COVID-19 research priorities for non-pharmaceutical public health and social measures.

Europe is in the midst of a COVID-19 epidemic and a number of non-pharmaceutical public health and social measures have been implemented, in order to contain the transmission of severe acute respiratory syndrome coronavirus 2. These measures are fundamental elements of the public health approach to controlling transmission but have proven not to be sufficiently effective. Therefore, the European Centre for Disease Prevention and Control has conducted an assessment of research gaps that can help inform policy decisions regarding the COVID-19 response. We have identified research gaps in the area of non-pharmaceutical measures, physical distancing, contact tracing, transmission, communication, mental health, seasonality and environment/climate, surveillance and behavioural aspects of COVID-19. This prioritisation exercise is a step towards the global efforts of developing a coherent research road map in coping with the current epidemic but also developing preparedness measures for the next unexpected epidemic.

National outbreak of Yersinia enterocolitica infections in military and civilian populations associated with consumption of mixed salad, Norway, 2014.

In May 2014, a cluster of Yersinia enterocolitica (YE) O9 infections was reported from a military base in northern Norway. Concurrently, an increase in YE infections in civilians was observed in the Norwegian Surveillance System for Communicable Diseases. We investigated to ascertain the extent of the outbreak and identify the source in order to implement control measures. A case was defined as a person with laboratory-confirmed YE O9 infection with the outbreak multilocus variable-number tandem repeat analysis (MLVA)-profile (5-6-9-8-9-9). We conducted a case-control study in the military setting and calculated odds ratios (OR) using logistic regression. Traceback investigations were conducted to identify common suppliers and products in commercial kitchens frequented by cases. By 28 May, we identified 133 cases, of which 117 were linked to four military bases and 16 were civilians from geographically dispersed counties. Among foods consumed by cases, multivariable analysis pointed to mixed salad as a potential source of illness (OR 10.26; 95% confidence interval (CI): 0.85-123.57). The four military bases and cafeterias visited by 14/16 civilian cases received iceberg lettuce or radicchio rosso from the same supplier. Secondary transmission cannot be eliminated as a source of infection in the military camps. The most likely source of the outbreak was salad mix containing imported radicchio rosso, due to its long shelf life. This outbreak is a reminder that fresh produce should not be discounted as a vehicle in prolonged outbreaks and that improvements are still required in the production and processing of fresh salad products.

Importance of molecular typing in confirmation of the source of a national hepatitis A virus outbreak in Norway and the detection of a related cluster in Germany.

In March 2014, after an increase of notifications of domestically acquired hepatitis A virus infections, an outbreak investigation was launched in Norway. Sequenced-based typing results showed that these cases were associated with a strain that was identical to one causing an ongoing multinational outbreak in Europe linked to frozen mixed berries. Thirty-three confirmed cases with the outbreak strain were notified in Norway from November 2013 to June 2014. Epidemiological evidence and trace-back investigations linked the outbreak to the consumption of a berry mix cake. Identification of the hepatitis A virus outbreak strain in berries from one of the implicated cakes confirmed the cake to be the source. Subsequently, a cluster in Germany linked to the cake was also identified.

[Health care quality perceived by the patients in an urban health centre in A Coruña]. / Calidad de atención en salud percibida por los pacientes en un centro de salud urbano de A Coruña.

OBJECTIVE: The aim of this study is to explore the reliability and validity of the adapted questionnaire SERVPERF in primary care and to obtain a measure of perceived quality from the patient point of view in an urban health centre. METHOD: A cross-sectional descriptive study. PARTICIPANTS: One in five of all the patients who visited the health centre during one week in March 2010 were systematically selected until completing the required sample size. MAIN MEASUREMENTS: Personal data were collected (age, sex, nationality, marital status, level of studies, working status and their own perception on their health status). To measure the perceived quality the adapted questionnaire SERVPERF was used, with 22 items measured using a Likert scale (1-7), to which was added three open questions. RESULTS: Out of a total of 132 patients, 67% of those who completed the questionnaire were women. All the interscale correlations were positive and significant. The overall statistical value for Cronbach́s-α was equal to 0.90 (95% CI: 0.87-0.93), and in all domains this value ranged from 0.71 to 0.90. The factor analysis identified 5 factors that explained 69.8% of the total variance. Of the studied items, the "Individualized follow up of each patient by the doctor", with an average of 6.66 ± 0.79 (95% CI: 6.53-6.79), was the best valued. CONCLUSIONS: The questionnaire (adapted SERVPERF) is reliable and valid for measuring perceived quality in primary care, and patients felt that the service offered is of good quality.

Calidad de atención en salud percibida por los pacientes en un centro de salud urbano de A Coruña / Health care quality perceived by the patients in an urban health centre in a coruna

Objetivos Explorar la fiabilidad y validez del cuestionario adaptado SERVPERF en el ámbito de atención primaria y obtener una medida de la calidad de atención en salud desde la perspectiva de los pacientes en un centro de salud (C. S.). Diseño Estudio descriptivo transversal. Participantes Del total de los pacientes que acudieron a consultas al centro de salud durante una semana de marzo de 2010 se seleccionó de forma sistemática uno de cada 5, hasta completar el tamaño muestral requerido. Mediciones principales: Para medir la calidad de atención en salud percibida se utilizó la encuesta adaptada SERVPERF, con 22 ítems medidos en escala Likert (1-7), a la que se añadieron 3 preguntas abiertas y variables personales. Resultados Participaron un total de 132 pacientes con una edad media de 50 años (rango 16-89), el 67% eran mujeres. La encuesta con los 22 ítems mostró una consistencia interna α-Cronbach= 0,90 (IC 95%: 0,87-0,93) y en cada una de las 5 dimensiones este valor estuvo entre (0,71-0,90). El análisis factorial señaló 5 factores que explicaron un 69,83% de la varianza. La puntuación total media obtenida fue de 123,22±16,95, el ítem mejor valorado fue el «Seguimiento individualizado por el médico de cada paciente» con una media de 6,66±0,79 (IC: 6,53-6,79). Conclusiones El cuestionario utilizado (SERVPERF adaptado) se mostró fiable y válido para medir percepción de calidad de la atención sanitaria en atención primaria. Los pacientes consideraron que el servicio de atención sanitaria que recibieron fue de buena calidad (AU)

Objective: The aim of this study is to explore the reliability and validity of the adapted questionnaire SERVPERF in primary care and to obtain a measure of perceived quality from the patient point of view in an urban health centre. Method: A cross-sectional descriptive study. Participants: One in five of all the patients who visited the health centre during one week in March 2010 were systematically selected until completing the required sample size. Main measurements: Personal data were collected (age, sex, nationality, marital status, level of studies, working status and their own perception on their health status). To measure the perceived quality the adapted questionnaire SERVPERF was used, with 22 items measured using a Likert scale (1-7), to which was added three open questions. Results: Out of a total of 132 patients, 67% of those who completed the questionnaire were women. All the interscale correlations were positive and significant. The overall statistical value for Cronbach's-Alpha was equal to 0.90 (95% CI: 0.87-0.93), and in all domains this value ranged from 0.71 to 0.90. The factor analysis identified 5 factors that explained 69.8% of the total variance. Of the studied items, the ‘‘Individualized follow up of each patient by the doctor’’, with an average of 6.66 ± 0.79 (95% CI: 6.53-6.79), was the best valued. Conclusions: The questionnaire (adapted SERVPERF) is reliable and valid for measuring perceived quality in primary care, and patients felt that the service offered is of good quality