Hospitalizations due to rotavirus gastroenteritis in Catalonia, Spain, 2003-2008

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis among young children in Spain and worldwide. We evaluated hospitalizations due to community and hospital-acquired rotavirus gastroenteritis (RVGE) and estimated related costs in children under 5 years old in Catalonia, Spain. RESULTS: We analyzed hospital discharge data from the Catalan Health Services regarding hospital admissions coded as infectious gastroenteritis in children under 5 for the period 2003-2008. In order to estimate admission incidence, we used population estimates for each study year published by the Statistic Institut of Catalonia (Idescat). The costs associated with hospital admissions due to rotavirus diarrhea were estimated for the same years. A decision tree model was used to estimate the threshold cost of rotavirus vaccine to achieve cost savings from the healthcare system perspective in Catalonia. From 2003 through 2008, 10655 children under 5 years old were admitted with infectious gastroenteritis (IGE). Twenty-two percent of these admissions were coded as RVGE, yielding an estimated average annual incidence of 104 RVGE hospitalizations per 100000 children in Catalonia. Eighty seven percent of admissions for RVGE occurred during December through March. The mean hospital stay was 3.7 days, 0.6 days longer than for other IGE. An additional 892 cases of presumed nosocomial RVGE were detected, yielding an incidence of 2.5 cases per 1000 child admissions. Total rotavirus hospitalization costs due to community acquired RVGE for the years 2003 and 2008 were 431,593 and 809,224 €, respectively. According to the estimated incidence and hospitalization costs, immunization would result in health system cost savings if the cost of the vaccine was 1.93 € or less. At a vaccine cost of 187 € the incremental cost per hospitalization prevented is 195,388 € (CI 95% 159,300; 238,400). CONCLUSIONS: The burden of hospitalizations attributable to rotavirus appeared to be lower in Catalonia than in other regions of Spain and Europe. The relatively low incidence of hospitalization due to rotavirus makes rotavirus vaccination less cost-effective in Catalonia than in other areas with higher rotavirus disease burden

Individual and area-level risk factors for suicidal ideation and attempt in people with severe depression

INTRODUCTION: Previous research has identified several risk factors that are strongly associated with suicidal behavior in patients with severe depression. However, the effects of area-level characteristics on suicidal ideation and attempt in this population remain unclear. METHODS: The Clinical Record Interactive Search (CRIS) database was used to identify 2587 patients with severe depression who received secondary mental health services from the Camden & Islington NHS Foundation Trust. Stepwise multivariable logistic regression models were used to examine associations between socio-demographic characteristics, clinical variables, area-level measures, and suicidal ideation and attempt as separate outcomes. RESULTS: Both suicidal ideation and attempts were common among this cohort of severely depressed individuals (70.5% and 37.7%, respectively). While several individual socio-demographic and clinical characteristics were associated with both outcomes, particularly past psychiatric admission (suicidal ideation: adjusted OR=2.86, 95% CI: 2.26-3.62; suicide attempt: adjusted OR=4.00, 95% CI: 3.30-4.89), neither social deprivation nor ethnic density (measured at the area-level) was associated with risk for either outcome. LIMITATIONS: Data were not collected specifically for research purposes and hence information on some potential confounders was not available. Additionally, information was restricted to individuals who accessed secondary mental health services in a defined catchment area and period. The study therefore does not take into account individuals who did not access mental health services. CONCLUSIONS: The variation in risk for suicidal ideation and attempt among severely depressed individuals is explained by differences in individual socio-demographic and clinical characteristics, most notably past psychiatric admission and substance misuse, and not by area-level measures

The Level of Europium-154 Contaminating Samarium-153-EDTMP Activates the Radiation Alarm System at the US Homeland Security Checkpoints

153Sm-EDTMP is a radiopharmaceutical composed of EDTMP (ethylenediamine-tetramethylenephosphonate) and Samarium-153 [1]. 153Sm-EDTMP has an affinity for skeletal tissue and concentrates in areas with increased bone turnover; thus, it is successfully used in relieving pain related to diffuse bone metastases [1]. The manufacturing process of 153Sm-EDTMP leads to contamination with 154Eu (Europium-154) [2]. A previous study only alluded to the retention of 154Eu in the bones after receiving treatment with 153Sm-EDTMP [2]. Activation of the alarm at security checkpoints after 153Sm-EDTMP therapy has not been previously reported. Two out of 15 patients who received 153Sm-EDTMP at Roger Maris Cancer Center (Fargo, N. Dak., USA) activated the radiation activity sensors while passing through checkpoints; one at a US airport and the other while crossing the American-Canadian border. We assume that the 154Eu which remained in the patients’ bones activated the sensors

Beyond the barrier: Female Genital Schistosomiasis as a potential risk factor for HIV-1 acquisition.

Female genital schistosomiasis (FGS) results from egg-deposition in the female reproductive tract primarily by the waterborne parasite Schistosoma (S.) haematobium, and less commonly by Schistosoma (S.) mansoni. FGS affects an estimated 20-56 million women worldwide, mostly in sub-Saharan Africa. There is cross-sectional evidence of increased HIV-1 prevalence in schistosomiasis-infected women, but a causal relationship between FGS and either HIV-1 acquisition or transmission has not been fully established. Beyond the pathognomonic breach in the cervicovaginal barrier caused by FGS, this narrative review explores potential mechanisms for a synergistic relationship between S. haematobium infection, FGS, and HIV-1 acquisition through vaginal inflammation and target cell recruitment

No electromagnetic interference exists between the new remote monitoring system and implantable devices

INTRODUCTION: The BodyGuardian® is a novel remote monitoring platform comprised of a rechargeable module that attaches to an adhesive patch with attached electrodes. ECG, respiration, activity level and other clinical parameters are transmitted via Bluetooth to a smartphone and then to the central cloud platform via cellular or Wi-Fi connection for clinical review (Figure). Although approved for clinical use, potential electromagnetic interference (EMI) precludes its use among patients with implantable ...postprin

The association between sleep patterns and obesity in older adults.

BackgroundReduced sleep duration has been increasingly reported to predict obesity. However, timing and regularity of sleep may also be important. In this study, the cross-sectional association between objectively measured sleep patterns and obesity was assessed in two large cohorts of older individuals.MethodsWrist actigraphy was performed in 3053 men (mean age: 76.4 years) participating in the Osteoporotic Fractures in Men Study and 2985 women (mean age: 83.5 years) participating in the Study of Osteoporotic Fractures. Timing and regularity of sleep patterns were assessed across nights, as well as daytime napping.ResultsGreater night-to-night variability in sleep duration and daytime napping were associated with obesity independent of mean nocturnal sleep duration in both men and women. Each 1 h increase in the standard deviation of nocturnal sleep duration increased the odds of obesity 1.63-fold (95% confidence interval: 1.31-2.02) among men and 1.22-fold (95% confidence interval: 1.01-1.47) among women. Each 1 h increase in napping increased the odds of obesity 1.23-fold (95% confidence interval: 1.12-1.37) in men and 1.29-fold (95% confidence interval: 1.17-1.41) in women. In contrast, associations between later sleep timing and night-to-night variability in sleep timing with obesity were less consistent.ConclusionsIn both older men and women, variability in nightly sleep duration and daytime napping were associated with obesity, independent of mean sleep duration. These findings suggest that characteristics of sleep beyond mean sleep duration may have a role in weight homeostasis, highlighting the complex relationship between sleep and metabolism

Proactive Highly Ambulatory Sensor Routing (PHASeR) protocol for mobile wireless sensor networks

This paper presents a novel multihop routing protocol for mobile wireless sensor networks called PHASeR (Proactive Highly Ambulatory Sensor Routing). The proposed protocol uses a simple hop-count metric to enable the dynamic and robust routing of data towards the sink in mobile environments. It is motivated by the application of radiation mapping by unmanned vehicles, which requires the reliable and timely delivery of regular measurements to the sink. PHASeR maintains a gradient metric in mobile environments by using a global TDMA MAC layer. It also uses the technique of blind forwarding to pass messages through the network in a multipath manner. PHASeR is analysed mathematically based on packet delivery ratio, average packet delay, throughput and overhead. It is then simulated with varying mobility, scalability and traffic loads. The protocol gives good results over all measures, which suggests that it may also be suitable for a wider array of emerging applications

Cascading training down into the classroom: The need for parallel planning

Cascade models of in-service training are widely considered to be a cost effective means of introducing educational change to large numbers of teachers. Data from 511 teachers completing a cascade training programme that introduced current ideas about and procedures for teaching English to young learners, suggests that provision of training alone is no guarantee that cascade training aims will actually be applied in classrooms. The paper considers implications for cascade projects, suggesting that planning needs to be a parallel process if an adequate return on outlay, in the sense of teachers applying skills introduced in training in their classrooms, is to be achieved

Bubble Lift-off Size in Forced Convective Subcooled Boiling Flow

Forced convective subcooled boiling flow experiments were conducted in a BWR-scaled vertical upward annular channel. Water was used as the testing fluid, and the tests were performed at atmospheric pressure. A high-speed digital video camera was applied to capture the dynamics of the bubble nucleation process. Bubble lift-off diameters were obtained from the images for a total of 91 test conditions. A force balance analysis of a growing bubble was performed to predict the bubble lift-off size. The dimensionless form of the bubble lift-off diameter was formulated to be a function of Jacob number and Prandtl number. The proposed model agreed well with the experimental data within the averaged relative deviation of ±35.2 %