scholarly journals Trends in incidence of pneumococcal disease before introduction of conjugate vaccine: South West England, 1996–2005

2007 ◽  
Vol 136 (8) ◽  
pp. 1096-1102 ◽  
Author(s):  
C. A. IHEKWEAZU ◽  
D. A. B. DANCE ◽  
R. PEBODY ◽  
R. C. GEORGE ◽  
M. D. SMITH ◽  
...  
Keyword(s):  
Blood Culture ◽  
Pneumococcal Disease ◽  
Annual Incidence ◽  
Protection Agency ◽  
South West ◽  
The Mean ◽  
The Impact ◽  
Susceptibility And Resistance ◽  
South West England ◽  
Immunization Programmes

SUMMARYIntroduction of pneumococcal conjugate and polysaccharide vaccines into the United Kingdom's routine immunization programmes is expected to change the epidemiology of invasive pneumococcal disease (IPD). We have documented the epidemiology of IPD in an English region (South West) with high-quality surveillance data before these programmes were established. We analysed data on isolates of Streptococcus pneumoniae from blood and CSF between 1996 and 2005 from microbiology laboratories in the South West that were reported and/or referred for serotyping to the Health Protection Agency Centre for Infections. The mean annual incidence of IPD increased from 11·2/100 000 in 1996 to 13·6/100 000 in 2005 (P<0·04). After adjusting for annual blood-culture sampling rates in hospitals serving the same catchment populations, an increase in annual incidence of IPD was no longer observed (P=1·0). Variation in overall incidence between laboratories could also be explained by variation in blood culture rates. The proportion of disease caused by serotypes 6B, 9V and 14 decreased significantly (P=0·001, P=0·007, and P=0·027 respectively) whereas that caused by serotype 4, 7F and 1 increased (P=0·001, P=0·003, and P<0·001 respectively) between 2000 and 2005. The level of penicillin non-susceptibility and resistance to erythromycin remained stable (2% and 12% respectively). This study provides an important baseline to assess the impact of changing vaccination programmes on the epidemiology of IPD, thus informing future use of pneumococcal vaccines.

scholarly journals 2701. The Impact of Infant 13-valent Conjugate Pneumococcal Vaccination Program on Invasive Pneumococcal Disease in Children in British Columbia, Canada

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S950-S950
Author(s):  
Nirma K Vadlamudi ◽  
David Patrick ◽  
Linda Hoang ◽  
Fawziah Marra
Keyword(s):  
British Columbia ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Annual Incidence ◽  
Immunization Program ◽  
Incremental Change ◽  
Laboratory Surveillance ◽  
Rate Ratios ◽  
The Impact

Abstract Background A significant reduction in invasive pneumococcal disease (IPD) has been reported following implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) infant immunization program, but not much has been reported after introduction of the 13-valent vaccine (PCV13). This study represents the effect of PCV13 on IPD in British Columbia, Canada over a 14 year period (2002–2015). Methods Using provincial IPD laboratory surveillance data, we calculated the annual incidence following implementation of PCV7 (September 2004), and PCV13 (September 2010) in children less than 17 years of age. We also compared incidence rate ratios (IRR) against pre-PCV13 (2004–2010) and pre-PCV7 (2002–2003) baselines for overall and age-specific IPD rates using Poisson regression. Results A total of 697 cases were reported over the 14 year period. The overall annual incidence decreased from 10.9 cases per 100,000 population in 2002 to 4.64 cases per 100,000 population in 2015. While overall decline of IPD was 59% (IRR 0.41; 95% CI: 0.35–0.51) compared with baseline, this reduction was greatest after introduction of PCV7 (IRR 0.44; 95% CI: 0.37–0.53); the incremental change after introduction of PCV13 was non-significant (IRR 0.94; 95% CI: 0.78–1.13). The greatest reduction in IPD was in children <2 years of age (PCV13 vs baseline: IRR 0.19; 95% CI: 0.14–0.25), followed by children 3–5 years of age (PCV13 vs baseline: IRR 0.34; 95% CI: 0.21–0.56); no significant change was observed in 6–17 year olds. Conclusion While IPD rates have been significantly reduced since the introduction of the PCV vaccines, the impact of the additional 6 serotypes in the PCV13 vaccine is non-significant. Disclosures All authors: No reported disclosures.

scholarly journals Understanding our value; assessing the nature of the impact of library services

2010 ◽  
Vol 33 (105) ◽  
pp. 62-89 ◽  
Author(s):  
David Bawden ◽  
Andrew Calvert ◽  
Lyn Robinson ◽  
Christine Urquhart ◽  
Colin Bray ◽  
...  
Keyword(s):  
Public Library ◽  
Learning Objectives ◽  
Library Services ◽  
Specific Information ◽  
South West ◽  
City Of London ◽  
The Impact ◽  
The City ◽  
Information Requests ◽  
South West England

This paper reports an approach to assessing the nature of the impact and benefit of library services, based on the concepts introduced in Urquhart's Value Project for healthcare information services. Two studies are described and compared. A project in the City of London public library service examined the benefits obtained from specific information requests. A project in several public library services in South West England examined the value obtained from the borrowing and reading of books, linking this with categories of learning objectives. These studies showed the promise, and also the difficulties, of adapting existing impact frameworks to understand the nature of the impact and value of library services

scholarly journals Highs and Lows of Lambing Time: Sheep Farmers’ Perceptions of the First Outbreak of Schmallenberg Disease in South West England on Their Well-Being

2019 ◽  
Vol 16 (24) ◽  
pp. 5057 ◽  
Author(s):  
Clare J. Phythian ◽  
Mike J. Glover
Keyword(s):  
Negative Impact ◽  
Well Being ◽  
Disease Outbreak ◽  
Production Cycle ◽  
Peak Period ◽  
Sheep Farmer ◽  
South West ◽  
The Impact ◽  
First Time ◽  
South West England

The outbreak of a previously unknown and new disease in the United Kingdom, known as ‘Schmallenberg disease’, a disease associated with abortions, stillbirths and fetal deformities in naïve ewes, was reported for the first time in South West England during the 2012/13 early lambing season. Epidemiological studies confirmed that the Schmallenberg virus (SBV) had a severe negative impact upon animal welfare and the productivity of affected flocks. By contrast, there was a specific lack of research on the impact of SBV on sheep farmer well-being. This study aimed to improve our understanding of sheep farmers’ experiences of Schmallenberg disease, and the impact of the first outbreak on sheep farmer well-being during the 2012/13 early lambing season in South West England. Face-to-face, semi-structured interviews with six farmers with small flocks of pedigree and purebred sheep in South West England were conducted in 2013. The data were analysed via thematic analysis. The main themes regarding the impact of disease on farmer well-being included: (i) emotional highs and lows are part of a normal lambing season; (ii) negative emotions and memories associated with the Schmallenberg disease outbreak; and (iii) resilience and coping with the unexpected disease outbreak. These novel data present preliminary findings from a small number of sheep farmers, and indicate that for some farmers, an unexpected outbreak of a new and emerging disease for the first time during lambing, and dealing with high levels of dystocia, deformities and deaths in their animals, had a negative impact on their emotional well-being during the peak period of the sheep production cycle.

scholarly journals Implications of Land Use Change on River Flow in South West England

10.29007/75p2 ◽  
2018 ◽  
Author(s):  
Lorena Liuzzo ◽  
Gabriele Freni
Keyword(s):  
Land Use ◽  
Water Resources ◽  
Urban Areas ◽  
River Flow ◽  
Hydrological Cycle ◽  
Land Use Changes ◽  
Positive Effects ◽  
South West ◽  
The Impact ◽  
South West England

Assessing the impacts of future changes in land use on the hydrological cycle is an important issue for the proper management of water resources, since land use changes have implications on both water quantity and quality. Land use changes, in particular the expansion of urban areas, can significantly affect river flow increasing flood risk, whereas, the development of woodland areas could have positive effects on the reduction of peak flow. The present study has been carried out to assess and quantify the impact of land use changes on the water resources of a river basin located in South West England. With this aim, a hydrological model has been applied to some land use scenarios. In particular, two scenarios have been investigated: the first includes the increase of agricultural areas and the decrease of woodlands, the second includes the increase of urban areas and the decrease of woodlands. Results showed that, in the area of study, river flow would likely to be affected by future land use changes, mainly in the case of urban areas increase.

The impact of a disused mine on uranium transport in the River Fal, South West England

2004 ◽  
Vol 6 (11) ◽  
pp. 907-913 ◽  
Author(s):  
Yolanda Moliner-Martinez ◽  
Pilar Campíns-Falcó ◽  
Paul J. Worsfold ◽  
Miranda J. Keith-Roach
Keyword(s):  
South West ◽  
The Impact ◽  
South West England

scholarly journals 1350. Optimizing Blood Culture Use in Critically Ill Children: Year One of a Multi-Center Diagnostic Stewardship Collaborative

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S685-S686
Author(s):  
Charlotte Z Woods-Hill ◽  
Danielle W Koontz ◽  
Annie Voskertchian MPH ◽  
Anping Xie PhD ◽  
Marlene R Miller ◽  
...  
Keyword(s):  
Blood Culture ◽  
Critically Ill ◽  
Culture Collection ◽  
Blood Cultures ◽  
Bright Star ◽  
Critically Ill Children ◽  
Site Specific ◽  
Phone Calls ◽  
The Mean ◽  
The Impact

Abstract Background Overuse of blood cultures can lead to false positives and unnecessary antibiotics. Our objective was to describe the implementation and 12-month impact of a multi-site quality improvement collaborative to reduce unnecessary blood cultures in pediatric intensive care unit (PICU) patients. Methods In 2018, 14 PICUs joined the Blood Culture Improvement Guidelines and Diagnostic Stewardship for Antibiotic Reduction in Critically Ill Children (Bright STAR) Collaborative, designed to understand and improve blood culture practices in PICUs. Guided by a multidisciplinary study team, sites 1) reviewed existing evidence for safe blood culture reduction, 2) assessed local practices and barriers to change, and 3) developed and implemented new blood culture practices informed by local context. We facilitated and monitored project progress through phone calls, site visits, and collaborative-wide teleconferences. We collected monthly blood culture rates and monitored for delays in culture collection as a safety balancing metric. We compared 24 months of baseline data to post-implementation data (2-14 months) using a Poisson regression model accounting for the site-specific patient days and correlation of culture use within a site over time. Results Across 14 sites, there were 41,986 pre-implementation blood cultures collected over 238,182 PICU patient days. The mean pre-implementation site-specific blood culture rate was 19.42 cultures/100 patient days (range 9.59 to 48.18 cultures/100 patient days). Post-implementation, there were 12,909 blood cultures collected over 118,600 PICU patient days. The mean post-implementation rate was 14.02 cultures/100 patient days (range 5.40 to 37.57 cultures/100 patient days), a 23% decrease (relative rate 0.77, 95% CI: 0.60, 0.99, p = 0.04). In 12 months post-implementation, sites reviewed 463 positive blood cultures, and identified only one suspected delay in culture collection possibly attributable to the site’s culture reduction program. Bright STAR Collaborative Site Blood Culture Rate 100 Patient Days Conclusion Multidisciplinary teams facilitated a 23% average reduction in blood culture use in 14 PICUs. Future work will determine the impact of blood culture diagnostic stewardship on antibiotic use and other important patient safety outcomes. Disclosures James C. Fackler MD, MD, Rubicon Health LLC (Other Financial or Material Support, Founder)

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