Epidemiology of Hepatitis E in 2017 in Bavaria, Germany

In the last decade, the number of reported hepatitis E virus (HEV) infections in Germany, including Bavaria, has continued to rise. In order to identify risk factors associated with HEV infection, we investigated notified hepatitis E cases from Bavaria during 2017. The project \textquotedblIntensified Hepatitis E Surveillance in Bavaria\textquotedbl included interviews with questionnaires, collection and genotyping of stool, serum and food samples. In addition, certain risk factors were examined in a sample comparison with healthy population using univariable analysis and logistic regression. In total, 135 hepatitis E cases from Bavaria were included in the analysis. Mean age for women was 46 (range 20-74) years and 47.5 (range 20-85) for men. 56 of the cases (41.5%) were asymptomatic. Among the symptomatic cases, both men and women were equally affected with symptoms like fever (16.3%), jaundice (18.8%) and upper abdominal pain (28.2%). 145 human samples (serum, stool) and 6 food samples were collected. 15.9% of the human samples (n = 23) were positive for HEV RNA by reverse-transcription quantitative real-time PCR (RT-qPCR). Identified risk factors significantly associated with hepatitis E were sausage consumption with odds ratio 9.6 (CI 1.3-70.1), fish with OR 2.2 (CI 1.1-4.4) and cat ownership with OR 1.9 (CI 1.3-3.0) in multivariable analyses. Further investigation is needed to confirm the role of fish in HEV transmission. Autochthonous HEV genotype 3 is prevalent in Bavaria and there could be more transmission routes contributing to the spread of HEV than previously known. Undercooked meat, offal, sausages, fish, shellfish and contact with animals and pets are possible sources for infection

Serological surveillance of influenza in an English sentinel network: pilot study protocol.

BACKGROUND: Rapidly undertaken age-stratified serology studies can produce valuable data about a new emerging infection including background population immunity and seroincidence during an influenza pandemic. Traditionally seroepidemiology studies have used surplus laboratory sera with little or no clinical information or have been expensive detailed population based studies. We propose collecting population based sera from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), a sentinel network with extensive clinical data. AIM: To pilot a mechanism to undertake population based surveys that collect serological specimens and associated patient data to measure seropositivity and seroincidence due to seasonal influenza, and create a population based serology bank. METHODS AND ANALYSIS: Setting and Participants: We will recruit 6 RCGP RSC practices already taking nasopharyngeal virology swabs. Patients who attend a scheduled blood test will be consented to donate additional blood samples. Approximately 100-150 blood samples will be collected from each of the following age bands - 18- 29, 30- 39, 40- 49, 50- 59, 60- 69 and 70+ years. METHODS: We will send the samples to the Public Health England (PHE) Seroepidemiology Unit for processing and storage. These samples will be tested for influenza antibodies, using haemagglutination inhibition assays. Serology results will be pseudonymised, sent to the RCGP RSC and combined using existing processes at the RCGP RSC secure hub. The influenza seroprevalence results from the RCGP cohort will be compared against those from the annual PHE influenza residual serosurvey. ETHICS AND DISSEMINATION: Ethical approval was granted by the Proportionate Review Sub- Committee of the London - Camden & Kings Cross on 6 February 2018. This study received approval from Health Research Authority on 7 February 2018. On completion the results will be made available via peer-reviewed journals

Pengembangan Instrumen Tes Multiple Representation untuk Mengukur Kemampuan Berpikir Kritis

Penelitian ini bertujuan untuk (1) mendeskripsikan karakteristik instrumen pengukuran kemampuan berpikir kritis berbasis multiple representation materi kesetimbangan kimia kelas XI SMA, (2) menganalisis kualitas instrumen pengukuran kemampuan berpikir kritis berbasis multiple representation materi kesetimbangan kimia kelas XI SMA, (3) menyelidiki kelayakan instrumen pengukuran berpikir kritis berbasis multiple representation materi kesetimbangan kimia kelas XI SMA, dan (4) mendeskripsikan profil kemampuan berpikir kritis peserta didik kelas XI SMA di Kota Salatiga yang diukur dengan instrumen tes materi kesetimbangan kimia berbasis multipel rerpresentasi. Pengembangan instrumen tes mengadopsi model 4D yang dikembangkan oleh Thiagarajan, Semmel & Semmel meliputi tahap Define, Design, Develop, dan Disseminate. Desain uji coba produk terdiri dari validasi produk dan uji coba instrumen tes. Subjek uji coba penelitian meliputi 10 guru kimia SMA dan 437 peserta didik kelas XI. Produk diimplementasikan pada 148 peserta didik kelas XI. Implementasi produk meliputi pengukuran profil kemampuan berpikir kritis, dan kemampuan representasi kimia peserta didik kelas XI SMA Kota Salatiga. Analisis data kualitas produk menggunakan pemodelan PCM, sementara analisis data kelayakan dan profil kemampuan berpikir kritis peserta didik menggunakan analisis kriteria penilaian ideal. Hasil penelitian menunjukan karakteristik instrumen tes yang dikembangkan terdiri dari 33 butir soal uraian materi kesetimbangan kimia berbasis multiple representation meliputi aspek makroskopik, submikroskopik, simbolik, dan matematis. Instrumen tes yang dikembangkan memiliki validitas tinggi, reliabilitas tes sangat bagus, dan tingkat kesukaran sedang. Hasil analisis tinjauan reviewer, instrumen tes yang dikembangkan dikategorikan sangat layak. Profil kemampuan berpikir kritis dikategorikan rendah. Indikator kemampuan berpikir kritis yang dicapai peserta didik dari tertinggi ke terendah yaitu penjelasan sederhana, membangun keterampilan dasar, analisis, interpretasi, inferensi, dan klasifikasi mendala