Auditing the Management of Vaccine-Preventable Disease Outbreaks: The Need for a Tool

Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p≤0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator “updated guidelines” and “timely reporting” had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators “availability of guidelines/protocol updated less than 3 years ago” (p = 0.03) and “days needed for outbreak control” (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

Periodontal Research Fund of the Unit of Periodontology at the Eastman Dental Institute, University College London, UK and a Scholarship of The Royal Thai Government

Facial age estimation by nonlinear aging pattern subspace

Human age estimation by face images is an interesting yet challenging research topic emerging in recent years. This paper extends our previous work on facial age estimation (a linear method named AGES). In order to match the nonlinear nature of the human aging progress, a new algorithm named KAGES is proposed based on a nonlinear subspace trained on the aging patterns, which are defined as sequences of individual face images sorted in time order. Both the training and test (age estimation) processes of KAGES rely on a probabilistic model of KPCA. In the experimental results, the performance of KAGES is not only better than all the compared algorithms, but also better than the human observers in age estimation. The results are sensitive to parameter choice however, and future research challenges are identified.<br /

Rabies in East and Southeast Asia: a mirror of the global situation

Despite the availability of efficacious and safe vaccines for human and animal use, rabies takes tens of thousands of human lives annually worldwide. The vast majority of human rabies cases are due to exposure through a rabid dog and subsequent lack of access to post-exposure prophylaxis (PEP) in remote and poor communities around the globe. Therefore, low- and middle-income countries and rural settings are highly affected by this deadly zoonotic disease, while rabies is eliminated from the domestic reservoir in most of the economically strong countries and areas. Although rabies reservoirs in wildlife remain a danger almost all around the world, human cases due to exposure to sylvatic and bat rabies is marginal. Recently momentum, fuelled by the World Health Organization and partners, has been gaining to achieve global elimination of dog-mediated human rabies. Main objectives are increasing efficiency of surveillance, wide scale vaccination of dog population together with dog population management and worldwide coverage for affordable PEP. Advances on the agenda to this global goal vary from country to country. Whereas surveillance and intervention in animals and humans remain patchy and inefficient in some countries, others are focussing on interventions in humans. Those most advanced in the control of rabies have implemented surveillance and prevention measures in the animal reservoir, which is the most cost-effective approach. The South and Southeast Asian region mirrors the described global situation comprising the whole spectrum from rabies-free countries, to countries with only sylvatic rabies and finally the largest group of those with endemic dog rabies. Within the latter, distinctions are made between those that focus on prevention in humans and those with a One Health approach including intervention in animals. Some areas have even adopted an integrative community participation approach including educational programmes. The different sections of this chapter describe the detailed rabies situation in South and Southeast Asian countries grouped by epidemiological context and implemented prevention measures. It highlights the need for holistic control programmes coordinated across the whole region to achieve sustainable elimination of rabies