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Partner notification for persons with chronic hepatitis B virus infection: use of a syphilis model service.

BACKGROUND: Adults with chronic hepatitis B virus (HBV) infection are usually the source of infection for persons who acquire sexually transmitted HBV infection. Vaccinating sex- and needle-sharing partners is recommended. GOAL: To evaluate the usefulness of a syphilis model partner notification (PN) service for high-risk persons with chronic HBV infection. STUDY DESIGN: Locatable partners were offered serologic testing and HBV vaccination. RESULTS: Of 190 eligible case patients, 129 (68%) were interviewed, which included 47 men who have sex with men (MSM), 26 who reported injecting drug use (IDU), and 12 who were MSM and injected drugs. Among the 129 interviewed, 85 (66%) reported having =1 recent sex partner, 46 (36%) provided locating information for 47 partners, 38 partners accepted PN services, 15 were not immune, and 14 (7% of total eligible case patients) started and 9 completed the HBV vaccine series. Overall, 15% of case patients were also hepatitis C positive, and 29% were HIV infected. PN services cost was estimated at 1472 US dollars per vaccinee. CONCLUSION: High-risk persons with chronic HBV infection provided few names or locating information for their partners, and the proportion eligible for vaccination was low. An integrated approach that provides hepatitis C screening, human immunodeficiency virus testing, and referral might be more useful and should be evaluated.

Adolescent↗

Effects of partner notification on reducing gonorrhea incidence rate.

OBJECTIVE: The objective of this study was to estimate the effectiveness of partner notification (PN) by linking measures of PN with the gonorrhea incidence rate in New York State exclusive of New York City. STUDY DESIGN: Gonorrhea cases were identified from the Communicable Disease Confidential Case Reports system. Case interview data were obtained from the case management database. Gonorrhea incidence data and interview data were aggregated from individual records and then linked at the county level. RESULTS: From 1992 to 2002, 100,756 gonorrhea cases were reported and 37% were interviewed. A total of 34,807 partners were elicited from 37,393 index cases: 18,291 (52.5%) partners sought medical evaluation, 10,159 (29.2%) received preventive treatment, and 7,474 (21.5%) were infected and treated. The gonorrhea incidence rate was inversely correlated with the percent of partners given preventive treatment and positively related to the percent of infected partners. CONCLUSIONS: Our study adds new evidence that PN is an effective mechanism to detect new cases and interrupt disease transmission within communities.

Contact Tracing↗

Notification of changes in taxonomic opinion previously published outside the IJSEM.

The Bacteriological Code deals with the nomenclature of prokaryotes. This may include existing names (the Approved Lists of Bacterial Names) as well as new names and new combinations. In this sense the Code is also dealing indirectly with taxonomic opinions. However, as with most codes of nomenclature there are no mechanisms for formally recording taxonomic opinions that do not involve the creation of new names or new combinations. In particular, it would be desirable for taxonomic opinions resulting from the creation of synonyms or emended descriptions to be made widely available to the public. In 2004, the Editorial Board of the International Journal of Systematic and Evolutionary Microbiology (IJSEM) agreed unanimously that it was desirable to cover such changes in taxonomic opinions (i.e. the creation of synonyms or the emendation of circumscriptions) previously published outside the IJSEM, and to introduce a List of Changes in Taxonomic Opinion [Notification of changes in taxonomic opinion previously published outside the IJSEM; Euzeby et al. (2004). Int J Syst Evol Microbiol 54, 1429-1430]. Scientists wishing to have changes in taxonomic opinion included in future lists should send one copy of the pertinent reprint or a photocopy or a PDF file thereof to the IJSEM Editorial Office or to the Lists Editor. It must be stressed that the date of proposed taxonomic changes is the date of the original publication not the date of publication of the list. Taxonomic opinions included in the List of Changes in Taxonomic Opinion cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission. The names that are to be used are those that are the 'correct names' (in the sense of Principle 6) in the opinion of the bacteriologist, with a given circumscription, position and rank. A particular name, circumscription, position and rank does not have to be adopted in all circumstances. Consequently, the List of Changes in Taxonomic Opinion must be considered as a service to bacteriology and it has no 'official character', other than providing a centralized point for registering/indexing such changes in a way that makes them easily accessible to the scientific community.

Bacteria↗

Notification of changes in taxonomic opinion previously published outside the IJSEM.

The Bacteriological Code deals with the nomenclature of prokaryotes. This may include existing names (the Approved Lists of Bacterial Names) as well as new names and new combinations. In this sense the Code is also dealing indirectly with taxonomic opinions. However, as with most codes of nomenclature there are no mechanisms for formally recording taxonomic opinions that do not involve the creation of new names or new combinations. In particular, it would be desirable for taxonomic opinions resulting from the creation of synonyms or emended descriptions to be made widely available to the public. In 2004, the Editorial Board of the International Journal of Systematic and Evolutionary Microbiology (IJSEM) agreed unanimously that it was desirable to cover such changes in taxonomic opinions (i.e. the creation of synonyms or the emendation of circumscriptions) previously published outside the IJSEM, and to introduce a List of Changes in Taxonomic Opinion [Notification of changes in taxonomic opinion previously published outside the IJSEM; Euzéby et al. (2004). Int J Syst Evol Microbiol 54, 1429-1430]. Scientists wishing to have changes in taxonomic opinion included in future lists should send one copy of the pertinent reprint or a photocopy or a PDF file thereof to the IJSEM Editorial Office or to the Lists Editor. It must be stressed that the date of proposed taxonomic changes is the date of the original publication not the date of publication of the list. Taxonomic opinions included in the List of Changes in Taxonomic Opinion cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission. The names that are to be used are those that are the 'correct names' (in the sense of Principle 6) in the opinion of the bacteriologist, with a given circumscription, position and rank. A particular name, circumscription, position and rank does not have to be adopted in all circumstances. Consequently, the List of Changes in Taxonomic Opinion must be considered as a service to bacteriology and it has no 'official character', other than providing a centralized point for registering/indexing such changes in a way that makes them easily accessible to the scientific community.

Bacteria↗

Notification of changes in taxonomic opinion previously published outside the IJSEM.

The Bacteriological Code deals with the nomenclature of prokaryotes. This may include existing names (the Approved Lists of Bacterial Names) as well as new names and new combinations. In this sense the Code is also dealing indirectly with taxonomic opinions. However, as with most codes of nomenclature there are no mechanisms for formally recording taxonomic opinions that do not involve the creation of new names or new combinations. In particular, it would be desirable for taxonomic opinions resulting from the creation of synonyms or emended descriptions to be made widely available to the public. In 2004, the Editorial Board of the International Journal of Systematic and Evolutionary Microbiology (IJSEM) agreed unanimously that it was desirable to cover such changes in taxonomic opinions (i.e. the creation of synonyms or the emendation of circumscriptions) previously published outside the IJSEM, and to introduce a List of Changes in Taxonomic Opinion [Notification of changes in taxonomic opinion previously published outside the IJSEM; Euzéby et al. (2004). Int J Syst Evol Microbiol 54, 1429-1430]. Scientists wishing to have changes in taxonomic opinion included in future lists should send one copy of the pertinent reprint or a photocopy or a PDF file thereof to the IJSEM Editorial Office or to the Lists Editor. It must be stressed that the date of proposed taxonomic changes is the date of the original publication not the date of publication of the list. Taxonomic opinions included in the List of Changes in Taxonomic Opinion cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission. The names that are to be used are those that are the 'correct names' (in the sense of Principle 6) in the opinion of the bacteriologist, with a given circumscription, position and rank. A particular name, circumscription, position and rank does not have to be adopted in all circumstances. Consequently, the List of Changes in Taxonomic Opinion must be considered as a service to bacteriology and it has no 'official character', other than providing a centralized point for registering/indexing such changes in a way that makes them easily accessible to the scientific community.

Bacteria↗

List of changes in taxonomic opinion no. 4. Notification of changes in taxonomic opinion previously published outside the IJSEM.

The Bacteriological Code deals with the nomenclature of prokaryotes. This may include existing names (the Approved Lists of Bacterial Names) as well as new names and new combinations. In this sense the Code is also dealing indirectly with taxonomic opinions. However, as with most codes of nomenclature there are no mechanisms for formally recording taxonomic opinions that do not involve the creation of new names or new combinations. In particular, it would be desirable for taxonomic opinions resulting from the creation of synonyms or emended descriptions to be made widely available to the public. In 2004, the Editorial Board of the International Journal of Systematic and Evolutionary Microbiology (IJSEM) agreed unanimously that it was desirable to cover such changes in taxonomic opinions (i.e. the creation of synonyms or the emendation of circumscriptions) previously published outside the IJSEM, and to introduce a List of Changes in Taxonomic Opinion [Notification of changes in taxonomic opinion previously published outside the IJSEM; Euzéby et al. (2004). Int J Syst Evol Microbiol 54, 1429-1430]. Scientists wishing to have changes in taxonomic opinion included in future lists should send one copy of the pertinent reprint or a photocopy or a PDF file thereof to the IJSEM Editorial Office or to the Lists Editor. It must be stressed that the date of proposed taxonomic changes is the date of the original publication not the date of publication of the list. Taxonomic opinions included in the List of Changes in Taxonomic Opinion cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission. The names that are to be used are those that are the "correct names" (in the sense of Principle 6) in the opinion of the bacteriologist, with a given circumscription, position and rank. A particular name, circumscription, position and rank does not have to be adopted in all circumstances. Consequently, the List of Changes in Taxonomic Opinion must be considered as a service to bacteriology and it has no "official character", other than providing a centralized point for registering/indexing such changes in a way that makes them easily accessible to the scientific community.

Bacteria↗

List of changes in taxonomic opinion no. 5. Notification of changes in taxonomic opinion previously published outside the IJSEM.

The Bacteriological Code deals with the nomenclature of prokaryotes. This may include existing names (the Approved Lists of Bacterial Names) as well as new names and new combinations. In this sense the Code is also dealing indirectly with taxonomic opinions. However, as with most codes of nomenclature there are no mechanisms for formally recording taxonomic opinions that do not involve the creation of new names or new combinations. In particular, it would be desirable for taxonomic opinions resulting from the creation of synonyms or emended descriptions to be made widely available to the public. In 2004, the Editorial Board of the International Journal of Systematic and Evolutionary Microbiology (IJSEM) agreed unanimously that it was desirable to cover such changes in taxonomic opinions (i.e. the creation of synonyms or the emendation of circumscriptions) previously published outside the IJSEM, and to introduce a List of Changes in Taxonomic Opinion [Notification of changes in taxonomic opinion previously published outside the IJSEM; Euzéby et al. (2004). Int J Syst Evol Microbiol 54, 1429-1430]. Scientists wishing to have changes in taxonomic opinion included in future lists should send one copy of the pertinent reprint or a photocopy or a PDF file thereof to the IJSEM Editorial Office or to the Lists Editor. It must be stressed that the date of proposed taxonomic changes is the date of the original publication not the date of publication of the list. Taxonomic opinions included in the List of Changes in Taxonomic Opinion cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission. The names that are to be used are those that are the "correct names" (in the sense of Principle 6) in the opinion of the bacteriologist, with a given circumscription, position and rank. A particular name, circumscription, position and rank does not have to be adopted in all circumstances. Consequently, the List of Changes in Taxonomic Opinion must be considered as a service to bacteriology and it has no "official character", other than providing a centralized point for registering/indexing such changes in a way that makes them easily accessible to the scientific community.

Bacteria↗

Anti-HTLV III ELISA and Western blot testing in a blood donor population: implications for donor notification.

We have evaluated the western blot (WB) test for distinguishing anti-HTLV III ELISA-positive donors who have likely been exposed to HTLV III from those that are false positives. Of 1,955 donors, 26 were positive for anti-HTLV III by ELISA testing. Only 6 (23%) were positive by WB: 5 of these 6 were male homosexuals with multiple partners and 5 of 6 had low Th/Ts ratios. The WB-positive donors gave the highest absorbance values in the anti-HTLV III ELISA assay. The immunologic abnormalities in the WB-positive donors suggest that they should be notified of their test results. We conclude that basing a donor notification policy on WB results is the optimum public health strategy for blood banks at the present time.

Antibodies, Viral↗

Physician notification of their diabetes patients' limited health literacy. A randomized, controlled trial.

BACKGROUND: Many patients with chronic disease have limited health literacy (HL). Because physicians have difficulty identifying these patients, some experts recommend instituting screening programs in clinical settings. It is unclear if notifying physicians of patients' limited HL improves care processes or outcomes. OBJECTIVE: To determine whether notifying physicians of their patients' limited HL affects physician behavior, physician satisfaction, or patient self-efficacy. DESIGN: We screened all patients for limited HL and randomized physicians to be notified if their patients had limited HL skills. PARTICIPANTS: Sixty-three primary care physicians affiliated with a public hospital and 182 diabetic patients with limited HL. MEASUREMENTS: After their visit, physicians reported their management strategies, satisfaction, perceived effectiveness, and attitudes toward HL screening. We also assessed patients' self-efficacy, feelings regarding HL screening's usefulness, and glycemic control. RESULTS: Intervention physicians were more likely than control physicians to use management strategies recommended for patients with limited HL (OR 3.2, P=.04). However, intervention physicians felt less satisfied with their visits (81% vs 93%, P=.01) and marginally less effective (38% vs 53%, P=.10). Intervention and control patients' post-visit self-efficacy scores were similar (12.6 vs 12.9, P=.6). Sixty-four percent of intervention physicians and 96% of patients felt HL screening was useful. CONCLUSIONS: Physicians are responsive to receiving notification of their patients' limited HL, and patients support the potential utility of HL screening. However, instituting screening programs without specific training and/or system-wide support for physicians and patients is unlikely to be a powerful tool in improving diabetes outcomes.

Adult↗

Testing for skin sensitization according to the notification procedure for new chemicals: the Magnusson and Kligman test.

The notification procedure for new chemicals in the European Union (called the Chemicals Act in Germany) requires a skin sensitization test when the amount of a new chemical produced exceeds 100 kg/year. The preferred test is that of Magnusson and Kligman; more than 90% of the tests submitted are performed with it. Though the Magnusson and Kligman test is described in the literature, and in the test guidelines of the European Union and of the OECD, discrepancies do occur in the performance of the test between test laboratories. In this paper, recommendations are given for standardized performance of the Magnusson and Kligman test.

Administration, Cutaneous↗

The incidence and notification of measles in Australia.

The incidence of measles in Australia in 1986 was estimated as 43 per 100,000 population, high by the standards of countries where immunization levels are high, low by the standards of countries where immunization levels are low. It is estimated that only 5 per cent of cases are notified in New South Wales, one of only 2 States which require notification. The reasons for this, its significance and a possible remedy are discussed.

Australia↗

Follow-up of cases of opiate addiction from the time of notification to the Home Office.

Follow-up of 108 opiate addicts for a period of six to seven years showed that 35 were still being prescribed opiates, 25 were off drugs, 19 were dead, and for 29 it was not certain whether they were on or off drugs. Most patients who came off drugs did so in the first two years after notification to the Home Office. Clearly treatment is more likely to be successful if given early in the life history of the addict, when it is appropriate to give treatment based on withdrawal of drugs rather than substitution.

Adult↗

Partner notification for HIV infection in Denmark: attitudes and preliminary results.

OBJECTIVES: To examine attitudes, experience and preliminary results of partner notification (PN) for HIV infection in Denmark among the doctors who inform one of their patients about being HIV infected. METHOD: The doctors who had reported to the national HIV surveillance unit about a new-identified HIV infected person, during a 9 months period, were searched for one year later. The traced doctors were interviewed. The results of the interview related to 102 out of 195 (52%) reports were compared between the 48 interviewed general practitioners (GPs) and the 33 interviewed hospital doctors (HDs). The proportion of traced reporting doctors were higher among GPs than among HDs. RESULTS: Both GPs and HDs found it difficult to give a positive HIV test result and wanted trained counsellors to work with them in the PN process. Less experience and fewer post-graduate courses about HIV may explain the GPs' lack of confidence to follow-up asymptomatic HIV positive patients. It was neither a routine for all the GPs or for all HDs to ask about patient behaviour nor to discuss safe sex with their index patients, and screening for other sexually transmitted diseases were seldomly performed. The numbers of partners notified, especially by the doctors were low. CONCLUSIONS: HIV reporting doctors in Denmark are motivated for PN. Educational programmes about counselling and care of HIV infected patients should, however, be offered at intervals, especially to GPs. The outcome of PN can only be measured to a certain level as long as exposed partners are neither obliged to be tested nor to be counselled and as long as information about counselling and testing can not be shared between doctors in different settings.

Attitude of Health Personnel↗

HIV partner notification policy and practice within GUM clinics in England: where are we now?

OBJECTIVES: To evaluate the extent to which larger genitourinary medicine (GUM) clinics in England have established local clinic policies for HIV Partner Notification (PN) and to describe the process of HIV PN within this setting. DESIGN: A cross-sectional survey of HIV PN policies and practices within GUM clinics. SUBJECTS AND SETTING: Senior consultants in 59 GUM clinics in England. MAIN OUTCOME MEASURES: The presence of clinic policies for HIV PN, indicators of HIV PN activity (that is, its initiation, documentation, performance and evaluation) and factors hindering the acceptance of HIV PN into clinical practice. RESULTS: Only 18% (10/57) of respondents stated that their clinics had developed their own local policies for HIV PN. Fifteen percent (9/58) of clinics had audited HIV PN activity, 15% had provided specific HIV PN training for doctors and 47% (27/58) for health advisers. Within GUM clinics, health advisers play a key role in the HIV PN process, being responsible for initiating the discussion of partners, patient follow-up and documenting HIV PN activity in patients' notes. Notifying partners was primarily seen as the responsibility of the newly diagnosed HIV positive patient. Although 77% (43/56) of responding consultants believed that HIV PN had become an accepted part of their clinics' practice, the perceived unacceptability of HIV PN to patients and health care workers were seen as important limiting factors. CONCLUSION: In many GUM clinics, local policies on HIV PN have yet to be established and appropriate training for the health personnel provided. Nevertheless, there appears to be wide-spread acceptance of HIV PN in clinical practice with an acknowledgement of its limiting factors. Further research into the acceptability of HIV PN to health care workers and patients in this setting should be undertaken.

Attitude of Health Personnel↗

[From the concept of guilt to the value-free notification of errors in medicine. Risks, errors and patient safety].

The number of liability cases but also the size of individual claims due to alleged treatment errors are increasing steadily. Spectacular sentences, especially in the USA, encourage this trend. Wherever human beings work, errors happen. The health care system is particularly susceptible and shows a high potential for errors. Therefore risk management has to be given top priority in hospitals. Preparing the introduction of critical incident reporting (CIR) as the means to notify errors is time-consuming and calls for a change in attitude because in many places the necessary base of trust has to be created first. CIR is not made to find the guilty and punish them but to uncover the origins of errors in order to eliminate them. The Department of Anesthesiology of the University Hospital of Basel has developed an electronic error notification system, which, in collaboration with the Swiss Medical Association, allows each specialist society to participate electronically in a CIR system (CIRS) in order to create the largest database possible and thereby to allow statements concerning the extent and type of error sources in medicine. After a pilot project in 2000-2004, the Swiss Society of Gynecology and Obstetrics is now progressively introducing the 'CIRS Medical' of the Swiss Medical Association. In our country, such programs are vulnerable to judicial intervention due to the lack of explicit legal guarantees of protection. High-quality data registration and skillful counseling are all the more important. Hospital directors and managers are called upon to examine those incidents which are based on errors inherent in the system.

Anesthesiology↗

Voluntarily informing others of positive HIV test results: patterns of notification by infected gay men.

Forty gay men who had recently learned that they were infected with human immunodeficiency virus (HIV) were interviewed to determine the frequency with which they voluntarily informed physicians, dentists, friends, family members, and current and past sexual partners of their positive test results. Ninety percent of the subjects informed a personal physician, and 48 percent of the subjects who sought dental care informed the dentist. Sixty-six percent of subjects with at least one current sexual partner notified every current sexual partner, although notification was not associated with a greater likelihood of safer sex practices. Ninety percent of the subjects who had past sexual partners made no attempt to inform them. Sixty-eight percent confided in at least one friend, but only 35 percent told a family member.

AIDS Serodiagnosis↗

The role of the medical examiner in the euthanasia notification procedure in The Netherlands.

The objective of the study was to provide an insight into the role of the medical examiner in the euthanasia notification procedure in The Netherlands. At the beginning of 1996 a representative group of 116 medical examiners was interviewed. The study found that there was a considerable variation in the way in which the medical examiners fulfilled their tasks. In all cases, after the physician-assisted death had taken place, the medical examiner investigated whether the attending physician had met the requirements for prudent practice, and in approximately 75% of the cases he reported his findings to the Public Prosecutor. In 78% of cases the attending physician was well known to the medical examiners, who were general practitioners, and in a third of the cases this influenced their assessment. Seventy-six per cent of the medical examiners, 61% of the members of the public prosecution and 47% of the physicians thought that it is the task to the medical examiner to review whether the requirements for prudent practice have been met by the attending physician. In conclusion further specification of the task of the medical examiner would appear to be beneficial to increase uniformity in the procedure. In particular, it should be determined whether it is the medical examiner's responsibility to review whether the requirements for prudent practice have been met. It should also be taken into consideration whether the position of the general practitioner medical examiner is sufficiently independent to make an objective report.

Coroners and Medical Examiners↗

Chlamydial ocular infection: efficacy of partner notification by patient referral.

Records on 254 patients with chlamydial ocular infection observed over a period of 67 months at the Moorfield's Eye Hospital were reviewed retrospectively in relation to sexual partners in the 6 months prior to diagnosis. Contactable partners were given an appointment through index patients to attend our clinic. Those unable to attend were issued contact slips, as used by the sexually transmitted disease (STD) clinics in the United Kingdom, to attend elsewhere: 175/328 (53%) of all partners were seen in our clinic: 161/218 (74%) of current regular partners compared to only 7/57 (12%) of ex-regular and 7/53 (13%) of casual partners. However, of those given appointments 175/201 (87%) attended: 161/179 (90%) of current regular, 7/14 (50%) of ex-regular and 7/8 (88%) of casual partners. Seventy of 328 (21%) of all partners were issued contact slips, of whom 47/70 (67%) were reported to have attended elsewhere. No contact slips were returned by other clinics, indicating a failure in the contact slip system. Thirty-five of 53 (66%) of casual, 22/57 (39%) of ex-regular and none of the current regular partners were untraceable. One hundred and five of 196 (54%) female partners were examined, of whom 59/105 (56%) had chlamydial genital infection, 45/105 (43%) had other genital infections and 35/105 (33%) had multiple genital infections. Seventy of 132 (53%) male partners were examined, of whom 58/70 (83%) had chlamydial or non-specific urethritis, 5/70 (7%) had other genital infections and 4/70 (6%) had multiple genital infections. Partner notification is important to interrupt chlamydia transmission.(ABSTRACT TRUNCATED AT 250 WORDS)

Appointments and Schedules↗