as compared to the United States. Methods. BC cases in the Gharbiah cancer registry (GCR), Egypt, were compared to those in the Surveillance, Epidemiology, and End Results (SEER) database. This analysis included 3,819 cases from the GCR and 273,019 from SEER diagnosed 2004–2008. Results. GCR cases were diagnosed at later stages, with <5% diagnosed at Stage I and 12% diagnosed at Stage IV. 48% of all SEER cases were diagnosed at Stage I, dropping to 30% among those ≤40. Significant differences in age, tumor grade, hormone receptor status, histology, and stage exist between GCR and SEER BCs. After adjustment, GCR cases were nearly 45 times more likely to be diagnosed at stage III and 16 times more likely to be diagnosed at stage IV than SEER cases. Conclusions. Future research should examine ways to increase literacy about early detection and prompt therapy in young cases. PMID:26495294

  17. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants

    PubMed Central

    2015-01-01

    Summary Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA1c (HbA1c ≥6·5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG ≥7·0 mmol/L or 2hOGTT ≥11·1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG-or-2hOGTT was correlated with prevalence based on FPG alone (r=0·98), but was higher by 2–6 percentage points at different prevalence levels. Prevalence based on HbA1c was lower than prevalence based on FPG in 42·8% of age–sex–survey groups and higher in another 41·6%; in

  18. No survival benefit associated with routine surveillance imaging for Hodgkin lymphoma in first remission: a Danish-Swedish population-based observational study.

    PubMed

    Jakobsen, Lasse H; Hutchings, Martin; de Nully Brown, Peter; Linderoth, Johan; Mylam, Karen J; Molin, Daniel; Johnsen, Hans E; Bøgsted, Martin; Jerkeman, Mats; El-Galaly, Tarec C

    2016-04-01

    The use of routine imaging for patients with classical Hodgkin lymphoma (HL) in complete remission (CR) is controversial. In a population-based study, we examined the post-remission survival of Danish and Swedish HL patients for whom follow-up practices were different. Follow-up in Denmark included routine imaging, usually for a minimum of 2 years, whereas clinical follow-up without routine imaging was standard in Sweden. A total of 317 Danish and 454 Swedish comparable HL patients aged 18-65 years, diagnosed in the period 2007-2012 and having achieved CR following ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)/BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) therapy, were included in the study. The cumulative progression rates in the first 2 years were 4% (95% confidence interval [CI] 1-7) for patients with stage I-II disease vs. 12% (95% CI 6-18) for patients with stage III-IV disease. An imaging-based follow-up practice was not associated with a better post-remission survival in general (P = 0·2) or in stage-specific subgroups (P = 0·5 for I-II and P = 0·4 for III-IV). Age ≥45 years was the only independent adverse prognostic factor for survival. In conclusion, relapse of HL patients with CR is infrequent and systematic use of routine imaging in these patients does not improve post-remission survival. The present study supports clinical follow-up without routine imaging, as encouraged by the recent Lugano classification. PMID:26846879

  19. The Association of Active Cancer With Venous Thromboembolism Location: A Population-Based Study

    PubMed Central

    Tafur, Alfonso J.; Kalsi, Henna; Wysokinski, Waldemar E.; McBane, Robert D.; Ashrani, Aneel A.; Marks, Randolph S.; Crusan, Daniel J.; Petterson, Tanya M.; Bailey, Kent R.; Heit, John A.

    2011-01-01

    OBJECTIVE: To test active cancer for an association with venous thromboembolism (VTE) location. PATIENTS AND METHODS: Using the resources of the Rochester Epidemiology Project, we identified all Olmsted County, MN, residents with incident VTE during the 35-year period 1966-2000 (N=3385). We restricted analyses to residents with objectively diagnosed VTE during the 17-year period from January 1, 1984, to December 31, 2000 (N=1599). For each patient, we reviewed the complete medical records in the community for patient age, gender, and most recent body mass index at VTE onset; VTE event type and location; and previously identified independent VTE risk factors (ie, surgery, hospitalization for acute medical illness, active cancer, leg paresis, superficial venous thrombosis, and varicose veins). Using logistic regression we tested active cancer for an association with each of 4 symptomatic VTE locations (arm or intra-abdominal deep venous thrombosis [DVT], intra-abdominal DVT, pulmonary embolism, and bilateral leg DVT), adjusted for age, gender, body mass index, and other VTE risk factors. RESULTS: In multivariate analyses, active cancer was independently associated with arm or intra-abdominal DVT (odds ratio [OR], 1.76; P=.01), intra-abdominal DVT (OR, 2.22; P=.004), and bilateral leg DVT (OR, 2.09; P=.02), but not pulmonary embolism (OR, 0.93). CONCLUSION: Active cancer is associated with VTE location. Location of VTE may be useful in decision making regarding cancer screening. PMID:21193652

  20. A population-based study of active and drug-resistant epilepsies in Northern Italy.

    PubMed

    Giussani, Giorgia; Canelli, Valentina; Bianchi, Elisa; Franchi, Carlotta; Nobili, Alessandro; Erba, Giuseppe; Beghi, Ettore

    2016-02-01

    Drug-resistant epilepsy (DRE) is defined by the International League Against Epilepsy as a failure of adequate trials of two tolerated, appropriately chosen, and used antiepileptic drugs to achieve sustained seizure freedom. Our aim was to calculate the following: (1) the prevalence of active epilepsy and DRE in a well-defined population of Northern Italy and (2) the proportion of incident cases developing DRE. The study population (146,506; year 2008) resided in the province of Lecco, Northern Italy. The medical records of 123 general practitioners were reviewed to identify patients with epilepsy, diagnosed by a neurologist during the period 2000-2008. The point prevalence of active epilepsy and DRE was calculated on December 31, 2008. A total of 747 prevalent patients with epilepsy, 684 patients with active epilepsy, and 342 incident cases were identified. The frequency of DRE was 15.6% (107/684) of all active epilepsies and 10.5% (36/342) of incident cases. The point prevalence was 0.73 per 1000. The standardized prevalence of DRE was 0.7 per 1000 (Italian population) and 0.8 per 1000 (world population). Our data indicate that 1/6 patients with active epilepsy in the general population has DRE, and 1/10 patients with newly diagnosed epilepsy will develop DRE within nine years from the diagnosis.

  1. A population-based profile of adult Canadians living with participation and activity limitations

    PubMed Central

    Goodridge, Donna; Lawson, Josh; Marciniuk, Darcy; Rennie, Donna

    2011-01-01

    Background: Currently, one out of every seven Canadians is affected by limitations to their participation and activity. This study describes the self-reported main causes of these limitations in a national sample. Methods: The 2006 Participation and Activity Limitation Survey was a two-phase stratified survey based on filter questions posed in the 2006 Census of Population conducted by Statistics Canada. Respondents to the survey represent 5 185 980 Canadian adults with activity and participation limitations. We used these data to develop a profile of our population of interest: adult Canadians with activity and participation limitations. Associations between demographic variables and self-reported causes of activity and participation limitations were assessed using multiple logistic regression. Results: One quarter of participants did not attribute their disability to any medical cause. The most prevalent medical conditions to which disabilities were attributed were musculoskeletal (46.1%), cardio/cerebrovascular (12.3%), mental health (8.4%), neurologic (6.0%), endocrine (6.0%) and respiratory (4.5%) conditions. Significant associations were noted between sociodemographic variables and participants’ attributions of medical conditions as cause of disability. Multiple logistic regression with bootstrapping showed that people who reported a medical cause for their limitation were more likely (p < 0.05) to be female, widowed, 40 years of age or older, born in Canada or white and were less likely (p < 0.05) to be in the highest income category or to be employed (i.e., to work more than 0 h/w). Interpretation: Most people living with activity and participation limitations report having a musculoskeletal disorder. However, a significant proportion of respondants did not attribute their limitations to a medical cause. PMID:21825051

  2. Population-Based Passive Tick Surveillance and Detection of Expanding Foci of Blacklegged Ticks Ixodes scapularis and the Lyme Disease Agent Borrelia burgdorferi in Ontario, Canada

    PubMed Central

    Nelder, Mark P.; Russell, Curtis; Lindsay, L. Robbin; Dhar, Badal; Patel, Samir N.; Johnson, Steven; Moore, Stephen; Kristjanson, Erik; Li, Ye; Ralevski, Filip

    2014-01-01

    We identified ticks submitted by the public from 2008 through 2012 in Ontario, Canada, and tested blacklegged ticks Ixodes scapularis for Borrelia burgdorferi and Anaplasma phagocytophilum. Among the 18 species of ticks identified, I. scapularis, Dermacentor variabilis, Ixodes cookei and Amblyomma americanum represented 98.1% of the 14,369 ticks submitted. Rates of blacklegged tick submission per 100,000 population were highest in Ontario's Eastern region; D. variabilis in Central West and Eastern regions; I. cookei in Eastern and South West regions; and A. americanum had a scattered distribution. Rates of blacklegged tick submission per 100,000 population were highest from children (0–9 years old) and older adults (55–74 years old). In two health units in the Eastern region (i.e., Leeds, Grenville & Lanark District and Kingston-Frontenac and Lennox & Addington), the rate of submission for engorged and B. burgdorferi-positive blacklegged ticks was 47× higher than the rest of Ontario. Rate of spread for blacklegged ticks was relatively faster and across a larger geographic area along the northern shore of Lake Ontario/St. Lawrence River, compared with slower spread from isolated populations along the northern shore of Lake Erie. The infection prevalence of B. burgdorferi in blacklegged ticks increased in Ontario over the study period from 8.4% in 2008 to 19.1% in 2012. The prevalence of B. burgdorferi-positive blacklegged ticks increased yearly during the surveillance period and, while increases were not uniform across all regions, increases were greatest in the Central West region, followed by Eastern and South West regions. The overall infection prevalence of A. phagocytophilum in blacklegged ticks was 0.3%. This study provides essential information on ticks of medical importance in Ontario, and identifies demographic and geographic areas for focused public education on the prevention of tick bites and tick-borne diseases. PMID:25171252

  3. Low-cost active optical system for fire surveillance

    NASA Astrophysics Data System (ADS)

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

    2009-06-01

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

  4. IASM: A System for the Intelligent Active Surveillance of Malaria

    PubMed Central

    Yang, Bo; Chen, Hechang; Gu, Xiao; Bai, Yuan

    2016-01-01

    Malaria, a life-threatening infectious disease, spreads rapidly via parasites. Malaria prevention is more effective and efficient than treatment. However, the existing surveillance systems used to prevent malaria are inadequate, especially in areas with limited or no access to medical resources. In this paper, in order to monitor the spreading of malaria, we develop an intelligent surveillance system based on our existing algorithms. First, a visualization function and active surveillance were implemented in order to predict and categorize areas at high risk of infection. Next, socioeconomic and climatological characteristics were applied to the proposed prediction model. Then, the redundancy of the socioeconomic attribute values was reduced using the stepwise regression method to improve the accuracy of the proposed prediction model. The experimental results indicated that the proposed IASM predicted malaria outbreaks more close to the real data and with fewer variables than other models. Furthermore, the proposed model effectively identified areas at high risk of infection. PMID:27563343

  5. IASM: A System for the Intelligent Active Surveillance of Malaria.

    PubMed

    Wang, Xinlei; Yang, Bo; Huang, Jing; Chen, Hechang; Gu, Xiao; Bai, Yuan; Du, Zhanwei

    2016-01-01

    Malaria, a life-threatening infectious disease, spreads rapidly via parasites. Malaria prevention is more effective and efficient than treatment. However, the existing surveillance systems used to prevent malaria are inadequate, especially in areas with limited or no access to medical resources. In this paper, in order to monitor the spreading of malaria, we develop an intelligent surveillance system based on our existing algorithms. First, a visualization function and active surveillance were implemented in order to predict and categorize areas at high risk of infection. Next, socioeconomic and climatological characteristics were applied to the proposed prediction model. Then, the redundancy of the socioeconomic attribute values was reduced using the stepwise regression method to improve the accuracy of the proposed prediction model. The experimental results indicated that the proposed IASM predicted malaria outbreaks more close to the real data and with fewer variables than other models. Furthermore, the proposed model effectively identified areas at high risk of infection. PMID:27563343

  6. Classification of positive blood cultures: computer algorithms versus physicians' assessment - development of tools for surveillance of bloodstream infection prognosis using population-based laboratory databases

    PubMed Central

    2012-01-01

    Background Information from blood cultures is utilized for infection control, public health surveillance, and clinical outcome research. This information can be enriched by physicians’ assessments of positive blood cultures, which are, however, often available from selected patient groups or pathogens only. The aim of this work was to determine whether patients with positive blood cultures can be classified effectively for outcome research in epidemiological studies by the use of administrative data and computer algorithms, taking physicians’ assessments as reference. Methods Physicians’ assessments of positive blood cultures were routinely recorded at two Danish hospitals from 2006 through 2008. The physicians’ assessments classified positive blood cultures as: a) contamination or bloodstream infection; b) bloodstream infection as mono- or polymicrobial; c) bloodstream infection as community- or hospital-onset; d) community-onset bloodstream infection as healthcare-associated or not. We applied the computer algorithms to data from laboratory databases and the Danish National Patient Registry to classify the same groups and compared these with the physicians’ assessments as reference episodes. For each classification, we tabulated episodes derived by the physicians’ assessment and the computer algorithm and compared 30-day mortality between concordant and discrepant groups with adjustment for age, gender, and comorbidity. Results Physicians derived 9,482 reference episodes from 21,705 positive blood cultures. The agreement between computer algorithms and physicians’ assessments was high for contamination vs. bloodstream infection (8,966/9,482 reference episodes [96.6%], Kappa = 0.83) and mono- vs. polymicrobial bloodstream infection (6,932/7,288 reference episodes [95.2%], Kappa = 0.76), but lower for community- vs. hospital-onset bloodstream infection (6,056/7,288 reference episodes [83.1%], Kappa = 0.57) and healthcare-association (3

  7. Short Communication: Population-Based Surveillance of HIV-1 Drug Resistance in Cameroonian Adults Initiating Antiretroviral Therapy According to the World Health Organization Guidelines.

    PubMed

    Fokam, Joseph; Takou, Désiré; Santoro, Maria Mercedes; Akonie, Haniel Ze; Kouanfack, Charles; Ceccherini-Silberstein, Francesca; Colizzi, Vittorio; Perno, Carlo-Federico; Ndjolo, Alexis

    2016-04-01

    With ongoing earlier enrollment on and rapid scale-up of antiretroviral therapy (ART) in Cameroon, there are increasing risks of transmitted HIV drug resistance (HIVDR) at population levels. We, therefore, evaluated the threshold of HIVDR in a population initiating ART, to inform on the effectiveness of first-line regimens, considering HIV-1 diversity, plasma viral load (PVL), and CD4-based disease progression. A total of 53 adults [median (interquartile range, IQR) CD4: 162 cell/mm(3) (48-284); median (IQR) PVL: 5.34 log10 RNA (4.17-6.42) copies/ml] initiating ART in 2014 at the Yaoundé Central Hospital were enrolled for HIV-1 protease-reverse transcriptase sequencing. Drug resistance mutations (DRMs) were interpreted using the 2009 World Health Organization (WHO) list versus the Stanford HIVdb algorithm version 7.0. Level of DRMs was low (3.77%) versus moderate (7.55%), respectively, following the WHO list (T69D, K103N) versus Stanford HIVdb (T69D, A98G, K103N, K238T), respectively. Prevailing clade was CRF02_AG (71.70%). Based on Stanford HIVdb, a slightly higher proportion of patients with DRMs were found among ones infected with CRF02_AG than in those non-CRF02_AG infected (7.89% vs. 6.67%, p = 1.000), with lower PVL (7.69% <5.5 vs. 0% ≥5.5 log10 RNA copies/ml, p = .488) and with higher CD4 counts (9.52% CD4 ≥200 vs. 3.33% CD4 <200 cells/mm(3), p = .749). Thresholds of DRMs suggest that standard first-line regimens currently used in Cameroon may remain effective at population levels, despite scale-up of ART in the country, pending adherence, and closed virological monitoring. With an intent-to-diagnose approach, the discrepant levels of DRMs support using Stanford HIVdb to evaluate initial ART, while revising the WHO list for surveillance.

  8. Atypical teratoid rhabdoid tumors: a population-based clinical outcomes study involving 174 patients from the Surveillance, Epidemiology, and End Results database (1973–2010)

    PubMed Central

    Lau, Christine SM; Mahendraraj, Krishnaraj; Chamberlain, Ronald S

    2015-01-01

    Introduction Atypical teratoid rhabdoid tumors (ATRTs) are rare, highly malignant embryonal tumors of the central nervous system (CNS) accounting for 20% of CNS tumors in children under the age of 3. This study examines a large cohort of ATRT patients to determine demographic, clinical, and pathologic factors which impact prognosis and survival. Methods Demographic and clinical data were abstracted on 174 ATRT patients (171 pediatric patients age <20 and 3 adult patients age ≥20) from the Surveillance, Epidemiology, and End Results database (1973–2010). Standard statistical methodology was used. Results A total of 174 ATRT cases (mean age of 2.84 years) were identified. ATRT had a higher incidence in males (56.3%), Caucasians (59.1%), and children <3 years of age (80.5%), P<0.001. The most common primary sites were the cerebellum (17.8%), ventricles (16.1%), and frontal lobe (12.6%). Mean overall survival was 3.2±0.4 years, while overall and cancer-specific mortality were 63.2% and 56.3%, respectively, P=0.005. Most ATRT cases were treated with surgery alone (58.0%), followed by a combination of surgery and radiation (34.3%), no treatment (6.5%), and radiation alone (1.2%). The use of combination therapy has increased significantly (16.1%) since 2005 (P<0.001), while primary surgical resection and radiation therapy rates remain relatively unchanged. The longest survival was observed among ATRT patients receiving combination therapy (5.9±0.7 years), followed by radiation alone (2.8±1.2 years), and surgery alone (1.9±0.4 years), P<0.001. Multivariable analysis identified only distant metastases (OR =4.6) as independently associated with increased mortality, whereas combination therapy (OR =0.4) was associated with reduced mortality, P<0.005. Conclusion ATRT is a rare and highly aggressive embryonal malignancy of the CNS that presents more often as locoregional tumors >4 cm in male Caucasian children of age <3 years, involving the cerebellum, ventricles, or

  9. Short Communication: Population-Based Surveillance of HIV-1 Drug Resistance in Cameroonian Adults Initiating Antiretroviral Therapy According to the World Health Organization Guidelines.

    PubMed

    Fokam, Joseph; Takou, Désiré; Santoro, Maria Mercedes; Akonie, Haniel Ze; Kouanfack, Charles; Ceccherini-Silberstein, Francesca; Colizzi, Vittorio; Perno, Carlo-Federico; Ndjolo, Alexis

    2016-04-01

    With ongoing earlier enrollment on and rapid scale-up of antiretroviral therapy (ART) in Cameroon, there are increasing risks of transmitted HIV drug resistance (HIVDR) at population levels. We, therefore, evaluated the threshold of HIVDR in a population initiating ART, to inform on the effectiveness of first-line regimens, considering HIV-1 diversity, plasma viral load (PVL), and CD4-based disease progression. A total of 53 adults [median (interquartile range, IQR) CD4: 162 cell/mm(3) (48-284); median (IQR) PVL: 5.34 log10 RNA (4.17-6.42) copies/ml] initiating ART in 2014 at the Yaoundé Central Hospital were enrolled for HIV-1 protease-reverse transcriptase sequencing. Drug resistance mutations (DRMs) were interpreted using the 2009 World Health Organization (WHO) list versus the Stanford HIVdb algorithm version 7.0. Level of DRMs was low (3.77%) versus moderate (7.55%), respectively, following the WHO list (T69D, K103N) versus Stanford HIVdb (T69D, A98G, K103N, K238T), respectively. Prevailing clade was CRF02_AG (71.70%). Based on Stanford HIVdb, a slightly higher proportion of patients with DRMs were found among ones infected with CRF02_AG than in those non-CRF02_AG infected (7.89% vs. 6.67%, p = 1.000), with lower PVL (7.69% <5.5 vs. 0% ≥5.5 log10 RNA copies/ml, p = .488) and with higher CD4 counts (9.52% CD4 ≥200 vs. 3.33% CD4 <200 cells/mm(3), p = .749). Thresholds of DRMs suggest that standard first-line regimens currently used in Cameroon may remain effective at population levels, despite scale-up of ART in the country, pending adherence, and closed virological monitoring. With an intent-to-diagnose approach, the discrepant levels of DRMs support using Stanford HIVdb to evaluate initial ART, while revising the WHO list for surveillance. PMID:26602836

  10. Prostate cancer and the increasing role of active surveillance.

    PubMed

    Alonzo, David Gabriel; Mure, Amanda Lynne; Soloway, Mark S

    2013-09-01

    Prostate cancer (PC) is the most often diagnosed non-skin cancer and the second leading cause of cancer-related death among men in the United States. As a result, for many years the American Urological Association (AUA) and the American Cancer Society have issued statements recommending screening for PC, resulting in its widespread implementation in the United States. Recently, the United States Preventative Services Task Force gave PC screening a recommendation of D, that is, against PC screening for all men. The AUA countered this recommendation, stating that since the development of PC screening using prostate-specific antigen, a reduction in PC-specific mortality has been seen, and that the risk reduction occurred in a setting in which many of the patients were not aggressively treated for prostate cancer. Active surveillance may be described as a method to potentially delay or obviate the need for treatment in men with clinically insignificant PC or PC thought to be at low risk for progression. Studies have shown no significant difference in outcome or pathology between men with low risk PC who receive treatment at the point of progression and those undergoing immediate treatment. Ongoing studies are evaluating the efficacy and utility of active surveillance for low-risk PC. Interim results of these studies have shown that approximately 30% of patients progress on active surveillance. However, "progression" does not necessarily mean treatment failure; rarely do patients develop locally advanced or metastatic disease. Active surveillance has also been shown to be cost-effective when compared with immediate treatment for PC. Longer follow-up may continue to show an increased benefit of active surveillance as a reasonable initial approach to the management of men with low-risk, clinically localized PC.

  11. Consequences of acne on stress, fatigue, sleep disorders and sexual activity: a population-based study.

    PubMed

    Misery, Laurent; Wolkenstein, Pierre; Amici, Jean-Michel; Maghia, Rémi; Brenaut, Emilie; Cazeau, Christine; Voisard, Jean-Jacques; Taïeb, Charles

    2015-04-01

    Acne is a common disease among young people, which could have a serious impact on quality of life. Based on a survey using the quotas method on a large sample of the French population, we studied the impact of acne on feelings of stress, fatigue upon waking, sleep disorders and sexual activity. We did not establish any relationship to sleep disorders, but clearly ascertained that people with acne (n = 1,375) feel more stressed and have less sexual intercourse. Hence, 18% of people from acne group declared to be stressed every day (13.9% in control group) and 37.5% had no sexual intercourse (20.4% in control group; n = 891). To our knowledge, this is the first study to show that fatigue upon waking is strongly associated with the presence of acne (65.4% versus 58.4%). This study emphasises the fact that acne could have a deep resounding impact on the lives of people suffering from the disease.

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

    PubMed

    Tomašković, Igor

    2015-09-01

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

  13. Low Physical Activity and Its Association with Diabetes and Other Cardiovascular Risk Factors: A Nationwide, Population-Based Study

    PubMed Central

    Brugnara, Laura; Murillo, Serafín; Novials, Anna; Rojo-Martínez, Gemma; Soriguer, Federico; Goday, Albert; Calle-Pascual, Alfonso; Castaño, Luis; Gaztambide, Sonia; Valdés, Sergio; Franch, Josep; Castell, Conxa; Vendrell, Joan; Casamitjana, Roser; Bosch-Comas, Anna; Bordiú, Elena; Carmena, Rafael; Catalá, Miguel; Delgado, Elias; Girbés, Juan; López-Alba, Alfonso; Martínez-Larrad, Maria Teresa; Menéndez, Edelmiro; Mora-Peces, Inmaculada; Pascual-Manich, Gemma; Serrano-Ríos, Manuel; Gomis, Ramon; Ortega, Emilio

    2016-01-01

    Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009–2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32.3% for men and 39% for women (p < 0.0001). Sex differences were particularly notable (age*sex interaction, p = 0.0024) at early and older ages. Sedentary individuals had higher BMI (28 vs. 27 kg/m2) and obesity prevalence (37 vs. 26%). Low PA was present in 44, 43, and 38% of individuals with known diabetes (KDM), prediabetes/unknown-diabetes (PREDM/UKDM), and normal glucose regulation (p = 0.0014), respectively. No difference between KDM and PREDM/UKDM (p = 0.72) was found. Variables independently associated (p < 0.05) with sedentariness were age, sex, BMI, central obesity, Mediterranean diet adherence, smoking habit, HDL-cholesterol, triglycerides and dyslipidemia. Low PA is on the rise in Spain, especially among women. Sedentariness is associated with several cardiovascular risk factors and may be responsible for the increasing prevalence of obesity and diabetes in this country. PMID:27532610

  14. Low Physical Activity and Its Association with Diabetes and Other Cardiovascular Risk Factors: A Nationwide, Population-Based Study.

    PubMed

    Brugnara, Laura; Murillo, Serafín; Novials, Anna; Rojo-Martínez, Gemma; Soriguer, Federico; Goday, Albert; Calle-Pascual, Alfonso; Castaño, Luis; Gaztambide, Sonia; Valdés, Sergio; Franch, Josep; Castell, Conxa; Vendrell, Joan; Casamitjana, Roser; Bosch-Comas, Anna; Bordiú, Elena; Carmena, Rafael; Catalá, Miguel; Delgado, Elias; Girbés, Juan; López-Alba, Alfonso; Martínez-Larrad, Maria Teresa; Menéndez, Edelmiro; Mora-Peces, Inmaculada; Pascual-Manich, Gemma; Serrano-Ríos, Manuel; Gomis, Ramon; Ortega, Emilio

    2016-01-01

    Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009-2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32.3% for men and 39% for women (p < 0.0001). Sex differences were particularly notable (age*sex interaction, p = 0.0024) at early and older ages. Sedentary individuals had higher BMI (28 vs. 27 kg/m2) and obesity prevalence (37 vs. 26%). Low PA was present in 44, 43, and 38% of individuals with known diabetes (KDM), prediabetes/unknown-diabetes (PREDM/UKDM), and normal glucose regulation (p = 0.0014), respectively. No difference between KDM and PREDM/UKDM (p = 0.72) was found. Variables independently associated (p < 0.05) with sedentariness were age, sex, BMI, central obesity, Mediterranean diet adherence, smoking habit, HDL-cholesterol, triglycerides and dyslipidemia. Low PA is on the rise in Spain, especially among women. Sedentariness is associated with several cardiovascular risk factors and may be responsible for the increasing prevalence of obesity and diabetes in this country. PMID:27532610

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

    PubMed

    Bakhtari, Ardevan; Benhabib, Beno

    2007-02-01

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

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

    PubMed

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

    2016-05-01

    A method for online incremental mining of activity patterns from the surveillance video stream is presented in this paper. The framework consists of a learning block in which Dirichlet process mixture model is employed for the incremental clustering of trajectories. Stochastic trajectory pattern models are formed using the Gaussian process regression of the corresponding flow functions. Moreover, a sequential Monte Carlo method based on Rao-Blackwellized particle filter is proposed for tracking and online classification as well as the detection of abnormality during the observation of an object. Experimental results on real surveillance video data are provided to show the performance of the proposed algorithm in different tasks of trajectory clustering, classification, and abnormality detection. PMID:26978823

  17. Antiepileptic drugs with histone deacetylase inhibition activity and prostate cancer risk: a population-based case-control study.

    PubMed

    Salminen, Jukka K; Tammela, Teuvo L J; Auvinen, Anssi; Murtola, Teemu J

    2016-05-01

    Previous studies suggest that antiepileptic drugs with histone deacetylase (HDAC) inhibitor properties may have prostate cancer preventive effects. We evaluated the association between antiepileptic drug use and prostate cancer risk in a population-based case-control study. The study included all new prostate cancer cases diagnosed in Finland in 1995-2002 and matched controls (24,657 case-control pairs) identified from the Finnish Cancer Registry and the Population Register Center, respectively. Information on antiepileptic drug purchases was obtained from the national prescription reimbursement database. Odds ratios and their 95 % confidence intervals were estimated using age-adjusted and multivariable-adjusted conditional logistic regression analysis. Compared to never-users of antiepileptic drugs, the overall prostate cancer risk was decreased among users of phenobarbital, carbamazepine, and valproic acid (multivariable-adjusted odds ratio (OR) 0.47, 95 % CI 0.24-0.92; OR 0.82, 95 % CI 0.71-0.94, and OR 0.62, 95 % CI 0.42-0.92, respectively), but not among users of other antiepileptic drugs. Overall prostate cancer risk decreased in a dose-dependent manner by cumulative amount, duration and yearly dosage (intensity) of HDAC inhibitors valproic acid and carbamazepine. The risk of advanced prostate cancer was decreased only among carbamazepine users (OR 0.65, 95 % CI 0.44-0.96). Our results support possible prostate cancer preventive effects of HDAC inhibitors. However, also phenobarbital use was associated with decreased prostate cancer risk, despite not having HDAC inhibiting activity. The mechanism of action for antiepileptic drugs in prostate cancer deserves further study. PMID:27038166

  18. Prevalence of Active and Passive Smoking among Adult Population: Findings of a Population-Based Survey in Kerman (KERCADRS), Iran

    PubMed Central

    Salimzadeh, Hamideh; Najafipour, Hamid; Mirzaiepour, Fatemeh; Navadeh, Soodabeh; Shadkam-Farrokhi, Mitra; Mirzazadeh, Ali

    2016-01-01

    Background Smoking is one of the major modifiable risk factors for non-communicable diseases. Our aim was to report the pattern of active and passive smoking using the data collected through a population-base household survey in Kerman, Iran [(KERCADRS) Kerman Coronary Artery Disease Risk Factors Study]. Methods Using a cluster random sampling design, we recruited 5900 adult persons (15-75 years old) into our survey. After consenting, every participant was interviewed by a trained interviewer. The section for smoking included questions about daily (smoking at least one cigarette per day), non-daily, past and passive cigarette smoking as well as the duration of the exposure. We used Kerman population distribution (as the target population) to adjust our estimates using direct standardization method. Findings Overall, 8.3% of study participants (15.5% in men vs. 0.8% in women, P = 0.010) reported themselves as daily smokers and an additional 1.7% (2.9% in men vs. 0.4% in women, P = 0.010) as non-daily smokers. The passive smoking was common in total (27.5%), while women experienced more exposure than men (30.1% vs. 25.0%, P = 0.010). In daily smokers, 3.2% smoked more than 20 cigarettes per day. Among passive smokers, 62.6% were exposed to cigarette smoke more than 6 days per week. Conclusion Smoking is pretty common among adult populations, particularly in men. A majority of tobacco-free young adult women are exposed to passive smoking. Age and gender oriented interventions are required to change this risk pattern in Kerman community to prevent from further smoking related morbidities and mortalities. PMID:27274789

  19. Behavioral Economics, Wearable Devices, and Cooperative Games: Results From a Population-Based Intervention to Increase Physical Activity

    PubMed Central

    2016-01-01

    Background Health care literature supports the development of accessible interventions that integrate behavioral economics, wearable devices, principles of evidence-based behavior change, and community support. However, there are limited real-world examples of large scale, population-based, member-driven reward platforms. Subsequently, a paucity of outcome data exists and health economic effects remain largely theoretical. To complicate matters, an emerging area of research is defining the role of Superusers, the small percentage of unusually engaged digital health participants who may influence other members. Objective The objective of this preliminary study is to analyze descriptive data from GOODcoins, a self-guided, free-to-consumer engagement and rewards platform incentivizing walking, running and cycling. Registered members accessed the GOODcoins platform through PCs, tablets or mobile devices, and had the opportunity to sync wearables to track activity. Following registration, members were encouraged to join gamified group challenges and compare their progress with that of others. As members met challenge targets, they were rewarded with GOODcoins, which could be redeemed for planet- or people-friendly products. Methods Outcome data were obtained from the GOODcoins custom SQL database. The reporting period was December 1, 2014 to May 1, 2015. Descriptive self-report data were analyzed using MySQL and MS Excel. Results The study period includes data from 1298 users who were connected to an exercise tracking device. Females consisted of 52.6% (n=683) of the study population, 33.7% (n=438) were between the ages of 20-29, and 24.8% (n=322) were between the ages of 30-39. 77.5% (n=1006) of connected and active members met daily-recommended physical activity guidelines of 30 minutes, with a total daily average activity of 107 minutes (95% CI 90, 124). Of all connected and active users, 96.1% (n=1248) listed walking as their primary activity. For members who

  20. Assessing the Validity of a Stage Measure on Physical Activity in a Population-Based Sample of Individuals with Type 1 or Type 2 Diabetes

    ERIC Educational Resources Information Center

    Plotnikoff, Ronald C.; Lippke, Sonia; Reinbold-Matthews, Melissa; Courneya, Kerry S.; Karunamuni, Nandini; Sigal, Ronald J.; Birkett, Nicholas

    2007-01-01

    This study was designed to test the validity of a transtheoretical model's physical activity (PA) stage measure with intention and different intensities of behavior in a large population-based sample of adults living with diabetes (Type 1 diabetes, n = 697; Type 2 diabetes, n = 1,614) and examine different age groups. The overall "specificity"…

  1. Applying precision medicine to the active surveillance of prostate cancer

    PubMed Central

    Reichard, Chad A.; Stephenson, Andrew J.

    2015-01-01

    The recent introduction of a variety of molecular tests will potentially reshape the care of patients with prostate cancer. These tests may make more accurate management decisions possible for those patients who have been “overdiagnosed” with biologically indolent disease, which represents an exceptionally small mortality risk. There is a wide range of possible applications of these tests to different clinical scenarios in patient populations managed with active surveillance. Cancer 2015;121:3435–43. © 2015 American Cancer Society. PMID:26149066

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

    PubMed

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

    2014-12-01

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

  3. Childhood hearing surveillance activity in Italy: preliminary recommendations.

    PubMed

    Orzan, E; Ruta, F; Bolzonello, P; Marchi, R; Ceschin, F; Ciciriello, E

    2016-02-01

    Following the positive outcomes of the newborn hearing screening programmes already underway in several Italian regions, it is now necessary to address the identification of childhood hearing impairments that missed the neonatal screening programme or have delayed onset. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", a group of professionals identified three main recommendations that can be useful to improve hearing surveillance activity within the regional and state Italian Health System. The family paediatrician is recognised as having a key role in ongoing monitoring of hearing capacity and development of the growing child.

  4. Active surveillance for prostate cancer: a legal perspective.

    PubMed

    Venderbos, Lionne Df; Roobol, Monique J; de Hoogh, August Nl

    2014-01-01

    Active surveillance (AS) for prostate cancer (PCa) has become a viable management strategy for men with low-risk PCa. With AS being offered more often and more patients being included in AS studies, the aim of this paper is to describe AS from a legal perspective. What might be pitfalls in the management strategy that urologists should be aware of? In order to construct an answer to our research question, a patient from the Prostate cancer Research International: Active Surveillance (PRIAS) study will be used as an example. In the methods section, first some information on the PRIAS study is given. Then a PRIAS case will be described after which the Dutch legal framework will be set-out. Finally, the Dutch legal framework will be applied to the PRIAS case to find what would happen if that particular patient would file a complaint. On the basis of the analysis we can conclude that urologists that offer AS should be aware of the information that they provide to patients when entering AS but also during follow-up. It is furthermore important that urologists act in line with their medical professional standards. Therefore it is advised that urologists follow the progress that is made within the field of AS carefully, as the field is moving rapidly. PMID:25606578

  5. Active surveillance for prostate cancer: a legal perspective

    PubMed Central

    Venderbos, Lionne DF; Roobol, Monique J; de Hoogh, August NL

    2014-01-01

    Active surveillance (AS) for prostate cancer (PCa) has become a viable management strategy for men with low-risk PCa. With AS being offered more often and more patients being included in AS studies, the aim of this paper is to describe AS from a legal perspective. What might be pitfalls in the management strategy that urologists should be aware of? In order to construct an answer to our research question, a patient from the Prostate cancer Research International: Active Surveillance (PRIAS) study will be used as an example. In the methods section, first some information on the PRIAS study is given. Then a PRIAS case will be described after which the Dutch legal framework will be set-out. Finally, the Dutch legal framework will be applied to the PRIAS case to find what would happen if that particular patient would file a complaint. On the basis of the analysis we can conclude that urologists that offer AS should be aware of the information that they provide to patients when entering AS but also during follow-up. It is furthermore important that urologists act in line with their medical professional standards. Therefore it is advised that urologists follow the progress that is made within the field of AS carefully, as the field is moving rapidly. PMID:25606578

  6. Active epidemiological surveillance of musculoskeletal disorders in a shoe factory

    PubMed Central

    Roquelaure, Y; Mariel, J; Fanello, S; Boissiere, J; Chiron, H; Dano, C; Bureau, D; Penneau-Fontbonne, D

    2002-01-01

    Aims: (1) To evaluate an active method of surveillance of musculoskeletal disorders (MSDs). (2) To compare different criteria for deciding whether or not a work situation could be considered at high risk of MSDs in a large, modern shoe factory. Methods: A total of 253 blue collar workers were interviewed and examined by the same physician in 1996; 191 of them were re-examined in 1997. Risk factors of MSDs were assessed for each worker by standardised job site work analysis. Prevalence and incidence rates of carpal tunnel syndrome, rotator cuff syndrome, and tension neck syndrome were calculated for each of the nine main types of work situation. Different criteria used to assess situations with high risk of MSDs were compared. Results: On the basis of prevalence data, three types of work situation were detected to be at high risk of MSDs: cutting, sewing, and assembly preparation. The three types of work situations identified on the basis of incidence data (sewing preparation, mechanised assembling, and finishing) were different from those identified by prevalence data. At least one recognised risk factor for MSDs was identified for all groups of work situations. The ergonomic risk could be considered as serious for the four types of work situation having the highest ergonomic scores (sewing, assembly preparation, pasting, and cutting). Conclusion: The results of the health surveillance method depend largely on the definition of the criteria used to define the risk of MSDs. The criteria based on incidence data are more valid than those based on prevalence data. Health and risk factor surveillance must be combined to predict the risk of MSDs in the company. However, exposure assessment plays a greater role in determining the priorities for ergonomic intervention. PMID:12107293

  7. Active Surveillance for Prostate Cancer: Contemporary State of Practice

    PubMed Central

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

    2016-01-01

    Prostate cancer remains among the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment appear to improve survival in men with unfavorable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favorable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate cancer-specific mortality are exceedingly low in the intermediate term (5–10 years). Such outcomes appear to be closely associated with program-specific criteria for selection, monitoring, and intervention, suggesting that AS – like other management strategies – could be individualized based on the level of risk acceptable to patients in light of personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis. PMID:26954332

  8. Active surveillance for low-risk prostate cancer.

    PubMed

    Klotz, Laurence

    2015-04-01

    There is ample evidence that low risk and many cases of low-/intermediate-risk prostate cancer, are indolent, have little or no metastatic potential, and do not pose a threat to the patient in his lifetime. Major strides have been made in understanding who these patients are and in encouraging the use of conservative management in such individuals. A component of conservative management is the early identification of those 'low-risk' patients who harbour higher risk disease, and benefit from definitive therapy. This represents about 30% of newly diagnosed low-risk patients. A further small proportion of patients with low-risk disease demonstrate biological progression to higher grade disease. Men with lower risk disease can defer treatment, in most cases for life. Men with higher risk disease that can be localized to a relatively small volume of the prostate can undergo selective therapy. The results of active surveillance, embodying conservative management with selective delayed intervention for the subset who are re-classified as higher risk overtime based on repeat biopsy, imaging or biomarker results have shown that this approach is safe in the intermediate to long term, with a 3% cancer specific mortality at 10-15 years. Further refinement of the surveillance approach is ongoing, incorporating MRI, targeted biopsies and molecular biomarkers.

  9. Correlates of smoking susceptibility among adolescents in a peri-urban area of Nepal: a population-based cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site

    PubMed Central

    Aryal, Umesh R.; Petzold, Max; Bondjers, Göran; Krettek, Alexandra

    2014-01-01

    Background Susceptibility to smoking is defined as an absence of firm commitment not to smoke in the future or when offered a cigarette by best friends. Susceptibility begins in adolescence and is the first step in the transition to becoming an established smoker. Many scholars have hypothesized and studied whether psychosocial risk factors play a crucial role in preventing adolescent susceptibility to smoking or discourage susceptible adolescents from becoming established smokers. Our study examined sociodemographic and family and childhood environmental factors associated with smoking susceptibility among adolescents in a peri-urban area of Nepal. Design We conducted a population-based cross-sectional study during October–November 2011 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) located in a peri-urban area near Kathmandu, the capital city of Nepal, where tobacco products are easily available. Trained local enumerators conducted face-to-face interviews with 352 respondents aged 14–16. We used stepwise logistic regression to assess sociodemographic and family and childhood environmental factors associated with smoking susceptibility. Results The percentage of smoking susceptibility among respondents was 49.70% (95% CI: 44.49; 54.93). Multivariable analysis demonstrated that smoking susceptibility was associated with smoking by exposure of adolescents to pro-tobacco advertisements (AOR [adjusted odds ratio] =2.49; 95% CI: 1.46–4.24), the teacher (2.45; 1.28–4.68), adolescents attending concerts/picnics (2.14; 1.13–4.04), and smoking by other family members/relatives (1.76; 1.05–2.95). Conclusions Smoking susceptible adolescents are prevalent in the JD-HDSS, a peri-urban community of Nepal. Several family and childhood environmental factors increased susceptibility to smoking among Nepalese non-smoking adolescents. Therefore, intervention efforts need to be focused on family and childhood environmental factors with emphasis on

  10. Insights and clinical questions about the active surveillance of low-risk papillary thyroid microcarcinomas [Review].

    PubMed

    Ito, Yasuhiro; Oda, Hitomi; Miyauchi, Akira

    2016-04-25

    Over 20 years ago, two Japanese institutions initiated an active surveillance policy for papillary microcarcinomas (PMCs) without high-risk features (such as clinical lymph node and distant metastases) and suspected trachea or recurrent laryngeal nerve invasion. Since the most recent American Thyroid Association (ATA) guidelines adopt active surveillance as a therapy option for low-risk PMCs, the number of institutions worldwide carrying out this policy can be expected to increase. However, before adopting an active surveillance strategy, some important clinical questions must be considered. In this review, conceivable clinical questions with our answers based on the present accumulation of low-risk PMC surveillance data are presented. PMID:26632168

  11. Childhood hearing surveillance activity in Italy: preliminary recommendations.

    PubMed

    Orzan, E; Ruta, F; Bolzonello, P; Marchi, R; Ceschin, F; Ciciriello, E

    2016-02-01

    Following the positive outcomes of the newborn hearing screening programmes already underway in several Italian regions, it is now necessary to address the identification of childhood hearing impairments that missed the neonatal screening programme or have delayed onset. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", a group of professionals identified three main recommendations that can be useful to improve hearing surveillance activity within the regional and state Italian Health System. The family paediatrician is recognised as having a key role in ongoing monitoring of hearing capacity and development of the growing child. PMID:27054386

  12. Active-passive bistatic surveillance for long range air defense

    SciTech Connect

    Wardrop, B.; Molyneux-Berry, M.R.B. )

    1992-06-01

    A hypothetical mobile support receiver capable of working within existing and future air defense networks as a means to maintain essential surveillance functions is considered. It is shown how multibeam receiver architecture supported by digital signal processing can substantially improve surveillance performance against chaff and jamming threats. A dual-mode support receiver concept is proposed which is based on the state-of-the-art phased-array technology, modular processing in industry standard hardware and existing networks. 20 refs.

  13. Current status of active surveillance in prostate cancer

    PubMed Central

    Chung, Mun Su

    2016-01-01

    Active surveillance (AS) is a management strategy involving close monitoring the course of disease with the expectation to intervene if the cancer progress, in a super-selected group of low-risk prostate cancer (PCa) patients. Determining AS candidates should be based on careful individualized weighing of numerous factors: life expectancy, general health condition, disease characteristics, potential side effects of treatment, and patient preference. Several protocols have been developed to determine insignificant PCa for choosing ideal AS candidates. Results regarding disease reclassification during AS have been also reported. In an effort to enhance accuracy during selection of AS candidate, there were several reports on using magnetic resonance imaging for prediction of insignificant PCa. Currently, there is an urgent need for further clinical studies regarding the criteria for recommending AS, the criteria for reclassification on AS, and the schedule for AS. Considering the racial differences in behavior of PCa between Western and Asian populations, more stringent AS protocols for Asian patients should be established from additional, well-designed, large clinical studies. PMID:26966722

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

    PubMed

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

    2014-04-01

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

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

    PubMed Central

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

    2012-01-01

    Background Real-time surveillance is fundamental for effective control of disease outbreaks, but the official sentinel surveillance in Japan collects information related to disease activity only weekly and updates it with a 1-week time lag. Objective To report on a prescription surveillance system using electronic records related to prescription drugs that was started in 2008 in Japan, and to evaluate the surveillance system for monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. Methods We developed an automatic surveillance system using electronic records of prescription drug purchases collected from 5275 pharmacies through the application service provider’s medical claims service. We then applied the system to monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. The surveillance system collected information related to drugs and patients directly and automatically from the electronic prescription record system, and estimated the number of influenza cases based on the number of prescriptions of anti-influenza virus medication. Then it shared the information related to influenza activity through the Internet with the public on a daily basis. Results During the 2009–2010 influenza season, the number of influenza patients estimated by the prescription surveillance system between the 28th week of 2009 and the 12th week of 2010 was 9,234,289. In the 2010–2011 influenza season, the number of influenza patients between the 36th week of 2010 and the 12th week of 2011 was 7,153,437. The estimated number of influenza cases was highly correlated with that predicted by the official sentinel surveillance (r = .992, P < .001 for 2009–2010; r = .972, P < .001 for 2010–2011), indicating that the prescription surveillance system produced a good approximation of activity patterns. Conclusions Our prescription surveillance system presents great potential for monitoring influenza activity and for

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

    PubMed

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

    2014-06-01

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

  17. Gamified physical activation of young men – a Multidisciplinary Population-Based Randomized Controlled Trial (MOPO study)

    PubMed Central

    2013-01-01

    Background Inactive and unhealthy lifestyles are common among adolescent men. The planned intervention examines the effectiveness of an interactive, gamified activation method, based on tailored health information, peer networks and participation, on physical activity, health and wellbeing in young men. We hypothesize that following the intervention the physical activation group will have an improved physical activity, as well as self-determined and measured health compared with the controls. Methods/design Conscription-aged men (18 years) attending compulsory annual call-ups for military service in the city of Oulu in Finland (n = 1500) will be randomized to a 6-months intervention (n = 640) or a control group (n = 640) during the fall 2013. A questionnaire on health, health behaviour, diet and wellbeing is administered in the beginning and end of the intervention. In addition, anthropometric measures (height, weight and waist circumference), body composition, grip strength, heart rate variability and aerobic fitness will be measured. The activation group utilizes an online gamified activation method in combination with communal youth services, objective physical activity measurement, social networking, tailored health information and exercise programs according to baseline activity level and the readiness of changes of each individual. Daily physical activity of the participants is monitored in both the activation and control groups. The activation service rewards improvements in physical activity or reductions in sedentary behaviour. The performance and completion of the military service of the participants will also be followed. Discussion The study will provide new information of physical activity, health and health behaviour of young men. Furthermore, a novel model including methods for increasing physical activity among young people is developed and its effects tested through an intervention. This unique gamified service for activating young men

  18. Active Smoking, Passive Smoking, and Risk of Nonalcoholic Fatty Liver Disease (NAFLD): A Population-Based Study in China

    PubMed Central

    Liu, Yu; Dai, Meng; Bi, Yufang; Xu, Min; Xu, Yu; Li, Mian; Wang, Tiange; Huang, Fei; Xu, Baihui; Zhang, Jie; Li, Xiaoying; Wang, Weiqing; Ning, Guang

    2013-01-01

    Background The effect of active smoking on development of nonalcoholic fatty liver disease (NAFLD) is controversial, and there are limited clinical data on the relationship between passive smoking and NAFLD. We investigated whether active and passive smoking are associated with NAFLD. Methods A total of 8580 subjects (2691 men) aged 40 years or older participated in a community-based survey in Shanghai, China. Information on active and passive smoking was collected using a validated questionnaire. NAFLD was diagnosed by abdominal B-mode ultrasound testing and serum liver enzymes. Results NAFLD prevalence was 29.4% in never smokers, 34.2% in former smokers, 27.8% in light smokers (<20 cigarettes/day), 30.8% in moderate smokers (20–39 cigarettes/day), and 43.5% in heavy smokers (≥40 cigarettes/day). Fully adjusted logistic regression analyses revealed that, as compared with never smoking, former and heavy smoking were associated with increased risk of prevalent NAFLD, with odds ratios of 1.45 (95% CI 1.05–2.00) and 2.29 (95% CI 1.30–4.03), respectively. Active smoking and body mass index (BMI) had a synergistic effect on the risk of prevalent NAFLD; the combination of these risk factors was associated with the highest observed odds ratio for NAFLD: 8.58. In never-smoking women, passive smoking during both childhood and adulthood was associated with a 25% increase in the risk of prevalent NAFLD (OR = 1.25, 95% CI 1.05–1.50) as compared with no passive smoking. Conclusions Passive smoking and heavy active smoking are associated with prevalent NAFLD in middle-aged and elderly Chinese. Active smoking and BMI have a synergistic effect on prevalent NAFLD. PMID:23399520

  19. [Epidemiological surveillance activities during the 2009 influenza pandemic in Spain: lessons learnt one year after].

    PubMed

    Sierra Moros, Maria José; Vázquez Torres, María; Santa-Olalla Peralta, Patricia; Limia Sánchez, Aurora; Cortes García, Marta; Pachón Del Amo, Isabel

    2010-01-01

    In this article the actions taken in the area of epidemiological surveillance in Spain during the influenza pandemic and the recommendations drawn from them during the progression of the pandemic are reviewed. The performance of the Surveillance Subcommittee established in the National Influenza Preparedness and Response Plan was central to the coordination of these activities. The Surveillance Subcommittee was immediately activated when the alert was issued. Its role is also described in this review. The existence of a National Plan allowed a rapid and coordinated response after the alert declaration. The epidemiological and virological surveillance of the influenza pandemic was adapted to an evolving situation. In addition to routine influenza monitoring systems, new surveillance systems were put in place such as a case-based surveillance for community influenza cases and a case-based surveillance for severe cases and deaths due to the pandemic. Among the lessons learned from this pandemic, we would highlight the need to strengthen the timely analysis of data collected during an alert, the need to promote the exchange of information among public health and health care professionals, and to strengthen the response capacity in order to have resilient and consolidated public health structures for future health alerts.

  20. Physical activity and self-reported health status among adolescents: a cross-sectional population-based study

    PubMed Central

    Galán, I; Boix, R; Medrano, M J; Ramos, P; Rivera, F; Pastor-Barriuso, R; Moreno, C

    2013-01-01

    Objectives Little is known about the dose–response relationship between physical activity and health benefits among young people. Our objective was to analyse the association between the frequency of undertaking moderate-to-vigorous physical activity (MVPA) and the self-reported health status of the adolescent population. Design Cross-sectional study. Setting All regions of Spain. Participants Students aged 11–18 years participating in the Spanish Health Behaviour in School-aged Children survey 2006. A total of 375 schools and 21 188 students were selected. Main outcomes The frequency of undertaking MVPA was measured by a questionnaire, with the following four health indicators: self-rated health, health complaints, satisfaction with life and health-related quality of life. Linear and logistic regression models were used to analyse the association, adjusting for potential confounding variables and the modelling of the dose–response relationship. Results As the frequency of MVPA increased, the association with health benefits was stronger. A linear trend (p<0.05) was found for self-rated health and health complaints in males and females and for satisfaction with life among females; for health-related quality of life this relationship was quadratic for both sexes (p<0.05). For self-reported health and health complaints, the effect was found to be of greater magnitude in males than in females and, in all scales, the benefits were observed from the lowest frequencies of MVPA, especially in males. Conclusions A protective effect of MVPA was found in both sexes for the four health indicators studied, and this activity had a gradient effect. Among males, health benefits were detected from very low levels of physical activity and the magnitude of the relationship was greater than that for females. PMID:23676798

  1. [Domains of physical activity in slave-descendant communities in Southwest Bahia State, Brazil: a population-based study].

    PubMed

    Bezerra, Vanessa Moraes; Andrade, Amanda Cristina de Souza; César, Cibele Comini; Caiaffa, Waleska Teixeira

    2015-06-01

    This study aimed to describe the prevalence of physical activity (PA) and associated factors in various domains (leisure-time, work, home, and commuting) among quilombolas (descendants of African slaves) in Bahia State, Brazil. This was a cross-sectional study of 797 individuals from 18 to 100 years of age. The study adopted a cutoff point of 150 minutes of PA per week. A hierarchical Poisson model was used. The highest prevalence of PA was at work (42.1%), followed by the home environment (39.3%), commuting (35.5%), and leisure time (13.1%). PA at work was associated with male gender, lower age, higher schooling, and consumption of alcohol and fruits. PA in the household domain was associated with female gender, lower age, marital status (married), and negative self-rated health. In commuting, PA was associated with male gender and lower age bracket, and during leisure time with safety, male gender, lower age, and higher schooling. The study concludes that this slave-descendant community displays a profile of PA that is characteristic of rural groups (more active at work, with little leisure-time activity). The determinants of PA were similar to those seen in urban groups.

  2. Active surveillance for influenza A virus among swine, midwestern United States, 2009-2011.

    PubMed

    Corzo, Cesar A; Culhane, Marie; Juleen, Kevin; Stigger-Rosser, Evelyn; Ducatez, Mariette F; Webby, Richard J; Lowe, James F

    2013-06-01

    Veterinary diagnostic laboratories identify and characterize influenza A viruses primarily through passive surveillance. However, additional surveillance programs are needed. To meet this need, an active surveillance program was conducted at pig farms throughout the midwestern United States. From June 2009 through December 2011, nasal swab samples were collected monthly from among 540 groups of growing pigs and tested for influenza A virus by real-time reverse transcription PCR. Of 16,170 samples, 746 were positive for influenza A virus; of these, 18.0% were subtype H1N1, 16.0% H1N2, 7.6% H3N2, and 14.5% (H1N1)pdm09. An influenza (H3N2) and (H1N1)pdm09 virus were identified simultaneously in 8 groups. This active influenza A virus surveillance program provided quality data and increased the understanding of the current situation of circulating viruses in the midwestern US pig population.

  3. Detection of Rare Antimicrobial Resistance Profiles by Active and Passive Surveillance Approaches.

    PubMed

    Mather, Alison E; Reeve, Richard; Mellor, Dominic J; Matthews, Louise; Reid-Smith, Richard J; Dutil, Lucie; Haydon, Daniel T; Reid, Stuart W J

    2016-01-01

    Antimicrobial resistance (AMR) surveillance systems are generally not specifically designed to detect emerging resistances and usually focus primarily on resistance to individual drugs. Evaluating the diversity of resistance, using ecological metrics, allows the assessment of sampling protocols with regard to the detection of rare phenotypes, comprising combinations of resistances. Surveillance data of phenotypic AMR of Canadian poultry Salmonella Heidelberg and swine Salmonella Typhimurium var. 5- were used to contrast active (representative isolates derived from healthy animals) and passive (diagnostic isolates) surveillance and assess their suitability for detecting emerging resistance patterns. Although in both datasets the prevalences of resistance to individual antimicrobials were not significantly different between the two surveillance systems, analysis of the diversity of entire resistance phenotypes demonstrated that passive surveillance of diagnostic isolates detected more unique phenotypes. Whilst the most appropriate surveillance method will depend on the relevant objectives, under the conditions of this study, passive surveillance of diagnostic isolates was more effective for the detection of rare and therefore potentially emerging resistance phenotypes. PMID:27391966

  4. Detection of Rare Antimicrobial Resistance Profiles by Active and Passive Surveillance Approaches

    PubMed Central

    Mather, Alison E.; Reeve, Richard; Mellor, Dominic J.; Matthews, Louise; Reid-Smith, Richard J.; Haydon, Daniel T.; Reid, Stuart W. J.

    2016-01-01

    Antimicrobial resistance (AMR) surveillance systems are generally not specifically designed to detect emerging resistances and usually focus primarily on resistance to individual drugs. Evaluating the diversity of resistance, using ecological metrics, allows the assessment of sampling protocols with regard to the detection of rare phenotypes, comprising combinations of resistances. Surveillance data of phenotypic AMR of Canadian poultry Salmonella Heidelberg and swine Salmonella Typhimurium var. 5- were used to contrast active (representative isolates derived from healthy animals) and passive (diagnostic isolates) surveillance and assess their suitability for detecting emerging resistance patterns. Although in both datasets the prevalences of resistance to individual antimicrobials were not significantly different between the two surveillance systems, analysis of the diversity of entire resistance phenotypes demonstrated that passive surveillance of diagnostic isolates detected more unique phenotypes. Whilst the most appropriate surveillance method will depend on the relevant objectives, under the conditions of this study, passive surveillance of diagnostic isolates was more effective for the detection of rare and therefore potentially emerging resistance phenotypes. PMID:27391966

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

    USGS Publications Warehouse

    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.

  6. Let’s Get Physical: Sexual Orientation Disparities in Physical Activity, Sports Involvement, and Obesity Among a Population-Based Sample of Adolescents

    PubMed Central

    Poteat, V. Paul

    2015-01-01

    Objectives. We examined sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based adolescent sample. Methods. We analyzed data from the 2012 Dane County Youth Assessment for 13 933 students in grades 9 through 12 in 22 Wisconsin high schools. We conducted logistic regressions to examine sexual orientation disparities in physical activity, sports involvement, and body mass index among male and female adolescents. Results. When we accounted for several covariates, compared with heterosexual females, sexual minority females were less likely to participate in team sports (adjusted odds ratio [AOR] = 0.44; 95% confidence interval [CI] = 0.37, 0.53) and more likely to be overweight (AOR = 1.28; 95% CI = 1.02, 1.62) or obese (AOR = 1.88; 95% CI = 1.43, 2.48). Sexual minority males were less likely than heterosexual males to be physically active (AOR = 0.62; 95% CI = 0.46, 0.83) or to participate in team sports (AOR = 0.26; 95% CI = 0.20, 0.32), but the 2 groups did not differ in their risk of obesity. Conclusions. Sexual orientation health disparities in physical activity and obesity are evident during adolescence. Culturally affirming research, interventions, and policies are needed for sexual minority youths. PMID:26180946

  7. A method for active surveillance of selected communicable diseases.

    PubMed

    O'Leary, M J

    2000-09-01

    In 1991, an initiative was launched in the Western Pacific Region of WHO to eradicate poliomyelitis by the year 2000. Confirmation of eradication requires a certification process, in which specific criteria must be met. A hospital-based surveillance system was developed. It was sensitive enough to detect, at least one case of acute flaccid paralysis (AFP) per 100,000 children under age 15 per year, which is considered the "background rate" of AFP. This system was instituted in 1997 in most countries in the Pacific, and included measles and neonatal tetanus as well as AFP. By mid-1998, 53 hospitals in the Pacific were submitting monthly forms indicating whether or not AFP, suspect measles, or neonatal tetanus had been seen in the preceding month. Compliance was excellent, with over 80% of forms submitted to WHO in 1998, thus meeting the certification standard. In 1999 a proposal was made to expand this method, in selected countries, to encompass most conditions presenting with acute fever plus rash, thus including, for example, cases of rubella and dengue. Important aspects of such surveillance include the capacity to confirm diagnoses in the laboratory, and to take effective public health action. A coordinated laboratory network had been established previously for virological analysis of stool specimens for conditions causing AFP, but laboratory support for other conditions is currently the responsibility of individual hospitals to arrange.

  8. Establishment of a cancer surveillance programme: the South African experience

    PubMed Central

    Singh, Elvira; Ruff, Paul; Babb, Chantal; Sengayi, Mazvita; Beery, Moira; Khoali, Lerato; Kellett, Patricia; Underwood, J Michael

    2015-01-01

    Cancer is projected to become a leading cause of morbidity and mortality in low-income and middle-income countries in the future. However, cancer incidence in South Africa is largely under-reported because of a lack of nationwide cancer surveillance networks. We describe present cancer surveillance activities in South Africa, and use the International Agency for Research on Cancer framework to propose the development of four population-based cancer registries in South Africa. These registries will represent the ethnic and geographical diversity of the country. We also provide an update on a cancer surveillance pilot programme in the Ekurhuleni Metropolitan District, and the successes and challenges in the implementation of the IARC framework in a local context. We examine the development of a comprehensive cancer surveillance system in a middle-income country, which might serve to assist other countries in establishing population-based cancer registries in a resource-constrained environment. PMID:26248849

  9. Active and passive smoking and the risk of breast cancer in women aged 36–45 years: a population based case–control study in the UK

    PubMed Central

    Roddam, A W; Pirie, K; Pike, M C; Chilvers, C; Crossley, B; Hermon, C; McPherson, K; Peto, J; Vessey, M; Beral, V

    2007-01-01

    Active smoking has little or no effect on breast cancer risk but some investigators have suggested that passive smoking and its interaction with active smoking may be associated with an increased risk. In a population based case–control study of breast cancer in women aged 36–45 years at diagnosis, information on active smoking, passive smoking in the home, and other factors, was collected at interview from 639 cases and 640 controls. Women were categorised jointly by their active and passive smoking exposure. Among never smoking controls, women who also reported no passive smoking exposure were significantly more likely to be nulliparous and to be recent users of oral contraceptives. Among those never exposed to passive smoking, there was no significant association between active smoking and breast cancer, relative risk (RR) of 1.12 (95% confidence interval (CI) 0.72–1.73) for past smokers and RR of 1.19 (95% CI 0.72–1.95) for current smokers, nor was there an association with age started, duration or intensity of active smoking. Compared with women who were never active nor passive smokers, there was no significant association between passive smoking in the home and breast cancer risk in never smokers, RR of 0.89 (95% CI 0.64–1.25), in past smokers, RR of 1.09 (95% CI 0.75–1.56), or in current smokers, RR of 0.93 (95% CI 0.67–1.30). There was no trend with increasing duration of passive smoking and there was no heterogeneity among any of the subgroups examined. In this study, there was no evidence of an association between either active smoking or passive smoking in the home and risk of breast cancer. PMID:17579618

  10. Active and Passive Smoking and Risk of Narcolepsy in People with HLA DQB1*0602: A Population-Based Case-Control Study

    PubMed Central

    Ton, Thanh G.N.; Longstreth, W.T.; Koepsell, Thomas

    2009-01-01

    Background We examined the risk of narcolepsy associated with active and passive smoking among genetically susceptible individuals. Methods We conducted a population-based case-control study in King County, Wash., USA. Between 2001 and 2005, we enrolled 67 cases through physicians and public outreach, and 95 controls through random-digit dialing. Subjects were aged between 18 and 50 years and positive for HLA DQB1*0602. All subjects were administered in-person interviews about their history of active and passive smoking. Results We observed an increased risk of narcolepsy associated with having lived with two or more household smokers (odds ratio, OR = 5.1; 95% confidence interval, CI: 1.6, 12.1); with a grandparent or a sibling who smoked (OR = 3.0; 95% CI: 1.1, 8.3); with a non-family household member who smoked (OR = 3.7; 95% CI: 1.6, 8.6); and with an unrelated smoker for 1–2 years (OR = 3.1; 95% CI: 1.0, 9.0). The risk of narcolepsy was not associated with exposure to smoke at work or with active smoking before age 21 or before age of narcolepsy onset. Conclusion Passive smoking may be a risk factor for narcolepsy in subjects with HLA DQB1*0602. Future studies could help clarify whether passive smoking is an important etiologic component of narcolepsy among genetically susceptible individuals. PMID:19039244

  11. Intussusception in southern India: comparison of retrospective analysis and active surveillance.

    PubMed

    Jehangir, Susan; John, Jacob; Rajkumar, Sangeeth; Mani, Betty; Srinivasan, Rajan; Kang, Gagandeep

    2014-08-11

    Surveillance for intussusception is a post marketing requirement for rotavirus vaccines following observation of a small increased risk of intussusception after rotavirus vaccination in some global settings. This study presents the clinical presentation and outcomes of children who presented with intussusception at a large tertiary care facility directly (non-surveillance) as retrospective analysis of a period where rotavirus vaccine was not in routine use, or as part of active surveillance in a phase III oral rotavirus vaccine trial. Hospital records of children under 2 years of age treated for intussusception between 1 January 2010 and 31 August 2013 at the Christian Medical College Hospital, Vellore, India, were reviewed. Sixty-one cases of intussusception in children under two years of age presented at the hospital. An additional 16 cases of ultrasound diagnosed intussusception were identified through the active surveillance of a cohort of 1500 children participating in a rotavirus phase III trial in the same period. In the nonsurveillance group, median age at presentation was 214 days (IQR 153-321) with 52 events (85.3%) occurring in the first year of life. Cases were seen year-round with no definitive evidence of seasonality. Thirty-one (50.8%) intussusceptions required surgical reduction, 26 (42.6%) had pneumatic reduction and 2 (3.3%) barium enema reduction. Two intussusceptions (3.3%) resolved spontaneously. There were no deaths, all children were discharged after recovery. Active surveillance identified 16 children with a median age at event of 375 days (IQR 248-574). Nine (56%) children had small bowel or transient intussusception that resolved spontaneously. Seven intussusceptions were reduced radiologically; none required surgery. In summary, there were significant differences between presentation and outcomes in cases of intussusception identified by passive and active surveillance, likely related to enhanced and early detection of intussusception

  12. Detection of septic transfusion reactions to platelet transfusions by active and passive surveillance.

    PubMed

    Hong, Hong; Xiao, Wenbin; Lazarus, Hillard M; Good, Caryn E; Maitta, Robert W; Jacobs, Michael R

    2016-01-28

    Septic transfusion reactions (STRs) resulting from transfusion of bacterially contaminated platelets are a major hazard of platelet transfusion despite recent interventions. Active and passive surveillance for bacterially contaminated platelets was performed over 7 years (2007-2013) by culture of platelet aliquots at time of transfusion and review of reported transfusion reactions. All platelet units had been cultured 24 hours after collection and released as negative. Five sets of STR criteria were evaluated, including recent AABB criteria; sensitivity and specificity of these criteria, as well as detection by active and passive surveillance, were determined. Twenty of 51,440 platelet units transfused (0.004%; 389 per million) were bacterially contaminated by active surveillance and resulted in 5 STRs occurring 9 to 24 hours posttransfusion; none of these STRs had been reported by passive surveillance. STR occurred only in neutropenic patients transfused with high bacterial loads. A total of 284 transfusion reactions (0.55%) were reported by passive surveillance. None of these patients had received contaminated platelets. However, 6 to 93 (2.1%-32.7%) of these 284 reactions met 1 or more STR criteria, and sensitivity of STR criteria varied from 5.1% to 45.5%. These results document the continued occurrence of bacterial contamination of platelets resulting in STR in neutropenic patients, failure of passive surveillance to detect STR, and lack of specificity of STR criteria. These findings highlight the limitations of reported national STR data based on passive surveillance and the need to implement further measures to address this problem such as secondary testing or use of pathogen reduction technologies.

  13. Urinary TMPRSS2:ERG and PCA3 in an active surveillance cohort: results from a baseline analysis in the Canary Prostate Active Surveillance Study

    PubMed Central

    Lin, Daniel W.; Newcomb, Lisa F.; Brown, Elissa C.; Brooks, James D.; Carroll, Peter R.; Feng, Ziding; Gleave, Martin E.; Lance, Raymond S.; Sanda, Martin G.; Thompson, Ian M.; Wei, John T.; Nelson, Peter S.

    2013-01-01

    Purpose Active surveillance is used to manage low risk prostate cancer. Both PCA3 and TMRPSS2-ERG are promising biomarkers that may be associated with aggressive disease. This study examines the correlation of these biomarkers with higher cancer volume and grade determined at the time of biopsy in an active surveillance cohort. Experimental Design Post-DRE urine was collected prospectively as part of the multi-institutional Canary Prostate Active Surveillance Study (PASS). PCA3 and TMPRSS2-ERG levels were analyzed in urine collected at study entry. Biomarker scores were correlated to clinical and pathologic variables. Results In 387 men, both PCA3 and TMPRSS2-ERG scores were significantly associated with higher volume disease. For a negative repeat biopsy, and 1–10%, 11–33%, ≥34% positive cores, median PCA3 and TMPRSS2-ERG scores increased incrementally (P < 0.005). Both PCA3 and TMPRSS2-ERG scores were also significantly associated with presence of high grade disease. For a negative repeat biopsy, Gleason 6 and Gleason ≥7 cancers, the median PCA3 and TMPRSS2-ERG scores also increased incrementally (P = 0.02 and P = 0.001, respectively). Using the marker scores as a continuous variables, the odds ratio for a biopsy in which cancer was detected versus a negative repeat biopsy (ref) on modeling was 1.41 (95% CI 1.07–1.85), P = 0.01 for PCA3 and 1.28 (95% CI 1.10–1.49), P = 0.001 for TMPRSS2-ERG. Conclusions For men on active surveillance both PCA3 and TMPRSS2-ERG appear to stratify risk of having aggressive cancer as defined by tumor volume or Gleason score. PMID:23515404

  14. 77 FR 52317 - Record of Decision for Surveillance Towed Array Sensor System Low Frequency Active Sonar

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

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

  15. Compliance of males with stage 1 testicular germ cell tumours on an active surveillance protocol.

    PubMed

    Honeyball, F; Murali-Ganesh, R; Hruby, G; Grimison, P

    2015-10-01

    The aim of this retrospective study was to determine the rate of compliance among 57 males with stage 1 testicular germ cell tumours on an active surveillance protocol at a single Australian centre. At median follow up of 24 months, 81% had adequate compliance with the follow-up regimen, 12% were lost to follow up, and 16% relapsed; none between protocol visits. Active surveillance is an acceptable alternative to adjuvant therapy for stage 1 testicular germ cell tumours, with reduced toxicity for most and equivalent survival, but requires efforts to maintain adequate compliance with follow up to avoid late detection of recurrence.

  16. Surveillance and maintenance activities of waste area groupings at Oak Ridge National Laboratory

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.; Jones, R.G.

    1991-12-01

    Surveillance and maintenance (S M) of 75 sites were conductd by the Remedial Action Section for the Environmental Restoration Program for surplus facilities and sites contaminated with radioactive materials and/or hazardous chemicals. S M activities on these sites were conducted from the end of their operating life until final facility disposal or site stabilization. The objectives of the Waste Area Grouping S M Program are met by maintaining a program of routine S M as well as by implementing interim corrective maintenance when deemed necessary as a result of site surveillance. This report briefly presents this program's activities and includes tables indicating tank levels and dry well data for FY 1991.

  17. Big Data for Population-Based Cancer Research

    PubMed Central

    Meyer, Anne-Marie; Olshan, Andrew F.; Green, Laura; Meyer, Adrian; Wheeler, Stephanie B.; Basch, Ethan; Carpenter, William R.

    2016-01-01

    The Integrated Cancer Information and Surveillance System (ICISS) facilitates population-based cancer research by developing extensive information technology systems that can link and manage large data sets. Taking an interdisciplinary “team science” approach, ICISS has developed data, systems, and methods that allow researchers to better leverage the power of big data to improve population health. PMID:25046092

  18. DEVELOPMENT OF AN ETD SURVEILLANCE CHECKLIST FOR MONITORING EPA RESEARCH ACTIVITIES

    EPA Science Inventory

    DEVELOPMENT OF AN ETD SURVEILLANCE CHECKLIST FOR MONITORING EPA RESEARCH ACTIVITIES, Thomas J. Hughes, National Health and Environmental Effects Research Laboratory (NHEERL), ORD, U.S. EPA, Experimental Toxicology Division (ETD), MD 66, RTP, NC 27711

    Research studies condu...

  19. Penicillin Use in Meningococcal Disease Management: Active Bacterial Core Surveillance Sites, 2009

    PubMed Central

    Blain, Amy E.; Mandal, Sema; Wu, Henry; MacNeil, Jessica R.; Harrison, Lee H.; Farley, Monica M.; Lynfield, Ruth; Miller, Lisa; Nichols, Megin; Petit, Sue; Reingold, Arthur; Schaffner, William; Thomas, Ann; Zansky, Shelley M.; Anderson, Raydel; Harcourt, Brian H.; Mayer, Leonard W.; Clark, Thomas A.; Cohn, Amanda C.

    2016-01-01

    In 2009, in the Active Bacterial Core surveillance sites, penicillin was not commonly used to treat meningococcal disease. This is likely because of inconsistent availability of antimicrobial susceptibility testing and ease of use of third-generation cephalosporins. Consideration of current practices may inform future meningococcal disease management guidelines. PMID:27704009

  20. Visceral Leishmaniasis Eradication is a Reality: Data from a Community-based Active Surveillance in Bangladesh

    PubMed Central

    Ferdousi, Farhana; Alam, Mohammad S.; Hossain, Mohammad S.; Ma, Enbo; Itoh, Makoto; Mondal, Dinesh; Haque, Rashidul; Wagatsuma, Yukiko

    2012-01-01

    More than 20 million people in Bangladesh are considered at risk of developing visceral leishmaniasis (VL). A community-based active surveillance was conducted in eight randomly selected villages in a highly endemic area of Bangladesh from 2006 to 2008. A total of 6,761 individuals living in 1,550 mud-walled houses were included in the active surveillance. Rapid rK39 dipstick tests were conducted throughout the study period to facilitate the case diagnosis. Individuals with previous or current clinical leishmaniasis were identified on the basis of the case definition of the VL elimination program. Untreated cases of suspected VL were referred to the hospital for treatment. Socioeconomic and environmental information including bed net use was also collected. In 2006, the annual incidence of clinical leishmaniasis in the study area was 141.9 cases per 10,000 population, which was significantly increased by the following year owing to community-based active surveillance for case detection and reporting. However, early case detection and early referral for treatment led to a significant decrease in incidence in 2008. This study suggests that community-based active surveillance using a simple diagnostic tool might play a role in achieving the goal of the VL elimination program. PMID:23532674

  1. Inspection of surveillance equipment and activities at DOE Field Office, Richland

    SciTech Connect

    Not Available

    1991-09-30

    The purpose of this inspection was to review surveillance activities by the Department of Energy's (DOE) Field Office, Richland (RL) and contractor employees at the RL Hanford site for efficiency and economy and compliance with laws and regulations. The scope included surveillance activities, procedures, training, types of surveillance equipment, and management controls over the equipment and activities. We also looked at Departmental policies and procedures regarding the equipment and activities. Allegations of illegal surveillance that came to our attention during the course of this inspection were referred to the Department of Justice. As part of our review, inspectors were on-site at RL from February 11, 1991, through March 1, 1991. Follow-up trips to RL were also made in April, May, and June 1991. We also conducted interviews at Albuquerque, Savannah River, and Germantown of former RL employees and RL contractors who were on travel. Officials from DOE's Office of General Counsel (OGC), Office of Security Affairs, and Office of Safeguards and Security (S S) were also interviewed regarding the Department's purchase and possession of wiretapping and eavesdropping devices. We obtained 75 signed sworn statements from 55 individuals during the course of the inspection. 1 fig., 1 tab.

  2. 'Active Surveillance' of Prostate Cancer Doesn't Dampen Quality of Life

    MedlinePlus

    ... gov/news/fullstory_160131.html 'Active Surveillance' of Prostate Cancer Doesn't Dampen Quality of Life Choosing no ... 28, 2016 (HealthDay News) -- Men with low-risk prostate cancer report a good quality of life after choosing ...

  3. Physical Activity, Study Sitting Time, Leisure Sitting Time, and Sleep Time Are Differently Associated With Obesity in Korean Adolescents: A Population-Based Study.

    PubMed

    Kong, Il Gyu; Lee, Hyo-Jeong; Kim, So Young; Sim, Songyong; Choi, Hyo Geun

    2015-11-01

    Low physical activity, long leisure sitting time, and short sleep time are risk factors for obesity, but the association with study sitting time is unknown. The objective of this study was to evaluate the association between these factors and obesity.We analyzed the association between physical activity, study sitting time, leisure sitting time, and sleep time and subject weight (underweight, healthy weight, overweight, and obese), using data from a large population-based survey, the 2013 Korea Youth Risk Behavior Web-based Survey. Data from 53,769 participants were analyzed using multinomial logistic regression analyses with complex sampling. Age, sex, region of residence, economic level, smoking, stress level, physical activity, sitting time for study, sitting time for leisure, and sleep time were adjusted as the confounders.Low physical activity (adjusted odds ratios [AORs] = 1.03, 1.12) and long leisure sitting time (AORs = 1.15, 1.32) were positively associated with overweight and obese. Low physical activity (AOR = 1.33) and long leisure sitting time (AOR = 1.12) were also associated with underweight. Study sitting time was negatively associated with underweight (AOR = 0.86) but was unrelated to overweight (AOR = 0.97, 95% confidence interval [CI] = 0.91-1.03) and obese (AOR = 0.94, 95% CI = 0.84-1.04). Sleep time (<6 hours; ≥6 hours, <7 hours; ≥7 hours, <8 hours) was adversely associated with underweight (AORs = 0.67, 0.79, and 0.88) but positively associated with overweight (AORs = 1.19, 1.17, and 1.08) and obese (AORs = 1.33, 1.36, and 1.30) in a dose-response relationship.In adolescents, increasing physical activity, decreasing leisure sitting time, and obtaining sufficient sleep would be beneficial in maintaining a healthy weight. However, study sitting time was not associated with overweight or obese. PMID:26554807

  4. Emergency department syndromic surveillance providing early warning of seasonal respiratory activity in England.

    PubMed

    Hughes, H E; Morbey, R; Hughes, T C; Locker, T E; Pebody, R; Green, H K; Ellis, J; Smith, G E; Elliot, A J

    2016-04-01

    Seasonal respiratory infections place an increased burden on health services annually. We used a sentinel emergency department syndromic surveillance system to understand the factors driving respiratory attendances at emergency departments (EDs) in England. Trends in different respiratory indicators were observed to peak at different points during winter, with further variation observed in the distribution of attendances by age. Multiple linear regression analysis revealed acute respiratory infection and bronchitis/bronchiolitis ED attendances in patients aged 1-4 years were particularly sensitive indicators for increasing respiratory syncytial virus activity. Using near real-time surveillance of respiratory ED attendances may provide early warning of increased winter pressures in EDs, particularly driven by seasonal pathogens. This surveillance may provide additional intelligence about different categories of attendance, highlighting pressures in particular age groups, thereby aiding planning and preparation to respond to acute changes in EDs, and thus the health service in general.

  5. The impacts of maternal mortality and cause of death on children’s risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013)

    PubMed Central

    2015-01-01

    Background Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children’s risk of dying in an HIV-endemic population in rural South Africa. Methods We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992 – 2013). We used discrete time event history analysis to estimate children’s risk of dying when they experienced a maternal death compared to children whose mother survived (N=3,740,992 child months). We also examined variation in risk due to cause of maternal death. We defined mother’s survival status as early maternal death (during pregnancy, childbirth, or within 42 days of most recent childbirth or identified cause of death), late maternal death (within 43-365 days of most recent childbirth), any other death, and mothers who survived. Results Children who experienced an early maternal death were at 15 times the risk of dying (RRR 15.2; 95% CI 8.3–27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an HIV/AIDS or TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (RRR 29.2; 95% CI 11.7–73.1). The risk of these children dying was significantly higher than those children whose mother died of a HIV/AIDS or TB-related non-maternal death (p=0.017). Conclusions This study contributes further evidence on the impact of a mother’s death on child survival in a poor, rural setting with high HIV prevalence. The intersecting epidemics of maternal mortality and HIV/AIDS – especially in sub-Saharan Africa – have profound implications for maternal and child health and well-being. Such evidence can help guide public and primary health care practice and interventions. PMID:26000547

  6. Comparison of disease trends in the Ontario swine population using active practitioner-based surveillance and passive laboratory-based surveillance (2007–2009)

    PubMed Central

    Amezcua, Rocio; Pearl, David L.; Friendship, Robert M.

    2013-01-01

    A concern about emerging swine diseases led to a pilot study to determine the feasibility of an active surveillance system referred to as the Ontario Swine Veterinary-based Surveillance System (OSVS). The OSVS recorded the incidence of various syndromes and investigated potential outbreaks. However, validation of the disease patterns observed was needed. The objective of this study was to compare the disease patterns observed in the OSVS system with submission data obtained from a regional diagnostic laboratory — the Animal Health Laboratory (AHL). Higher rates of submission were reported to the OSVS compared with AHL records. However, OSVS and AHL data captured similar trends of disease. The OSVS data captured potential outbreaks that were not reflected in the laboratory data. Validation of active and passive syndromic surveillance data is necessary, and efforts should be made to integrate these types of data sources. PMID:24155479

  7. Active Surveillance for Small Renal Masses: A Review of the Aims and Preliminary Results of the DISSRM Registry.

    PubMed

    Danzig, Matthew R; Chang, Peter; Wagner, Andrew A; Allaf, Mohamad E; McKiernan, James M; Pierorazio, Phillip M

    2016-01-01

    Active surveillance is an increasingly accepted treatment modality for select patients with small renal masses. The DISSRM (delayed intervention and surveillance for small renal masses) registry is a multi-institutional, prospectively collected data repository which includes patients who select active surveillance for their small renal masses, as well as others who select immediate intervention. Preliminary results from the registry suggest oncological equivalence of active surveillance and surgical modalities in the intermediate term. Additionally, the registry provides the first published data regarding trends in renal function among patients undergoing active surveillance. On average, these patients experience a decline in renal function, and their renal functional outcomes are superior to those of patients undergoing radical nephrectomy, but do not significantly differ from those of patients undergoing partial nephrectomy.

  8. Active Surveillance for Influenza A Virus among Swine, Midwestern United States, 2009–2011

    PubMed Central

    Corzo, Cesar A.; Juleen, Kevin; Stigger-Rosser, Evelyn; Ducatez, Mariette F.; Webby, Richard J.; Lowe, James F.

    2013-01-01

    Veterinary diagnostic laboratories identify and characterize influenza A viruses primarily through passive surveillance. However, additional surveillance programs are needed. To meet this need, an active surveillance program was conducted at pig farms throughout the midwestern United States. From June 2009 through December 2011, nasal swab samples were collected monthly from among 540 groups of growing pigs and tested for influenza A virus by real-time reverse transcription PCR. Of 16,170 samples, 746 were positive for influenza A virus; of these, 18.0% were subtype H1N1, 16.0% H1N2, 7.6% H3N2, and 14.5% (H1N1)pdm09. An influenza (H3N2) and (H1N1)pdm09 virus were identified simultaneously in 8 groups. This active influenza A virus surveillance program provided quality data and increased the understanding of the current situation of circulating viruses in the midwestern US pig population. PMID:23735740

  9. Global data collection and the surveillance of active volcanoes

    USGS Publications Warehouse

    Ward, P.L.

    1990-01-01

    Data relay systems on existing earth-orbiting satellites provide an inexpensive way to collect environmental data from numerous remote sites around the world. This technology could be used effectively for fundamental monitoring of most of the world's active volcanoes. Such global monitoring would focus attention on the most dangerous volcanoes that are likely to significantly impact the geosphere and the biosphere. ?? 1990.

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

    USGS Publications Warehouse

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

    2010-01-01

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

  11. [Improving public health and hygiene surveillance activity: the Lombardy experience].

    PubMed

    Poloni, M

    2012-01-01

    In light of changing health needs, it has become a necessity to modify the instruments used in prevention, and this is thanks also to all the new preventive health professions that have been added to the existing ones. This presentation describes the results of the activities of prevention and control of occupational injuries, environmental hygiene and food and nutrition security in the Lombardy Region. PMID:22880384

  12. Active surveillance for acute flaccid paralysis in poliomyelitis high-risk areas in southern China.

    PubMed Central

    Chiba, Y.; Hikita, K.; Matuba, T.; Chosa, T.; Kyogoku, S.; Yu, J.; Wang, Z.

    2001-01-01

    OBJECTIVE: On 29 October 2000 poliomyelitis was officially declared to have been eradicated from the Western Pacific Region. This article describes the results of surveillance for cases of acute flaccid paralysis (AFP) in China during the final phase of the eradication effort. METHODS: We conducted hospital-based active surveillance in high-risk areas for poliomyelitis in 5 provinces of southern-China (Sichuan, Yunnan, Guizhou, Guangxi and Jiangxi) between 1995 and 1997 to determine the adequacy of reporting and laboratory diagnosis of cases of AFP. FINDINGS: A total of 1069 AFP cases occurring since 1993 were identified in 311 hospital visits. Less than 50% of AFP cases occurring in 1993 and 1994 had been reported by AFP surveillance, and laboratory diagnosis had been carried out on only a small proportion of these. However, improved cooperation between hospital sectors increased the rate of case reporting and laboratory diagnosis to 85% and 78%, respectively, in 1997. Despite this overall improvement, these two indicators were approximately 10-20% lower in Yunnan Province. Epidemiological analysis revealed that cases of clinical poliomyelitis accounted for as much as one-third of all AFP in 1993 and that some of these cases were clustered. Clusters were rarely observed after 1994. Active surveillance in the China-Myanmar border areas of Yunnan over 1995-96 detected 9 cross-border cases of clinical poliomyelitis, including 2 of wild poliomyelitis. Import of poliomyelitis was thus considered to have occurred frequently until 1996 in this border area of Yunnan. These data were important for the outbreak response immunization carried out in 1996 in the border prefectures of Yunnan. CONCLUSION: Our investigation confirmed a high level of AFP surveillance in poliomyelitis high-risk areas of the five provinces and provided valuable information on the interruption of wild poliovirus circulation in southern China that will be of use to countries in other regions that have

  13. Disease Surveillance and the Academic, Clinical, and Public Health Communities

    PubMed Central

    Rebmann, Catherine A.; Schuchat, Anne; Hughes, James M.

    2003-01-01

    The Emerging Infections Programs (EIPs), a population-based network involving 10 state health departments and the Centers for Disease Control and Prevention, complement and support local, regional, and national surveillance and research efforts. EIPs depend on collaboration between public health agencies and clinical and academic institutions to perform active, population-based surveillance for infectious diseases; conduct applied epidemiologic and laboratory research; implement and evaluate pilot prevention and intervention projects; and provide capacity for flexible public health response. Recent EIP work has included monitoring the impact of a new conjugate vaccine on the epidemiology of invasive pneumococcal disease, providing the evidence base used to derive new recommendations to prevent neonatal group B streptococcal disease, measuring the impact of foodborne diseases in the United States, and developing a systematic, integrated laboratory and epidemiologic method for syndrome-based surveillance. PMID:12890317

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

    PubMed

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

    2012-10-01

    Work-related accidents are complex phenomena determined by the work organization process, the dimensions of which are usually invisible to surveillance agents. The scope of this paper was a case study based on documentary evidence to analyze and compare the success of an intervention conducted at a meat processing and packaging factory, by focusing on checking health and safety norms in 1997, and incorporating ergonomic concepts in 2008. In 1997, surveillance actions focused primarily on visible risk factors. Despite fulfilling sanitation requirements, the company still had an annual accident rate of 26% in 2008, which motivated the search for a new approach. In 2008, it was seen that accidents were caused by a vicious cycle involving intense work, technical inadequacy, absenteeism and high turnover (84%) that led the company to recruit inexperienced workers. This scenario was aggravated by authoritarian management practices. The ergonomics of the activity contributed to the understanding of organizational causes -thus superseding the normative aspects of traditional surveillance - which revealed the importance of ensuring that surveillance actions for prevention are more effective. PMID:23099767

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

    PubMed

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

    2012-10-01

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

  16. [Active clinical surveillance for detection of Legionnaires' disease: implications for health care structures].

    PubMed

    Marchesi, I; Bargellini, A; Cencetti, S; Concetti, S; Marchegiano, P; Cauteruccio, L; Casolari, C; Borella, P

    2007-01-01

    In an university hospital of about 900 beds, a clinical surveillance was activated to detect cases of Legionnaires' disease in patients affected by community and/or nosocomial-acquired pneumonia. In the hospital Legionella spp was detected in the hot water distribution system and various disinfecting and control procedures were adopted to reduce contamination. Contemporary, the clinical surveillance began with the systematic detection of Legionella urinary antigen among recovered pneumonia, seroconversion as confirmation test and the collection of respiratory secretions or other biological materials to isolate the microorganism in patients positive to the urinary antigen. From September 2003 to May 2005, 486 pneumonia were followed, 98 of which considered of nosocomial origin. In total, 15 cases of community-acquired Legionnaires' disease were detected by the urinary test, whereas no cases of nosocomial origin were found. The characteristics of the detected cases are described in comparison with the other pneumonia and the surveillance cost was evaluated. The systematic clinical surveillance for Legionella infections is feasible with limit costs, allows to detect community-acquired cases otherwise unknown and to ascertain the absence/presence of nosocomial-acquired pneumonia, irrespective of the environment contamination. PMID:17937322

  17. Advancing the science for active surveillance: rationale and design for the Observational Medical Outcomes Partnership.

    PubMed

    Stang, Paul E; Ryan, Patrick B; Racoosin, Judith A; Overhage, J Marc; Hartzema, Abraham G; Reich, Christian; Welebob, Emily; Scarnecchia, Thomas; Woodcock, Janet

    2010-11-01

    The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data owners, and the pharmaceutical industry that is responding to the need to advance the science of active medical product safety surveillance by using existing observational databases. The Observational Medical Outcomes Partnership's transparent, open innovation approach is designed to systematically and empirically study critical governance, data resource, and methodological issues and their interrelationships in establishing a viable national program of active drug safety surveillance by using observational data. This article describes the governance structure, data-access model, methods-testing approach, and technology development of this effort, as well as the work that has been initiated.

  18. Advancing the science for active surveillance: rationale and design for the Observational Medical Outcomes Partnership.

    PubMed

    Stang, Paul E; Ryan, Patrick B; Racoosin, Judith A; Overhage, J Marc; Hartzema, Abraham G; Reich, Christian; Welebob, Emily; Scarnecchia, Thomas; Woodcock, Janet

    2010-11-01

    The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data owners, and the pharmaceutical industry that is responding to the need to advance the science of active medical product safety surveillance by using existing observational databases. The Observational Medical Outcomes Partnership's transparent, open innovation approach is designed to systematically and empirically study critical governance, data resource, and methodological issues and their interrelationships in establishing a viable national program of active drug safety surveillance by using observational data. This article describes the governance structure, data-access model, methods-testing approach, and technology development of this effort, as well as the work that has been initiated. PMID:21041580

  19. Decision-Making in Prostate Cancer: Active Surveillance Over Other Treatment Options.

    PubMed

    Bayliss, David; Duff, Jed; Stricker, Phil; Walker, Kim

    2016-01-01

    A qualitative-descriptive study of four patients with prostate cancer used the Cognitive-Social Health Information Processing framework to understand how and why men diagnosed with prostate cancer choose active surveillance over other treatment options. In accordance with the literature, it was found that the surgeon or general practitioner's recommendation was the most influential factor when patients are making a treatment decision. PMID:27501595

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

    PubMed

    Andreas, Darian; Tosoian, Jeffrey J; Landis, Patricia; Wolf, Sacha; Glavaris, Stephanie; Lotan, Tamara L; Schaeffer, Edward M; Sokoll, Lori J; Ross, Ashley E

    2016-07-01

    The Prostate Health Index (phi) has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer. PMID:27335798

  1. 5-alpha reductase inhibitors in patients on active surveillance: do the benefits outweigh the risk?

    PubMed

    Al Edwan, Ghazi; Fleshner, Neil

    2013-06-01

    Prostate cancer (PCa) is a slow, progressive disease. Prostate specific antigen testing, screening, and aggressive case identification has made PCa the most frequently diagnosed cancer. Concerns regarding overdiagnosis and overtreatment flourish on a large scale. In order to avoid overtreatment for those in whom therapeutic intervention is not required, active surveillance for eligible patients with the use of 5-alpha reductase can be considered a safe and a promising approach to delay the progression of the disease with minimal side effects. PMID:23579402

  2. Validation of a common data model for active safety surveillance research

    PubMed Central

    Ryan, Patrick B; Reich, Christian G; Hartzema, Abraham G; Stang, Paul E

    2011-01-01

    Objective Systematic analysis of observational medical databases for active safety surveillance is hindered by the variation in data models and coding systems. Data analysts often find robust clinical data models difficult to understand and ill suited to support their analytic approaches. Further, some models do not facilitate the computations required for systematic analysis across many interventions and outcomes for large datasets. Translating the data from these idiosyncratic data models to a common data model (CDM) could facilitate both the analysts' understanding and the suitability for large-scale systematic analysis. In addition to facilitating analysis, a suitable CDM has to faithfully represent the source observational database. Before beginning to use the Observational Medical Outcomes Partnership (OMOP) CDM and a related dictionary of standardized terminologies for a study of large-scale systematic active safety surveillance, the authors validated the model's suitability for this use by example. Validation by example To validate the OMOP CDM, the model was instantiated into a relational database, data from 10 different observational healthcare databases were loaded into separate instances, a comprehensive array of analytic methods that operate on the data model was created, and these methods were executed against the databases to measure performance. Conclusion There was acceptable representation of the data from 10 observational databases in the OMOP CDM using the standardized terminologies selected, and a range of analytic methods was developed and executed with sufficient performance to be useful for active safety surveillance. PMID:22037893

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

    PubMed

    Tukana, Andrew; Hedlefs, Robert; Gummow, Bruce

    2016-10-01

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

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

    PubMed

    Tukana, Andrew; Hedlefs, Robert; Gummow, Bruce

    2016-10-01

    There have been no surveys of the cattle population for brucellosis in the Pacific Island Countries and Territories (PICTs) for more than 15 years. This study used disease surveillance as a capacity building training tool and to examine some of the constraints that impede surveillance in PICTs. The study also developed and implemented a series of surveys for detecting antibodies to B. abortus in cattle in Fiji, Papua New Guinea, Vanuatu and the Solomon Islands contributing to OIE requirements. The findings indicated lack of funds, lack of technical capacity, shortage of veterinarians, high turnover of in-country officials and lack of awareness on the impacts of animal diseases on public health that were constraining active disease surveillance. During the development and implementation of the surveys, constraints highlighted were outdated census data on farm numbers and cattle population, lack of funds for mobilisation of officials to carry out the surveys, lack of equipment for collecting and processing samples, lack of staff knowledge on blood sampling, geographical difficulties and security in accessing farms. Some of the reasons why these were constraints are discussed with likely solutions presented. The detection surveys had the objectives of building capacity for the country officials and demonstrating freedom from brucellosis in cattle for PNG, Vanuatu and the Solomon Islands. PNG, Vanuatu and the Solomon Islands all demonstrated freedom from bovine brucellosis in the areas surveyed using the indirect ELISA test. Fiji had an outbreak of brucellosis, and the objective was to determine its distribution and prevalence on untested farms. The Muaniweni district surveyed during the training had a 95 % confidence interval for true prevalence between 1.66 and 5.45 %. The study showed that active disease surveillance could be used as a tool for training officials thus, improves surveillance capacity in resource poor countries. PMID:27522595

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

    SciTech Connect

    Not Available

    1994-04-01

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

  6. Using a combined population-based and kinetic modelling approach to assess timescales and durations of magma migration activities prior to the 1669 flank eruption of Mt. Etna

    NASA Astrophysics Data System (ADS)

    Kahl, M.; Morgan, D. J.; Viccaro, M.; Dingwell, D. B.

    2015-12-01

    The March-July eruption of Mt. Etna in 1669 is ranked as one of the most destructive and voluminous eruptions of Etna volcano in historical times. To assess threats from future eruptions, a better understanding of how and over what timescales magma moved underground prior to and during the 1669 eruption is required. We present a combined population based and kinetic modelling approach [1-2] applied to 185 olivine crystals that erupted during the 1669 eruption. By means of this approach we provide, for the first time, a dynamic picture of magma mixing and magma migration activity prior to and during the 1669 flank eruption of Etna volcano. Following the work of [3] we have studied 10 basaltic lava samples (five SET1 and five SET2 samples) that were erupted from different fissures that opened between 950 and 700 m a.s.l. Following previous work [1-2] we were able to classify different populations of olivine based on their overall core and rim compositional record and the prevalent zoning type (i.e. normal vs. reverse). The core plateau compositions of the SET1 and SET2 olivines range from Fo70 up to Fo83 with a single peak at Fo75-76. The rims differ significantly and can be distinguished into two different groups. Olivine rims from the SET1 samples are generally more evolved and range from Fo50 to Fo64 with a maximum at Fo55-57. SET2 olivine rims vary between Fo65-75 with a peak at Fo69. SET1 and SET2 olivines display normal zonation with cores at Fo75-76 and diverging rim records (Fo55-57 and Fo65-75). The diverging core and rim compositions recorded in the SET1 and SET2 olivines can be attributed to magma evolution possibly in three different magmatic environments (MEs): M1 (=Fo75-76), M2 (=Fo69) and M3 (=Fo55-57) with magma transfer and mixing amongst them. The MEs established in this study differ slightly from those identified in previous works [1-2]. We note the relative lack of olivines with Fo-rich core and rim compositions indicating a major mafic magma

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

    Ahmed, S. Sohail; Oviedo-Orta, Ernesto; Mekaru, Sumiko R.; Freifeld, Clark C.; Tougas, Gervais; Brownstein, John S.

    2015-01-01

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

  9. Epidemiology of Rett syndrome: a population-based registry.

    PubMed

    Kozinetz, C A; Skender, M L; MacNaughton, N; Almes, M J; Schultz, R J; Percy, A K; Glaze, D G

    1993-02-01

    The Texas Rett Syndrome Registry maintains the largest population-based registry of cases and potential cases of Rett syndrome in the world. The most precise estimate of the prevalence of Rett syndrome of 1 per 22800 (0.44/10000) females aged 2 through 18 years of age was generated from this Registry. In addition, the first prevalence figures for black and Hispanic female cases were estimated. Registry cases are actively ascertained from multiple sources. Registry staff identify presumptive cases from review of information provided to the Registry by the parent or guardian. Preliminary diagnostic evaluation includes standardized review of medical records and videotape of key behaviors. Diagnosis is confirmed at clinical evaluation. The active surveillance system is monitored with the two-source capture-recapture methodology and case ascertainment is projected. The 1990 prevalence estimate of Rett syndrome indicates that the syndrome occurs less frequently than previously estimated. Until a biologic marker for Rett syndrome is identified or a standard definition for an incident case of Rett syndrome is designated, the prevalence of Rett syndrome will remain a major investigative issue of its epidemiology, and the Registry will be an important, systematic mean to gather case material for clinical and laboratory studies providing the foundation for the development of preventive interventions.

  10. Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer

    PubMed Central

    Ahmed, Hashim U.; Akin, Oguz; Coleman, Jonathan A.; Crane, Sarah; Emberton, Mark; Goldenberg, Larry; Hricak, Hedvig; Kattan, Mike W.; Kurhanewicz, John; Moore, Caroline M.; Parker, Chris; Polascik, Thomas J.; Scardino, Peter; van As, Nicholas; Villers, Arnauld

    2013-01-01

    OBJECTIVE To reach consensus on key issues for clinical practice and future research in active surveillance and focal therapy in managing localized prostate cancer. PATIENTS AND METHODS A group of expert urologists, oncologists, radiologists, pathologists and computer scientists from North America and Europe met to discuss issues in patient population, interventions, comparators and outcome measures to use in both tissue-preserving strategies of active surveillance and focal therapy. Break-out sessions were formed to provide agreement or highlight areas of disagreement on individual topics which were then collated by a writing group into statements that formed the basis of this report and agreed upon by the whole Transatlantic Consensus Group. RESULTS The Transatlantic group propose that emerging diagnostic tools such as precision imaging and transperineal prostate mapping biopsy can improve prostate cancer care. These tools should be integrated into prostate cancer management and research so that better risk stratification and more effective treatment allocation can be applied. The group envisaged a process of care in which active surveillance, focal therapy, and radical treatments lie on a continuum of complementary therapies for men with a range of disease grades and burdens, rather than being applied in the mutually exclusive and competitive way they are now. CONCLUSION The changing landscape of prostate cancer epidemiology requires the medical community to re-evaluate the entire prostate cancer diagnostic and treatment pathway in order to minimize harms resulting from over-diagnosis and over-treatment. Precise risk stratification at every point in this pathway is required alongside paradigm shifts in our thinking about what constitutes cancer in the prostate. PMID:22077593

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

    PubMed Central

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

    2016-01-01

    AIM: To examine whether addition of 3T multiparametric magnetic resonance imaging (mpMRI) to an active surveillance protocol could detect aggressive or progressive prostate cancer. METHODS: Twenty-three patients with low risk disease were enrolled on this active surveillance study, all of which had Gleason score 6 or less disease. All patients had clinical assessments, including digital rectal examination and prostate specific antigen (PSA) testing, every 6 mo with annual 3T mpMRI scans with gadolinium contrast and minimum sextant prostate biopsies. The MRI images were anonymized of patient identifiers and clinical information and each scan underwent radiological review without the other results known. Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mpMRI to identify prostate cancer and progressive disease were calculated. RESULTS: During follow-up (median 24.8 mo) 11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment. Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years. All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mpMRI scans at baseline (43.5% sensitivity). Aggressive disease prediction from baseline mpMRI scans had satisfactory specificity (81.8%) but low sensitivity (58.3%). Twenty-two patients had serial mpMRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy (30% specificity and 100% sensitivity). CONCLUSION: Addition of mpMRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods. PMID:27158428

  12. Prevention of stricture recurrence following urethral internal urethrotomy: routine repeated dilations or active surveillance?

    PubMed

    Tian, Ye; Wazir, Romel; Wang, Jianzhong; Wang, Kunjie; Li, Hong

    2016-01-01

    Strictures of the urethra are the most common cause of obstructed micturition in younger men and there is frequent recurrence after initial treatment. Currently, routine repeated dilations, including intermittent self-catheterisation (ISC) are prescribed by urologists to prevent urethral stricture recurrence. There is, however, no high level evidence available supporting the effectiveness of practicing these painful techniques. Balancing efficacy, adverse effects and costs, we hypothesize that active surveillance is a better option for preventing stricture recurrence as compared with routine repeated dilations. However, well designed, adequately powered multi-center trials with comprehensive evaluation are urgently needed to confirm our hypothesis. .

  13. Prevention of stricture recurrence following urethral internal urethrotomy: routine repeated dilations or active surveillance?

    PubMed

    Tian, Ye; Wazir, Romel; Wang, Jianzhong; Wang, Kunjie; Li, Hong

    2016-01-01

    Strictures of the urethra are the most common cause of obstructed micturition in younger men and there is frequent recurrence after initial treatment. Currently, routine repeated dilations, including intermittent self-catheterisation (ISC) are prescribed by urologists to prevent urethral stricture recurrence. There is, however, no high level evidence available supporting the effectiveness of practicing these painful techniques. Balancing efficacy, adverse effects and costs, we hypothesize that active surveillance is a better option for preventing stricture recurrence as compared with routine repeated dilations. However, well designed, adequately powered multi-center trials with comprehensive evaluation are urgently needed to confirm our hypothesis. . PMID:27576888

  14. Active surveillance of sudden cardiac death in young athletes by periodic Internet searches.

    PubMed

    Choi, Kristal; Pan, Yann Ping; Pock, Michelle; Chang, Ruey-Kang R

    2013-01-01

    The authors hypothesized that prospective, systematic Internet searches could identify occurrences of sudden cardiac death (SCD) in athletes and would be useful for establishing a system of active surveillance. Weekly advanced Google searches of the Internet were conducted for cases of SCD in young athletes during a 12-month period (2007-2008). Athletes ages 11-30 years who collapsed during a game, practice, or within an hour of exercise were included in the study. Individuals with known histories of cardiac issues and events occurring outside the United States were excluded. Verification of SCD was by autopsy reports and death certificates from county coroner offices and vital record agencies. Initially, 71 events were identified. Verification for the cause of death by coroner reports was possible in 45 cases, 43 (96 %) of which were confirmed to be SCDs. A total of 69 individuals 11-30 years of age (mean 17 ± 5 years) died suddenly of cardiovascular causes while participating in 15 different organized sports and a variety of nonorganized physical activities. The most common cause of death was hypertrophic cardiomyopathy (30 %), followed by coronary artery anomalies (9 %), and myocarditis (9 %). The incidence of athlete SCD, the types of sports involved, and the cardiac causes of death in our study were comparable with those of previous reports. Readily available Internet searches have the potential to be a powerful tool for identifying occurrences of athlete SCD. An active surveillance system using Google searches followed by coroner report verification can provide important epidemiologic and clinical information.

  15. Active Surveillance of Sudden Cardiac Death in Young Athletes by Periodic Internet Searches

    PubMed Central

    Choi, Kristal; Pan, Yann Ping; Pock, Michelle; Chang, Ruey-Kang R.

    2013-01-01

    Objective We hypothesized that prospective, systematic Internet searches could identify occurrences of sudden cardiac death (SCD) in athletes, and would be useful to establish a system of active surveillance. Methods Weekly advanced Google searches of the Internet were conducted for cases of SCD in young athletes over a 12-month period (2007–8). Athletes aged 11 to 30 years who collapsed during a game, practice, or within an hour of exercise were included. Individuals with known histories of cardiac issues and events occurring outside the United States were excluded. Verification of SCD was by autopsy reports and death certificates from county coroner offices and vital record agencies. Results A total of 71 events were initially identified. Verification of the cause of death by coroner reports was possible in 45 cases, of which 43 (96%) were confirmed to be SCDs. Sixty-nine individuals, 11 to 30 years of age (mean 17 ± 5), died suddenly from cardiovascular causes while participating in 15 different organized sports and a variety of non-organized physical activities. The most common cause of death was hypertrophic cardiomyopathy (30%), followed by coronary artery anomalies (9%), and myocarditis (9%). The incidence of athlete SCD, types of sports involved, and cardiac causes of death in our study were comparable to previous reports. Conclusions Readily available Internet searches have the potential to be a powerful tool for identifying occurrences of athlete SCD. An active surveillance system using Google searches followed by coroner report verification can provide important epidemiologic and clinical information. PMID:23681420

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

    PubMed Central

    Dinger, Juergen C; Heinemann, Lothar AJ

    2006-01-01

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

  17. Operational Activations Of Maritime Surveillance Services Within The Framework Of MARISS, NEREIDS And SAGRES Projects

    NASA Astrophysics Data System (ADS)

    Margarit, G.

    2013-12-01

    This paper presents the results obtained by GMV in the maritime surveillance operational activations conducted in a set of research projects. These activations have been actively supported by users, which feedback has been essential for better understanding their needs and the most urgent requested improvements. Different domains have been evaluated from pure theoretical and scientific background (in terms of processing algorithms) up to pure logistic issues (IT configuration issues, strategies for improving system performance and avoiding bottlenecks, parallelization and back-up procedures). In all the cases, automatizing is the key work because users need almost real time operations where the interaction of human operators is minimized. In addition, automatizing permits reducing human-derived errors and provides better error tracking procedures. In the paper, different examples will be depicted and analysed. For sake of space limitation, only the most representative ones will be selected. Feedback from users will be include and analysed as well.

  18. Active and Passive Surveillance and Phylogenetic Analysis of Borrelia burgdorferi Elucidate the Process of Lyme Disease Risk Emergence in Canada

    PubMed Central

    Ogden, Nicholas H.; Bouchard, Catherine; Kurtenbach, Klaus; Margos, Gabriele; Lindsay, L. Robbin; Trudel, Louise; Nguon, Soulyvane; Milord, François

    2010-01-01

    Background Northward expansion of the tick Ixodes scapularis is driving Lyme disease (LD) emergence in Canada. Information on mechanisms involved is needed to enhance surveillance and identify where LD risk is emerging. Objectives We used passive and active surveillance and phylogeographic analysis of Borrelia burgdorferi to investigate LD risk emergence in Quebec. Methods In active surveillance, we collected ticks from the environment and from captured rodents. B. burgdorferi transmission was detected by serological analysis of rodents and by polymerase chain reaction assays of ticks. Spatiotemporal trends in passive surveillance data assisted interpretation of active surveillance. Multilocus sequence typing (MLST) of B. burgdorferi in ticks identified likely source locations of B. burgdorferi. Results In active surveillance, we found I. scapularis at 55% of sites, and we were more likely to find them at sites with a warmer climate. B. burgdorferi was identified at 13 I. scapularis–positive sites, but infection prevalence in ticks and animal hosts was low. Low infection prevalence in ticks submitted in passive surveillance after 2004—from the tick-positive regions identified in active surveillance—coincided with an exponential increase in tick submissions during this time. MLST analysis suggested recent introduction of B. burgdorferi from the northeastern United States. Conclusions These data are consistent with I. scapularis ticks dispersed from the United States by migratory birds, founding populations where the climate is warmest, and then establishment of B. burgdorferi from the United States several years after I. scapularis have established. These observations provide vital information for public health to minimize the impact of LD in Canada. PMID:20421192

  19. Confirmatory biopsy for the assessment of prostate cancer in men considering active surveillance: reference centre experience

    PubMed Central

    Bosco, Cecilia; Cozzi, Gabriele; Kinsella, Janette; Bianchi, Roberto; Acher, Peter; Challacombe, Benjamin; Popert, Rick; Brown, Christian; George, Gincy; Van Hemelrijck, Mieke; Cahill, Declan

    2016-01-01

    Objectives To evaluate how accurate a 12-core transrectal biopsy derived low-risk prostate cancer diagnosis is for an active surveillance programme by comparing the histological outcome with that from confirmatory transperineal sector biopsy. Subjects and methods The cohort included 166 men diagnosed with low volume Gleason score 3+3 prostate cancer on initial transrectal biopsy who also underwent a confirmatory biopsy. Both biopsy techniques were performed according to standard protocols and samples were taken for histopathology analysis. Subgroup analysis was performed according to disease severity at baseline to determine possible disease parameters of upgrading at confirmatory biopsy. Results After confirmatory biopsy, 34% demonstrated Gleason score upgrade, out of which 25% were Gleason score 3+4 and 8.5% primary Gleason pattern 4. Results remained consistent for the subgroup analysis and a weak positive association, but not statistically significant, between prostate specific antigen (PSA), age, and percentage of positive cores, and PCa upgrading at confirmatory biopsy was found. Conclusion In our single centre study, we found that one-third of patients had higher Gleason score at confirmatory biopsy. Furthermore 8.5% of these upgraders had a primary Gleason pattern 4. Our results together with previously published evidence highlight the need for the revision of current guidelines in prostate cancer diagnosis for the selection of men for active surveillance. PMID:27170833

  20. Vaxtracker: Active on-line surveillance for adverse events following inactivated influenza vaccine in children.

    PubMed

    Cashman, Patrick; Moberley, Sarah; Dalton, Craig; Stephenson, Jody; Elvidge, Elissa; Butler, Michelle; Durrheim, David N

    2014-09-22

    Vaxtracker is a web based survey for active post marketing surveillance of Adverse Events Following Immunisation. It is designed to efficiently monitor vaccine safety of new vaccines by early signal detection of serious adverse events. The Vaxtracker system automates contact with the parents or carers of immunised children by email and/or sms message to their smart phone. A hyperlink on the email and text messages links to a web based survey exploring adverse events following the immunisation. The Vaxtracker concept was developed during 2011 (n=21), and piloted during the 2012 (n=200) and 2013 (n=477) influenza seasons for children receiving inactivated influenza vaccine (IIV) in the Hunter New England Local Health District, New South Wales, Australia. Survey results were reviewed by surveillance staff to detect any safety signals and compare adverse event frequencies among the different influenza vaccines administered. In 2012, 57% (n=113) of the 200 participants responded to the online survey and 61% (290/477) in 2013. Vaxtracker appears to be an effective method for actively monitoring adverse events following influenza vaccination in children.

  1. Vaxtracker: Active on-line surveillance for adverse events following inactivated influenza vaccine in children.

    PubMed

    Cashman, Patrick; Moberley, Sarah; Dalton, Craig; Stephenson, Jody; Elvidge, Elissa; Butler, Michelle; Durrheim, David N

    2014-09-22

    Vaxtracker is a web based survey for active post marketing surveillance of Adverse Events Following Immunisation. It is designed to efficiently monitor vaccine safety of new vaccines by early signal detection of serious adverse events. The Vaxtracker system automates contact with the parents or carers of immunised children by email and/or sms message to their smart phone. A hyperlink on the email and text messages links to a web based survey exploring adverse events following the immunisation. The Vaxtracker concept was developed during 2011 (n=21), and piloted during the 2012 (n=200) and 2013 (n=477) influenza seasons for children receiving inactivated influenza vaccine (IIV) in the Hunter New England Local Health District, New South Wales, Australia. Survey results were reviewed by surveillance staff to detect any safety signals and compare adverse event frequencies among the different influenza vaccines administered. In 2012, 57% (n=113) of the 200 participants responded to the online survey and 61% (290/477) in 2013. Vaxtracker appears to be an effective method for actively monitoring adverse events following influenza vaccination in children. PMID:25077424

  2. [Influenza surveillance].

    PubMed

    Bednarska, Karolina; Hallmann-Szelińska, Ewelina; Kondratiuk, Katarzyna; Brydak, Lidia B

    2016-01-01

    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. PMID:27117107

  3. In vivo tumor surveillance by NK cells requires TYK2 but not TYK2 kinase activity

    PubMed Central

    Prchal-Murphy, Michaela; Witalisz-Siepracka, Agnieszka; Bednarik, Karoline T; Putz, Eva Maria; Gotthardt, Dagmar; Meissl, Katrin; Sexl, Veronika; Müller, Mathias; Strobl, Birgit

    2015-01-01

    Tyrosine kinase 2 (TYK2) is a Janus kinase (JAK) that is crucially involved in inflammation, carcinogenesis and defense against infection. The cytotoxic activity of natural killer (NK) cells in TYK2-deficient (Tyk2−/−) mice is severely reduced, although the underlying mechanisms are largely unknown. Using Tyk2−/− mice and mice expressing a kinase-inactive version of TYK2 (Tyk2K923E), we show that NK cell function is partly independent of the enzymatic activity of TYK2. Tyk2−/− and Tyk2K923E NK cells develop normally in the bone marrow, but the maturation of splenic Tyk2−/− NK cells (and to a lesser extent of Tyk2K923E NK cells) is impaired. In contrast, the production of interferon γ (IFNγ) in response to interleukin 12 (IL-12) or to stimulation through NK cell-activating receptors strictly depends on the presence of enzymatically active TYK2. The cytotoxic activity of Tyk2K923E NK cells against a range of target cells in vitro is higher than that of Tyk2−/− NK cells. Consistently, Tyk2K923E mice control the growth of NK cell-targeted tumors significantly better than TYK2-deficient mice, showing the physiological relevance of the finding. Inhibitors of TYK2's kinase activity are being developed for the treatment of inflammatory diseases and cancers, but their effects on tumor immune surveillance have not been investigated. Our finding that TYK2 has kinase-independent functions in vivo suggests that such inhibitors will leave NK cell mediated tumor surveillance largely intact and that they will be suitable for use in cancer therapy. PMID:26451322

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

    PubMed

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

    2002-08-01

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

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

    PubMed

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

    2016-04-01

    Prostate cancer remains one of the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment seem to improve survival in men with unfavourable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favourable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate-cancer-specific mortality are exceedingly low in the intermediate term (5-10 years). Such outcomes seem to be closely associated with programme-specific criteria for selection, monitoring, and intervention, suggesting that AS--like other management strategies--could be individualized based on the level of risk acceptable to patients in light of their personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis. PMID:26954332

  6. Active surveillance for prostate cancer: a narrative review of clinical guidelines.

    PubMed

    Bruinsma, Sophie M; Bangma, Chris H; Carroll, Peter R; Leapman, Michael S; Rannikko, Antti; Petrides, Neophytos; Weerakoon, Mahesha; Bokhorst, Leonard P; Roobol, Monique J

    2016-03-01

    In the past decade active surveillance (AS) of men with localized prostate cancer has become an increasingly popular management option, and a range of clinical guidelines have been published on this topic. Existing guidelines regarding AS for prostate cancer vary widely, but predominantly state that the most suitable patients for AS are those with pretreatment clinical stage T1c or T2 tumours, serum PSA levels <10 ng/ml, biopsy Gleason scores of 6 or less, a maximum of one or two tumour-positive biopsy core samples and/or a maximum of 50% of cancer per core sample. Following initiation of an AS programme, most guidelines recommend serial serum PSA measurements, digital rectal examinations and surveillance biopsies to check for and identify pathological indications of tumour progression. Definitions of disease reclassification and progression differ among guidelines and multiple criteria for initiation of definitive treatment are proposed. The variety of descriptions of criteria for clinically insignificant prostate cancer indicates a lack of consensus on optimal AS and intervention thresholds. A single set of guidelines are needed in order to reduce variations in clinical practice and to optimize clinical decision-making. To enable truly evidence-based guidelines, further research that combines existing evidence, while also gathering information from more long-term studies is needed. PMID:26813955

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

    PubMed

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

    2016-04-01

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

  8. Individuals with a family history of ESRD are a high-risk population for CKD: implications for targeted surveillance and intervention activities.

    PubMed

    McClellan, William M; Satko, Scott G; Gladstone, Elisa; Krisher, Jenna O; Narva, Andrew S; Freedman, Barry I

    2009-03-01

    Activities intended to improve the detection, treatment, and control of chronic kidney disease (CKD) should be incorporated into existing health care systems and targeted to high-risk populations to avoid redundancy and waste of resources. One high-risk population consists of first- or second-degree family members of patients with end-stage renal disease (ESRD), who are 2 to 3 times as likely to have incident ESRD, have high rates of impaired kidney function and undetected and uncontrolled high blood pressure, and are more likely to be obese. These individuals usually are unaware of their underlying CKD and may discount their own risk of ESRD. The ESRD Network 6 Family History Project shows that the ESRD Networks, which constitute a national CKD surveillance system for patients with stage 5 CKD, may be an existing resource that can be used to identify relatives of incident patients with ESRD and provide these families with information about CKD. Nationally available resources have been developed by the National Kidney Disease Education Program for use with these at-risk families. Individuals interested in population-based CKD control activities should be aware of and use these resources. PMID:19231753

  9. Situational Awareness of Influenza Activity Based on Multiple Streams of Surveillance Data Using Multivariate Dynamic Linear Model

    PubMed Central

    Lau, Eric H. Y.; Cheng, Calvin K. Y.; Ip, Dennis K. M.; Cowling, Benjamin J.

    2012-01-01

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

  10. Objectively assessed physical activity and aerobic fitness in a population-based sample of Norwegian 9- and 15-year-olds.

    PubMed

    Kolle, E; Steene-Johannessen, J; Andersen, L B; Anderssen, S A

    2010-02-01

    The present study described current physical activity, determined compliance with physical activity guidelines and assessed aerobic fitness in a nationally representative sample of 9- and 15-year-olds in Norway. In 2005-2006, 2299 children and adolescents were randomly recruited. The participation rate was 89% and 74% among the 9- and 15-year-olds, respectively. Physical activity was assessed objectively by accelerometry, and aerobic fitness was measured directly as peak oxygen uptake during a cycle ergometry test. Boys were more physically active than girls, and 9-year-olds were substantially more active than 15-year-olds. Physical activity was higher during weekdays than weekends, and 9-year-olds were most active during spring. While four out of five children met current physical activity guidelines, only half of the adolescents did. The mean (SD) values for peak VO2 were: 9-year-old boys, 48.2 (7.1) mL/min/kg; 9-year-old girls, 42.9 (6.7) mL/min/kg; and 15-year-old girls 41.1 (6.0) mL/min/kg and 15-year-old boys 51.9 (8.0) mL/min/kg. Because of the high participation rate, this study provides a good description of the physical activity and aerobic fitness in the young population. Finally, girls and adolescents seem appropriate targets when promoting physical activity in order to increase the proportion meeting the recommendations.

  11. Risk Reduction Activities for the Near-Earth Object Surveillance Satellite Project

    NASA Astrophysics Data System (ADS)

    Bédard, D.; Scott, L.; Wallace, B.; Harvey, W.

    The Near-Earth Object Surveillance Satellite (NEOSSat) is a joint project between Defence Research and Development Canada (DRDC) and the Canadian Space Agency (CSA). The NEOSSat project will develop a multi-mission micro-satellite bus that is expected to satisfy two concurrent missions: detection and tracking near-Earth asteroids (Near Earth Space Surveillance: NESS) and obtaining metric information on deep-space satellites (High Earth Orbit Surveillance System: HEOSS). The former will use NEOSSat's 15 cm diameter space telescope to discover and determine the orbits of inner Earth orbit (IEO) near-earth objects (NEOs) that cannot be easily observed from the ground. For its part, the HEOSS mission will demonstrate that a micro-satellite can be employed to produce surveillance of space (SofS) metric data of artificial earth-orbiting objects having orbital altitudes between 15,000 and 40,000 km having sufficient quality to be accepted by the U.S. Space Surveillance Network. As a risk reduction effort for the NEOSSat project, a joint satellite tracking experiment was conducted by DRDC, CSA, the University of British Columbia and Dynacon using the MOST (Microvariability Oscillations of STars) microsatellite. MOST conducts precision photometric observations of bright stars and does not usually image starfields, but in October 2005, MOST returned Canada's first space based satellite tracking observations of two GPS spacecraft. Good quality metric tracking data were obtained despite the fact MOST was not designed to image, let alone attempt satellite tracking. The observations also provided an estimate of the targeted satellite brightness and the results were consistent with ground based V-band observations. These results demonstrate the soundness of the NEOSSat concept and the feasibility of the HEOSS mission. The nature of both science missions will require the NEOSSat sensor to be pointed to a different position in the sky on average every five minutes, with a goal of

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

    PubMed

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

    2015-09-18

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

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

    PubMed

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

    2015-09-18

    A market surveillance study has been established by using different atomic spectrometric methods for the determination of selected elemental impurities of particular interest, to gain an overview about the quality of presently marketed drug products and their bulk drug substances. The limit tests were carried out with respect to the existing EMA guideline on the specification limits for residuals of metal catalysts or metal reagents. Also attention was given to the future implementation of two new chapters of the United States Pharmacopoeia (USP) stating limit concentrations of elemental impurities. The methods used for determination of metal residues were inductively coupled plasma-mass spectrometry (ICP-MS), inductively coupled plasma-optical emission spectrometry (ICP-OES), and atomic absorption spectrometry technologies (GFAAS, CVAAS, HGAAS). This article presents the development and validation of the methods used for the determination of 21 selected metals in 113 samples from drug products and their active pharmaceutical ingredients. PMID:26036232

  14. Serial Magnetic Resonance Imaging in Active Surveillance of Prostate Cancer: Incremental Value

    PubMed Central

    Felker, Ely R.; Wu, Jason; Natarajan, Shyam; Margolis, Daniel J.; Raman, Steven S.; Huang, Jiaoti; Dorey, Fred; Marks, Leonard S.

    2016-01-01

    Purpose We assessed whether changes in serial multiparametric magnetic resonance imaging can help predict the pathological progression of prostate cancer in men on active surveillance. Materials and Methods A retrospective cohort study was conducted of 49 consecutive men with Gleason 6 prostate cancer who underwent multi-parametric magnetic resonance imaging at baseline and again more than 6 months later, each followed by a targeted prostate biopsy, between January 2011 and May 2015. We evaluated whether progression on multiparametric magnetic resonance imaging (an increase in index lesion suspicion score, increase in index lesion volume or decrease in index lesion apparent diffusion coefficient) could predict pathological progression (Gleason 3 + 4 or greater on subsequent biopsy, in systematic or targeted cores). Diagnostic performance of multiparametric magnetic resonance imaging was determined with and without clinical data using a binary logistic regression model. Results The mean interval between baseline and followup multiparametric magnetic resonance imaging was 28.3 months (range 11 to 43). Pathological progression occurred in 19 patients (39%). The sensitivity, specificity, positive predictive value and negative predictive value of multiparametric magnetic resonance imaging was 37%, 90%, 69% and 70%, respectively. Area under the receiver operating characteristic curve was 0.63. A logistic regression model using clinical information (maximum cancer core length greater than 3 mm on baseline biopsy or a prostate specific antigen density greater than 0.15 ng/ml2 at followup biopsy) had an AUC of 0.87 for predicting pathological progression. The addition of serial multiparametric magnetic resonance imaging data significantly improved the AUC to 0.91 (p = 0.044). Conclusions Serial multiparametric magnetic resonance imaging adds incremental value to prostate specific antigen density and baseline cancer core length for predicting Gleason 6 upgrading in men on

  15. Can Confirmatory Biopsy be Omitted in Prostate Cancer Active Surveillance Patients with Favorable Diagnostic Features?

    PubMed Central

    Satasivam, Prassannah; Poon, Bing Ying; Ehdaie, Behfar; Vickers, Andrew J.; Eastham, James A.

    2016-01-01

    Purpose We evaluated whether initial diagnostic parameters could predict the confirmatory biopsy result in patients initiating active surveillance for prostate cancer, to determine whether some men at low risk of reclassification could be spared unnecessary biopsy. Materials and Methods The cohort included 392 men with Gleason 6 prostate cancer on initial biopsy undergoing confirmatory biopsy. We used univariate and multivariable logistic regression to assess if high-grade cancer (Gleason ≥ 7) on confirmatory biopsy could be predicted from initial diagnostic parameters (prostate-specific antigen density, magnetic resonance imaging result, percent positive cores, percent cancer in positive cores, and total tumor length). Results Median age was 62 years (IQR 56–66) and 47% of patients were found to have a dominant or focal lesion on magnetic resonance imaging. Of the 392 patients, 44 (11%) were found to have high-grade cancer on confirmatory biopsy, among whom 39 had 3+4, 1 had 4+3, 3 had Gleason 8, and 1 patient had Gleason 9 disease. All predictors were significantly associated with high-grade cancer at confirmatory biopsy on univariate analysis. However, in the multivariable model only prostate-specific antigen density and total tumor length were significantly associated (AUC of 0.85). Using this model to select patients for confirmatory biopsy would generally provide a higher net benefit than performing confirmatory biopsy in all patients, across a wide range of threshold probabilities. Conclusion If externally validated, a model based on initial diagnostic criteria could be used to avoid confirmatory biopsy in many patients initiating active surveillance. PMID:26192258

  16. Habitual Levels of Physical Activity Influence Bone Mass in 11-Year-Old Children From the United Kingdom: Findings From a Large Population-Based Cohort

    PubMed Central

    Tobias, Jon H; Steer, Colin D; Mattocks, Calum G; Riddoch, Chris; Ness, Andy R

    2009-01-01

    We examined the influence of habitual levels of physical activity on bone mass in childhood by studying the relationship between accelerometer recordings and DXA parameters in 4457 11-year-old children. Physical activity was positively related to both BMD and bone size in fully adjusted models. However, further exploration revealed that this effect on bone size was modified by fat mass. Introduction Exercise interventions have been reported to increase bone mass in children, but it is unclear whether levels of habitual physical activity also influence skeletal development. Materials and Methods We used multivariable linear regression to analyze associations between amount of moderate and vigorous physical activity (MVPA), derived from accelerometer recordings for a minimum of 3 days, and parameters obtained from total body DXA scans in 4457 11-year-old boys and girls from the Avon Longitudinal Study of Parents and Children. The influence of different activity intensities was also studied by stratification based on lower and higher accelerometer cut-points for moderate (3600 counts/minute) and vigorous (6200 counts/minute) activity, respectively. Results MVPA was positively associated with lower limb BMD and BMC adjusted for bone area (aBMC; p < 0.001, adjusted for age, sex, socio-economic factors, and height, with or without additional adjustment for lean and fat mass). MVPA was inversely related to lower limb bone area after adjusting for height and lean mass (p = 0.01), whereas a positive association was observed when fat mass was also adjusted for (p < 0.001). Lower limb BMC was positively related to MVPA after adjusting for height and lean and fat mass (p < 0.001), whereas little relationship was observed after adjusting for height and lean mass alone (p = 0.1). On multivariable regression analysis using the fully adjusted model, moderate activity exerted a stronger influence on lower limb BMC compared with light activity (light activity: 2.9 [1.2–4.7, p = 0

  17. Uncertainty induced by chest wall thickness assessment methods on lung activity estimation for plutonium and americium: a large population-based study.

    PubMed

    Broggio, D; Lechaftois, X; Franck, D

    2015-03-01

    In vivo lung counting aims at assessing the retained activity in the lungs. The calibration factor relating the measured counts to the worker's specific retained lung activity can be obtained by several means and strongly depends on the chest wall thickness. Here we compare, for 374 male nuclear workers, the activity assessed with a reference protocol, where the material equivalent chest wall thickness is known from ultrasound measurements, with two other protocols. The counting system is an array of four germanium detectors.It is found that non site-specific equations for the assessment of the chest wall thickness induce large biases in the assessment of activity. For plutonium isotopes or (241)Am the proportion of workers for whom the retained activity is within ± 10% of the reference one is smaller than 10%.The use of site-specific equations raises this proportion to 20% and 58% for plutonium and (241)Am, respectively.Finally, for the studied population, when site-specific equations are used for the chest wall thickness, the standard uncertainties for the lung activity are 42% and 12.5%, for plutonium and (241)Am, respectively. Due to the relatively large size of the studied population, these values are a relatively robust estimate of the uncertainties due to the assessment of the chest wall thickness for the current practice at this site. PMID:25517347

  18. Uncertainty induced by chest wall thickness assessment methods on lung activity estimation for plutonium and americium: a large population-based study.

    PubMed

    Broggio, D; Lechaftois, X; Franck, D

    2015-03-01

    In vivo lung counting aims at assessing the retained activity in the lungs. The calibration factor relating the measured counts to the worker's specific retained lung activity can be obtained by several means and strongly depends on the chest wall thickness. Here we compare, for 374 male nuclear workers, the activity assessed with a reference protocol, where the material equivalent chest wall thickness is known from ultrasound measurements, with two other protocols. The counting system is an array of four germanium detectors.It is found that non site-specific equations for the assessment of the chest wall thickness induce large biases in the assessment of activity. For plutonium isotopes or (241)Am the proportion of workers for whom the retained activity is within ± 10% of the reference one is smaller than 10%.The use of site-specific equations raises this proportion to 20% and 58% for plutonium and (241)Am, respectively.Finally, for the studied population, when site-specific equations are used for the chest wall thickness, the standard uncertainties for the lung activity are 42% and 12.5%, for plutonium and (241)Am, respectively. Due to the relatively large size of the studied population, these values are a relatively robust estimate of the uncertainties due to the assessment of the chest wall thickness for the current practice at this site.

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

    PubMed

    Wang, S F; Zhan, S Y

    2016-07-01

    Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China. PMID:27453095

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

    PubMed

    Wang, S F; Zhan, S Y

    2016-07-01

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

  1. Salmonella infections associated with international travel: a Foodborne Diseases Active Surveillance Network (FoodNet) study.

    PubMed

    Johnson, Laura R; Gould, L Hannah; Dunn, John R; Berkelman, Ruth; Mahon, Barbara E

    2011-09-01

    Salmonella species cause an estimated 1.2 million infections per year in the United States, making it one of the most commonly reported enteric pathogens. In addition, Salmonella is an important cause of travel-associated diarrhea and enteric fever, a systemic illness commonly associated with Salmonella serotypes Typhi and Paratyphi A. We reviewed cases of Salmonella infection reported to the Centers for Disease Control and Prevention's (CDC) Foodborne Diseases Active Surveillance Network (FoodNet), a sentinel surveillance network, from 2004 to 2008. We compared travelers with Salmonella infection to nontravelers with Salmonella infection with respect to demographics, clinical characteristics, and serotypes. Among 23,712 case-patients with known travel status, 11% had traveled internationally in the 7 days before illness. Travelers with Salmonella infection tended to be older (median age, 30 years) than nontravelers (median age, 24 years; p<0.0001), but were similar with respect to gender. The most common destinations reported were Mexico (38% of travel-associated infections), India (9%), Jamaica (7%), the Dominican Republic (4%), China (3%), and the Bahamas (2%). The proportions of travelers with Salmonella infection hospitalized and with invasive disease were inversely related to the income level of the destination (p<0.0001). The most commonly reported serotypes, regardless of travel status, were Enteritidis (19% of cases), Typhimurium (14%), Newport (9%), and Javiana (5%). Among infections caused by these four serotypes, 22%, 6%, 5%, and 4%, respectively, were associated with travel. A high index of clinical suspicion for Salmonella infection is appropriate when evaluating recent travelers, especially those who visited Africa, Asia, or Latin America.

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

    PubMed

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

    2016-01-01

    Creating environments that support all types of physical activity, including active transportation, is a public health priority (1). Public health surveillance that identifies the locations where community members walk and bicycle (i.e., engage in active transportation) can inform such efforts. Traditional population-representative active transportation surveillance incurs a considerable time lag between data collection and dissemination, and often lacks geographic specificity (2). Conversely, user-generated active transportation data from Global Positioning System (GPS)-based activity tracking devices and mobile applications can provide near real-time information, but might be subject to self-selection bias among users. CDC analyzed the association between GPS-based commuting data from a company that allows tracking of activity with a mobile application (Strava, Inc., San Francisco, California) and population-representative commuting data from the U.S. Census Bureau's American Community Survey (ACS) (3) for four U.S. cities. The level of analysis was the Census block group. The number of GPS-tracked commuters in Strava was associated with the number of ACS active commuters (Spearman's rho = 0.60), suggesting block groups were ranked similarly based on these distinct but related measurements. The correlation was higher in high population density areas. User-generated active transportation data might complement traditional surveillance systems by providing near real-time, location-specific information on where active transportation occurs. PMID:27632357

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

    PubMed

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

    2016-09-16

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

  4. HORMAD2 is essential for synapsis surveillance during meiotic prophase via the recruitment of ATR activity.

    PubMed

    Kogo, Hiroshi; Tsutsumi, Makiko; Inagaki, Hidehito; Ohye, Tamae; Kiyonari, Hiroshi; Kurahashi, Hiroki

    2012-11-01

    Meiotic chromosome segregation requires homologous pairing, synapsis and crossover recombination during meiotic prophase. The checkpoint kinase ATR has been proposed to be involved in the quality surveillance of these processes, although the underlying mechanisms remain largely unknown. In our present study, we generated mice lacking HORMAD2, a protein that localizes to unsynapsed meiotic chromosomes. We show that this Hormad2 deficiency hampers the proper recruitment of ATR activity to unsynapsed chromosomes. Male Hormad2-deficient mice are infertile due to spermatocyte loss as a result of characteristic impairment of sex body formation; an ATR- and γH2AX-enriched repressive chromatin domain is formed, but is partially dissociated from the elongated sex chromosome axes. In contrast to males, Hormad2-deficient females are fertile. However, our analysis of Hormad2/Spo11 double-mutant females shows that the oocyte number is negatively correlated with the frequency of pseudo-sex body formation in a Hormad2 gene dosage-dependent manner. This result suggests that the elimination of Spo11-deficient asynaptic oocytes is associated with the HORMAD2-dependent pseudo-sex body formation that is likely initiated by local concentration of ATR activity in the absence of double-strand breaks. Our results thus show a HORMAD2-dependent quality control mechanism that recognizes unsynapsis and recruits ATR activity during mammalian meiosis. PMID:23039116

  5. Enhancing active surveillance of prostate cancer: the potential of exercise medicine.

    PubMed

    Galvão, Daniel A; Taaffe, Dennis R; Spry, Nigel; Gardiner, Robert A; Taylor, Renea; Risbridger, Gail P; Frydenberg, Mark; Hill, Michelle; Chambers, Suzanne K; Stricker, Phillip; Shannon, Tom; Hayne, Dickon; Zopf, Eva; Newton, Robert U

    2016-05-01

    Active surveillance (AS) is a strategy for the management of patients with low-risk, localized prostate cancer, in which men undergo regular monitoring of serum PSA levels and tumour characteristics, using multiparametric MRI and repeat biopsy sampling, to identify signs of disease progression. This strategy reduces overtreatment of clinically insignificant disease while also preserving opportunities for curative therapy in patients whose disease progresses. Preliminary studies of lifestyle interventions involving basic exercise advice have indicated that exercise reduces the numbers of patients undergoing active treatment, as well as modulating the biological processes involved in tumour progression. Therefore, preliminary evidence suggests that lifestyle and/or exercise interventions might have therapeutic potential in this growing population of men with prostate cancer. However, several important issues remain unclear: the exact value of different types of lifestyle and exercise medicine interventions during AS; the biological mechanisms of exercise in delaying disease progression; and the influence of the anxieties and distress created by having a diagnosis of cancer without then receiving active treatment. Future studies are required to confirm and expand these findings and determine the relative contributions of each lifestyle component to specific end points and patient outcomes during AS. PMID:26954333

  6. Habitual Levels of High, But Not Moderate or Low, Impact Activity Are Positively Related to Hip BMD and Geometry: Results From a Population-Based Study of Adolescents

    PubMed Central

    Deere, Kevin; Sayers, Adrian; Rittweger, Jörn; Tobias, Jon H

    2012-01-01

    Whether a certain level of impact needs to be exceeded for physical activity (PA) to benefit bone accrual is currently unclear. To examine this question, we performed a cross-sectional analysis between PA and hip BMD in 724 adolescents (292 boys, mean 17.7 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC), partitioning outputs from a Newtest accelerometer into six different impact bands. Counts within 2.1 to 3.1g, 3.1 to 4.2g, 4.2 to 5.1g, and >5.1g bands were positively related to femoral neck (FN) BMD, in boys and girls combined, in our minimally adjusted model including age, height, and sex (0.5–1.1g: beta = −0.007, p = 0.8; 1.1–2.1g: beta = 0.003, p = 0.9; 2.1–3.1g: beta = 0.042, p = 0.08; 3.1–4.2g: beta = 0.058, p = 0.009; 4.2–5.1g: beta = 0.070, p = 0.001; >5.1g: beta = 0.080, p < 0.001) (beta = SD change per doubling in activity). Similar positive relationships were observed between high-impact bands and BMD at other hip sites (ward's triangle, total hip), hip structure indices derived by hip structural analysis of dual-energy X-ray absorptiometry (DXA) scans (FN width, cross-sectional area, cortical thickness), and predicted strength (cross-sectional moment of inertia). In analyses where adjacent bands were combined and then adjusted for other impacts, high impacts (>4.2g) were positively related to FN BMD, whereas, if anything, moderate (2.1–4.2g) and low impacts (0.5–2.1g) were inversely related (low: beta = −0.052, p = 0.2; medium: beta = −0.058, p = 0.2; high: beta = 0.137, p < 0.001). Though slightly attenuated, the positive association between PA and FN BMD, confined to high impacts, was still observed after adjustment for fat mass, lean mass, and socioeconomic position (high: beta = 0.096, p = 0.016). These results suggest that PA associated with impacts >4.2g, such as jumping and running (which further studies suggested requires speeds >10 km/h) is positively related to hip BMD and structure in adolescents

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

    PubMed

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

    2013-10-01

    Despite its confirmed establishment in neighboring Greece and Bulgaria, the presence of the Oriental invasive species Stegomyia albopicta (Skuse) (=Aedes albopictus) has never been confirmed in Turkey. Active surveillance for this container-breeding species was carried out using oviposition traps at 15 discrete sites in the towns of Ipsala (n=8 sites), Kesan (n=5) (Edirne District), and Malkara (n=2) (Tekirdag District) in the Thrace region of northwestern Turkey, from May 23 through November 10, 2011. Eggs collected were reared to the fourth larval instar and adult stages where possible to facilitate integrated morphological and molecular species identification. DNA barcodes (658 bp of the mitochondrial cytochrome c oxidase I [COI] gene) were compared with all four potentially invasive Stegomyia species: St. aegypti, St. albopicta, St. cretina, and St. japonica. Sequences generated for samples collected in Thrace Region were herein confirmed as St. albopicta, the first record of this vector species in Turkey. Eggs of St. albopicta were detected in two discrete localities: (1) In the grounds of a restaurant in Kesan (in week 36), and (2) in the customs area of the Turkish-Greek border at Ipsala (in weeks 32 and 38). Multiple detection of St. albopicta eggs indicates the possible establishment of the species in northwestern Turkey. Finding this important disease vector has implications for public health and requires the implementation of active vector monitoring programs and targeted vector suppression strategies to limit the spread of this invasive vector species in Turkey. PMID:23808976

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

    PubMed

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

    2013-10-01

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

  9. Designing normative messages about active surveillance for men with localized prostate cancer

    PubMed Central

    Volk, Robert J.; Kinsman, Gianna T.; Le, Yen-Chi L.; Swank, Paul; Blumenthal-Barby, Jennifer; McFall, Stephanie L.; Byrd, Theresa L.; Mullen, Patricia Dolan; Cantor, Scott B.

    2016-01-01

    Active surveillance (AS) is increasingly recognized as a reasonable option for men with low-risk, localized prostate cancer, yet few men who might benefit from conservative management receive it. We examined the acceptability of normative messages about AS as a management option for patients with low-risk prostate cancer. Men with a diagnosis of localized prostate cancer who were recruited through prostate cancer support organizations completed a web-based survey (N=331). They rated messages about AS for believability, accuracy, and importance for men to hear when making treatment decisions. The message “you don’t have to panic…you have time to think about your options” was perceived as believable, accurate, and important by over 80% of the survivors. In contrast, messages about trust in the AS protocol and “knowing in plenty of time” if treatment is needed were rated as accurate by only about 36% of respondents. For AS to be viewed as a reasonable alternative, men will need reassurance that following an AS protocol is likely to allow time for curative treatment if the cancer progresses. PMID:26066011

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

    PubMed

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

    2014-07-01

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

  11. Active surveillance for the management of localized prostate cancer: Guideline recommendations

    PubMed Central

    Morash, Chris; Tey, Rovena; Agbassi, Chika; Klotz, Laurence; McGowan, Tom; Srigley, John; Evans, Andrew

    2015-01-01

    Introduction: The objective is to provide guidance on the role of active surveillance (AS) as a management strategy for low-risk prostate cancer patients and to ensure that AS is offered to appropriate patients assessed by a standardized protocol. Prostate cancer is often a slowly progressive or sometimes non-progressive indolent disease diagnosed at an early stage with localized tumours that are unlikely to cause morbidity or death. Standard active treatments for prostate cancer include radiotherapy (RT) or radical prostatectomy (RP), but the harms from over diagnosis and overtreatment are of a significant concern. AS is increasingly being considered as a management strategy to avoid or delay the potential harms caused by unnecessary radical treatment. Methods: A literature search of MEDLINE, EMBASE, the Cochrane library, guideline databases and relevant meeting proceedings was performed and a systematic review of identified evidence was synthesized to make recommendations relating to the role of AS in the management of localized prostate cancer. Results: No exiting guidelines or reviews were suitable for use in the synthesis of evidence for the recommendations, but 59 reports of primary studies were identified. Due to studies being either non-comparative or heterogeneous, pooled meta-analyses were not conducted. Conclusion: The working group concluded that for patients with low-risk (Gleason score ≤6) localized prostate cancer, AS is the preferred disease management strategy. Active treatment (RP or RT) is appropriate for patients with intermediate-risk (Gleason score 7) localized prostate cancer. For select patients with low-volume Gleason 3+4=7 localized prostate cancer, AS can be considered. PMID:26225165

  12. A Multi-Institutional Evaluation of Active Surveillance for Low-Risk Prostate Cancer

    PubMed Central

    Eggener, Scott E; Mueller, Alex; Berglund, Ryan K; Ayyathurai, Raj; Soloway, Cindy; Soloway, Mark S; Abouassaly, Robert; Klein, Eric A; Jones, Steven J; Zappavigna, Chris; Goldenberg, Larry; Scardino, Peter T; Eastham, James A; Guillonneau, Bertrand

    2014-01-01

    Purpose For select men with low-risk prostate cancer, active surveillance (AS) is more often being considered a management strategy. In a multicenter retrospective study we evaluated the actuarial rates and predictors of remaining on AS, incidence of cancer progression, and pathologic findings of delayed radical prostatectomy. Methods A cohort of 262 men from four institutions met the following inclusion criteria: age ≤75, PSA ≤10 ng/ml, clinical stage T1-T2a, biopsy Gleason sum ≤6, ≤3 positive cores at diagnostic biopsy, a repeat biopsy before AS, and no treatment for six months following the repeat biopsy. AS started on the date of the second biopsy. Actuarial rates of remaining on AS were calculated and univariate Cox regression used to assess predictors of discontinuing AS. Results With a median follow-up of 29 months 43 patients ultimately received active treatment. The two and five-year probabilities of remaining on AS were 91% and 75%, respectively. Patients with cancer on the second biopsy (HR=2.23; 95% CI: 1.23–4.06; p=0.007) and a higher number of cancerous cores from the two biopsies combined (p=0.002) were more likely to undergo treatment. Age, PSA, clinical stage, prostate volume, and number of total biopsy cores sampled were not predictive of outcome. One patient developed skeletal metastases 38 months after starting AS. Of the 43 patients undergoing delayed treatment, 41 (95%) are without disease progression at a median of 23 months following treatment. Conclusions With a median follow-up of 29 months, AS for select patients appears to be safe and associated with a low risk of systemic progression. Cancer at restaging biopsy and a higher total number of cancerous cores are associated with a lower likelihood of remaining on AS. A restaging biopsy should be strongly considered to finalize eligibility for AS. PMID:19233410

  13. HIV surveillance in complex emergencies.

    PubMed

    Salama, P; Dondero, T J

    2001-04-01

    Many studies have shown a positive association between both migration and temporary expatriation and HIV risk. This association is likely to be similar or even more pronounced for forced migrants. In general, HIV transmission in host-migrant or host-forced-migrant interactions depends on the maturity of the HIV epidemic in both the host and the migrant population, the relative seroprevalence of HIV in the host and the migrant population, the prevalence of other sexually transmitted infections (STIs) that may facilitate transmission, and the level of sexual interaction between the two communities. Complex emergencies are the major cause of mass population movement today. In complex emergencies, additional factors such as sexual interaction between forced-migrant populations and the military; sexual violence; increasing commercial sex work; psychological trauma; and disruption of preventive and curative health services may increase the risk for HIV transmission. Despite recent success in preventing HIV infection in stable populations in selected developing countries, internally displaced persons and refugees (or forced migrants) have not been systematically included in HIV surveillance systems, nor consequently in prevention activities. Standard surveillance systems that rely on functioning health services may not provide useful data in many complex emergency settings. Secondary sources can provide some information in these settings. Little attempt has been made, however, to develop innovative HIV surveillance systems in countries affected by complex emergencies. Consequently, data on the HIV epidemic in these countries are scarce and HIV prevention programs are either not implemented or interventions are not effectively targeted. Second generation surveillance methods such as cross-sectional, population-based surveys can provide rapid information on HIV, STIs, and sexual behavior. The risks for stigmatization and breaches of confidentiality must be recognized

  14. A bacterial cyclic dinucleotide activates the cytosolic surveillance pathway and mediates innate resistance to tuberculosis

    PubMed Central

    Dey, Bappaditya; Dey, Ruchi Jain; Cheung, Laurene S.; Pokkali, Supriya; Guo, Haidan; Lee, Jong-Hee; Bishai, William R.

    2015-01-01

    Detection of cyclic-di-adenosine monophosphate (c-di-AMP), a bacterial second messenger, by the host cytoplasmic surveillance pathway (CSP) is known to elicit Type I interferon responses critical for antimicrobial defense1–3. However, the mechanisms and role of c-di-AMP signaling in Mycobacterium tuberculosis virulence remain unclear. Here we show that resistance to tuberculosis (TB) requires CSP-mediated detection of c-di-AMP produced by M. tuberculosis and that levels of c-di-AMP modulate the fate of infection. We found that a di-adenylate cyclase (disA or dacA)4 over-expressing M. tuberculosis strain that secretes excess c-di-AMP activates the interferon regulatory factor (IRF) pathway with enhanced levels of IFN-β, elicits increased macrophage autophagy, and exhibits significant attenuation in mice. We show that c-di-AMP-mediated IFN-β induction during M. tuberculosis infection requires stimulator of interferon genes (STING)5-signaling. We observed that c-di-AMP induction of IFN-β is independent of the cytosolic nucleic acid receptor cyclic-GMP-AMP (cGAMP) synthase (cGAS)6–7, but cGAS nevertheless contributes substantially to the overall IFN-β response to M. tuberculosis infection. In sum, our results reveal c-di-AMP to be a key mycobacterial pathogen associated molecular pattern (PAMP) driving host Type I IFN responses and autophagy. These findings suggest that modulating the levels of this small molecule may lead to novel immunotherapeutic strategies against TB. PMID:25730264

  15. Role for 11C-choline PET in active surveillance of prostate cancer

    PubMed Central

    Boychak, Oleksandr; Vos, Larissa; Makis, William; Buteau, Francois-Alexandre; Pervez, Nadeem; Parliament, Matthew; McEwan, Alexander J.B.; Usmani, Nawaid

    2015-01-01

    Introduction: Active surveillance (AS) is an increasingly popular management strategy for men diagnosed with low-risk indolent prostate cancer. Current tests (prostate-specific antigen [PSA], clinical staging, and prostate biopsies) to monitor indolent disease lack accuracy. 11C-choline positron emission tomography (PET) has excellent detection rates in local and distant recurrence of prostate cancer. We examine 11C-choline PET for identifying aggressive prostate cancer warranting treatment in the AS setting. Methods: In total, 24 patients on AS had clinical assessment and PSA testing every 6 months and 11C-choline PET and prostate biopsies annually. The sensitivity and specificity to identify prostate cancer and progressive disease (PD) were calculated for each 11C-choline PET scan. Results: In total, 62 biopsy-paired, serial 11C-choline PET scans were analyzed using a series of standard uptake value-maximum (SUVmax) cut-off thresholds. During follow-up (mean 25.3 months), 11 of the 24 low-risk prostate cancer patients developed PD and received definitive treatment. The prostate cancer detection rate with 11C-choline PET had moderate sensitivity (72.1%), but low specificity (45.0%). PD prediction from baseline 11C-choline PET had satisfactory sensitivity (81.8%), but low specificity (38.5%). The addition of clinical parameters to the baseline 11C-choline PET improved specificity (69.2%), with a slight reduction in sensitivity (72.7%) for PD prediction. Conclusions: Addition of 11C-choline PET imaging during AS may help to identify aggressive disease earlier than traditional methods. However, 11C-choline PET alone has low specificity due to overlap of SUV values with benign pathologies. Triaging low-risk prostate cancer patients into AS versus therapy will require further optimization of PET protocols or consideration of alternative strategies (i.e., magnetic resonance imaging, biomarkers). PMID:25844108

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

    PubMed Central

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

    2016-01-01

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

  17. Analysis of expanded criteria to select candidates for active surveillance of low-risk prostate cancer

    PubMed Central

    Jo, Jung Ki; Lee, Han Sol; Lee, Young Ik; Lee, Sang Eun; Hong, Sung Kyu

    2015-01-01

    We aimed to analyze the value of each criterion for clinically insignificant prostate cancer (PCa) in the selection of men for active surveillance (AS) of low-risk PCa. We identified 532 men who were treated with radical prostatectomy from 2006 to 2013 who met 4 or all 5 of the criteria for clinically insignificant PCa (clinical stage ≤ T1, prostate specific antigen [PSA] density ≤ 0.15, biopsy Gleason score ≤ 6, number of positive biopsy cores ≤ 2, and no core with > 50% involvement) and analyzed their pathologic and biochemical outcomes. Patients who met all 5 criteria for clinically insignificant PCa were designated as group A (n = 172), and those who met 4 of 5 criteria were designated as group B (n = 360). The association of each criterion with adverse pathologic features was assessed via logistic regression analyses. Comparison of group A and B and also logistic regression analyses showed that PSA density > 0.15 ng ml−1 and high (≥7) biopsy Gleason score were associated with adverse pathologic features. Higher (> T1c) clinical stage was not associated with any adverse pathologic features. Although ≤ 3 positive cores were not associated with any adverse pathology, ≥4 positive cores were associated with higher risk of extracapsular extension. Among potential candidates for AS, PSA density > 0.15 ng ml−1 and biopsy Gleason score > 6 pose significantly higher risks of harboring more aggressive disease. The eligibility criteria for AS may be expanded to include men with clinical stage T2 tumor and 3 positive cores. PMID:25432498

  18. Control of dengue fever with active surveillance and the use of insecticidal aerosol cans.

    PubMed

    Osaka, K; Ha, D Q; Sakakihara, Y; Khiem, H B; Umenai, T

    1999-09-01

    An interventional study was conducted in southern Vietnam to evaluate the feasibility and effectiveness of a new approach to control dengue fever. The approach consisted of active surveillance of dengue patients and the use of insecticidal aerosol cans. Febrile patients were tested serologically at local health centers and insecticidal aerosol cans were given to the family and employed in the neighborhood of dengue patients instead of ultra low volume (ULV) fogging with insecticide. The number of dengue IgM antibody positive cases among febrile patients, the number of reported dengue hemorrhagic fever patients and the total cost were compared in the 2 approaches (prompt focal ULV fogging and the use of insecticidal aerosol cans) in 1997. The aerosol cans were employed 5 times (in June, July, August, September and October) in the study area. ULV fogging in the control area was performed 5 times (in March, May, July, August and September). Twenty-two serologically positive cases were found in the study area which was about half that found in the control area (43 cases). A total of 16 dengue hemorrhagic fever patients was reported in the study area and 43 in the control area. Compared with the reported numbers of the previous year, the reduction rate in the number of dengue hemorrhagic fever cases was 71.4% in the study area and 51.7% in the control area. There were statistically significant differences in the morbidity of dengue fever and the reduction rate of dengue hemorrhagic fever. The cost of the insecticidal aerosol cans was US$393 which was lower than the cost of US$553 for ULV fogging. The findings suggest that insecticidal aerosol cans were effective and feasible for dengue fever control.

  19. Analysis of expanded criteria to select candidates for active surveillance of low-risk prostate cancer.

    PubMed

    Jo, Jung Ki; Lee, Han Sol; Lee, Young Ik; Lee, Sang Eun; Hong, Sung Kyu

    2015-01-01

    We aimed to analyze the value of each criterion for clinically insignificant prostate cancer (PCa) in the selection of men for active surveillance (AS) of low-risk PCa. We identified 532 men who were treated with radical prostatectomy from 2006 to 2013 who met 4 or all 5 of the criteria for clinically insignificant PCa (clinical stage ≤ T1, prostate specific antigen [PSA] density ≤ 0.15, biopsy Gleason score ≤ 6, number of positive biopsy cores ≤ 2, and no core with > 50% involvement) and analyzed their pathologic and biochemical outcomes. Patients who met all 5 criteria for clinically insignificant PCa were designated as group A (n = 172), and those who met 4 of 5 criteria were designated as group B (n = 360). The association of each criterion with adverse pathologic features was assessed via logistic regression analyses. Comparison of group A and B and also logistic regression analyses showed that PSA density > 0.15 ng ml-1 and high (≥7) biopsy Gleason score were associated with adverse pathologic features. Higher (> T1c) clinical stage was not associated with any adverse pathologic features. Although ≤ 3 positive cores were not associated with any adverse pathology, ≥4 positive cores were associated with higher risk of extracapsular extension. Among potential candidates for AS, PSA density > 0.15 ng ml-1 and biopsy Gleason score > 6 pose significantly higher risks of harboring more aggressive disease. The eligibility criteria for AS may be expanded to include men with clinical stage T2 tumor and 3 positive cores.

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

    PubMed

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

    2015-11-01

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

  1. Annual summary report on the surveillance and maintenance activities for the Oak Rige National Laboratory Environmental Restoration Program for fiscal year 1995

    SciTech Connect

    1995-11-01

    This Annual Summary Report on the Surveillance and Maintenance Activities for the Oak Ridge National Laboratory Environmental Restoration Program for Fiscal Year 1995 was prepared to communicate the accomplishments of the Program during fiscal year 1995. This work was performed under work breakdown structure element 1.4.12.6.1.14.20 (activity data sheet 3314, ``Remedial Action Surveillance and Maintenance``). Publication of this document meets the Life Cycle Baseline milestone date of November 30, 1995. This document provides the accomplishments for both the Remedial Action and Decontamination and Decommissioning Surveillance and Maintenance programs.

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

    SciTech Connect

    1996-11-01

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

  3. Vaccine Safety Surveillance Systems: Critical Elements and Lessons Learned in the Development of the US Vaccine Safety Datalink’s Rapid Cycle Analysis Capabilities

    PubMed Central

    Davis, Robert L.

    2013-01-01

    Since the late 1990s, there have been tremendous strides made in improving the capacity for carrying out routine active surveillance of new vaccines in the United States. These strides have led to new surveillance systems that are now in place. Some of the critical elements that are part of successful vaccine or drug safety surveillance systems include their use of (i) longitudinal data from a discrete enumerated population base, (ii) frequent, routine transfers of small amounts of data that are easy to collect and collate, (iii) avoidance of mission creep, (iv) statistical capabilities, (v) creation of an “industrialized process” approach and (vi) political safe harbor. PMID:24300403

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

    PubMed Central

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

    2013-01-01

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

  5. Methods for observational post-licensure medical product safety surveillance.

    PubMed

    Nelson, Jennifer C; Cook, Andrea J; Yu, Onchee; Zhao, Shanshan; Jackson, Lisa A; Psaty, Bruce M

    2015-04-01

    Post-licensure medical product safety surveillance is important for detecting adverse events potentially not identified pre-licensure. Historically, post-licensure safety monitoring has been accomplished using passive reporting systems and by conducting formal Phase IV randomized trials or large epidemiological studies, also known as safety surveillance or pharmacovigilance studies. However, crucial gaps in the safety evidence base provided by these approaches have led to high profile product withdrawals and growing public concern about unknown health risks associated with licensed products. To address the limitations of existing surveillance systems and to facilitate more accurate and rapid detection of safety problems, new systems involving active surveillance of large, population-based cohorts using observational health care databases are being developed. In this article, we review common statistical methods that have been employed previously for post-licensure safety monitoring, including data mining and sequential hypothesis testing, and assess which methods may be promising for potential use within this newly proposed prospective observational cohort monitoring framework. We discuss gaps in existing approaches and identify areas where methodological development is needed to improve the success of safety surveillance efforts in this setting.

  6. Mathematical model of tumor-immune surveillance.

    PubMed

    Mahasa, Khaphetsi Joseph; Ouifki, Rachid; Eladdadi, Amina; Pillis, Lisette de

    2016-09-01

    We present a novel mathematical model involving various immune cell populations and tumor cell populations. The model describes how tumor cells evolve and survive the brief encounter with the immune system mediated by natural killer (NK) cells and the activated CD8(+) cytotoxic T lymphocytes (CTLs). The model is composed of ordinary differential equations describing the interactions between these important immune lymphocytes and various tumor cell populations. Based on up-to-date knowledge of immune evasion and rational considerations, the model is designed to illustrate how tumors evade both arms of host immunity (i.e. innate and adaptive immunity). The model predicts that (a) an influx of an external source of NK cells might play a crucial role in enhancing NK-cell immune surveillance; (b) the host immune system alone is not fully effective against progression of tumor cells; (c) the development of immunoresistance by tumor cells is inevitable in tumor immune surveillance. Our model also supports the importance of infiltrating NK cells in tumor immune surveillance, which can be enhanced by NK cell-based immunotherapeutic approaches.

  7. Evaluating, Migrating, and Consolidating Databases and Applications for Long-Term Surveillance and Maintenance Activities at the Rocky Flats Site

    SciTech Connect

    Surovchak, S.; Marutzky, S.; Thompson, B.; Miller, K.; Labonte, E.

    2006-07-01

    The U.S. Department of Energy (DOE) Office of Legacy Management (LM) is assuming responsibilities for long-term surveillance and maintenance (LTS and M) activities at the Rocky Flats Environmental Technology Site (RFETS) during fiscal year 2006. During the transition, LM is consolidating databases and applications that support these various functions into a few applications which will streamline future management and retrieval of data. This paper discussed the process of evaluating, migrating, and consolidating these databases and applications for LTS and M activities and provides lessons learned that will benefit future transitions. (authors)

  8. Using Electronic Health Record Data to Identify Prostate Cancer Patients That May Qualify for Active Surveillance

    PubMed Central

    Knighton, Andrew J.; Belnap, Tom; Brunisholz, Kim; Huynh, Kelly; Bishoff, Jay T.

    2016-01-01

    Introduction: The introduction of the protein-specific antigen (PSA) test in care means that prostate cancer (PCa) is being detected earlier and more frequently. The result of increased screening using PSA, digital rectal examination and awareness of prostate was an increase in the number of men with low risk cancers. Active surveillance has become a viable alternative to immediate treatment with surgery, radiation and other forms of localized treatment. Evidence suggests that there is no significant difference in mortality rates between AS and surgery. In addition, patients may potentially delay other complications associated with surgery, radiation or deprivation therapy. Methods: This quality improvement study using a delivery system science framework describes the electronic identification of AS candidates given an evidence-based identification criteria based upon national guidelines and clinical judgement. The study population (n=649) was drawn from health records of all patients who received a prostate biopsy (n=1731) at Intermountain Healthcare from 1/1/2013 to 12/31/2014. Automated and manual abstraction was performed. Receiver operating characteristic (ROC) analysis was used to compare AS-eligible patients to the actual treatment received to identify potential care improvement opportunities. Among those with complete data, 24.7% of this population (n=160) met “AS-eligible” criteria. 39.1% of the population had not received surgery, radiation or androgen deprivation therapy and were considered as being treated using an AS approach. 9% of AS-eligible patients did not receive AS; 27% of patients who did not meet AS-eligible criteria received AS. Estimated guideline adherence measured using area under the curve was 0.70 (95% CI: 0.66–0.73). Modest variation in criteria parameters for identifying AS-eligible patients did not significantly change estimated adherence levels. Conclusion: Implementation of evidence-based criteria for detection of AS

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

    PubMed Central

    Pearce, Shane M; Wang, Chi-Hsiung E; Victorson, David E; Helfand, Brian T; Novakovic, Kristian R; Brendler, Charles B; Albaugh, Jeffrey A

    2015-01-01

    Aim The aim of this study was to examine the relationship between sexual dysfunction, repeat biopsies and other demographic and clinical factors in men on active surveillance (AS). Methods Patient-reported outcomes (PROs) measures were administered at enrollment and every 6 months to assess quality of life (QOL), psychosocial and urological health outcomes. Using mixed-effects models, we examined the impact of repeat biopsies, total number of cores taken, anxiety, age, and comorbidity on sexual function over the first 24 months of enrolling in AS. Main Outcome Measures PROs included the Expanded Prostate Cancer Index Composite-26 (EPIC-26) Sexual Function (SF) subscale, the American Urological Association-Symptom Index (AUA-SI), and the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Results At enrollment (n = 195), mean age was 66.5 ± 6.8 with a mean EPIC-26 SF score of 61.4 ± 30.4. EPIC-26 SF scores steadily decreased to 53.9 ± 30.7 at 24 months (P < 0.01). MAX-PC scores also progressively decreased over time (P = 0.03). Factors associated with lower EPIC-26 scores over time included age, unemployed status, diabetes, coronary artery disease, and hypertension (all P < 0.05). Higher prostate-specific antigen (PSA) was associated with a more rapid decline in EPIC-26 SF over time (P = 0.03). In multivariable analysis, age, diabetes, and PSA × time interaction remained significant predictors of diminished sexual function. Anxiety, number of biopsies, and total cores taken did not predict sexual dysfunction or change over time in our cohort. Conclusions Men on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA-SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS. PMID:26468379

  10. Multidrug-resistant nontyphoidal Salmonella in New York state's foodborne diseases active surveillance network counties.

    PubMed

    Solghan, Suzanne M; Dumas, Nellie B; Root, Timothy P; Quinlan, Tammy M; Armstrong, Leeanna R; Spina, Nancy L; Zansky, Shelley M

    2010-02-01

    With the emergence of multidrug-resistant nontyphoidal (NT) Salmonella, knowledge of resistance patterns is critical for appropriate presumptive treatment. This report describes the prevalence and trends of NT Salmonella antimicrobial susceptibility within the New York State (NYS) Foodborne Diseases Active Surveillance Network (FoodNet). The NYS Department of Health, Wadsworth Center Public Health Laboratory tested all Salmonella isolates from the NYS FoodNet catchment area between May 2003 and December 2007 for antimicrobial susceptibility to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, tetracycline, nalidixic acid, and ciprofloxacin. Isolate susceptibility results were linked to their corresponding demographic and clinical data and analyzed. Multidrug-resistant isolates were defined as resistant to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline (R-type ACSSuT). Antimicrobial susceptibility for 2189 FoodNet cases (98.5% of total cases) showed 79.6% pansusceptible, 6.9% R-type ACSSuT, and 13.5% resistant to at least one antimicrobial agent but not R-type ACSSuT. Four (0.2%) isolates were resistant to ciprofloxacin. From 2004 to 2007, cases with R-type ACSSuT significantly decreased from 8.7% (37/424) to 4.8% (24/499) (p < 0.01). Serotypes with the highest proportion of R-type ACSSuT included Salmonella Typhimurium 17.9% (79/444), and Salmonella Newport 29.1% (51/175). Among Salmonella Typhimurium isolates, over 40% of the African-American cases (19/46) had R-type ACSSuT isolates, compared with 15.7% of the Caucasian cases (58/369) (p < 0.01). R-type ACSSuT Salmonella Typhimurium cases were hospitalized (41.8%) more frequently than pansusceptible Salmonella Typhimurium cases (24.9%), after controlling for age (p < 0.05). Length of hospitalization was not significantly different. Although R-type ACSSuT NT Salmonella has decreased since 2003 within the NYS FoodNet catchment area, monitoring resistance patterns remains important

  11. High Risk of Under-Grading and -Staging in Prostate Cancer Patients Eligible for Active Surveillance

    PubMed Central

    Heidegger, Isabel; Skradski, Viktor; Steiner, Eberhard; Klocker, Helmut; Pichler, Renate; Pircher, Andreas; Horninger, Wolfgang; Bektic, Jasmin

    2015-01-01

    Background Active surveillance (AS) is increasingly offered to patients with low risk prostate cancer. The present study was conducted to evaluate the risk of tumor under-grading and -staging for AS eligibility. Moreover, we analyzed possible biomarkers for predicting more unfavorable final tumor histology. Methods 197 patients who underwent radical prostatectomy (RPE) but would have met the EAU (European Association of Urology) criteria for AS (PSA<10 ng/ml, biopsy GS ≤6, ≤2 cancer-positive biopsy cores with ≤50% of tumor in any core and clinical stage ≤T2a) were included in the study. These AS inclusion parameters were correlated to the final histology of the RPE specimens. The impact of preoperative PSA level (low PSA ≤4 ng/ml vs. intermediate PSA of >4–10 ng/ml), PSA density (<15 vs. ≥ 15 ng/ml) and the number of positive biopsy cores (1 vs. 2 positive cores) on predicting upgrading and final adverse histology of the RPE specimens was analyzed in uni- and multivariate analyses. Moreover, clinical courses of undergraded patients were assessed. Results In our patient cohort 41.1% were found under-graded in the biopsy (final histology 40.1% GS7, 1% GS8). Preoperative PSA levels, PSA density or the number of positive cores were not predictive for worse final pathological findings including GS >6, extraprostatic extension and positive resection margin (R1) or correlated significantly with up-grading and/or extraprostatic extension in a multivariate model. Only R1 resections were predictable by combining intermediate PSA levels with two positive biopsy cores (p = 0.004). Sub-analyses showed that the number of biopsy cores (10 vs. 15 biopsy cores) had no influence on above mentioned results on predicting biopsy undergrading. Clinical courses of patients showed that 19.9% of patients had a biochemical relapse after RPE, among all of them were undergraded in the initial biopsy. Conclusion In summary, this study shows that a multitude of patients fulfilling

  12. Using Electronic Health Record Data to Identify Prostate Cancer Patients That May Qualify for Active Surveillance

    PubMed Central

    Knighton, Andrew J.; Belnap, Tom; Brunisholz, Kim; Huynh, Kelly; Bishoff, Jay T.

    2016-01-01

    Introduction: The introduction of the protein-specific antigen (PSA) test in care means that prostate cancer (PCa) is being detected earlier and more frequently. The result of increased screening using PSA, digital rectal examination and awareness of prostate was an increase in the number of men with low risk cancers. Active surveillance has become a viable alternative to immediate treatment with surgery, radiation and other forms of localized treatment. Evidence suggests that there is no significant difference in mortality rates between AS and surgery. In addition, patients may potentially delay other complications associated with surgery, radiation or deprivation therapy. Methods: This quality improvement study using a delivery system science framework describes the electronic identification of AS candidates given an evidence-based identification criteria based upon national guidelines and clinical judgement. The study population (n=649) was drawn from health records of all patients who received a prostate biopsy (n=1731) at Intermountain Healthcare from 1/1/2013 to 12/31/2014. Automated and manual abstraction was performed. Receiver operating characteristic (ROC) analysis was used to compare AS-eligible patients to the actual treatment received to identify potential care improvement opportunities. Among those with complete data, 24.7% of this population (n=160) met “AS-eligible” criteria. 39.1% of the population had not received surgery, radiation or androgen deprivation therapy and were considered as being treated using an AS approach. 9% of AS-eligible patients did not receive AS; 27% of patients who did not meet AS-eligible criteria received AS. Estimated guideline adherence measured using area under the curve was 0.70 (95% CI: 0.66–0.73). Modest variation in criteria parameters for identifying AS-eligible patients did not significantly change estimated adherence levels. Conclusion: Implementation of evidence-based criteria for detection of AS

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

    PubMed Central

    Foresti, Gian Luca; Micheloni, Christian; Piciarelli, Claudio; Snidaro, Lauro

    2009-01-01

    The paper is a survey of the main technological aspects of advanced visual-based surveillance systems. A brief historical view of such systems from the origins to nowadays is given together with a short description of the main research projects in Italy on surveillance applications in the last twenty years. The paper then describes the main characteristics of an advanced visual sensor network that (a) directly processes locally acquired digital data, (b) automatically modifies intrinsic (focus, iris) and extrinsic (pan, tilt, zoom) parameters to increase the quality of acquired data and (c) automatically selects the best subset of sensors in order to monitor a given moving object in the observed environment. PMID:22574011

  14. Case-based Surveillance of Influenza Hospitalizations during 2004–2008, Colorado, USA

    PubMed Central

    Proff, Rosemary; Lezotte, Dennis; Nyquist, Ann-Christine

    2009-01-01

    Colorado became the first state to make laboratory-confirmed influenza-associated hospitalizations a case-based reportable condition in 2004. We summarized surveillance for influenza hospitalizations in Colorado during the first 4 recorded influenza seasons (2004–2008). We highlight the similarities and differences among influenza seasons; no 2 seasons were entirely the same. The 2005–06 influenza season had 2 distinct waves of activity (types A and B), the 2006–07 season was substantially later and milder, and 2007–08 had substantially greater influenza B activity. The case-based surveillance for influenza hospitalizations provides information regarding the time course of seasonal influenza activity, reported case numbers and population-based rates by age group and influenza virus type, and a measure of relative severity. Influenza hospitalization surveillance provides more information about seasonal influenza activity than any other surveillance measure (e.g., surveillance for influenza-like illness) currently in widespread use among states. More states should consider implementing case-based surveillance for influenza hospitalizations. PMID:19523287

  15. Activity and function recognition for moving and static objects in urban environments from wide-area persistent surveillance inputs

    NASA Astrophysics Data System (ADS)

    Levchuk, Georgiy; Bobick, Aaron; Jones, Eric

    2010-04-01

    In this paper, we describe results from experimental analysis of a model designed to recognize activities and functions of moving and static objects from low-resolution wide-area video inputs. Our model is based on representing the activities and functions using three variables: (i) time; (ii) space; and (iii) structures. The activity and function recognition is achieved by imposing lexical, syntactic, and semantic constraints on the lower-level event sequences. In the reported research, we have evaluated the utility and sensitivity of several algorithms derived from natural language processing and pattern recognition domains. We achieved high recognition accuracy for a wide range of activity and function types in the experiments using Electro-Optical (EO) imagery collected by Wide Area Airborne Surveillance (WAAS) platform.

  16. [Surveillance and active search of suspected cases of hemorrhagic dengue in Ribeirão Preto, São Paulo].

    PubMed

    Pontes, R J; Ruffino-Netto, A

    1997-03-01

    A clinical-epidemiological case study was carried out to evaluate a surveillance and active search system for suspect cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) during a dengue epidemic in the Ribeirão Preto municipality, State of São Paulo, Brazil, between November 1990 and March 199. This was the first dengue epidemic ever recorded in this region. Although dengue is a growing public health problem in Brazil, and DHF/DSS has been reported to be evolving in the Americas, health officials have shown a passive attitude towards the disease, partly due to lack of experience. Reporting dengue occurrences, both of isolated cases and of epidemics, is essential to reduce mortality. The data analyzed were collected through the official epidemiological surveillance system during the 1990-1991 epidemic. Out of 2,521 confirmed cases of dengue, 34 cases of febrile acute illness with hemorrhagic manifestations were identified as possible cases of DHF/DSS, as well as two deaths associated to dengue. From these 36 cases, 12 cases were confirmed by laboratory exams as dengue with hemorrhagic manifestations. Examinations of clinical and laboratory data, and results of the autopsies suggested that the two deaths were cases of primary DHF/DSS. The difficulty of the health system in establishing the clinical suspicion of DHF/DSS was confirmed in the study. This resulted in delayed and inadequate clinical procedure. The present study also confirmed the need for a permanent active epidemiological surveillance system for the early identification of DHF/DSS suspect cases thus enabling quick and adequate control actions.

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

    PubMed

    Berner, Włodzimierz

    2009-01-01

    At the time of the Second Republic of Poland, in March 1922, the city of Vilnius together with the Vilnius Region was incorporated into Poland. Sanitary and health negligence was one of the main problems of the city. The genesis of that situation dates back to the 120-year national bondage, when the city was under the Russian rule. Since 1915 it was occupied by the German invader, and from January to April 1919 it belonged to Soviet Russia. The legacy left by this epoch concerned bad housing conditions, problems with removal of impurities, scarcity of fresh water supply, uneven and dirt roads, which along with other bionegative factors resulted in dissemination of contagious diseases and occurrence of other health risks. In Vilnius of the interwar period, similarly to other big cities in Poland, sanitary surveillances played a significant role in controlling acute contagious diseases, inspecting sanitary conditions of living quarters, service outlets, industrial plants, sites of production and selling food articles, as well as surveillance of food. Municipal doctors supervised the work of sanitary inspectors in each sanitary office. PMID:19899609

  18. Active surveillance for Vibrio cholerae O1 and vibriophages in sewage water as a potential tool to predict cholera outbreaks.

    PubMed Central

    Madico, G; Checkley, W; Gilman, R H; Bravo, N; Cabrera, L; Calderon, M; Ceballos, A

    1996-01-01

    The 1991 Peruvian cholera epidemic has thus far been responsible for 600,000 cholera cases in Peru. In an attempt to design a cholera surveillance program in the capital city of Lima, weekly sewage samples were collected between August 1993 and May 1996 and examined for the presence of Vibrio cholerae O1 bacteria and V. cholerae O1 bacteriophages (i.e., vibriophages). During the 144 weeks of surveillance, 6,323 cases of clinically defined cholera were recorded in Lima. We arbitrarily defined an outbreak as five or more reported cases of cholera in a week. The odds of having an outbreak were 7.6 times greater when V. cholerae O1 was present in sewage water during the four previous weeks compared with when it was not (P < 0.001). Furthermore, the odds of having an outbreak increased as the number of V. cholerae O1 isolations during the previous 4 weeks increased (P < 0.001). The odds of having an outbreak were 2.4 times greater when vibriophages were present in sewage water during the four previous weeks compared with when they were not, but this increase was not statistically significant (P = 0.15). The odds of having an outbreak increased as the number of vibriophage isolations during the previous 4 weeks increased (P < 0.05). The signaling of a potential cholera outbreak 1 month in advance may be a valuable tool for implementation of preventive measures. In Peru, active surveillance for V. cholerae O1 and possibly vibriophages in sewage water appears to be a feasible and effective means of predicting and outbreak of cholera. PMID:8940432

  19. Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science).

    PubMed

    Kumanyika, Shiriki K; Obarzanek, Eva; Stettler, Nicolas; Bell, Ronny; Field, Alison E; Fortmann, Stephen P; Franklin, Barry A; Gillman, Matthew W; Lewis, Cora E; Poston, Walker Carlos; Stevens, June; Hong, Yuling

    2008-07-22

    Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted.

  20. [TV, overweight and nutritional surveillance. Ads content, food intake and physical activity].

    PubMed

    Spagnoli, T D; Bioletti, L; Bo, C; Formigatti, M

    2003-01-01

    The relationship between television viewing and obesity in children and adults was examined in a large number of cross-sectional epidemiological studies. Some randomised, controlled trials confirmed the evidence that television viewing is a cause of increased body fatness. It seems of utility in nutritional surveillance to esteem time spent by children and adults in television watching and to evaluate ads contents and food preferences suggested by them. This editorial shows a two-years long analysis of food commercials broadcasted by the main Italian TV networks; food ads targeted on children, housewives and sport fans were evaluated; the relationship between television viewing, commercials and food intake or global lifestyle was investigated in a Piedmont's population (from Northern Italy). School projects aimed to reduce television viewing represent a promising strategy for preventing childhood obesity. PMID:14969315

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

    NASA Technical Reports Server (NTRS)

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

    1980-01-01

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

  2. Effect of Culture-Independent Diagnostic Tests on Future Emerging Infections Program Surveillance.

    PubMed

    Langley, Gayle; Besser, John; Iwamoto, Martha; Lessa, Fernanda C; Cronquist, Alicia; Skoff, Tami H; Chaves, Sandra; Boxrud, Dave; Pinner, Robert W; Harrison, Lee H

    2015-09-01

    The Centers for Disease Control and Prevention Emerging Infections Program (EIP) network conducts population-based surveillance for pathogens of public health importance. Central to obtaining estimates of disease burden and tracking microbiological characteristics of these infections is accurate laboratory detection of pathogens. The use of culture-independent diagnostic tests (CIDTs) in clinical settings presents both opportunities and challenges to EIP surveillance. Because CIDTs offer better sensitivity than culture and are relatively easy to perform, their use could potentially improve estimates of disease burden. However, changes in clinical testing practices, use of tests with different sensitivities and specificities, and changes to case definitions make it challenging to monitor trends. Isolates are still needed for performing strain typing, antimicrobial resistance testing, and identifying other molecular characteristics of organisms. In this article, we outline current and future EIP activities to address issues associated with adoption of CIDTs, which may apply to other public health surveillance. PMID:26291736

  3. Intimate Partner Violence and Depression in a Population-Based Sample of Women: Can Social Support Help?

    ERIC Educational Resources Information Center

    Mburia-Mwalili, Adel; Clements-Nolle, Kristen; Lee, William; Shadley, Meri; Wei Yang,

    2010-01-01

    Data from the 2006 Behavioral Risk Factor Surveillance System in Nevada was analyzed to determine whether social support is independently associated with depression in a population-based sample of women with a history of intimate partner violence (IPV). More than a quarter (27%) of the women who were randomly chosen to participate in the survey…

  4. Increasing incidence of Barrett's oesophagus: a population-based study.

    PubMed

    Coleman, Helen G; Bhat, Shivaram; Murray, Liam J; McManus, Damian; Gavin, Anna T; Johnston, Brian T

    2011-09-01

    Oesophageal adenocarcinoma, a highly fatal cancer, has risen in incidence in Western societies, but it is unclear whether this is due to increasing incidence of its pre-cursor condition, Barrett's oesophagus (BO) or whether the proportion of BO patients undergoing malignant progression has increased in the face of unchanged BO incidence. Data from population-based studies of BO incidence is limited, with equivocal results to date difficult to distinguish from changes in endoscopic practices. The aim of this study was to assess population trends in Barrett's oesophagus (BO) diagnoses in relation to endoscopy and biopsy rates over a 13 year period. The Northern Ireland Barrett's oesophagus Register (NIBR) is a population-based register of all 9,329 adults diagnosed with columnar epithelium of the oesophagus in Northern Ireland between 1993 and 2005, of whom 58.3% were male. European age-standardised annual BO incidence rates were calculated per 100,000 of the population, per 100 endoscopies and per 100 endoscopies including an oesophageal biopsy. Average annual BO incidence rates rose by 159% during the study period, increasing from 23.9/100,000 during 1993-1997 to 62.0/100,000 during 2002-2005. This elevation far exceeded corresponding increases in rates of endoscopies and oesophageal biopsies being conducted. BO incidence increased most markedly in individuals aged < 60 years, and most notably amongst males aged < 40 years. This study points towards a true increase in the incidence of BO which would appear to be most marked in young males. These findings have significant implications for future rates of oesophageal adenocarcinoma and surveillance programmes.

  5. Extremely high prevalence of multidrug resistant tuberculosis in Murmansk, Russia: a population-based study.

    PubMed

    Mäkinen, J; Marjamäki, M; Haanperä-Heikkinen, M; Marttila, H; Endourova, L B; Presnova, S E; Mathys, V; Bifani, P; Ruohonen, R; Viljanen, M K; Soini, H

    2011-09-01

    Drug resistance and molecular epidemiology of tuberculosis (TB) in the Murmansk region was investigated in a 2-year, population-based surveillance of the civilian population. During 2003 and 2004, isolates from all culture-positive cases were collected (n = 1,226). Prevalence of multi-drug resistance (MDR) was extremely high, as 114 out of 439 new cases (26.0%), and 574 out of 787 previously treated cases (72.9%) were resistant to at least isoniazid (INH) and rifampin (RIF). Spoligotyping of the primary MDR-TB isolates revealed that most isolates grouped to the Beijing SIT1 genotype (n = 91, 79.8%). Isolates of this genotype were further analyzed by IS6110 RFLP. Sequencing of gene targets associated with INH and RIF resistance further showed that the MDR-TB strains are highly homogeneous as 78% of the MDR, SIT1 strains had the same resistance-conferring mutations. The genetic homogeneity of the MDR-TB strains indicates that they are actively transmitted in Murmansk. PMID:21394425

  6. Using semantic technologies and the OSU ontology for modelling context and activities in multi-sensory surveillance systems

    NASA Astrophysics Data System (ADS)

    Gómez A, Héctor F.; Martínez-Tomás, Rafael; Arias Tapia, Susana A.; Rincón Zamorano, Mariano

    2014-04-01

    Automatic systems that monitor human behaviour for detecting security problems are a challenge today. Previously, our group defined the Horus framework, which is a modular architecture for the integration of multi-sensor monitoring stages. In this work, structure and technologies required for high-level semantic stages of Horus are proposed, and the associated methodological principles established with the aim of recognising specific behaviours and situations. Our methodology distinguishes three semantic levels of events: low level (compromised with sensors), medium level (compromised with context), and high level (target behaviours). The ontology for surveillance and ubiquitous computing has been used to integrate ontologies from specific domains and together with semantic technologies have facilitated the modelling and implementation of scenes and situations by reusing components. A home context and a supermarket context were modelled following this approach, where three suspicious activities were monitored via different virtual sensors. The experiments demonstrate that our proposals facilitate the rapid prototyping of this kind of systems.

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

    PubMed

    Ringelstein-Harlev, Shimrit; Fineman, Riva

    2014-10-01

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

  8. Using a representative sample of workers for constructing the SUMEX French general population based job-exposure matrix

    PubMed Central

    Gueguen, A; Goldberg, M; Bonenfant, S; Martin, J

    2004-01-01

    Background: Job-exposure matrices (JEMs) applicable to the general population are usually constructed by using only the expertise of specialists. Aims: To construct a population based JEM for chemical agents from data based on a sample of French workers for surveillance purposes. Methods: The SUMEX job-exposure matrix was constructed from data collected via a cross-sectional survey of a sample of French workers representative of the main economic sectors through the SUMER-94 survey: 1205 occupational physicians questioned 48 156 workers, and inventoried exposure to 102 chemicals. The companies' economic activities and the workers' occupations were coded according to the official French nomenclatures. A segmentation method was used to construct job groups that were homogeneous for exposure prevalence to chemical agents. The matrix was constructed in two stages: consolidation of occupations according to exposure prevalence; and establishment of exposure indices based on individual data from all the subjects in the sample. Results: An agent specific matrix could be constructed for 80 of the chemicals. The quality of the classification obtained for each was variable: globally, the performance of the method was better for less specific and therefore more easy to assess agents, and for exposures specific to certain occupations. Conclusions: Software has been developed to enable the SUMEX matrix to be used by occupational physicians and other prevention professionals responsible for surveillance of the health of the workforce in France. PMID:15208374

  9. Poliomyelitis surveillance.

    PubMed

    1998-04-01

    Attention to the 4 poliomyelitis surveillance indicators approved by the International Commission for the Certification of Poliomyelitis Eradication (ICCPE) in 1994, has deteriorated since the Americas were declared free from wild poliovirus. The indicators are designed to measure the performance of health services and the sensitivity of the surveillance system to detect wild poliovirus circulating in the community. Sensitivity is the most important characteristic of the poliomyelitis surveillance system and it is measured by the rate of acute flaccid paralysis (AFP) per 100,000 under age 15 years. As of March 21, 1998, the AFP rate reached its lowest level yet in the Americas, with only Bolivia, Chile, and Honduras presenting an acceptable rate (the analysis does not include the US and Canada). The other countries in the Caribbean region and Latin America had rates under 1 AFP case per 100,000 children under age 15. It follows that only 6% of children under age 15 in the region are currently protected by a sensitive AFP surveillance system. Poliovirus may therefore be circulating silently in the region. Renewed attention must be given to the AFP surveillance indicators. PMID:12321498

  10. A population-based study of large granular lymphocyte leukemia

    PubMed Central

    Shah, M V; Hook, C C; Call, T G; Go, R S

    2016-01-01

    Large granular lymphocyte (LGL) leukemia is a lymphoproliferative disorder of cytotoxic cells. T-cell LGL (T-LGL) leukemia is characterized by accumulation of cytotoxic T cells in blood and infiltration of the bone marrow, liver or spleen. Population-based studies have not been reported in LGL leukemia. We present clinical characteristics, natural history and risk factors for poor survival in patients with LGL leukemia using the Surveillance, Epidemiology, and End Results Program (SEER) and the United States National Cancer Data Base (NCDB). LGL leukemia is an extremely rare disease with the incidence of 0.2 cases per 1 000 000 individuals. The median age at diagnosis was 66.5 years with females likely to be diagnosed at 3 years earlier compared with males. Analysis of patient-level data using NCDB (n=978) showed that 45% patients with T-LGL leukemia required some form of systemic treatment at the time of diagnosis. T-LGL leukemia patients have reduced survival compared with general population, with a median overall survival of 9 years. Multivariate analysis showed that age >60 years at the time of diagnosis and the presence of significant comorbidities were independent predictors of poor survival. PMID:27494824

  11. Surveillance of antibiotic resistance

    PubMed Central

    Johnson, Alan P.

    2015-01-01

    Surveillance involves the collection and analysis of data for the detection and monitoring of threats to public health. Surveillance should also inform as to the epidemiology of the threat and its burden in the population. A further key component of surveillance is the timely feedback of data to stakeholders with a view to generating action aimed at reducing or preventing the public health threat being monitored. Surveillance of antibiotic resistance involves the collection of antibiotic susceptibility test results undertaken by microbiology laboratories on bacteria isolated from clinical samples sent for investigation. Correlation of these data with demographic and clinical data for the patient populations from whom the pathogens were isolated gives insight into the underlying epidemiology and facilitates the formulation of rational interventions aimed at reducing the burden of resistance. This article describes a range of surveillance activities that have been undertaken in the UK over a number of years, together with current interventions being implemented. These activities are not only of national importance but form part of the international response to the global threat posed by antibiotic resistance. PMID:25918439

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

    PubMed

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

    2012-06-01

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

  13. Seroepidemiology and active surveillance of dengue fever/dengue haemorrhagic fever in Delhi.

    PubMed

    Kurukumbi, M; Wali, J P; Broor, S; Aggarwal, P; Seth, P; Handa, R; Dhar, L; Vajapayee, M

    2001-03-01

    The aims of the present study were to carry out surveillance for dengue virus infection in adults with short-duration fever, and serological study of dengue virus infection in persons without fever. Patients were divided into two groups. Group 1 included patients above 12 years of age with fever of 2-12 days duration without any apparent cause. Of these, patients who presented with fever for 2-5 days were included for virus isolation (group 1a) while those who presented within 6-12 days of the onset of fever were included for the dengue-specific IgM serology (group 1b). Group 2 included a sample of population belonging to all age groups but without pyrexia and blood was collected for dengue-specific IgG serology. Twenty-six patients were enrolled in group 1a over a period of 4 months (September to December, 1997). Of these, DEN1 was isolated in 5 cases. Group 1b included 182 patients, out of which 34 (18.68%) were positive for dengue-specific IgM antibodies. Significantly, all the positive cases were detected during the months of September to November. Retro-orbital pain was present in a significantly more number of IgM-positive cases as compared to IgM-negative cases. Group 2 included 125 cases without fever. The overall positivity for dengue-specific IgG antibodies was 77.6%, with the highest positivity of 100% in the age group of 31-40 years. It was concluded that dengue virus infection is endemic in and around Delhi with peak incidence between September and Novemver. The prevalent serotype during September and December 1997 was DEN1. Since previous epidemic of DHF was due to DEN2 type, isolation of DEN1 serotype indicates changes of another epidemic of DHF due to DEN1 serotype. The stresses the urgent need for implementation of measures to control the transmission of dengue infection.

  14. Incidence of foodborne illnesses reported by the foodborne diseases active surveillance network (FoodNet)-1997. FoodNet Working Group.

    PubMed

    Wallace, D J; Van Gilder, T; Shallow, S; Fiorentino, T; Segler, S D; Smith, K E; Shiferaw, B; Etzel, R; Garthright, W E; Angulo, F J

    2000-06-01

    In 1997, the Foodborne Diseases Active Surveillance Program (FoodNet) conducted active surveillance for culture-confirmed cases of Campylobacter, Escherichia coli O157, Listeria, Salmonella, Shigella, Vibrio, Yersinia, Cyclospora, and Cryptosporidium in five Emerging Infections Program sites. FoodNet is a collaborative effort of the Centers for Disease Control and Prevention's National Center for Infectious Diseases, the United States Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration's Center for Food Safety and Applied Nutrition, and state health departments in California, Connecticut, Georgia, Minnesota, and Oregon. The population under active surveillance for foodborne infections was approximately 16.1 million persons or roughly 6% of the United States Population. Through weekly or monthly contact with all clinical laboratories in these sites, 8,576 total isolations were recorded: 2,205 cases of salmonellosis, 1,273 cases of shigellosis, 468 cases of cryptosporidiosis, 340 of E. coli O157:H7 infections, 139 of yersiniosis, 77 of listeriosis, 51 of Vibrio infections, and 49 of cyclosporiasis. Results from 1997 demonstrate that while there are regional and seasonal differences in reported incidence rates of certain bacterial and parasitic diseases, and that some pathogens showed a change in incidence from 1996, the overall incidence of illness caused by pathogens under surveillance was stable. More data over more years are needed to assess if observed variations in incidence reflect yearly fluctuations or true changes in the burden of foodborne illness.

  15. Surveillance metrics sensitivity study.

    SciTech Connect

    Hamada, Michael S.; Bierbaum, Rene Lynn; Robertson, Alix A.

    2011-09-01

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

  16. Surveillance Metrics Sensitivity Study

    SciTech Connect

    Bierbaum, R; Hamada, M; Robertson, A

    2011-11-01

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

  17. FY 1994 annual summary report of the surveillance and maintenance activities for the Oak Ridge National Laboratory Environmental Restoration Program

    SciTech Connect

    Not Available

    1994-11-01

    The Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Surveillance and Maintenance (S and M) Program was initiated to manage former waste management and environmental research sites contaminated with radioactive materials and/or hazardous chemicals. The S and M Program is responsible for managing designated sites/facilities from the end of their operating lives until final disposition or site stabilization. To effectively manage and perform the various S and M Program responsibilities, five summary-level work breakdown structure (WBS) elements have been established: S and M Preliminary Investigations, Special Projects, Routine S and M, Inactive Groundwater Wells, and Project Management. Routine S and M activities were conducted as scheduled throughout fiscal years (FY) 1994 at applicable inactive waste management (WM) and other contaminated areas. Overall, the ER S and M Program maintains 47 facilities, performs vegetation maintenance on approximately 230 acres, maintains 54 inactive tanks, and provides overall site management on over 700 acres. In addition to the routine S and M activities, detailed site inspections were conducted at established frequencies on appropriate sites in the ER S and M Program. This document provides a summary of the FY 1994 ORNL ER S and M Program accomplishments.

  18. [Worker's Health Surveillance

    PubMed

    Machado

    1997-01-01

    This paper is part of a broader discussion on the need for more in-depth study of workers' health surveillance practices, which are most often developed empirically, without well-defined theoretical or technical foundations. The paper presents a concept of surveillance in workers' health as a fulcrum for actions in the relationship between the work process and health. It emphasizes the exposure-based perspective involved in the epidemiological approach. Risk situations and effects are placed in spatial and technological context. The model provides an interdisciplinary approach with a technological, social, and epidemiological basis in a three-dimensional structure. A matrix for planning actions in workers' health surveillance is also presented, focusing on the connections between effects, risks, territory, and activities.

  19. [Worker's Health Surveillance

    PubMed

    Machado

    1997-01-01

    This paper is part of a broader discussion on the need for more in-depth study of workers' health surveillance practices, which are most often developed empirically, without well-defined theoretical or technical foundations. The paper presents a concept of surveillance in workers' health as a fulcrum for actions in the relationship between the work process and health. It emphasizes the exposure-based perspective involved in the epidemiological approach. Risk situations and effects are placed in spatial and technological context. The model provides an interdisciplinary approach with a technological, social, and epidemiological basis in a three-dimensional structure. A matrix for planning actions in workers' health surveillance is also presented, focusing on the connections between effects, risks, territory, and activities. PMID:10886936

  20. A survey of Canadian urologists’ opinions and prescribing patterns of testosterone replacement therapy in men on active surveillance for low-risk prostate cancer

    PubMed Central

    Millar, Adam C.; Elterman, Dean S.; Goldenberg, Larry; Van Asseldonk, Brandon; Curtis, Ashley; Jarvi, Keith

    2016-01-01

    Introduction: Attitudes regarding the safety of testosterone replacement therapy (TRT) in hypogonadal men with prostate cancer (PCa) have changed over the past few years with the emergence of case studies suggesting a low risk of cancer progression and a better understanding of the interaction of different levels of androgen with prostate cellular metabolism. This new view has the potential to change clinical practice. Methods: Active members of the Canadian Urological Association were surveyed about their opinions on the safety of TRT in men with low-risk PCa, as well as their current prescribing habits. Results: Of 57 responding urologists, 86% actively prescribe TRT in men with testosterone deficiency syndrome (TDS), 93% are involved in the treatment of men with PCa, and 95% offer active surveillance as a management option for low-grade/low-stage disease. Furthermore, 65% stated that they would offer TRT to men with TDS who were on active surveillance for PCa and 63% believed that TRT did not increase the risk of progression of PCa in these men. In terms of treatment methods, 96% believed TRT was safe for men who have undergone radical prostatectomy, while a smaller number felt it was safe for patients who have undergone brachytherapy (86%) or external beam radiation (84%). Despite these figures, only 35% of the surveyed physicians had ever offered TRT for men on active surveillance and only 42% actually had men in their practice who were taking testosterone while on active surveillance. Conclusions: The discrepancy between urologists’ beliefs about the safety of TRT and their clinical practice patterns may be due to multiple factors, such as hesitation in recommending treatment in real-life practice, low numbers of eligible patients, absence of screening for testosterone deficiency in patients on active surveillance, and patient preference or fears. Furthermore, the difference in perceived safety in men treated by radical prostatectomy vs. radiation therapy

  1. N-nitroso-N-ethylurea activates DNA damage surveillance pathways and induces transformation in mammalian cells

    PubMed Central

    2014-01-01

    Background The DNA damage checkpoint signalling cascade sense damaged DNA and coordinates cell cycle arrest, DNA repair, and/or apoptosis. However, it is still not well understood how the signalling system differentiates between different kinds of DNA damage. N-nitroso-N-ethylurea (NEU), a DNA ethylating agent induces both transversions and transition mutations. Methods Immunoblot and comet assays were performed to detect DNA breaks and activation of the canonical checkpoint signalling kinases following NEU damage upto 2 hours. To investigate whether mismatch repair played a role in checkpoint activation, knock-down studies were performed while flow cytometry analysis was done to understand whether the activation of the checkpoint kinases was cell cycle phase specific. Finally, breast epithelial cells were grown as 3-dimensional spheroid cultures to study whether NEU can induce upregulation of vimentin as well as disrupt cell polarity of the breast acini, thus causing transformation of epithelial cells in culture. Results We report a novel finding that NEU causes activation of major checkpoint signalling kinases, Chk1 and Chk2. This activation is temporally controlled with Chk2 activation preceding Chk1 phosphorylation, and absence of cross talk between the two parallel signalling pathways, ATM and ATR. Damage caused by NEU leads to the temporal formation of both double strand and single strand breaks. Activation of checkpoints following NEU damage is cell cycle phase dependent wherein Chk2 is primarily activated during G2-M phase whilst in S phase, there is immediate Chk1 phosphorylation and delayed Chk2 response. Surprisingly, the mismatch repair system does not play a role in checkpoint activation, at doses and duration of NEU used in the experiments. Interestingly, NEU caused disruption of the well-formed polarised spheroid archithecture and upregulation of vimentin in three-dimensional breast acini cultures of non-malignant breast epithelial cells upon NEU

  2. Air surveillance

    SciTech Connect

    Patton, G.W.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  3. Automatic association of chats and video tracks for activity learning and recognition in aerial video surveillance.

    PubMed

    Hammoud, Riad I; Sahin, Cem S; Blasch, Erik P; Rhodes, Bradley J; Wang, Tao

    2014-01-01

    We describe two advanced video analysis techniques, including video-indexed by voice annotations (VIVA) and multi-media indexing and explorer (MINER). VIVA utilizes analyst call-outs (ACOs) in the form of chat messages (voice-to-text) to associate labels with video target tracks, to designate spatial-temporal activity boundaries and to augment video tracking in challenging scenarios. Challenging scenarios include low-resolution sensors, moving targets and target trajectories obscured by natural and man-made clutter. MINER includes: (1) a fusion of graphical track and text data using probabilistic methods; (2) an activity pattern learning framework to support querying an index of activities of interest (AOIs) and targets of interest (TOIs) by movement type and geolocation; and (3) a user interface to support streaming multi-intelligence data processing. We also present an activity pattern learning framework that uses the multi-source associated data as training to index a large archive of full-motion videos (FMV). VIVA and MINER examples are demonstrated for wide aerial/overhead imagery over common data sets affording an improvement in tracking from video data alone, leading to 84% detection with modest misdetection/false alarm results due to the complexity of the scenario. The novel use of ACOs and chat Sensors 2014, 14 19844 messages in video tracking paves the way for user interaction, correction and preparation of situation awareness reports. PMID:25340453

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

    PubMed Central

    Hammoud, Riad I.; Sahin, Cem S.; Blasch, Erik P.; Rhodes, Bradley J.; Wang, Tao

    2014-01-01

    We describe two advanced video analysis techniques, including video-indexed by voice annotations (VIVA) and multi-media indexing and explorer (MINER). VIVA utilizes analyst call-outs (ACOs) in the form of chat messages (voice-to-text) to associate labels with video target tracks, to designate spatial-temporal activity boundaries and to augment video tracking in challenging scenarios. Challenging scenarios include low-resolution sensors, moving targets and target trajectories obscured by natural and man-made clutter. MINER includes: (1) a fusion of graphical track and text data using probabilistic methods; (2) an activity pattern learning framework to support querying an index of activities of interest (AOIs) and targets of interest (TOIs) by movement type and geolocation; and (3) a user interface to support streaming multi-intelligence data processing. We also present an activity pattern learning framework that uses the multi-source associated data as training to index a large archive of full-motion videos (FMV). VIVA and MINER examples are demonstrated for wide aerial/overhead imagery over common data sets affording an improvement in tracking from video data alone, leading to 84% detection with modest misdetection/false alarm results due to the complexity of the scenario. The novel use of ACOs and chat messages in video tracking paves the way for user interaction, correction and preparation of situation awareness reports. PMID:25340453

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

    NASA Technical Reports Server (NTRS)

    Friedman, J. D. (Principal Investigator)

    1974-01-01

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

  6. Health & Demographic Surveillance System Profile: The Rufiji Health and Demographic Surveillance System (Rufiji HDSS).

    PubMed

    Mrema, Sigilbert; Kante, Almamy M; Levira, Francis; Mono, Amaniel; Irema, Kahema; de Savigny, Don; Masanja, Honorati

    2015-04-01

    The Rufiji Health and Demographic Surveillance System (HDSS) was established in October 1998 to evaluate the impact on burden of disease of health system reforms based on locally generated data, prioritization, resource allocation and planning for essential health interventions. The Rufiji HDSS collects detailed information on health and survival and provides a framework for population-based health research of relevance to local and national health priorities.In December 2012 the population under surveillance was about 105,503 people, residing in 19,315 households. Monitoring of households and members within households is undertaken in regular 6-month cycles known as 'rounds'. Self reported information is collected on demographic, household, socioeconomic and geographical characteristics. Verbal autopsy is conducted using standardized questionnaires, to determine probable causes of death. In conjunction with core HDSS activities, the ongoing studies in Rufiji HDSS focus on maternal and new-born health, evaluation of safety of artemether-lumefantrine (AL) exposure in early pregnancy and the clinical safety of a fixed dose of dihydroartemisinin-piperaquine (DHA-PQP) in the community. Findings of studies conducted in Rufiji HDSS can be accessed at www.ihi.or.tz/IHI-Digital-Library. PMID:25747869

  7. Overview of Randomized Controlled Treatment Trials for Clinically Localized Prostate Cancer: Implications for Active Surveillance and the United States Preventative Task Force Report on Screening?

    PubMed Central

    2012-01-01

    Prostate cancer and its management have been intensely debated for years. Recommendations range from ardent support for active screening and immediate treatment to resolute avoidance of screening and active surveillance. There is a growing body of level I evidence establishing a clear survival advantage for treatment of subsets of patients with clinically localized prostate cancer. This chapter presents a review of these randomized controlled trials. We argue that an understanding of this literature is relevant not only to those considering active surveillance but also to those evaluating the merits of screening. In addition, a number of important evidence-based conclusions concerning what should and should not be done can be gleaned from these trials. PMID:23271777

  8. [Opportunities and risks of 5α reductase inhibitors in the medical management of Active surveillance for localized prostate cancer].

    PubMed

    Linares Espinos, Estefania; Carballido Rodriguez, Joaquin

    2014-06-01

    Active surveillance (AS) as a therapeutic option is already integrated as a primary treatment strategy in low risk localized prostate cancer (PCa). There is a recent interest for the search of therapeutic interventions that result in a delay in the progression of such indolent cancers. The evaluation of the possible implication of 5 ARI drugs in the reduction of the risk of progression of PCa was enacted by the results of the clinical trials PCPT (Prostate Cancer Prevention Trial) and REDUCE (Reduction by Dutasteride of Prostate Cancer Events study). The results of the REDEEM clinical trial (Reduction by Dutasteride of clinical progression events in expectant management trial) revealed a delay in PCa progression favoring Dutasteride in comparison with placebo, being advanced age and PSA Density independent predictive factors for pathologic progression. Evidences regarding the influence of 5 ARIs in the evolution of AS patients come from few studies with limited follow up. Thus, the conclusions probably are far from being consiidered as definitive. PMID:24914845

  9. Prevalence of microcephaly in Europe: population based study

    PubMed Central

    Rankin, Judith; Garne, Ester; Loane, Maria; Greenlees, Ruth; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bergman, Jorieke E H; Csaky-Szunyogh, Melinda; Dias, Carlos; Draper, Elizabeth S; Gatt, Miriam; Khoshnood, Babak; Klungsoyr, Kari; Kurinczuk, Jennifer J; Lynch, Catherine; McDonnell, Robert; Nelen, Vera; Neville, Amanda J; O’Mahony, Mary T; Pierini, Anna; Randrianaivo, Hanitra; Rissmann, Anke; Tucker, David; Verellen-Dumoulin, Christine; de Walle, Hermien E K; Wellesley, Diana; Wiesel, Awi; Dolk, Helen

    2016-01-01

    Objectives To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies). Design Questionnaire and population based observational study. Setting 24 EUROCAT registries covering 570 000 births annually in 15 countries. Participants Cases of microcephaly not associated with a genetic condition among live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy for fetal anomaly at any gestation. Main outcome measures Prevalence of microcephaly (1 Jan 2003-31 Dec 2012) analysed with random effects Poisson regression models to account for heterogeneity across registries. Results 16 registries responded to the questionnaire, of which 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 SD below the mean for sex, age, and ethnic origin), 19% (3/16) used a 2 SD cut off, 31% (5/16) were reliant on the criteria used by individual clinicians, and one changed criteria between 2003 and 2012. Prevalence of microcephaly in Europe was 1.53 (95% confidence interval 1.16 to 1.96) per 10 000 births, with registries varying from 0.4 (0.2 to 0.7) to 4.3 (3.6 to 5.0) per 10 000 (χ2=338, df=23, I2=93%). Registries with a 3 SD cut off reported a prevalence of 1.74 per 10 000 (0.86 to 2.93) compared with those with the less stringent 2 SD cut off of 1.21 per 10 000 (0.21 to 2.93). The prevalence of microcephaly would need to increase in one year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (P<0.01). Conclusions EUROCAT could detect increases in the prevalence of microcephaly from the Zika virus of a similar magnitude to those observed in Brazil. Because of the rarity

  10. Investigating Measures of Social Context on 2 Population-Based Health Surveys, Hawaii, 2010-2012.

    PubMed

    Pobutsky, Ann M; Baker, Kathleen Kromer; Reyes-Salvail, Florentina

    2015-01-01

    Measures from the Social Context Module of the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System were used on 2 population-based health surveys in Hawaii to explicate the role of the nonmedical and social determinants of health; these measures were also compared with conventional socioeconomic status (SES) variables. Results showed that the self-reported SES vulnerabilities of food and housing insecurity are both linked to demographic factors and physical and mental health status and significant when controlling for the conventional measures of SES. The social context module indicators should be increasingly used so results can inform appropriate interventions for vulnerable populations.

  11. Microglial P2Y12 Receptors Regulate Microglial Activation and Surveillance during Neuropathic Pain

    PubMed Central

    Gu, Nan; Eyo, Ukpong B.; Murugan, Madhuvika; Peng, Jiyun; Matta, Sanjana; Dong, Hailong; Wu, Long-Jun

    2016-01-01

    Microglial cells are critical in the pathogenesis of neuropathic pain and several microglial receptors have been proposed to mediate this process. Of these receptors, the P2Y12 receptor is a unique purinergic receptor that is exclusively expressed by microglia in the central nervous system (CNS). In this study, we set forth to investigate the role of P2Y12 receptors in microglial electrophysiological and morphological (static and dynamic) activation during spinal nerve transection (SNT)-induced neuropathic pain in mice. First, we found that a genetic deficiency of the P2Y12 receptor (P2Y12−/− mice) ameliorated pain hypersensitivities during the initiation phase of neuropathic pain. Next, we characterized both the electrophysiological and morphological properties of microglia in the superficial spinal cord dorsal horn following SNT injury. We show dramatic alterations including a peak at 3 days post injury in microglial electrophysiology while high resolution two-photon imaging revealed significant changes of both static and dynamic microglial morphological properties by 7 days post injury. Finally, in P2Y12−/− mice, these electrophysiological and morphological changes were ameliorated suggesting roles for P2Y12 receptors in SNT-induced microglial activation. Our results therefore indicate that P2Y12 receptors regulate microglial electrophysiological as well as static and dynamic microglial properties after peripheral nerve injury, suggesting that the microglial P2Y12 receptor could be a potential therapeutic target for the treatment of neuropathic pain. PMID:26576724

  12. Safety and Acceptability of the PrePex Device When Used in Routine Male Circumcision Service Delivery During Active Surveillance in Zimbabwe

    PubMed Central

    Mavhu, Webster; Ncube, Getrude; Xaba, Sinokuthemba; Madidi, Ngonidzashe; Keatinge, Jo; Dhodho, Efison; Samkange, Christopher A.; Tshimanga, Mufuta; Mangwiro, Tonderayi; Mugurungi, Owen; Njeuhmeli, Emmanuel; Cowan, Frances M.

    2016-01-01

    Background: Male circumcision devices have the potential to accelerate voluntary medical male circumcision roll-out, with PrePex being one promising device. Here, we present findings on safety and acceptability from active surveillance of the implementation of PrePex among 1000 males circumcised in Zimbabwe. Methods: The first 1000 men consecutively circumcised using PrePex during routine service delivery were actively followed up. Outcome measures included PrePex uptake, attendance for postcircumcision visits, and adverse events (AEs). A survey was conducted among 500 consecutive active surveillance clients to assess acceptability and satisfaction with PrePex. Results: A total of 2156 men aged 18 years or older were circumcised across the 6 PrePex active surveillance sites. Of these, 1000 (46.4%) were circumcised using PrePex. Among them, 4 (0.4%) self-removals that required surgery (severe AEs) were observed. Six (0.6%) removals by providers (moderate AEs) did not require surgery. A further 280 (28%) AEs were mild or moderate pain during device removal. There were also 12 (1.2%) moderate AEs unrelated to pain. All AEs resolved without sequelae. There was high adherence to follow-up appointments, with 97.7% of clients attending the scheduled day 7 visit. Acceptability of PrePex was high among survey participants, 93% indicated willingness to recommend the device to peers. Of note, 95.8% of respondents reported experiencing pain when the device was being removed. Additionally, 85.2% reported experiencing odor while wearing the device or during removal. Conclusions: Active surveillance of the first 1000 men circumcised using PrePex suggests that the device is both safe and acceptable when used in routine service delivery. PMID:27331593

  13. Predicting Pathological Features at Radical Prostatectomy in Patients with Prostate Cancer Eligible for Active Surveillance by Multiparametric Magnetic Resonance Imaging

    PubMed Central

    de Cobelli, Ottavio; Terracciano, Daniela; Tagliabue, Elena; Raimondi, Sara; Bottero, Danilo; Cioffi, Antonio; Jereczek-Fossa, Barbara; Petralia, Giuseppe; Cordima, Giovanni; Almeida, Gilberto Laurino; Lucarelli, Giuseppe; Buonerba, Carlo; Matei, Deliu Victor; Renne, Giuseppe; Di Lorenzo, Giuseppe; Ferro, Matteo

    2015-01-01

    Purpose The aim of this study was to investigate the prognostic performance of multiparametric magnetic resonance imaging (mpMRI) and Prostate Imaging Reporting and Data System (PIRADS) score in predicting pathologic features in a cohort of patients eligible for active surveillance who underwent radical prostatectomy. Methods A total of 223 patients who fulfilled the criteria for “Prostate Cancer Research International: Active Surveillance”, were included. Mp–1.5 Tesla MRI examination staging with endorectal coil was performed at least 6–8 weeks after TRUS-guided biopsy. In all patients, the likelihood of the presence of cancer was assigned using PIRADS score between 1 and 5. Outcomes of interest were: Gleason score upgrading, extra capsular extension (ECE), unfavorable prognosis (occurrence of both upgrading and ECE), large tumor volume (≥0.5ml), and seminal vesicle invasion (SVI). Receiver Operating Characteristic (ROC) curves and Decision Curve Analyses (DCA) were performed for models with and without inclusion of PIRADS score. Results Multivariate analysis demonstrated the association of PIRADS score with upgrading (P<0.0001), ECE (P<0.0001), unfavorable prognosis (P<0.0001), and large tumor volume (P = 0.002). ROC curves and DCA showed that models including PIRADS score resulted in greater net benefit for almost all the outcomes of interest, with the only exception of SVI. Conclusions mpMRI and PIRADS scoring are feasible tools in clinical setting and could be used as decision-support systems for a more accurate selection of patients eligible for AS. PMID:26444548

  14. Collaborations in Population-Based Health Research

    PubMed Central

    Lieu, Tracy A.; Hinrichsen, Virginia L.; Moreira, Andrea; Platt, Richard

    2011-01-01

    The HMO Research Network (HMORN) is a consortium of 16 health care systems with integrated research centers. Approximately 475 people participated in its 17th annual conference, hosted by the Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School. The theme, “Collaborations in Population-Based Health Research,” reflected the network’s emphasis on collaborative studies both among its members and with external investigators. Plenary talks highlighted the initial phase of the HMORN’s work to establish the NIH-HMO Collaboratory, opportunities for public health collaborations, the work of early career investigators, and the state of the network. Platform and poster presentations showcased a broad spectrum of innovative public domain research in areas including disease epidemiology and treatment, health economics, and information technology. Special interest group sessions and ancillary meetings provided venues for informal conversation and structured work among ongoing groups, including networks in cancer, cardiovascular diseases, lung diseases, medical product safety, and mental health. PMID:22090515

  15. Surveillance and maintenance activities of waste area groupings at Oak Ridge National Laboratory. Annual summary report for period ending September 30, 1991: Environmental Restoration Program

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.; Jones, R.G.

    1991-12-01

    Surveillance and maintenance (S & M) of 75 sites were conductd by the Remedial Action Section for the Environmental Restoration Program for surplus facilities and sites contaminated with radioactive materials and/or hazardous chemicals. S & M activities on these sites were conducted from the end of their operating life until final facility disposal or site stabilization. The objectives of the Waste Area Grouping S & M Program are met by maintaining a program of routine S & M as well as by implementing interim corrective maintenance when deemed necessary as a result of site surveillance. This report briefly presents this program`s activities and includes tables indicating tank levels and dry well data for FY 1991.

  16. Assessing digital literacy in web-based physical activity surveillance: the WIN study.

    PubMed

    Mathew, Merly; Morrow, James R; Frierson, Georita M; Bain, Tyson M

    2011-01-01

    PURPOSE. Investigate relations between demographic characteristics and submission method, Internet or paper, when physical activity behaviors are reported. DESIGN. Observational. SETTING . Metropolitan. SUBJECTS. Adult women (N  =  918) observed weekly for 2 years (total number of weekly reports, 44,963). MEASURES. Independent variables included age, race, education, income, employment status, and Internet skills. Dependent variables were method of submission (Internet or paper) and adherence. ANALYSIS . Logistic regression to analyze weekly odds of submitting data online and meeting study adherence criteria. Model 1 investigated method of submission, model 2 analyzed meeting study's Internet adherence, and model 3 analyzed meeting total adherence regardless of submission method. RESULTS. Whites, those with good Internet skills, and those reporting higher incomes were more likely to log online. Those who were white, older, and reported good Internet skills were more likely to be at least 75% adherent online. Older women were more likely to be adherent regardless of method. Employed women were less likely to log online or be adherent. CONCLUSION . Providing participants with multiple submission methods may reduce potential bias and provide more generalizable results relevant for future Internet-based research.

  17. Evaluation of a MMW active through-the-wall surveillance system

    NASA Astrophysics Data System (ADS)

    Currie, Nicholas C.; Stiefvater, Kenneth

    2002-08-01

    This paper discusses the TWS data collected with a state-of- the-art 100 GHz radar imager developed for law enforcement use by Millivision, PPC. The system collects a cube of data consisting of 16 azimuth elements by 16 elevation elements by 256 range elements. The cube represents 11 degrees by 11 degrees by 25 m of coverage. The relatively narrow field-of- view (fov) was extended by physically moving the antenna in 11 degree segments and collecting data which is stitched together into larger images, e.g. a 3X3 stitched image represents 33 degrees by 33 degrees by 26 m of coverage. Unfortunately, this stitching process required up to 5 minutes to collect a single (3X3) stitched image. Thus, motion had to be simulated. The paper will discuss the phenomenology of the MMW radar return from various objects including walls, wall-corners, desks and other furniture, and persons simulating walking. Successive frames from a simulated move of a man and woman walking will be presented, and the actual movie shown at the presentation. Comments will be offered as to the practicality of active MMW imaging for TWS application.

  18. Effects of surveillance towed array sensor system (SURTASS) low frequency active sonar on fish

    NASA Astrophysics Data System (ADS)

    Popper, Arthur N.; Halvorsen, Michele B.; Miller, Diane; Smith, Michael E.; Song, Jiakun; Wysocki, Lidia E.; Hastings, Mardi C.; Kane, Andrew S.; Stein, Peter

    2005-04-01

    We investigated the effects of exposure to Low Frequency Active (LFA) sonar on rainbow trout (a hearing non-specialist related to several endangered salmonids) and channel catfish (a hearing specialist), using an element of the standard SURTASS LFA source array. We measured hearing sensitivity using auditory brainstem response, effects on inner ear structure using scanning electron microscopy, effects on non-auditory tissues using general pathology and histopathology, and behavioral effects with video monitoring. Exposure to 193 dB re 1 microPa (rms received level) in the LFA frequency band for 324 seconds resulted in a TTS of 20 dB at 400 Hz in rainbow trout, with less TTS at 100 and 200 Hz. TTS in catfish ranged from 6 to 12 dB at frequencies from 200 to 1000 Hz. Both species recovered from hearing loss in several days. Inner ears sensory tissues appeared unaffected by acoustic exposure. Gross pathology indicated no damage to non-auditory tissues, including the swim bladder. Both species showed consistent startle responses at sound onsets and changed their position relative to the sound source during exposures. There was no fish death attributable to sound exposure even up to four days post-exposure. [Work supported by Chief of Naval Operations.

  19. Assessing digital literacy in web-based physical activity surveillance: the WIN study.

    PubMed

    Mathew, Merly; Morrow, James R; Frierson, Georita M; Bain, Tyson M

    2011-01-01

    PURPOSE. Investigate relations between demographic characteristics and submission method, Internet or paper, when physical activity behaviors are reported. DESIGN. Observational. SETTING . Metropolitan. SUBJECTS. Adult women (N  =  918) observed weekly for 2 years (total number of weekly reports, 44,963). MEASURES. Independent variables included age, race, education, income, employment status, and Internet skills. Dependent variables were method of submission (Internet or paper) and adherence. ANALYSIS . Logistic regression to analyze weekly odds of submitting data online and meeting study adherence criteria. Model 1 investigated method of submission, model 2 analyzed meeting study's Internet adherence, and model 3 analyzed meeting total adherence regardless of submission method. RESULTS. Whites, those with good Internet skills, and those reporting higher incomes were more likely to log online. Those who were white, older, and reported good Internet skills were more likely to be at least 75% adherent online. Older women were more likely to be adherent regardless of method. Employed women were less likely to log online or be adherent. CONCLUSION . Providing participants with multiple submission methods may reduce potential bias and provide more generalizable results relevant for future Internet-based research. PMID:22040389

  20. Neisseria meningitidis and Streptococcus pneumoniae as leading causes of pediatric bacterial meningitis in nine Mexican hospitals following 3 years of active surveillance

    PubMed Central

    Chacon-Cruz, Enrique; Martinez-Longoria, Cesar Adrian; Llausas-Magana, Eduardo; Luevanos-Velazquez, Antonio; Vazquez-Narvaez, Jorge Alejandro; Beltran, Sandra; Limon-Rojas, Ana Elena; Urtiz-Jeronimo, Fernando; Castaneda-Narvaez, Jose Luis; Otero-Mendoza, Francisco; Aguilar-Del Real, Fernando; Rodriguez-Chagoyan, Jesus; Rivas-Landeros, Rosa Maria; Volker-Soberanes, Maria Luisa; Hinojosa-Robles, Rosa Maria; Arzate-Barbosa, Patricia; Aviles-Benitez, Laura Karina; Elenes-Zamora, Fernando Ivan; Becka, Chandra M.; Ruttimann, Ricardo

    2016-01-01

    Objectives: Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals. Methods: From January 2010 to February 2013, we conducted a three years of active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspected case, and microbiological studies confirmed/ruled out all potentially bacterial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diagnostic tests), and both pneumococcal serotyping and meningococcal serogrouping by using standard methods. Results: Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup C was predominant. Streptococcus pneumoniae followed Neisseria meningitides, but was uniformly distributed throughout the country. Serotype 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants). Conclusions: Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures – negative but presumably bacterial meningitis cases. PMID:27551428

  1. Adaptive maritime video surveillance

    NASA Astrophysics Data System (ADS)

    Gupta, Kalyan Moy; Aha, David W.; Hartley, Ralph; Moore, Philip G.

    2009-05-01

    Maritime assets such as ports, harbors, and vessels are vulnerable to a variety of near-shore threats such as small-boat attacks. Currently, such vulnerabilities are addressed predominantly by watchstanders and manual video surveillance, which is manpower intensive. Automatic maritime video surveillance techniques are being introduced to reduce manpower costs, but they have limited functionality and performance. For example, they only detect simple events such as perimeter breaches and cannot predict emerging threats. They also generate too many false alerts and cannot explain their reasoning. To overcome these limitations, we are developing the Maritime Activity Analysis Workbench (MAAW), which will be a mixed-initiative real-time maritime video surveillance tool that uses an integrated supervised machine learning approach to label independent and coordinated maritime activities. It uses the same information to predict anomalous behavior and explain its reasoning; this is an important capability for watchstander training and for collecting performance feedback. In this paper, we describe MAAW's functional architecture, which includes the following pipeline of components: (1) a video acquisition and preprocessing component that detects and tracks vessels in video images, (2) a vessel categorization and activity labeling component that uses standard and relational supervised machine learning methods to label maritime activities, and (3) an ontology-guided vessel and maritime activity annotator to enable subject matter experts (e.g., watchstanders) to provide feedback and supervision to the system. We report our findings from a preliminary system evaluation on river traffic video.

  2. Oral Sex and HPV: Population Based Indications.

    PubMed

    Mishra, Anupam; Verma, Veerendra

    2015-03-01

    Human pappilloma virus (HPV) is well established in etiology of uterine cervical cancers, but its role in head and neck cancer is strongly suggested through many epidemiological and laboratory studies. Although HPV-16 induced oropharyngeal cancer is a distinct molecular entity, its role at other sub-sites (oral cavity, larynx, nasopharynx, hypopharynx) is less well established. Oral sex is supposedly the most commonly practiced unnatural sex across the globe and may prove to be a potential transmitting link between cancers of the uterine cervix and the oropharynx in males particularly in those 10-15% non-smokers. In India with the second largest population (higher population density than China) the oral sex is likely to be a common 'recreation-tool' amongst the majority (poor) and with the concurrent highly prevalent bad cervical/oral hygiene the HPV is likely to synergize other carcinogens. Hence in accordance (or coincidently), in India the cervical cancer happens to be the commonest cancer amongst females while oral/oropharyngeal cancer amongst males. Oral sex as a link between these two cancer types, can largely be argued considering a poor level of evidence in the existing literature. The modern world has even commercialized oral sex in the form of flavored condoms. The inadequate world literature currently is of a low level of evidence to conclude such a relationship because no such specific prospective study has been carried out and also due to wide (and unpredictable) variety of sexual practices, such a relationship can only be speculated. This article briefly reviews the existing literature on various modes and population based indications for HPV to be implicated in head and neck cancer with reference to oral sexual practice.

  3. A population-based Habitable Zone perspective

    NASA Astrophysics Data System (ADS)

    Zsom, Andras

    2015-08-01

    What can we tell about exoplanet habitability if currently only the stellar properties, planet radius, and the incoming stellar flux are known? The Habitable Zone (HZ) is the region around stars where planets can harbor liquid water on their surfaces. The HZ is traditionally conceived as a sharp region around the star because it is calculated for one planet with specific properties e.g., Earth-like or desert planets , or rocky planets with H2 atmospheres. Such planet-specific approach is limiting because the planets’ atmospheric and geophysical properties, which influence the surface climate and the presence of liquid water, are currently unknown but expected to be diverse.A statistical HZ description is outlined which does not select one specific planet type. Instead the atmospheric and surface properties of exoplanets are treated as random variables and a continuous range of planet scenarios are considered. Various probability density functions are assigned to each observationally unconstrained random variable, and a combination of Monte Carlo sampling and climate modeling is used to generate synthetic exoplanet populations with known surface climates. Then, the properties of the liquid water bearing subpopulation is analyzed.Given our current observational knowledge of small exoplanets, the HZ takes the form of a weakly-constrained but smooth probability function. The model shows that the HZ has an inner edge: it is unlikely that planets receiving two-three times more stellar radiation than Earth can harbor liquid water. But a clear outer edge is not seen: a planet that receives a fraction of Earth's stellar radiation (1-10%) can be habitable, if the greenhouse effect of the atmosphere is strong enough. The main benefit of the population-based approach is that it will be refined over time as new data on exoplanets and their atmospheres become available.

  4. Defining 'surveillance' in drug safety.

    PubMed

    Aronson, Jeffrey K; Hauben, Manfred; Bate, Andrew

    2012-05-01

    The concept of surveillance in pharmacovigilance and pharmacoepidemiology has evolved from the concept of surveillance in epidemiology, particularly of infectious diseases. We have surveyed the etymology, usages, and previous definitions of 'surveillance' and its modifiers, such as 'active' and 'passive'. The following essential definitional features of surveillance emerge: (i) surveillance and monitoring are different--surveillance involves populations, while monitoring involves individuals; (ii) surveillance can be performed repeatedly and at any time during the lifetime of a medicinal product or device; (iii) although itself non-interventional, it can adduce any types of evidence (interventional, observational, or anecdotal, potentially at different times); (iv) it encompasses data collection, management, analysis, and interpretation; (v) it includes actions to be taken after signal detection, including initial evaluation and communication; and (vi) it should contribute to the classification of adverse reactions and their prevention or mitigation and/or to the harnessing of beneficial effects. We conclude that qualifiers add ambiguity and uncertainty without enhancing the idea of surveillance. We propose the following definition of surveillance of health-care products, which embraces all the surveyed ideas and reflects real-world pharmacovigilance processes: 'a form of non-interventional public health research, consisting of a set of processes for the continued systematic collection, compilation, interrogation, analysis, and interpretation of data on benefits and harms (including relevant spontaneous reports, electronic medical records, and experimental data).' As a codicil, we note that the purposes of surveillance are to identify, evaluate, understand, and communicate previously unknown effects of health-care products, or new aspects of known effects, in order to harness such effects (if beneficial) or prevent or mitigate them (if harmful).

  5. The association between institution at orchiectomy and outcomes on active surveillance for clinical stage I germ cell tumours

    PubMed Central

    Nayan, Madhur; Jewett, Michael A.S.; Anson-Cartwright, Lynn; Bedard, Philippe L.; Moore, Malcolm; Chung, Peter; Warde, Padraig; Sweet, Joan; O’Malley, Martin; Hamilton, Robert J.

    2016-01-01

    Introduction: Institutional experience has been associated with improved outcomes for various malignancies, including testicular cancer. The present study evaluated whether institution at orchiectomy was associated with outcomes on active surveillance (AS) for clinical stage (CS) I germ cell tumours (GCT). Methods: 815 patients with CSI GCT managed with AS at the Princess Margaret Cancer Centre were identified. Princess Margaret is a tertiary academic institution with a multidisciplinary testicular cancer clinic involving radiation oncologists, medical oncologists, and urologists, and has research experience in testicular cancer care. The association between institution of orchiectomy (Princess Margaret vs. Other) and time to progression on AS was analyzed using multivariable Cox proportional hazards models. Academic vs. non-academic institutions were compared in a sensitivity analysis. Results: Patients undergoing orchiectomy at Princess Margaret for non-seminoma GCT were significantly less likely to have pure embryonal carcinoma (EC) in orchiectomy pathology (odds ratio [OR] 0.33; p=0.008) and CSIB disease (OR 0.47; p=0.014). Seminoma characteristics did not differ significantly between institution groups. In non-seminoma GCT, median followup was 5.4 years, 27% progressed on AS, and institution of orchiectomy was not associated with time to progression in either univariate (hazard ratio [HR] 0.79; p=0.33) or multivariable analyses (HR 1.01; p=0.97). In seminoma, median followup was 4.7 years, 12% progressed on AS, and institution of orchiectomy was not associated with progression (univariate: HR 0.87; p=0.73; multivariable: HR 0.98; p=0.96). Sensitivity analyses demonstrated similar results. Conclusions: Among CSI GCT patients managed on AS at a specialized cancer centre, there appears to be no difference in oncologic outcomes based upon the institution where orchiectomy was performed.

  6. A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance

    PubMed Central

    Watts, Sam; Leydon, Geraldine; Eyles, Caroline; Moore, Caroline M; Richardson, Alison; Birch, Brian; Prescott, Philip; Powell, Catrin; Lewith, George

    2015-01-01

    Objective To quantitatively determine the prevalence of anxiety and depression in men on active surveillance (AS). Design Cross-sectional questionnaire survey. Setting Secondary care prostate cancer (PCa) clinics across South, Central and Western England. Participants 313 men from a total sample of 426 with a histological diagnosis of PCa currently managed with AS were identified from seven UK urology departments. The mean age of respondents was 70 (51–86) years with the majority (76%) being married or in civil partnerships. 94% of responders were of white British ethnicity. Primary outcome measures The prevalence of clinically meaningful depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS; score ≥8/21). Secondary outcome measures Patient demographic data (age, employment, relationship, ethnic and educational status). Each demographic variable was cross-tabulated against patients identified as depressed or anxious to allow for the identification of variables that were significantly associated with depression and anxiety. In order to determine predictors for depression and anxiety among the demographic variables, logistic regression analyses were conducted, with p<0.05 considered as indicating statistical significance. Results The prevalence of clinical anxiety and depression as determined via the HADS (HADS ≥8) was 23% (n=73) and 12.5% (n=39), respectively. Published data from men in the general population of similar age has shown prevalence rates of 8% and 6%, respectively, indicating a twofold increase in depression and a threefold increase in anxiety among AS patients. Our findings also suggest that AS patients experience substantially greater levels of anxiety than patients with PCa treated radically. The only demographic predictor for anxiety or depression was divorce. Conclusions Patients with PCa managed with AS experienced substantially higher rates of anxiety and depression than that expected in the general

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

    PubMed

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

    2016-01-01

    The objective of our study was to describe decision making by men and their partners regarding active surveillance (AS) or treatment for early-stage, localized prostate cancer. Fifteen couples were recruited from a cancer center multispecialty clinic, which gave full information about all options, including AS. Data were collected via individual, semi-structured telephone interviews. Most patients were white, non-Hispanic, had private insurance, had completed at least some college, and were aged 49-72 years. Ten chose AS. All partners were female, and couples reported strong marital satisfaction and cohesion. All couples described similar sequences of a highly emotional initial reaction and desire to be rid of the cancer, information seeking, and decision making. The choice of AS was built on a nuanced evaluation of the man's condition in which the couple differentiated prostate cancer from other cancers and early stage from later stages, wanted to avoid/delay side effects, and trusted the AS protocol to identify negative changes in time for successful treatment. Treated couples continued to want immediate treatment to remove the cancer. We concluded that having a partner's support for AS may help a man feel more comfortable with choosing and adhering to AS. Using decision aids that address both a man's and his partner's concerns regarding AS may increase its acceptability. Our research shows that some patients want to and do involve their partners in the decision-making process. Ethical issues are related to the tension between desire for partner involvement and the importance of the patient as autonomous decision-maker. The extended period of decision making, particularly for AS, is also an ethical issue that requires additional support for patients and couples in the making of fully informed choices that includes AS. PMID:27346824

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

    PubMed

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

    2016-01-01

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

  9. Association between number of prostate biopsies and patient-reported functional outcomes after radical prostatectomy: implications for active surveillance protocols

    PubMed Central

    Anderson, Christopher B.; Tin, Amy L.; Sjoberg, Daniel D.; Mulhall, John P.; Sandhu, Jaspreet; Laudone, Vincent P.; Eastham, James A.; Scardino, Peter T.; Ehdaie, Behfar

    2016-01-01

    Purpose Men with prostate cancer who progress on active surveillance (AS) are subject to multiple prostate biopsies prior to radical prostatectomy (RP). Our objective was to evaluate whether the number of preoperative prostate biopsies affects functional outcomes after RP. Materials and methods We identified men treated with RP at our institution between 2008 and 2011. At 6 and 12 months post-operatively, patients completed questionnaires assessing erectile and urinary function. Men with preoperative incontinence or erectile dysfunction or who did not complete the questionnaire were excluded. Primary outcomes were urinary and erectile function at 12 months postoperatively. We used logistic regression to estimate the impact of number of prostate biopsies on functional outcomes after adjusting for demographic and clinical factors. Results We identified 2,712 men treated with RP between 2008 and 2011. Most men (80%) had 1 preoperative prostate biopsy, 16% had 2, and 4% had at least 3. On adjusted analysis, erectile function at 12 months was not significantly different for men with 2 (OR 1.25; 95% CI 0.90, 1.75) or 3 or more (OR 1.52; 95% CI 0.84, 2.78) biopsies, compared to those with 1. Similarly, urinary function at 12 months was not significantly different for men with 2 (0.84, 95% CI 0.64, 1.10) or 3 or more (0.99, 95% CI 0.60, 1.61) biopsies compared to those with 1. Conclusions We did not find evidence that more preoperative prostate biopsies adversely affected erectile or urinary function at 12 months following RP. PMID:26118438

  10. Long-Term Prediction of the Demand of Colonoscopies Generated by a Population-Based Colorectal Cancer Screening Program

    PubMed Central

    Mendivil, Joan; Andreu, Montserrat; Hernández, Cristina; Castells, Xavier

    2016-01-01

    Objective To estimate the long-term need for colonoscopies after a positive fecal immunochemical test (FIT) and post-polypectomy surveillance in the context of a population-based colorectal cancer (CRC) screening program. Methods A discrete-event simulation model was built to reproduce the process of CRC screening and post-polypectomy surveillance following European guidelines in a population of 100,000 men and women aged 50–69 years over a 20-year period. Screening consisted of biennial FIT and colonoscopy in participants with positive results. The model was mainly fed using data from the first and second rounds of a Spanish program (2010–2013). Data on post-polypectomy surveillance results were obtained from the literature. A probabilistic multivariate sensitivity analysis was performed on the effect of participation, FIT positivity, and adherence to surveillance colonoscopies. The main outcome variables were the number of colonoscopies after a positive FIT, surveillance colonoscopies, and the overall number of colonoscopies. Results An average yearly number of 1,200 colonoscopies after a positive FIT were predicted per 100,000 inhabitants with a slight increase to 1,400 at the end of the 20-year period. Surveillance colonoscopies increased to an average of 1,000 per 100,000 inhabitants in the long-term, showing certain stabilization in the last years of the 20-year simulation horizon. The results were highly sensitive to FIT positivity. Conclusions Implementing a population-based CRC screening program will increase the demand for colonoscopies, which is expected to double in 20 years, mainly due to an increase in surveillance colonoscopies. PMID:27732635

  11. Study of Natural Health Product Adverse Reactions (SONAR): Active Surveillance of Adverse Events Following Concurrent Natural Health Product and Prescription Drug Use in Community Pharmacies

    PubMed Central

    Vohra, Sunita; Cvijovic, Kosta; Boon, Heather; Foster, Brian C.; Jaeger, Walter; LeGatt, Don; Cembrowski, George; Murty, Mano; Tsuyuki, Ross T.; Barnes, Joanne; Charrois, Theresa L.; Arnason, John T.; Necyk, Candace; Ware, Mark; Rosychuk, Rhonda J.

    2012-01-01

    Background Many consumers use natural health products (NHPs) concurrently with prescription medications. As NHP-related harms are under-reported through passive surveillance, the safety of concurrent NHP-drug use remains unknown. To conduct active surveillance in participating community pharmacies to identify adverse events related to concurrent NHP-prescription drug use. Methodology/Principal Findings Participating pharmacists asked individuals collecting prescription medications about (i) concurrent NHP/drug use in the previous three months and (ii) experiences of adverse events. If an adverse event was identified and if the patient provided written consent, a research pharmacist conducted a guided telephone interview to gather additional information after obtaining additional verbal consent and documenting so within the interview form. Over a total of 112 pharmacy weeks, 2615 patients were screened, of which 1037 (39.7%; 95% CI: 37.8% to 41.5%) reported concurrent NHP and prescription medication use. A total of 77 patients reported a possible AE (2.94%; 95% CI: 2.4% to 3.7%), which represents 7.4% of those using NHPs and prescription medications concurrently (95%CI: 6.0% to 9.2%). Of 15 patients available for an interview, 4 (26.7%: 95% CI: 4.3% to 49.0%) reported an AE that was determined to be “probably” due to NHP use. Conclusions/Significance Active surveillance markedly improves identification and reporting of adverse events associated with concurrent NHP-drug use. Although not without challenges, active surveillance is feasible and can generate adverse event data of sufficient quality to allow for meaningful adjudication to assess potential harms. PMID:23028841

  12. [Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--II. Gram-negative bacteria].

    PubMed

    Igari, Jun; Oguri, Toyoko; Hiramatsu, Nobuyoshi; Akiyama, Kazumitsu; Koyama, Tsuneo

    2002-02-01

    As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, monobactams, and carbapenems. Changes in CZOP susceptibility for the bacteria were also evaluated with the bacterial resistance ratio calculated with the breakpoint MIC. Twenty-five species (3,362 strains) of Gram-negative bacteria were isolated from the clinical materials annually collected from 1996 to 2000, and consisted of Moraxella (Branhamella) catarrhalis (n = 136), Haemophilus influenzae (n = 289), Escherichia coli (n = 276), Klebsiella pneumoniae (n = 192), Klebsiella oxytoca (n = 157), Enterobacter cloacae (n = 189), Enterobacter aerogenes (n = 93), Serratia marcescens (n = 172), Serratia liquefaciens (n = 24), Citrobacter freundii (n = 177), Citrobacter koseri (n = 70), Proteus mirabilis (n = 113), Proteus vulgaris (n = 89), Morganella morganii (n = 116), Providencia spp. (n = 41), Pseudomonas aeruginosa (n = 290), Pseudomonas fluorescens (n = 56), Pseudomonas putida (n = 63), Acinetobacter baumannii (n = 146), Acinetobacter lwoffii (n = 34), Burkholderia cepacia (n = 101), Stenotrophomonas maltophilia (n = 169), Bacteroides fragilis group (n = 196), and Prevotella/Porphyromonas (n = 173). An antibacterial activity of CZOP against E. coli, K. pneumoniae, K. oxytoca, and S. marcescens was potent and consistent with or more preferable than the study results obtained until the new drug application approval. MIC90 of CZOP against M.(B.) catarrhalis, C. koseri, and P. aeruginosa was not considerably changed and consistent with the study results obtained until the new drug application approval. MIC90 of CZOP against E. cloacae, E. aerogenes, and P. mirabilis increased year by year. The increase in MIC90 of CZOP against E. aerogenes and P. mirabilis, however, was not considered to be an obvious decline in susceptibility. In

  13. Risk factors for pneumonic and ulceroglandular tularaemia in Finland: a population-based case-control study.

    PubMed

    Rossow, H; Ollgren, J; Klemets, P; Pietarinen, I; Saikku, J; Pekkanen, E; Nikkari, S; Syrjälä, H; Kuusi, M; Nuorti, J P

    2014-10-01

    Few population-based data are available on factors associated with pneumonic and ulceroglandular type B tularaemia. We conducted a case-control study during a large epidemic in 2000. Laboratory-confirmed case patients were identified through active surveillance and matched control subjects (age, sex, residency) from the national population information system. Data were collected using a self-administered questionnaire. A conditional logistic regression model addressing missing data with Bayesian full-likelihood modelling included 227 case patients and 415 control subjects; reported mosquito bites [adjusted odds ratio (aOR) 9·2, 95% confidence interval (CI) 4·4-22, population-attributable risk (PAR) 82%] and farming activities (aOR 4·3, 95% CI 2·5-7·2, PAR 32%) were independently associated with ulceroglandular tularaemia, whereas exposure to hay dust (aOR 6·6, 95% CI 1·9-25·4, PAR 48%) was associated with pneumonic tularaemia. Although the bulk of tularaemia type B disease burden is attributable to mosquito bites, risk factors for ulceroglandular and pneumonic forms of tularaemia are different, enabling targeting of prevention efforts accordingly.

  14. Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013.

    PubMed

    Savage, E J; Mohammed, H; Leong, G; Duffell, S; Hughes, G

    2014-12-04

    A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.

  15. Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013.

    PubMed

    Savage, E J; Mohammed, H; Leong, G; Duffell, S; Hughes, G

    2014-01-01

    A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described. PMID:25496573

  16. Risk factors, clinical presentation and prognosis of mixed candidaemia: a population-based surveillance in Spain.

    PubMed

    Ramos, Antonio; Romero, Yolanda; Sánchez-Romero, Isabel; Fortún, Jesús; Paño, José Ramón; Pemán, Javier; Gurguí, Mercè; Rodríguez-Baño, Jesús; Padilla, Belén

    2016-10-01

    The low incidence of mixed candidaemia (MC) may have precluded a better knowledge of its clinical presentation. The aim of the study was to analyse the risk factors, clinical presentation and prognosis of MC episodes. A comparison between MC and monomicrobial candidaemia within a prospective programme on candidaemia was performed in 29 hospitals between April 2010 and May 2011. In fifteen episodes of candidaemia corresponding to 15 patients, out of 752, two species of Candida (1.9%) were isolated. MC was more frequent in patients with HIV infection (12%, P = 0.038) and those admitted due to extensive burns (23%, P = 0.012). The Candida species most frequently identified in MC were C. albicans 12 patients (40%), C. glabrata seven patients (23.3%) and C. parapsilosis six patients (20%). Early mortality was higher (nine patients, 60%) in patients with MC than in patients with MMC (223 patients, 30.3%, P = 0.046). In conclusion, MC was was independently associated with increased mortality even after considering other prognostic factors. MC is an infrequent event that is more common in HIV infection and in patients suffering from burns, and is associated with increased mortality.

  17. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    PubMed

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further.

  18. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    PubMed

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further. PMID:21728077

  19. Assessment of military population-based psychological resilience programs.

    PubMed

    Morgan, Brenda J; Bibb, Sandra C Garmon

    2011-09-01

    Active duty service members' (ADSMs) seemingly poor adaptability to traumatic stressors is a risk to force health. Enhancing the psychological resilience of ADSMs has become a key focus of Department of Defense (DoD) leaders and the numbers of military programs for enhancing psychological resilience have increased. The purpose of this article is to describe the results of an assessment conducted to determine comprehensiveness of current psychological resilience building programs that target ADSMs. A modified six-step, population-based needs assessment was used to evaluate resilience programs designed to meet the psychological needs of the ADSM population. The assessment results revealed a gap in published literature regarding program outcomes. DoD leaders may benefit from targeted predictive research that assesses program effectiveness outcomes. The necessity of including preventive, evidence-based interventions in new programs, such as positive emotion interventions shown to enhance psychological resilience in civilian samples, is also recommended.

  20. Comprehensive Challenges for the Well Being of Young Children: A Population-Based Study of Publicly Monitored Risks in a Large Urban Center

    ERIC Educational Resources Information Center

    Rouse, Heather L.; Fantuzzo, John W.; LeBoeuf, Whitney

    2011-01-01

    This population-based study investigated the unique and cumulative relations between risks that are monitored by public surveillance systems and academic and behavioral outcomes for an entire cohort of third graders in a large, urban public school system. Using integrated, administrative records from child welfare, public health, housing, and…

  1. Subdural haemorrhages in infants: population based study

    PubMed Central

    Jayawant, S; Rawlinson, A; Gibbon, F; Price, J; Schulte, J; Sharples, P; Sibert, J R; Kemp, A M

    1998-01-01

    Objectives To identify the incidence, clinical outcome, and associated factors of subdural haemorrhage in children under 2 years of age, and to determine how such cases were investigated and how many were due to child abuse. Design Population based case series. Setting South Wales and south west England. Subjects Children under 2 years of age who had a subdural haemorrhage. We excluded neonates who developed subdural haemorrhage during their stay on a neonatal unit and infants who developed a subdural haemorrhage after infection or neurosurgical intervention. Main outcome measures Incidence and clinical outcome of subdural haemorrhage in infants, the number of cases caused by child abuse, the investigations such children received, and associated risk factors. Results Thirty three children (23 boys and 10 girls) were identified with subdural haemorrhage. The incidence was 12.8/100 000 children/year (95% confidence interval 5.4 to 20.2). Twenty eight cases (85%) were under 1 year of age. The incidence of subdural haemorrhage in children under 1 year of age was 21.0/100 000 children/year and was therefore higher than in the older children. The clinical outcome was poor: nine infants died and 15 had profound disability. Only 22 infants had the basic investigations of a full blood count, coagulation screen, computed tomography or magnetic resonance imaging, skeletal survey or bone scan, and ophthalmological examination. In retrospect, 27 cases (82%) were highly suggestive of abuse. Conclusion Subdural haemorrhage is common in infancy and carries a poor prognosis; three quarters of such infants die or have profound disability. Most cases are due to child abuse, but in a few the cause is unknown. Some children with subdural haemorrhage do not undergo appropriate investigations. We believe the clinical investigation of such children should include a full multidisciplinary social assessment, an ophthalmic examination, a skeletal survey supplemented with a bone scan or a

  2. Surface-water surveillance

    SciTech Connect

    Saldi, K.A.; Dirkes, R.L.; Blanton, M.L.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the Surface water on and near the Hanford Site is monitored to determine the potential effects of Hanford operations. Surface water at Hanford includes the Columbia River, riverbank springs, ponds located on the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site. Columbia River sediments are also included in this discussion. Tables 5.3.1 and 5.3.2 summarize the sampling locations, sample types, sampling frequencies, and sample analyses included in surface-water surveillance activities during 1994. Sample locations are also identified in Figure 5.3.1. This section describes the surveillance effort and summarizes the results for these aquatic environments. Detailed analytical results are reported by Bisping (1995).

  3. [Activity of sanitary surveillances/offices in Warsaw at the time of the second republic of Poland].

    PubMed

    Berner, Włodzimierz

    2006-01-01

    At the time of the Second Republic of Poland, Warsaw, the capital of the rebirth country, was a neglected town as regards sanitary conditions. The genesis of this situation dates back to the period of the national bondage by the Russian partitioner, and since 1915 by the German invader who did not care about the problems associated with public health. The sanitary and hygienic conditions worsened significantly in 1916, after incorporating into Warsaw large out-of-town regions whose housing was of the rural character with numerous wooden cottages, field roads, without any sanitary sewage system. Poor municipal sanitary-maintenance conditions and infectious diseases spreading in Warsaw made the Town Authorities implement preventive action and entrust sanitary surveillances with this difficult task. These surveillances were set up at the time of the First World War, and after 1920 were changed into sanitary offices. Their duties included control of acute infectious diseases, sanitary inspection of living quarters, sites of production and selling of food articles, plants, service outlets, shops of a different character, as well as surveillance of food purchased by the inhabitants. In each sanitary office a doctor was employed who supervised the work of one, two or three sanitary inspectors. PMID:17682766

  4. [Activity of sanitary surveillances/offices in Warsaw at the time of the second republic of Poland].

    PubMed

    Berner, Włodzimierz

    2006-01-01

    At the time of the Second Republic of Poland, Warsaw, the capital of the rebirth country, was a neglected town as regards sanitary conditions. The genesis of this situation dates back to the period of the national bondage by the Russian partitioner, and since 1915 by the German invader who did not care about the problems associated with public health. The sanitary and hygienic conditions worsened significantly in 1916, after incorporating into Warsaw large out-of-town regions whose housing was of the rural character with numerous wooden cottages, field roads, without any sanitary sewage system. Poor municipal sanitary-maintenance conditions and infectious diseases spreading in Warsaw made the Town Authorities implement preventive action and entrust sanitary surveillances with this difficult task. These surveillances were set up at the time of the First World War, and after 1920 were changed into sanitary offices. Their duties included control of acute infectious diseases, sanitary inspection of living quarters, sites of production and selling of food articles, plants, service outlets, shops of a different character, as well as surveillance of food purchased by the inhabitants. In each sanitary office a doctor was employed who supervised the work of one, two or three sanitary inspectors.

  5. The surveillant assemblage.

    PubMed

    Haggerty, K D; Ericson, R V

    2000-12-01

    George Orwell's 'Big Brother' and Michel Foucault's 'panopticon' have dominated discussion of contemporary developments in surveillance. While such metaphors draw our attention to important attributes of surveillance, they also miss some recent dynamics in its operation. The work of Gilles Deleuze and Felix Guattari is used to analyse the convergence of once discrete surveillance systems. The resultant 'surveillant assemblage' operates by abstracting human bodies from their territorial settings, and separating them into a series of discrete flows. These flows are then reassembled in different locations as discrete and virtual 'data doubles'. The surveillant assemblage transforms the purposes of surveillance and the hierarchies of surveillance, as well as the institution of privacy. PMID:11140886

  6. Summary of Ceftaroline Activity against Pathogens in the United States, 2010: Report from the Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) Surveillance Program

    PubMed Central

    Sader, Helio S.; Farrell, David J.; Jones, Ronald N.

    2012-01-01

    The Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) surveillance program is a sentinel resistance monitoring system designed to track the activity of ceftaroline and comparator agents. In the United States, a total of 8,434 isolates were collected during the 2010 surveillance program from 65 medical centers distributed across the nine census regions (5 to 10 medical centers per region). All organisms were isolated from documented infections, including 3,055 (36.2%) bloodstream infections, 2,282 (27.1%) respiratory tract infections, 1,965 (23.3%) acute bacterial skin and skin structure infections, 665 (7.9%) urinary tract infections, and 467 (5.5%) miscellaneous other infection sites. Ceftaroline was the most potent β-lactam agent tested against staphylococci. The MIC90 values were 1 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA; 98.4% susceptible) and 0.5 μg/ml for methicillin-resistant coagulase-negative staphylococci (CoNS). Ceftaroline was 16- to 32-fold more potent than ceftriaxone against methicillin-susceptible staphylococcal strains. All staphylococcus isolates (S. aureus and CoNS) were inhibited at ceftaroline MIC values of ≤2 μg/ml. Ceftaroline also displayed potent activity against streptococci (MIC90, 0.015 μg/ml for beta-hemolytic streptococci; MIC90, 0.25 μg/ml for penicillin-resistant Streptococcus pneumoniae). Potent activity was also shown against Gram-negative pathogens (Haemophilus influenzae, Haemophilus parainfluenzae, and Moraxella catarrhalis). Furthermore, wild-type strains of Enterobacteriaceae (non-extended-spectrum β-lactamase [ESBL]-producing strains and non-AmpC-hyperproducing strains) were often susceptible to ceftaroline. Continued monitoring through surveillance networks will allow for the assessment of the evolution of resistance as this new cephalosporin is used more broadly to provide clinicians with up-to-date information to assist in antibiotic stewardship and therapeutic decision making

  7. Surveillance for dengue and dengue hemorrhagic fever.

    PubMed

    Gubler, D J

    1989-01-01

    Dengue and dengue hemorrhagic fever are emerging as major public health problems in most tropical countries. Effective prevention and control programs will depend on improved surveillance designed to provide early warning of dengue epidemics. This article outlines a reasonable approach to dengue surveillance of this kind. Virologic surveillance should be considered the most important element in any such early warning system. Dengue virus transmission should be monitored to determine which serotypes are present, their distribution, and the type of illnesses associated with each. Other key components of an active surveillance system should include monitoring of fever activity and clinical surveillance for cases of severe and fatal disease associated with viral syndromes. Collectively, these three surveillance components can provide an early warning capability permitting emergency mosquito control measures to be implemented and major epidemics to be averted.

  8. Systems for persistent surveillance

    NASA Astrophysics Data System (ADS)

    Lewis, Keith

    2011-09-01

    The requirements for a persistent wide-area surveillance system are discussed in the context of evolving military operations. Significant emphasis has been placed on the development of new sensing technologies to meet the challenges posed by asymmetric threats. Within the UK, the Electro-Magnetic Remote Sensing Defence Technology Centre (EMRS DTC) has supported the research and development of new capabilities including radio-frequency (RF) and electro-optic (EO) systems, as well as work on sensor exploitation, with a goal of developing solutions for enhancing situational awareness. This activity has been supported by field trials to determine the efficacy of competing technologies in relation to realistic threat scenarios.

  9. GSFC Supplier Surveillance

    NASA Technical Reports Server (NTRS)

    Kelly, Michael P.

    2011-01-01

    Topics covered include: Develop Program/Project Quality Assurance Surveillance Plans The work activities performed by the developer and/or his suppliers are subject to evaluation and audit by government-designated representatives. CSO supports project by selecting on-site supplier representative s by one of several methods: (1) a Defense Contract Management Agency (DCMA) person via a Letter Of Delegation (LOD), (2) an independent assurance contractor (IAC) via a contract Audits, Assessments, and Assurance (A3) Contract Code 300 Mission Assurance Support Contract (MASC)

  10. [Measles surveillance in Germany. From sentinel to mandatory surveillance].

    PubMed

    Siedler, A; Grüber, A; Mankertz, A

    2013-09-01

    From September 1999 to March 2011, sentinel surveillance of measles was conducted by a self-selected sample of private physicians in Germany. From 2001, when mandatory surveillance for measles was established, two surveillance systems worked in parallel. The aim of this article is to summarize the strengths and limitations of sentinel versus mandatory surveillance. Active monthly reporting included case-based questionnaires on patients with (suspected) measles or zeroreporting. For confirmation of measles, the diagnostic patient specimens were sent to regional laboratories for serological tests or to the National Reference Laboratory (NRC). In the NRC in addition to serological tests measles-virus (MV) detection by PCR in urine, throat swabs, and oral fluid (since 2003) as well as MVgenotyping was offered. From January 2000 to December 2010, 934 out of 1,488 participating sentinel-practices did not see any measles case, while 554 reported 3,573 suspected cases. Measles was confirmed by laboratory testing in 801 cases, excluded in 473 cases, and the diagnosis remained uncertain in 215 cases. Of 3,100 analyzed cases, 2,712 (87 %) were unvaccinated, 217 (7 %) and 32 (1 %) were vaccinated with one or two doses, respectively, and for 139 (4 %) cases the vaccination status was unknown. The main reason for not being vaccinated against measles was refusal (n = 1,383). The confirmation rate was lower in the vaccinated than in the unvaccinated patients (19 % vs. 63 %). Since 2006, sentinel-cases have differed from notified cases by region and age. The proportion of sentinel cases from all NRC-investigated cases decreased from more than  50 % (2002) to less than  5 % (since 2007). Sentinel surveillance allowed for the detection of trends, delivered additional information for measles prevention, and played a major role in measles diagnostics. Since mandatory surveillance was established and sentinel surveillance no longer reflected the epidemiologic

  11. ASSOCIATON BETWEEN INTIMATE PARTNER VIOLENCE AND IRRITABLE BOWEL SYNDROME: A POPULATION-BASED STUDY IN NICARAGUA

    PubMed Central

    Becker-Dreps, Sylvia; Morgan, Douglas; Peña, Rodolfo; Cortes, Loreto; Martin, Christopher F.; Valladares, Eliette

    2010-01-01

    Irritable bowel syndrome (IBS) is a disabling functional gastrointestinal disorder, which serves as a model for abdominal pain syndromes. An association between intimate partner violence and IBS has been shown among Caucasian women in the industrialized world. To determine whether this relationship transcends cultural boundaries, we conducted a population-based, cross-sectional survey in Nicaragua, using the innovative Health and Demographic Surveillance System in the León province. Women who had experienced physical intimate partner violence had significantly increased risk of IBS (OR 2.08, 95% CI, 1.35, 3.21), as did those who had experienced sexual intimate partner violence (OR 2.85, 95% CI 1.45, 5.59). These findings argue for intimate partner violence screening among Latina women with IBS. PMID:20558772

  12. Digital Dashboard Design Using Multiple Data Streams for Disease Surveillance With Influenza Surveillance as an Example

    PubMed Central

    Cheng, Calvin KY; Ip, Dennis KM; Cowling, Benjamin J; Ho, Lai Ming; Leung, Gabriel M

    2011-01-01

    Background 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. Objective 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. Methods 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. Results 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. Conclusions 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

  13. Cancer incidence in Ghana, 2012: evidence from a population-based cancer registry

    PubMed Central

    2014-01-01

    registration in Ghana indicates that such registries are feasible in resource limited settings as ours. Strengthening Public Health Surveillance and establishing more Population-based Cancer Registries will help improve data quality and national efforts at cancer prevention and control in Ghana. PMID:24884730

  14. Lessons learned in the conduct, validation, and interpretation of national population based HIV surveys.

    PubMed

    Calleja, Jesús M García; Marum, Lawrence H; Cárcamo, César P; Kaetano, Lovemore; Muttunga, James; Way, Ann

    2005-05-01

    In the past few years several countries have conducted national population-based HIV surveys. Survey methods, levels of participation bias from absence or refusal and lessons learned conducting such surveys are compared in four national population surveys: Mali, Kenya, Peru and Zambia. In Mali, Zambia, and Kenya, HIV testing of adult women and men was included in the national-level demographic and health surveys carried out regularly in these countries, whereas in Peru the national HIV survey targeted young people in 24 cities with populations over 50 000.The household response rate was above 90% in all countries, but some individuals were absent for interviews. HIV testing rates were between 70 and 79% of those eligible, with higher test rates for women. Three critical questions in this type of survey need to be answered: who did the surveys miss; how much it matters that they were missed; and what can be done to increase the participation of respondents so the coverage rates are adequate. The level of representativeness of the populations tested was adequate in each survey to provide a reliable national estimate of HIV prevalence that complements other methods of HIV surveillance. Different lessons were learned from each survey. These population-based HIV seroprevalence surveys demonstrate that reliable and useful results can be obtained, although they require careful planning and increased financial and human resource investment to maximize responses at the household and individual level, which are key elements to validate survey results.This review was initiated through an international meeting on 'New strategies for HIV/AIDS Surveillance in Resource-constrained Countries' held in Addis Ababa on 26-30 January 2004 to share and develop recommendations to guide future surveys. PMID:15930844

  15. General Medical Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on the General Medical Surveillance Program at LeRC is presented. The purpose of the General Medical Surveillance Program at LeRC is outlined, and the specifics of the program are discussed.

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

    PubMed

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

    2016-03-01

    Wild polioviruses still remain endemic in three countries (Afghanistan, Pakistan, and Nigeria) and re-emergency of wild polio has been reported in previously polio-free countries. Environmental surveillance has been used as a supplementary tool in monitoring the circulation of wild poliovirus (PVs) and/or vaccine-derived PVs even in the absence of acute flaccid paralysis cases. This study aimed to monitor the presence of polioviruses in wastewater samples collected at one wastewater treatment plant located in the municipality of Rio de Janeiro, Brazil. From December 2011 to June 2012 and from September to December 2012, 31 samples were collected and processed. RD and L20B cell cultures were able to isolate PVs and non-polio enteroviruses in 27/31 samples. Polioviruses were isolated in eight samples (type 1 Sabin = 1, type 2 Sabin = 5, and type 3 Sabin = 2). Vaccine-derived polioviruses were not detected nor evidence of recombination with other PVs or non-polio enterovirus serotypes were observed among the isolates. The Sabin-related serotypes 2 and 3 presented nucleotide substitutions in positions associated with the neurovirulent phenotype at the 5'-UTR. Changes in important Amino acid residues at VP1 were also observed in the serotypes 2 and 3. Environmental surveillance has been used successfully in monitoring the circulation of PVs and non-polio enteroviruses and it is of crucial importance in the final stages of the WHO global polio eradication initiative. Our results show the continuous circulation of Sabin-like PVs and non-polio enteroviruses in the analyzed area during the study period. PMID:26538420

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

    PubMed

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

    2016-03-01

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

  18. Does geography influence the treatment and outcomes of colorectal cancer? A population-based analysis

    PubMed Central

    2013-01-01

    Background The Canadian province of Manitoba covers a large geographical area but only has one major urban center, Winnipeg. We sought to determine if regional differences existed in the quality of colorectal cancer care in a publicly funded health care system. Methods This was a population-based historical cohort analysis of the treatment and outcomes of Manitobans diagnosed with colorectal cancer between 2004 and 2006. Administrative databases were utilized to assess quality of care using published quality indicators. Results A total of 2,086 patients were diagnosed with stage I to IV colorectal cancer and 42.2% lived outside of Winnipeg. Patients from North Manitoba had a lower odds of undergoing major surgery after controlling for other confounders (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.26 to 0.90). No geographic differences existed in the quality measures of 30-day operative mortality, consultations with oncologists, surveillance colonoscopy, and 5-year survival. However, there was a trend towards lower survival in North Manitoba. Conclusion We found minimal differences by geography. However, overall compliance with quality measures is low and there are concerning trends in North Manitoba. This study is one of the few to evaluate population-based benchmarks for colorectal cancer therapy in Canada. PMID:23773619

  19. The potential and limitations of data from population-based state cancer registries.

    PubMed

    Izquierdo, J N; Schoenbach, V J

    2000-05-01

    Cancer incidence varies markedly among states because of population heterogeneity regarding risk, genetic, and demographic factors. Population-based cancer registries are essential to monitoring cancer trends and control. The Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries, through the National Program of Cancer Registries, are helping state registries generate more and better data nationwide. The National Program of Cancer Registries has supported the enhancement of 36 registries and the creation of 13 new registries in 45 states, 3 territories, and the District of Columbia, providing national standards for completeness, timeliness, and quality; financial support; and technical assistance. Users must be aware of diverse issues that influence collection and interpretation of cancer registry data, such as multiple cancer diagnoses, duplicate reports, reporting delays, misclassification of race/ethnicity, and pitfalls in estimations of cancer incidence rates. Attention to these issues and intense use of the available data for cancer surveillance will enable maximum societal benefit from the emerging network of population-based state cancer registries.

  20. The potential and limitations of data from population-based state cancer registries.

    PubMed Central

    Izquierdo, J N; Schoenbach, V J

    2000-01-01

    Cancer incidence varies markedly among states because of population heterogeneity regarding risk, genetic, and demographic factors. Population-based cancer registries are essential to monitoring cancer trends and control. The Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries, through the National Program of Cancer Registries, are helping state registries generate more and better data nationwide. The National Program of Cancer Registries has supported the enhancement of 36 registries and the creation of 13 new registries in 45 states, 3 territories, and the District of Columbia, providing national standards for completeness, timeliness, and quality; financial support; and technical assistance. Users must be aware of diverse issues that influence collection and interpretation of cancer registry data, such as multiple cancer diagnoses, duplicate reports, reporting delays, misclassification of race/ethnicity, and pitfalls in estimations of cancer incidence rates. Attention to these issues and intense use of the available data for cancer surveillance will enable maximum societal benefit from the emerging network of population-based state cancer registries. PMID:10800415

  1. Wallops Ship Surveillance System

    NASA Technical Reports Server (NTRS)

    Smith, Donna C.

    2011-01-01

    Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

  2. Public participation in radiological surveillance.

    PubMed

    Hanf, R W; Schreckhise, R G; Patton, G W; Poston, T M; Jaquish, R E

    1997-10-01

    In 1989, Pacific Northwest National Laboratory developed a program, for the U.S. Department of Energy, to involve local citizens in environmental surveillance at the Hanford Site. The Community-Operated Environmental Surveillance Program was patterned after similar community-involvement efforts at the Nevada Test Site and the Three Mile Island nuclear facility. Its purpose is to increase the flow of information to the public, thereby enhancing the public's awareness and understanding of surveillance activities. The program consists of two components: radiological air monitoring at nine offsite locations and agricultural product sampling at selected locations near the site. At each air-monitoring station, two local school teachers collect air particulate samples and operate equipment to monitor ambient radiation levels. Atmospheric tritium samples (as water vapor) are also collected at some locations. Four of the air-monitoring stations include large, colorful informational displays for public viewing. These displays provide details on station equipment, sample types, and sampling purposes. Instruments in the displays also monitor, record, and show real-time ambient radiation readings (measured with a pressurized ionization chamber) and meteorological conditions. Agricultural products, grown primarily by middle-school-aged students, are obtained from areas downwind of the site. Following analysis of these samples, environmental surveillance staff visit the schools to discuss the results with the students and their teachers. The data collected by these air and agricultural sampling efforts are summarized with other routinely collected sitewide surveillance data and reported annually in the Hanford Site environmental report. PMID:9314235

  3. The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

    PubMed Central

    Bayar, Göksel; Horasanlı, Kaya; Acinikli, Hüseyin; Tanrıverdi, Orhan; Dalkılıç, Ayhan; Arısan, Serdar

    2016-01-01

    Objective To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. Material and methods In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005–2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level <10 ng/mL, number of positive cores <3, maximum cancer involvement ratio <50% each core. Immediate re-biopsy (within 3 months) was performed to 65 patients who accepted AS. Finally, 43 patients who met re-biopsy criteria were included in the study. Prostate biopsy specimens were harvested from 12 cores under the guidance of transrectal ultrasound (TRUS). Re-biopsy was performed within 3 months (1–12 weeks). In re-biopsy, a total of 20 core biopsies were performed including the far lateral (6 cores) and transition zone (2 cores) in addition to standard 12 core biopsy. Our follow-up protocol is PSA measurement and digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens. Results Patients’ median age was 61 years and PSA level was 5 (2.7–9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active

  4. Epidemiology of traffic injuries and motor vehicles utilization in the Capital of Iran: A population based study

    PubMed Central

    2011-01-01

    Background Road traffic injuries are a serious public health problem worldwide. The incidence rate of fatal road traffic injuries is 26.4 per 100000 in the Eastern Mediterranean Region. Road traffic injuries are a major public health problem in Iran. Different routine sources are available for road traffic injuries in Iran, but they present several limitations. This study aimed to determine the epidemiology of road traffic injuries in greater Tehran, using a population-based approach which is less prone to under-estimation compared to service-based data. Methods In the year 2008, 2488 households were randomly selected for a face to face interview. Trained interviewers referred to the selected households to collect the subjects' demographic information, as well as their motor vehicle utilization and traffic injuries during the year prior to data collection. All interviews were recorded using a digital voice recorder and reviewed by a quality control team the day after the interview. The Student's t-test and ANOVA were used to analyze continuous variables. Chi-square test -including a test for trend for ordinal data- was used to analyze categorical variables. Ninety-five percent confidence interval was calculated for point estimates of incidences using Poisson or binomial distribution assumptions accordingly. Results There were 119 traffic injury cases including 3 deaths (33 per 100 000) in the survey sample (n = 9100). The annual incidence of all traffic injuries for 1000 population was 13.1 (95% CI: 10.8 - 15.6), and that of fatal traffic injuries was 33.0 per 100 000 population (95% CI: 6.80 - 96.32). The annual incidence of collision traffic injury for 1000 motorcycles was 95. Conclusion This population-based study demonstrates that the morbidity rate of RTIs is about ten times higher than the national figures reported by other available sources; and this can serve as an important warning to countries like Iran to prioritize this issue in their public health

  5. Intelligent route surveillance

    NASA Astrophysics Data System (ADS)

    Schoemaker, Robin; Sandbrink, Rody; van Voorthuijsen, Graeme

    2009-05-01

    Intelligence on abnormal and suspicious behaviour along roads in operational domains is extremely valuable for countering the IED (Improvised Explosive Device) threat. Local sensor networks at strategic spots can gather data for continuous monitoring of daily vehicle activity. Unattended intelligent ground sensor networks use simple sensing nodes, e.g. seismic, magnetic, radar, or acoustic, or combinations of these in one housing. The nodes deliver rudimentary data at any time to be processed with software that filters out the required information. At TNO (Netherlands Organisation for Applied Scientific Research) research has started on how to equip a sensor network with data analysis software to determine whether behaviour is suspicious or not. Furthermore, the nodes should be expendable, if necessary, and be small in size such that they are hard to detect by adversaries. The network should be self-configuring and self-sustaining and should be reliable, efficient, and effective during operational tasks - especially route surveillance - as well as robust in time and space. If data from these networks are combined with data from other remote sensing devices (e.g. UAVs (Unmanned Aerial Vehicles)/aerostats), an even more accurate assessment of the tactical situation is possible. This paper shall focus on the concepts of operation towards a working intelligent route surveillance (IRS) research demonstrator network for monitoring suspicious behaviour in IED sensitive domains.

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

    PubMed Central

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

    2015-01-01

    As visual impairment (VI) due to adverse drug reactions (ADR) is rare in adults and children, there is an incomplete evidence base to inform guidance for screening and for counseling patients on the potential risks of medications. We report on suspected drugs and the eye conditions found in a national study of incidence of diagnosis of visual impairment due to suspected ADR. Case ascertainment was via the British Ophthalmological Surveillance Unit (BOSU), between March 2010 and February 2012, with follow-up after 6 months. Case definition: any child or adult with bilateral or unilateral visual impairment due to a suspected ADR, using distance acuity worse than Snellen 6/18 (logMAR 0.48) in the better eye (bilateral) or affected eye (unilateral). Anonymized patient information on potential cases was provided by managing ophthalmologists, comprising visual status before and after suspected ADR, ophthalmic condition attributable to the ADR, preexisting eye disease and prescribed medications at the time of the ADR. Permanency and causality of the visual impairment were confirmed by the managing clinician, after 6 months, using the WHO Uppsala Monitoring Committee criteria. Over 2 years, 36 eligible cases were reported of whom 23 had permanent VI. While most cases were due to drugs known to have adverse side-effects, some were unanticipated sporadic cases. Visual impairment due to ADRs is rare. However, with for example, increasing polypharmacy in the elderly, monitoring of ocular ADRs, although challenging, is necessary. PMID:25692024

  7. Genetic variants of the Wnt signaling pathway as predictors of aggressive disease and reclassification in men with early stage prostate cancer on active surveillance.

    PubMed

    Shu, Xiang; Ye, Yuanqing; Gu, Jian; He, Yonggang; Davis, John W; Thompson, Timothy C; Logothetis, Christopher J; Kim, Jeri; Wu, Xifeng

    2016-10-01

    Little is known about the genetic predictors of prostate cancer aggressiveness and reclassification in men with localized prostate cancer undergoing active surveillance. The Wnt signaling pathway is important for prostate cancer development and progression. Identifying genetic variants associated with prostate cancer aggressiveness and reclassification may have a potential role in the management of localized patients. In this study, we used a three-phase design. In phases I and II prostate cancer patient cohort, 578 single nucleotide polymorphisms (SNPs) from 45 genes of the Wnt signaling pathway were analyzed in 1762 localized prostate cancer patients. Twelve SNPs from four regions were significantly associated with aggressive disease, among which, three linked SNPs in CSNK1A1 at 5q32 (represented by rs752822) may differentiate GS 4+3 from GS 3+4 patients (OR = 1.44, 95% CI = 1.12-1.87, P = 4.76×10(-3)). In phase III active surveillance (AS) cohort, genotyping of rs752822 (candidate from phases I and II) and previously identified rs2735839 were determined in 494 GS ≤7 patients. We found a significant association between rs2735839 and prostate cancer reclassification in the AS cohort (AG + AA versus GG, HR = 1.59, 95% CI = 1.11-2.28, P = 0.012) and a suggestive association of rs752822. Jointly, rs752822 and rs2735839 showed good potentials in risk-stratifying GS 7 patients and predicting disease reclassification (OR = 2.71, 95% CI = 1.62-4.51, P = 1×10(-4) in phase II; HR = 1.89, 95% CI = 1.13-3.18, P = 0.016 in phase III). In summary, rs752822 and rs2735839 may assist in risk-stratifying GS 7 patients and predict prostate cancer reclassification. The significant associations were independent from GS, T stage and PSA levels at baseline. PMID:27515962

  8. PTEN loss and chromosome 8 alterations in Gleason grade 3 prostate cancer cores predicts the presence of un-sampled grade 4 tumor: implications for active surveillance.

    PubMed

    Trock, Bruce J; Fedor, Helen; Gurel, Bora; Jenkins, Robert B; Knudsen, B S; Fine, Samson W; Said, Jonathan W; Carter, H Ballentine; Lotan, Tamara L; De Marzo, Angelo M

    2016-07-01

    Men who enter active surveillance because their biopsy exhibits only Gleason grade 3 (G3) frequently have higher grade tumor missed by biopsy. Thus, biomarkers are needed that, when measured on G3 tissue, can predict the presence of higher grade tumor in the whole prostate. We evaluated whether PTEN loss, chromosome 8q gain (MYC) and/or 8p loss (LPL) measured only on G3 cores is associated with un-sampled G4 tumor. A tissue microarray was constructed of prostatectomy tissue from patients whose prostates exhibited only Gleason score 3+3, only 3+4 or only 4+3 tumor (n=50 per group). Cores sampled only from areas of G3 were evaluated for PTEN loss by immunohistochemistry, and PTEN deletion, LPL/8p loss and MYC/8q gain by fluorescence in situ hybridization. Biomarker results were compared between Gleason score 6 vs 7 tumors using conditional logistic regression. PTEN protein loss, odds ratio=4.99, P=0.033; MYC/8q gain, odds ratio=5.36, P=0.010; and LPL/8p loss, odds ratio=3.96, P=0.003 were significantly more common in G3 cores derived from Gleason 7 vs Gleason 6 tumors. PTEN gene deletion was not statistically significant. Associations were stronger comparing Gleason 4+3 vs 6 than for Gleason 3+4 vs 6. MYC/8q gain, LPL/8p loss and PTEN protein loss measured in G3 tissue microarray cores strongly differentiate whether the core comes from a Gleason 6 or Gleason 7 tumor. If validated to predict upgrading from G3 biopsy to prostatectomy these biomarkers could reduce the likelihood of enrolling high-risk men and facilitate safe patient selection for active surveillance.

  9. Genetic variants of the Wnt signaling pathway as predictors of aggressive disease and reclassification in men with early stage prostate cancer on active surveillance.

    PubMed

    Shu, Xiang; Ye, Yuanqing; Gu, Jian; He, Yonggang; Davis, John W; Thompson, Timothy C; Logothetis, Christopher J; Kim, Jeri; Wu, Xifeng

    2016-10-01

    Little is known about the genetic predictors of prostate cancer aggressiveness and reclassification in men with localized prostate cancer undergoing active surveillance. The Wnt signaling pathway is important for prostate cancer development and progression. Identifying genetic variants associated with prostate cancer aggressiveness and reclassification may have a potential role in the management of localized patients. In this study, we used a three-phase design. In phases I and II prostate cancer patient cohort, 578 single nucleotide polymorphisms (SNPs) from 45 genes of the Wnt signaling pathway were analyzed in 1762 localized prostate cancer patients. Twelve SNPs from four regions were significantly associated with aggressive disease, among which, three linked SNPs in CSNK1A1 at 5q32 (represented by rs752822) may differentiate GS 4+3 from GS 3+4 patients (OR = 1.44, 95% CI = 1.12-1.87, P = 4.76×10(-3)). In phase III active surveillance (AS) cohort, genotyping of rs752822 (candidate from phases I and II) and previously identified rs2735839 were determined in 494 GS ≤7 patients. We found a significant association between rs2735839 and prostate cancer reclassification in the AS cohort (AG + AA versus GG, HR = 1.59, 95% CI = 1.11-2.28, P = 0.012) and a suggestive association of rs752822. Jointly, rs752822 and rs2735839 showed good potentials in risk-stratifying GS 7 patients and predicting disease reclassification (OR = 2.71, 95% CI = 1.62-4.51, P = 1×10(-4) in phase II; HR = 1.89, 95% CI = 1.13-3.18, P = 0.016 in phase III). In summary, rs752822 and rs2735839 may assist in risk-stratifying GS 7 patients and predict prostate cancer reclassification. The significant associations were independent from GS, T stage and PSA levels at baseline.

  10. PTEN loss and chromosome 8 alterations in Gleason grade 3 prostate cancer cores predicts the presence of un-sampled grade 4 tumor: implications for Active Surveillance

    PubMed Central

    Trock, Bruce J.; Fedor, Helen; Gurel, Bora; Jenkins, Robert B.; Knudsen, BS; Fine, Samson W.; Said, Jonathan W.; Carter, H. Ballentine; Lotan, Tamara L.; De Marzo, Angelo M.

    2016-01-01

    Men who enter active surveillance because their biopsy exhibits only Gleason grade 3 (G3) frequently have higher grade tumor missed by biopsy. Thus, biomarkers are needed that, when measured on G3 tissue, can predict the presence of higher grade tumor in the whole prostate. We evaluated whether PTEN loss, chromosome 8q gain (MYC) and/or 8p loss (LPL) measured only on G3 cores is associated with un-sampled G4 tumor. A tissue microarray was constructed of prostatectomy tissue from patients whose prostates exhibited only Gleason score 3+3, only 3+4, or only 4+3 tumor (n=50 per group). Cores sampled only from areas of G3 were evaluated for PTEN loss by immunohistochemistry, and PTEN deletion, LPL/8p loss, and MYC/8q gain by fluorescence in situ hybridization (FISH). Biomarker results were compared between Gleason score 6 vs. 7 tumors using conditional logistic regression. PTEN protein loss, odds ratio=4.99, p=.033, MYC/8q gain, odds ratio=5.36, p=.010, and LPL/8p loss, odds ratio=3.96, p=.003 were significantly more common in G3 cores derived from Gleason 7 vs. Gleason 6 tumors. PTEN gene deletion was not statistically significant. Associations were stronger comparing Gleason 4+3 vs. 6 than for Gleason 3+4 vs. 6. MYC/8q gain, LPL/8p loss, and PTEN protein loss measured in G3 tissue microarray cores strongly differentiate whether the core comes from a Gleason 6 or Gleason 7 tumor. If validated to predict upgrading from G3 biopsy to prostatectomy these biomarkers could reduce the likelihood of enrolling high risk men and facilitate safe patient selection for active surveillance. PMID:27080984

  11. DATA SHARING REPORT CHARACTERIZATION OF POPULATION 7: PERSONAL PROTECTIVE EQUIPMENT, DRY ACTIVE WASTE, AND MISCELLANEOUS DEBRIS, SURVEILLANCE AND MAINTENANCE PROJECT OAK RIDGE NATIONAL LABORATORY OAK RIDGE, TENNESSEE

    SciTech Connect

    Harpenau, Evan M

    2013-10-10

    The U.S. Department of Energy (DOE) Oak Ridge Office of Environmental Management (EM-OR) requested that Oak Ridge Associated Universities (ORAU), working under the Oak Ridge Institute for Science and Education (ORISE) contract, provide technical and independent waste management planning support under the American Recovery and Reinvestment Act (ARRA). Specifically, DOE EM-OR requested that ORAU plan and implement a sampling and analysis campaign targeting certain URS|CH2M Oak Ridge, LLC (UCOR) surveillance and maintenance (S&M) process inventory waste. Eight populations of historical and reoccurring S&M waste at the Oak Ridge National Laboratory (ORNL) have been identified in the Waste Handling Plan for Surveillance and Maintenance Activities at the Oak Ridge National Laboratory, DOE/OR/01-2565&D2 (WHP) (DOE 2012) for evaluation and processing to determine a final pathway for disposal. Population 7 (POP 7) consists of 56 containers of aged, low-level and potentially mixed S&M waste that has been staged in various locations around ORNL. Several of these POP 7 containers primarily contain personal protective equipment (PPE) and dry active waste (DAW), but may contain other miscellaneous debris. This data sharing report addresses the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) specified waste in a 13-container subpopulation (including eight steel boxes, three 55-gal drums, one sealand, and one intermodal) that lacked sufficient characterization data for possible disposal at the Environmental Management Waste Management Facility (EMWMF) using the approved Waste Lot (WL) 108.1 profile.

  12. Pan-European Chikungunya surveillance: designing risk stratified surveillance zones

    PubMed Central

    Tilston, Natasha; Skelly, Chris; Weinstein, Phil

    2009-01-01

    The first documented transmission of Chikungunya within Europe took place in Italy during the summer of 2007. Chikungunya, a viral infection affecting millions of people across Africa and Asia, can be debilitating and no prophylactic treatment exists. Although imported cases are reported frequently across Europe, 2007 was the first confirmed European outbreak and available evidence suggests that Aedes albopictus was the vector responsible and the index case was a visitor from India. This paper proposed pan-European surveillance zones for Chikungunya, based on the climatic conditions necessary for vector activity and viral transmission. Pan-European surveillance provides the best hope for an early-warning of outbreaks, because national boundaries do not play a role in defining the risk of this new vector borne disease threat. A review of climates, where Chikungunya has been active, was used to inform the delineation of three pan-European surveillance zones. These vary in size each month across the June-September period of greatest risk. The zones stretch across southern Europe from Portugal to Turkey. Although the focus of this study was to define the geography of potential surveillance zones based on the climatic limits on the vector and virus, a preliminary examination of inward bound airline passengers was also undertaken. This indicated that France and Italy are likely to be at greater risk due to the number of visitors they receive from Chikungunya active regions, principally viraemic visitors from India. Therefore this study represents a first attempt at creating risk stratified surveillance zones, which we believe could be usefully refined with the use of higher resolution climate data and more complete air travel data. PMID:19878588

  13. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011: A Population-Based SEER Analysis.

    PubMed

    Chen, Haiyan; Cai, Yibo; Liu, Yue; He, Jinjie; Hu, Yeting; Xiao, Qian; Hu, Wangxiong; Ding, Kefeng

    2016-02-01

    Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM.We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery.We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision.This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis.

  14. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011: A Population-Based SEER Analysis.

    PubMed

    Chen, Haiyan; Cai, Yibo; Liu, Yue; He, Jinjie; Hu, Yeting; Xiao, Qian; Hu, Wangxiong; Ding, Kefeng

    2016-02-01

    Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM.We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery.We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision.This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis. PMID:26886623

  15. Temporal trends in mucocutaneous findings among human immunodeficiency virus 1-infected children in a population-based cohort.

    PubMed

    Sturt, Amy S; Anglemyer, Andrew; Berk, David R; Maldonado, Yvonne A

    2013-01-01

    The objective of the study was to determine the prevalence of pediatric human immunodeficiency virus 1 (HIV-1) mucocutaneous manifestations in the era of highly active antiretroviral therapy (HAART). We conducted population-based, prospective, multicenter pediatric HIV-1 surveillance in 276 children with perinatally acquired HIV-1 from 1988 to 2009. Centers for Disease Control and Prevention (CDC)-defined HIV-1 related mucocutaneous conditions among the 276 children were: category A (n = 152), B (n = 60), and C (n = 1). Nearly half of the category A and B diagnoses (43.4% [66/152] and 35.0% [21/60], respectively) occurred in the first year of life, with 59.2% (90/152) and 61.7% (37/60), respectively, occurring in the first 2 years of life. The most frequent infectious diagnosis was oropharyngeal thrush (n = 117, 42.4%); the most common inflammatory diagnosis was diaper dermatitis (n = 71, 25.7%). There was a temporal decline in the prevalence of A (pre-HAART cohort, 123; post-HAART cohort, 29; p < 0.01) and B (pre-HAART, 55; post-HAART, 5; p < 0.01) mucocutaneous diagnoses. In children with perinatal HIV-1, there was a significant decline in CDC category A and B mucocutaneous diagnoses by temporal cohort, consistent with the introduction of antiretroviral medications and HAART. Clinical category A and B mucocutaneous diagnoses were most common in the first 2 years of life, emphasizing the importance of early HIV-1 testing and HAART initiation. PMID:23131130

  16. The value of information: Current challenges in surveillance implementation.

    PubMed

    Stärk, Katharina D C; Häsler, Barbara

    2015-11-01

    Animal health surveillance is a complex activity that involves multiple stakeholders and provides decision support across sectors. Despite progress in the design of surveillance systems, some technical challenges remain, specifically for emerging hazards. Surveillance can also be impacted by political interests and costly consequences of case reporting, particularly in relation to international trade. Constraints on surveillance can therefore be of technical, economic and political nature. From an economic perspective, both surveillance and intervention are resource-using activities that are part of a mitigation strategy. Surveillance provides information for intervention decisions and thereby helps to offset negative effects of animal disease and to reduce the decision uncertainty associated with choices on disease control. It thus creates monetary and non-monetary benefits, both of which may be challenging to quantify. The technical relationships between surveillance, intervention and loss avoidance have not been established for most hazards despite being important consideration for investment decisions. Therefore, surveillance cannot just be maximised to minimise intervention costs. Economic appraisals of surveillance need to be done on a case by case basis for any hazard considering both surveillance and intervention performance, the losses avoided and the values attached to them. This can be achieved by using an evaluation approach which provides a systematic investigation of the worth or merit of surveillance activities. Evaluation is driven by a specific evaluation question which for surveillance systems commonly considers effectiveness, efficiency, implementation and/or compliance issues. More work is needed to provide guidance on the appropriate selection of evaluation attributes and general good practice in surveillance evaluation. Due to technical challenges, economic constraints and variable levels of capacity, the implementation of surveillance systems

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

    PubMed

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

    2016-03-01

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

  18. The U.S.-Mexico Border Infectious Disease Surveillance Project: Establishing Binational Border Surveillance

    PubMed Central

    Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin

    2003-01-01

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California–Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS. PMID:12533288

  19. The U.S.-Mexico Border Infectious Disease Surveillance project: establishing bi-national border surveillance.

    PubMed

    Weinberg, Michelle; Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin

    2003-01-01

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California-Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS.

  20. The U.S.-Mexico Border Infectious Disease Surveillance project: establishing bi-national border surveillance.

    PubMed

    Weinberg, Michelle; Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin

    2003-01-01

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California-Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS. PMID:12533288

  1. Which surveillance systems were operational after Typhoon Haiyan?

    PubMed Central

    Villa, Eireen; Pacho, Agnes; Galvan, Maria Adona; Corpuz, Aura

    2015-01-01

    Introduction Effective disease surveillance is vital for a successful disaster response. This study assessed the functionality of the three disease surveillance systems used post-Haiyan: Philippine Integrated Disease Surveillance and Response (PIDSR), Event-based Surveillance and Response (ESR) and Surveillance in Post Extreme Emergencies and Disasters (SPEED). Methods A survey of 45 government health officers from affected areas was conducted in March 2014. The survey documented when each of the systems was operational and included questions that ranked the functionality of the three surveillance systems and whether they complemented each other. Results Two of 11 (18%) surveillance units had an operational SPEED system pre-event. PIDSR and ESR remained operational in five of 11 (45%) surveillance units without interruption of reporting. Ten surveillance units (91%) rated PIDSR as functional post-Typhoon; eight (72.7%) considered ESR functional. SPEED was rated as functional by three (27%) surveillance units. Seven of 11 (63.6%) surveillance units rated the three systems as being complementary to each other. Discussion In most of the areas affected by Typhoon Haiyan, the routine surveillance systems (PIDSR and ESR) were not disrupted; although, in Leyte it took seven weeks for these to be operational. Although SPEED is recommended for activation within 48 hours after a disaster, this did not occur in most of the surveyed areas. Most of the surveillance units rated PIDSR, ESR and SPEED to be complementary to each other. PMID:26767139

  2. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Hori, Megumi; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2015-09-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2009 based on data collected from 32 of 37 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project. The incidence of only primary invasive cancer in Japan for 2009 was estimated to be 775 601. Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  3. Cancer incidence and incidence rates in Japan in 2008: a study of 25 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Matsuda, Ayako; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2014-04-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2008 based on data collected from 25 of 34 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan project. The incidence in Japan for 2008 was estimated to be 749 767 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

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

    PubMed

    Hoban, Daryl; Biedenbach, Douglas; Sahm, Daniel; Reiszner, Edina; Iaconis, Joseph

    2015-01-01

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

  5. Active Surveillance for Adverse Events After a Mass Vaccination Campaign With a Group A Meningococcal Conjugate Vaccine (PsA-TT) in Mali

    PubMed Central

    Vannice, Kirsten S.; Keita, Modibo; Sow, Samba O.; Durbin, Anna P.; Omer, Saad B.; Moulton, Lawrence H.; Yaméogo, Téné M.; Zuber, Patrick L. F.; Onwuchekwa, Uma; Sacko, Massambou; Diomandé, Fabien V. K.; Halsey, Neal A.

    2015-01-01

    Background. The monovalent meningococcal A conjugate vaccine (PsA-TT, MenAfriVac) was developed for use in the “meningitis belt” of sub-Saharan Africa. Mali was 1 of 3 countries selected for early introduction. As this is a new vaccine, postlicensure surveillance is particularly important to identify and characterize possible safety issues. Methods. The national vaccination campaign was phased from September 2010 to November 2011. We conducted postlicensure safety surveillance for PsA-TT in 40 government clinics from southern Mali serving approximately 400 000 people 1–29 years of age. We conducted analyses with individual-level data and population-level data, and we calculated rates of adverse events using the conditional exact test, a modified vaccine cohort risk interval method, and a modified self-controlled case series method for each outcome of interest, including 18 prespecified adverse events and 18 syndromic categories. Results. An increased rate of clinic visits for fever within 3 days after vaccination was found using multiple methods for all age groups. Although other signals were found with some methods, complete assessment of all other prespecified outcomes and syndromic categories did not reveal that PsA-TT was consistently associated with any other health problem. Conclusions. No new safety concerns were identified in this study. These results are consistent with prelicensure data and other studies indicating that PsA-TT is safe. The approach presented could serve as a model for future active postlicensure vaccine safety monitoring associated with large-scale immunization campaigns in low-income countries. PMID:26553680

  6. Presence, Distribution, and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Small Animal Teaching Hospital: A Year-Long Active Surveillance Targeting Dogs and Their Environment

    PubMed Central

    van Balen, Joany; Kelley, Christina; Nava-Hoet, Rocio C.; Bateman, Shane; Hillier, Andrew; Dyce, Jonathan; Wittum, Thomas E.

    2013-01-01

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) is known to be present in small animal veterinary clinical environments. However, a better understanding of the ecology and dynamics of MRSA in these environments is necessary for the development of effective infectious disease prevention and control programs. To achieve this goal, a yearlong active MRSA surveillance program was established at The Ohio State University (OSU) Veterinary Medical Center to describe the spatial and molecular epidemiology of this bacterium in the small animal hospital. Antimicrobial susceptibility testing, staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) typing, and dendrogram analysis were used to characterize and analyze the 81 environmental and 37 canine-origin MRSA isolates obtained during monthly sampling events. Overall, 13.5% of surfaces were contaminated with MRSA at 1 or more sampling times throughout the year. The majority of the environmental and canine isolates were SCCmec type II (93.8% and 86.5%, respectively) and USA100 (90.1% and 86.5%, respectively). By PFGE analysis, these isolates were found to be closely related, which reflects a low diversity of MRSA strains circulating in the hospital. For 5 consecutive months, 1 unique pulsotype was the most prevalent across the medical services and was recovered from a variety of surfaces and hospital locations. Carts/gurneys, doors, and examination tables/floors were the most frequently contaminated surfaces. Some surfaces maintained the same pulsotypes for 3 consecutive months. Molecular analysis found that incoming MRSA-positive dogs were capable of introducing a new pulsotype into the hospital environment during the surveillance period. Our results suggest that once a MRSA strain is introduced into the hospital environment, it can be maintained and spread for extended periods of time. These findings can aid in the development of biosecurity and biocontainment protocols

  7. Ebola Surveillance - Guinea, Liberia, and Sierra Leone.

    PubMed

    McNamara, Lucy A; Schafer, Ilana J; Nolen, Leisha D; Gorina, Yelena; Redd, John T; Lo, Terrence; Ervin, Elizabeth; Henao, Olga; Dahl, Benjamin A; Morgan, Oliver; Hersey, Sara; Knust, Barbara

    2016-01-01

    Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html). PMID:27389614

  8. Bovine tuberculosis surveillance alternatives in Belgium.

    PubMed

    Welby, S; Govaerts, M; Vanholme, L; Hooyberghs, J; Mennens, K; Maes, L; Van Der Stede, Y

    2012-09-15

    Belgium obtained the bovine tuberculosis (bTB) officially free status in 2003 (EC Decision 2003/467/EC). This study was carried out to evaluate the components of the current bTB surveillance program in Belgium and to determine the sensitivity of this program. Secondly, alternatives to optimize the bTB surveillance in accordance with European legislation (Council Directive 64/432/EEC) were evaluated. Separate scenario trees were designed for each active surveillance component of the bTB surveillance program. Data from 2005 to 2009 regarding cattle population, movement and surveillance were collected to feed the stochastic scenario tree simulation model. A total of 7,403,826 cattle movement history records were obtained for the 2,678,020 cattle from 36,059 cattle herds still active in 2009. The current surveillance program sensitivity as well as the impact of alternative surveillance protocols was simulated in a stochastic model using 10,000 iterations per simulation. The median (50% percentile) of the component sensitivities across 10,000 iterations was 0.83, 0.85, 0.99, 0.99, respectively, for (i) testing the cattle only during the winter screening, (ii) testing only imported cattle, (iii) testing only purchased cattle and (iv) testing only all slaughtered cattle. The sensitivity analysis showed that the most influential input parameter explaining the variability around the output came from the uncertainty distribution around the sensitivity of the diagnostic tests used within the bTB surveillance. Providing all animals are inspected and post mortem inspection is highly sensitive, slaughterhouse surveillance was the most effective surveillance component. If these conditions were not met, the uncertainty around the mean sensitivity of this component was important. Using an antibody ELISA at purchase and an interferon gamma test during winter screening and at import would increase greatly the sensitivity and the confidence level of Belgium's freedom from b

  9. 76 FR 40736 - NIH State-of-the-Science Conference on the Role of Active Surveillance in the Management of Men...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... Surveillance in the Management of Men With Localized Prostate Cancer ACTION: Notice. Notice is hereby given of... Surveillance in the Management of Men With Localized Prostate Cancer,'' to be held December 5-7, 2011, in the... cancer is the second leading cause of cancer-related deaths among men in the United States. It...

  10. HIV surveillance systems in the Asia Pacific region.

    PubMed

    Loo, Virginia; Saidel, Tobi; Reddy, Amala; Htin, Khin Cho Win; Shwe, Ye Yu; Verbruggen, Bob

    2012-07-01

    In 2011, the United Nations Joint Programme on HIV/AIDS (UNAIDS) Regional Support Team for Asia-Pacific conducted a stock-taking process of available strategic information in the Asia Pacific region. This paper summarizes the progress of HIV surveillance for 20 countries in the region, covering population size estimates of key populations at higher risk, HIV case reporting, HIV sentinel surveillance and probability surveys of behavioural and biological markers. Information on surveillance activities was obtained from publically available surveillance reports and protocols, supplemented by personal communication with the UNAIDS monitoring and evaluation advisers and surveillance experts in country. Key findings include substantial efforts in broadening the number and types of HIV surveillance components included in national HIV surveillance systems and adopting approaches to make surveillance more cost-efficient, such as integrating routine programme monitoring data and passive surveillance case reporting systems. More investment in regularly analysing and applying surveillance data to programme strengthening at the subnational level is needed but will require additional capacity-building and resources. The ability to triangulate multiple sources of surveillance data into a more comprehensive view of the HIV epidemic will be enhanced if more investment is made in better documentation and dissemination of surveillance activities and findings. PMID:23908915

  11. Influence of Individual Determinants on Physical Activity at Work and During Leisure Time in Soldiers: A Prospective Surveillance Study.

    PubMed

    Schulze, Christoph; Lindner, Tobias; Goethel, Pauline; Müller, Marie; Mittelmeier, Wolfram; Bader, Rainer

    2016-01-01

    Quantified physical activity is an important parameter for evaluating the risk of the incidence of internal and musculoskeletal disorders. The objective of this study was to evaluate the physical activity of German Soldiers on duty and during leisure time with regard to individual determinants and to evaluate if factors associated with the risk of the incidence of internal or musculoskeletal disorders are of relevance for physical activity. For this purpose, we conducted activity measurements on 169 subjects. The accelerometer-based activity sensor was worn for 7 consecutive days. The number of steps taken was evaluated as an activity marker.We observed that a high body mass index and a large waist circumference were associated with a low activity level. Women were found to be more active than men, particularly during leisure time. Personnel under 25 years of age were more physically active than those between 25 and 50 years of age. Subjects with underlying musculoskeletal disorders were less active than those who had internal disorders or were healthy. Men and overweight people run a higher risk of developing musculoskeletal and internal disorders. Health promotion should focus on raising the physical activity level with the aim of exerting a positive influence on the associated risk factors. PMID:26874098

  12. Influence of Individual Determinants on Physical Activity at Work and During Leisure Time in Soldiers: A Prospective Surveillance Study.

    PubMed

    Schulze, Christoph; Lindner, Tobias; Goethel, Pauline; Müller, Marie; Mittelmeier, Wolfram; Bader, Rainer

    2016-01-01

    Quantified physical activity is an important parameter for evaluating the risk of the incidence of internal and musculoskeletal disorders. The objective of this study was to evaluate the physical activity of German Soldiers on duty and during leisure time with regard to individual determinants and to evaluate if factors associated with the risk of the incidence of internal or musculoskeletal disorders are of relevance for physical activity. For this purpose, we conducted activity measurements on 169 subjects. The accelerometer-based activity sensor was worn for 7 consecutive days. The number of steps taken was evaluated as an activity marker.We observed that a high body mass index and a large waist circumference were associated with a low activity level. Women were found to be more active than men, particularly during leisure time. Personnel under 25 years of age were more physically active than those between 25 and 50 years of age. Subjects with underlying musculoskeletal disorders were less active than those who had internal disorders or were healthy. Men and overweight people run a higher risk of developing musculoskeletal and internal disorders. Health promotion should focus on raising the physical activity level with the aim of exerting a positive influence on the associated risk factors.

  13. Conceptual evaluation of population health surveillance programs: method and example.

    PubMed

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  14. Autonomous surveillance for biosecurity.

    PubMed

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan

    2015-04-01

    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance.

  15. Autonomous surveillance for biosecurity.

    PubMed

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan

    2015-04-01

    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance. PMID:25744760

  16. On-line image analysis of the stromboli volcanic activity recorded by the surveillance camera helps the forecasting of the major eruptive events.

    NASA Astrophysics Data System (ADS)

    Cristaldi, A.; Coltelli, M.; Mangiagli, S.; Pecora, E.

    2003-04-01

    The typical activity of Stromboli consists of intermittent mild explosions lasting a few seconds, which take place at different vents and at variable intervals, the most common time interval being 10-20 minutes. However, the routine activity can be interrupted by more violent, paroxysmal explosions, that eject m-sized scoriaceous bombs and lava blocks to a distance of several hundreds of meters from the craters, endangering the numerous tourists that watch the spectacular activity from the volcano's summit located about two hundreds meters from the active vents. On average, 1-2 paroxysmal explosions occurred per year over the past century, but this statistic may be underestimated in absence of continuous monitoring. For this reason from summer 1996 a remote surveillance camera works on Stromboli recording continuously the volcanic activity. It is located on Pizzo Sopra la Fossa, 100 metres above the crater terrace where are the active vents. Using image analysis we seeks to identify any change of the explosive activity trend that could precede a particular eruptive event, like paroxysmal explosions, fire fountains, lava flows. From the day of the camera installation up to present 12 paroxysmal events and lava flows occurred. The analysis include the counting of the explosions occurred at the different craters and the parameterization in classes of intensity for each explosion on the base of tephra dispersion and kinetics energy. The plot of dissipated energy by each crater versus time shows a cyclic behavior with max and min of explosive activity ranging from a few days to a month. Often the craters show opposite trends so when the activity decreases in a crater, increases in the other. Before every paroxysmal explosions recorded, the crater that produced the event decreased and then stopped its activity from a few days to weeks before. The other crater tried to compensate increasing its activity and when it declined the paroxysmal explosion occurred suddenly at

  17. Smart sensing surveillance video system

    NASA Astrophysics Data System (ADS)

    Hsu, Charles; Szu, Harold

    2016-05-01

    An intelligent video surveillance system is able to detect and identify abnormal and alarming situations by analyzing object movement. The Smart Sensing Surveillance Video (S3V) System is proposed to minimize video processing and transmission, thus allowing a fixed number of cameras to be connected on the system, and making it suitable for its applications in remote battlefield, tactical, and civilian applications including border surveillance, special force operations, airfield protection, perimeter and building protection, and etc. The S3V System would be more effective if equipped with visual understanding capabilities to detect, analyze, and recognize objects, track motions, and predict intentions. In addition, alarm detection is performed on the basis of parameters of the moving objects and their trajectories, and is performed using semantic reasoning and ontologies. The S3V System capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments. It would be directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.

  18. Smart sensing surveillance system

    NASA Astrophysics Data System (ADS)

    Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

    2010-04-01

    network and use the specific presentation methods. In addition, the S4 is compliant with Open Geospatial Consortium - Sensor Web Enablement (OGC-SWE) standards to efficiently discover, access, use, and control heterogeneous sensors and their metadata. These S4 capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments. The S4 system is directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.

  19. Smart sensing surveillance system

    NASA Astrophysics Data System (ADS)

    Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

    2010-04-01

    Unattended ground sensor (UGS) networks have been widely used in remote battlefield and other tactical applications over the last few decades due to the advances of the digital signal processing. The UGS network can be applied in a variety of areas including border surveillance, special force operations, perimeter and building protection, target acquisition, situational awareness, and force protection. In this paper, a highly-distributed, fault-tolerant, and energyefficient Smart Sensing Surveillance System (S4) is presented to efficiently provide 24/7 and all weather security operation in a situation management environment. The S4 is composed of a number of distributed nodes to collect, process, and disseminate heterogeneous sensor data. Nearly all S4 nodes have passive sensors to provide rapid omnidirectional detection. In addition, Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR cameras are integrated to selected nodes to track the objects and capture associated imagery. These S4 camera-connected nodes will provide applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. In the S4, all the nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology, which can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The S4 utilizes a Service Oriented Architecture such that remote applications can interact with the S4 network and use the specific presentation methods. The S4 capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded

  20. Surveillance for West Nile Virus in Clinic-admitted Raptors, Colorado

    PubMed Central

    Kratz, Gail; Edwards, Eric; Scherpelz, Judy; Bowen, Richard; Komar, Nicholas

    2007-01-01

    In 2005, 13.5% of clinic-admitted raptors in northern Colorado tested positive for West Nile virus (WNV). Clinic-admitted–raptor surveillance detected WNV activity nearly 14 weeks earlier than other surveillance systems. WNV surveillance using live raptor admissions to rehabilitation clinics may offer a novel surveillance method and should be considered along with other techniques already in use. PMID:17479898

  1. The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

    PubMed Central

    Bayar, Göksel; Horasanlı, Kaya; Acinikli, Hüseyin; Tanrıverdi, Orhan; Dalkılıç, Ayhan; Arısan, Serdar

    2016-01-01

    Objective To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. Material and methods In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005–2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level <10 ng/mL, number of positive cores <3, maximum cancer involvement ratio <50% each core. Immediate re-biopsy (within 3 months) was performed to 65 patients who accepted AS. Finally, 43 patients who met re-biopsy criteria were included in the study. Prostate biopsy specimens were harvested from 12 cores under the guidance of transrectal ultrasound (TRUS). Re-biopsy was performed within 3 months (1–12 weeks). In re-biopsy, a total of 20 core biopsies were performed including the far lateral (6 cores) and transition zone (2 cores) in addition to standard 12 core biopsy. Our follow-up protocol is PSA measurement and digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens. Results Patients’ median age was 61 years and PSA level was 5 (2.7–9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active

  2. Surveillance and maintenance report on decontamination and decommissioning and remedial action activities at the Oak Ridge Y-12 plant, Oak Ridge, Tennessee. Fiscal year 1996

    SciTech Connect

    King, H.L.; Sollenberger, M.L.; Sparkman, D.E.; Reynolds, R.M.; Wayland, G.S.

    1996-12-01

    The Oak Ridge Y-12 Plant Decontamination and Decommissioning (D&D) and Remedial Action (RA) programs are part of the Environmental Restoration (ER) Division and are funded by the Office of Environmental Management (EM-40). Building 9201-4 (known as Alpha-4), three sites located within Building 9201-3 (the Oil Storage Tank, the Molten Salt Reactor Experiment Fuel Handling Facility, and the Coolant Salt Technology Facility), and Building 9419-1 (the Decontamination Facility) are currently the facilities at the Y-12 Plant included in the D&D program. The RA program provides surveillance and maintenance (S&M) and program management of ER sites at the Y-12 Plant, including selected sites listed in Appendix C of the Federal Facilities Agreement (FFA), sites listed in the Hazardous and Solid Waste Amendment (HSWA) permit Solid Waste Management Unit (SWM-U) list, and sites currently closed or undergoing post-closure activities under the Resource Conservation and Recovery Act of 1976 (RCRA) or the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). This report communicates the status of the program plans and specific S&M activities for the D&D and RA programs.

  3. Surveillance of Traumatic Firefighter Fatalities: An Assessment of Four Systems

    PubMed Central

    Estes, Chris R.; Marsh, Suzanne M.; Castillo, Dawn N.

    2011-01-01

    Objectives Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures. Methods We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003–2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods. Results Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers. Conclusions The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts. PMID:21800748

  4. Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

    PubMed Central

    Miranda, J Jaime

    2013-01-01

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

  5. Mining Surveillance and Maintenance Dollars

    SciTech Connect

    MARTINEZ, R.

    2000-02-01

    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&M) activities. However, ongoing S&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.

  6. Survival of women with inflammatory breast cancer: a large population-based study†

    PubMed Central

    Dawood, S.; Lei, X.; Dent, R.; Gupta, S.; Sirohi, B.; Cortes, J.; Cristofanilli, M.; Buchholz, T.; Gonzalez-Angulo, A. M.

    2014-01-01

    Background Our group has previously reported that women with inflammatory breast cancer (IBC) continue to have worse outcome compared with those with non-IBC. We undertook this population-based study to see if there have been improvements in survival among women with stage III IBC, over time. Patient and methods We searched the Surveillance, Epidemiology and End Results Registry to identify female patients diagnosed with stage III IBC between 1990 and 2010. Patients were divided into four groups according to year of diagnosis: 1990–1995, 1996–2000, 2001–2005, and 2006–2010. Breast cancer-specific survival (BCSS) was estimated using the Kaplan–Meier method and compared across groups using the log-rank test. Cox models were then fit to determine the association of year of diagnosis and BCSS after adjusting for patient and tumor characteristics. Results A total of 7679 patients with IBC were identified of whom 1084 patients (14.1%) were diagnosed between 1990 and 1995, 1614 patients (21.0%) between 1996 and 2000, 2683 patients (34.9%) between 2001 and 2005, and 2298 patients (29.9%) between 2006 and 2010. The 2-year BCSS for the whole cohort was 71%. Two-year BCSS were 62%, 67%, 72%, and 76% for patients diagnosed between 1990–1995, 1996–2000, 2001–2005, and 2006–2010, respectively (P < 0.0001). In the multivariable analysis, increasing year of diagnosis (modeled as a continuous variable) was associated with decreasing risks of death from breast cancer (HR = 0.98, 95% confidence interval 0.97–0.99, P < 0.0001). Conclusion There has been a significant improvement in survival of patients diagnosed with IBC over a two-decade time span in this large population-based study. This suggests that therapeutic strategies researched and evolved in the context of non-IBC have also had a positive impact in women with IBC. PMID:24669011

  7. Population Based Cohort Study for Pediatric Infectious Diseases Research in Vietnam

    PubMed Central

    Yoshida, Lay-Myint; Suzuki, Motoi; Thiem, Vu Dinh; Smith, Wolf Peter; Tsuzuki, Ataru; Huong, Vu Thi Thu; Takahashi, Kensuke; Miyakawa, Masami; Anh, Nguyen Thi Hien; Watanabe, Kiwao; Ai, Nguyen Thu Thuy; Tho, Le Huu; Kilgore, Paul; Yoshino, Hiroshi; Toizumi, Michiko; Yasunami, Michio; Moriuchi, Hiroyuki; Anh, Dang Duc; Ariyoshi, Koya

    2014-01-01

    A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges. PMID:25425951

  8. Population-Based Burden of COPD-Related Visits in the ED

    PubMed Central

    Lippmann, Steven J.; Waller, Anna E.; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F.

    2013-01-01

    Background: Little is known about the population-based burden of ED care for COPD. Methods: We analyzed statewide ED surveillance system data to quantify the frequency of COPD-related ED visits, hospital admissions, and comorbidities. Results: In 2008 to 2009 in North Carolina, 97,511 COPD-related ED visits were made by adults ≥ 45 years of age, at an annual rate of 13.8 ED visits/1,000 person-years. Among patients with COPD (n = 33,799), 7% and 28% had a COPD-related return ED visit within a 30- and 365-day period of their index visit, respectively. Compared with patients on private insurance, Medicare, Medicaid, and noninsured patients were more likely to have a COPD-related return visit within 30 and 365 days and have three or more COPD-related visits within 365 days. There were no differences in return visits by sex. Fifty-one percent of patients with COPD were admitted to the hospital from the index ED visit. Subsequent hospital admission risk in the cohort increased with age, peaking at 65 to 69 years (risk ratio [RR], 1.41; 95% CI, 1.26-1.57); there was no difference by sex. Patients with congestive heart failure (RR, 1.29; 95% CI, 1.22-1.37), substance-related disorders (RR, 1.35; 95% CI, 1.13-1.60), or respiratory failure/supplemental oxygen (RR, 1.25; 95% CI, 1.19-1.31) were more likely to have a subsequent hospital admission compared with patients without these comorbidities. Conclusions: The population-based burden of COPD-related care in the ED is significant. Further research is needed to understand variations in COPD-related ED visits and hospital admissions. PMID:23579283

  9. Population based cohort study for pediatric infectious diseases research in Vietnam.

    PubMed

    Yoshida, Lay-Myint; Suzuki, Motoi; Thiem, Vu Dinh; Smith, Wolf Peter; Tsuzuki, Ataru; Huong, Vu Thi Thu; Takahashi, Kensuke; Miyakawa, Masami; Anh, Nguyen Thi Hien; Watanabe, Kiwao; Ai, Nguyen Thu Thuy; Tho, Le Huu; Kilgore, Paul; Yoshino, Hiroshi; Toizumi, Michiko; Yasunami, Michio; Moriuchi, Hiroyuki; Anh, Dang Duc; Ariyoshi, Koya

    2014-06-01

    A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2016-06-01

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

  12. Arsenic surveillance program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background information about arsenic is presented including forms, common sources, and clinical symptoms of arsenic exposure. The purpose of the Arsenic Surveillance Program and LeRC is outlined, and the specifics of the Medical Surveillance Program for Arsenic Exposure at LeRC are discussed.

  13. Soil and vegetation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.

  14. Asbestos Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on asbestos is presented including the different types and the important medical distinctions between those different types. The four diseases associated with asbestos exposure are discussed: mesothelioma, lung cancer, asbestosis, and benign pleural disorders. The purpose of the LeRC Asbestos Surveillance Program is outlined, and the specifics of the Medical Surveillance Program for Asbestos Monitoring at LeRC are discussed.

  15. Mercury Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on mercury exposure is presented including forms, sources, permissible exposure limits, and physiological effects. The purpose of the Mercury Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Mercury Exposure at LeRC are discussed.

  16. Lead Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on lead exposure is presented including forms of lead, sources, hematologic effects, neurologic effects, endocrine effects, renal effects, and reproductive and developmental effects. The purpose of the Lead Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Lead Exposure at LeRC are discussed.

  17. The prevalence of ADHD in a population-based sample

    PubMed Central

    Rowland, Andrew S.; Skipper, Betty J.; Umbach, David M.; Rabiner, David L.; Campbell, Richard A.; Naftel, A. Jack; Sandler, Dale P.

    2014-01-01

    Objective Few studies of ADHD prevalence have used population-based samples, multiple informants, and DSM-IV criteria. In addition, children who are asymptomatic while receiving ADHD mediction often have been misclassified. Therefore, we conducted a population-based study to estimate the prevalence of ADHD in elementary school children using DSM-IV critera. Methods We screened 7587 children for ADHD. Teachers of 81% of the children completed a DSM-IV checklist. We then interviewed parents using a structured interview (DISC). Of these, 72% participated. Parent and teacher ratings were combined to determine ADHD status. We also estimated the proportion of cases attributable to other conditions. Results Overall, 15.5% of our sample (95% confidence interval (C.I.) 14.6%-16.4%) met DSM-IV-TR criteria for ADHD. Over 40% of cases reported no previous diagnosis. With additional information, other conditions explained about 9% of cases. Conclusions The prevalence of ADHD in this population-based sample was higher than the 3-7% commonly reported. To compare study results, the methods used to implement the DSM criteria need to be standardized. PMID:24336124

  18. Continuous thermal infrared monitoring at Campi Flegrei and Vesuvius (Italy) by automated data processing: an effective surveillance tool of active volcanoes

    NASA Astrophysics Data System (ADS)

    Sansivero, Fabio; Vilardo, Giuseppe

    2014-05-01

    The INGV-Osservatorio Vesuviano Thermal Infrared Imagery Monitoring Network (TIIMNet) is made up of IR acquisition stations designed to continuously acquire IR scenes of diffuse degassing areas in the Neapolitan volcanic district. Every station consists of a RMS (Remote Monitoring Station) which manages the shooting functionalities of the IR camera and the connection to the surveillance Centre of INGV-Osservatorio Vesuviano in Naples. The first developed station was equipped with a NEC Thermo Tracer TS7302 IR camera (with 320x240 pixel FPA uncooled microbolometer); a newer one is equipped with a FLIR SC645 IR camera (with 640x480 pixel FPA uncooled microbolometer) and is supported by an in-house developed hardware which manages a fully real-time control of data acquisition and transfer procedures. As a whole, TIIMNet is composed of four permanent stations and three transportable ones. The first permanent NEC Station was installed at Vesuvius on July 2004 and dismissed on May 2007. A new permanent FLIR Station was set up on June 2011 and it acquires IR scenes from the inner SW slope of Vesuvius crater. In the Campi Flegrei caldera (Pozzuoli, Italy) a permanent NEC Station was operative at Solfatara since September 2004 and it acquired scenes of the major fumaroles area located on the SE inner slope at the intersection of two active, SW-NE and NW-SE main faults. A permanent FLIR Station has been installed at Solfatara on June 2013 and takes IR shots of a significant thermal anomaly on the Northern inner slope of the crater. At Pisciarelli locality, on the Solfatara NE outer slope, a transportable NEC Station was set up on October 2006 and dismissed on September 2013. It was abreast of a permanent FLIR Station on March 2013. Both stations stored IR scenes of the outer eastern flank of the Solfatara tuff-cone characterized by heavy water vapor and CO2 emissions close to an active NW-SE fault. IR scenes are acquired every night by the TIIMNet stations and in real time

  19. Dengue surveillance in the Pacific Islands.

    PubMed

    Condon, R; Taleo, G; Stewart, T; Sweeney, T; Kiedrzynski, T

    2000-09-01

    Adequate monitoring of dengue activity can be achieved using a combination of mosquito vector surveillance, fever surveillance, sentinel clinicians and laboratory screening. An apparent increase in fever cases or clinically suspected DF should prompt a careful clinical and laboratory investigation. If an outbreak of dengue is confirmed, health authorities will need to implement emergency community-wide control strategies. Laboratories will quickly feel the burden of clinical monitoring of cases admitted with DHF/DSS. Surveillance can change to clinical case definitions as health workers become familiar with the presenting features of DF and DHF/DSS. Criteria for hospital referral and admission must be well understood. Routine laboratory and sentinel surveillance may resume as the epidemic wanes, and should then continue indefinitely to monitor any resurgence of dengue activity.

  20. Population-based programs for increasing colorectal cancer screening in the United States.

    PubMed

    Verma, Manisha; Sarfaty, Mona; Brooks, Durado; Wender, Richard C

    2015-01-01

    Answer questions and earn CME/CNE Screening to detect polyps or cancer at an early stage has been shown to produce better outcomes in colorectal cancer (CRC). Programs with a population-based approach can reach a large majority of the eligible population and can offer cost-effective interventions with the potential benefit of maximizing early cancer detection and prevention using a complete follow-up plan. The purpose of this review was to summarize the key features of population-based programs to increase CRC screening in the United States. A search was conducted in the SCOPUS, OvidSP, and PubMed databases. The authors selected published reports of population-based programs that met at least 5 of the 6 International Agency for Research on Cancer (IARC) criteria for cancer prevention and were known to the National Colorectal Cancer Roundtable. Interventions at the level of individual practices were not included in this review. IARC cancer prevention criteria served as a framework to assess the effective processes and elements of a population-based program. Eight programs were included in this review. Half of the programs met all IARC criteria, and all programs led to improvements in screening rates. The rate of colonoscopy after a positive stool test was heterogeneous among programs. Different population-based strategies were used to promote these screening programs, including system-based, provider-based, patient-based, and media-based strategies. Treatment of identified cancer cases was not included explicitly in 4 programs but was offered through routine medical care. Evidence-based methods for promoting CRC screening at a population level can guide the development of future approaches in health care prevention. The key elements of a successful population-based approach include adherence to the 6 IARC criteria and 4 additional elements (an identified external funding source, a structured policy for positive fecal occult blood test results and confirmed cancer

  1. Population-based programs for increasing colorectal cancer screening in the United States.

    PubMed

    Verma, Manisha; Sarfaty, Mona; Brooks, Durado; Wender, Richard C

    2015-01-01

    Answer questions and earn CME/CNE Screening to detect polyps or cancer at an early stage has been shown to produce better outcomes in colorectal cancer (CRC). Programs with a population-based approach can reach a large majority of the eligible population and can offer cost-effective interventions with the potential benefit of maximizing early cancer detection and prevention using a complete follow-up plan. The purpose of this review was to summarize the key features of population-based programs to increase CRC screening in the United States. A search was conducted in the SCOPUS, OvidSP, and PubMed databases. The authors selected published reports of population-based programs that met at least 5 of the 6 International Agency for Research on Cancer (IARC) criteria for cancer prevention and were known to the National Colorectal Cancer Roundtable. Interventions at the level of individual practices were not included in this review. IARC cancer prevention criteria served as a framework to assess the effective processes and elements of a population-based program. Eight programs were included in this review. Half of the programs met all IARC criteria, and all programs led to improvements in screening rates. The rate of colonoscopy after a positive stool test was heterogeneous among programs. Different population-based strategies were used to promote these screening programs, including system-based, provider-based, patient-based, and media-based strategies. Treatment of identified cancer cases was not included explicitly in 4 programs but was offered through routine medical care. Evidence-based methods for promoting CRC screening at a population level can guide the development of future approaches in health care prevention. The key elements of a successful population-based approach include adherence to the 6 IARC criteria and 4 additional elements (an identified external funding source, a structured policy for positive fecal occult blood test results and confirmed cancer

  2. HIV testing in national population-based surveys: experience from the Demographic and Health Surveys.

    PubMed Central

    Mishra, Vinod; Vaessen, Martin; Boerma, J. Ties; Arnold, Fred; Way, Ann; Barrere, Bernard; Cross, Anne; Hong, Rathavuth; Sangha, Jasbir

    2006-01-01

    OBJECTIVES: To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. METHODS: During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. RESULTS: Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. CONCLUSIONS: Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics. PMID:16878227

  3. Tank Farm Operations Surveillance Automation Analysis

    SciTech Connect

    MARQUEZ, D.L.

    2000-12-21

    The Nuclear Operations Project Services identified the need to improve manual tank farm surveillance data collection, review, distribution and storage practices often referred to as Operator Rounds. This document provides the analysis in terms of feasibility to improve the manual data collection methods by using handheld computer units, barcode technology, a database for storage and acquisitions, associated software, and operational procedures to increase the efficiency of Operator Rounds associated with surveillance activities.

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

    PubMed Central

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

    2016-01-01

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

  5. Cardiovascular Disease Mortality After Chemotherapy or Surgery for Testicular Nonseminoma: A Population-Based Study

    PubMed Central

    Fung, Chunkit; Fossa, Sophie D.; Milano, Michael T.; Sahasrabudhe, Deepak M.; Peterson, Derick R.; Travis, Lois B.

    2015-01-01

    Purpose Increased risks of incident cardiovascular disease (CVD) in patients with testicular cancer (TC) given chemotherapy in European studies were largely restricted to long-term survivors and included patients from the 1960s. Few population-based investigations have quantified CVD mortality during, shortly after, and for two decades after TC diagnosis in the era of cisplatin-based chemotherapy. Patients and Methods Standardized mortality ratios (SMRs) for CVD and absolute excess risks (AERs; number of excess deaths per 10,000 person-years) were calculated for 15,006 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2010) who initially received chemotherapy (n = 6,909) or surgery (n = 8,097) without radiotherapy and accrued 60,065 and 81,227 person-years of follow-up, respectively. Multivariable modeling evaluated effects of age, treatment, extent of disease, and other factors on CVD mortality. Results Significantly increased CVD mortality occurred after chemotherapy (SMR, 1.36; 95% CI, 1.03 to 1.78; n = 54) but not surgery (SMR, 0.81; 95% CI, 0.60 to 1.07; n = 50). Significant excess deaths after chemotherapy were restricted to the first year after TC diagnosis (SMR, 5.31; AER, 13.90; n = 11) and included cerebrovascular disease (SMR, 21.72; AER, 7.43; n = 5) and heart disease (SMR, 3.45; AER, 6.64; n = 6). In multivariable analyses, increased CVD mortality after chemotherapy was confined to the first year after TC diagnosis (hazard ratio, 4.86; 95% CI, 1.25 to 32.08); distant disease (P < .05) and older age at diagnosis (P < .01) were independent risk factors. Conclusion This is the first population-based study, to our knowledge, to quantify short- and long-term CVD mortality after TC diagnosis. The increased short-term risk of CVD deaths should be further explored in analytic studies that enumerate incident events and can serve to develop comprehensive evidence-based approaches

  6. Annual summary report on surveillance and maintenance activities of the surplus contaminated facilities program at Oak Ridge National Laboratory for period ending September 30, 1991

    SciTech Connect

    Cannon, T.R.; Ford, M.K.; Holder, L. Jr.

    1991-09-01

    The Surplus Contaminated Facilities Program (SCFP) was established at the Oak Ridge National Laboratory (ORNL) in 1985 to provide support for inactive contaminated facilities that were largely abandoned by the programs which they formerly served. This support provides for routine surveillance and maintenance (S M) and special projects beyond a routine nature when such actions are needed to ensure adequate protection of personnel or the environment. The facilities included in the program had been used for research, technology development, isotope production and processing, and waste management. Support for facilities in the SCFP has previously been provided by the Department of Energy's (DOE's) Office of Energy Research: Multiprogram Energy Laboratories -- Facilities Support (ERKG) because of multiprogram use of the facilities or because of the landlord responsibility of Energy Research. Recently, an integrated Decontamination and Decommissioning (D D) program within the DOE Office of Environmental Restoration and Waste Management has been established to collectively manage the former Surplus Facilities Management Program, Defense D D Program, and the KG-funded, ORNL-originated SCFP. This report gives an overview of the S M planning, routine S M, and special maintenance project activities which have occurred at the SCFP facilities during the 1991 Fiscal Year.

  7. Out of the black box: expansion of a theory-based intervention to self-manage the uncertainty associated with active surveillance (AS) for prostate cancer.

    PubMed

    Kazer, Meredith Wallace; Bailey, Donald E; Whittemore, Robin

    2010-01-01

    Active surveillance (AS) (sometimes referred to as watchful waiting) is an alternative approach to managing low-risk forms of prostate cancer. This management approach allows men to avoid expensive prostate cancer treatments and their well-documented adverse events of erectile dysfunction and incontinence. However, AS is associated with illness uncertainty and reduced quality of life (QOL; Wallace, 2003). An uncertainty management intervention (UMI) was developed by Mishel et al. (2002) to manage uncertainty in women treated for breast cancer and men treated for prostate cancer. However, the UMI was not developed for men undergoing AS for prostate cancer and has not been adequately tested in this population. This article reports on the expansion of a theory-based intervention to manage the uncertainty associated with AS for prostate cancer. Intervention Theory (Sidani & Braden, 1998) is discussed as a framework for revising the UMI intervention for men undergoing AS for prostate cancer (UMI-AS). The article concludes with plans for testing of the expanded intervention and implications for the extended theory. PMID:20549916

  8. Preliminary incidence and trends of infection with pathogens transmitted commonly through food - Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006-2014.

    PubMed

    Crim, Stacy M; Griffin, Patricia M; Tauxe, Robert; Marder, Ellyn P; Gilliss, Debra; Cronquist, Alicia B; Cartter, Matthew; Tobin-D'Angelo, Melissa; Blythe, David; Smith, Kirk; Lathrop, Sarah; Zansky, Shelley; Cieslak, Paul R; Dunn, John; Holt, Kristin G; Wolpert, Beverly; Henao, Olga L

    2015-05-15

    Foodborne illnesses represent a substantial, yet largely preventable, health burden in the United States. In 10 U.S. geographic areas, the Foodborne Diseases Active Surveillance Network (FoodNet) monitors the incidence of laboratory-confirmed infections caused by nine pathogens transmitted commonly through food. This report summarizes preliminary 2014 data and describes changes in incidence compared with 2006-2008 and 2011-2013. In 2014, FoodNet reported 19,542 infections, 4,445 hospitalizations, and 71 deaths. The incidence of Shiga toxin-producing Escherichia coli (STEC) O157 and Salmonella enterica serotype Typhimurium infections declined in 2014 compared with 2006-2008, and the incidence of infection with Campylobacter, Vibrio, and Salmonella serotypes Infantis and Javiana was higher. Compared with 2011-2013, the incidence of STEC O157 and Salmonella Typhimurium infections was lower, and the incidence of STEC non-O157 and Salmonella serotype Infantis infections was higher in 2014. Despite ongoing food safety efforts, the incidence of many infections remains high, indicating that further prevention measures are needed to make food safer and achieve national health objectives.

  9. Data Sharing Report for the Quantification of Removable Activity in Various Surveillance and Maintenance Facilities at the Oak Ridge National Laboratory Oak Ridge TN

    SciTech Connect

    King, David A

    2013-12-12

    The U.S. Department of Energy (DOE) Oak Ridge Office of Environmental Management (OR-EM) requested that Oak Ridge Associated Universities (ORAU), working under the Oak Ridge Institute for Science and Education (ORISE) contract, provide technical and independent waste management planning support using American Recovery and Reinvestment Act (ARRA) funds. Specifically, DOE OR-EM requested that ORAU plan and implement a sampling and analysis campaign targeting potential removable radiological contamination that may be transferrable to future personal protective equipment (PPE) and contamination control materials—collectively referred to as PPE throughout the remainder of this report—used in certain URS|CH2M Oak Ridge, LLC (UCOR) Surveillance and Maintenance (S&M) Project facilities at the Oak Ridge National Laboratory (ORNL). Routine surveys in Bldgs. 3001, 3005, 3010, 3028, 3029, 3038, 3042, 3517, 4507, and 7500 continuously generate PPE. The waste is comprised of Tyvek coveralls, gloves, booties, Herculite, and other materials used to prevent worker exposure or the spread of contamination during routine maintenance and monitoring activities. This report describes the effort to collect and quantify removable activity that may be used by the ORNL S&M Project team to develop radiation instrumentation “screening criteria.” Material potentially containing removable activity was collected on smears, including both masselin large-area wipes (LAWs) and standard paper smears, and analyzed for site-related constituents (SRCs) in an analytical laboratory. The screening criteria, if approved, may be used to expedite waste disposition of relatively clean PPE. The ultimate objectives of this effort were to: 1) determine whether screening criteria can be developed for these facilities, and 2) provide process knowledge information for future site planners. The screening criteria, if calculated, must be formally approved by Federal Facility Agreement parties prior to use for

  10. Critical issues in implementing a national integrated all-vaccine preventable disease surveillance system☆

    PubMed Central

    Hyde, Terri B.; Andrus, Jon K.; Dietz, Vance J.; Andrus, Jon K.; Hyde, Terri B.; Lee, Carla E.; Widdowson, Marc-Alain; Verani, Jennifer R.; Friedman, Cindy; Azziz-Baumgartner, Eduardo; Lopez, Adriana S.; Jumaan, Aisha; Dietz, Vance J.

    2015-01-01

    In 2007, the World Health Organization published the Global Framework for Immunization Monitoring and Surveillance (GFIMS) outlining measures to enhance national surveillance for vaccine preventable diseases (VPDs). The GFIMS emphasized that VPD surveillance should be integrated and placed in a ‘unified framework’ building upon the strengths of existing surveillance systems to prevent duplication of activities common to all surveillance systems and to minimize human resource and supply expenditures. Unfortunately, there was little experience in actually developing integrated VPD surveillance. We describe the process of developing operational guidance for ministries of health to implement such an integrated surveillance system for multiple VPDs. PMID:23777699

  11. Macrolide-induced digoxin toxicity: a population-based study.

    PubMed

    Gomes, T; Mamdani, M M; Juurlink, D N

    2009-10-01

    In this 15-year, population-based, nested case-control study, we investigated the association between hospitalization for digoxin toxicity and recent exposure to individual macrolide antibiotics. Clarithromycin was associated with the highest risk of digoxin toxicity (adjusted odds ratio (OR) 14.8; 95% confidence interval (CI) 7.9-27.9), whereas erythromycin and azithromycin were associated with much lower risk (adjusted OR 3.7; 95% CI 1.7-7.9; and adjusted OR 3.7; 95% CI 1.1-12.5, respectively). We found no increased risk with a neutral comparator, cefuroxime (adjusted OR 0.8; 95% CI 0.2-3.4).

  12. ATIVS: analytical tool for influenza virus surveillance.

    PubMed

    Liao, Yu-Chieh; Ko, Chin-Yu; Tsai, Ming-Hsin; Lee, Min-Shi; Hsiung, Chao A

    2009-07-01

    The WHO Global Influenza Surveillance Network has routinely performed genetic and antigenic analyses of human influenza viruses to monitor influenza activity. Although these analyses provide supporting data for the selection of vaccine strains, it seems desirable to have user-friendly tools to visualize the antigenic evolution of influenza viruses for the purpose of surveillance. To meet this need, we have developed a web server, ATIVS (Analytical Tool for Influenza Virus Surveillance), for analyzing serological data of all influenza viruses and hemagglutinin sequence data of human influenza A/H3N2 viruses so as to generate antigenic maps for influenza surveillance and vaccine strain selection. Functionalities are described and examples are provided to illustrate its usefulness and performance. The ATIVS web server is available at http://influenza.nhri.org.tw/ATIVS/.

  13. Breaking Out of Surveillance Silos: Integrative Geospatial Data Collection for Child Injury Risk and Active School Transport.

    PubMed

    Schuch, Laura; Curtis, Jacqueline W; Curtis, Andrew; Hudson, Courtney; Wuensch, Heather; Sampsell, Malinda; Wiles, Erika; Infantino, Mary; Davis, Andrew J

    2016-02-01

    The preponderance of active school transport (AST) and child injury research has occurred independently, yet they are inherently related. This is particularly true in urban areas where the environmental context of AST may pose risks to safety. However, it can be difficult to make these connections due to the often segregated nature in which these veins of research operate. Spatial video presents a geospatial approach for simultaneous data collection related to both issues. This article reports on a multi-sector pilot project among researchers, a children's hospital, and a police department, using spatial video to map child AST behaviors; a geographic information system (GIS) is used to analyze these data in the environmental context of child pedestrian injury and community violence.

  14. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample.

    PubMed

    Fang, Lin; Chuang, Deng-Min; Lee, Yookyong

    2016-12-01

    Recent HIV research suggested assessing adverse childhood experiences (ACEs) as contributing factors of HIV risk behaviors. However, studies often focused on a single type of adverse experience and very few utilized population-based data. This population study examined the associations between ACE (individual and cumulative ACE score) and HIV risk behaviors. We analyzed the 2012 Behavioral Risk Factor Surveillance Survey (BRFSS) from 5 states. The sample consisted of 39,434 adults. Eight types of ACEs that included different types of child abuse and household dysfunctions before the age of 18 were measured. A cumulative score of ACEs was also computed. Logistic regression estimated of the association between ACEs and HIV risk behaviors using odds ratio (OR) with 95% confidence intervals (CIs) for males and females separately. We found that ACEs were positively associated with HIV risk behaviors overall, but the associations differed between males and females in a few instances. While the cumulative ACE score was associated with HIV risk behaviors in a stepwise manner, the pattern varied by gender. For males, the odds of HIV risk increased at a significant level as long as they experienced one ACE, whereas for females, the odds did not increase until they experienced three or more ACEs. Future research should further investigate the gender-specific associations between ACEs and HIV risk behaviors. As childhood adversities are prevalent among general population, and such experiences are associated with increased risk behaviors for HIV transmission, service providers can benefit from the principles of trauma-informed practice. PMID:27413671

  15. Survival of patients with mixed phenotype acute leukemias: A large population-based study.

    PubMed

    Shi, Runhua; Munker, Reinhold

    2015-06-01

    Little is known about the incidence and treatment outcome of patients with acute biphenotypic leukemias. The World Health Organization (WHO) established the term of acute leukemia of ambiguous phenotype in 2001 (revised in 2008) introducing the term of mixed phenotype acute leukemias. Using the database of the Surveillance, Epidemiology, and End Results registry (SEER), we identified 313 patients with mixed phenotype acute leukemias and compared them with 14,739 patients with acute lymphoblastic leukemia and 34,326 patients with acute myelogenous leukemias diagnosed between 2001 and 2011. As a further control group, 1777 patients were included who were not classified as myeloid, lymphoid or biphenotypic (other acute leukemias). The incidence of mixed phenotype acute leukemias is 0.35 cases/1,000,000 person-years. In a multivariate analysis, the prognosis depends strongly on age (as with other leukemias) and it has the worst outcome of all four types of leukemia. However, the prognosis has improved, comparing 2001-2005 with 2006-2011. We present the first comprehensive, population-based study of acute biphenotypic or mixed phenotype acute leukemias according to the WHO classification. Especially in older patients, the prognosis is unfavorable and new treatments should be investigated.

  16. Colorectal cancer risk following adenoma removal: a large prospective population-based cohort study

    PubMed Central

    Coleman, Helen G.; Loughrey, Maurice B.; Murray, Liam J.; Johnston, Brian T.; Gavin, Anna T.; Shrubsole, Martha J.; Bhat, Shivaram K.; Allen, Patrick B.; McConnell, Vivienne; Cantwell, Marie M.

    2015-01-01

    Background Randomised controlled trials have demonstrated significant reductions in colorectal cancer (CRC) incidence and mortality associated with polypectomy. However, little is known about whether polypectomy is effective at reducing CRC risk in routine clinical practice. The aim of this investigation was to quantify CRC risk following polypectomy in a large prospective population-based cohort study. Methods Patients with incident colorectal polyps between 2000 and 2005 in Northern Ireland (NI) were identified via electronic pathology reports received to the NI Cancer Registry (NICR). Patients were matched to the NICR to detect CRC and deaths up to 31st December 2010. CRC standardised incidence ratios (SIRs) were calculated and Cox proportional hazards modelling applied to determine CRC risk. Results During 44,724 person-years of follow-up, 193 CRC cases were diagnosed amongst 6,972 adenoma patients, representing an annual progression rate of 0.43%. CRC risk was significantly elevated in patients who had an adenoma removed (SIR 2.85; 95% CI: 2.61 to 3.25) compared with the general population. Male sex, older age, rectal site and villous architecture were associated with an increased CRC risk in adenoma patients. Further analysis suggested that not having a full colonoscopy performed at, or following, incident polypectomy contributed to the excess CRC risk. Conclusions CRC risk was elevated in individuals following polypectomy for adenoma, outside of screening programmes. Impact This finding emphasises the need for full colonoscopy and adenoma clearance, and appropriate surveillance, after endoscopic diagnosis of adenoma. PMID:26082403

  17. Estimating the personal cure rate of cancer patients using population-based grouped cancer survival data.

    PubMed

    Binbing Yu; Tiwari, Ram C; Feuer, Eric J

    2011-06-01

    Cancer patients are subject to multiple competing risks of death and may die from causes other than the cancer diagnosed. The probability of not dying from the cancer diagnosed, which is one of the patients' main concerns, is sometimes called the 'personal cure' rate. Two approaches of modelling competing-risk survival data, namely the cause-specific hazards approach and the mixture model approach, have been used to model competing-risk survival data. In this article, we first show the connection and differences between crude cause-specific survival in the presence of other causes and net survival in the absence of other causes. The mixture survival model is extended to population-based grouped survival data to estimate the personal cure rate. Using the colorectal cancer survival data from the Surveillance, Epidemiology and End Results Programme, we estimate the probabilities of dying from colorectal cancer, heart disease, and other causes by age at diagnosis, race and American Joint Committee on Cancer stage.

  18. Population-based survival-cure analysis of ER-negative breast cancer.

    PubMed

    Huang, Lan; Johnson, Karen A; Mariotto, Angela B; Dignam, James J; Feuer, Eric J

    2010-08-01

    This study investigated the trends over time in age and stage specific population-based survival of estrogen receptor negative (ER-) breast cancer patients by examining the fraction of cured patients and the median survival time for uncured patients. Cause-specific survival data from the Surveillance, Epidemiology, and End Results program for cases diagnosed during 1992-1998 were used in mixed survival cure models to evaluate the cure fraction and the extension in survival for uncured patients. Survival trends were compared with adjuvant chemotherapy data available from an overlapping patterns-of-care study. For stage II N+ disease, the largest increase in cure fraction was 44-60% (P = 0.0257) for women aged >or=70 in contrast to a 7-8% point increase for women aged <50 or 50-69 (P = 0.056 and 0.038, respectively). For women with stage III disease, the increases in the cure fraction were not statistically significant, although women aged 50-69 had a 10% point increase (P = 0.103). Increases in cure fraction correspond with increases in the use of adjuvant chemotherapy, particularly for the oldest age group. In this article, for the first time, we estimate the cure fraction for ER- patients. We notice that at age >o5r=70, the accelerated increase in cure fraction from 1992 to 1998 for women with stage II N+ compared with stage III suggests a selective benefit for chemotherapy in the lower stage group.

  19. Treatment profile and complications associated with cryotherapy for localized prostate cancer: A population-based study

    PubMed Central

    Roberts, Calpurnyia B.; Jang, Thomas L.; Shao, Yu-Hsuan; Kabadi, Shaum; Moore, Dirk F.; Lu-Yao, Grace L.

    2011-01-01

    The aim of this study was to assess the treatment patterns and 3 to 12-month complication rates associated with receiving prostate cryotherapy in a population-based study. Men > 65 years diagnosed with incident localized prostate cancer in Surveillance Epidemiology End Results (SEER) - Medicare linked database from 2004 to 2005 were identified. A total of 21,344 men were included in the study, of which 380 were treated initially with cryotherapy. Recipients of cryotherapy versus aggressive forms of prostate therapy (i.e. radical prostatectomy or radiation therapy) were more likely to be older, have one co-morbidity, low income, live in the South, and be diagnosed with indolent cancer. Complication rates increased from 3 to 12 months following cryotherapy. By the twelfth month, the rates for urinary incontinence, lower urinary tract obstruction, erectile dysfunction, and bowel bleeding reached 9.8%, 28.7%, 20.1%, and 3.3%, respectively. Diagnoses of hydronephrosis, urinary fistula, or bowel fistula were not evident. The rates of corrective invasive procedures for lower urinary tract obstruction and erectile dysfunction were both <2.9% by the twelfth month. Overall, complications post cryotherapy were modest; however, diagnoses for lower urinary tract obstruction and erectile dysfunction were common. PMID:21519347

  20. Establishing nurse-led active surveillance for men with localised prostate cancer: development and formative evaluation of a model of care in the ProtecT trial

    PubMed Central

    Wade, Julia; Holding, Peter N; Bonnington, Susan; Rooshenas, Leila; Lane, J Athene; Salter, C Elizabeth; Tilling, Kate; Speakman, Mark J; Brewster, Simon F; Evans, Simon; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L

    2015-01-01

    Objectives To develop a nurse-led, urologist-supported model of care for men managed by active surveillance or active monitoring (AS/AM) for localised prostate cancer and provide a formative evaluation of its acceptability to patients, clinicians and nurses. Nurse-led care, comprising an explicit nurse-led protocol with support from urologists, was developed as part of the AM arm of the Prostate testing for cancer and Treatment (ProtecT) trial. Design Interviews and questionnaire surveys of clinicians, nurses and patients assessed acceptability. Setting Nurse-led clinics were established in 9 centres in the ProtecT trial and compared with 3 non-ProtecT urology centres elsewhere in UK. Participants Within ProtecT, 22 men receiving AM nurse-led care were interviewed about experiences of care; 11 urologists and 23 research nurses delivering ProtecT trial care completed a questionnaire about its acceptability; 20 men managed in urology clinics elsewhere in the UK were interviewed about models of AS/AM care; 12 urologists and three specialist nurses working in these clinics were also interviewed about management of AS/AM. Results Nurse-led care was commended by ProtecT trial participants, who valued the flexibility, accessibility and continuity of the service and felt confident about the quality of care. ProtecT consultant urologists and nurses also rated it highly, identifying continuity of care and resource savings as key attributes. Clinicians and patients outside the ProtecT trial believed that nurse-led care could relieve pressure on urology clinics without compromising patient care. Conclusions The ProtecT AM nurse-led model of care was acceptable to men with localised prostate cancer and clinical specialists in urology. The protocol is available for implementation; we aim to evaluate its impact on routine clinical practice. Trial registration numbers NCT02044172; ISRCTN20141297. PMID:26384727

  1. One Decade of Active Avian Influenza Wild Bird Surveillance in Belgium Showed a Higher Viroprevalence in Hunter-Harvested Than in Live-Ringed Birds.

    PubMed

    Steensels, M; Vangeluwe, D; Linden, A; Houdart, Ph; van den Berg, Thierry P; Lambrecht, B

    2016-05-01

    Active monitoring of avian influenza (AI) viruses in wild birds was initiated in Belgium in 2005 in response to the first highly pathogenic avian influenza (HPAI) H5N1 outbreaks occurring in Europe. In Belgium, active wild bird surveillance that targeted live-ringed and hunter-harvested wild birds was developed and maintained from 2005 onward. After one decade, this program assimilated, analyzed, and reported on over 35,000 swabs. The 2009-2014 datasets were used for the current analysis because detailed information was available for this period. The overall prevalence of avian influenza (AI) in samples from live-ringed birds during this period was 0.48% whereas it was 6.12% in hunter-harvested samples. While the ringing sampling targeted a large number of bird species and was realized over the years, the hunting sampling was mainly concentrated on mallard (Anas platyrhynchos) during the hunting season, from mid-August to late January. Even when using just AI prevalence for live-ringed A. platyrhynchos during the hunting season, the value remained significantly lower (2.10%) compared to that detected for hunter-harvested mallards. One explanation for this significant difference in viroprevalence in hunter-harvested mallards was the game restocking practice, which released captive-bred birds in the wild before the hunting period. Indeed, the released game restocking birds, having an AI-naïve immune status, could act as local amplifiers of AI viruses already circulating in the wild, and this could affect AI epidemiology. Also, the release into the wild of noncontrolled restocking birds might lead to the introduction of new strains in the natural environment, leading to increased AI presence in the environment. Consequently, the release of naïve or infected restocking birds may affect AI dynamics. PMID:27309083

  2. One Decade of Active Avian Influenza Wild Bird Surveillance in Belgium Showed a Higher Viroprevalence in Hunter-Harvested Than in Live-Ringed Birds.

    PubMed

    Steensels, M; Vangeluwe, D; Linden, A; Houdart, Ph; van den Berg, Thierry P; Lambrecht, B

    2016-05-01

    Active monitoring of avian influenza (AI) viruses in wild birds was initiated in Belgium in 2005 in response to the first highly pathogenic avian influenza (HPAI) H5N1 outbreaks occurring in Europe. In Belgium, active wild bird surveillance that targeted live-ringed and hunter-harvested wild birds was developed and maintained from 2005 onward. After one decade, this program assimilated, analyzed, and reported on over 35,000 swabs. The 2009-2014 datasets were used for the current analysis because detailed information was available for this period. The overall prevalence of avian influenza (AI) in samples from live-ringed birds during this period was 0.48% whereas it was 6.12% in hunter-harvested samples. While the ringing sampling targeted a large number of bird species and was realized over the years, the hunting sampling was mainly concentrated on mallard (Anas platyrhynchos) during the hunting season, from mid-August to late January. Even when using just AI prevalence for live-ringed A. platyrhynchos during the hunting season, the value remained significantly lower (2.10%) compared to that detected for hunter-harvested mallards. One explanation for this significant difference in viroprevalence in hunter-harvested mallards was the game restocking practice, which released captive-bred birds in the wild before the hunting period. Indeed, the released game restocking birds, having an AI-naïve immune status, could act as local amplifiers of AI viruses already circulating in the wild, and this could affect AI epidemiology. Also, the release into the wild of noncontrolled restocking birds might lead to the introduction of new strains in the natural environment, leading to increased AI presence in the environment. Consequently, the release of naïve or infected restocking birds may affect AI dynamics.

  3. IMPROVING WATERBORNE DISEASE SURVEILLANCE

    EPA Science Inventory

    Public health surveillance has played a key role in controlling the spread of communicable disease and identifying the need for specific publich health practices, such as the filteration and chlorination of drinking water supplies. However, the characteristics of waterborne ou...

  4. A Simulation-Based Evaluation of Premovement Active Surveillance Protocol Options for the Managed Movement of Turkeys to Slaughter During an Outbreak of Highly Pathogenic Avian Influenza in the United States.

    PubMed

    Todd Weaver, J; Malladi, Sasidhar; Bonney, Peter J; Patyk, Kelly A; Bergeron, Justin G; Middleton, Jamie L; Alexander, Catherine Y; Goldsmith, Timothy J; Halvorson, David A

    2016-05-01

    Risk management decisions associated with live poultry movement during a highly pathogenic avian influenza (HPAI) outbreak should be carefully considered. Live turkey movements may pose a risk for disease spread. On the other hand, interruptions in scheduled movements can disrupt business continuity. The Secure Turkey Supply (STS) Plan was developed through an industry-government-academic collaboration to address business continuity concerns that might arise during a HPAI outbreak. STS stakeholders proposed outbreak response measure options that were evaluated through risk assessment. The developed approach relies on 1) diagnostic testing of two pooled samples of swabs taken from dead turkeys immediately before movement via the influenza A matrix gene real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test; 2) enhanced biosecurity measures in combination with a premovement isolation period (PMIP), restricting movement onto the premises for a few days before movement to slaughter; and 3) incorporation of a distance factor from known infected flocks such that exposure via local area spread is unlikely. Daily exposure likelihood estimates from spatial kernels from past HPAI outbreaks were coupled with simulation models of disease spread and active surveillance to evaluate active surveillance protocol options that differ with respect to the number of swabs per pooled sample and the timing of the tests in relation to movement. Simulation model results indicate that active surveillance testing, in combination with strict biosecurity, substantially increased HPAI virus detection probability. When distance from a known infected flock was considered, the overall combined likelihood of moving an infected, undetected turkey flock to slaughter was predicted to be lower at 3 and 5 km. The analysis of different active surveillance protocol options is designed to incorporate flexibility into HPAI emergency response plans.

  5. A Simulation-Based Evaluation of Premovement Active Surveillance Protocol Options for the Managed Movement of Turkeys to Slaughter During an Outbreak of Highly Pathogenic Avian Influenza in the United States.

    PubMed

    Todd Weaver, J; Malladi, Sasidhar; Bonney, Peter J; Patyk, Kelly A; Bergeron, Justin G; Middleton, Jamie L; Alexander, Catherine Y; Goldsmith, Timothy J; Halvorson, David A

    2016-05-01

    Risk management decisions associated with live poultry movement during a highly pathogenic avian influenza (HPAI) outbreak should be carefully considered. Live turkey movements may pose a risk for disease spread. On the other hand, interruptions in scheduled movements can disrupt business continuity. The Secure Turkey Supply (STS) Plan was developed through an industry-government-academic collaboration to address business continuity concerns that might arise during a HPAI outbreak. STS stakeholders proposed outbreak response measure options that were evaluated through risk assessment. The developed approach relies on 1) diagnostic testing of two pooled samples of swabs taken from dead turkeys immediately before movement via the influenza A matrix gene real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test; 2) enhanced biosecurity measures in combination with a premovement isolation period (PMIP), restricting movement onto the premises for a few days before movement to slaughter; and 3) incorporation of a distance factor from known infected flocks such that exposure via local area spread is unlikely. Daily exposure likelihood estimates from spatial kernels from past HPAI outbreaks were coupled with simulation models of disease spread and active surveillance to evaluate active surveillance protocol options that differ with respect to the number of swabs per pooled sample and the timing of the tests in relation to movement. Simulation model results indicate that active surveillance testing, in combination with strict biosecurity, substantially increased HPAI virus detection probability. When distance from a known infected flock was considered, the overall combined likelihood of moving an infected, undetected turkey flock to slaughter was predicted to be lower at 3 and 5 km. The analysis of different active surveillance protocol options is designed to incorporate flexibility into HPAI emergency response plans. PMID:27309049

  6. Active post-marketing surveillance of the intralesional administration of human recombinant epidermal growth factor in diabetic foot ulcers

    PubMed Central

    2013-01-01

    Background After several exploratory and confirmatory clinical trials, the intralesional administration of human recombinant epidermal growth factor (hrEGF) has been approved for the treatment of advanced diabetic foot ulcers (DFU). The aim of this work was to evaluate the effectiveness and safety of this procedure in medical practice. Methods A prospective, post-marketing active pharmacosurveillance was conducted in 41 hospitals and 19 primary care polyclinics. Patients with DFU received hrEGF, 25 or 75 μg, intralesionally 3 times per week until complete granulation of the ulcer or 8 weeks maximum, adjuvant to standard wound care. Outcomes measured were complete granulation, amputations, and adverse events (AE) during treatment; complete lesion re-epithelization and relapses in follow-up (median: 1.2; maximum 4.2 years). Results The study included 1788 patients with 1835 DFU (81% Wagner’s grades 3 or 4; 43% ischemic) treated from May 2007 to April 2010. Complete granulation was observed in 76% of the ulcers in 5 weeks (median). Ulcer non-ischemic etiology (OR: 3.6; 95% CI: 2.8-4.7) and age (1.02; 1.01-1.03, for each younger year) were the main variables with influence on this outcome. During treatment, 220 (12%) amputations (171 major) were required in 214 patients, mostly in ischemic or Wagner’s grade 3 to 5 ulcers. Re-epithelization was documented in 61% of the 1659 followed-up cases; 5% relapsed per year. AE (4171) were reported in 47% of the subjects. Mild or moderate local pain and burning sensation, shivering and chills, were 87% of the events. Serious events, not related to treatment, occurred in 1.7% of the patients. Conclusions The favorable benefit/risk balance, confirms the beneficial clinical profile of intralesional hrEGF in the treatment of DFUs. PMID:24004460

  7. Endometrial cancer and antidepressants: A nationwide population-based study.

    PubMed

    Lin, Chiao-Fan; Chan, Hsiang-Lin; Hsieh, Yi-Hsuan; Liang, Hsin-Yi; Chiu, Wei-Che; Huang, Kuo-You; Lee, Yena; McIntyre, Roger S; Chen, Vincent Chin-Hung

    2016-07-01

    To our knowledge, the association between antidepressant exposure and endometrial cancer has not been previously explored. Herein, we aim to investigate the association between antidepressant prescription, including novel antidepressants, and the risk for endometrial cancer in a population-based study.Data for the analysis were derived from National Health Insurance Research Database. We identified 8392 cases with a diagnosis of endometrial cancer and 82,432 matched controls. A conditional logistic regression model was used, with adjusting for potentially confounding variables (e.g., comorbid psychiatric diseases, comorbid physical diseases, and other medications). Risk for endometrial cancer in the population-based study sample was categorized by, and assessed as a function of, antidepressant prescription and cumulative dosage.We report no association between endometrial cancer incidence and antidepressant prescription, including those prescribed either selective serotonin reuptake inhibitors (adjusted odds ratio [OR] = 0.98; 95% confidence interval [CI], 0.84-1.15) or serotonin norepinephrine reuptake inhibitors (adjusted OR = 1.14; 95% CI, 0.76-1.71). We also did not identify an association between higher cumulative doses of antidepressant prescription and endometrial cancer.There was no association between antidepressant prescription and endometrial cancer. PMID:27442640

  8. Population-based incidence and prevalence of facioscapulohumeral dystrophy

    PubMed Central

    Arnts, Hisse; van der Maarel, Silvère M.; Padberg, George W.; Verschuuren, Jan J.G.M.; Bakker, Egbert; Weinreich, Stephanie S.; Verbeek, André L.M.; van Engelen, Baziel G.M.

    2014-01-01

    Objective: To determine the incidence and prevalence of facioscapulohumeral muscular dystrophy (FSHD) in the Netherlands. Methods: Using 3-source capture-recapture methodology, we estimated the total yearly number of newly found symptomatic individuals with FSHD, including those not registered in any of the 3 sources. To this end, symptomatic individuals with FSHD were available from 3 large population-based registries in the Netherlands if diagnosed within a 10-year period (January 1, 2001 to December 31, 2010). Multiplication of the incidence and disease duration delivered the prevalence estimate. Results: On average, 52 people are newly diagnosed with FSHD every year. This results in an incidence rate of 0.3/100,000 person-years in the Netherlands. The prevalence rate was 12/100,000, equivalent to 2,000 affected individuals. Conclusions: We present population-based incidence and prevalence estimates regarding symptomatic individuals with FSHD, including an estimation of the number of symptomatic individuals not present in any of the 3 used registries. This study shows that the total number of symptomatic persons with FSHD in the population may well be underestimated and a considerable number of affected individuals remain undiagnosed. This suggests that FSHD is one of the most prevalent neuromuscular disorders. PMID:25122204

  9. Groundwater surveillance plan for the Oak Ridge Reservation

    SciTech Connect

    Forstrom, J.M.; Smith, E.D.; Winters, S.L.; Haase, C.S.; King, H.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.

  10. Anomaly detection for internet surveillance

    NASA Astrophysics Data System (ADS)

    Bouma, Henri; Raaijmakers, Stephan; Halma, Arvid; Wedemeijer, Harry

    2012-06-01

    Many threats in the real world can be related to activity of persons on the internet. Internet surveillance aims to predict and prevent attacks and to assist in finding suspects based on information from the web. However, the amount of data on the internet rapidly increases and it is time consuming to monitor many websites. In this paper, we present a novel method to automatically monitor trends and find anomalies on the internet. The system was tested on Twitter data. The results showed that it can successfully recognize abnormal changes in activity or emotion.

  11. African American Men With Very Low–Risk Prostate Cancer Exhibit Adverse Oncologic Outcomes After Radical Prostatectomy: Should Active Surveillance Still Be an Option for Them?

    PubMed Central

    Sundi, Debasish; Ross, Ashley E.; Humphreys, Elizabeth B.; Han, Misop; Partin, Alan W.; Carter, H. Ballentine; Schaeffer, Edward M.

    2013-01-01

    Purpose Active surveillance (AS) is a treatment option for men with very low–risk prostate cancer (PCa); however, favorable outcomes achieved for men in AS are based on cohorts that under-represent African American (AA) men. To explore whether race-based health disparities exist among men with very low–risk PCa, we evaluated oncologic outcomes of AA men with very low–risk PCa who were candidates for AS but elected to undergo radical prostatectomy (RP). Patients and Methods We studied 1,801 men (256 AA, 1,473 white men, and 72 others) who met National Comprehensive Cancer Network criteria for very low–risk PCa and underwent RP. Presenting characteristics, pathologic data, and cancer recurrence were compared among the groups. Multivariable modeling was performed to assess the association of race with upgrading and adverse pathologic features. Results AA men with very low–risk PCa had more adverse pathologic features at RP and poorer oncologic outcomes. AA men were more likely to experience disease upgrading at prostatectomy (27.3% v 14.4%; P < .001), positive surgical margins (9.8% v 5.9%; P = .02), and higher Cancer of the Prostate Risk Assessment Post-Surgical scoring system (CAPRA-S) scores. On multivariable analysis, AA race was an independent predictor of adverse pathologic features (odds ratio, [OR], 3.23; P = .03) and pathologic upgrading (OR, 2.26; P = .03). Conclusion AA men with very low–risk PCa who meet criteria for AS but undergo immediate surgery experience significantly higher rates of upgrading and adverse pathology than do white men and men of other races. AA men with very low–risk PCa should be counseled about increased oncologic risk when deciding among their disease management options. PMID:23775960

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

    PubMed

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

    2011-01-01

    The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST). A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %), Candida parapsilosis (26 %), Candida tropicalis (15.4 %) and Candida glabrata (4.3 %). Other uncommon species, such as Candida viswanathii (0.6 %), Candida haemulonii (0.4 %), Candida inconspicua (0.2 %) and Candida fermentati (0.2 %) were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC < 1 mg/l). For anidulafungin, 21.6 % of C. parapsilosis showed a MIC value of 4 mg/l. Fluconazole was less active against 53.1 % of Cryptococcus neoformans (MIC > 8 mg/l), 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.

  13. Clinical implications of family history of prostate cancer and genetic risk single nucleotide polymorphism (SNP) profiles in an active surveillance cohort

    PubMed Central

    Goh, Chee L.; Saunders, Edward J.; Leongamornlert, Daniel A.; Tymrakiewicz, Malgorzata; Thomas, Karen; Selvadurai, Elizabeth D.; Woode-Amissah, Ruth; Dadaev, Tokhir; Mahmud, Nadiya; Castro, Elena; Olmos, David; Guy, Michelle; Govindasami, Koveela; O’Brien, Lynne T.; Hall, Amanda L.; Wilkinson, Rosemary A.; Sawyer, Emma J.; Olama, Ali Amin Al; Easton, Douglas F.; Kote-Jarai, Zsofia; Parker, Chris C.; Eeles, Rosalind A.

    2012-01-01

    Objectives To explore the potential prognostic role of family history (FH) of prostate cancer and prostate cancer risk single nucleotide polymorphisms (SNPs) in patients undergoing active surveillance (AS) for prostate cancer. This is the first study to date, which has investigated the potential prognostic role of SNP profiles in an AS cohort Patients and methods FH data were collected from patients in the Royal Marsden Hospital AS study. In all, 39 prostate cancer-risk SNPs identified from published genome wide association studies (GWAS) were genotyped using the Sequenom Platform and TaqMan™ assays from available DNA. The cumulative genetic-risk scores for each patient were then calculated using the weighted effect estimated from previous GWAS (log-additive model). FH status and the genetic-risk scores were assessed against adverse outcomes in AS, time to treatment and adverse histology on repeat biopsy, using univariable and multivariable Cox regression models to address time to treatment; and binary logistic regression to address biopsy upgrade. Results Of 471 patients, 55 (13.6%) had adverse histology on repeat biopsies and 145 (30.8%) had deferred treatment. On univariate analysis, there was no significant relationship between FH of prostate cancer in any degree of relation, and adverse histology or time to treatment. For risk score analyses, 386 patients’ DNA was studied; and there was also no relationship found between the calculated genetic risk scores and adverse histology or time to treatment (P = 0.573 and P = 0.965, respectively). The retrospective study design and the few events was the main limitation of the study. Conclusions There is currently insufficient data to support the use of FH status or prostate cancer SNP profile-risk scores as prognostic factors in AS and these should not be used to influence management decisions. As more genetic variants are discovered this may change and should be reassessed in multicentre AS cohorts. PMID:23320731

  14. HIV surveillance among injecting drug users.

    PubMed

    Des Jarlais, D C; Dehne, K; Casabona, J

    2001-04-01

    Injecting drug users (IDUs) should be considered a 'partially hidden population' at high risk for HIV infection. In almost all locations it should be possible to locate and conduct research with IDUs, but it will probably never be possible to enumerate or draw random samples from an IDU population. Surveillance research studies with IDUs should include risk behaviors, as surveillance of HIV infection only will not be sufficiently time sensitive, and be used to develop and refine HIV prevention programming for the population. Contacts with IDUs can be developed at multiple settings, including voluntary treatment programs, law enforcement settings, and through 'street outreach.' Each type of setting has different advantages, disadvantages and ethical concerns. HIV testing as part of surveillance also raises additional important ethical concerns. The primary risk behaviors that should be included in surveillance studies are 'sharing' of drug injection equipment, the potential for rapid partner change among risk partners, and sexual risk behavior. Additional important objectives for surveillance research include: (1) the size of the local IDU population, (2) patterns of drug use, (3) availability injection equipment, (4) participation in prevention activities, and (5) access to and use of anti-retroviral treatments. HIV incidence is an ultimate objective for surveillance research, but there are no currently available cost-efficient methods for studying HIV incidence, so estimation from indirect measurements is usually required. PMID:11421178

  15. 2003 Nevada Test Site Annual Illness and Injury Surveillance Report

    SciTech Connect

    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.

  16. [Operative guidelines for the shoe industry: health surveillance].

    PubMed

    Ferrari, Massimo; Vignola, Roberto

    2012-01-01

    Medical surveillance of workers exposed to occupational risk factors means secondary prevention and entails medical activities which are related to the assessed risk. In particular, the chief risk factors evaluated in the footwear industry frequently imply medical surveillance of exposed workers. These risk factors include organic solvents and chemicals, leather dust, noise, repetitive movements and upper limb overload, vibrations, manual lifting action and video display terminal operation. We consider some operative standardized and validated protocols for medical surveillance of these industry employees.

  17. Characteristics of Korean patients with suspected Creutzfeldt-Jakob disease with 14-3-3 protein in cerebrospinal fluid: Preliminary study of the Korean Creutzfeldt-Jakob disease active surveillance program.

    PubMed

    Lim, Jae-Sung; Kwon, Hyung-Min; Jang, Jae-Won; Ju, Young-Ran; Kim, SuYeon; Park, Young Ho; Park, So Young; Kim, SangYun

    2015-01-01

    Although Korea had a national surveillance system for Creutzfeldt-Jakob disease (CJD), it was mainly dependent on attending physician's reports. Thus, little prospective data about the epidemiology, characteristics, and final diagnoses of suspected patients were available. We have established a nationwide network for the active surveillance of patients with suspected CJD. When the requested cerebrospinal fluid (CSF) samples tested positive for 14-3-3 protein, we investigated the clinical characteristics of the corresponding patients and followed them until their final diagnoses were confirmed. A total of 218 samples were requested for CSF assays from May 2010 to August 2012, and 106 (48.6%) were positive for 14-3-3 protein. In 89 patients with complete clinical data, 38 (42.7%) were diagnosed with probable CJD and the estimated annual occurrence of CJD was 16.3 persons-per-year. The most common diagnoses of the remainder were central nervous system infection and any-cause encephalopathy. Non-CJD subjects showed worse initial consciousness levels than CJD patients. This preliminary study showed that the number of reported cases of CJD and the true positivity rates of CSF 14-3-3 protein assays were both low in Korea. An active surveillance system is urgently needed to provide the latest nationwide epidemiological data of CJD.

  18. Characteristics of Korean patients with suspected Creutzfeldt-Jakob disease with 14-3-3 protein in cerebrospinal fluid: Preliminary study of the Korean Creutzfeldt-Jakob disease active surveillance program

    PubMed Central

    Lim, Jae-Sung; Kwon, Hyung-Min; Jang, Jae-Won; Ju, Young-Ran; Kim, SuYeon; Park, Young Ho; Park, So Young; Kim, SangYun

    2015-01-01

    Abstract Although Korea had a national surveillance system for Creutzfeldt-Jakob disease (CJD), it was mainly dependent on attending physician's reports. Thus, little prospective data about the epidemiology, characteristics, and final diagnoses of suspected patients were available. We have established a nationwide network for the active surveillance of patients with suspected CJD. When the requested cerebrospinal fluid (CSF) samples tested positive for 14-3-3 protein, we investigated the clinical characteristics of the corresponding patients and followed them until their final diagnoses were confirmed. A total of 218 samples were requested for CSF assays from May 2010 to August 2012, and 106 (48.6%) were positive for 14-3-3 protein. In 89 patients with complete clinical data, 38 (42.7%) were diagnosed with probable CJD and the estimated annual occurrence of CJD was 16.3 persons-per-year. The most common diagnoses of the remainder were central nervous system infection and any-cause encephalopathy. Non-CJD subjects showed worse initial consciousness levels than CJD patients. This preliminary study showed that the number of reported cases of CJD and the true positivity rates of CSF 14-3-3 protein assays were both low in Korea. An active surveillance system is urgently needed to provide the latest nationwide epidemiological data of CJD. PMID:25996401

  19. Predictors of Childhood Anxiety: A Population-Based Cohort Study

    PubMed Central

    2015-01-01

    Background Few studies have explored predictors of early childhood anxiety. Objective To determine the prenatal, postnatal, and early life predictors of childhood anxiety by age 5. Methods Population-based, provincial administrative data (N = 19,316) from Manitoba, Canada were used to determine the association between demographic, obstetrical, psychosocial, medical, behavioral, and infant factors on childhood anxiety. Results Risk factors for childhood anxiety by age 5 included maternal psychological distress from birth to 12 months and 13 months to 5 years post-delivery and an infant 5-minute Apgar score of ≤7. Factors associated with decreased risk included maternal age < 20 years, multiparity, and preterm birth. Conclusion Identifying predictors of childhood anxiety is a key step to early detection and prevention. Maternal psychological distress is an early, modifiable risk factor. Future research should aim to disentangle early life influences on childhood anxiety occurring in the prenatal, postnatal, and early childhood periods. PMID:26158268

  20. Health system reform and the role of field sites based upon demographic and health surveillance.

    PubMed Central

    Tollman, S. M.; Zwi, A. B.

    2000-01-01

    Field sites for demographic and health surveillance have made well-recognized contributions to the evaluation of new or untested interventions, largely through efficacy trials involving new technologies or the delivery of selected services, e.g. vaccines, oral rehydration therapy and alternative contraceptive methods. Their role in health system reform, whether national or international, has, however, proved considerably more limited. The present article explores the characteristics and defining features of such field sites in low-income and middle-income countries and argues that many currently active sites have a largely untapped potential for contributing substantially to national and subnational health development. Since the populations covered by these sites often correspond with the boundaries of districts or subdistricts, the strategic use of information generated by demographic surveillance can inform the decentralization efforts of national and provincial health authorities. Among the areas of particular importance are the following: making population-based information available and providing an information resource; evaluating programmes and interventions; and developing applications to policy and practice. The question is posed as to whether their potential contribution to health system reform justifies arguing for adaptations to these field sites and expanded investment in them. PMID:10686747

  1. An assessment of occupation and industry data from death certificates and hospital medical records for population-based cancer surveillance.

    PubMed

    Swanson, G M; Schwartz, A G; Burrows, R W

    1984-05-01

    This study analyzed 30,194 incident cases and 4,301 death certificates for completeness of occupational reporting. Analysis of data accuracy was based upon a comparison of more than 2,000 death certificates with incident abstracts and 352 death certificates with interview data. Death certificates had a higher proportion with occupation (94.3%) and industry (93.4%) reported than did incident abstracts of hospital medical records (39.0% and 63.5%, respectively). Compared with occupational history data obtained by interview, 76.1% of the death certificates were exact matches for usual occupation and industry.

  2. The development of an evaluation framework for injury surveillance systems

    PubMed Central

    Mitchell, Rebecca J; Williamson, Ann M; O'Connor, Rod

    2009-01-01

    Background Access to good quality information from injury surveillance is essential to develop and monitor injury prevention activities. To determine if information obtained from surveillance is of high quality, the limitations and strengths of a surveillance system are often examined. Guidelines have been developed to assist in evaluating certain types of surveillance systems. However, to date, no standard guidelines have been developed to specifically evaluate an injury surveillance system. The aim of this research is to develop a framework to guide the evaluation of injury surveillance systems. Methods The development of an Evaluation Framework for Injury Surveillance Systems (EFISS) involved a four stage process. First, a literature review was conducted to identify an initial set of characteristics that were recognised as important and/or had been recommended to be assessed in an evaluation of a surveillance system. Second, this set of characteristics was assessed using SMART criteria. Third, those surviving were presented to an expert panel using a two round modified-Delphi study to gain an alternative perspective on characteristic definitions, practicality of assessment, and characteristic importance. Finally, a rating system was created for the EFISS characteristics. Results The resulting EFISS consisted of 18 characteristics that assess three areas of an injury surveillance system – five characteristics assess data quality, nine characteristics assess the system's operation, and four characteristics assess the practical capability of an injury surveillance system. A rating system assesses the performance of each characteristic. Conclusion The development of the EFISS builds upon existing evaluation guidelines for surveillance systems and provides a framework tailored to evaluate an injury surveillance system. Ultimately, information obtained through an evaluation of an injury data collection using the EFISS would be useful for agencies to recommend how a

  3. Survival of Patients with Chronic Myelocytic Leukemia: Comparisons of Estimates from Clinical Trial Settings and Population-Based Cancer Registries

    PubMed Central

    Gondos, Adam; Redaniel, Maria Theresa; Brenner, Hermann

    2011-01-01

    Introduction. The survival of patients with chronic myelocytic leukemia (CML) has improved during the past decades. However, there have been discrepancies between results reported from clinical trials and population-based studies. We aimed to elucidate the extent of these discrepancies. Methods. We examined the 5-year survival rate of patients in clinical trials of CML treatment and compared these results with the survival of patients in the general population using the Surveillance, Epidemiology, and End Results (SEER) database, correcting for differences in the age structure of the patient populations. Results. Twenty-nine trials were identified for data extraction. The survival rate calculated from SEER data was lower than the survival rate in clinical trials in the corresponding period, with differences of 2.1%–50.7%. Age-adapted survival was similar for four trials, but differences up to 35.8% were seen in most. Limitations of the study include the lack of information on chemotherapy in the SEER database and possible heterogeneity of cases. Discussion. The survival rate in clinical trials of CML treatment is higher than the survival rate of all patients with CML. We speculate that the difference may be a result of access to better medications, selection of healthier patients for trials, and the time necessary for adoption of new treatments. This finding underscores the need for population-based studies to give a more realistic idea of survival for patients with a given malignancy in the general population. PMID:21471276

  4. Population-Based Incidence Rates of Diarrheal Disease Associated with Norovirus, Sapovirus, and Astrovirus in Kenya

    PubMed Central

    Shioda, Kayoko; Cosmas, Leonard; Audi, Allan; Gregoricus, Nicole; Vinjé, Jan; Parashar, Umesh D.; Montgomery, Joel M.; Feikin, Daniel R.; Breiman, Robert F.; Hall, Aron J.

    2016-01-01

    Background Diarrheal diseases remain a major cause of mortality in Africa and worldwide. While the burden of rotavirus is well described, population-based rates of disease caused by norovirus, sapovirus, and astrovirus are lacking, particularly in developing countries. Methods Data on diarrhea cases were collected through a population-based surveillance platform including healthcare encounters and household visits in Kenya. We analyzed data from June 2007 to October 2008 in Lwak, a rural site in western Kenya, and from October 2006 to February 2009 in Kibera, an urban slum. Stool specimens from diarrhea cases of all ages who visited study clinics were tested for norovirus, sapovirus, and astrovirus by RT-PCR. Results Of 334 stool specimens from Lwak and 524 from Kibera, 85 (25%) and 159 (30%) were positive for norovirus, 13 (4%) and 31 (6%) for sapovirus, and 28 (8%) and 18 (3%) for astrovirus, respectively. Among norovirus-positive specimens, genogroup II predominated in both sites, detected in 74 (87%) in Lwak and 140 (88%) in Kibera. The adjusted community incidence per 100,000 person-years was the highest for norovirus (Lwak: 9,635; Kibera: 4,116), followed by astrovirus (Lwak: 3,051; Kibera: 440) and sapovirus (Lwak: 1,445; Kibera: 879). For all viruses, the adjusted incidence was higher among children aged <5 years (norovirus: 22,225 in Lwak and 17,511 in Kibera; sapovirus: 5,556 in Lwak and 4,378 in Kibera; astrovirus: 11,113 in Lwak and 2,814 in Kibera) compared to cases aged ≥5 years. Conclusion Although limited by a lack of controls, this is the first study to estimate the outpatient and community incidence rates of norovirus, sapovirus, and astrovirus across the age spectrum in Kenya, suggesting a substantial disease burden imposed by these viruses. By applying adjusted rates, we estimate approximately 2.8–3.3 million, 0.45–0.54 million, and 0.77–0.95 million people become ill with norovirus, sapovirus, and astrovirus, respectively, every year in

  5. Surveillance for Occupational Respiratory Diseases in Developing Countries

    PubMed Central

    Antao, Vinicius C.; Pinheiro, Germania A.

    2015-01-01

    The burden of chronic diseases, including occupational respiratory diseases (ORDs), is increasing worldwide. Nevertheless, epidemiological data on these conditions are scarce in most countries. Therefore, it is important to conduct surveillance to monitor ORDs, particularly in developing countries, where the working population is especially vulnerable and the health system infrastructure is usually weak. This article provides a general framework for the implementation of ORD surveillance in developing countries. The main objectives of surveillance are to describe incidence and prevalence of ORDs, as well as to identify sentinel events and new associations between occupational exposures and health outcomes. Diseases with high morbidity and mortality and those in which early diagnosis with standardized tests are available are especially suitable for surveillance activities. Simple strategies, preferably using existing resources and technology, are the best option for surveillance in developing countries. This article offers examples of specific surveillance systems that are in place in Brazil, China, Cuba, India, and South Africa. PMID:26024351

  6. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    SciTech Connect

    Lesko, Samuel M.

    2007-07-31

    OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supports surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US

  7. Imaging surveillance programs for women at high breast cancer risk in Europe: Are women from ethnic minority groups adequately included? (Review).

    PubMed

    Belkić, Karen; Cohen, Miri; Wilczek, Brigitte; Andersson, Sonia; Berman, Anne H; Márquez, Marcela; Vukojević, Vladana; Mints, Miriam

    2015-09-01

    Women from ethnic minority groups, including immigrants and refugees are reported to have low breast cancer (BC) screening rates. Active, culturally-sensitive outreach is vital for increasing participation of these women in BC screening programs. Women at high BC risk and who belong to an ethnic minority group are of special concern. Such women could benefit from ongoing trials aimed at optimizing screening strategies for early BC detection among those at increased BC risk. Considering the marked disparities in BC survival in Europe and its enormous and dynamic ethnic diversity, these issues are extremely timely for Europe. We systematically reviewed the literature concerning European surveillance studies that had imaging in the protocol and that targeted women at high BC risk. The aim of the present review was thereby to assess the likelihood that women at high BC risk from minority ethnic groups were adequately included in these surveillance programs. Twenty-seven research groups in Europe reported on their imaging surveillance programs for women at increased BC risk. The benefit of strategies such as inclusion of magnetic resonance imaging and/or more intensive screening was clearly documented for the participating women at increased BC risk. However, none of the reports indicated that sufficient outreach was performed to ensure that women at increased BC risk from minority ethnic groups were adequately included in these surveillance programs. On the basis of this systematic review, we conclude that the specific screening needs of ethnic minority women at increased BC risk have not yet been met in Europe. Active, culturally-sensitive outreach is needed to identify minority women at increased BC risk and to facilitate their inclusion in on-going surveillance programs. It is anticipated that these efforts would be most effective if coordinated with the development of European-wide, population-based approaches to BC screening. PMID:26134040

  8. Imaging surveillance programs for women at high breast cancer risk in Europe: Are women from ethnic minority groups adequately included? (Review).

    PubMed

    Belkić, Karen; Cohen, Miri; Wilczek, Brigitte; Andersson, Sonia; Berman, Anne H; Márquez, Marcela; Vukojević, Vladana; Mints, Miriam

    2015-09-01

    Women from ethnic minority groups, including immigrants and refugees are reported to have low breast cancer (BC) screening rates. Active, culturally-sensitive outreach is vital for increasing participation of these women in BC screening programs. Women at high BC risk and who belong to an ethnic minority group are of special concern. Such women could benefit from ongoing trials aimed at optimizing screening strategies for early BC detection among those at increased BC risk. Considering the marked disparities in BC survival in Europe and its enormous and dynamic ethnic diversity, these issues are extremely timely for Europe. We systematically reviewed the literature concerning European surveillance studies that had imaging in the protocol and that targeted women at high BC risk. The aim of the present review was thereby to assess the likelihood that women at high BC risk from minority ethnic groups were adequately included in these surveillance programs. Twenty-seven research groups in Europe reported on their imaging surveillance programs for women at increased BC risk. The benefit of strategies such as inclusion of magnetic resonance imaging and/or more intensive screening was clearly documented for the participating women at increased BC risk. However, none of the reports indicated that sufficient outreach was performed to ensure that women at increased BC risk from minority ethnic groups were adequately included in these surveillance programs. On the basis of this systematic review, we conclude that the specific screening needs of ethnic minority women at increased BC risk have not yet been met in Europe. Active, culturally-sensitive outreach is needed to identify minority women at increased BC risk and to facilitate their inclusion in on-going surveillance programs. It is anticipated that these efforts would be most effective if coordinated with the development of European-wide, population-based approaches to BC screening.

  9. Viral surveillance and discovery

    PubMed Central

    Lipkin, Walter Ian; Firth, Cadhla

    2014-01-01

    The field of virus discovery has burgeoned with the advent of high throughput sequencing platforms and bioinformatics programs that enable rapid identification and molecular characterization of known and novel agents, investments in global microbial surveillance that include wildlife and domestic animals as well as humans, and recognition that viruses may be implicated in chronic as well as acute diseases. Here we review methods for viral surveillance and discovery, strategies and pitfalls in linking discoveries to disease, and identify opportunities for improvements in sequencing instrumentation and analysis, the use of social media and medical informatics that will further advance clinical medicine and public health. PMID:23602435

  10. Clinical Assessment of Self-Reported Acute Flaccid Paralysis in a Population-Based Setting in Guatemala

    PubMed Central

    Sejvar, James J.; Lindblade, Kim A.; Arvelo, Wences; Padilla, Norma; Pringle, Kimberly; Zielinski-Gutierrez, Emily; Farnon, Eileen; Schonberger, Lawrence B.; Dueger, Erica

    2010-01-01

    Historically, poliovirus infection has been an important cause of acute flaccid paralysis (AFP) worldwide; however, successful elimination of wild-type poliovirus in much of the world has highlighted the importance of other causes of AFP. Despite the evolving etiology, AFP surveillance in most developing countries still focuses on poliovirus detection and fails to detect many AFP cases, particularly among adults. We assessed 41 subjects self-reporting symptoms suggestive of AFP during a population-based health survey in the Department of Santa Rosa, Guatemala. Thirty-five (85%) of the suspected cases were not hospitalized. Most subjects (37) did not have features consistent with AFP or had other diagnoses explaining weakness. We identified two adults who had not received medical attention for a clinical illness consistent with Guillain-Barré syndrome, the most important cause of non-poliovirus AFP. Usual surveillance methods for AFP, particularly in developing countries, may underestimate the true burden of non-poliovirus AFP. PMID:20348524

  11. Estimating glomerular filtration rate in a population-based study

    PubMed Central

    Shankar, Anoop; Lee, Kristine E; Klein, Barbara EK; Muntner, Paul; Brazy, Peter C; Cruickshanks, Karen J; Nieto, F Javier; Danforth, Lorraine G; Schubert, Carla R; Tsai, Michael Y; Klein, Ronald

    2010-01-01

    Background: Glomerular filtration rate (GFR)-estimating equations are used to determine the prevalence of chronic kidney disease (CKD) in population-based studies. However, it has been suggested that since the commonly used GFR equations were originally developed from samples of patients with CKD, they underestimate GFR in healthy populations. Few studies have made side-by-side comparisons of the effect of various estimating equations on the prevalence estimates of CKD in a general population sample. Patients and methods: We examined a population-based sample comprising adults from Wisconsin (age, 43–86 years; 56% women). We compared the prevalence of CKD, defined as a GFR of <60 mL/min per 1.73 m2 estimated from serum creatinine, by applying various commonly used equations including the modification of diet in renal disease (MDRD) equation, Cockcroft–Gault (CG) equation, and the Mayo equation. We compared the performance of these equations against the CKD definition of cystatin C >1.23 mg/L. Results: We found that the prevalence of CKD varied widely among different GFR equations. Although the prevalence of CKD was 17.2% with the MDRD equation and 16.5% with the CG equation, it was only 4.8% with the Mayo equation. Only 24% of those identified to have GFR in the range of 50–59 mL/min per 1.73 m2 by the MDRD equation had cystatin C levels >1.23 mg/L; their mean cystatin C level was only 1 mg/L (interquartile range, 0.9–1.2 mg/L). This finding was similar for the CG equation. For the Mayo equation, 62.8% of those patients with GFR in the range of 50–59 mL/min per 1.73 m2 had cystatin C levels >1.23 mg/L; their mean cystatin C level was 1.3 mg/L (interquartile range, 1.2–1.5 mg/L). The MDRD and CG equations showed a false-positive rate of >10%. Discussion: We found that the MDRD and CG equations, the current standard to estimate GFR, appeared to overestimate the prevalence of CKD in a general population sample. PMID:20730018

  12. Youth Risk Behavior Surveillance System

    MedlinePlus

    ... What's this? Submit Button Youth Risk Behavior Surveillance System (YRBSS) Recommend on Facebook Tweet Share Compartir New ... Minority Data Released! The Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors ...

  13. Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

    PubMed

    Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

    2015-05-01

    Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis.

  14. Use of BPPV processes in Emergency Department Dizziness Presentations: A Population-Based Study

    PubMed Central

    Kerber, Kevin A.; Burke, James F.; Skolarus, Lesli E.; Meurer, William J.; Callaghan, Brian C.; Brown, Devin L.; Lisabeth, Lynda D.; McLaughlin, Thomas J.; Fendrick, A. Mark; Morgenstern, Lewis B.

    2013-01-01

    Objective A common cause of dizziness, benign paroxysmal positional vertigo (BPPV), is effectively diagnosed and cured with the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). We aimed to describe the use of these processes in Emergency Departments (ED), to assess for trends in use over time, and to determine provider level variability in use. Design Prospective population-based surveillance study Setting EDs in Nueces County, Texas, January 15, 2008 to January 14, 2011 Subjects and Methods Adult patients discharged from EDs with dizziness, vertigo, or imbalance documented at triage. Clinical information was abstracted from source documents. A hierarchical logistic regression model adjusting for patient and provider characteristics was used to estimate trends in DHT use and provider level variability. Results 3,522 visits for dizziness were identified. A DHT was documented in 137 visits (3.9%). A CRM was documented in 8 visits (0.2%). Among patients diagnosed with BPPV, a DHT was documented in only 21.8% (34 of 156) and a CRM in 3.9% (6 of 156). In the hierarchical model (c statistic = 0.93), DHT was less likely to be used over time (odds ratio, 0.97, 95% CI [0.95, 0.99]) and the provider level explained 50% (ICC, 0.50) of the variance in the probability of DHT use. Conclusion BPPV is seldom examined for, and when diagnosed, infrequently treated in this ED population. DHT use is decreasing over time, and varies substantially by provider. Implementation research focused on BPPV care may be an opportunity to optimize management in ED dizziness presentations. PMID:23264119

  15. Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

    PubMed

    Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

    2015-05-01

    Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis. PMID:25354028

  16. Radiotherapy and Survival in Prostate Cancer Patients: A Population-Based Study

    SciTech Connect

    Zhou, Esther H. Ellis, Rodney J.; Cherullo, Edward; Colussi, Valdir; Xu Fang; Chen Weidong; Gupta, Sanjay; Whalen, Christopher C.; Bodner, Donald; Resnick, Martin I.; Rimm, Alfred A.

    2009-01-01

    Purpose: To investigate the association of overall and disease-specific survival with the five standard treatment modalities for prostate cancer (CaP): radical prostatectomy (RP), brachytherapy (BT), external beam radiotherapy, androgen deprivation therapy, and no treatment (NT) within 6 months after CaP diagnosis. Methods and Materials: The study population included 10,179 men aged 65 years and older with incident CaP diagnosed between 1999 and 2001. Using the linked Ohio Cancer Incidence Surveillance System, Medicare, and death certificate files, overall and disease-specific survival through 2005 among the five clinically accepted therapies were analyzed. Results: Disease-specific survival rates were 92.3% and 23.9% for patients with localized vs. distant disease at 7 years, respectively. Controlling for age, race, comorbidities, stage, and Gleason score, results from the Cox multiple regression models indicated that the risk of CaP-specific death was significantly reduced in patients receiving RP or BT, compared with NT. For localized disease, compared with NT, in the monotherapy cohort, RP and BT were associated with reduced hazard ratios (HR) of 0.25 and 0.45 (95% confidence intervals 0.13-0.48 and 0.23-0.87, respectively), whereas in the combination therapy cohort, HR were 0.40 (0.17-0.94) and 0.46 (0.27-0.80), respectively. Conclusions: The present population-based study indicates that RP and BT are associated with improved survival outcomes. Further studies are warranted to improve clinical determinates in the selection of appropriate management of CaP and to improve predictive modeling for which patient subsets may benefit most from definitive therapy vs. conservative management and/or observation.

  17. Ulcerative colitis-associated hospitalization costs: A population-based study

    PubMed Central

    Coward, Stephanie; Heitman, Steven J; Clement, Fiona; Hubbard, James; Proulx, Marie-Claude; Zimmer, Scott; Panaccione, Remo; Seow, Cynthia; Leung, Yvette; Datta, Neel; Ghosh, Subrata; Myers, Robert P; Swain, Mark; Kaplan, Gilaad G

    2015-01-01

    BACKGROUND: Hospitalization costs for ulcerative colitis (UC) following the introduction of infliximab have not been evaluated. OBJECTIVE: To study predictors of costs for UC patients who were hospitalized for a flare or colectomy. METHODS: Population-based surveillance identified adults (≥18 years of age) admitted to hospital for UC flare or colectomy between 2001 and 2009 in the Calgary Health Zone (Alberta). Medical charts were reviewed and patients stratified into three admission types: responsive to inpatient medical therapy (n=307); emergent colectomy (n=227); and elective colectomy (n=208). The annual median cost with interquartile range (IQR) was calculated. Linear regression determined the effect of admission type on hospital charges after adjusting for age, sex, smoking, comorbidities, disease extent, medication use (eg, infliximab) and year. The adjusted cost increase was presented as the percent increase with 95% CIs. Joinpoint analysis assessed for an inflection point in hospital cost after the introduction of infliximab. RESULTS: Median hospitalization cost for UC flare, emergent colectomy and elective colectomy, respectively, were: $5,499 (IQR $3,374 to $8,904), $23,698 (IQR $17,981 to $32,385) and $14,316 (IQR $11,932 to $18,331). Adjusted hospitalization costs increased approximately 6.0% annually (95% CI 4.5% to 7.5%). Adjusted costs were higher for patients who underwent an elective colectomy (percent increase cost 179.8% [95% CI 151.6% to 211.1%]) or an emergent colectomy (percent increase cost 211.1% [95% CI 183.2% to 241.6%]) than medically responsive patients. Infliximab in hospital was an independent predictor of increased costs (percent increase cost 69.5% [95% CI 49.2% to 92.5%]). No inflection points were identified. CONCLUSION: Hospitalization costs for UC increased due to colectomy and infliximab. PMID:26079072

  18. Plutonium Surveillance Destructive Examination Requirements at Savannah River National Laboratory for K-Area Interim Surveillance

    SciTech Connect

    Stefek, T. M.

    2005-09-29

    The DOE 3013 storage standard requires nested, welded 300 series stainless steel containers to store plutonium-bearing materials for up to 50 years. Packaged contents include stabilized plutonium-bearing residues that contain chloride salts and a low (< 0.5 weight %) water content. The DOE 3013 STD requires surveillance of the packages over the 50 year lifetime. These surveillance requirements have been further defined by the Integrated Surveillance Program to include both non-destructive examination (NDE) and destructive examination (DE) of the 3013 container. The DE portion of surveillance involves examining the 3013 nested containers, analyzing the head space gas, and evaluating the plutonium oxide chemistry. At SRS, the stored 3013 containers will undergo preparation for the DE surveillance activities in facilities located in K-Area. The actual DE surveillance will be performed in SRNL. This report provides preliminary functional requirements for the destructive examination (DE) of plutonium-bearing oxide materials and containers in support of K-Area Interim Surveillance (KIS). The KIS project will install interim facilities to prepare the samples for analysis in SRNL. This document covers the requirements for the interim period beginning in 2007, and lasting until the Container Storage and Surveillance Capability (CSSC) project provides the permanent facilities in K-Area to perform sampling and repackaging operations associated with the 3013 container storage and surveillance program. Initial requirements for the CSSC project have been previously defined in WSRC-TR-2004-00584 ''Plutonium Surveillance Destructive Examination Requirements at Savannah River National Laboratory''. As part of the Plutonium Surveillance Program of 3013 Containers at the Savannah River Site (SRS), the Savannah River National Laboratory (SRNL) will receive the emptied 3013 container components, plutonium oxide samples and headspace gas samples from K-Area. The DE program scope

  19. Optimal inverse functions created via population-based optimization.

    PubMed

    Jennings, Alan L; Ordóñez, Raúl

    2014-06-01

    Finding optimal inputs for a multiple-input, single-output system is taxing for a system operator. Population-based optimization is used to create sets of functions that produce a locally optimal input based on a desired output. An operator or higher level planner could use one of the functions in real time. For the optimization, each agent in the population uses the cost and output gradients to take steps lowering the cost while maintaining their current output. When an agent reaches an optimal input for its current output, additional agents are generated in the output gradient directions. The new agents then settle to the local optima for the new output values. The set of associated optimal points forms an inverse function, via spline interpolation, from a desired output to an optimal input. In this manner, multiple locally optimal functions can be created. These functions are naturally clustered in input and output spaces allowing for a continuous inverse function. The operator selects the best cluster over the anticipated range of desired outputs and adjusts the set point (desired output) while maintaining optimality. This reduces the demand from controlling multiple inputs, to controlling a single set point with no loss in performance. Results are demonstrated on a sample set of functions and on a robot control problem. PMID:24235281

  20. Men's health: a population-based study on social inequalities.

    PubMed

    Bastos, Tássia Fraga; Alves, Maria Cecília Goi Porto; Barros, Marilisa Berti de Azevedo; Cesar, Chester Luiz Galvão

    2012-11-01

    This study evaluates social inequalities in health according to level of schooling in the male population. This was a cross-sectional, population-based study with a sample of 449 men ranging from 20 to 59 years of age and living in Campinas, São Paulo State, Brazil. The chi-square test was used to verify associations, and a Poisson regression model was used to estimate crude and adjusted prevalence ratios. Men with less schooling showed higher rates of alcohol consumption and dependence, smoking, sedentary lifestyle during leisure time, and less healthy eating habits, in addition to higher prevalence of bad or very bad self-rated health, at least one chronic disease, hypertension, and other health problems. No differences were detected between the two schooling strata in terms of use of health services, except for dental services. The findings point to social inequality in health-related behaviors and in some health status indicators. However, possible equity was observed in the use of nearly all types of health services.

  1. Histocompatibility antigens in a population based silicosis series.

    PubMed Central

    Kreiss, K; Danilovs, J A; Newman, L S

    1989-01-01

    Individual susceptibility to silicosis is suggested by the lack of a uniform dose response relation and by the presence of immunological epiphenomena, such as increased antibody levels and associated diseases that reflect altered immune regulation. Human leucocyte antigens (HLA) are linked with immune response capability and might indicate a possible genetic susceptibility to silicosis. Forty nine silicotic subjects were identified from chest radiographs in a population based study in Leadville, Colorado. They were interviewed for symptoms and occupational history and gave a blood specimen for HLA-A, -B, -DR, and -DQ typing and for antinuclear antibody, immune complexes, immunoglobulins, and rheumatoid factor. Silicotic subjects had twice the prevalence of B44 (45%) of the reference population and had triple the prevalence of A29 (20%), both of which were statistically significant when corrected for the number of comparisons made. No perturbations in D-region antigen frequencies were detected. B44-positive subjects were older at diagnosis and had less dyspnoea than other subjects. A29-positive subjects were more likely to have abnormal levels of IgA and had higher levels of immune complexes. This study is the first to find significant HLA antigen excesses among a series of silicotic cases and extends earlier reported hypotheses that were based on groups of antigens of which B44 and A29 are components. PMID:2818968

  2. Optimal inverse functions created via population-based optimization.

    PubMed

    Jennings, Alan L; Ordóñez, Raúl

    2014-06-01

    Finding optimal inputs for a multiple-input, single-output system is taxing for a system operator. Population-based optimization is used to create sets of functions that produce a locally optimal input based on a desired output. An operator or higher level planner could use one of the functions in real time. For the optimization, each agent in the population uses the cost and output gradients to take steps lowering the cost while maintaining their current output. When an agent reaches an optimal input for its current output, additional agents are generated in the output gradient directions. The new agents then settle to the local optima for the new output values. The set of associated optimal points forms an inverse function, via spline interpolation, from a desired output to an optimal input. In this manner, multiple locally optimal functions can be created. These functions are naturally clustered in input and output spaces allowing for a continuous inverse function. The operator selects the best cluster over the anticipated range of desired outputs and adjusts the set point (desired output) while maintaining optimality. This reduces the demand from controlling multiple inputs, to controlling a single set point with no loss in performance. Results are demonstrated on a sample set of functions and on a robot control problem.

  3. Small animal disease surveillance.

    PubMed

    Sánchez-Vizcaíno, Fernando; Jones, Philip H; Menacere, Tarek; Heayns, Bethaney; Wardeh, Maya; Newman, Jenny; Radford, Alan D; Dawson, Susan; Gaskell, Rosalind; Noble, Peter J M; Everitt, Sally; Day, Michael J; McConnell, Katie

    2015-12-12

    This is the first UK small animal disease surveillance report from SAVSNET. Future reports will expand to other syndromes and diseases. As data are collected for longer, the estimates of changes in disease burden will become more refined, allowing more targeted local and perhaps national interventions. Anonymised data can be accessed for research purposes by contacting the authors. SAVSNET welcomes feedback on this report.

  4. The association between leisure-time physical activity and dietary fat in American adults.

    PubMed Central

    Simoes, E J; Byers, T; Coates, R J; Serdula, M K; Mokdad, A H; Heath, G W

    1995-01-01

    Relations between leisure-time physical activity and dietary fat were examined in a population-based probability sample of 29,672 adults in the 1990 Behavioral Risk Factor Surveillance System. Consumption of 13 high-fat food items and participation in physical activities were measured, and fat and activity scores were calculated. Dietary fat and physical activity were strongly and inversely associated. This association was independent of nine other demographic and behavioral risk factors. Etiologic researchers should consider that diet and physical activity can potentially confound each other, and creators of public health messages that target one behavior should consider including the other. PMID:7856785

  5. Volcano surveillance using infrared cameras

    NASA Astrophysics Data System (ADS)

    Spampinato, Letizia; Calvari, Sonia; Oppenheimer, Clive; Boschi, Enzo

    2011-05-01

    Volcanic eruptions are commonly preceded, accompanied, and followed by variations of a number of detectable geophysical and geochemical manifestations. Many remote sensing techniques have been applied to tracking anomalies and eruptive precursors, and monitoring ongoing volcanic eruptions, offering obvious advantages over in situ techniques especially during hazardous activity. Whilst spaceborne instruments provide a distinct advantage for collecting data remotely in this regard, they still cannot match the spatial detail or time resolution achievable using portable imagers on the ground or aircraft. Hand-held infrared camera technology has advanced significantly over the last decade, resulting in a proliferation of commercially available instruments, such that volcano observatories are increasingly implementing them in monitoring efforts. Improved thermal surveillance of active volcanoes has not only enhanced hazard assessment but it has contributed substantially to understanding a variety of volcanic processes. Drawing on over a decade of operational volcano surveillance in Italy, we provide here a critical review of the application of infrared thermal cameras to volcano monitoring. Following a summary of key physical principles, instrument capabilities, and the practicalities and methods of data collection, we discuss the types of information that can be retrieved from thermal imagery and what they have contributed to hazard assessment and risk management, and to physical volcanology. With continued developments in thermal imager technology and lower instrument costs, there will be increasing opportunity to gather valuable observations of volcanoes. It is thus timely to review the state of the art and we hope thereby to stimulate further research and innovation in this area.

  6. Environmental surveillance master sampling schedule

    SciTech Connect

    Bisping, L.E.

    1996-02-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the US Department of Energy (DOE). This document contains the planned 1996 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project.

  7. The dimensions of nursing surveillance: a concept analysis

    PubMed Central

    Kelly, Lesly; Vincent, Deborah

    2011-01-01

    Aim This paper is a report of an analysis of the concept of nursing surveillance. Background Nursing surveillance, a primary function of acute care nurses, is critical to patient safety and outcomes. Although it has been associated with patient outcomes and organizational context of care, little knowledge has been generated about the conceptual and operational process of surveillance. Data sources A search using the CINAHL, Medline and PubMed databases was used to compile an international data set of 18 papers and 4 book chapters published from 1985 to 2009. Review methods Rodger’s evolutionary concept analysis techniques were used to analyse surveillance in a systems framework. This method focused the search to nursing surveillance (as opposed to other medical uses of the term) and used a theoretical framework to guide the analysis. Results The examination of the literature clarifies the multifaceted nature of nursing surveillance in the acute care setting. Surveillance involves purposeful and ongoing acquisition, interpretation and synthesis of patient data for clinical decision- making. Behavioural activities and multiple cognitive processes are used in surveillance in order for the nurse to make decisions for patient safety and health maintenance. A systems approach to the analysis also demonstrates how organizational characteristics and contextual factors influence the process in the acute care environment. Conclusion This conceptual analysis describes the nature of the surveillance process and clarifies the concept for effective communication and future use in health services research. PMID:21129007

  8. The Past, Present, and Future of Public Health Surveillance

    PubMed Central

    Choi, Bernard C. K.

    2012-01-01

    This paper provides a review of the past, present, and future of public health surveillance—the ongoing systematic collection, analysis, interpretation, and dissemination of health data for the planning, implementation, and evaluation of public health action. Public health surveillance dates back to the first recorded epidemic in 3180 B.C. in Egypt. Hippocrates (460 B.C.–370 B.C.) coined the terms endemic and epidemic, John Graunt (1620–1674) introduced systematic data analysis, Samuel Pepys (1633–1703) started epidemic field investigation, William Farr (1807–1883) founded the modern concept of surveillance, John Snow (1813–1858) linked data to intervention, and Alexander Langmuir (1910–1993) gave the first comprehensive definition of surveillance. Current theories, principles, and practice of public health surveillance are summarized. A number of surveillance dichotomies, such as epidemiologic surveillance versus public health surveillance, are described. Some future scenarios are presented, while current activities that can affect the future are summarized: exploring new frontiers; enhancing computer technology; improving epidemic investigations; improving data collection, analysis, dissemination, and use; building on lessons from the past; building capacity; enhancing global surveillance. It is concluded that learning from the past, reflecting on the present, and planning for the future can further enhance public health surveillance. PMID:24278752

  9. Unattended digital video surveillance: A system prototype for EURATOM safeguards

    SciTech Connect

    Chare, P.; Goerten, J.; Wagner, H.; Rodriguez, C.; Brown, J.E.

    1994-09-01

    Ever increasing capabilities in video and computer technology have changed the face of video surveillance. From yesterday`s film and analog video tape-based systems, we now emerge into the digital era with surveillance systems capable of digital image processing, image analysis, decision control logic, and random data access features -- all of which provide greater versatility with the potential for increased effectiveness in video surveillance. Digital systems also offer other advantages such as the ability to ``compress`` data, providing increased storage capacities and the potential for allowing longer surveillance Periods. Remote surveillance and system to system communications are also a benefit that can be derived from digital surveillance systems. All of these features are extremely important in today`s climate Of increasing safeguards activity and decreasing budgets -- Los Alamos National Laboratory`s Safeguards Systems Group and the EURATOM Safeguards Directorate have teamed to design and implement a period surveillance system that will take advantage of the versatility of digital video for facility surveillance system that will take advantage of the versatility of digital video for facility surveillance and data review. In this Paper we will familiarize you with system components and features and report on progress in developmental areas such as image compression and region of interest processing.

  10. An emergency response UAV Surveillance System.

    PubMed

    Rodriguez, Pedro A; Geckle, William J; Barton, Jeffrey D; Samsundar, John; Gao, Tia; Brown, Myron Z; Martin, Sean R

    2006-01-01

    A system using Unmanned Air Vehicles (UAVs), equipped for real time telemetry of video imagery, sensor support data, and GPS/INS navigation, is being developed to provide situational awareness (SA) to the central command of mass casualty incident response. UAVs provide an inexpensive and safe means of acquiring video surveillance in chaotic disaster scenes, while being durable and non-intrusive. The system provides autonomous surveillance of defined perimeters, video tracking and active following of targets of interest, and real time cueing to other imaging UAVs.

  11. Enterovirus spectrum from the active surveillance of hand foot and mouth disease patients under the clinical trial of inactivated Enterovirus A71 vaccine in Jiangsu, China, 2012-2013.

    PubMed

    Yao, Xin; Bian, Lian-Lian; Lu, Wei-Wei; Li, Jing-Xin; Mao, Qun-Ying; Wang, Yi-Ping; Gao, Fan; Wu, Xing; Ye, Qiang; Xu, Miao; Li, Xiu-Ling; Zhu, Feng-Cai; Liang, Zheng-Lun

    2015-12-01

    Epidemiological data from active surveillance on human enterovirus, which could cause hand, foot, and mouth disease, were limited. An active surveillance system was used to investigate the enterovirus spectrum and the incidence of different enteroviruses in infants aged 6-35 months in Jiangsu Province from 2012 to 2013. Fifty-nine infants were randomly selected from 522 non-EV-A71/CV-A16 HFMD patients. We collected 173 throat swabs and 174 rectal swabs from these infants. RT-PCR was used to amplify 5'-UTR and VP1 regions of enteroviruses and the serotypes were determined by the sequence comparison using BLAST. Twenty-one non-EV-A71/CA16 enterovirus serotypes were detected in those infants. E16, E18 were firstly reported in HFMD patients. The four top common non-EV-A71/CV-A enteroviruses among infants were CV-B3, CV-A10, CV-A6, and E9 with the HFMD incidence rates at 1.4%, 0.84%, 0.56%, and 0.47%, respectively. Over 20.8% patients were co-infected with multiple enteroviruses. Neither the course of sickness nor clinical symptoms of the co-infected patients was more severe than those infected with single enterovirus. Two patients were infected different enterovirus successively within 2 months. Several new enterovirus serotypes and multiple models of infection associated with HFMD were discovered through the active surveillance system. These data provide a better understanding of the viral etiology of HFMD.

  12. Community-Operated Environmental Surveillance Program

    SciTech Connect

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the environmental surveillance activities with which citizens living near the Hanford Site have been participating. Local teachers have been managing and operating three special radiological air sampling stations located in Richland, Basin City, and Franklin County, Washington. Other expansion efforts of this program are also described.

  13. Semantic-based surveillance video retrieval.

    PubMed

    Hu, Weiming; Xie, Dan; Fu, Zhouyu; Zeng, Wenrong; Maybank, Steve

    2007-04-01

    Visual surveillance produces large amounts of video data. Effective indexing and retrieval from surveillance video databases are very important. Although there are many ways to represent the content of video clips in current video retrieval algorithms, there still exists a semantic gap between users and retrieval systems. Visual surveillance systems supply a platform for investigating semantic-based video retrieval. In this paper, a semantic-based video retrieval framework for visual surveillance is proposed. A cluster-based tracking algorithm is developed to acquire motion trajectories. The trajectories are then clustered hierarchically using the spatial and temporal information, to learn activity models. A hierarchical structure of semantic indexing and retrieval of object activities, where each individual activity automatically inherits all the semantic descriptions of the activity model to which it belongs, is proposed for accessing video clips and individual objects at the semantic level. The proposed retrieval framework supports various queries including queries by keywords, multiple object queries, and queries by sketch. For multiple object queries, succession and simultaneity restrictions, together with depth and breadth first orders, are considered. For sketch-based queries, a method for matching trajectories drawn by users to spatial trajectories is proposed. The effectiveness and efficiency of our framework are tested in a crowded traffic scene. PMID:17405446

  14. Second Cancer Risk and Late Mortality in Adult Australians Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A Population-Based Cohort Study.

    PubMed

    Vajdic, Claire M; Mayson, Eleni; Dodds, Anthony J; O'Brien, Tracey; Wilcox, Leonie; Nivison-Smith, Ian; Le Marsney, Renate; Daniels, Benjamin; Ashton, Lesley J

    2016-05-01

    We quantified the risk of second cancer and late mortality in a population-based Australian cohort of 3273 adult (≥15 years) allogeneic hematopoietic stem cell transplant recipients (1992 to 2007). Most recipients received nonradiation-based conditioning and a peripheral blood graft from a matched related donor. Using record linkage with death and cancer registries, 79 second cancers were identified a median of 3.5 years after transplantation. The competing-risk adjusted cumulative incidence of second cancers was 3.35% (95% CI, 2.59 to 4.24) at 10 years, and the cancer risk relative to the matched general population was 2.10 (95% CI, 1.65 to 2.56). We observed an excess risk of melanoma and lip, tongue, esophagus, and soft tissue cancers. Cancer risk relative to the general population was elevated for those transplanted for lymphoma, some leukemia subtypes, and severe aplastic anemia, recipients who developed chronic graft-versus-host disease (cGVHD) and irrespective of radiation-based conditioning or stem cell source. In those alive 2 years after transplantation (n = 1463), the cumulative incidence of late mortality was 22.2% (95% CI, 19.7 to 24.9) at 10 years, and the risk of death relative to the matched general population was 13.8 (95% CI, 12.2 to 15.6). In multivariable modeling, risk of late death was reduced for females compared with males and those transplanted for chronic myeloid leukemia compared with acute myeloid leukemia; risk was increased for recipients with discordant sex donors, cGVHD, those undergoing second transplants, and disease relapse. Adults undergoing allogeneic transplantation have unique cancer and mortality risk profiles that continue to warrant prevention and surveillance activities targeted at high-risk subgroups.

  15. Diagnostic, treatment, and demographic factors influencing survival in a population-based study of adult glioma patients in the San Francisco Bay Area.

    PubMed

    Wrensch, Margaret; Rice, Terri; Miike, Rei; McMillan, Alex; Lamborn, Kathleen R; Aldape, Kenneth; Prados, Michael D

    2006-01-01

    We compare survival estimates for population-based glioma cases by using two diagnostic coding schemes, (1) the International Classification of Diseases, Oncology, second edition (ICD-O-2) as reported by the Surveillance, Epidemiology, and End Results (SEER) program and (2) central neuropathology review diagnosis based on the World Health Organization II classification. In addition, among review categories, we estimate survival in relation to several patient demographic and treatment factors. Eligible cases included adults residing in the San Francisco Bay SEER Area with newly diagnosed, histologically confirmed glioma during the years 1991-1994 and 1997-1999. The study group included participating subjects for whom subsequent central neuropathology review confirmed glioma. We determined treatments, vital status, and other factors by using registry, interview, medical record, and active follow-up data. Survival differences between anaplastic astrocytoma (AA) and astrocytoma were apparent from review diagnoses (median months of survival for AA, 13.0 [95% CI, 9.9-19.5], and astrocytoma, 101.3 [95% CI lower limit, 42.1; upper limit not yet reached]), but not with ICD-O-2 diagnoses reported by SEER (median months of survival for AA, 16.6 [95% CI, 12.0-20.7], and astrocytoma, not otherwise specified, 17.2 [95% CI, 10.6-71.6]). This finding emphasizes the need for improvements in coding for nonglioblastoma astrocytomas to provide better population survival estimates. When review diagnosis was used, younger age and resection (vs. biopsy) were statistically significant for all histology groups analyzed by multivariable Cox proportional hazard models. Additional statistically significant variables were as follows: among 517 glioblastoma patients, radiation treatment and being married; among 105 AA patients, inclusion of chemotherapy in the initial treatment; and among 106 patients with nonanaplastic oligodendroglial tumors, college education. Further consideration of impact

  16. Diagnostic, treatment, and demographic factors influencing survival in a population-based study of adult glioma patients in the San Francisco Bay Area1

    PubMed Central

    Wrensch, Margaret; Rice, Terri; Miike, Rei; McMillan, Alex; Lamborn, Kathleen R.; Aldape, Kenneth; Prados, Michael D.

    2006-01-01

    We compare survival estimates for population-based glioma cases by using two diagnostic coding schemes, (1) the International Classification of Diseases, Oncology, second edition (ICD-O-2) as reported by the Surveillance, Epidemiology, and End Results (SEER) program and (2) central neuropathology review diagnosis based on the World Health Organization II classification. In addition, among review categories, we estimate survival in relation to several patient demographic and treatment factors. Eligible cases included adults residing in the San Francisco Bay SEER Area with newly diagnosed, histologically confirmed glioma during the years 1991–1994 and 1997–1999. The study group included participating subjects for whom subsequent central neuropathology review confirmed glioma. We determined treatments, vital status, and other factors by using registry, interview, medical record, and active follow-up data. Survival differences between anaplastic astrocytoma (AA) and astrocytoma were apparent from review diagnoses (median months of survival for AA, 13.0 [95% CI, 9.9–19.5], and astrocytoma, 101.3 [95% CI lower limit, 42.1; upper limit not yet reached]), but not with ICD-O-2 diagnoses reported by SEER (median months of survival for AA, 16.6 [95% CI, 12.0–20.7], and astrocytoma, not otherwise specified, 17.2 [95% CI, 10.6–71.6]). This finding emphasizes the need for improvements in coding for nonglioblastoma astrocytomas to provide better population survival estimates. When review diagnosis was used, younger age and resection (vs. biopsy) were statistically significant for all histology groups analyzed by multivariable Cox proportional hazard models. Additional statistically significant variables were as follows: among 517 glioblastoma patients, radiation treatment and being married; among 105 AA patients, inclusion of chemotherapy in the initial treatment; and among 106 patients with nonanaplastic oligodendroglial tumors, college education. Further consideration

  17. Effectiveness of the live attenuated rotavirus vaccine produced by a domestic manufacturer in China studied using a population-based case-control design.

    PubMed

    Zhen, Shan-Shan; Li, Yue; Wang, Song-Mei; Zhang, Xin-Jiang; Hao, Zhi-Yong; Chen, Ying; Wang, Dan; Zhang, Yan-Hong; Zhang, Zhi-Yong; Ma, Jing-Chen; Zhou, Peng; Zhang, Zhen; Jiang, Zhi-Wei; Zhao, Yu-Liang; Wang, Xuan-Yi

    2015-10-01

    A universal rotavirus (RV) immunization program is a potentially cost-effective measure for preventing RV infection in China. However, the efficacy of the only licensed RV vaccine (Lanzhou lamb rotavirus vaccine, LLR), which is made by a domestic manufacturer, has not been proven by a properly designed clinical trial. In October 2011 to March 2012, to measure the potential protection provided by LLR, a case-control study nested in a population-based active diarrhea surveillance study of children <5 years of age was conducted in rural Zhengding county. During the study period, 308 episodes of diarrhea were identified as being caused by RV infection, resulting in an incidence rate of 48.0/1000 people/year. The predominant RV serotype was G3 (61.5%), followed by G1 (15.2%), and G9 (6.5%). Overall, a protection of 35.0% (95% confidence interval (CI), 13.0%-52.0%) was identified, and higher protection was found among moderate RV gastroenteritis cases caused by the serotype G3 (52.0% 95% CI: 2.0%-76.1%). A concurrently conducted case-control study comparing non-RV viral diarrheal cases with non-diarrheal controls in the same population found that the RV vaccine offered no protection against non-RV diarrhea. Even under a less ideal immunization schedule, the oral LLR conferred a certain level of protection against RV gastroenteritis. However, further studies are needed to understand the full characteristics of the LLR, including its efficacy when administered following the optimal regimen, the potential risk of inducing intussusception, and the direct and indirect protective effects of LLR.

  18. Effectiveness of the live attenuated rotavirus vaccine produced by a domestic manufacturer in China studied using a population-based case-control design.

    PubMed

    Zhen, Shan-Shan; Li, Yue; Wang, Song-Mei; Zhang, Xin-Jiang; Hao, Zhi-Yong; Chen, Ying; Wang, Dan; Zhang, Yan-Hong; Zhang, Zhi-Yong; Ma, Jing-Chen; Zhou, Peng; Zhang, Zhen; Jiang, Zhi-Wei; Zhao, Yu-Liang; Wang, Xuan-Yi

    2015-10-01

    A universal rotavirus (RV) immunization program is a potentially cost-effective measure for preventing RV infection in China. However, the efficacy of the only licensed RV vaccine (Lanzhou lamb rotavirus vaccine, LLR), which is made by a domestic manufacturer, has not been proven by a properly designed clinical trial. In October 2011 to March 2012, to measure the potential protection provided by LLR, a case-control study nested in a population-based active diarrhea surveillance study of children <5 years of age was conducted in rural Zhengding county. During the study period, 308 episodes of diarrhea were identified as being caused by RV infection, resulting in an incidence rate of 48.0/1000 people/year. The predominant RV serotype was G3 (61.5%), followed by G1 (15.2%), and G9 (6.5%). Overall, a protection of 35.0% (95% confidence interval (CI), 13.0%-52.0%) was identified, and higher protection was found among moderate RV gastroenteritis cases caused by the serotype G3 (52.0% 95% CI: 2.0%-76.1%). A concurrently conducted case-control study comparing non-RV viral diarrheal cases with non-diarrheal controls in the same population found that the RV vaccine offered no protection against non-RV diarrhea. Even under a less ideal immunization schedule, the oral LLR conferred a certain level of protection against RV gastroenteritis. However, further studies are needed to understand the full characteristics of the LLR, including its efficacy when administered following the optimal regimen, the potential risk of inducing intussusception, and the direct and indirect protective effects of LLR. PMID:26576341

  19. Effectiveness of the live attenuated rotavirus vaccine produced by a domestic manufacturer in China studied using a population-based case–control design

    PubMed Central

    Zhen, Shan-Shan; Li, Yue; Wang, Song-Mei; Zhang, Xin-Jiang; Hao, Zhi-Yong; Chen, Ying; Wang, Dan; Zhang, Yan-Hong; Zhang, Zhi-Yong; Ma, Jing-Chen; Zhou, Peng; Zhang, Zhen; Jiang, Zhi-Wei; Zhao, Yu-Liang; Wang, Xuan-Yi

    2015-01-01

    A universal rotavirus (RV) immunization program is a potentially cost-effective measure for preventing RV infection in China. However, the efficacy of the only licensed RV vaccine (Lanzhou lamb rotavirus vaccine, LLR), which is made by a domestic manufacturer, has not been proven by a properly designed clinical trial. In October 2011 to March 2012, to measure the potential protection provided by LLR, a case–control study nested in a population-based active diarrhea surveillance study of children <5 years of age was conducted in rural Zhengding county. During the study period, 308 episodes of diarrhea were identified as being caused by RV infection, resulting in an incidence rate of 48.0/1000 people/year. The predominant RV serotype was G3 (61.5%), followed by G1 (15.2%), and G9 (6.5%). Overall, a protection of 35.0% (95% confidence interval (CI), 13.0%–52.0%) was identified, and higher protection was found among moderate RV gastroenteritis cases caused by the serotype G3 (52.0% 95% CI: 2.0%–76.1%). A concurrently conducted case–control study comparing non-RV viral diarrheal cases with non-diarrheal controls in the same population found that the RV vaccine offered no protection against non-RV diarrhea. Even under a less ideal immunization schedule, the oral LLR conferred a certain level of protection against RV gastroenteritis. However, further studies are needed to understand the full characteristics of the LLR, including its efficacy when administered following the optimal regimen, the potential risk of inducing intussusception, and the direct and indirect protective effects of LLR. PMID:26576341

  20. Young adults' trajectories of Ecstasy use: a population based study.

    PubMed

    Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Plotnikova, Maria; Wells, Helene; Legosz, Margot; Kemp, Robert

    2013-11-01

    Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns.

  1. Guiding principles and checklist for population-based quality metrics.

    PubMed

    Krishnan, Mahesh; Brunelli, Steven M; Maddux, Franklin W; Parker, Thomas F; Johnson, Douglas; Nissenson, Allen R; Collins, Allan; Lacson, Eduardo

    2014-06-01

    The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect

  2. Increasing incidence of cataract surgery: Population-based study

    PubMed Central

    Gollogly, Heidrun E.; Hodge, David O.; St. Sauver, Jennifer L.; Erie, Jay C.

    2015-01-01

    PURPOSE To estimate the incidence of cataract surgery in a defined population and to determine longitudinal cataract surgery patterns. SETTING Mayo Clinic, Rochester, Minnesota, USA. DESIGN Cohort study. METHODS Rochester Epidemiology Project (REP) databases were used to identify all incident cataract surgeries in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2011. Age-specific and sex-specific incidence rates were calculated and adjusted to the 2010 United States white population. Data were merged with previous REP data (1980 to 2004) to assess temporal trends in cataract surgery. Change in the incidence over time was assessed by fitting generalized linear models assuming a Poisson error structure. The probability of second-eye cataract surgery was calculated using the Kaplan-Meier method. RESULTS Included were 8012 cataract surgeries from 2005 through 2011. During this time, incident cataract surgery significantly increased (P < .001), peaking in 2011 with a rate of 1100 per 100 000 (95% confidence interval, 1050–1160). The probability of second-eye surgery 3, 12, and 24 months after first-eye surgery was 60%, 76%, and 86%, respectively, a significant increase compared with the same intervals in the previous 7 years (1998 to 2004) (P < .001). When merged with 1980 to 2004 REP data, incident cataract surgery steadily increased over the past 3 decades (P < .001). CONCLUSION Incident cataract surgery steadily increased over the past 32 years and has not leveled off, as reported in Swedish population-based series. Second-eye surgery was performed sooner and more frequently, with 60% of residents having second-eye surgery within 3-months of first-eye surgery. PMID:23820302

  3. Recurrent Wheezing in Infants: A Population-Based Study.

    PubMed

    Belhassen, Manon; De Blic, Jacques; Laforest, Laurent; Laigle, Valérie; Chanut-Vogel, Céline; Lamezec, Liliane; Brouard, Jacques; Fauroux, Brigitte; de Pouvourville, Gérard; Ginoux, Marine; Van Ganse, Eric

    2016-04-01

    Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data. Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms. A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms. In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care. PMID:27082618

  4. Young adults' trajectories of Ecstasy use: a population based study.

    PubMed

    Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Plotnikova, Maria; Wells, Helene; Legosz, Margot; Kemp, Robert

    2013-11-01

    Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns. PMID:23899430

  5. Postmarketing surveillance for drug abuse.

    PubMed

    Arfken, Cynthia L; Cicero, Theodore J

    2003-06-01

    Assessing actual abuse of prescribed medications requires postmarketing surveillance. In this article we discuss general systems of postmarketing surveillance that exist as of the end of 2002 in the United States and two medication-specific surveillance systems that were devised and tested. The two specific surveillance systems are compared with limitations highlighted. Postmarketing surveillance is in its infancy and requires more research on ways to improve its validity without inducing illicit experimentation. Information on comparator medications is highly recommended both to validate the system and to place the results in context.

  6. Detection and Isolation of Swine Influenza A Virus in Spiked Oral Fluid and Samples from Individually Housed, Experimentally Infected Pigs: Potential Role of Porcine Oral Fluid in Active Influenza A Virus Surveillance in Swine

    PubMed Central

    Decorte, Inge; Steensels, Mieke; Lambrecht, Bénédicte

    2015-01-01

    Background The lack of seasonality of swine influenza A virus (swIAV) in combination with the capacity of swine to harbor a large number of co-circulating IAV lineages, resulting in the risk for the emergence of influenza viruses with pandemic potential, stress the importance of swIAV surveillance. To date, active surveillance of swIAV worldwide is barely done because of the short detection period in nasal swab samples. Therefore, more sensitive diagnostic methods to monitor circulating virus strains are requisite. Methods qRT-PCR and virus isolations were performed on oral fluid and nasal swabs collected from individually housed pigs that were infected sequentially with H1N1 and H3N2 swIAV strains. The same methods were also applied to oral fluid samples spiked with H1N1 to study the influence of conservation time and temperature on swIAV infectivity and detectability in porcine oral fluid. Results All swIAV infected animals were found qRT-PCR positive in both nasal swabs and oral fluid. However, swIAV could be detected for a longer period in oral fluid than in nasal swabs. Despite the high detectability of swIAV in oral fluid, virus isolation from oral fluid collected from infected pigs was rare. These results are supported by laboratory studies showing that the PCR detectability of swIAV remains unaltered during a 24 h incubation period in oral fluid, while swIAV infectivity drops dramatically immediately upon contact with oral fluid (3 log titer reduction) and gets lost after 24 h conservation in oral fluid at ambient temperature. Conclusions Our data indicate that porcine oral fluid has the potential to replace nasal swabs for molecular diagnostic purposes. The difficulty to isolate swIAV from oral fluid could pose a drawback for its use in active surveillance programs. PMID:26431039

  7. Mobile security surveillance system

    NASA Astrophysics Data System (ADS)

    Sokolnikov, Andre

    2006-05-01

    The necessity to control certain areas from outside intrusion or, vice versa, preventing subjects/objects (e.g. prisoners) from leaving a controlled area has brought to life numerous designs of surveillance systems for the above-mentioned tasks. Fibers, laser beams, microwaves, etc have been used for decades to provide an alarm signal, should anyone or anything cross a light, radio beam or break a fiber. However, it is difficult to distinguish a stray animal from a human being, or even a snow ball from the first two using the conventional surveillance designs. False alarms render practically useless the above means, especially for field applications. It is possible, nonetheless, to set up an automatic system that discriminates objects/subjects crossing the control line/perimeter - a statistical approach which includes time series analysis is proposed as a solution for the problem.

  8. [Health surveillance of workers].

    PubMed

    Alessio, L; Curti, R; Rivolta, G

    1987-01-01

    The paper deals with the concepts of environmental monitoring and health surveillance, which include the following tasks: biological monitoring, health information, pre-employment and periodical medical examinations. Biological monitoring permits evaluation of the degree of exposure and its early effects. The early effects can be detected with specific tests exploring initial biological alterations while the organism is still capable of compensating such changes. Application of biological monitoring requires a profound knowledge of toxicology and health surveillance in general terms requires a solid basis of occupational medicine in order to set objectives and make judgements concerning fitness for specific jobs. Details are given of the measures the occupational health physician must take and when he must take them in the case of development of an occupational disease. Particular attention is given to the removal of the subject from exposure, the first certificate of occupational disease, the notification to the Local Health Unit and the diagnosis.

  9. Surveillance for gastrointestinal malignancies

    PubMed Central

    Tiwari, Ashish K; Laird-Fick, Heather S; Wali, Ramesh K; Roy, Hemant K

    2012-01-01

    Gastrointestinal (GI) malignancies are notorious for frequently progressing to advanced stages even in the absence of serious symptoms, thus leading to delayed diagnoses and dismal prognoses. Secondary prevention of GI malignancies through early detection and treatment of cancer-precursor/premalignant lesions, therefore, is recognized as an effective cancer prevention strategy. In order to efficiently detect these lesions, systemic application of screening tests (surveillance) is needed. However, most of the currently used non-invasive screening tests for GI malignancies (for example, serum markers such as alpha-fetoprotein for hepatocellular carcinoma, and fecal occult blood test, for colon cancer) are only modestly effective necessitating the use of highly invasive endoscopy-based procedures, such as esophagogastroduodenoscopy and colonoscopy for screening purposes. Even for hepatocellular carcinoma where non-invasive imaging (ultrasonography) has become a standard screening tool, the need for repeated liver biopsies of suspicious liver nodules for histopathological confirmation can’t be avoided. The invasive nature and high-cost associated with these screening tools hinders implementation of GI cancer screening programs. Moreover, only a small fraction of general population is truly predisposed to developing GI malignancies, and indeed needs surveillance. To spare the average-risk individuals from superfluous invasive procedures and achieve an economically viable model of cancer prevention, it’s important to identify cohorts in general population that are at substantially high risk of developing GI malignancies (risk-stratification), and select suitable screening tests for surveillance in these cohorts. We herein provide a brief overview of such high-risk cohorts for different GI malignancies, and the screening strategies that have commonly been employed for surveillance purpose in them. PMID:22969223

  10. Supportive housing and surveillance.

    PubMed

    Boyd, Jade; Cunningham, David; Anderson, Solanna; Kerr, Thomas

    2016-08-01

    Urban centres in the US, Britain and Canada have responded to identified visible 'social problems' such addiction, mental health and homelessness by providing some supportive housing for the urban poor and marginalized. While some critics have questioned what supportive housing specifically entails in terms of the built environment, what remains under explored, though a growing area of concern, is the relationship between surveillance and supportive housing for urban residents identified as having addiction and mental health problems - a gap addressed in this paper. Drawing upon qualitative ethnographic observational data we examine some of the measures of control and coercion that are encroaching into social housing primarily established for poor and marginalized people with addiction and mental health problems in the urban centre of Vancouver, Canada. We witnessed three modes of regulation and control, that vary widely, among the residencies observed: physical surveillance technologies; site-specific modes of coercion; police presence and staff surveillance, which all together impact the everyday lives of residents living in low-income and supportive housing. We argue that supportive housing has the potential to provide its intended commitment - safe and secure affordable housing. However, owing to an (over)emphasis on 'security', the supportive housing we observed were also sites of social control. PMID:27453148

  11. Cyberbullying among Finnish adolescents – a population-based study

    PubMed Central

    2012-01-01

    Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, and its frequency and perceived seriousness among 12 to 18-year-old adolescents in Finland. We studied four dimensions of cyberbullying: being a victim, bully, or both victim and bully of cyberbullying, and witnessing the cyberbullying of friends. Methods Self-administered questionnaires, including four questions on cyberbullying, were mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns in 2009 (the Adolescent Health and Lifestyle Survey). The respondents could answer via the internet or paper questionnaire. Results The number of respondents was 5516 and the response rate was 56%. Girls more often than boys reported experiencing at least one dimension of cyberbullying during the last year. The proportion was highest among 14-year-olds and lowest among 18-year-olds of both sexes. Among girls, the most commonly encountered dimension was witnessing the cyberbullying of friends (16%); and being a victim was slightly more common than being a bully (11% vs. 9%). Among boys, an equal proportion, approximately 10%, had been a victim, a bully, or had witnessed cyberbullying. The proportion of bully-victims was 4%. Serious and disruptive cyberbullying was experienced by 2% of respondents and weekly cyberbullying by 1%; only 0.5% of respondents had been bullied weekly and considered bullying serious and disruptive. Conclusions Adolescents are commonly exposed to cyberbullying, but it is rarely frequent or considered serious or disruptive. Cyberbullying exposure differed between

  12. Familial risk of cerebral palsy: population based cohort study

    PubMed Central

    Wilcox, Allen J; Lie, Rolv T; Moster, Dag

    2014-01-01

    Objective To investigate risks of recurrence of cerebral palsy in family members with various degrees of relatedness to elucidate patterns of hereditability. Design Population based cohort study. Setting Data from the Medical Birth Registry of Norway, linked to the Norwegian social insurance scheme to identify cases of cerebral palsy and to databases of Statistics Norway to identify relatives. Participants 2 036 741 Norwegians born during 1967-2002, 3649 of whom had a diagnosis of cerebral palsy; 22 558 pairs of twins, 1 851 144 pairs of first degree relatives, 1 699 856 pairs of second degree relatives, and 5 165 968 pairs of third degree relatives were identified. Main outcome measure Cerebral palsy. Results If one twin had cerebral palsy, the relative risk of recurrence of cerebral palsy was 15.6 (95% confidence interval 9.8 to 25) in the other twin. In families with an affected singleton child, risk was increased 9.2 (6.4 to 13)-fold in a subsequent full sibling and 3.0 (1.1 to 8.6)-fold in a half sibling. Affected parents were also at increased risk of having an affected child (6.5 (1.6 to 26)-fold). No evidence was found of differential transmission through mothers or fathers, although the study had limited power to detect such differences. For people with an affected first cousin, only weak evidence existed for an increased risk (1.5 (0.9 to 2.7)-fold). Risks in siblings or cousins were independent of sex of the index case. After exclusion of preterm births (an important risk factor for cerebral palsy), familial risks remained and were often stronger. Conclusions People born into families in which someone already has cerebral palsy are themselves at elevated risk, depending on their degree of relatedness. Elevated risk may extend even to third degree relatives (first cousins). The patterns of risk suggest multifactorial inheritance, in which multiple genes interact with each other and with environmental factors. These data offer additional

  13. Surveillance for fetal alcohol syndrome in Colorado.

    PubMed Central

    Miller, L A; Shaikh, T; Stanton, C; Montgomery, A; Rickard, R; Keefer, S; Hoffman, R

    1995-01-01

    The authors performed surveillance for fetal alcohol syndrome with an existing birth defects registry. Fetal alcohol syndrome cases were identified from multiple sources using passive surveillance and from two selected medical sites using enhanced surveillance. Between May 1992 and March 1994, a total of 173 cases were identified, and the medical records of the cases were reviewed to determine whether the cases met a surveillance case definition for fetal alcohol syndrome. Of these cases, 37 (21 percent) met either definite (28) or probable (9) criteria for fetal alcohol syndrome, 76 met possible criteria (44 percent), and 60 (35 percent) were defined as not fetal alcohol syndrome. Enhanced surveillance had the highest sensitivity for definite or probable cases, 31 of 37 (84 percent), followed by hospital discharge data, 14 of 37 (38 percent). The authors also compared birth certificate information for 22 definite or probable cases in children born between 1989 and 1992 to birth certificate information for all Colorado births for that period. The proportion of mothers of children with fetal alcohol syndrome was statistically significantly greater (as determined by exact binomial 95 percent confidence limits) than the proportion of all mothers for the following characteristics: black race (0.23 versus 0.05), unmarried (0.55 versus 0.22), not employed during pregnancy (0.86 versus 0.43), and started prenatal care in the third trimester (0.18 versus 0.04). Surveillance for fetal alcohol syndrome can be accomplished with an existing registry system in combination with additional case finding and verification activities. Through followup investigation of reported cases, data can be gathered on the mothers of children with fetal alcohol syndrome. These data could be used to target fetal alcohol syndrome prevention programs. PMID:8570819

  14. Radiological surveillance of Remedial Action activities at the processing site, Ambrosia Lake, New Mexico, April 12--16, 1993. Final report

    SciTech Connect

    1993-04-01

    The Uranium Mill Tailings Remedial Action (UMTRA) Project`s Technical Assistance Contractor (TAC) performed a radiological surveillance of the Remedial Action Contractor (RAC), MK-Ferguson and CWM Federal Environmental Services, Inc., at the processing site in Ambrosia Lake, New Mexico. The requirements and attributes examined during the audit were developed from reviewing working-level procedures developed by the RAC. Objective evidence, comments, and observations were verified based on investigating procedures, documentation, records located at the site, personal interviews, and tours of the site. No findings were identified during this audit. Ten site-specific observations, three good practice observations, and five programmatic observations are presented in this report. The overall conclusion from the surveillance is that the radiological aspects of the Ambrosia Lake, New Mexico, remedial action program are performed adequately. The results of the good practice observations indicate that the site health physics (HP) staff is taking the initiative to address and resolve potential issues, and implement suggestions useful to the UMTRA Project. However, potential exists for improving designated storage areas for general items, and the RAC Project Office should consider resolving site-specific and procedural inconsistencies.

  15. Assessment of Arbovirus Surveillance 13 Years after Introduction of West Nile Virus, United States.

    PubMed

    Hadler, James L; Patel, Dhara; Nasci, Roger S; Petersen, Lyle R; Hughes, James M; Bradley, Kristy; Etkind, Paul; Kan, Lilly; Engel, Jeffrey

    2015-07-01

    Before 1999, the United States had no appropriated funding for arboviral surveillance, and many states conducted no such surveillance. After emergence of West Nile virus (WNV), federal funding was distributed to state and selected local health departments to build WNV surveillance systems. The Council of State and Territorial Epidemiologists conducted assessments of surveillance capacity of resulting systems in 2004 and in 2012; the assessment in 2012 was conducted after a 61% decrease in federal funding. In 2004, nearly all states and assessed local health departments had well-developed animal, mosquito, and human surveillance systems to monitor WNV activity and anticipate outbreaks. In 2012, many health departments had decreased mosquito surveillance and laboratory testing capacity and had no systematic disease-based surveillance for other arboviruses. Arboviral surveillance in many states might no longer be sufficient to rapidly detect and provide information needed to fully respond to WNV outbreaks and other arboviral threats (e.g., dengue, chikungunya).

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

    PubMed

    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.

  17. Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness, and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data

    PubMed Central

    Goldman, G.S.; King, P.G.

    2013-01-01

    In a cooperative agreement starting January 1995, prior to the FDA's licensure of the varicella vaccine on March 17, the Centers for Disease Control and Prevention (CDC) funded the Los Angeles Department of Health Services’ Antelope Valley Varicella Active Surveillance Project (AV-VASP). Since only varicella case reports were gathered, baseline incidence data for herpes zoster (HZ) or shingles was lacking. Varicella case reports decreased 72%, from 2834 in 1995 to 836 in 2000 at which time approximately 50% of children under 10 years of age had been vaccinated. Starting in 2000, HZ surveillance was added to the project. By 2002, notable increases in HZ incidence rates were reported among both children and adults with a prior history of natural varicella. However, CDC authorities still claimed that no increase in HZ had occurred in any US surveillance site. The basic assumptions inherent to the varicella cost–benefit analysis ignored the significance of exogenous boosting caused by those shedding wild-type VZV. Also ignored was the morbidity associated with even rare serious events following varicella vaccination as well as the morbidity from increasing cases of HZ among adults. Vaccine efficacy declined below 80% in 2001. By 2006, because 20% of vaccinees were experiencing breakthrough varicella and vaccine-induced protection was waning, the CDC recommended a booster dose for children and, in 2007, a shingles vaccination was approved for adults aged 60 years and older. In the prelicensure era, 95% of adults experienced natural chickenpox (usually as children)—these cases were usually benign and resulted in long-term immunity. Varicella vaccination is less effective than the natural immunity that existed in prevaccine communities. Universal varicella vaccination has not proven to be cost-effective as increased HZ morbidity has disproportionately offset cost savings associated with reductions in varicella disease. Universal varicella vaccination has failed to

  18. Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness, and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data.

    PubMed

    Goldman, G S; King, P G

    2013-03-25

    In a cooperative agreement starting January 1995, prior to the FDA's licensure of the varicella vaccine on March 17, the Centers for Disease Control and Prevention (CDC) funded the Los Angeles Department of Health Services' Antelope Valley Varicella Active Surveillance Project (AV-VASP). Since only varicella case reports were gathered, baseline incidence data for herpes zoster (HZ) or shingles was lacking. Varicella case reports decreased 72%, from 2834 in 1995 to 836 in 2000 at which time approximately 50% of children under 10 years of age had been vaccinated. Starting in 2000, HZ surveillance was added to the project. By 2002, notable increases in HZ incidence rates were reported among both children and adults with a prior history of natural varicella. However, CDC authorities still claimed that no increase in HZ had occurred in any US surveillance site. The basic assumptions inherent to the varicella cost-benefit analysis ignored the significance of exogenous boosting caused by those shedding wild-type VZV. Also ignored was the morbidity associated with even rare serious events following varicella vaccination as well as the morbidity from increasing cases of HZ among adults. Vaccine efficacy declined below 80% in 2001. By 2006, because 20% of vaccinees were experiencing breakthrough varicella and vaccine-induced protection was waning, the CDC recommended a booster dose for children and, in 2007, a shingles vaccination was approved for adults aged 60 years and older. In the prelicensure era, 95% of adults experienced natural chickenpox (usually as children)-these cases were usually benign and resulted in long-term immunity. Varicella vaccination is less effective than the natural immunity that existed in prevaccine communities. Universal varicella vaccination has not proven to be cost-effective as increased HZ morbidity has disproportionately offset cost savings associated with reductions in varicella disease. Universal varicella vaccination has failed to provide

  19. Disease surveillance in Guam: a historical perspective.

    PubMed

    Haddock, Robert L

    2005-09-01

    Passive, active, and syndromic disease surveillance, together with disease registries and surveys, are undertaken by the Guam Department of Public Health and Social Services to provide a rational basis for decision making by health care officials. Each of these activities serves a unique purpose in the process of detecting and confirming or disproving the presence or extent of disease on the island and evaluating the effectiveness of control measures.

  20. A two-stage cluster sampling method using gridded population data, a GIS, and Google EarthTM imagery in a population-based mortality survey in Iraq

    PubMed Central

    2012-01-01

    Background Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys. Results We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described. Conclusion Sampling is a challenge in retrospective