Economics of One Health: Costs and benefits of integrated West Nile virus surveillance in Emilia-Romagna

Since 2013 in Emilia-Romagna, Italy, surveillance information generated in the public health and in the animal health sectors has been shared and used to guide public health interventions to mitigate the risk of West Nile virus (WNV) transmission via blood transfusion. The objective of the current study was to identify and estimate the costs and benefits associated with this One Health surveillance approach, and to compare it to an approach that does not integrate animal health information in blood donations safety policy (uni-sectoral scenario). Costs of human, animal, and entomological surveillance, sharing of information, and triggered interventions were estimated. Benefits were quantified as the averted costs of potential human cases of WNV neuroinvasive disease associated to infected blood transfusion. In the 2009–2015 period, the One Health approach was estimated to represent a cost saving of €160,921 compared to the uni-sectoral scenario. Blood donation screening was the main cost for both scenarios. The One Health approach further allowed savings of €1.21 million in terms of avoided tests on blood units. Benefits of the One Health approach due to short-term costs of hospitalization and compensation for transfusion-associated disease potentially avoided, were estimated to range from €0 to €2.98 million according to the probability of developing WNV neuroinvasive disease after receiving an infected blood transfusion

Microbiological surveillance of hospital ventilation systems in departments at high risk of nosocomial infections

The air in hospital wards with patients at high risk (Surgeries, Intensive Care Units and Bone Marrow Transplant Centers) has been surveyed less than the one in Operating Rooms. Therefore in this study we considered useful to verify the microbic contamination of the air of those wards evaluating the consistency of ventilation systems in relation also to the presence and location of HEPA absolute filters. Seven departments of Genoese San Martino Hospital at high risk of infection were taken into account. In there, environmental investigations have been performed by air samplings and by analyzing bacterial and fungal growth on plates after an incubation period. Almost 60% of all samples taken in wards yielded a positive result and the average values of bacterial and aspergillar charges measured at air flow emission openings decisively exceed the ones considered standard in operating rooms. Still, the average values of airborne bacterial charges were significantly higher in those wards equipped with central filters (p inf. 0.001), while as far as the aspergillar charge is concerned, no statistically relevant differences were noticed. In wards with ventilation system, the bacterial charge value raises from the emission grids to the middle of the room and to the aspiration grids, while the ward not equipped with a ventilation system presents in the middle of the room an average bacterial charge 2 to 10 times higher than the one in other wards. The average values regarding bacterial and aspergillar charges resulted quite high in all the departments surveyed. Nevertheless, if we take into account ventilation systems equipped with absolute filters HEPA located centrally or peripherally, it can be outlined that the air quality from the point of view of both microbic and aspergillar contamination turns out to be decisively better in systems with peripheral filters. Moreover, a compared analysis of the three Hematology wards allows us to infer that the presence of artificial ventilation systems can lower the bacterial and fungal compared with a ward with natural ventilation

The CUORE Cryostat: A 1-Ton Scale Setup for Bolometric Detectors

The cryogenic underground observatory for rare events (CUORE) is a 1-ton scale bolometric experiment whose detector consists of an array of 988 TeO2 crystals arranged in a cylindrical compact structure of 19 towers. This will be the largest bolometric mass ever operated. The experiment will work at a temperature around or below 10 mK. CUORE cryostat consists of a cryogen-free system based on pulse tubes and a custom high power dilution refrigerator, designed to match these specifications. The cryostat has been commissioned in 2014 at the Gran Sasso National Laboratories and reached a record temperature of 6 mK on a cubic meter scale. In this paper, we present results of CUORE commissioning runs. Details on the thermal characteristics and cryogenic performances of the system will be also given.Comment: 7 pages, 2 figures, LTD16 conference proceedin

CUORE and CUORE-0 experiments

Neutrino oscillation experiments proved that neutrinos have mass and this enhanced the interest in neutrinoless double-beta decay (0νββ). The observation of this very rare hypothetical decay would prove the leptonic number violation and would give us indications about neutrinos mass hierarchy and absolute mass scale. CUORE (Cryogenic Underground Observatory for Rare Events) is an array of 988 crystals of TeO2, for a total sensitive mass of 741kg. Its goal is the observation of 0νββ of 130Te. The crystals, placed into the a dilution cryostat, are operated as bolometers at a temperature close to 10mK. CUORE commissioning phase has been concluded recently in Gran Sasso National Laboratory, Italy, and data taking is expected to start in spring 2017. If target background rate is reached (0.01counts/day/keV/kg), the sensibility of CUORE will be, in five years of data taking, T1/2 - 1026years (1σ CL). In order to test the quality of materials and optimize the construction procedures, the collaboration realized CUORE-0, that took data from spring of 2013 to summer 2015. Here, after a brief description of CUORE, I report its commissioning status and CUORE-0 results

The CUORE cryostat: an infrastructure for rare event searches at millikelvin temperatures

The CUORE experiment is the world's largest bolometric experiment. The detector consists of an array of 988 TeO2 crystals, for a total mass of 742 kg. CUORE is presently taking data at the Laboratori Nazionali del Gran Sasso, Italy, searching for the neutrinoless double beta decay of 130Te. A large custom cryogen-free cryostat allows reaching and maintaining a base temperature of about 10 mK, required for the optimal operation of the detector. This apparatus has been designed in order to achieve a low noise environment, with minimal contribution to the radioactive background for the experiment. In this paper, we present an overview of the CUORE cryostat, together with a description of all its sub-systems, focusing on the solutions identified to satisfy the stringent requirements. We briefly illustrate the various phases of the cryostat commissioning and highlight the relevant steps and milestones achieved each time. Finally, we describe the successful cooldown of CUORE

A randomised controlled feasibility trial of family and social network intervention for young people who misuse alcohol and drugs : study protocol (Y-SBNT)

Background: A growing body of research has identified family interventions to be effective in treating young people’s substance use problems. However, despite this evidence, take-up of family-based approaches in the UK has been low. Key factors for this appear to include the resource-intensive nature of most family interventions which challenges implementation and delivery in many service settings and the cultural adaptation of approaches developed in the USA to a UK setting. This study aims to demonstrate the feasibility of recruiting young people to a specifically developed family- and wider social network-based intervention by testing an adapted version of adult social behaviour and network therapy (SBNT). Methods: A pragmatic, randomised controlled, open feasibility trial delivered in two services for young people in the UK. Potential participants are aged 12–18 years referred for drug or alcohol problems to either service. The main purpose of this study is to demonstrate the feasibility of recruiting young people to a specifically developed family and social network-based intervention. The feasibility and acceptability of this intervention will be measured by recruitment rates, treatment retention, follow-up rates and qualitative interviews. The feasibility of training staff from existing services to deliver this intervention will be explored. Using this opportunity to compare the effectiveness of the intervention against treatment as usual, Timeline Follow-Back interviews will document the proportion of days on which the main problem substance was used in the preceding 90-day period at each assessment point. The economic component will examine the feasibility of conducting a full incremental cost-effectiveness analysis of the two treatments. The study will also explore and develop models of patient and public involvement which support the involvement of young people in a study of this nature. Discussion: An earlier phase of work adapted social behaviour and network therapy (adult approach) to produce a purpose-designed youth version supported by a therapy manual and associated resources. This was achieved by consultation with young people with experience of services and professionals working in services for young people. This feasibility trial alongside ongoing consultations with young people will offer a meaningful understanding of processes of delivery and implementation. Trial registration: ISRCTN93446265; Date ISRCTN assigned 31/05/2013