Surveillance strategies for Classical Swine Fever in wild boar – a comprehensive evaluation study to ensure powerful surveillance

Surveillance of Classical Swine Fever (CSF) should not only focus on livestock, but must also include wild boar. To prevent disease transmission into commercial pig herds, it is therefore vital to have knowledge about the disease status in wild boar. In the present study, we performed a comprehensive evaluation of alternative surveillance strategies for Classical Swine Fever (CSF) in wild boar and compared them with the currently implemented conventional approach. The evaluation protocol was designed using the EVA tool, a decision support tool to help in the development of an economic and epidemiological evaluation protocol for surveillance. To evaluate the effectiveness of the surveillance strategies, we investigated their sensitivity and timeliness. Acceptability was analysed and finally, the cost-effectiveness of the surveillance strategies was determined. We developed 69 surveillance strategies for comparative evaluation between the existing approach and the novel proposed strategies. Sampling only within sub-adults resulted in a better acceptability and timeliness than the currently implemented strategy. Strategies that were completely based on passive surveillance performance did not achieve the desired detection probability of 95%. In conclusion, the results of the study suggest that risk-based approaches can be an option to design more effective CSF surveillance strategies in wild boar

Regional socioeconomic indicators and ethnicity as predictors of regional infant mortality rate in Slovakia

OBJECTIVE: Exploring the associations of regional differences in infant mortality with selected socioeconomic indicators and ethnicity could offer important clues for designing public health policy measures. METHODS: Data included perinatal and infant mortality in the 79 districts of the Slovak population in 2004. Linear regression was used to analyse the contribution of education, unemployment, income and proportion of Roma population on regional differences in perinatal and infant mortality rates. RESULTS: All the explored socioeconomic indicators and ethnicity individually contributed significantly to both perinatal and infant mortality, with the exception of income. In the model exploring the influence of all these variables together on perinatal and infant mortality, only the effect of the proportion of Roma population remained significant. This model explained 34.9% of the variance for perinatal and 36.4% of the variance for infant mortality. CONCLUSIONS: Living in Roma settlements indicates an accumulation of socioeconomic disadvantage. Health literacy, health-related behaviour and many other factors might contribute to the explanation of the differences in infant mortality, and a better understanding of these processes might help us to design tailored interventions

Knowledge into action: using research findings to inform policies in maternal and newborn health

Background: Many interventions found to be effective in research studies on maternal and newborn health and survival, fail to translate into policies and health service delivery models in settings with high maternal and newborn morbidity and mortality. IDEAS is a 5-year project funded by Bill & Melinda Gates Foundation, in three areas with high burden of maternal and neonatal mortality: Ethiopia, North-Eastern Nigeria and Uttar Pradesh in India. The project is a multi-method evaluation of complex interventions in maternal and newborn health (MNH), and is implemented by the London school of Hygiene & Tropical Medicine. One of the objectives of the project is to assess the extent to which innovative MNH care models are scaled up and to identify enabling and inhibiting factors to scale up. As part of this assessment we have undertaken a qualitative study to explore how research findings and knowledge generated in pilot projects are used by policy makers in developing policies and strategies for MNH. Methods Building on frameworks for transferring knowledge into action (Lavis et al 2009; Darmschroder et al 2009), we developed a topic guide seeking to explore views of researchers, policy makers and other stakeholders on translating research findings into policy. A total of about 75 in-depth interviews are being undertaken in Ethiopia, Nigeria and India. The topic guide is used as a flexible tool allowing participants to express opinions and raise issues that are most relevant to them. The interviews are recorded and transcribed verbatim. The transcripts are analysed by a team of researchers from London and the three countries, using framework analysis for policy research. This abstract presents emerging findings from pilot interviews in Ethiopia and India. Findings Willingness of policy makers to consider research findings depends to a great extent on how they perceive the quality of the evidence: whether it is conducted by an independent organisation, whether it is statistically significant and whether health outcomes could be attributed to particular components of complex, multi-layered programmes. The way evidence is disseminated influences the likelihood of its uptake into policy. It is more likely to be considered if it is presented by people who had legitimacy (experts in the field); if the audience included high level decision makers and donors who had the authority to act on the data; and if it included demonstartion sites (taking decision makers to the field to get emotional buy-in. Interpretation Translation of research evidence into policy depends on 1) the nature of the evidence and how the strength and validity (independence) of the evidence is perceived; 2) the way research is communicated: by whom (messenger), to whom (audience) and how (vehicle); 3) the ability and willingness of decision-makers to use evidence depending on capacity and context. References Damschroder LJ, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009 Aug 7;4:50. Lavis JN, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). Introduction. Health Research Policy and Systems 2009, 7(Suppl 1):I

Methodological approaches to evaluation of complex interventions in maternal and newborn health: IDEAS project

The IDEAS project aims to improve the health and survival of mothers and babies through generating evidence to inform policy and practice. IDEAS uses measurement, learning and evaluation to find out what works, why and how in maternal and newborn health. IDEAS is funded between 2010 and 2015 by a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine. This poster outlines the reseach objectives and how research questions will be addressed

Ice hockey injuries among United States high school athletes from 2008/2009–2012/2013

Background. The popularity of ice hockey has grown in recent years and injuries are a concern given the physical nature of the sport. We sought to report the rates, mechanisms, and severity of boys' US high school ice hockey injuries. We hypothesized that body checking would be a major source of injury and that concussions would be common. We also expected to find that competition would have a higher rate of injury than practice. Design. Descriptive epidemiology study. Methods. Boys' US high school ice hockey injury data from 2008/2009 through 2012/2013 academic years were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online database. The primary outcome was rate of injury per 10,000 athlete exposures (AEs). Results. Overall, 724 boys ice hockey injuries occurred during 311,817 AEs for an injury rate of 23.2 per 10,000 AEs. Injury rates were significantly higher during competition compared to practice (rate ratio = 7.8, 95% confidence interval: 6.5-9.4). Concussion was the most frequent injury reported at a rate of 6.4 per 10,000 AEs. Body checking was the mechanism of injury in over 46% of injuries. The head/face/neck region (33.8%) and upper arm/shoulder region (20.6%) were the most commonly injured body sites. Just over 6% of injuries resulted in surgical intervention. Conclusion. Injuries among high school ice hockey athletes are common. Increases in the number of high school ice hockey injuries will likely parallel the increase in high school ice hockey participation in the United States