11. Electronic Surveillance Criteria for Non-Ventilator HAP: Empiric testing and Chart Review at Veterans Affairs Facilities

Background Surveillance of Non-Ventilator Hospital-Acquired Pneumonia (NV-HAP) is limited by the ambiguity in diagnosing pneumonia. We implemented electronic surveillance criteria for NV-HAP across the VA healthcare system and tested for reliability, validity and meaning of the electronic criteria vs manual chart review. Methods We defined NV-HAP surveillance criteria as oxygen deterioration concurrent with fever or abnormal WBC count, ≥3 days of antibiotics, and orders for chest imaging. We applied these criteria to EHR data from all patients hospitalized ≥3 days at all VA acute care facilities from 1/1/2015-12/31/2020 and calculated NV-HAP incidence and inpatient mortality. Clinician reviewers used a consensus review guide to independently review and adjudicate 47 cases meeting NV-HAP surveillance criteria for 1) clinical deterioration, 2) CDC-NHSN pneumonia criteria, 3) treating clinicians’ assessment, and 4) reviewer’s diagnosis. All reviewers subsequently adjudicated all cases and conducted an error analysis to identify sources of discordance. Results Among 2.3M hospitalizations, 14,023 met NV-HAP surveillance criteria (0.6 per 100 admissions). Inpatient mortality was 26% (vs 2% for non-flagged hospitalizations). Among 47 hospitalizations flagged by surveillance criteria, 45 (97%) had a confirmed clinical deterioration, (the other 2 were immediate post-operative cases), 20 (43%) met CDC-NHSN pneumonia criteria, 21 (47%) had possible pneumonia per treating clinicians, and 25 (53%) had possible or probable NV-HAP per reviewers. Agreement among the 3 reviewers before adjudication was 51% (Fleiss’ κ 0.43) for CDC-NHSN and 58% (Fleiss’ κ 0.33) for NV-HAP. The most common source of discordance between reviewers was chest imaging classification (15/19 discordant cases). Conclusion NV-HAP electronic surveillance criteria demonstrated high precision for identifying clinical deterioration and moderate concordance with CDC-NHSN pneumonia criteria or reviewer diagnosis. Agreement between electronic surveillance criteria vs manual chart review was low but similar to agreement amongst manual reviewers applying NHSN criteria. Electronic surveillance may provide greater consistency than human review while facilitating wide-scale automated surveillance. Disclosures Chanu Rhee, MD, MPH, UpToDate (Other Financial or Material Support, Chapter Author) Michael Klompas, MD, MPH, UpToDate (Other Financial or Material Support, Chapter Author)

Electronic surveillance system for COVID-19 virus management in Palestine- an observational study

This research investigated the performance of the electronic surveillance system of COVID 19 and assessed its key attributes. The research results for the overall system performance were good (82.81%). The highest attribute score was 100% for representativeness and data completeness and the lowest score was 75.30% for acceptability. The COVID-19 surveillance system is generally simple and accepted by users, although the instability of electricity and the Internet, the benefit from the training on the system, and the lack of willingness to participate in the system at the health facility level had the greatest impact on simplicity and acceptability scores. The quality and completeness of the data enabled stakeholders to carry out the most effective prevention and control activities. System developers indicated that the system has achieved the desired benefit, due to the flexibility and stability of the system and comprehensiveness of geographical coverage.

CRIMINAL LIABILITY RELATED TO THE SYSTEM OF ELECTRONIC SURVEILLANCE AND CIRCUMSTANCES IN WHICH SENTENCED PERSON AVOIDS PERFORMING DUTIES ORDERED BY THE COURT

The crucial aim of this article is to indicate grounds of legal liability connected with situations in which person sentenced to penalty, punitive measure or safeguard measure, within the system of electronic surveillance, violates certain duties. Considerations concerning the aforementioned issues are preceded by the analysis on the essence of the electronic surveillance, reasons for its implementation into the applicable legal system and means of its usage related to legal instruments of penal reaction to perpetrator’s behavior. Moreover, author of the article analyses legal character of the prison sentence performed with the usage of electronic surveillance. This constitutes starting point for answering practically important question: whether leaving the place of performing prison sentence within the system of electronic surveillance can be qualified as the offence of self-release, determined in art. 242 § 1 of the Criminal Code. At the end of the article, author presents de lege ferenda postulates concerning normative solution related to the legal ground of qualifying behaviors consisting in avoiding electronic surveillance.

Fireworks Injuries to the Head and Neck: A Retrospective Analysis Between 2008 and 2017

Background This study examines firework-associated head and neck injuries in the United States from 2008 to 2017 obtained from a single epidemiology source. Methods The National Electronic Surveillance System was used to collect epidemiologic data and retrospectively analyze firework-associated injuries from 2008 to 2017. Injury types included burns, concussions, contusions, foreign bodies, hematomas, internal organ injury, lacerations, and puncture wounds. 431 individuals were originally included, however, 14 participants were excluded due to inadequate injury information. Chi-squared analyses were performed between the following categorical variables: gender versus body part injured, patient age versus injury type, and patient age versus body part injured. Results 417 injuries to the head and neck (67.4% male, 32.6% female) were treated in National Electronic Surveillance System-reporting emergency departments during the 10-year period. 69% of the injuries occurred in July. Body parts injured included the ear (10.6%), face (61.6%), head (13.0%), mouth (4.8%), and neck (10.0%). Chi-squared analysis demonstrated an association between gender and body part injured (p=0.0001). Patient age (p=0.066) was independent of injury type. Children aged 0-12 years had the highest probability of being injured (40.2%), then adults 22+ (33.1%) and adolescents 13-21 years (26.9%). Conclusions Given that the preponderance of injuries caused by fireworks occurred primarily in minors, pediatricians should screen for any household firework use during the anticipatory guidance portion of well-child checks, which we believe would improve patient safety and decrease injury rates.

WORK (CYBER) BULLYİNG, POWER IMBALANCES AND VİCTİMİZATİON: A REVİEW ON PANOPTİC METAPHOR AND EMPLOYEE SURVEİLLANCE İN INDİAN WORKPLACES

The dominant interpretation of electronic surveillance in the workplace focusing mainly on the invasion of privacy does not give sufficient explanation of its various and nuanced underpinnings and other adverse effects. Likewise, harassment or bullying in the workplace has been at the forefront of major concerns of organizations and employees for several decades and is currently more prevalent and opaque. Combining these two factors and through a methodical revisit of the metaphor of the Panopticon, this paper aims to examine its relevance for the analysis of modern electronic surveillance used in the workplace, and sparks discussion around the issue of workplace bullying and the consequent control mechanism, power imbalances and victimization, with a special focus and application on Indian scenario. This research exposes the unfair and unjustifiable victimization of workplace bullying by going beyond Foucault’s concept of “disciplinary society,” according to which persons are “normalized” by their categorical locations, as well as beyond Deleuze’s argument of “society of control,” where people are forced to live in circumscribed parameters. It is an exploratory research that follows an analytic research methodology of theoretical analysis (literature reviews) and critical discourse analysis. Persistent victimization is relayed as a co-existent phenomenon of workplace bullying.

Perception of the health surveillance users on the health electronic surveillance network (HESN), Saudi Arabia, 2016

Background The established aim of the Saudi Health Electronic Surveillance Network (HESN) is to support the prevention and control of different health events, and to facilitate the delivery of other public health programs. This study aims to evaluate the perceptions of active HESN users regarding its general performance through five major components: practicability, design, data and communication, technical support, and general impression. Methods A cross-sectional study was conducted in 2016 using a sample of active HESN users. Out of 1535 active users, 700 were randomly selected. A predesigned electronic questionnaire was sent to each participant via email which was completed by 485 participants. Different composite scores were calculated and compared to the sociodemographic and other technical variables. Results The mean age of the participants was 36.92 ± 9.12 (24–65 years), and 57.8% of the sample were male. Riyadh and the KSA’s eastern province represented the highest two regions of participation, at (18.4%) and (14.2%) participants, respectively. About 70.8% were generally satisfied with HESN, while 86.6%% believed that it is better than the traditional paper-work system. Participants who used to work more frequently expressed more level of satisfaction compared to those with minimal use per week or month (P ≤ 0.001). Internet speed displayed a significant association with the general level of satisfaction with HESN (P < 0.001). Additionally, users who accessed HESN with the Google Chrome browser displayed higher levels of satisfaction when compared to users who relied on other browsers (P = 0.003). Conclusion Presently, the level of user satisfaction with HESN is reasonable. However, to achieve optimal outcomes for HESN usage, improvements should be considered.

Electronic Surveillance and Security Applications of Magnetic Microwires

Applications in security and electronic surveillance require a combination of excellent magnetic softness with good mechanical and anticorrosive properties and low dimensionality. We overviewed the feasibility of using glass-coated microwires for electronic article surveillance and security applications, as well as different routes of tuning the magnetic properties of individual microwires or microwire arrays, making them quite attractive for electronic article surveillance and security applications. We provide the routes for tuning the hysteresis loops’ nonlinearity by the magnetostatic interaction between the microwires in the arrays of different types of amorphous microwires. The presence of neighboring microwire (either Fe- or Co-based) significantly affects the hysteresis loop of the whole microwires array. In a microwires array containing magnetically bistable microwires, we observed splitting of the initially rectangular hysteresis loop with a number of Barkhausen jumps correlated with the number of magnetically bistable microwires. Essentially, nonlinear and irregular hysteresis loops have been observed in mixed arrays containing Fe- and Co-rich microwires. The obtained nonlinearity in hysteresis loops allowed to increase the harmonics and tune their magnetic field dependencies. On the other hand, several routes allowing to tune the switching field by either postprocessing or modifying the magnetoelastic anisotropy have been reviewed. Nonlinear hysteresis loops have been also observed upon devitrification of amorphous microwires. Semihard magnetic microwires have been obtained by annealing of Fe–Pt–Si microwires. The observed unique combination of magnetic properties together with thin dimensions and excellent mechanical and anticorrosive properties provide excellent perspectives for the use of glass-coated microwires for security and electronic surveillance applications.