Occupational safety and health (OSH) surveillance systems track work-related fatalities, injuries and illnesses as well as the presence of workplace hazards and exposures to inform prevention efforts. Periodic evaluation is critical to the improvement of these systems to meet the demand for more timely, complete, accurate and efficient data processing and analysis. Despite the existence of general guidance for public health surveillance evaluation, no tailored guidance exists for evaluating OSH surveillance systems to date. This study utilized the Delphi technique to collect consensus among experts in the United States on surveillance elements (components, attributes and measures) to inform the development of a tailored evaluation framework.
A Delphi study approach with three survey rounds invited an expert panel to rate and comment on potential OSH surveillance evaluation framework elements, resulting in an optimal list of elements through the panel\'s consensus. Additionally, experts completed a review of OSH surveillance systems they worked with and answered questions regarding the development of an evaluation framework. Descriptive statistics of the ratings were compiled for the Delphi process. Major themes from experts\' comments were further identified using content analysis to inform contextual information underlying their choices.
Fifty-four potential experts across the United States were contacted to participate in the Delphi study. Ten experts began the first survey round with eight then seven experts continuing in the subsequent rounds, respectively. A total of 64 surveillance components, 31 attributes, and 116 example measures were selected into the final list through panel consensus, with 134 (63.5%) reaching high consensus. Major themes regarding current OSH surveillance focused on resources and feasibility, data collection, flexibility, and the inter-relatedness among elements.
A Delphi process identified tailored OSH surveillance elements and major themes regarding OSH surveillance. The identified elements can serve as a preliminary guide for evaluating OSH surveillance systems. A more detailed evaluation framework is under development to incorporate these elements into a standard yet flexible approach to OSH surveillance evaluation.

The use of big data containing millions of primary care medical records provides an opportunity for rapid research to help inform patient care and policy decisions during the first and subsequent waves of the coronavirus disease 2019 (COVID-19) pandemic. Routinely collected primary care data have previously been used for national pandemic surveillance, quantifying associations between exposures and outcomes, identifying high risk populations, and examining the effects of interventions at scale, but there is no consensus on how to effectively conduct or report these data for COVID-19 research. A COVID-19 primary care database consortium was established in April 2020 and its researchers have ongoing COVID-19 projects in overlapping data sets with over 40 million primary care records in the United Kingdom that are variously linked to public health, secondary care, and vital status records. This consensus agreement is aimed at facilitating transparency and rigor in methodological approaches, and consistency in defining and reporting cases, exposures, confounders, stratification variables, and outcomes in relation to the pharmacoepidemiology of COVID-19. This will facilitate comparison, validation, and meta-analyses of research during and after the pandemic.

Despite the 2016 German \"National Recommendations for Physical Activity and Physical Activity Promotion\" stating that adults (≥18 years) should engage in: [a] ≥150 minutes of aerobic moderate-to-vigorous-intensity physical activity/week (MVPA); and [b] ≥2 days/week of muscle-strengthening exercise (MSE), there is limited research on the descriptive epidemiology on the adherence to these guidelines among German adults. This study describes the prevalence and correlates of physical activity guideline adherence among a nationally representative sample of German adults. Data were drawn from the 2014 German Health Update survey, collected via a combination of web-based and mail surveys. Self-reported physical activity levels were assessed using the previously validated European Health Interview Survey Physical Activity Questionnaire. Weighted prevalence levels of the sample meeting the aerobic MVPA (≥150 minutes/week), MSE (≥2 times/week), and combined MVPA-MSE guidelines were calculated. Poisson regressions were used to assess prevalence ratios for physical activity guideline adherence categories across sociodemographic and lifestyle-related variables. Out of 24,016 participants (response rate = 27.6%), aged ≥ 18 years, 45.3% (95% CI: 44.5%-46.0%), 29.4% (95% CI: 28.7%-30.1%), and 22.6% (95% CI: 21.9%-23.2%) met the aerobic MVPA, MSE, and combined guidelines, respectively. Population sub-groups less likely to meet the combined guidelines included those with poor self-rated health, being unemployed, low socioeconomic status, being a current smoker, and those being overweight or obese. Since ~ 80% of German adults do not meet the nationally recommended combined aerobic MVPA-MSE physical activity guidelines, there is a necessity for large-scale public health interventions promoting both aerobic MVPA and MSE.

Developing a cure for HIV is a global priority. Target product profiles are a tool commonly used throughout the drug development process to align interested parties around a clear set of goals or requirements for a potential product. Three distinct therapeutic modalities (combination therapies, ex-vivo gene therapy, and in-vivo gene therapy) for a target product profile for an HIV cure were identified. Using a process of expert face-to-face consultation and an online Delphi consultation, we found a high degree of agreement regarding the criteria for the optimum target product profile. Although the minimum attributes for a cure were debated, the broad consensus was that an acceptable cure need not be as safe and effective as optimally delivered antiretroviral therapy. An intervention that successfully cured a reasonable fraction of adults would be sufficient to advance to the clinic. These target product profiles will require further discussion and ongoing revisions as the field matures.

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BACKGROUND: In the absence of a vaccine or treatment, the most pragmatic strategies against an infectious disease pandemic are extensive early detection testing and social distancing. This study aimed to summarize public and workplace responses to Coronavirus Disease-19 (COVID-19) and show how the Korean system has operated during the COVID-19 pandemic.
METHODS: Daily briefings from the Korean Center for Disease Control and the Central Disaster Management Headquarters were assembled from January 20 to May 15, 2020.
RESULTS: By May 15, 2020, 11,018 COVID-19 cases were identified, of which 15.7% occurred in workplaces such as health-care facilities, call centers, sports clubs, coin karaoke, and nightlife destinations. When the first confirmed case was diagnosed, the Korean Center for Disease Control and Central Disaster Management Headquarters responded quickly, emphasizing early detection with numerous tests and a social distancing policy. This slowed the spread of infection without intensive containment, shut down, or mitigation interventions. After entering the public health blue alert level, a business continuity plan was distributed. After entering the orange level, the Ministry of Employment and Labor developed workplace guidelines for COVID-19 consisting of social distancing, flexible working schedules, early identification of workers with suspected infections, and disinfection of workplaces. Owing to the intensive workplace social distancing policy, workplaces remained safe with only small sporadic group infections.
CONCLUSIONS: The workplace social distancing policy with timely implementation of specific guidelines was a key to preventing a large outbreak of COVID-19 in Korean workplaces. However, sporadic incidents of COVID-19 are still ongoing, and risk assessment in vulnerable workplaces should be continued.

The Oregon Occupational Public Health Program (OOPHP) monitors occupational health indicators (OHIs) to inform occupational safety and health (OSH) surveillance. In 2018, OOPHP evaluated the performance of the OSH surveillance system and identified areas for future improvement.
Following the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems, the OOPHP evaluation team engaged internal and external stakeholders using a mixed-methods approach. Operational measures for ten surveillance attributes were developed. Multiple data collection methods resulted in credible evidence for evaluation conclusions. Analyses included summary statistics and qualitative analysis of interviews, a focus group, and online surveys.
Twenty stakeholders took part in this evaluation, with an average participation rate of 55%. Results showed the Oregon OSH surveillance system was simple, flexible, and highly accepted by its stakeholders. Funding security presents challenges for stability. A lack of timeliness of OHIs, low relevance of OHIs to local OSH issues, and the system\'s ineffectual data dissemination all limit the usefulness of the OSH surveillance system. A review of key data sources for the system showed good data quality and predictive value positive, but relatively poor sensitivity and representativeness.
The evaluation team successfully adapted attributes and examples in the CDC guidelines to this Oregon OSH surveillance evaluation. The evaluation findings have informed the development of recommendations for improvements to OOPHP\'s OSH surveillance. Future research is needed to develop guidance specific to OSH surveillance evaluation.

Focusing on the current challenges and opportunities of China National Infectious Disease Surveillance Network (CNIDS), the exploration and development of pathogen detecting and tracing technologies, and the key issues in vaccine development, 48 experts from the disease control and prevention centers; research institutes, universities and hospitals launched an in-depth discussion on October 24-27, 2019, and reached the following consensus. (1) CNIDS needs to coordinate operational activities and to integrate data across governmental departments in order to build a human-centered and life-cycle based disease monitoring and health managing system. (2) In addition to standardize and further strengthen pathogen culturing and isolating techniques, it is desired to develop multi-targeted, ultra-sensitive, high-specific, high-throughput, digitalized and easy-to-use techniques for pathogen detections and pathobionts analyses. (3) The rapid development of pathogen tracing technologies calls to facilitate the formulation of a more efficient pathogen-tracing system by integrating technologies from genomics, bioinformatics and microbiology.(4) To strengthen the basic researches to support new vaccine developments, to explore vaccination strategies and to unfold the post-marketing evaluation on vaccines. Finally, experts proposed and discussed possiblecountermeasures and suggestions tackling with those challenges.
来自疾病控制、高校科研院所、医疗机构的48位专家于2019年10月24—27日围绕我国传染病监测网络面临的挑战与机遇，病原微生物检测与溯源技术的探索和未来发展需求，以及疫苗研发面临的关键问题等内容展开了深入的讨论，并达成共识：（1）我国传染病监测网络亟须跨部门进行业务和数据整合，建设并完善以人为核心的全生命周期疾病监测与健康管理系统；（2）传统病原分离培养技术仍需进一步规范和加强，病原微生物检测技术亟须发展多靶标、超灵敏、高特异、便捷化和数字化的高中通量的新技术，并发展基于致病共栖菌谱新靶标的疾病诊断新技术；（3）亟须建立基因组学、生物信息学、微生物学等多学科交叉的溯源技术体系；（4）疫苗研发亟须相关基础研究支撑，并需加强疫苗接种策略和上市后评价与评估策略的研究。同时根据以上问题提出了专家建议。.

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BACKGROUND: With improving survival for patients with multiple myeloma (MM), supportive care that is focused on optimizing quality of life and minimizing treatment-related toxicities is increasingly important. The extent to which patients with MM are receiving recommended supportive care is unknown.
METHODS: This study used the Surveillance, Epidemiology, and End Results-Medicare database to identify older adults (age ≥66 years) diagnosed with MM in 2008-2013 who had received active treatment and survived 1 year or longer after their diagnosis. Outcomes of interest included guideline-recommended supportive care, which was defined as 1) bone-modifying drugs (BMDs) within the 12 months after the diagnosis, 2) influenza vaccination in the first season after the diagnosis, and 3) concomitant use of prophylactic antivirals with proteasome inhibitors. Multivariable logistic regression models were used to evaluate associations between patient/facility-level characteristics and supportive care use.
RESULTS: Among 1996 patients receiving MM-directed therapy, 64%, 52%, and 49% received BMDs, an influenza vaccination, and antiviral prophylaxis, respectively. Non-Hispanic black patients (odds ratio [OR] vs white patients, 0.63; 95% confidence interval [CI], 0.46-0.88) and patients with baseline renal impairment (OR, 0.43; 95% CI, 0.34-0.54) had lower odds of BMDs. Non-Hispanic blacks (OR, 0.52; 95% CI, 0.37-0.73) and those with dual Medicaid enrollment (OR, 0.76; 95% CI, 0.58-0.99) had lower odds of influenza vaccination. Treatment in a community-based setting was associated with reduced odds of antiviral prophylaxis (OR, 0.58; 95% CI, 0.46-0.72).
CONCLUSIONS: Substantial underutilization of guideline-recommended supportive care was observed among older adults with MM in the United States, and this was associated with both patient and facility characteristics. Targeted interventions are needed to improve supportive care for patients with MM.