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2.
Front Public Health ; 11: 1261165, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37829087

RESUMEN

Introduction: Detection of community respiratory syncytial virus (RSV) infections informs the timing of immunoprophylaxis programs and hospital preparedness for surging pediatric volumes. In many jurisdictions, this relies upon RSV clinical test positivity and hospitalization (RSVH) trends, which are lagging indicators. Wastewater-based surveillance (WBS) may be a novel strategy to accurately identify the start of the RSV season and guide immunoprophylaxis administration and hospital preparedness. Methods: We compared citywide wastewater samples and pediatric RSVH in Ottawa and Hamilton between August 1, 2022, and March 5, 2023. 24-h composite wastewater samples were collected daily and 5 days a week at the wastewater treatment facilities in Ottawa and Hamilton, Ontario, Canada, respectively. RSV WBS samples were analyzed in real-time for RSV by RT-qPCR. Results: RSV WBS measurements in both Ottawa and Hamilton showed a lead time of 12 days when comparing the WBS data set to pediatric RSVH data set (Spearman's ρ = 0.90). WBS identify early RSV community transmission and declared the start of the RSV season 36 and 12 days in advance of the provincial RSV season start (October 31) for the city of Ottawa and Hamilton, respectively. The differing RSV start dates in the two cities is likely associated with geographical and regional variation in the incidence of RSV between the cities. Discussion: Quantifying RSV in municipal wastewater forecasted a 12-day lead time of the pediatric RSVH surge and an earlier season start date compared to the provincial start date. These findings suggest an important role for RSV WBS to inform regional health system preparedness, reduce RSV burden, and understand variations in community-related illness as novel RSV vaccines and monoclonal antibodies become available.


Asunto(s)
Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Humanos , Niño , Palivizumab/uso terapéutico , Antivirales/uso terapéutico , Ontario/epidemiología , Monitoreo Epidemiológico Basado en Aguas Residuales , Estaciones del Año , Ciudades , Aguas Residuales , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico
3.
Front Pediatr ; 10: 997349, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36683806

RESUMEN

Aim: The study objective was to compare the Pediatric Investigators Collaborative Network on Infections in Canada risk scoring tool (CRST) that determines need for respiratory syncytial virus (RSV) prophylaxis in infants 33-35 weeks gestational age during the RSV season, with the newly developed international risk scoring tool (IRST). Methods: Children 33-35 weeks gestational age born during the 2018-2021 RSV seasons were prospectively identified following birth and scored with the validated CRST and IRST, that comprises seven and three variables respectively, into low- moderate- and high-risk groups that predict RSV-related hospitalization. Correlations between total scores on the two tools, and cut-off scores for the low-, moderate- and high-risk categories were conducted using the Spearman rank correlation. Results: Over a period of 3 RSV seasons, 556 infants were scored. Total risk scores on the CRST and the IRST were moderately correlated (rs = 0.64, p < 0.001). A significant relationship between the risk category rank on the CRST and the risk category rank on the IRST (rs = 0.53; p < 0.001) was found. The proportion of infants categorized as moderate risk for RSV hospitalization by the CRST and IRST were 19.6% (n = 109) and 28.1% (n = 156), respectively. Conclusion: The IRST may provide a time-efficient scoring alternative to the CRST with three vs. seven variables, and it selects a larger number of infants who are at moderate risk for RSV hospitalization for prophylaxis. A cost-utility analysis is necessary to justify country-specific use of the IRST, while in Canada a cost comparison is necessary between the IRST vs. the currently approved CRST prior to adoption.

4.
Int J Audiol ; 53(2): 101-14, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24417459

RESUMEN

OBJECTIVE: The speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure. DESIGN: Statistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals. STUDY SAMPLE: 1220 people who have attended MRC IHR over the last decade. RESULTS: We found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed "speech understanding", "spatial perception", and "clarity, separation, and identification". Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, "effort and concentration", representing two more questions. CONCLUSIONS: These results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores.


Asunto(s)
Evaluación de la Discapacidad , Audición , Personas con Deficiencia Auditiva/psicología , Localización de Sonidos , Percepción Espacial , Percepción del Habla , Encuestas y Cuestionarios , Anciano , Atención , Audiometría , Comprensión , Análisis Factorial , Femenino , Trastornos de la Audición/diagnóstico , Trastornos de la Audición/fisiopatología , Trastornos de la Audición/psicología , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Psicoacústica , Índice de Severidad de la Enfermedad , Acústica del Lenguaje , Inteligibilidad del Habla
5.
J Acoust Soc Am ; 130(1): 312-23, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21786901

RESUMEN

Localization dominance (one of the phenomena of the "precedence effect") was measured in a large number of normal-hearing and hearing-impaired individuals and related to self-reported difficulties in everyday listening. The stimuli (single words) were made-up of a "lead" followed 4 ms later by a equal-level "lag" from a different direction. The stimuli were presented from a circular ring of loudspeakers, either in quiet or in a background of spatially diffuse babble. Listeners were required to identify the loudspeaker from which they heard the sound. Localization dominance was quantified by the weighting factor c [B.G. Shinn-Cunningham et al., J. Acoust. Soc. Am. 93, 2923-2932 (1993)]. The results demonstrated large individual differences: Some listeners showed near-perfect localization dominance (c near 1) but many showed a much reduced effect. Two-thirds (64/93) of the listeners gave a value of c of at least 0.75. There was a significant correlation with hearing loss, such that better hearing listeners showed better localization dominance. One of the items of the self-report questionnaire ("Do you have the impression of sounds being exactly where you would expect them to be?") showed a significant correlation with the experimental results. This suggests that reductions in localization dominance may affect everyday auditory perception.


Asunto(s)
Trastornos de la Audición/psicología , Personas con Deficiencia Auditiva/psicología , Localización de Sonidos , Percepción del Habla , Estimulación Acústica , Adulto , Anciano , Análisis de Varianza , Audiometría del Habla , Umbral Auditivo , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Trastornos de la Audición/fisiopatología , Humanos , Persona de Mediana Edad , Ruido/efectos adversos , Enmascaramiento Perceptual , Análisis de Regresión , Inteligibilidad del Habla , Factores de Tiempo
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