1
|
Timpka T. Time for Medicine and Public Health to Leave Platform X. JMIR MEDICAL EDUCATION 2024; 10:e53810. [PMID: 38801712 PMCID: PMC11144836 DOI: 10.2196/53810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 05/29/2024]
Abstract
Unlabelled For more than 50 years, digital technologies have been employed for the creation and distribution of knowledge in health services. In the last decade, digital social media have been developed for applications in clinical decision support and population health monitoring. Recently, these technologies have also been used for knowledge translation, such as in the process where research findings created in academic settings are established as evidence and distributed for use in clinical practice, policy making, and health self-management. To date, it has been common for medical and public health institutions to have social media accounts for the dissemination of novel research findings and to facilitate conversations about these findings. However, recent events such as the transformation of the microblog Twitter to platform X have brought to light the need for the social media industry to exploit user data to generate revenue. In this viewpoint, it is argued that a redirection of social media use is required in the translation of knowledge to action in the fields of medicine and public health. A new kind of social internet is currently forming, known as the "fediverse," which denotes an ensemble of open social media that can communicate with each other while remaining independent platforms. In several countries, government institutions, universities, and newspapers use open social media to distribute information and enable discussions. These organizations control their own channels while being able to communicate with other platforms through open standards. Examples of medical knowledge translation via such open social media platforms, where users are less exposed to disinformation than in general platforms, are also beginning to appear. The current status of the social media industry calls for a broad discussion about the use of social technologies by health institutions involving researchers and health service practitioners, academic leaders, scientific publishers, social technology providers, policy makers, and the public. This debate should not primarily take place on social media platforms but rather at universities, in scientific journals, at public seminars, and other venues, allowing for the transparent and undisturbed communication and formation of opinions.
Collapse
Affiliation(s)
- Toomas Timpka
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
- Regional Executive Office, Region Östergötland, Linköping, Sweden
| |
Collapse
|
2
|
Spreco A, Eriksson O, Dahlström Ö, Cowling BJ, Biggerstaff M, Ljunggren G, Jöud A, Istefan E, Timpka T. Nowcasting (Short-Term Forecasting) of Influenza Epidemics in Local Settings, Sweden, 2008-2019. Emerg Infect Dis 2021; 26:2669-2677. [PMID: 33079036 PMCID: PMC7588521 DOI: 10.3201/eid2611.200448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The timing of influenza case incidence during epidemics can differ between regions within nations and states. We conducted a prospective 10-year evaluation (January 2008–February 2019) of a local influenza nowcasting (short-term forecasting) method in 3 urban counties in Sweden with independent public health administrations by using routine health information system data. Detection-of-epidemic-start (detection), peak timing, and peak intensity were nowcasted. Detection displayed satisfactory performance in 2 of the 3 counties for all nonpandemic influenza seasons and in 6 of 9 seasons for the third county. Peak-timing prediction showed satisfactory performance from the influenza season 2011–12 onward. Peak-intensity prediction also was satisfactory for influenza seasons in 2 of the counties but poor in 1 county. Local influenza nowcasting was satisfactory for seasonal influenza in 2 of 3 counties. The less satisfactory performance in 1 of the study counties might be attributable to population mixing with a neighboring metropolitan area.
Collapse
|
3
|
Machado C, Melina Nassif Mantovani Ribeiro D, Backx Noronha Viana A. Public health in times of crisis: An overlooked variable in city management theories? SUSTAINABLE CITIES AND SOCIETY 2021; 66:102671. [PMID: 36570570 PMCID: PMC9760343 DOI: 10.1016/j.scs.2020.102671] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 05/20/2023]
Abstract
The volume of research that associates the theme of city management with crises resulting from emerging infectious disease is modest, even after the occurrences of Ebola and Severe Acute Respiratory Syndrome. Similarly, the Coronavirus disease (COVID-19) pandemic has thus far contributed only modestly to the expansion of attention to people's health, through city management, in times of crisis. This study, by means of a systematic literature review, analyzes the gap in research on urban theory on how epidemics are confronted. The term "cities" had 2,440,607 articles published and were identified 665 that presents the combination of the term "pandemic". After the development of content analysis were identified 11 articles prior to 2019 and 10 articles published between January and June 2020, adhering to the objective of this investigation. Prior to 2019 studies addressed topics related to the construction of an urban structure aimed at reducing people's vulnerability to infectious diseases, starting in 2020, the focus of researchers' attention is on the use of information and communication technologies used as tools for prevention and control. Theories of the management of cities indicate the need to extrapolate the urban perimeter, incorporating the relations of dependence in cities with the other actors within the surroundings, especially in times of crisis. Studies have emphasized that cities are not isolated islands; rather, they are parts of a complex system with multiple exchanges. This thematic field of study enhances research that presents urban planning solutions by using data-driven management to consider conduct, parameters, and protocols relating to public health in moments of crisis.
Collapse
Affiliation(s)
- Celso Machado
- Universidade de São Paulo - USP, Avenida Professor Luciano Gualberto, 908 - FEA/USP - Sala G-175, Cidade Universitária, 05508-900, São Paulo, SP, Brazil
| | | | - Adriana Backx Noronha Viana
- Universidade de São Paulo - USP, Avenida Professor Luciano Gualberto, 908 - FEA/USP - Sala G-175, Cidade Universitária, 05508-900, São Paulo, SP, Brazil
| |
Collapse
|
4
|
|
5
|
Place-based social contact and mixing: a typology of generic meeting places of relevance for infectious disease transmission. Epidemiol Infect 2017. [PMID: 28625193 DOI: 10.1017/s0950268817001169] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study aims to develop a typology of generic meeting places based on social contact and mixing of relevance for infectious disease transmission. Data were collected by means of a contact diary survey conducted on a representative sample of the Swedish population. The typology is derived from a cluster analysis accounting for four dimensions associated with transmission risk: visit propensity and its characteristics in terms of duration, number of other persons present and likelihood of physical contact. In the analysis, we also study demographic, socio-economic and geographical differences in the propensity of visiting meeting places. The typology identifies the family venue, the fixed activity site, the family vehicle, the trading plaza and the social network hub as generic meeting places. The meeting place typology represents a spatially explicit account of social contact and mixing relevant to infectious disease modelling, where the social context of the outbreak can be highlighted in light of the actual infectious disease.
Collapse
|
6
|
Spreco A, Eriksson O, Dahlström Ö, Cowling BJ, Timpka T. Integrated Detection and Prediction of Influenza Activity for Real-Time Surveillance: Algorithm Design. J Med Internet Res 2017; 19:e211. [PMID: 28619700 PMCID: PMC5491899 DOI: 10.2196/jmir.7101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/15/2017] [Accepted: 04/19/2017] [Indexed: 12/23/2022] Open
Abstract
Background Influenza is a viral respiratory disease capable of causing epidemics that represent a threat to communities worldwide. The rapidly growing availability of electronic “big data” from diagnostic and prediagnostic sources in health care and public health settings permits advance of a new generation of methods for local detection and prediction of winter influenza seasons and influenza pandemics. Objective The aim of this study was to present a method for integrated detection and prediction of influenza virus activity in local settings using electronically available surveillance data and to evaluate its performance by retrospective application on authentic data from a Swedish county. Methods An integrated detection and prediction method was formally defined based on a design rationale for influenza detection and prediction methods adapted for local surveillance. The novel method was retrospectively applied on data from the winter influenza season 2008-09 in a Swedish county (population 445,000). Outcome data represented individuals who met a clinical case definition for influenza (based on International Classification of Diseases version 10 [ICD-10] codes) from an electronic health data repository. Information from calls to a telenursing service in the county was used as syndromic data source. Results The novel integrated detection and prediction method is based on nonmechanistic statistical models and is designed for integration in local health information systems. The method is divided into separate modules for detection and prediction of local influenza virus activity. The function of the detection module is to alert for an upcoming period of increased load of influenza cases on local health care (using influenza-diagnosis data), whereas the function of the prediction module is to predict the timing of the activity peak (using syndromic data) and its intensity (using influenza-diagnosis data). For detection modeling, exponential regression was used based on the assumption that the beginning of a winter influenza season has an exponential growth of infected individuals. For prediction modeling, linear regression was applied on 7-day periods at the time in order to find the peak timing, whereas a derivate of a normal distribution density function was used to find the peak intensity. We found that the integrated detection and prediction method detected the 2008-09 winter influenza season on its starting day (optimal timeliness 0 days), whereas the predicted peak was estimated to occur 7 days ahead of the factual peak and the predicted peak intensity was estimated to be 26% lower than the factual intensity (6.3 compared with 8.5 influenza-diagnosis cases/100,000). Conclusions Our detection and prediction method is one of the first integrated methods specifically designed for local application on influenza data electronically available for surveillance. The performance of the method in a retrospective study indicates that further prospective evaluations of the methods are justified.
Collapse
Affiliation(s)
- Armin Spreco
- Faculty of Health Sciences, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Olle Eriksson
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Benjamin John Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Toomas Timpka
- Faculty of Health Sciences, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Region Östergötland, Center for Health Services Development, Linköping, Sweden
| |
Collapse
|
7
|
Silva ML, Paget WJ, Mosnier A, Buthion V, Cohen JM, Perrier L, Späth HM. Development of Seasonal Influenza Vaccination Recommendations: Relevance and Influence of the Evidence on the Decision-Making Process in France and the Netherlands. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:670-679. [PMID: 27565285 DOI: 10.1016/j.jval.2016.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Target groups for seasonal influenza vaccination are defined at the country level and are based on several factors. However, little is known about the national decision-making procedures. OBJECTIVE The purpose of this study was to compare the evidence used for the development of recommendations and its impact on the choice of target groups in France and the Netherlands. METHODS A preliminary documentary analysis identified institutions to include in the assessment: governmental authorities, research institutions, associations, and manufacturers. At least one expert from each group was invited to our study. Thirty-three semi-structured interviews were conducted in 2013 (16 France, 17 the Netherlands). We used NVivo10® to perform a thematic content analysis. RESULTS Clinical/epidemiological studies were the evidence most used in both countries. Economic models were increasingly being used; these had greater influence on the decision making in the Netherlands than in France, probably because of the presence of a modeler. Generally, the quality of the evidence used was poor, although no systematic use of standard protocol for its assessment was observed. A general protocol was sometimes used in France; however, the personal judgment of the experts was crucial for the assessment in both countries. CONCLUSIONS There were differences in the target groups, for example, pregnant women, recommended only in France. France and the Netherlands use similar evidence for developing vaccination recommendations, although different decisions are sometimes made regarding target groups. This could be associated with the lack of systematic standard appraisals, increasing the influence of the experts' judgment on decision making. The development of standards for the appraisal of evidence is recommended.
Collapse
Affiliation(s)
- Maria Laura Silva
- University of Lyon, Lyon, France; University of Bordeaux, Bordeaux Population Health Research Center U1219 Inserm, Bordeaux, France; University Lumière Lyon 2, CNRS, GATE-LSE UMR 5824, Ecully, France.
| | - W John Paget
- Netherlands Institute For Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - Valérie Buthion
- University of Lyon, Lyon, France; University Lumière Lyon 2 COACTIS, EA 4161, Lyon, France
| | | | - Lionel Perrier
- University of Lyon, Lyon, France; University Lumière Lyon 2, CNRS, GATE-LSE UMR 5824, Ecully, France; Direction of Clinical Research and Innovation DRCI, Léon Bérard Cancer Centre, Lyon, France
| | - Hans Martin Späth
- University of Lyon, Lyon, France; University Claude Bernard Lyon 1, EAM 4128, Lyon, France
| |
Collapse
|
8
|
Relevance of workplace social mixing during influenza pandemics: an experimental modelling study of workplace cultures. Epidemiol Infect 2016; 144:2031-42. [PMID: 26847017 DOI: 10.1017/s0950268816000169] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Workplaces are one of the most important regular meeting places in society. The aim of this study was to use simulation experiments to examine the impact of different workplace cultures on influenza dissemination during pandemics. The impact is investigated by experiments with defined social-mixing patterns at workplaces using semi-virtual models based on authentic sociodemographic and geographical data from a North European community (population 136 000). A simulated pandemic outbreak was found to affect 33% of the total population in the community with the reference academic-creative workplace culture; virus transmission at the workplace accounted for 10·6% of the cases. A model with a prevailing industrial-administrative workplace culture generated 11% lower incidence than the reference model, while the model with a self-employed workplace culture (also corresponding to a hypothetical scenario with all workplaces closed) produced 20% fewer cases. The model representing an academic-creative workplace culture with restricted workplace interaction generated 12% lower cumulative incidence compared to the reference model. The results display important theoretical associations between workplace social-mixing cultures and community-level incidence rates during influenza pandemics. Social interaction patterns at workplaces should be taken into consideration when analysing virus transmission patterns during influenza pandemics.
Collapse
|
9
|
Silva ML, Perrier L, Paget JW, Mosnier A, Buthion V, Cohen JM, Späth HM. Influenza vaccination policy-making processes in France and The Netherlands: Framework and determinants. Health Policy 2016; 120:293-305. [PMID: 26806677 DOI: 10.1016/j.healthpol.2016.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/17/2015] [Accepted: 01/05/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Target groups for seasonal influenza vaccination are nationally defined based on several factors. However, few studies have explored the policy-making processes at the country-level. We investigated key differences in the policy-making process for the development of vaccination recommendations between France (FR) and The Netherlands (NL). This paper presents preliminary results on the evidence used in the decision-making process and focuses on the interactions between the experts and stakeholders. METHODS A documentary analysis identified the stakeholders of this process as governmental authorities, research institutions, associations, and manufacturers. This qualitative study included at least one expert from each stakeholder group. Thirty-three semi-structured interviews were performed in 2013 (16 FR, 17 NL). We used NVivo10® to perform a thematic content analysis on the data. RESULTS National Immunization Technical Advisory Groups (NITAGs) were the key stakeholders in the development of recommendations. There was no systematic standard evaluation of evidence during the decision-making process in both countries. Likewise, voting was not systematic, although it did occur more often in FR. A declaration of interests was obligatory in both countries. Experts with no conflicts of interest were rare because many depend on private funding for their research on influenza vaccination. CONCLUSIONS The transparency of the NITAGs' procedures for the development of recommendations should be improved. We believe improvements might be achieved by the systematic standard evaluation of evidence, consistent voting, clear declarations of interest, and increased public funding for vaccination research.
Collapse
Affiliation(s)
- Maria Laura Silva
- University of Lyon, Lyon, France; University of Bordeaux; Research Center Bordeaux Population HealthU1219 Inserm, Bordeaux, France; University Lumière Lyon 2; CNRS, GATELSEUMR 5824, Ecully, France.
| | - Lionel Perrier
- University of Lyon, Lyon, France; University Lumière Lyon 2; CNRS, GATELSEUMR 5824, Ecully, France; Direction of Clinical Research and Innovation, DRCI, Léon Bérard Cancer Centre, Lyon, France
| | - John W Paget
- Netherlands Institute For Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - Valérie Buthion
- University of Lyon, Lyon, France; University Lumière Lyon 2 COACTIS, EA 4161, Lyon, France
| | | | - Hans Martin Späth
- University of Lyon, Lyon, France; University Claude Bernard Lyon 1, EAM 4128, Lyon, France
| |
Collapse
|
10
|
A literature review to identify factors that determine policies for influenza vaccination. Health Policy 2015; 119:697-708. [DOI: 10.1016/j.healthpol.2015.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 03/31/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022]
|
11
|
Meinck F, Cluver LD, Boyes ME. Household illness, poverty and physical and emotional child abuse victimisation: findings from South Africa's first prospective cohort study. BMC Public Health 2015; 15:444. [PMID: 25924818 PMCID: PMC4418047 DOI: 10.1186/s12889-015-1792-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Physical and emotional abuse of children is a large scale problem in South Africa, with severe negative outcomes for survivors. Although chronic household illness has shown to be a predictor for physical and emotional abuse, no research has thus far investigated the different pathways from household chronic illness to child abuse victimisation in South Africa. Methods Confidential self-report questionnaires using internationally utilised measures were completed by children aged 10-17 (n = 3515, 56.7% female) using door-to-door sampling in randomly selected areas in rural and urban locations of South Africa. Follow-up surveys were conducted a year later (96.7% retention rate). Using multiple mediation analyses, this study investigated direct and indirect effects of chronic household illness (AIDS or other illness) on frequent (monthly) physical and emotional abuse victimisation with poverty and extent of the ill person’s disability as hypothesised mediators. Results For children in AIDS-ill families, a positive direct effect on physical abuse was obtained. In addition, positive indirect effects through poverty and disability were established. For boys, a positive direct and indirect effect of AIDS-illness on emotional abuse through poverty were detected. For girls, a positive indirect effect through poverty was observed. For children in households with other chronic illness, a negative indirect effect on physical abuse was obtained. In addition, a negative indirect effect through poverty and positive indirect effect through disability was established. For boys, positive and negative indirect effects through poverty and disability were found respectively. For girls, a negative indirect effect through poverty was observed. Conclusions These results indicate that children in families affected by AIDS-illness are at higher risk of child abuse victimisation, and this risk is mediated by higher levels of poverty and disability. Children affected by other chronic illness are at lower risk for abuse victimisation unless they are subject to higher levels of household disability. Interventions aiming to reduce poverty and increase family support may help prevent child abuse in families experiencing illness in South Africa. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1792-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
| | - Lucie D Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. .,Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa.
| | - Mark E Boyes
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. .,Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| |
Collapse
|
12
|
Strasser S, Smith MO, Pendrick Denney D, Jackson MC, Buckmaster P. A Poverty Simulation to Inform Public Health Practice. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2013.811366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
13
|
Pandemic H1N1 in Canada and the use of evidence in developing public health policies--a policy analysis. Soc Sci Med 2013; 83:1-9. [PMID: 23465198 PMCID: PMC7125641 DOI: 10.1016/j.socscimed.2013.02.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 01/22/2013] [Accepted: 02/06/2013] [Indexed: 01/09/2023]
Abstract
When responding to a novel infectious disease outbreak, policies are set under time constraints and uncertainty which can limit the ability to control the outbreak and result in unintended consequences including lack of public confidence. The H1N1 pandemic highlighted challenges in public health decision-making during a public health emergency. Understanding this process to identify barriers and modifiable influences is important to improve the response to future emergencies. The purpose of this study is to examine the H1N1 pandemic decision-making process in Canada with an emphasis on the use of evidence for public health decisions. Using semi-structured key informant interviews conducted after the pandemic (July–November 2010) and a document analysis, we examined four highly debated pandemic policies: use of adjuvanted vaccine by pregnant women, vaccine priority groups and sequencing, school closures and personal protective equipment. Data were analysed for thematic content guided by Lomas' policy decision-making framework as well as indicative coding using iterative methods. We interviewed 40 public health officials and scientific advisors across Canada and reviewed 76 pandemic policy documents. Our analysis revealed that pandemic pre-planning resulted in strong beliefs, which defined the decision-making process. Existing ideological perspectives of evidence strongly influenced how information was used such that the same evidentiary sources were interpreted differently according to the ideological perspective. Participants recognized that current models for public health decision-making failed to make explicit the roles of scientific evidence in relation to contextual factors. Conflict avoidance theory explained policy decisions that went against the prevailing evidence. Clarification of roles and responsibilities within the public health system would reduce duplication and maintain credibility. A more transparent and iterative approach to incorporating evidence into public health decision-making that reflects the realities of the external pressures present during a public health emergency is needed.
Collapse
|
14
|
Seetoh T, Liverani M, Coker R. Framing risk in pandemic influenza policy and control. Glob Public Health 2012; 7:717-30. [PMID: 22823752 DOI: 10.1080/17441692.2012.699541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This article explores differing understandings of 'risk' in relation to pandemic influenza policy and control. After a preliminary overview of methodological and practical problems in risk analysis, ways in which risk was framed and managed in three historical cases were examined. The interdependence between scientific empiricism and political decision-making led to the mismanagement of the 1976 swine influenza scare in the USA. The 2004 H5N1 avian influenza outbreak in Thailand, on the other hand, was undermined by questions of national economic interest and concerns over global health security. Finally, the recent global emergency of pandemic influenza H1N1 in 2009 demonstrated the difficulties of risk management under a context of pre-established perceptions about the characteristics and inevitability of a pandemic. Following the analysis of these cases, a conceptual framework is presented to illustrate ways in which changing relationships between risk assessment, risk perception and risk management can result in differing policy strategies.
Collapse
Affiliation(s)
- Theresa Seetoh
- Communicable Diseases Policy Research Group (London School of Hygiene and Tropical Medicine), Mahidol University, Bangkok, Thailand.
| | | | | |
Collapse
|
15
|
Timpka T, Eriksson O, Spreco A, Gursky EA, Strömgren M, Holm E, Ekberg J, Dahlström O, Valter L, Eriksson H. Age as a determinant for dissemination of seasonal and pandemic influenza: an open cohort study of influenza outbreaks in Östergötland County, Sweden. PLoS One 2012; 7:e31746. [PMID: 22384066 PMCID: PMC3285651 DOI: 10.1371/journal.pone.0031746] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 01/12/2012] [Indexed: 11/19/2022] Open
Abstract
An understanding of the occurrence and comparative timing of influenza infections in different age groups is important for developing community response and disease control measures. This study uses data from a Scandinavian county (population 427.000) to investigate whether age was a determinant for being diagnosed with influenza 2005-2010 and to examine if age was associated with case timing during outbreaks. Aggregated demographic data were collected from Statistics Sweden, while influenza case data were collected from a county-wide electronic health record system. A logistic regression analysis was used to explore whether case risk was associated with age and outbreak. An analysis of variance was used to explore whether day for diagnosis was also associated to age and outbreak. The clinical case data were validated against case data from microbiological laboratories during one control year. The proportion of cases from the age groups 10-19 (p<0.001) and 20-29 years old (p<0.01) were found to be larger during the A pH1N1 outbreak in 2009 than during the seasonal outbreaks. An interaction between age and outbreak was observed (p<0.001) indicating a difference in age effects between circulating virus types; this interaction persisted for seasonal outbreaks only (p<0.001). The outbreaks also differed regarding when the age groups received their diagnosis (p<0.001). A post-hoc analysis showed a tendency for the young age groups, in particular the group 10-19 year olds, led outbreaks with influenza type A H1 circulating, while A H3N2 outbreaks displayed little variations in timing. The validation analysis showed a strong correlation (r = 0.625;p<0.001) between the recorded numbers of clinically and microbiologically defined influenza cases. Our findings demonstrate the complexity of age effects underlying the emergence of local influenza outbreaks. Disentangling these effects on the causal pathways will require an integrated information infrastructure for data collection and repeated studies of well-defined communities.
Collapse
Affiliation(s)
- Toomas Timpka
- Department of Public Health, Östergötland County Council, Linköping, Sweden.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Hwang GM, Mahoney PJ, James JH, Lin GC, Berro AD, Keybl MA, Goedecke DM, Mathieu JJ, Wilson T. A model-based tool to predict the propagation of infectious disease via airports. Travel Med Infect Dis 2012; 10:32-42. [PMID: 22245113 PMCID: PMC7185572 DOI: 10.1016/j.tmaid.2011.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/09/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022]
Abstract
Epidemics of novel or re-emerging infectious diseases have quickly spread globally via air travel, as highlighted by pandemic H1N1 influenza in 2009 (pH1N1). Federal, state, and local public health responders must be able to plan for and respond to these events at aviation points of entry. The emergence of a novel influenza virus and its spread to the United States were simulated for February 2009 from 55 international metropolitan areas using three basic reproduction numbers (R(0)): 1.53, 1.70, and 1.90. Empirical data from the pH1N1 virus were used to validate our SEIR model. Time to entry to the U.S. during the early stages of a prototypical novel communicable disease was predicted based on the aviation network patterns and the epidemiology of the disease. For example, approximately 96% of origins (R(0) of 1.53) propagated a disease into the U.S. in under 75 days, 90% of these origins propagated a disease in under 50 days. An R(0) of 1.53 reproduced the pH1NI observations. The ability to anticipate the rate and location of disease introduction into the U.S. provides greater opportunity to plan responses based on the scenario as it is unfolding. This simulation tool can aid public health officials to assess risk and leverage resources efficiently.
Collapse
Affiliation(s)
- Grace M Hwang
- The MITRE Corporation, 2275 Rolling Run Drive, Woodlawn, MD 21244, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Discussion: Managing late periprosthetic fluid collections (seroma) in patients with breast implants: a consensus panel recommendation and review of the literature. Plast Reconstr Surg 2011; 128:13-16. [PMID: 21701294 DOI: 10.1097/prs.0b013e31821cf88f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Timpka T, Eriksson H, Gursky EA, Strömgren M, Holm E, Ekberg J, Eriksson O, Grimvall A, Valter L, Nyce JM. Requirements and design of the PROSPER protocol for implementation of information infrastructures supporting pandemic response: a Nominal Group study. PLoS One 2011; 6:e17941. [PMID: 21464918 PMCID: PMC3065450 DOI: 10.1371/journal.pone.0017941] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 02/17/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Advanced technical systems and analytic methods promise to provide policy makers with information to help them recognize the consequences of alternative courses of action during pandemics. Evaluations still show that response programs are insufficiently supported by information systems. This paper sets out to derive a protocol for implementation of integrated information infrastructures supporting regional and local pandemic response programs at the stage(s) when the outbreak no longer can be contained at its source. METHODS Nominal group methods for reaching consensus on complex problems were used to transform requirements data obtained from international experts into an implementation protocol. The analysis was performed in a cyclical process in which the experts first individually provided input to working documents and then discussed them in conferences calls. Argument-based representation in design patterns was used to define the protocol at technical, system, and pandemic evidence levels. RESULTS The Protocol for a Standardized information infrastructure for Pandemic and Emerging infectious disease Response (PROSPER) outlines the implementation of information infrastructure aligned with pandemic response programs. The protocol covers analyses of the community at risk, the response processes, and response impacts. For each of these, the protocol outlines the implementation of a supporting information infrastructure in hierarchical patterns ranging from technical components and system functions to pandemic evidence production. CONCLUSIONS The PROSPER protocol provides guidelines for implementation of an information infrastructure for pandemic response programs both in settings where sophisticated health information systems already are used and in developing communities where there is limited access to financial and technical resources. The protocol is based on a generic health service model and its functions are adjusted for community-level analyses of outbreak detection and progress, and response program effectiveness. Scientifically grounded reporting principles need to be established for interpretation of information derived from outbreak detection algorithms and predictive modeling.
Collapse
Affiliation(s)
- Toomas Timpka
- Department of Medical and Health Sciences, Linköpings universitet, Linköping, Sweden.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Eastwood K, Durrheim DN, Butler M, Jon A. Responses to pandemic (H1N1) 2009, Australia. Emerg Infect Dis 2010; 16:1211-6. [PMID: 20678313 PMCID: PMC3298308 DOI: 10.3201/eid1608.100132] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Perception of risk affects compliance with public health control measures. In 2007, adults in Australia were interviewed about their willingness to comply with potential health interventions during a hypothetical influenza outbreak. After the first wave of pandemic (H1N1) 2009 in Australia, many of the same respondents were interviewed about behavior and protection measures they actually adopted. Of the original 1,155 respondents, follow-up interviews were conducted for 830 (71.9%). Overall, 20.4% of respondents in 2009 had recently experienced influenza-like illness, 77.7% perceived pandemic (H1N1) 2009 to be mild, and 77.8% reported low anxiety. Only 14.5% could correctly answer 4 questions about influenza virus transmission, symptoms, and infection control. Some reported increasing handwashing (46.6%) and covering coughs and sneezes (27.8%) to reduce transmission. Compared with intentions reported in 2007, stated compliance with quarantine or isolation measures in 2009 remained high. However, only respondents who perceived pandemic (H1N1) 2009 as serious or who had attained higher educational levels expressed intention to comply with social distancing measures.
Collapse
Affiliation(s)
- Keith Eastwood
- Hunter New England Health, Newcastle, New South Wales, Australia.
| | | | | | | |
Collapse
|
20
|
Timpka T, Eriksson H, Strömgren M, Eriksson O, Ekberg J, Grimvall A, Nyce J, Gursky E, Holm E. A neighborhood susceptibility index for planning of local physical interventions in response to pandemic influenza outbreaks. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2010; 2010:792-796. [PMID: 21347087 PMCID: PMC3041303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The global spread of a novel A (H1N1) influenza virus in 2009 has highlighted the possibility of a devastating pandemic similar to the 'Spanish flu' of 1917-1918. Responding to such pandemics requires careful planning for the early phases where there is no availability of pandemic vaccine. We set out to compute a Neighborhood Influenza Susceptibility Index (NISI) describing the vulnerability of local communities of different geo-socio-physical structure to a pandemic influenza outbreak. We used a spatially explicit geo-physical model of Linköping municipality (pop. 136,240) in Sweden, and employed an ontology-modeling tool to define simulation models and transmission settings. We found considerable differences in NISI between neighborhoods corresponding to primary care areas with regard to early progress of the outbreak, as well as in terms of the total accumulated share of infected residents counted after the outbreak. The NISI can be used in local preparations of physical response measures during pandemics.
Collapse
Affiliation(s)
- Toomas Timpka
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Background The 2009 influenza A(H1N1) pandemic has generated thousands of articles and news items. However, finding relevant scientific articles in such rapidly developing health crises is a major challenge which, in turn, can affect decision-makers' ability to utilise up-to-date findings and ultimately shape public health interventions. This study set out to show the impact that the inconsistent naming of the pandemic can have on retrieving relevant scientific articles in PubMed/MEDLINE. Methodology We first formulated a PubMed search algorithm covering different names of the influenza pandemic and simulated the results that it would have retrieved from weekly searches for relevant new records during the first 10 weeks of the pandemic. To assess the impact of failing to include every term in this search, we then conducted the same searches but omitted in turn “h1n1,” “swine,” “influenza” and “flu” from the search string, and compared the results to those for the full string. Principal Findings On average, our core search string identified 44.3 potentially relevant new records at the end of each week. Of these, we determined that an average of 27.8 records were relevant. When we excluded one term from the string, the percentage of records missed out of the total number of relevant records averaged 18.7% for omitting “h1n1,” 13.6% for “swine,” 17.5% for “influenza,” and 20.6% for “flu.” Conclusions Due to inconsistent naming, while searching for scientific material about rapidly evolving situations such as the influenza A(H1N1) pandemic, there is a risk that one will miss relevant articles. To address this problem, the international scientific community should agree on nomenclature and the specific name to be used earlier, and the National Library of Medicine in the US could index potentially relevant materials faster and allow publishers to add alert tags to such materials.
Collapse
Affiliation(s)
- Ole Norgaard
- National Centre for Health Promotion and Disease Prevention, National Board of Health, Copenhagen, Denmark
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Jeffrey V. Lazarus
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
- Copenhagen School of Global Health, Copenhagen University, Copenhagen, Denmark
- * E-mail:
| |
Collapse
|
22
|
Bondy SJ, Russell ML, Laflèche JM, Rea E. Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine. BMC Public Health 2009; 9:488. [PMID: 20034405 PMCID: PMC2808319 DOI: 10.1186/1471-2458-9-488] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 12/24/2009] [Indexed: 12/04/2022] Open
Abstract
Background Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Methods Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Results Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Conclusions Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated.
Collapse
Affiliation(s)
- Susan J Bondy
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, MT5 3M7, Canada.
| | | | | | | |
Collapse
|
23
|
Ekberg J, Eriksson H, Morin M, Holm E, Strömgren M, Timpka T. Impact of precautionary behaviors during outbreaks of pandemic influenza: modeling of regional differences. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2009; 2009:163-167. [PMID: 20351842 PMCID: PMC2815480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Using time geographic theory for representation of population mixing, we set out to analyze the relative impact from precautionary behaviors on outbreaks of pandemic influenza in Europe and Asia. We extended an existing simulator environment with behavioral parameters from a population survey to model different behaviors. We found that precautionary behaviors even among a minority of the population can have a decisive effect on the probability of the outbreak to propagate. The results also display that assumptions strongly influences the outcome. Depending on the interpretation of how many "children" are kept from "school", R(0) changes from a range where outbreak progression is possible to a range where it is improbable in both European (R(0)=1.77/1.23) and Asian (R(0)=1.70/1.05) conditions. We conclude that unprompted distancing can have a decisive effect on pandemic propagation. An important response strategy can be to promote voluntary precautionary behavior shown to reduce disease transmission.
Collapse
Affiliation(s)
- Joakim Ekberg
- Dept. of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Dept. of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Henrik Eriksson
- Dept. of Computer and Information Science, Linköping University, Linköping, Sweden
| | | | - Einar Holm
- Dept. of Social and Economic Geography, Umeå University, Umeå, Sweden
| | - Magnus Strömgren
- Dept. of Social and Economic Geography, Umeå University, Umeå, Sweden
| | - Toomas Timpka
- Dept. of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Dept. of Computer and Information Science, Linköping University, Linköping, Sweden
| |
Collapse
|
24
|
Eriksson H, Morin M, Ekberg J, Jenvald J, Timpka T. Assumptions management in simulation of infectious disease outbreaks. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2009; 2009:173-177. [PMID: 20351844 PMCID: PMC2815436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Simulation of outbreaks of infectious disease is an important tool for understanding the dynamics of the outbreak process, the impact of disease and population properties, and the potential effect of interventions. However, the interpretation of the simulation results requires a clear understanding of the assumptions made in the underlying model. Typical simulation tasks, such as exploring the space of different scenarios for population and disease properties, require multiple runs with varying model parameters. For such complex tasks, the management of the assumptions made becomes a daunting and potentially error-prone undertaking. We report explicit assumptions management as an approach to capture, model, and document the assumptions for simulator runs. It was found possible to extend ontology-based simulation, which uses an ontological model to parameterize the simulator, to incorporate an assumptions model in the ontology. We conclude that explicit assumptions modeling should be part of any infectious disease simulation architecture from start.
Collapse
Affiliation(s)
- Henrik Eriksson
- Dept. of Computer and Information Science, Linköping University
| | | | | | | | | |
Collapse
|