Impact of free on-site vaccine and/or healthcare workers training on hepatitis B vaccination acceptability in high-risk subjects: a pre-post cluster randomized study

AbstractDespite recommendations for adults at high-risk of hepatitis B virus (HBV) infection, HBV vaccine uptake remains low in this population. A pre-post randomized cluster study was conducted to evaluate the impact of on-site free HBV vaccine availability and/or healthcare worker training on HBV vaccination acceptability in high-risk adults consulting in 12 free and anonymous HIV and hepatitis B/C testing centres (FATC). The FATC were randomly allocated into three groups receiving a different intervention: training on HBV epidemiology, risk factors and vaccination (Group A), free vaccination in the FATC (Group B), both interventions (Group C). The main outcomes were the increase in HBV vaccination acceptability (receipt of at least one dose of vaccine) and vaccine coverage (receipt of at least two doses of vaccine) after intervention. Respectively, 872 and 809 HBV-seronegative adults at high-risk for HBV infection were included in the pre- and post-intervention assessments. HBV vaccination acceptability increased from 14.0% to 75.6% (p <0.001) in Group B and from 17.1% to 85.8% (p <0.001) in Group C and HBV vaccine coverage increased from 9.4% to 48.8% (p <0.001) in Group B and from 11.2% to 41.0% (p <0.001) in Group C. The association of training and free on-site vaccine availability was more effective than free on-site vaccine availability alone to increase vaccination acceptability (ratio 1.14; from 1.02 to 1.26; p 0.017). No effect of training alone was observed. These results support the policy of making HBV vaccine available in health structures attended by high-risk individuals. Updating healthcare workers’ knowledge on HBV virus and its prevention brings an additional benefit to vaccination acceptability

Can J Public Health

During the pandemic, the world's media have publicized preliminary findings suggesting that tobacco use is protective against COVID-19. An ad hoc multidisciplinary group was created to address the major public health implications of this messaging. Key messages of this commentary are as follows: 1) The COVID-19 crisis may increase tobacco consumption and decrease access to healthcare. As a result, smoking-related morbidity and mortality could increase in the coming months and years; 2) Smoking and tobacco-related diseases are prognostic factors for severe COVID-19; and 3) In theory, smokers may be at lower risk of COVID-19 infection because of having fewer social contacts. In conclusion, tobacco control is a greater challenge than ever in the context of the COVID-19 pandemic. Public decision-makers must be vigilant in ensuring that public health practices are consistent and compliant with the principles of the WHO Framework Convention on Tobacco Control. In addition, researchers and the media have a responsibility to be cautious in communicating preliminary results that may promote non-evidence-based research, self-destructive individual behaviours, and commercial agendas

Identification of tower-wake distortions using sonic anemometer and lidar measurements

The eXperimental Planetary boundary layer Instrumentation Assessment (XPIA) field campaign took place in March through May 2015 at the Boulder Atmospheric Observatory, utilizing its 300 m meteorological tower, instrumented with two sonic anemometers mounted on opposite sides of the tower at six heights. This allowed for at least one sonic anemometer at each level to be upstream of the tower at all times and for identification of the times when a sonic anemometer is in the wake of the tower frame. Other instrumentation, including profiling and scanning lidars aided in the identification of the tower wake. Here we compare pairs of sonic anemometers at the same heights to identify the range of directions that are affected by the tower for each of the opposing booms. The mean velocity and turbulent kinetic energy are used to quantify the wake impact on these first- and second-order wind measurements, showing up to a 50 % reduction in wind speed and an order of magnitude increase in turbulent kinetic energy. Comparisons of wind speeds from profiling and scanning lidars confirmed the extent of the tower wake, with the same reduction in wind speed observed in the tower wake, and a speed-up effect around the wake boundaries. Wind direction differences between pairs of sonic anemometers and between sonic anemometers and lidars can also be significant, as the flow is deflected by the tower structure. Comparisons of lengths of averaging intervals showed a decrease in wind speed deficit with longer averages, but the flow deflection remains constant over longer averages. Furthermore, asymmetry exists in the tower effects due to the geometry and placement of the booms on the triangular tower. An analysis of the percentage of observations in the wake that must be removed from 2 min mean wind speed and 20 min turbulent values showed that removing even small portions of the time interval due to wakes impacts these two quantities. However, a vast majority of intervals have no observations in the tower wake, so removing the full 2 or 20 min intervals does not diminish the XPIA dataset

Strengthened Ebola surveillance in France during a major outbreak in West Africa: March 2014–January 2016

International audienceSUMMARY Introduction An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases. Methods Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure. Results From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea ( n = 531; 49%) and Mali ( n = 113; 10%) accounted for the highest number of notifications. Conclusion No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period