The Experts below are selected from a list of 52281 Experts worldwide ranked by ideXlab platform
Ran D. Balicer - One of the best experts on this subject based on the ideXlab platform.
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characterizing hospital workers willingness to report to duty in an Influenza Pandemic through threat and efficacy based assessment
BMC Public Health, 2010Co-Authors: Ran D. Balicer, Daniel J Barnett, Carol B Thompson, Christina L Catlett, Christopher M Watson, Natalie L Semon, Howard Gwon, Jonathan M LinksAbstract:Background Hospital-based providers' willingness to report to work during an Influenza Pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff.
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gauging u s emergency medical services workers willingness to respond to Pandemic Influenza using a threat and efficacy based assessment framework
PLOS ONE, 2010Co-Authors: Daniel J Barnett, Carol B Thompson, Jonathan M Links, Roger Levine, Gamunu U Wijetunge, Anthony L Oliver, Melissa A Bentley, Patrick D Neubert, Ronald G Pirrallo, Ran D. BalicerAbstract:Background Emergency Medical Services workers' willingness to report to duty in an Influenza Pandemic is essential to healthcare system surge amidst a global threat. Application of Witte's Extended Parallel Process Model (EPPM) has shown utility for revealing influences of perceived threat and efficacy on non-EMS public health providers' willingness to respond in an Influenza Pandemic. We thus propose using an EPPM-informed assessment of EMS workers' perspectives toward fulfilling their Influenza Pandemic response roles. Methodology/Principal Findings We administered an EPPM-informed snapshot survey about attitudes and beliefs toward Pandemic Influenza response, to a nationally representative, stratified random sample of 1,537 U.S. EMS workers from May–June 2009 (overall response rate: 49%). Of the 586 respondents who met inclusion criteria (currently active EMS providers in primarily EMS response roles), 12% indicated they would not voluntarily report to duty in a Pandemic Influenza emergency if asked, 7% if required. A majority (52%) indicated their unwillingness to report to work if risk of disease transmission to family existed. Confidence in personal safety at work (OR = 3.3) and a high threat/high efficacy (“concerned and confident”) EPPM profile (OR = 4.7) distinguished those who were more likely to voluntarily report to duty. Although 96% of EMS workers indicated that they would probably or definitely report to work if they were guaranteed a Pandemic Influenza vaccine, only 59% had received an Influenza immunization in the preceding 12 months. Conclusions/Significance EMS workers' response willingness gaps pose a substantial challenge to prehospital surge capacity in an Influenza Pandemic. “Concerned and confident” EMS workers are more than four times as likely to fulfill Pandemic Influenza response expectations. Confidence in workplace safety is a positively influential modifier of their response willingness. These findings can inform insights into interventions for enhancing EMS workers' willingness to respond in the face of a global infectious disease threat.
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local public health workers perceptions toward responding to an Influenza Pandemic
BMC Public Health, 2006Co-Authors: Ran D. Balicer, Daniel J Barnett, Saad B Omer, George S EverlyAbstract:Current national preparedness plans require local health departments to play an integral role in responding to an Influenza Pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward Pandemic Influenza response, we surveyed 308 employees at three health departments in Maryland from March – July 2005, on factors that may influence their ability and willingness to report to duty in such an event. The data suggest that nearly half of the local health department workers are likely not to report to duty during a Pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3–4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6–19.9). The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to Pandemic Influenza response and must be specifically addressed to enable effective local public health response to this significant threat.
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Cost-Benefit of Stockpiling Drugs for Influenza Pandemic
Emerging Infectious Diseases, 2005Co-Authors: Ran D. Balicer, Michael Huerta, Nadav Davidovitch, Itamar GrottoAbstract:We analyzed strategies for the use of stockpiled antiviral drugs in the context of a future Influenza Pandemic and estimated cost-benefit ratios. Current stockpiling of oseltamivir appears to be cost-saving to the economy under several treatment strategies, including therapeutic treatment of patients and postexposure prophylactic treatment of patients' close contacts.
Daniel J Barnett - One of the best experts on this subject based on the ideXlab platform.
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characterizing hospital workers willingness to report to duty in an Influenza Pandemic through threat and efficacy based assessment
BMC Public Health, 2010Co-Authors: Ran D. Balicer, Daniel J Barnett, Carol B Thompson, Christina L Catlett, Christopher M Watson, Natalie L Semon, Howard Gwon, Jonathan M LinksAbstract:Background Hospital-based providers' willingness to report to work during an Influenza Pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff.
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gauging u s emergency medical services workers willingness to respond to Pandemic Influenza using a threat and efficacy based assessment framework
PLOS ONE, 2010Co-Authors: Daniel J Barnett, Carol B Thompson, Jonathan M Links, Roger Levine, Gamunu U Wijetunge, Anthony L Oliver, Melissa A Bentley, Patrick D Neubert, Ronald G Pirrallo, Ran D. BalicerAbstract:Background Emergency Medical Services workers' willingness to report to duty in an Influenza Pandemic is essential to healthcare system surge amidst a global threat. Application of Witte's Extended Parallel Process Model (EPPM) has shown utility for revealing influences of perceived threat and efficacy on non-EMS public health providers' willingness to respond in an Influenza Pandemic. We thus propose using an EPPM-informed assessment of EMS workers' perspectives toward fulfilling their Influenza Pandemic response roles. Methodology/Principal Findings We administered an EPPM-informed snapshot survey about attitudes and beliefs toward Pandemic Influenza response, to a nationally representative, stratified random sample of 1,537 U.S. EMS workers from May–June 2009 (overall response rate: 49%). Of the 586 respondents who met inclusion criteria (currently active EMS providers in primarily EMS response roles), 12% indicated they would not voluntarily report to duty in a Pandemic Influenza emergency if asked, 7% if required. A majority (52%) indicated their unwillingness to report to work if risk of disease transmission to family existed. Confidence in personal safety at work (OR = 3.3) and a high threat/high efficacy (“concerned and confident”) EPPM profile (OR = 4.7) distinguished those who were more likely to voluntarily report to duty. Although 96% of EMS workers indicated that they would probably or definitely report to work if they were guaranteed a Pandemic Influenza vaccine, only 59% had received an Influenza immunization in the preceding 12 months. Conclusions/Significance EMS workers' response willingness gaps pose a substantial challenge to prehospital surge capacity in an Influenza Pandemic. “Concerned and confident” EMS workers are more than four times as likely to fulfill Pandemic Influenza response expectations. Confidence in workplace safety is a positively influential modifier of their response willingness. These findings can inform insights into interventions for enhancing EMS workers' willingness to respond in the face of a global infectious disease threat.
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local public health workers perceptions toward responding to an Influenza Pandemic
BMC Public Health, 2006Co-Authors: Ran D. Balicer, Daniel J Barnett, Saad B Omer, George S EverlyAbstract:Current national preparedness plans require local health departments to play an integral role in responding to an Influenza Pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward Pandemic Influenza response, we surveyed 308 employees at three health departments in Maryland from March – July 2005, on factors that may influence their ability and willingness to report to duty in such an event. The data suggest that nearly half of the local health department workers are likely not to report to duty during a Pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3–4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6–19.9). The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to Pandemic Influenza response and must be specifically addressed to enable effective local public health response to this significant threat.
Neil M Ferguson - One of the best experts on this subject based on the ideXlab platform.
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closure of schools during an Influenza Pandemic
Lancet Infectious Diseases, 2009Co-Authors: Simon Cauchemez, Neil M Ferguson, Claude Wachtel, Anders Tegnell, Guillaume Saour, Ben Duncan, Angus NicollAbstract:In response to WHO raising the Influenza Pandemic alert level from phase five to phase six, health officials around the world are carefully reviewing Pandemic mitigation protocols. School closure (also called class dismissal in North America) is a non-pharmaceutical intervention that is commonly suggested for mitigating Influenza Pandemics. Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues, and the possible disruption of key services such as health care. Also, if schools are expected to close as a deliberate policy option, or just because of high levels of staff absenteeism, it is important to plan to mitigate the negative features of closure. In this context, there is still debate about if, when, and how school closure policy should be used. In this Review, we take a multidisciplinary and holistic perspective and review the multiple aspects of school closure as a public health policy. Implications for the mitigation of the swine-origin Influenza A H1N1 Pandemic are also discussed.
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face mask use and control of respiratory virus transmission in households
Emerging Infectious Diseases, 2009Co-Authors: Raina C Macintyre, Simon Cauchemez, Dominic E Dwyer, Holly Seale, Pamela Cheung, Gary J Browne, Michael Fasher, James G Wood, Robert Booy, Neil M FergusonAbstract:Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an Influenza Pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of Influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time. We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease. However, during a severe Pandemic when use of face masks might be greater, Pandemic transmission in households could be reduced. Many countries are stockpiling face masks for use as nonpharmaceutical interventions to reduce viral transmission during an Influenza Pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of Influenza-like illness (ILI) in households. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. Intent-to-treat analysis showed no significant difference in the relative risk of ILI in the mask use groups compared with the control group; however, <50% of those in the mask use groups reported wearing masks most of the time. Adherence to mask use was associated with a significantly reduced risk of ILI-associated infection. We concluded that household use of masks is associated with low adherence and is ineffective in controlling seasonal ILI. If adherence were greater, mask use might reduce transmission during a severe Influenza Pandemic.
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the effect of public health measures on the 1918 Influenza Pandemic in u s cities
Proceedings of the National Academy of Sciences of the United States of America, 2007Co-Authors: Martin C J Bootsma, Neil M FergusonAbstract:During the 1918 Influenza Pandemic, the U.S., unlike Europe, put considerable effort into public health interventions. There was also more geographic variation in the autumn wave of the Pandemic in the U.S. compared with Europe, with some cities seeing only a single large peak in mortality and others seeing double-peaked epidemics. Here we examine whether differences in the public health measures adopted by different cities can explain the variation in epidemic patterns and overall mortality observed. We show that city-specific per-capita excess mortality in 1918 was significantly correlated with 1917 per-capita mortality, indicating some intrinsic variation in overall mortality, perhaps related to sociodemographic factors. In the subset of 23 cities for which we had partial data on the timing of interventions, an even stronger correlation was found between excess mortality and how early in the epidemic interventions were introduced. We then fitted an epidemic model to weekly mortality in 16 cities with nearly complete intervention-timing data and estimated the impact of interventions. The model reproduced the observed epidemic patterns well. In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early. San Francisco, St. Louis, Milwaukee, and Kansas City had the most effective interventions, reducing transmission rates by up to 30–50%. Our analysis also suggests that individuals reactively reduced their contact rates in response to high levels of mortality during the Pandemic.
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strategies for mitigating an Influenza Pandemic
Nature, 2006Co-Authors: Neil M Ferguson, Christophe Fraser, Derek A T Cummings, James Cajka, Philip C Cooley, Donald S BurkeAbstract:Development of strategies for mitigating the severity of a new Influenza Pandemic is now a top global public health priority. Influenza prevention and containment strategies can be considered under the broad categories of antiviral, vaccine and non-pharmaceutical (case isolation, household quarantine, school or workplace closure, restrictions on travel) measures. Mathematical models are powerful tools for exploring this complex landscape of intervention strategies and quantifying the potential costs and benefits of different options. Here we use a large-scale epidemic simulation to examine intervention options should initial containment of a novel Influenza outbreak fail, using Great Britain and the United States as examples. We find that border restrictions and/or internal travel restrictions are unlikely to delay spread by more than 2-3 weeks unless more than 99% effective. School closure during the peak of a Pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact, if feasible. Treatment of clinical cases can reduce transmission, but only if antivirals are given within a day of symptoms starting. Given enough drugs for 50% of the population, household-based prophylaxis coupled with reactive school closure could reduce clinical attack rates by 40-50%. More widespread prophylaxis would be even more logistically challenging but might reduce attack rates by over 75%. Vaccine stockpiled in advance of a Pandemic could significantly reduce attack rates even if of low efficacy. Estimates of policy effectiveness will change if the characteristics of a future Pandemic strain differ substantially from those seen in past Pandemics.
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strategies for mitigating an Influenza Pandemic
Nature, 2006Co-Authors: Neil M Ferguson, Christophe Fraser, Derek A T Cummings, James Cajka, Philip C Cooley, Donald S BurkeAbstract:Numerical models of the epidemiology of a potential flu Pandemic show there is no single magic bullet which can control the outbreak, but that a combination of approaches could reduce transmission and save many lives. Border restrictions are unlikely to have much effect and travel restrictions within one country would make very little difference to the spread of a Pandemic within that country. The models predict that a Pandemic in the United Kingdom would peak within two to three months of the first case, and be over within 4 months. It also shows that vaccines need to be available within two months of the start of a Pandemic to have a big effect in reducing infection rates. That means that vaccines would need to be stockpiled in advance to be effective. Development of strategies for mitigating the severity of a new Influenza Pandemic is now a top global public health priority. Influenza prevention and containment strategies can be considered under the broad categories of antiviral, vaccine and non-pharmaceutical (case isolation, household quarantine, school or workplace closure, restrictions on travel) measures1. Mathematical models are powerful tools for exploring this complex landscape of intervention strategies and quantifying the potential costs and benefits of different options2,3,4,5. Here we use a large-scale epidemic simulation6 to examine intervention options should initial containment6,7 of a novel Influenza outbreak fail, using Great Britain and the United States as examples. We find that border restrictions and/or internal travel restrictions are unlikely to delay spread by more than 2–3 weeks unless more than 99% effective. School closure during the peak of a Pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact, if feasible. Treatment of clinical cases can reduce transmission, but only if antivirals are given within a day of symptoms starting. Given enough drugs for 50% of the population, household-based prophylaxis coupled with reactive school closure could reduce clinical attack rates by 40–50%. More widespread prophylaxis would be even more logistically challenging but might reduce attack rates by over 75%. Vaccine stockpiled in advance of a Pandemic could significantly reduce attack rates even if of low efficacy. Estimates of policy effectiveness will change if the characteristics of a future Pandemic strain differ substantially from those seen in past Pandemics.
Jonathan M Links - One of the best experts on this subject based on the ideXlab platform.
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characterizing hospital workers willingness to report to duty in an Influenza Pandemic through threat and efficacy based assessment
BMC Public Health, 2010Co-Authors: Ran D. Balicer, Daniel J Barnett, Carol B Thompson, Christina L Catlett, Christopher M Watson, Natalie L Semon, Howard Gwon, Jonathan M LinksAbstract:Background Hospital-based providers' willingness to report to work during an Influenza Pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM) has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff.
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gauging u s emergency medical services workers willingness to respond to Pandemic Influenza using a threat and efficacy based assessment framework
PLOS ONE, 2010Co-Authors: Daniel J Barnett, Carol B Thompson, Jonathan M Links, Roger Levine, Gamunu U Wijetunge, Anthony L Oliver, Melissa A Bentley, Patrick D Neubert, Ronald G Pirrallo, Ran D. BalicerAbstract:Background Emergency Medical Services workers' willingness to report to duty in an Influenza Pandemic is essential to healthcare system surge amidst a global threat. Application of Witte's Extended Parallel Process Model (EPPM) has shown utility for revealing influences of perceived threat and efficacy on non-EMS public health providers' willingness to respond in an Influenza Pandemic. We thus propose using an EPPM-informed assessment of EMS workers' perspectives toward fulfilling their Influenza Pandemic response roles. Methodology/Principal Findings We administered an EPPM-informed snapshot survey about attitudes and beliefs toward Pandemic Influenza response, to a nationally representative, stratified random sample of 1,537 U.S. EMS workers from May–June 2009 (overall response rate: 49%). Of the 586 respondents who met inclusion criteria (currently active EMS providers in primarily EMS response roles), 12% indicated they would not voluntarily report to duty in a Pandemic Influenza emergency if asked, 7% if required. A majority (52%) indicated their unwillingness to report to work if risk of disease transmission to family existed. Confidence in personal safety at work (OR = 3.3) and a high threat/high efficacy (“concerned and confident”) EPPM profile (OR = 4.7) distinguished those who were more likely to voluntarily report to duty. Although 96% of EMS workers indicated that they would probably or definitely report to work if they were guaranteed a Pandemic Influenza vaccine, only 59% had received an Influenza immunization in the preceding 12 months. Conclusions/Significance EMS workers' response willingness gaps pose a substantial challenge to prehospital surge capacity in an Influenza Pandemic. “Concerned and confident” EMS workers are more than four times as likely to fulfill Pandemic Influenza response expectations. Confidence in workplace safety is a positively influential modifier of their response willingness. These findings can inform insights into interventions for enhancing EMS workers' willingness to respond in the face of a global infectious disease threat.
Douglas Almond - One of the best experts on this subject based on the ideXlab platform.
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is the 1918 Influenza Pandemic over long term effects of in utero Influenza exposure in the post 1940 u s population
Journal of Political Economy, 2006Co-Authors: Douglas AlmondAbstract:This paper uses the 1918 Influenza Pandemic as a natural experiment for testing the fetal origins hypothesis. The Pandemic arrived unexpectedly in the fall of 1918 and had largely subsided by January 1919, generating sharp predictions for long‐term effects. Data from the 1960–80 decennial U.S. Census indicate that cohorts in utero during the Pandemic displayed reduced educational attainment, increased rates of physical disability, lower income, lower socioeconomic status, and higher transfer payments compared with other birth cohorts. These results indicate that investments in fetal health can increase human capital.