Semi-interactive tracing of persons in real-life surveillance data

2010 ◽  
Author(s):  
Michael J. Metternich ◽  
Marcel Worring
Keyword(s):  
Real Life ◽  
Surveillance Data

scholarly journals Visualizing Infection Surveillance Data for Policymaking Using Open Source Dashboarding

2019 ◽  
Vol 10 (03) ◽  
pp. 534-542 ◽  
Author(s):  
Monika Maya Wahi ◽  
Natasha Dukach
Keyword(s):  
Decision Making ◽  
Open Source ◽  
Real Life ◽  
Surveillance Data ◽  
Development Environment ◽  
Mortality And Morbidity ◽  
Policy Level ◽  
Health Surveillance Data ◽  
Tract Infections ◽  
And Function

Background Health care-associated infections, specifically catheter-associated urinary tract infections (CAUTIs), can cause significant mortality and morbidity. However, the process of collecting CAUTI surveillance data, storing it, and visualizing the data to inform health policy has been fraught with challenges. Objectives No standard has been developed, so the objective of this article is to present a prototype solution for dashboarding public health surveillance data based on a real-life use-case for the purposes of enhancing clinical and policy-level decision-making. Methods The solution was developed in open source software R, which allows for the creation of dashboard applications using the integrated development environment developed for R called RStudio, and a package for R called Rshiny. How the surveillance system was designed, why R was chosen, how the dashboard was developed, and how the dashboard features were programmed and function will be described. Results The prototype dashboard includes multiple tabs for visualizing data, and allows the user to interact with the data by setting dynamic filters. Controls were used to facilitate the interaction between the user and application. Rshiny is reactive, in that when the user (e.g., clinician or policymaker) changes the parameters on the data, the application automatically updates the visualization as well as parameters available based on current filters. Conclusion The prototype dashboard has the potential to enhance clinical and policy-level decision-making because it facilitates interaction with the data that provides useful visualizations to provide such guidance.

scholarly journals Development and Evaluation of an HIV-Testing Intervention for Primary Care: Protocol for a Mixed Methods Study

10.2196/16486 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e16486
Author(s):  
Hanne Apers ◽  
Bea Vuylsteke ◽  
Jasna Loos ◽  
Tom Smekens ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Hiv Testing ◽  
Intervention Study ◽  
Intervention Mapping ◽  
Real Life ◽  
Surveillance Data ◽  
Evidence Based ◽  
Starting Point ◽  
Undiagnosed Hiv

Background Late diagnosis of HIV fosters HIV transmission and may lead to hidden HIV epidemics. In Belgium, mathematical modeling indicates a high prevalence of undiagnosed HIV infections among men who have sex with men of non-Belgian origin and among sub-Saharan African migrants. Promotion of HIV testing facilitates early diagnosis, but diagnostic opportunities are missed in primary care. Objective The intervention study aims to enhance provider-initiated HIV testing by GPs. This protocol presents the conceptual development, implementation, and evaluation of an HIV-testing intervention for Flemish general practitioners (GPs). Methods A mixed methods evaluation design is used. Guided by a simplified intervention mapping approach, an evidence-based intervention was developed in collaboration, guided by an interdisciplinary advisory board. The intervention consisted of an evidence-based tool (ie, “HIV-testing advice for primary care”) to support GPs in provider-initiated HIV testing. A modified stepped-wedge design compare two different intervention levels: (1) online dissemination of the HIV-testing advice and (2) dissemination with additional group-level training. Both conditions were compared against a control condition with no intervention. The effect of the intervention was measured using Poisson regression for national surveillance data. The primary outcome was the number of HIV diagnoses made by GPs. Secondary outcomes were HIV diagnoses among groups at risk for undiagnosed HIV, distribution of new diagnoses by CD4 cell count, number of HIV tests prescribed by GPs, and rate of new diagnoses by tests. To evaluate the intervention’s implementation, the GPs’ fidelity to the intervention and the intervention’s feasibility and acceptability by GPs were assessed through (web-based) surveys and in-depth telephone interviews. Results The study was funded in 2016 and ethically approved in January 2017. The implementation of the intervention started in January 2017 and ended in December 2018. Data was completed in October 2019 and was the starting point for the ongoing data analysis. The results are expected to be published in the second half of 2020. Conclusions Results of the intervention study will provide useful information on the intervention’s effectiveness among Flemish GPs and can inform further development of official testing guidelines. Limitations of this real-life intervention approach are potential spill-over effects, delay in access to surveillance data, and little detailed information on HIV-testing practices among GPs. Trial Registration ClinicalTrials.gov NCT04056156; https://clinicaltrials.gov/ct2/show/NCT04056156 International Registered Report Identifier (IRRID) DERR1-10.2196/16486

scholarly journals Accounting for aetiology: can regional surveillance data alongside host biomarker-guided antibiotic therapy improve treatment of febrile illness in remote settings?

2019 ◽  
Vol 4 ◽  
pp. 1
Author(s):  
Arjun Chandna ◽  
Lisa J. White ◽  
Tiengkham Pongvongsa ◽  
Mayfong Mayxay ◽  
Paul N. Newton ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Workers ◽  
Point Of Care ◽  
Real Life ◽  
Febrile Illness ◽  
Cost Effective ◽  
Integrated System ◽  
Surveillance Data ◽  
The Impact ◽  
Regional Surveillance

Background: Across Southeast Asia, declining malaria incidence poses a challenge for healthcare providers, in how best to manage the vast majority of patients with febrile illnesses who have a negative malaria test. In rural regions, where the majority of the population reside, empirical treatment guidelines derived from central urban hospitals are often of limited relevance. In these settings, health workers with limited training deliver care, often without any laboratory diagnostic support. In this paper, we model the impact of point-of-care C-reactive protein testing to inform the decision to prescribe antibiotics and regional surveillance data to inform antibiotic selection, and then stimulate thesubsequent impact on mortality from febrile illnesses, rooted in the real-world context of rural Savannakhet province, southern Laos. Methods: Our model simulates 100 scenarios with varying quarterly incidence of six key pathogens known to be prevalent in rural Laos. In the simulations, community health workers either prescribe antibiotics in-line with current practice as documented in health facilities in rural Laos, or with the aid of the two interventions. We provide cost-effectiveness estimates for each strategy alone and then for an integrated approach using both interventions. Results: We find that each strategy is predicted to be highly cost-effective, and that the combined approach is predicted to result in the biggest reduction in mortality (averting a predicted 510 deaths per year in rural Savannakhet, a 28% reduction compared to standard practice) and is highly cost-effective, with an incremental cost-effectiveness ratio of just USD $66 per disability-adjusted life year averted. Conclusions: Substantial seasonal variation in the predicted optimal empirical antibiotic treatment for febrile illness highlights the benefits of up-to-date information on regional causes of fever. In this modelling analysis, an integrated system incorporating point-of-care host biomarker testing and regional surveillance data appears highly cost-effective, and may warrant piloting in a real-life setting.

scholarly journals Accounting for aetiology: can regional surveillance data alongside host biomarker-guided antibiotic therapy improve treatment of febrile illness in remote settings?

2019 ◽  
Vol 4 ◽  
pp. 1 ◽  
Author(s):  
Arjun Chandna ◽  
Lisa J. White ◽  
Tiengkham Pongvongsa ◽  
Mayfong Mayxay ◽  
Paul N. Newton ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Workers ◽  
Point Of Care ◽  
Real Life ◽  
Febrile Illness ◽  
Cost Effective ◽  
Integrated System ◽  
Surveillance Data ◽  
The Impact ◽  
Regional Surveillance

Background: Across Southeast Asia, declining malaria incidence poses a challenge for healthcare providers, in how best to manage the vast majority of patients with febrile illnesses who have a negative malaria test. In rural regions, where the majority of the population reside, empirical treatment guidelines derived from central urban hospitals are often of limited relevance. In these settings, relatively untrained health workers deliver care, often without any laboratory diagnostic support. In this paper, our aim was to model the impact on mortality from febrile illness of using point-of-care C-reactive protein testing to inform the decision to prescribe antibiotics and regional surveillance data to inform antibiotic selection, rooted in the real-world context of rural Savannakhet province, southern Laos. Methods: Our model simulates 100 scenarios with varying quarterly incidence of six key pathogens known to be prevalent in rural Laos. In the simulations, community health workers either prescribe antibiotics in-line with current practice as documented in health facilities in rural Laos, or with the aid of the two interventions. We provide cost-effectiveness estimates for each strategy alone and then for an integrated approach using both interventions. Results: We find that each strategy alone is predicted to be highly cost-effective, and that the combined approach is predicted to result in the biggest reduction in mortality (averting a predicted 510 deaths per year in rural Savannakhet, a 28% reduction compared to standard practice) and is highly cost-effective, with an incremental cost-effectiveness ratio of just $66 per disability-adjusted life year averted. Conclusions: Substantial seasonal variation in the predicted optimal empirical antibiotic treatment for febrile illness highlights the benefits of up-to-date information on regional causes of fever. In this modelling analysis, an integrated system incorporating point-of-care host biomarker testing and regional surveillance data appears highly cost-effective, and may warrant piloting in a real-life setting.

scholarly journals Development and Evaluation of an HIV-Testing Intervention for Primary Care: Protocol for a Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Hanne Apers ◽  
Bea Vuylsteke ◽  
Jasna Loos ◽  
Tom Smekens ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Hiv Testing ◽  
Intervention Study ◽  
Intervention Mapping ◽  
Real Life ◽  
Surveillance Data ◽  
Evidence Based ◽  
Starting Point ◽  
Undiagnosed Hiv

BACKGROUND Late diagnosis of HIV fosters HIV transmission and may lead to hidden HIV epidemics. In Belgium, mathematical modeling indicates a high prevalence of undiagnosed HIV infections among men who have sex with men of non-Belgian origin and among sub-Saharan African migrants. Promotion of HIV testing facilitates early diagnosis, but diagnostic opportunities are missed in primary care. OBJECTIVE The intervention study aims to enhance provider-initiated HIV testing by GPs. This protocol presents the conceptual development, implementation, and evaluation of an HIV-testing intervention for Flemish general practitioners (GPs). METHODS A mixed methods evaluation design is used. Guided by a simplified intervention mapping approach, an evidence-based intervention was developed in collaboration, guided by an interdisciplinary advisory board. The intervention consisted of an evidence-based tool (ie, “HIV-testing advice for primary care”) to support GPs in provider-initiated HIV testing. A modified stepped-wedge design compare two different intervention levels: (1) online dissemination of the HIV-testing advice and (2) dissemination with additional group-level training. Both conditions were compared against a control condition with no intervention. The effect of the intervention was measured using Poisson regression for national surveillance data. The primary outcome was the number of HIV diagnoses made by GPs. Secondary outcomes were HIV diagnoses among groups at risk for undiagnosed HIV, distribution of new diagnoses by CD4 cell count, number of HIV tests prescribed by GPs, and rate of new diagnoses by tests. To evaluate the intervention’s implementation, the GPs’ fidelity to the intervention and the intervention’s feasibility and acceptability by GPs were assessed through (web-based) surveys and in-depth telephone interviews. RESULTS The study was funded in 2016 and ethically approved in January 2017. The implementation of the intervention started in January 2017 and ended in December 2018. Data was completed in October 2019 and was the starting point for the ongoing data analysis. The results are expected to be published in the second half of 2020. CONCLUSIONS Results of the intervention study will provide useful information on the intervention’s effectiveness among Flemish GPs and can inform further development of official testing guidelines. Limitations of this real-life intervention approach are potential spill-over effects, delay in access to surveillance data, and little detailed information on HIV-testing practices among GPs. CLINICALTRIAL ClinicalTrials.gov NCT04056156; https://clinicaltrials.gov/ct2/show/NCT04056156 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16486

A peek in the micro-sized world: a review of design principles, engineering tools, and applications of engineered microbial community

2020 ◽  
Vol 48 (2) ◽  
pp. 399-409
Author(s):  
Baizhen Gao ◽  
Rushant Sabnis ◽  
Tommaso Costantini ◽  
Robert Jinkerson ◽  
Qing Sun
Keyword(s):  
Microbial Community ◽  
Microbial Communities ◽  
Environmental Remediation ◽  
Real Life ◽  
Design Principles ◽  
Microbial Interactions ◽  
Potential Applications ◽  
New Gene ◽  
Global Biogeochemical Cycles ◽  
Synthetic Microbial Communities

Microbial communities drive diverse processes that impact nearly everything on this planet, from global biogeochemical cycles to human health. Harnessing the power of these microorganisms could provide solutions to many of the challenges that face society. However, naturally occurring microbial communities are not optimized for anthropogenic use. An emerging area of research is focusing on engineering synthetic microbial communities to carry out predefined functions. Microbial community engineers are applying design principles like top-down and bottom-up approaches to create synthetic microbial communities having a myriad of real-life applications in health care, disease prevention, and environmental remediation. Multiple genetic engineering tools and delivery approaches can be used to ‘knock-in' new gene functions into microbial communities. A systematic study of the microbial interactions, community assembling principles, and engineering tools are necessary for us to understand the microbial community and to better utilize them. Continued analysis and effort are required to further the current and potential applications of synthetic microbial communities.

The Speech-Language Pathologist in the Public Schools: Preparation for Real Life Practices From the Perspective of a Speech-Language Pathology Program Coordinator

2010 ◽  
Vol 11 (2) ◽  
pp. 60-65
Author(s):  
Francine Wenhardt
Keyword(s):  
Public Schools ◽  
School Setting ◽  
Real Life ◽  
Effective School ◽  
Program Coordinator ◽  
Educational Preparation ◽  
The Public ◽  
Speech Language Pathologist ◽  
New Graduate ◽  
Language Pathology

Abstract The speech-language pathologist (SLP) working in the public schools has a wide variety of tasks. Educational preparation is not all that is needed to be an effective school-based SLP. As a SLP currently working in the capacity of a program coordinator, the author describes the skills required to fulfill the job requirements and responsibilities of the SLP in the school setting and advises the new graduate regarding the interview process and beginning a career in the public schools.

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