The activation mode of a dirty-bomb can modify the health risk estimation profile.

Purpose: This study focuses on analytical computer simulations performed to investigate a hypothetical event where the activation of a radiological dispersion device (RDD) triggers a crisis.

Materials And Methods: The methodology presents steps centered on the initial evaluation phase of the event (initial 100 hours), aiming to evaluate the radiological risks regarding the development of leukemia. Local environmental changes, sex, and age were also used to assess risks.

Comparison of the management recommendations of the Kaiser Permanente neonatal early-onset sepsis risk calculator (SRC) with NICE guideline CG149 in infants ≥34 weeks' gestation who developed early-onset sepsis.

Objective: To compare the management recommendations of the Kaiser Permanente neonatal early-onset sepsis risk calculator (SRC) with National Institute for Health and Care Excellence (NICE) guideline CG149 in infants ≥34 weeks' gestation who developed early-onset sepsis (EOS).

Design: Retrospective multicentre study.

Setting: Five maternity services in South West of England and Wales.

Parent-to-parent support interventions for parents of babies cared for in a neonatal unit-protocol of a systematic review of qualitative and quantitative evidence.

Background: Parents of babies admitted to neonatal units experience an arduous emotional journey. Feelings of helplessness, fear, sadness, guilt, grief and anger are common. These feelings can lead to anxiety, depression and post-traumatic stress which may persist long after discharge from the unit.

Developing a local antimicrobial resistance action plan: the Cornwall One Health Antimicrobial Resistance Group.

Objectives: The UK Five Year Antimicrobial Resistance (AMR) Strategy was published in September 2013 and recommended a One Health approach emphasizing the importance of collaboration to tackle AMR. We describe the inauguration of what we believe to be the first regional One Health group established in the UK. The purpose of the group was to ensure the implementation of a coordinated Cornwall-wide response to the UK AMR Strategy and we describe the outputs of the group to date.

Schedules for Pneumococcal Vaccination of Preterm Infants: An RCT.

Background And Objective: Premature infants have a higher risk of invasive pneumococcal disease and are more likely to have lower vaccine responses compared with term infants. Increasingly, immunization schedules are including a reduced, 2-dose, pneumococcal conjugate vaccine priming schedule. Our goal was to assess the immunogenicity of 3 commonly used 13-valent pneumococcal conjugate vaccine (PCV13) priming schedules in premature infants and their response to a 12-month booster dose.

Vaccine-preventable disease susceptibility in a British paediatric assessment unit.

: To evaluate practice within a paediatric secondary-care centre before and after introduction of simple interventions to improve identification of under-immunised children and facilitate catch-up immunisations. : The population-based child health database was used to check immunisation status for two cohorts of 200 consecutive admissions before and after routine printing of immunisation histories from the database and raising staff awareness. Vaccine-preventable disease (VPD) susceptibility burdens were calculated for each child.

Interventions to reduce acute paediatric hospital admissions: a systematic review.

Objective: To compare the effectiveness of interventions aimed at reducing the rate of acute paediatric hospital admissions.

Design: Systematic review.

Data Sources: Medline, Embase, PsychINFO, The Cochrane Library, Science Citation Index Expanded from inception to September 2010; hand searches of the reference lists of included papers and other review papers identified in the search.

Predictors of immune response and reactogenicity to AS03B-adjuvanted split virion and non-adjuvanted whole virion H1N1 (2009) pandemic influenza vaccines.

In 2009, 943 children aged 6 months to 10 years were randomised to receive two doses of an oil-in water AS03B-adjuvanted split virion or a non-adjuvanted whole virion H1N1 (2009) vaccine. The large numbers allowed investigation of possible predictors of immune response and reactogenicity. We used regression analysis to examine the effect of variables including past receipt of seasonal vaccine, antipyretics post-vaccination, interval between doses and pre-existing antibodies to H1N1 (2009) on immunogenicity.

An outbreak of norovirus infection linked to oyster consumption at a UK restaurant, February 2010.

Background: We present the investigation of an outbreak of gastroenteritis at a UK restaurant incorporating both epidemiological and microbiological analysis.

Methods: Structured postal questionnaires were sent to 30 diners who ate at the restaurant during the outbreak period (5-7 February 2010). Stool specimens collected from staff and diners were submitted for bacterial culture and norovirus testing, and 15 Pacific oysters (Crassostrea gigas) from the batch served during the outbreak period were tested for norovirus.

Neonatal infections in England: the NeonIN surveillance network.

Introduction: Neonatal infection is an important cause of morbidity and mortality. Neonatal infection surveillance networks are necessary for defining the epidemiology of infections and monitoring changes over time.

Design: Prospective multicentre surveillance using a web-based database.

Birth season and environmental influences on blood leucocyte and lymphocyte subpopulations in rural Gambian infants.

Background: In rural Gambia, birth season predicts infection-related adult mortality, providing evidence that seasonal factors in early life may programme immune development. This study tested whether lymphocyte subpopulations assessed by automated full blood count and flow cytometry in cord blood and at 8, 16 and 52 weeks in rural Gambian infants (N = 138) are affected by birth season (DRY = Jan-Jun, harvest season, few infections; WET = Jul-Dec, hungry season, many infections), birth size or micronutrient status.

Results: Geometric mean cord and postnatal counts were higher in births occurring in the WET season with both season of birth and season of sampling effects.

Aflatoxin exposure in utero causes growth faltering in Gambian infants.

Background: Growth faltering in West African children has previously been associated with dietary exposure to aflatoxins, particularly upon weaning. However, in animal studies in utero exposure to low levels of aflatoxin also results in growth faltering.

Objective: This study investigated the effect of in utero aflatoxin exposure on infant growth in the first year of life in The Gambia.

Effect of month of vaccine administration on antibody responses in The Gambia and Pakistan.

Objective: To explore the relationship between calendar month of administration and antibody (Ab) response to vaccination in subjects from The Gambia and Pakistan, two countries with distinct patterns of seasonality.

Methods: Three cohorts were investigated: Responses to rabies and pneumococcal vaccine were assessed in 472 children (mean age 8 years, males 53%) from rural Gambia. Responses to tetanus, diphtheria and hepatitis B (HBsAg) were investigated in 138 infants also from The Gambia (birth to 52 weeks of age, males 54%).

Early immunological development and mortality from infectious disease in later life.

In rural Gambia the risk of mainly infection-related mortality is 10-fold higher for adults born in the nutritionally-debilitating 'hungry' season, suggesting that immune function may be compromised by events early in life. The current programme of research focuses on the biological mechanisms underlying this hypothesis, exploring early-life environmental influences on immune development and the long-term functional consequences these influences may have. Results obtained to date show that thymus development during infancy is critically sensitive to environmental exposures, with smaller thymuses observed in the hungry season.

Developmental changes in leptin as a measure of energy status in human infants in a natural ecologic setting.

Background: Most human research on leptin has involved well-nourished subjects or clinical states such as anorexia nervosa or cancer cachexia.

Objective: We studied the development of leptin as a monitor of energy status in young African infants whose growth patterns probably reflect the evolutionary norm.

Design: We enrolled a prospective birth cohort of 138 rural Gambian mother-infant pairs.

Improved thymic function in exclusively breastfed infants is associated with higher interleukin 7 concentrations in their mothers' breast milk.

Background: In rural Gambians, the season of birth strongly predicts adult mortality. Those born during the harvest season have longer life spans than do those born during the hungry season, and the deaths associated with infectious diseases suggest permanent early-life influences on immunity. Thymic measurements showed significantly smaller thymuses in infants born during the hungry season than in those born during the harvest season.

Observational study of vaccine efficacy 14 years after trial of hepatitis B vaccination in Gambian children.

Objective: To determine the duration of protection from hepatitis B vaccine given in infancy and early childhood.

Design: Cross sectional serological study of hepatitis B virus infection in children of various ages 14 years after the start of a trial of vaccination regimens.

Setting: Two villages in the Gambia.