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Aim: The current study compared disclosure of mental health problems to staff, faculty, and peers among college students from different ethnic backgrounds. Background: Although there are differences in mental health stigma between college students from different ethnic backgrounds, there is limited research on whether these differences are associated with negative experiences disclosing mental health conditions on campus. Methods: The sample (N = 66) was 71% female; average age was 19.03 years (SD = 1.14). Participants identified as Latino/a (35.4%), Asian American (33.8%), Caucasian (13.8%), or other/mixed ethnicity (16.9%). Results: For disclosure to staff, there was a main effect of ethnicity. Post-hoc analyses found that Latino/a students were significantly more comfortable disclosing mental health problems to staff than Asian American students. There were no significant effects for disclosure to faculty or peers. Conclusions: This preliminary study suggests that universities must optimize outreach and mental health services for different ethnic groups to improve campus experience around mental health conditions.

Summary: In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A(H1N1)pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR (Polymerase Chain Reaction) and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 (41%) subject locations were contaminated with virus. Overall, 33 of the 671 (4.9%) surface swabs were PCR positive for influenza, of which two (0.3%) yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads (geometric mean ratio 25.7; 95% CI 1.75, 376.0, p = 0.021) and a positive correlation (r = 0.47, p = 0.006) was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five (42%) samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei (aerosol) transmission of influenza. Keywords: Influenza, Environmental, Deposition, Infection, Control

PROBLEM: Improving pandemic planning and preparedness is a challenge in Europe, a diverse region whose regional bodies (the Regional Office for Europe of the World Health Organization [WHO], the European Commission and the European Centre for Disease Prevention and Control) have overlapping roles and responsibilities. APPROACH: European pandemic preparedness indicators were used to develop an assessment tool and procedure based on the 2005 global WHO checklist for pandemic preparedness. These were then applied to Member States of WHO's European Region, initially as part of structured national assessments conducted during short visits by external teams. LOCAL SETTING: Countries in WHO's European Region. RELEVANT CHANGES: From 2005 to 2008, 43 countries underwent a pandemic preparedness assessment that included a short external assessment visit by an expert team. These short visits developed into a longer self-assessment procedure involving an external team but "owned" by the countries, which identified gaps and developed plans for improving preparedness. The assessment tool and procedure became more sophisticated as national and local pandemic preparedness became more complex. The 2009 pandemic revealed new gaps in planning, surveillance communications and immunization. LESSONS LEARNT: Structured national self-assessments with support from external teams allow individual countries to identify gaps in their pandemic preparedness plans and enable regional bodies to assess the regional and global resources that such plans require. The 2009 pandemic revealed additional problems with surveillance, pandemic severity estimates, the flexibility of the response, vaccination, involvement of health-care workers and communication. European national plans are being upgraded and global leadership is required to ensure that these plans are uniformly applied across the region.

Summary: We evaluated the effectiveness of inactivated influenza vaccine in persons aged ≥45 years with co-morbidities (including essential hypertension) likely to have prompted consideration of prophylactic statin therapy. Using case–control analyses, we measured the impact of vaccination on General Practitioner (GP) reported new episodes of illness for clinically diagnosed influenza-like illness (ILI) and total acute respiratory infection (TARI) during eight consecutive winters, adjusting for potential confounders using multivariable techniques. Although the study failed to demonstrate the effectiveness of influenza vaccine, we identified important potential confounding related to a greater likelihood of vaccinees than non-vaccinees to consult with a GP for respiratory infections. Future researchers should consider and account for this phenomenon. Keywords: Influenza, Inter-pandemic, Vaccine, Effectiveness, Cardiovascular risk

Abstract Objective To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. Methods We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. Findings The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Conclusion Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus.