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NCCID Alert:
Public Health Approaches to Infectious Disease Prevention & Control
September 10, 2018
Focusing on practices and policies which serve to move beyond individual diseases to more global methods of understanding and approaching public health.

New at NCCID

NCCID Webinar on Multi Drug Resistance in Refugee Population to learn from European experience

Title : “Multi Drug Resistance in Refugee Population: Lessons to Learn from Europe”
Date : September 12, 2018; 12:00 PM - 1:00 PM (CDT) (1 pm – 2 pm EDT)
Speaker : Dr. Helena Maltezou, Pediatrician – Infectious Diseases Specialist, Athens – Greece
The National Collaborating Centre for Infectious Diseases (NCCID) continues its series of public health webinars on refugee health. This upcoming webinar will offer an overview to public health physicians and policy makers in Canada on the rising issue of multi drug resistance in refugee population in European Union countries. Over the past decade, the Middle East and Southeastern Europe have witnessed an enormous influx of refugees due to the Syrian war and conflicts in Asia and Africa. Data indicate that refugees carry a significant burden of multi-drug resistant strains, which is attributed to the rising antimicrobial resistance rates in their countries of origin, both in healthcare settings and in the community. This webinar will present the available data on anti-microbial resistance in refugees and migrants and the public health implications in the frame of the current refugee crisis in Europe. In addition, issues of microbiological screening and infection control will also be addressed.
Participants will have a chance to discuss problems and practical issues in an interactive Q & A session following the presentation.
More information & registration here:
NCCID TB Performance Indicators Projects to help eliminate Tuberculosis in Canada

NCCID is undertaking a series of projects on Tuberculosis elimination performance indicators in Canada. Stay tuned for upcoming products and resources. In the meantime, feel free to take a look at this recent commentary in the “Canadian Journal of Public Health” by authors Courtney Heffernan and Richard Long on TB program performance indicators in Canada.

Title of article : Would program performance indicators and a nationally coordinated response accelerate the elimination of tuberculosis in Canada?
Authors : Courtney Heffernan and Richard Long.
Source : Canadian Journal of Public Health, 16 July 2018
“Twenty years ago, a National Consensus Conference on Tuberculosis (TB) recommended that the provinces and territories of Canada jointly declare a commitment to TB elimination with national coordination and assured funding, executed by a committee of federal and provincial/territorial representatives. Canada has committed to the global TB elimination targets set forth by the World Health Organization but lacks a coordinated response. In particular, with the exception of one published and implemented by Indigenous Services Canada, there has been no national monitoring and performance framework. Herein, we provide a commentary on the importance, to TB elimination in Canada, of developing such a framework. We invite a debate about whether more can and should be done to monitor and report for action at every jurisdictional level. Of utmost importance will be the need to achieve consensus from stakeholders about what is measured, among whom, how often, who collects and processes data, and how to respond to the successes and failures those data indicate. Insofar, as performance targets are well defined and implemented, national progress towards tuberculosis elimination should accelerate”.
Across the Web
  1. The Health Innovation We Need / Dave A. Chokshi, MD, Msc. JAMA, 2018 (320)5. 427-429.
The word innovation is omnipresent in health and health care, describing new uses of technology and data, entrepreneurial ventures, and public sector efforts. Given the many challenges in the US health sector-including decreasing life expectancy, increasing costs, declining rates of health coverage, and potentially widening health disparities-new approaches are undoubtedly needed. But innovation is often tantamount to small-scale pilot projects or to digital tools mismatched with clinical realities, as seen with the electronic health record and clinician burnout.
  1. Many Canadian health facilities unprepared for disasters / Lauren Vogel. CMAJ. 16 August 2018
According to Dr. Daniel Kollek, director of the Centre for Excellence in Emergency Preparedness at McMaster University, frontline workers have repeatedly expressed serious concerns about the ability of the health system to respond in a disaster. Part of the problem is an assumption that disasters won’t happen here. This level of preparedness, that isn’t the norm across Canada, let alone in community practice, where physicians are sometimes caught off guard by even routine emergencies.
  1. Now we’re talking: bringing a voice to digital medicine / Steven R. Steinhubl, Erin J. Topol. The Lancet, vol. 392, issue 10148, August 25, 2018.
Communication-respectful, honest, accurate, and individualised-is the cornerstone of effective health care. But such communication can be near impossible to receive in a location convenient for the individual, and even after travelling to a primary care visit it will typically last less than 5 min for half of the world's population. Consequently, communication with health-care providers is too often relegated to sickness care in response to one consultation rather than to overall health management. There's potential for voice-powered virtual medical assistants to change that.
  1. Internet-based interventions for people with HIV and depression / Eirini Karyotaki. The Lancet HIV, 19 August 2018.
Many people with HIV have depression or depressive symptoms.This comorbidity might prevent individuals from accessing HIV care, result in poor adherence to antiretroviral therapy, accelerate disease progression, and increase the risk of suicide.The provision of effective depression treatment is therefore of high importance. However, not many people with HIV who have depression seek or receive treatment for their psychological condition, mostly because of perceived stigma.Internet-based psychotherapeutic interventions offer a potentially low-cost, easily accessible, flexible, and confidential treatment option for depressive symptoms.Several studies have demonstrated the effectiveness of internet-based interventions in treating depressive symptoms in the general population. Additionally, several trials have shown that this type of treatment seems to be effective for patients with primary somatic disease who have depressive symptoms.
  1. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study / Mai Stafford, PhD; Christian von Wagner, PhD; Sarah Perman, MSc; Jayne Taylor, MPH; Diana Kuh, PhD; Jessica Sheringham, PhD. The Lancet Public Health, 21 August 2018.
This paper aimed to examine poor social connectedness as a possible barrier to participation in preventive health services among older people (aged 53–69 years). As methods used, authors analysed data from a prospective cohort study of 5362 socially stratified births from the Medical Research Council National Survey of Health and Development enrolled in England, Scotland, and Wales in March 1946. At ages 68–69 years, participants reported participation in blood pressure and cholesterol measurement, eyesight and dental check-ups, influenza immunisation, and bowel and breast cancer screening. Our primary outcome measure summed participation across all these tests and services at ages 68–69 years. They also tested associations between structural and functional social connectedness from ages 53 years to 69 years and total count of participation in these preventive services in Poisson models controlling for sex, education, occupational class, employment, chronic illnesses, and general practitioner consultations for health problems.
  1. Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis / Laura B. Nellum, PhD; Hayley Thompson, MPH; Prof. Alison Holme.The Lancet Infectious Diseases, vol. 18, issue 7, July 2018. Pp. 796-811.
This systematic review and meta-analysis aim at identifying and synthesising data for AMR carriage or infection in migrants to Europe and to examine differences in patterns of AMR across migrant groups and in different settings. The authors searched in MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries.
NCCID is one of six National Collaborating Centres for Public Health funded by the Public Health Agency of Canada (PHAC).
Production of this newsletter has been made possible through a financial contribution from PHAC. The views expressed herein do not necessarily represent the views of PHAC.

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