scholarly journals “Scuola Sicura”: a school screening program to prevent the spread of COVID-19 among students in Piedmont, Italy

2021 ◽  
Author(s):  
Elena Farina ◽  
Ilenia Eboli ◽  
Teresa Spadea ◽  
Carlo Saugo ◽  
Lorenzo Richiardi ◽  
...  
Keyword(s):  
Large Scale ◽  
Screening Program ◽  
Outcome Evaluation ◽  
Birth Certificates ◽  
Local Health ◽  
Predictive Capacity ◽  
School Screening ◽  
Case Identification ◽  
Third Grade Students ◽  
Early Case

Abstract ObjectivesAims of “Scuola Sicura” (SS) were to monitor the rate of COVID-19 and to contain its spread within the school population through early case isolation. We report the initial process and outcome evaluation results.DesignDescriptive study of an experimental screening testing program in children in Piedmont in the period January-March 2021. We used data from the COVID-19 platform and the Local Health Units, the archives of birth certificates (CedAP) and hospital discharge files (SDO).Setting and participantsThe screening program targeted second and third grade students in first level secondary schools. Participants were subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresWe calculated:1. number of positive cases detected vs. total number of students tested in the SS program;2. number of positive cases detected outside the SS program vs. total number of students in the target population.We detected the number of quarantines due to SS and no-SS case identification. To investigate the spread of COVID-19 in households, the mother-child pairs were identified through record linkage between the CedAP and SDO archives, and positive mothers were identified.ResultsSixty-nine percent of schools and 19.5% of the students participated in the program. SS detected 114 positives cases for SARS-CoV-2. On 08.03.2021, the target classes started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. We were able to identify the mothers of 61 out of 69 of those students (88%); 46 mothers had performed a swab test after the positivity of their child with a positive result in 11 cases. Asymptomatic cases identified at screening during in-class learning period accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for SARS-CoV-2 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs.

scholarly journals “Scuola Sicura”: a school screening program to prevent the spread of COVID-19 among students in Piedmont, Italy

2021 ◽  
Author(s):  
Elena Farina ◽  
Ilenia Eboli ◽  
Teresa Spadea ◽  
Carlo Saugo ◽  
Lorenzo Richiardi ◽  
...  
Keyword(s):  
Secondary Schools ◽  
Large Scale ◽  
Screening Program ◽  
Transmission Rate ◽  
Outcome Evaluation ◽  
Mitigation Strategies ◽  
Contact Tracing ◽  
Local Health ◽  
Regional Government ◽  
School Screening

Abstract ObjectivesThe regional government of Piedmont approved an experimental screening testing program entitled “Scuola Sicura” with the aim to: rapidly contain thes spread of COVID-19 in the school population together with general mitigation strategies such as contact tracing, and case isolation, and to monitor the transmission rate in this population. In this paper we report the initial process and outcome evaluation results and the criticalities encountered during program rollout.DesignDescriptive study of the trend in the period Janaury-March 2021.The evaluation of the preventive capacity of the program is limited to the period of in-class learning. The data sources used are the COVID-19 platform Piedmont, the archives of the local health Departments and the CedAP-SDO archive. Setting and participantsThe screening program targeted second and third grade students in first level secondary schools throughout Piedmont. Each class was subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresThe following indices were calculated with a 95% confidence interval: 1. number of positive cases detected vs. total number of students tested in the “Scuola Sicura” program;2. number of positive cases detected outside the “Scuola Sicura” program vs total number of students enrolled in the 2nd and 3rd grades of first-level secondary schools in Piedmont.To evaluate the preventive capacity, quarantines were detected. In order to investigate the spread of COVID-19 in households, the mother-child pair was tracked and cases of positivity among mothers were identified. Results69% of schools in Piedmont participated in the program; the actual participation was 19.5% of the total number of students enrolled in second and third grades of first-level secondary schools. SS detected 114 positives cases for SARS-CoV-2, yielding a prevalence of 0.52% (95%CI 0.42-0.61) when calculated for the total number of students tested by the program. Starting from 08.03.2021, the target classes have started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. For 61 of the 69 cases (88%) identified by SS before 8 March, the mother-child couple was reconstruncted through record linkage between the CedAP and SDO archives. Forty-six mothers perfomed a swab test after that of the child with a positive result in 24% of cases (n=11). Asymptomatic cases identified at screening accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for COVID-19 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs. When well organized and implemented jointly with other transmission prevention measures and contact tracing, school screening may be a viable strategy to keep schools open when high levels of the virus are circulating in the community.

scholarly journals Subsequent attendance in a breast cancer screening program after a false-positive result in the Local Health Authority of Bologna (Italy)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorena Squillace ◽  
Lorenzo Pizzi ◽  
Flavia Rallo ◽  
Carmen Bazzani ◽  
Gianni Saguatti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Positive Result ◽  
Breast Cancer Screening ◽  
Health Authority ◽  
False Positive ◽  
Screening Program ◽  
Local Health Authority ◽  
Local Health ◽  
False Positive Result

AbstractWe conducted a cross-sectional study to assess the likelihood of returning for routine breast cancer screening among women who have experienced a false-positive result (FPR) and to describe the possible individual and organizational factors that could influence subsequent attendance to the screening program. Several information were collected on demographic and clinical characteristics data. Electronic data from 2014 to 2016 related to breast screening program of the Local Health Authority (LHA) of Bologna (Italy) of women between 45 and 74 years old were reviewed. A total of 4847 women experienced an FPR during mammographic screening and were recalled to subsequent round; 80.2% adhered to the screening. Mean age was 54.2 ± 8.4 years old. Women resulted to be less likely to adhere to screening if they were not-Italian (p = 0.001), if they lived in the Bologna district (p < 0.001), if they had to wait more than 5 days from II level test to end of diagnostic procedures (p = 0.001), if the diagnostic tests were performed in a hospital with the less volume of activity and higher recall rate (RR) (p < 0.001) and if they had no previous participation to screening tests (p < 0.001). Our results are consistent with previous studies, and encourages the implementation and innovation of the organizational characteristics for breast cancer screening. The success of screening programs requires an efficient indicators monitoring strategy to develop and evaluate continuous improvement processes.

scholarly journals Use of Antiplatelet Agents Decreases the Positive Predictive Value of Fecal Immunochemical Tests for Colorectal Cancer but Does Not Affect Their Sensitivity

2021 ◽  
Vol 11 (6) ◽  
pp. 497
Author(s):  
Yoonsuk Jung ◽  
Eui Im ◽  
Jinhee Lee ◽  
Hyeah Lee ◽  
Changmo Moon
Keyword(s):  
Colorectal Cancer ◽  
Large Scale ◽  
Screening Program ◽  
Antiplatelet Agents ◽  
Population Based ◽  
Small Sample ◽  
Antithrombotic Agents ◽  
Predictive Values ◽  
Prescription Rates ◽  
Small Sample Sizes

Previous studies have evaluated the effects of antithrombotic agents on the performance of fecal immunochemical tests (FITs) for the detection of colorectal cancer (CRC), but the results were inconsistent and based on small sample sizes. We studied this topic using a large-scale population-based database. Using the Korean National Cancer Screening Program Database, we compared the performance of FITs for CRC detection between users and non-users of antiplatelet agents and warfarin. Non-users were matched according to age and sex. Among 5,426,469 eligible participants, 768,733 used antiplatelet agents (mono/dual/triple therapy, n = 701,683/63,211/3839), and 19,569 used warfarin, while 4,638,167 were non-users. Among antiplatelet agents, aspirin, clopidogrel, and cilostazol ranked first, second, and third, respectively, in terms of prescription rates. Users of antiplatelet agents (3.62% vs. 4.45%; relative risk (RR): 0.83; 95% confidence interval (CI): 0.78–0.88), aspirin (3.66% vs. 4.13%; RR: 0.90; 95% CI: 0.83–0.97), and clopidogrel (3.48% vs. 4.88%; RR: 0.72; 95% CI: 0.61–0.86) had lower positive predictive values (PPVs) for CRC detection than non-users. However, there were no significant differences in PPV between cilostazol vs. non-users and warfarin users vs. non-users. For PPV, the RR (users vs. non-users) for antiplatelet monotherapy was 0.86, while the RRs for dual and triple antiplatelet therapies (excluding cilostazol) were 0.67 and 0.22, respectively. For all antithrombotic agents, the sensitivity for CRC detection was not different between users and non-users. Use of antiplatelet agents, except cilostazol, may increase the false positives without improving the sensitivity of FITs for CRC detection.

scholarly journals Assisting scalable diagnosis automatically via CT images in the combat against COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bohan Liu ◽  
Pan Liu ◽  
Lutao Dai ◽  
Yanlin Yang ◽  
Peng Xie ◽  
...  
Keyword(s):  
Large Scale ◽  
Area Under The Curve ◽  
Independent Set ◽  
Reference Method ◽  
Ct Images ◽  
Loss Of Life ◽  
Case Identification ◽  
Reverse Transcription Pcr ◽  
Using Data

AbstractThe pandemic of Coronavirus Disease 2019 (COVID-19) is causing enormous loss of life globally. Prompt case identification is critical. The reference method is the real-time reverse transcription PCR (RT-PCR) assay, whose limitations may curb its prompt large-scale application. COVID-19 manifests with chest computed tomography (CT) abnormalities, some even before the onset of symptoms. We tested the hypothesis that the application of deep learning (DL) to 3D CT images could help identify COVID-19 infections. Using data from 920 COVID-19 and 1,073 non-COVID-19 pneumonia patients, we developed a modified DenseNet-264 model, COVIDNet, to classify CT images to either class. When tested on an independent set of 233 COVID-19 and 289 non-COVID-19 pneumonia patients, COVIDNet achieved an accuracy rate of 94.3% and an area under the curve of 0.98. As of March 23, 2020, the COVIDNet system had been used 11,966 times with a sensitivity of 91.12% and a specificity of 88.50% in six hospitals with PCR confirmation. Application of DL to CT images may improve both efficiency and capacity of case detection and long-term surveillance.

Toolkit for Epidemiologic Response to an Acute Chemical Release

2016 ◽  
Vol 10 (4) ◽  
pp. 631-632 ◽  
Author(s):  
Mary Anne Duncan ◽  
Maureen F. Orr
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Technical Assistance ◽  
Local Health ◽  
Toxic Substances ◽  
Public Health Action ◽  
Public Health Agencies ◽  
Chemical Release ◽  
State And Local ◽  
The Many

AbstractWhen a large chemical incident occurs and people are injured, public health agencies need to be able to provide guidance and respond to questions from the public, the media, and public officials. Because of this urgent need for information to support appropriate public health action, the Agency for Toxic Substances and Disease Registry (ATSDR) of the US Department of Health and Human Services has developed the Assessment of Chemical Exposures (ACE) Toolkit. The ACE Toolkit, available on the ATSDR website, offers materials including surveys, consent forms, databases, and training materials that state and local health personnel can use to rapidly conduct an epidemiologic investigation after a large-scale acute chemical release. All materials are readily adaptable to the many different chemical incident scenarios that may occur and the data needs of the responding agency. An expert ACE team is available to provide technical assistance on site or remotely. (Disaster Med Public Health Preparedness. 2016;10:631–632)

PHENYLKETONURIA, AND GUTHRIE INHIBITION ASSAY SCREENING PROCEDURE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (3) ◽  
pp. 344-346
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Human Genetics ◽  
Screening Program ◽  
Genetic Diseases ◽  
State Department ◽  
The State ◽  
Detection Methods ◽  
Inhibition Assay ◽  
Pilot Studies

Recommendations were made in view of the following facts: (1) the need for further information on the mechanisms involved in the phenotypic expressions of phenylketonuria; (2) the present lack of adequate data on the effectiveness of the Guthrie Inhibition Assay, in terms of number of cases which may be missed, factors making for positive determinations and providing other information on which to evaluate the appropriateness of the large-scale screening program proposed; (3) the undesirability of deploying inordinate resources in the evaluation of the Guthrie Inhibition Assay to the detriment of the needs of other areas of child health including phenylketonuria; (4) the indications that a multi-faceted approach to phenylketonuria would be productive, not only in resolving the problems involving this disorder but also as a model for the investigation of and application to the treatment of other genetic diseases; (5) the possibility that the Guthrie Inhibition Assay could be a useful tool in the early detection, treatment and investigation of phenylketonuria; and (6) the fact that other state health departments are participating in the Guthrie Field Trials, indicating that the California State Department of Public Health should apply its resources to a more intensive study of PKU and detection methods. The consultants made the following recommendations, through resolution, to the California State Department of Public Health. It was resolved that: 1. The State of California not be responsible at this time for initiating or recommending that the Guthrie procedure be accomplished on a state-wide basis in all newborn nurseries (one dissent). 2. The State of California initiate and coordinate the development of pilot studies in selected hospitals and medical centers throughout the State in the investigation of phenylketonuria, utilizing the Guthrie Inhibition Assay or other tests. 3. A scientific committee be appointed immediately as an advisory committee to the State Department of Public Health to develop recommendations for carrying out the suggested investigations. 4. A registry for phenylketonuria and other diseases (as listed in the recommendations by the Subcommittee on Human Genetics) be established within the framework of the State organization.

scholarly journals A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Patricia H. McNamara ◽  
Robert Coen ◽  
Janice Redmond ◽  
Colin P. Doherty ◽  
Colm Bergin
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cognitive Impairment ◽  
Large Scale ◽  
Screening Program ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Study Cohort ◽  
Cross Sectional ◽  
Positive Screen ◽  
Immunodeficiency Virus

Abstract Background Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. Methods This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. Results A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P &lt; .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. Conclusions The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training.

Referral patterns and patient characteristics at the first visit to a scoliosis center: a 2-year experience in South Korea without a school scoliosis-screening program

2018 ◽  
Vol 21 (4) ◽  
pp. 414-420
Author(s):  
Nam Ik Cho ◽  
Chang Ju Hwang ◽  
Ho Yeon Kim ◽  
Jong-Min Baik ◽  
Youn Suk Joo ◽  
...  
Keyword(s):  
Health Care ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
South Korea ◽  
Screening Program ◽  
Referral Rate ◽  
Referral Patterns ◽  
School Screening ◽  
Late Referral ◽  
Scoliosis Screening

OBJECTIVEThe need for scoliosis screening remains controversial. Nationwide school screening for scoliosis has not been performed in South Korea, and there are few studies on the referral patterns of patients suspected of having scoliosis. This study aimed to examine the referral patterns to the largest scoliosis center in South Korea in the absence of a school screening program and to analyze the factors that influence the appropriateness of referral.METHODSThe medical records of patients who visited a single scoliosis center for a spinal deformity evaluation were reviewed. Among 1895 new patients who visited this scoliosis center between April 2014 and March 2016, 1211 with presumed adolescent idiopathic scoliosis were included in the study. Patients were classified into 4 groups according to the referral method: non–health care provider, primary physician, hospital specialist, or school screening program. The appropriateness of referral was labeled as inappropriate, late, or appropriate. In total, 213 of 1211 patients were excluded because they had received treatment at another medical facility; 998 patients were evaluated to determine the appropriateness of referral.RESULTSOf the 998 referrals of new patients with presumed adolescent idiopathic scoliosis, 162 (16.2%) were classified as an inappropriate referral, 272 (27.3%) were classified as a late referral, and 564 (56.5%) were classified as an appropriate referral. Age, sex, Cobb angle of the major curve, and skeletal maturity were identified as statistically significant factors that correlated with the appropriateness of referral. The referral method did not correlate with the appropriateness of referral.CONCLUSIONSUnder the current health care system in South Korea, a substantial number of patients with presumed adolescent idiopathic scoliosis are referred either late or inappropriately to a tertiary medical center. Although patients referred by school screening programs had a significantly lower late referral rate and higher appropriate referral rate than the other 3 groups, the referral method was not a significant factor in terms of the appropriateness of referral.

scholarly journals The importance of an early alert from the Microbiology Laboratory and multidisciplinary collaboration during a suspected salmonellosis outbreak

2017 ◽  
Vol 32 (1) ◽  
Author(s):  
Adriano Anesi ◽  
Maria Lucia Panceri ◽  
Sara Asticcioli ◽  
Dominga Baroni ◽  
Vanina Rognoni ◽  
...  
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Food Industry ◽  
Large Scale ◽  
Regulatory Agencies ◽  
Local Health ◽  
Microbiology Laboratory ◽  
Food Borne ◽  
Local Health Service ◽  
Sporadic Cases

<em>Background and aims.</em> Salmonellosis is one of the most common and widely distributed food-borne diseases. The increasing complexity and globalization of the food industry are causing an increase of some of these large-scale food-borne illnesses, thus there is a need for improvements in public health signal detection and communication streams between laboratories and regulatory agencies. The aim of this study is to show how the early reporting of salmonellosis cases directly from the Laboratory of Microbiology to the Local Health Service Infectious Diseases Office along with the prompt response of the ASL, and the rapid involvement of the Local Veterinary Prevention Department resulted in an improved individuation and investigation of a suspected food-borne outbreak with anomalous manifestation. <br /><em>Materials and methods.</em> From August to November 2014 the early warning from the Laboratory of Microbiology regarding <em>Salmonella</em> spp. isolates with the identical serogroup and antibiotic resistance phenotype, allowed for prompt identification of a food-borne infection. <br /><em>Results and conclusions.</em> The genotyping analysis suggested that over the period considered there was more than a single monophasic <em>Salmonella</em> <em>typhimurium</em> isolate: one responsible for the sporadic cases that occurred in September and October, and another in November.

scholarly journals Taming the chaos: NHS professionals’ perspective of using video consulting during COVID-19 in Wales

2021 ◽  
Vol 10 (4) ◽  
pp. e001318
Author(s):  
Gemma Johns ◽  
Sara Khalil ◽  
Mike Ogonovsky ◽  
Markus Hesseling ◽  
Allan Wardhaugh ◽  
...  
Keyword(s):  
National Health Service ◽  
Large Scale ◽  
Future Research ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Wide Range ◽  
Early Use ◽  
Observational Study Design ◽  
The Uk

The use of video consulting (VC) in the UK has expanded rapidly during the COVID-19 pandemic. Technology Enabled Care (TEC) Cymru, the Welsh Government and Local Health boards began implementing the National Health Service (NHS) Wales VC Service in March 2020. This has been robustly evaluated on a large-scale All-Wales basis, across a wide range of NHS Wales specialities.AimsTo understand the early use of VC in Wales from the perspective of NHS professionals using it. NHS professionals were approached by TEC Cymru to provide early data.MethodsUsing an observational study design with descriptive methods including a cross-sectional survey, TEC Cymru captured data on the use, benefits and challenges of VC from NHS professionals in Wales during August and September 2020. This evidence is based on the rapid adoption of VC in Wales, which mirrors that of other nations.ResultsA total of 1256 NHS professionals shared their VC experience. Overall, responses were positive, and professionals expressed optimistic views regarding the use and benefit of VC, even when faced with challenges on occasions.ConclusionsThis study provides evidence of general positivity, acceptance and the success of the VC service in Wales. Future research studies will now be able to explore and evaluate the implementation methods used within this study, and investigate their effectiveness in being able to achieve better outcomes through VC.

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