A human metapneumovirus outbreak at a community hospital in England, July to September 2010

We describe an outbreak of human metapneumovirus (hMPV) which occurred in July-September 2010 at a community hospital in the East of England. Based on the medical and nursing records, cases were retrospectively defined as suspected if they had had an influenza-like illness (ILI), and probable if they had had an ILI and an epidemiological link to a laboratory-confirmed case. Of a total of 17 symptomatic inpatients, five were classified as probable cases, five were laboratory confirmed and seven were suspected. The attack rate was 29.4% for confirmed and probable cases combined. The median age of symptomatic inpatients was 85 years-old (range 68-96) and the majority (16/17) of symptomatic inpatients had an underlying medical condition. Control measures introduced appeared to restrict further exposure of susceptible patients to infection although modelling suggested that up to four of 10 confirmed and probable cases (40%) could have been prevented through more timely diagnosis and recognition of an outbreak. These findings suggest that there should be increased awareness of hMPV infection within healthcare settings, particularly when the population at risk has a high prevalence of underlying co-morbidities.

A human metapneumovirus outbreak at a community hospital in England, July to September 2010

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Dual sensing of oxygen and temperature using quantum dots and a ruthenium complex

A scheme for the simultaneous determination of oxygen and temperature using quantum dots and a ruthenium complex is demonstrated. The luminescent complex [Ru(II)-tris(4,7-diphenyl-1,10-phenanthroline)]2+ is immobilized in a non-hydrolytic sol-gel matrix and used as the oxygen sensor. The temperature information is provided by the luminescent emission of core-shell CdSe-ZnS semiconductor nanocrystals immobilized in the same material. Measurements of oxygen and temperature could be performed with associated errors of +/-2% of oxygen concentration and +/-1 degrees C, respectively. In addition, it is shown that while the dye luminescence intensity is quenched both by oxygen and temperature, the nanocrystals luminescent emission responds only to temperature. Results presented demonstrate that the combined luminescence response allows the simultaneous assessment of both parameters using a single optical fiber system. In particular, it was shown that a 10% error in the measured oxygen concentration, induced by a change in the sample temperature, could be compensated using the nanocrystals temperature information and a correction function.

Developing performance indicators that reflect an expanded view of health: findings from the use of an innovative methodology

BACKGROUND

The increasing presence of managed health care in the United States has been accompanied by the widespread use of performance indicators to assess health plans along various dimensions of quality. Current performance indicator sets virtually ignore psychosocial and behavioral factors in the prevention and management of illness, especially chronic illness, in spite of documented evidence in the medical literature of the importance of these factors. Instead, current indicator sets focus primarily on biomedical interventions to prevent, treat, and manage illness.

METHODOLOGY

In a novel method for developing performance indicators--the use of a storytelling methodology--eight interdisciplinary panels, composed of health care experts at the community, state, and national levels, each completed two stories about patients with chronic illnesses. The first story described experiences a patient might have in the health care system as it is today; the second story retold the events that might transpire if attention to psychosocial and behavioral factors were integrated into the health care system.

FINDINGS

Differences between the two sets of stories developed by the panels revealed common themes and specific areas where indicator development might prove fruitful. Performance indicators were identified from these themes, and work is underway to operationalize them; to identify barriers and opportunities for their inclusion in indicator sets; and to further document their potential health and cost-effectiveness.

DISCUSSION

Although not scientifically rigorous, the storytelling method was found to provide consistent results and may be applied to many aspects of the health care planning process, health education, and quality improvement efforts.