Urogenital chlamydia infection, caused by the bacterium Chlamydia trachomatis (CT), is the most common sexually transmitted bacterial infection in Sweden. In 2008 it was estimated by WHO that there were 105.7 million new cases of CT worldwide, an increase by 4.2 million cases (4.1%) compared to 2005. If untreated, CT infections can progress to serious reproductive health problems, especially in women. These complications include subfertility/infertility, ectopic pregnancy and chronic pain. The CT infection is often asymptomatic and reliable diagnostic methods and contact tracing are important tools for identifying infected individuals. CT infection is classified in the Swedish Communicable Diseases Act as a serious disease; consequently, written reporting and contact tracing are compulsory. Previous or ongoing CT infection is not uncommon in infertile couples, especially in women with tubal factor infertility (TFI). We have tested 244 infertile couples for CT antibodies, and CT IgG positive couples were tested for CT DNA in urine. The prevalence of CT antibodies was higher in infertile men and women, and ongoing CT infection was common. Our results support a role of CT in infertility and underscore the importance of prevention of CT infection. Contact tracing was studied during using questionnaires. A total of 544 questionnaires was sent to tracers in a Swedish county and 534 (98%) were completed. Centralized contact tracing performed by experienced tracers is effective; on average 65% of sexual contacts found by contact tracing are CT-infected. Our data show that it is worthwhile to extend the tracing period beyond 6 months as 30% of reported sexual contacts between months 7-12 were CT-infected. Contact tracing may be performed face-to-face at the clinic or by telephone. Because of the severe consequences of CT infection there is a need for useful methods for both primary and secondary prevention of CT and other sexually transmitted infections (STIs). An important sub-population for CT/STI-prevention is the “core group”, i.e. a subpopulation with high incidence of STIs combined with risky sexual behaviours. This subpopulation contributes particularly to the spread of STIs in the population. Therefore, we have developed and evaluated a brief standardised but flexible manual-based single-session intervention based on motivational interviewing (MI) for the reduction of high risk sexual behaviour. Women (n=105) and men (n=119) at high risk of contracting CT infection were randomly eighter offered brief MI counselling or standard care. Our findings support the effectiveness of brief MI-based counselling in reducing high-risk sexual behaviour and incident CT infection in women (p<0.01) but not in men. Our results suggest that gender aspects need to be considered and that men and women should be treated differently for achieving maximal risk-reduction. Whereas it might be sufficient to include information and motivation when performing risk-reducing counselling on women, counsellors may also add other components, such as behavioural skills and booster sessions, when counselling is performed on men. / Klamydiainfektion orsakas av Chlamydia trachomatis och är den vanligaste sexuellt överförda bakterieinfektionen. WHO har uppskattat att det år 2008 var 105,7 miljoner nya fall av klamydia i världen, en ökning med 4,2 miljoner fall (4,1 %) jämfört med år 2005. Klamydiainfektion är ett folkhälsoproblem och klassificeras i den svenska smittskyddslagen som en allmänfarlig sjukdom varför det är obligatoriskt att smittspåra och göra en skriftlig anmälan till smittskyddsläkaren och Smittskyddsinstitutet. Klamydiainfektionen ger oftast inga symtom och tillförlitliga diagnostiska metoder och smittspårning är viktiga ”redskap” för att hitta smittade personer. Om klamydiainfektionen inte behandlas kan den leda till allvarliga hälsoproblem, speciellt hos kvinnor. Bland komplikationer efter klamydiainfektion ingår ofrivillig barnlöshet, utomkvedshavandeskap och kronisk buksmärta. Tecken på tidigare eller pågående klamydiainfektion är vanliga hos ofrivilligt barnlösa par, speciellt hos kvinnor med skadade äggledare som orsak till barnlösheten. Våra resultat ger stöd för betydelsen av klamydia vid ofrivillig barnlöshet och understryker vikten av förebyggande åtgärder mot klamydia samt klamydiaprovtagning av både män och kvinnor vid utredning av ofrivillig barnlöshet. Centraliserad klamydiasmittspårning utförd av erfarna smittspårare är effektiv och i genomsnitt är 65 % av spårade sexuella kontakter klamydiasmittade. Våra data visar att det lönar sig att förlänga smittspårningsperioden från 6 till 12 månader eftersom betydligt fler klamydiasmittade kontakter då hittas. Den så kallade ”Västerbottensmodellen” med en smittspårningsperiod på 12 månader rekommenderas nu av Socialstyrelsen. Kontaktspårning kan utföras antingen på mottagningen eller per telefon. På grund av risk för allvarliga konsekvenser av klamydia finns det behov av metoder för att förebygga klamydiasmitta. En viktig grupp för prevention är den så kallade ”kärngruppen", alltså de personer som har en hög förekomst av klamydia och andra sexuellt överförda infektioner i kombination med sexuellt riskbeteende. Denna grupp bidrar särskilt till spridningen av sexuellt överförda infektioner bland befolkningen. Därför har vi utvecklat och utvärderat en kort samtalsmetod som bygger på metoden motiverande samtal (MI, motivational interviewing) för att minska sexuellt risktagande. Våra fynd visar att kort MI-baserad rådgivning för att minska sexuellt riskbeteende och klamydiainfektion fungerar bra på kvinnor men inte lika bra på män. Resultaten tyder på att genusaspekter måste beaktas och att kvinnor och män ska behandlas på olika sätt för att uppnå maximal riskminskning. Det kan vara tillräckligt att fokusera på information och motivation vid rådgivning av kvinnor men för rådgivning av män kan man behöva komplettera med beteendemässiga färdigheter och/eller upprepad MI-baserad rådgivning för att nå god effekt.

Purpose: The purpose of our work is to develop a system for automatic contact tracing with the goal of identifying individuals who are most likely infected, even if we do not have direct diagnostic information on their health status. Control of the spread of respiratory pathogens (e.g. novel influenza viruses) in the population using vaccination is a challenging problem that requires quick identification of the infectious agent followed by large-scale production and administration of a vaccine. This takes a significant amount of time. A complementary approach to control transmission is contact tracing and quarantining, which are currently applied to sexually transmitted diseases (STDs). For STDs, identifying the contacts that might have led to disease transmission is relatively easy; however, for respiratory pathogens, the contacts that can lead to transmission include a huge number of face-to-face daily social interactions that are impossible to trace manually. Method: We developed a Bayesian network model to process context awareness proximity sensor information together with (possibly incomplete) diagnosis information to track the spread of disease in a population. Our model tracks real-time proximity contacts and can provide public health agencies with the probability of infection for each individual in the model. For testing our algorithm, we used a real-world mobile sensor dataset of 80 individuals, and we simulated an outbreak. Result: We ran several experiments where different sub-populations were ???infected??? and ???diagnosed.??? By using the contact information, our model was able to automatically identify individuals in the population who were likely to be infected even though they were not directly ???diagnosed??? with an illness. Conclusion: Automatic contact tracing for respiratory pathogens is a powerful idea, however we have identified several implementation challenges. The first challenge is scalability: we note that a contact tracing system with a hundred thousand individuals requires a Bayesian model with a billion nodes. Bayesian inference on models of this scale is an open problem and an active area of research. The second challenge is privacy protection: although the test data were collected in an academic setting, deploying any system will require appropriate safeguards for user privacy. Nonetheless, our work illustrates the potential for broader use of contact tracing for modelling and controlling disease transmission.

To stem the spread of infectious diseases, epidemiologists use contact tracing interviews to identify individuals who may need treatment or, if indicated, quarantine or isolation. Given the high stakes, the most exhaustive list of potentially infected contacts must be reported. However, standard contact tracing procedures may fail to extract the most complete report possible from sick individuals. One of the most reliable methods for maximizing recall is the Cognitive Interview (CI). The CI uses several techniques grounded in psychological theory and was expected to increase the number of contacts listed during contact tracing interviewing compared to a standard contact tracing interview. In Study One, participants imagined they were infected with meningococcal meningitis, and reported every person with whom they had physical contact, shared saliva, or lived with over the previous three days (i.e., at a high risk for developing meningococcal meningitis). Participants were interviewed with either a CI or a standard interview. Results suggested that the CI generated 35% more total contacts listed, however, when examining only the contacts listed who would be at a high risk of meningococcal meningitis there was no significant difference between the CI and the standard interview. Study Two followed the same procedure as that in Study One, but added a manipulation of cognitive resources intended to model impairment experienced by individuals who are interviewed while suffering from acute illness. Participants completed (or did not complete) a working memory impairment task (pressed a spacebar on a keyboard every time 7 seconds passed) while reporting their physical contacts during either a CI or a standard interview. Results clearly demonstrated a superiority of the CI in generating both more total contacts and more contacts at a risk of meningococcal meningitis than the standard interview. However, when the working memory impairment task was completed, the CI generated no more contacts than the standard interview. Findings have serious implications for contact tracing interviewing for infectious diseases such as Ebola and Zika. In light of the findings, we recommend the CI be considered as an alternative to the typical contact tracing interview, particularly if the interviewee is not cognitively impaired.

Channel State Information (CSI) refers to a set of measurements used to characterize a radio communication link. Radio infrastructure collects CSI and derives useful metrics that indicate changes to modulation and coding to be made to improve the link performance (e.g. throughput, reliability). The CSI, however, has a wider potential use. It contains an environment-specific signature that can be used to extract information about users’ position and activity. In our work, we explore the problem of proximity estimation, which consists of identifying how close a pair of devices are to each other. By assuming that Cellular Base Stations (BSs) are distributed spatially according to a Poisson Point Process (PPP), and that the channel is under Rayleigh fading, we were able to probabilistically model radio measurements and use Bayesian inference to estimate the separation between two devices given their measurements only. We first explore a shadowless channel model, then we investigate how spatially-correlated shadowing can prove useful for estimation. For both cases, Bayesian estimators are proposed and tested through simulations. We also perform experiments and evaluate how well the estimators fit to actual data.

Background. In parallel with public health responses, health systems have had to rapidly implement infection control strategies during the SARS-CoV-2 (COVID-19) pandemic. Various technologies, such as digital contact tracing (DCT), have been implemented to enhance case investigations among healthcare workers' (HCWs). Currently, little attention has focused on the perspectives of those who have implemented DCT innovations and those who have adopted such technologies within a healthcare environment. -- Objective. This study aimed to describe the implementation, acceptance, and outcomes of a web-based DCT tool used extensively at a specialized pediatric acute-care hospital in Ontario during the COVID-19 pandemic from the perspective of key stakeholders. -- Methods. Using an exploratory qualitative design, this research involved 21 semi-structured interviews with healthcare administrators (n=6; 29%), occupational health specialists (n=8; 38%), and healthcare workers (n=7; 33/%) at the Children's Hospital of Eastern Ontario. Interview protocols and analysis were guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The interviews lasted on average 33.6 minutes in length and were audio-recorded. Verbatim transcripts were subjected to thematic analysis using NVivo software. -- Results. The implementation of DCT during the COVID-19 pandemic was viable and well-received among stakeholders. End-users cited that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk-assessment consequences and access concerns were present as barriers (reach). Stakeholders commonly agreed that the DCT tool exerted a positive outcome on the hospital's capacity to meet the demands of COVID-19, notably through the facilitation of timely case investigations and by informing decision-making processes (effectiveness). Implementors and occupational specialists conveyed staffing impacts, and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a technology that was human-centered were crucial factors driving staff adoption. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs standard practices, alongside the evolving perspectives of COVID-19. Some end-users expressed an initial disconnect towards the DCT tool, raising questions about the fidelity of the implementation. However, stakeholders collectively agreed on the viability of the DCT approach and its applicability to infectious disease practices (maintenance). -- Conclusion. Stakeholders reported DCT in the hospital context to be acceptable and efficient in meeting the demands of the COVID-19 pandemic. Recommendations for optimized DCT use include education and training for relevant personnel, improved access and usability, and integration into clinical systems. The findings contribute to evidence-based practices and guide future scale-up initiatives focused on digital surveillance in the hospital context.

Yes / Contact tracing involves collecting people’s information to track the spread of COVID-19 and to warn people who have been in the proximity of infected individuals. This measure is important to public health and safety during the pandemic. However, customers’ concerns about the violation of their privacy might inhibit their cooperation in the contact tracing process, which poses a risk to public safety. This research investigates how to facilitate customers’ cooperative behavior in contact tracing based on cognitive trust and affective trust. The findings show that cognitive trust increases people’s willingness to disclose information and reduces their willingness to falsify it, whereas affective trust increases the willingness for both disclosure and falsification. This research contributes to the literature on customer data privacy by illuminating how cognitive and affective trust distinctly influence cooperative behavior, which has important implications for hospitality businesses.

Text in English / Botswana has witnessed highest TB rates in the southern African countries, ranking the fourth after South Africa, Swaziland and Zimbabwe. In 2012, the TB rate was on average 531/100 000 population. About 2 380 contacts out of a possible 8 110 (amounting to 29.30%) were traced nationally (Botswana 2011:8), indicating a possible gap of 5 730 which was yet to be traced in 2011. The TBCT strategies might be inadequate leading to absence of screening and treating TB contacts and reducing PTB related deaths. The purpose of this study was to describe utilisation of current TBCT and develop a strategy for a more effective TBCT in Botswana. Data was collected through a quantitative cross-sectional research design. The study further described the association between TBCT strategies and practices and determined the gaps, challenges and needs in the TBCT. Results revealed under-tracing of contacts in the number of registered and enumerated TB contacts. The results further established the risk of mixing TB contacts and the general patients. The differences in the perceptions and knowledge of the cause of TB as well as poor utilisation of the current programmes by the PTB patients denotes the need for aggressive awareness raising and health promotion strategies. The results were used to develop an alternative strategy, the IC-TBCT, which has a potential to trace all TB contacts. The strategy encourages participation, effective accountability and involvement of the beneficiaries in all efforts aiming at early contact identification and reducing the incidence of PTB. / Health Studies / D. Litt. et Phil. (Health Studies)

I samband med utbrottet av covid-19 introducerades kontaktspårningsapplikationer (contact tracing application, CTA), eftersom de har bevisats kunna vara ett effektivt verktyg för kontaktspårning och därmed minska smittspridning. CTA kan med hjälp av Bluetooth signaler bestämma en individs positionering och vilka personer de varit i kontakt med. Detta innebär att personlig data om dess användare samlas in, hanteras och lagras. CTA är beroende av en hög acceptans och användningsnivå för att fungera på ett effektivt sätt. I tidigare forskningsstudier uppmärksammas därmed att etiken kopplad till dessa applikationerna behöver belysas. Studien syftar därmed till att belysa vilka etiska problem som finns kopplade till användningen av CTA. Studien är utformad som en litteraturstudie med en kvalitativ innehållsanalys. Resultatet består av en sammanställning av de etiska problemen kopplade till CTA utifrån kategorierna i ramverket PAPA. Sammanställningen visar på att det finns många etiska problem kopplade till CTA som behöver bemötas och det visar även på att det är till stor del samma etiska problem som uppstår och är relevanta inom IS idag, som det har varit inom området i årtionden sedan PAPA skapades. / During the outbreak of covid-19, contact tracing applications (CTA) were introduced as they have been proven to be an effective tool for contact tracing and thereby reduce the spread of infection. With Bluetooth signals, CTA can determine an individual’s positioning and which people they have been in contact with. This means that personal data about its users is collected, managed, and stored. CTA depends on a high level of acceptance and usage to function effectively. In previous research studies, attention is thus drawn to the fact that ethics linked to these applications need to be enlightened. Therefore, this study aims to shed light on the ethical problems associated with CTA. The study is designed as a literature review with a qualitative content analysis. The result consists of a compilation of the ethical problems linked to CTA based on the categories in the PAPA framework. The compilation shows that there are many ethical problems linked to CTA that need to be addressed and it also shows that it is largely the same ethical problems that arise and are relevant in IS today, as it has been in the field for decades since PAPA was created.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed on June 23, 2009). Includes bibliographical references.

The study aims to identify the role of artificial intelligence and big data that can help us to confront the COVID-19. The study adopted the literature review methodology by reading and analyzing academic studies. This study was divided into two parts: a theoretical part that deals with the basic concepts of artificial intelligence and big data, and an analytical section that deals with reviewing and analyzing artificial intelligence and big data applications to confront COVID-19, including Contact Tracing Apps, then find the weaknesses and develop a recommendation list. The paper concludes that artificial intelligence and big data applications and apps could help to confrontCOVID-19 to some extent. However, artificial intelligence and big data are in the first steps. Moreover, they have not yet had a significant impact on controlling the COVID-19 since some issues and challenges hamper the use of these technologies like accuracy and public trust, etc. Hard work from governments is required in order to overcome these challenges in the first place. It is doubtful that these challenges will be addressed during the COVID-19. However, it is a great learning experience and an opportunity to develop our technologies to overcome future pandemics.