national seasonal influenza vaccination survey in europe 2008

A cross-sectional survey was undertaken with the European Union (EU) Member States and Norway and Iceland to describe seasonal influenza immunisation in the 2006-7 season, in particular to identify country-specific recommendations for risk groups, obtain vaccine uptake information and allow comparison with global recommendations. A standardised questionnaire was completed electronically by each country's project gatekeeper. Of the 29 countries surveyed, 28 recommended seasonal influenza vaccination for older age groups (22 for those aged > 65 years), and in one country vaccine was recommended for all age groups. All countries recommended vaccinating patients with chronic pulmonary and cardiovascular diseases and most countries advised to immunise patients with haematologic or metabolic disorders (n=28), immunologic disorders (n=27) and renal disease (n=27), as well as residents of long-term care facilities (n=24). Most countries recommended vaccination for staff in hospitals (n=25), long-term care facilities (n=25) and outpatient clinics (n=23), and one-third had such recommendations for workers in essential (n=10), military (n=10) and veterinary services (n=10) and poultry industry (n=13). Eight countries recommended vaccine for pregnant women; and five advised to vaccinate children (with age limits ranging from 6 months to 5 years). Twenty countries measured influenza vaccine uptake among those aged > 65 years (range 1.8%-82.1%), seven reported uptake in healthcare workers (range 14%-48%) and seven assessed coverage in persons with underlying medical conditions (range 27.6%-75.2%). The data provided by this study can assist EU states to assess and compare their influenza vaccination programme performance with other countries. The information provides a comprehensive overview of policies and programmes and their outcomes and can be used to inform joint discussions on how the national policies in the EU might be standardised in the future to achieve optimal coverage. Annual surveys could be used to monitor changes in these national policies

A Survey of Bottlenose Dolphins (Tursiops truncatus) in the Shannon Estuary

The bottlenose dolphin Tursiops truncatus is a ubiquitous species found throughout the temperate and tropical oceans of the world. The bottlenose dolphin population that occurs in the Shannon is one of only six known resident European populations. Since 1994, a small dolphin watching industry has been operating in the estuary, with plans for expansion. The objectives of this were to a) assess the degree of residency of bottlenose dolphins in the Shannon; b) estimate the population size and assess the production of calves; c) examine the social structure of the population; d) study habitat use and e) examine the effects of boats on dolphin behaviour. Boat-based surveys and photo-identification techniques were used to derive a population estimate and to examine distribution and movements of individually identifiable dolphins over a two-year period. Land-based scan samples were used to examine behavioural activity and interactions of dolphins with all categories of boat traffic. Trips on dolphin watching boats examined whether these boats were interacting with the same individual dolphins on a trip, daily or weekly basis. Dolphins were recorded in all months of the year but with a seasonal peak between May and September. Many of the identifiable dolphins were resighted throughout the study indicating a high degree of residency. Using photo-identification and mark-recapture analyses, the population estimate for the Shannon is 113 dolphins (CV 0.14, 95% C.I. 94 - 161). The presence of neonatal calves only from July – September indicates that there is a marked breeding season for this population and that the area is important as a nursery area. Group sizes ranged from singletons to groups of 32 animals and while dolphins were seen throughout the study area, groups were frequently encountered in the narrow water at Kilcredaun and in the mouth of the estuary. A second area of concentrated sightings was identified further up-river around Moneypoint and Tarbert/Killimer. This group comprised a smaller number of individuals, and the re-encounter rate of these individuals in the same area suggests a degree of habitat partitioning. These dolphins may be more vulnerable to dolphin watching activities than the more diffuse numbers in the outer estuary. The influence of tidal cycle was recorded at Kilcredaun and at Killimer/Tarbert with a distinct peak in sightings in the four-hour period before low tide. The frequency distribution of association indices shows that there are few "strong" associations between individuals and supports the notion of a fluid and gregarious social structure. Dolphin watching boats were involved in 61.8% of all interactions with dolphin groups, higher than any other category of boat. At present, two operators make approximately 200 dolphin watching trips annually, carrying a total of 2,400 passengers per year. The operators are highly successful in locating dolphins (97%) and the tour boats rarely come into contact with each other on the water and generally search in different areas and watch different groups. The potential for land-based dolphin watching was examined and possible sites identified. The information from this study provides a basis from which sound conservation management strategies can be developed, in order to properly conserve the species and its habitat, to develop a sustainable dolphin watching industry and to develop/monitor other coastal zone industries such as oil and gas exploration and shipping development within the Shannon.Funder: Marine Institut

Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey

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Innovative placement allocation model for pre-registration student nurses

Student nurses require a variety of high quality practice placements to prepare them for registration with the Nursing and Midwifery Council (NMC) yet in reality this can be difficult to achieve. This case study reports on the development and implementation of a Practice Placement Allocation Model that has provided one University in the north west of England and its partner practice placement healthcare organisations with a framework to shift from a traditional, process-led pre-registration nursing student placement allocation system (adult field) to a robust, proactive, student-focused approach. The model is based upon practice placement allocation partnership concepts and these include advanced planning of student placements and clear lines of communication between all stakeholders involved in the practice placement of students. Application of the model has resulted in the sharing of timely information across organisations via a central framework and this has allowed for any underlying practice allocation problems to be quickly identified and resolved. Importantly, each practice partner now fully understands the role that they play and how to communicate more effectively. Challenges and opportunities are presented together with the evidence of how the model can be transferred to other healthcare professions and fields of nursing. 5 key points: 1. The government is insistent on producing and maintain a nursing workforce that provides quality and compassionate nursing care 2. The nursing students’ practice placement is a key component of an effective pre-registration nurse education programme 3. Ensuring that all nursing students have the variety of placements can be a challenge to providers of pre-registration nurse education 4. Practice placements should be mapped and allocated according to the students education programme requirements and individual needs 5. Application of a Practice Placement Allocation Model provides the best platform for the effective placement of nursing students and promotes partnership working between stakeholder

Are we preparing student nurses for final practice placement

The aims of this research were to illuminate student nurses’ perceptions of preparedness for final practice placement, and to ascertain factors that supported and hindered preparation for final placement practice. This phenomenological qualitative research was carried out in a UK higher education institution (HEI) with eight adult branch student nurses maintaining written diaries for the first 4 weeks of their final 10-week practice placement. Data were then analysed by means of an interpretive phenomenological approach (IPA). Results showed that students felt ill-prepared for placement. Eight clear themes emerged, including: being used as ‘an extra pair of hands’; mentors appearing to treat student practice documentation as unimportant; and high staff expectations. Other themes were: mentor importance; students feeling that they lacked knowledge; and students feeling unsupported and stressed. In conclusion, although students felt that they lacked knowledge and were used as an extra pair of hands, they did show clinical competence

Comparative genomic analysis of two emergent human adenovirus type 14 respiratory pathogen isolates in China reveals similar yet divergent genomes

Human adenovirus type 14 (HAdV-B14p) was originally identified as an acute respiratory disease (ARD) pathogen in The Netherlands in 1955. For approximately fifty years, few sporadic infections were observed. In 2005, HAdV-B14p1, a genomic variant, re-emerged and was associated with several large ARD outbreaks across the U.S. and, subsequently, in Canada, the U.K., Ireland, and China. This strain was associated with an unusually higher fatality rate than previously reported for both this prototype and other HAdV types in general. In China, HAdV-B14 was first observed in 2010, when two unrelated HAdV-B14-associated ARD cases were reported in Southern China (GZ01) and Northern China (BJ430), followed by three subsequent outbreaks. While comparative genomic analysis, including indel analysis, shows that the three China isolates, with whole genome data available, are similar to the de Wit prototype, all are divergent from the U.S. strain (303600; 2007). Although the genomes of strains GZ01 and BJ430 are nearly identical, as per their genome type characterization and percent identities, they are subtly divergent in their genome mutation patterns. These genomes indicate possibly two lineages of HAdV-B14 and independent introductions into China from abroad, or subsequent divergence from one; CHN2012 likely represents a separate sub-lineage. Observations of these simultaneously reported emergent strains in China add to the understanding of the circulation, epidemiology, and evolution of these HAdV pathogens, as well as provide a foundation for developing effective vaccines and public health strategies, including nationwide surveillance in anticipation of larger outbreaks with potentially higher fatality rates associated with HAdV-B14p1

Epidemiology of severe pediatric adenovirus lower respiratory tract infections in Manitoba, Canada, 1991-2005

<p>Abstract</p> <p>Background</p> <p>Most pediatric adenovirus respiratory infections are mild and indistinguishable from other viral causes. However, in a few children, the disease can be severe and result in substantial morbidity. We describe the epidemiologic, clinical, radiologic features and outcome of adenovirus lower respiratory tract infections (LRTI) in Aboriginal and Non-Aboriginal children in Manitoba, Canada during the years 1991 and 2005.</p> <p>Methods</p> <p>This was a retrospective study of 193 children who presented to the department of pediatrics at Winnipeg Children's Hospital, Manitoba, Canada with LRTI and had a positive respiratory culture for adenovirus. Patients' demographics, clinical and radiologic features and outcomes were collected. Adenovirus serotype distributions and temporal associations were described. Approximate incidence comparisons (detection rates) of adenovirus LRTI among Aboriginal and Non-Aboriginal children were estimated with 95% confidence intervals.</p> <p>Results</p> <p>Adenovirus infections occurred throughout the year with clusters in the fall and winter. Serotypes 1 to 3 were the predominant isolates (two thirds of the cases). The infection was more frequent among Canadian Aboriginals, as illustrated in 2004, where its incidence in children 0-4 years old was 5.6 fold higher in Aboriginals (13.51 vs. 2.39 per 10,000, <it>p </it>< 0.000). There were no significant differences in length of hospitalization and use of ventilator assistance between the two groups (<it>p </it>> 0.185 and <it>p </it>> 0.624, respectively) nor across serotypes (<it>p </it>> 0.10 and <it>p </it>> 0.05, respectively). The disease primarily affected infants (median age, 9.5 months). Most children presented with bronchiolitis or pneumonia, with multi-lobar consolidations on the chest x-ray. Chronic (residual) changes were documented in 16 patients, with eight patients showing bronchiectasis on the chest computerized tomography scan.</p> <p>Conclusions</p> <p>Adenovirus infection is associated with significant respiratory morbidities, especially in young infants. The infection appears to be more frequent in Aboriginal children. These results justify a careful follow-up for children with adenovirus LRTI.</p

A Primer on Regression Methods for Decoding cis-Regulatory Logic

The rapidly emerging field of systems biology is helping us to understand the molecular determinants of phenotype on a genomic scale [1]. Cis-regulatory elements are major sequence-based determinants of biological processes in cells and tissues [2]. For instance, during transcriptional regulation, transcription factors (TFs) bind to very specific regions on the promoter DNA [2,3] and recruit the basal transcriptional machinery, which ultimately initiates mRNA transcription (Figure 1A). Learning cis-Regulatory Elements from Omics Data A vast amount of work over the past decade has shown that omics data can be used to learn cis-regulatory logic on a genome-wide scale [4-6]--in particular, by integrating sequence data with mRNA expression profiles. The most popular approach has been to identify over-represented motifs in promoters of genes that are coexpressed [4,7,8]. Though widely used, such an approach can be limiting for a variety of reasons. First, the combinatorial nature of gene regulation is difficult to explicitly model in this framework. Moreover, in many applications of this approach, expression data from multiple conditions are necessary to obtain reliable predictions. This can potentially limit the use of this method to only large data sets [9]. Although these methods can be adapted to analyze mRNA expression data from a pair of biological conditions, such comparisons are often confounded by the fact that primary and secondary response genes are clustered together--whereas only the primary response genes are expected to contain the functional motifs [10]. A set of approaches based on regression has been developed to overcome the above limitations [11-32]. These approaches have their foundations in certain biophysical aspects of gene regulation [26,33-35]. That is, the models are motivated by the expected transcriptional response of genes due to the binding of TFs to their promoters. While such methods have gathered popularity in the computational domain, they remain largely obscure to the broader biology community. The purpose of this tutorial is to bridge this gap. We will focus on transcriptional regulation to introduce the concepts. However, these techniques may be applied to other regulatory processes. We will consider only eukaryotes in this tutorial

GRISOTTO: A greedy approach to improve combinatorial algorithms for motif discovery with prior knowledge

<p>Abstract</p> <p>Background</p> <p>Position-specific priors (PSP) have been used with success to boost EM and Gibbs sampler-based motif discovery algorithms. PSP information has been computed from different sources, including orthologous conservation, DNA duplex stability, and nucleosome positioning. The use of prior information has not yet been used in the context of combinatorial algorithms. Moreover, priors have been used only independently, and the gain of combining priors from different sources has not yet been studied.</p> <p>Results</p> <p>We extend RISOTTO, a combinatorial algorithm for motif discovery, by post-processing its output with a greedy procedure that uses prior information. PSP's from different sources are combined into a scoring criterion that guides the greedy search procedure. The resulting method, called GRISOTTO, was evaluated over 156 yeast TF ChIP-chip sequence-sets commonly used to benchmark prior-based motif discovery algorithms. Results show that GRISOTTO is at least as accurate as other twelve state-of-the-art approaches for the same task, even without combining priors. Furthermore, by considering combined priors, GRISOTTO is considerably more accurate than the state-of-the-art approaches for the same task. We also show that PSP's improve GRISOTTO ability to retrieve motifs from mouse ChiP-seq data, indicating that the proposed algorithm can be applied to data from a different technology and for a higher eukaryote.</p> <p>Conclusions</p> <p>The conclusions of this work are twofold. First, post-processing the output of combinatorial algorithms by incorporating prior information leads to a very efficient and effective motif discovery method. Second, combining priors from different sources is even more beneficial than considering them separately.</p