The relevance of WHO injury surveillance guidelines for evaluation: learning from the aboriginal community-centered injury surveillance system (ACCISS) and two institution-based systems

<p>Abstract</p> <p>Background</p> <p>Over the past three decades, the capacity to develop and implement injury surveillance systems (ISS) has grown worldwide and is reflected by the diversity of data gathering environments in which ISS operate. The capacity to evaluate ISS, however, is less advanced and existing evaluation guidelines are ambiguous. Furthermore, the applied relevance of these guidelines to evaluate ISS operating in various settings is unclear. The aim of this paper was to examine how the World Health Organization (WHO) injury surveillance guidelines have been applied to evaluate systems operating in three different contexts.</p> <p>Methods</p> <p>The attributes of a good surveillance system as well as instructions for conducting evaluations, outlined in the WHO injury surveillance guidelines, were used to develop an analytical framework. Using this framework, a comparative analysis of the application of the guidelines was conducted using; the Aboriginal Community-Centered Injury Surveillance System (ACCISS) from Canada, the Shantou-Emergency Department Injury Surveillance Project (S-EDISP) from China, and the Yorkhill-Canadian Hospitals Injury Reporting and Prevention Program (Y-CHIRPP) imported from Canada and implemented in Scotland.</p> <p>Results</p> <p>The WHO guidelines provide only a basic platform for evaluation. The guidelines over emphasize epidemiologic attributes and methods and under emphasize public health and injury prevention perspectives requiring adaptation for context-based relevance. Evaluation elements related to the dissemination and use of knowledge, acceptability, and the sustainability of ISS are notably inadequate. From a public health perspective, alternative reference points are required for re-conceptualizing evaluation paradigms. This paper offers an ISS evaluation template that considers how the WHO guidelines could be adapted and applied.</p> <p>Conclusions</p> <p>Findings suggest that attributes of a good surveillance system, when used as evaluation metrics, cannot be weighted equally across ISS. In addition, the attribute of acceptability likely holds more relevance than previously recognized and should be viewed as a critical underpinning attribute of ISS. Context-oriented evaluations sensitive to distinct operational environments are more likely to address knowledge gaps related to; understanding links between the production of injury data and its use, and the effectiveness, impact, and sustainability of ISS. Current frameworks are predisposed to disassociating epidemiologic approaches from subjective factors and social processes.</p

Disease Surveillance Networks Initiative Asia: Final Evaluation

The DSN Initiative was launched in 2007 under the new strategy of the Rockefeller Foundation. The initiative intends:[1] To improve human resources for disease surveillance in developing countries, thus bolstering national capacity to monitor, report, and respond to outbreaks;[2] To support regional networks to promote collaboration in disease surveillance and response across countries; and[3] To build bridges between regional and global monitoring effortsThe purpose of the DSN evaluation in the Mekong region was twofold:[1]To inform the work and strategy of the Foundation, its grantees, and the broader field of disease surveillance, based on the experience of DSN investments in the Mekong region. More specifically, the evaluation will inform future directions and strategies for current areas of DSN Initiative work, particularly in Asia, and will highlight potential new areas of work and strategy; and[2] To provide accountability to the Rockefeller Foundation's board, staff, and stakeholders for the DSN funds spent in the Mekong region

The CONSTANCES cohort, an epidemiological research infrastructure. Methods and results of the pilot phase

Background: prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an epidemiological research infrastructure accessible to the epidemiologic research community. Although designed as a “general-purpose” cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on chronic diseases and aging. Methods: the CON STANC ES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200 000 subjects will be included over a five-year period. At inclusion, the selected subjects are invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities is performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data are collected from the French national retirement, health and death databases. The data include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants was set up and will be followed through the same national databases as participants. Results: a field-pilot was performed in 2010 in seven HSCs, which included about 3 500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data. Conclusions: the constitution of the full eligible sample begun in 2012 and the cohort will be completed by the end of 2017. A public call for ancillary research projects will be launched in 2014

Decreased microbial co-occurrence network stability and SCFA receptor level correlates with obesity in African-origin women.

We compared the gut microbial populations in 100 women, from rural Ghana and urban US [50% lean (BMI &lt; 25 kg/m2) and 50% obese (BMI ≥ 30 kg/m2)] to examine the ecological co-occurrence network topology of the gut microbiota as well as the relationship of short chain fatty acids (SCFAs) with obesity. Ghanaians consumed significantly more dietary fiber, had greater microbial alpha-diversity, different beta-diversity, and had a greater concentration of total fecal SCFAs (p-value &lt; 0.002). Lean Ghanaians had significantly greater network density, connectivity and stability than either obese Ghanaians, or lean and obese US participants (false discovery rate (FDR) corrected p-value ≤ 0.01). Bacteroides uniformis was significantly more abundant in lean women, irrespective of country (FDR corrected p &lt; 0.001), while lean Ghanaians had a significantly greater proportion of Ruminococcus callidus, Prevotella copri, and Escherichia coli, and smaller proportions of Lachnospiraceae, Bacteroides and Parabacteroides. Lean Ghanaians had a significantly greater abundance of predicted microbial genes that catalyzed the production of butyric acid via the fermentation of pyruvate or branched amino-acids, while obese Ghanaians and US women (irrespective of BMI) had a significantly greater abundance of predicted microbial genes that encoded for enzymes associated with the fermentation of amino-acids such as alanine, aspartate, lysine and glutamate. Similar to lean Ghanaian women, mice humanized with stool from the lean Ghanaian participant had a significantly lower abundance of family Lachnospiraceae and genus Bacteroides and Parabacteroides, and were resistant to obesity following 6-weeks of high fat feeding (p-value &lt; 0.01). Obesity-resistant mice also showed increased intestinal transcriptional expression of the free fatty acid (Ffa) receptor Ffa2, in spite of similar fecal SCFAs concentrations. We demonstrate that the association between obesity resistance and increased predicted ecological connectivity and stability of the lean Ghanaian microbiota, as well as increased local SCFA receptor level, provides evidence of the importance of robust gut ecologic network in obesity

Construction and evaluation of epidemiologic simulation models for the within- and among-unit spread and control of infectious diseases of livestock and poultry

2012 Fall.Includes bibliographical references.Epidemiologic modeling is an increasingly common method of estimating the potential impact of outbreaks of highly contagious diseases, such as foot-and-mouth disease (FMD) and highly pathogenic avian influenza (HPAI), in populations of domesticated animals. Disease models are also used to inform policy decisions regarding disease control methods and outbreak response plans, to estimate the possible magnitude of an outbreak, and to estimate the resources needed for outbreak response. Although disease models are computationally sophisticated, the quality of the results of modeling studies depends on the quality and accuracy of the data on which they are based, and on the conceptual soundness and validity of the models themselves. For such models to be credibly applied, they should realistically represent the systems they are intended to reflect, should be based to as great an extent as possible on valid data, and should be subjected to careful and ongoing scrutiny. Two key steps in the evaluation of epidemiologic models are model verification and model validation. Verification is the demonstration that a computer-driven model is operating correctly, and conforms to its intended design. Validation refers to the process of determining how well a model corresponds to the system that it intended to represent. For a veterinary epidemiologic model, validation would address issues such as how well the model represents the dynamics of the disease in question in a population to which the model is applied, and how well the model represents the application of different measures for disease control. Among the steps that can be taken by epidemiologic modelers to facilitate the processes of model verification and validation are to clearly state the purpose, assumptions, and limitations of a model; to provide a detailed description of the conceptual model for use by everyone who might be tasked with evaluation of a model; document steps already taken to test the model; and thoroughly describe the data sources and the process used to produce model input parameters from data. The realistic representation of the dynamics of spread of disease within individual herds or flocks can have important implications for disease detection and surveillance, as well as for disease transmission between herds or flocks. We have developed a simulation model of within-unit (within-herd or within-flock) disease spread that operates at the level of the individual animal, and fully incorporates sources of individual-level variation such as variability in the durations of incubating and infectious periods, the stochastic nature of disease spread among individuals, and the effects of vaccination. We describe this stochastic model, along with the processes employed for verification and validation. The incorporation of this approach to modeling of within-unit disease dynamics into models of between-unit disease spread should improve the utility of these models for emergency preparedness and response planning by making it possible to assess the value of different approaches to disease detection and surveillance, in populations with or without some existing level of vaccine immunity. Models rely not only on realistic representations of the systems of interest, but also on valid and realistic information. For spatially explicit models of the spread and control of disease in populations of livestock and poultry, this means a heavy reliance upon valid spatial representations of the populations of interest, including such characteristics as the geographic locations of farms and their proximity to others in the population. In the United States, limited information regarding the locations of actual farm premises is available, and modeling work often makes use of artificially generated population datasets. In order to evaluate the accuracy and validity of the use of such artificially generated datasets, we compared the outcomes of mechanistic epidemiologic simulation models that were run using an empirical population dataset to those of models that made use of several different synthetic population datasets. Although we found generally good qualitative agreement among models run using various population datasets, the quantitative differences in model outcomes could be substantial. When quantitative outcomes from epidemiologic models are desired or required, care should be taken to adequately capture or describe the uncertainty in model-based outcomes due to the use of synthetic population datasets

Behavioral and Emotional Changes Across COVID-19 School Experiences in Children and Adolescents

The COVID 19 pandemic has necessitated several containment measures including full or partial remote learning for some children and adolescents. Displacement from school is known to be socially isolating with the potential to impact child behavior. However, the direction of effect of pandemic school closures on the emotional well-being of children and adolescents is not yet clear. This study aims to determine the effect of remote learning on emotional and behavioral changes in children and adolescents. Using participants from the Adolescent Brain Cognitive Development study, this longitudinal prospective cohort study will compare mean, current, and follow-up scores on the Child Behavior Checklist to pre-pandemic Child Behavior Checklist Scores across students with remote, hybrid, and full classroom learning experiences from August to December 2020. This study will shed light on risk and resilience factors as well as potential points for intervention relating to the social emotional well-being of socially isolated children

Bacterial ligands as flexible and sensitive detectors in rapid tests for antibodies to SARS-CoV-2

Lateral flow immunoassay (LFIA) is widely employed as point-of-care tests (POCT) for the diagnosis of infectious diseases. The accuracy of LFIA largely depends on the quality of the immunoreagents used. Typical LFIAs to reveal the immune response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) employ anti-human immunoglobulin (hIG) antibodies and recombinant viral antigens, which usually are unstable and poorly soluble. Broad selective bacterial proteins, such as Staphylococcal protein A (SpA) and Streptococcal protein G (SpG) can be considered alternatives to anti-hIG to increase versatility and sensitivity of serological LFIAs because of their high binding capacity, interspecies reactivity, and robustness. We developed two colorimetric LFA devices including SpA and SpG linked to gold nanoparticles (GNP) as detectors and explored the use of a specific, stable, and soluble immunodominant fraction of the nucleocapsid protein from SARS-CoV-2 as the capturing agent. The optimal amount of SpA-GNP and SpG-GNP conjugates and the protein-to-GNP ratios were defined through a full factorial experimental design to maximize the diagnostic sensitivity of the LFIAs. The new LFA devices were applied to analyze 105 human serum samples (69 positive and 36 negatives according to reference molecular diagnostic methods). The results showed higher sensitivity (89.9%, 95% CI 82.7-97.0) and selectivity (91.7%, 82.6-100) for the SpA-based compared to the SpG-based LFA. In addition, 18 serum samples from cats and dogs living with COVID-19 patients were analyzed and 14 showed detectable levels of anti-SARS-CoV-2 antibodies, thus illustrating the flexibility of the SpA- and SpG-based LFAs