Princeton University will offer Meningitis B vaccines to recommended groups

CDC/MMWR Watch [to 30 November 2013]

Princeton University will offer Meningitis B vaccines to recommended groups
Posted November 26, 2013; 03:00 p.m.
Excerpt
The Centers for Disease Control and Prevention (CDC) has now officially recommended that all Princeton University undergraduate students, and also graduate students living in undergraduate dormitories, the Graduate College and annexes, and other members of the University community with certain medical conditions, receive a vaccine that helps protect against meningococcal disease caused by serogroup B bacteria. The vaccine will be provided only to these groups, and it will not be administered anywhere else.

The specified groups were recommended by the CDC to receive the vaccine because young adults and people with certain medical conditions are at increased risk of getting meningitis, especially those who live in close quarters, such as dormitories.

Since March 2013 there have been eight cases of meningococcal disease contracted by Princeton University students and a student visitor, all of which were caused by meningococcal bacteria known as serogroup B, including the latest case reported on Nov. 21….

…The CDC recommends that all members of the University community who have problems with their spleen (including sickle cell disease) or complement pathway disorder (a specific type of immune deficiency) be considered for vaccination. Those who have these conditions would be required to present documentation or a physician’s note to University Health Services before receiving the vaccine.

Princeton University will cover the cost of the vaccine.
http://www.princeton.edu/main/news/archive/S38/54/94A32/index.xml?section=topstories

B95: A new respirator for health care personnel

American Journal of Infection Control
Vol 41 | No. 12 | December 2013 | Pages 1147-1302
http://www.ajicjournal.org/current

B95: A new respirator for health care personnel
Megan E. Gosch, MPH, Ronald E. Shaffer, PhD, Aaron E. Eagan, RN, BSN, Raymond J. Roberge, MD, MPH, Victoria J. Davey, PhD, MPH, RN, Lewis J. Radonovich Jr., MD
published online 31 May 2013.

Abstract
Background
Respiratory protection relies heavily on user compliance to be effective, but compliance among health care personnel is less than ideal.

Methods
In 2008, the Department of Veterans Affairs formed the Project Better Respiratory Equipment using Advanced Technologies for Healthcare Employees (BREATHE) Working Group, composed of a variety of federal stakeholders, to discuss strategies for improving respirator compliance, including the need for more comfortable respirators.

Results
The Working Group developed 28 desirable performance characteristics that can be grouped into 4 key themes: (1) respirators should perform their intended function safely and effectively; (2) respirators should support, not interfere, with occupational activities; (3) respirators should be comfortable and tolerable for the duration of wear; and (4) respiratory protective programs should comply with federal/state standards and guidelines and local policies. As a necessary next step, the Working Group identified the need for a new class of respirators, to be called “B95,” which would better address the unique needs of health care personnel.

Conclusion
This article summarizes the outputs of the Project BREATHE Working Group and provides a national strategy to develop clinically validated respirator test methods, to promulgate B95 respirator standards, and to invent novel design features, which together will lead to commercialized B95 respirators.

Social media in public health

British Medical Bulletin
Volume 108 Issue 1 December 2013
http://bmb.oxfordjournals.org/content/current

Social media in public health
Taha A. Kass-Hout* and Hend Alhinnawi
Author Affiliations
Humanitarian Tracker, Washington, DC, USA
Accepted August 27, 2013.
http://bmb.oxfordjournals.org/content/108/1/5.abstract

Abstract
Introduction or background
While social media interactions are currently not fully understood, as individual health behaviors and outcomes are shared online, social media offers an increasingly clear picture of the dynamics of these processes.

Sources of data
Social media is becoming an increasingly common platform among clinicians and public health officials to share information with the public, track or predict diseases.

Areas of agreement
Social media can be used for engaging the public and communicating key public health interventions, while providing an important tool for public health surveillance.

Areas of controversy
Social media has advantages over traditional public health surveillance, as well as limitations, such as poor specificity, that warrant additional study.

Growing points
Social media can provide timely, relevant and transparent information of public health importance; such as tracking or predicting the spread or severity of influenza, west nile virus or meningitis as they propagate in the community, and, in identifying disease outbreaks or clusters of chronic illnesses.

Areas timely for developing research
Further work is needed on social media as a valid data source for detecting or predicting diseases or conditions. Also, whether or not it is an effective tool for communicating key public health messages and engaging both, the general public and policy-makers.

Non-publication of large randomized clinical trials: cross sectional analysis

British Medical Journal
30 November 2013 (Vol 347, Issue 7935)
http://www.bmj.com/content/347/7935

Research
Non-publication of large randomized clinical trials: cross sectional analysis
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6104 (Published 29 October 2013)
Cite this as: BMJ 2013;347:f6104
Christopher W Jones, attending physician1, Lara Handler, school of medicine liaison librarian2, Karen E Crowell, clinical information specialist2, Lukas G Keil, research assistant3, Mark A Weaver, assistant professor4, Timothy F Platts-Mills, assistant professor3
http://www.bmj.com/content/347/bmj.f6104

Abstract
Objective  To estimate the frequency with which results of large randomized clinical trials registered with ClinicalTrials.gov are not available to the public.

Design  Cross sectional analysis

Setting  Trials with at least 500 participants that were prospectively registered with ClinicalTrials.gov and completed prior to January 2009.

Data sources  PubMed, Google Scholar, and Embase were searched to identify published manuscripts containing trial results. The final literature search occurred in November 2012. Registry entries for unpublished trials were reviewed to determine whether results for these studies were available in the ClinicalTrials.gov results database.

Main outcome measures   The frequency of non-publication of trial results and, among unpublished studies, the frequency with which results are unavailable in the ClinicalTrials.gov database.

Results  Of 585 registered trials, 171 (29%) remained unpublished. These 171 unpublished trials had an estimated total enrollment of 299 763 study participants. The median time between study completion and the final literature search was 60 months for unpublished trials. Non-publication was more common among trials that received industry funding (150/468, 32%) than those that did not (21/117, 18%), P=0.003. Of the 171 unpublished trials, 133 (78%) had no results available in ClinicalTrials.gov.

Conclusions  Among this group of large clinical trials, non-publication of results was common and the availability of results in the ClinicalTrials.gov database was limited. A substantial number of study participants were exposed to the risks of trial participation without the societal benefits that accompany the dissemination of trial results.

Knowledge is power; information is liberation [sharing clinical trials test results with subjects]

Bulletin of the World Health Organization
Volume 91, Number 12, December 2013, 897-972http://www.who.int/bulletin/volumes/91/12/en/index.html

Editorial
Knowledge is power; information is liberation
Rachel Baggaley a, Jesus M Garcia Calleja a, Lawrence Marum b & Elizabeth Marum b
a. Department of HIV/AIDS, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.
b. US Centers for Disease Control and Prevention, Lusaka, Zambia.
Bulletin of the World Health Organization 2013;91:898-898A. doi: http://dx.doi.org/10.2471/BLT.13.132464
http://www.who.int/bulletin/volumes/91/12/13-132464/en/index.html

Excerpt
In 1597 Francis Bacon stated that “knowledge itself is power”1 and Nelson Mandela, in the same vein, said in 2003 that “education is the most powerful weapon we can use to change the world”.2 In this issue of the Bulletin of the World Health Organization, Dermot Maher discusses the ethics of conducting population-based surveys involving clinical tests for research and surveillance purposes without routinely giving participants their test results, if these are positive, so that they can seek access to lifesaving treatment. Maher argues specifically that because antiretroviral treatment is now widely available, even in low- and middle-income countries, it is no longer ethical to fail to inform research participants when the result of a test for the detection of human immunodeficiency virus (HIV) infection turns out to be positive.3,4

According to the Council for International Organizations of Medical Sciences, “individual subjects will be informed of any finding that relates to their particular health status”.5 In 2004 and 2013, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) issued ethical guidance for HIV surveillance that included a guiding principle particularly relevant to this discussion: in household or clinical surveys, “participants must be given the opportunity to be informed of their test results”.6 Currently, participants in many population-based surveys in which blood or other samples are collected for research purposes are “given the opportunity” to learn their test results, through testing services provided in the community or referral to local counselling and testing services, but are still allowed to “opt out” of learning their results…

Editorial: Public health management of mass gatherings: the Saudi Arabian experience with MERS-CoV

Bulletin of the World Health Organization
Volume 91, Number 12, December 2013, 897-972http://www.who.int/bulletin/volumes/91/12/en/index.html

Editorial
Public health management of mass gatherings: the Saudi Arabian experience with MERS-CoV
Ziad A Memish & Abdullah A Al-Rabeeah
doi: 10.2471/BLT.13.132266
Excerpt
…Building on decades of experience, in October 2010 the Saudi Arabian health ministry established the Global Center for Mass Gathering Medicine, subsequently endorsed by health minis­ters of the League of Arab States. WHO’s Executive Board soon mandated a strat­egy for mass gatherings and established a framework to address the health chal­lenges these entail.

The scientific and practical methods applied in mass gathering medicine, as the field is called, were examined during the Second International Con­ference on Mass Gathering Medicine in Riyadh, Saudi Arabia, in September 2013. The conference highlighted the importance of research and of drawing on the experience of states and regional and international organizations to control accidents and diseases during mass gatherings. The resulting Riyadh declaration calls for cooperation and in­formation exchange between the Global Centre for Mass Gathering Medicine and other WHO collaborating centres and between states, international or­ganizations and scientific centres, with due observance of patient confidentiality and medical ethics. It also states that  global developments in the control of MERS-CoV transmission should be followed to inform arrangements for the hajj and other mass gatherings. Finally, it calls for the coordination of policies and procedures to better define the nature, methods and scope of mass gathering medicine and to launch media and educational campaigns for increas­ing awareness of the field. The confer­ence acknowledged the media’s role in conveying accurate and unbiased health information and underscored the im­portance of relying on reputable sources; ensuring balanced, non-alarmist cover­age based on scientific facts and mindful of public health ethics; and establishing benchmarks for the resources needed during mass gatherings.

The complex public health chal­lenges posed by mass gatherings are best addressed through mutual trust and equitable partnerships and col­laborations. In a globalized world, such collaborations inevitably extend beyond national and regional borders and hence require a fine balance be­tween respect for national sovereignty, public health ethics and global health security priorities.