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Additional file 1. Complete Search Strategy. Outlines the search strategies used across all databases.

Additional file 3. List of Excluded Studies. List of excluded studies and main reason for exclusion.

Additional file 2. List of AGMPs Considered in the Context of this Review. List of all the AGMPs considered in the context of this review, based on existing AGMP lists and by consensus from the Alberta Health Services’ AGMP guidance tool.

Additional file 1: Figure S1. Total rate of antimicrobials used among adult inpatients at CNISP hospitals, by hospital bed size category, 2009–2016. Table S1. ATC codes and defined daily doses (DDDs) for all systemic antibacterials included in CNISP AMU surveillance in 2016 (unless otherwise indicated DDD values are the 2016 World Health Organization ATC/DDD Index*).

Figure S5. Norovirus outbreak settings in Alberta by genogroup. Outbreaks from mixed GI and GII strains (nâ =â 7) were excluded from the analysis. (PDF 23 kb)

Figure S1. Maximum likelihood phylogeny of GII.17 strains based on complete ORF2 sequences. GII.17 strains from outbreaks in Alberta are shown with triangles. A) Tree based on nucleotide sequences constructed using the Tamura-Nei substitution model assuming gamma-distributed rates of evolution among sites B) Tree based on amino acid sequences constructed using the Jones-Taylor-Thornton (JTT) substitution model assuming gamma-distributed rates of evolution among sites. Both trees were rooted using a GII.13 outgroup reference sequence. Branch significance was estimated based on 1000 bootstrap replicates. Clusters and subclusters are shown as defined in previous studies [31, 32] (PDF 92 kb)

Figure S2. Maximum likelihood phylogeny of complete GII.P16/GII.4 Sydney capsid sequences. The maximum-likelihood tree was constructed using the Tamura-Nei substitution model, assuming gamma-distributed rates of evolution among sites. The analysis included strains representative of different countries and different years. (PDF 14 kb)

Figure S3. Description of data: Analysis of variable sites in capsid sequences of GII.P16/GII.4 Sydney recombinants compared to GII.Pe/GII.4 Sydney strains. Tables depict all variable amino acid residues identified in the alignment used to construct the tree shown in Additional file 2. Evolving amino acid positions previously reported by Lindesmith et al. [33] to play a role in the evasion of antibody immune responses are shown in red. (PDF 80 kb)

Figure S4. Saliva-binding of NoV P-domain proteins. The P-domain proteins of (A) AB-2016-26 (GII.P16/GII.4 Sydney), (B) AB-2016-190 (GII.P16/GII.4 Sydney) and (C) Syd9-2B (GII.Pe/GII.4 Sydney) were tested in their ability to bind saliva from individuals with different HBGAs profiles. (PDF 255 kb)

Companies have been concerned on measurement and improvement of their employees’ engagement using various conceptual models. Since every company has their own specific vision, mission, and values, customization is needed to measure employee engagement objectively. One of the biggest state-owned company in Indonesia develops a specific model of employee engagement, consisted of 12-dimensions. Those dimensions have been operationalized in order to build a set of questionnaire to measure employee engagement. This study elaborates the procedure taken to create, validate, and testing the reliability of the measure. We administered the newly designed questionnaire (38 items measuring 12-dimensions) as well as Gallup Employee Engagement and Aon Hewitt questionnaires to 869 employees of the company. Significant correlations between measures, significant item-total item correlations, factorial robustness, and discriminative power confirmed the validity of the measure. Internal consistency, test-retest reliability, and Cronbach Alpha confirmed the reliability of the measure. These multiple sources of evidence are discussed.

Major components of stool RNA after bacterial rRNA depletion. This file provides a description of the rRNA and non-NoV-non-rRNA reads from each sample. (DOCX 1108Â kb)

Various supporting data. This file contains: 1) the data used to estimate the correlation between percentage of NoVreads and Ct values, 2) the commands used for NGS analysis, 3) a summary of the sequences filtered out by Prinseq-lite due to quality control and 4) a description of the primers designed for sequencing sample OU3 via Sanger's method. (DOCX 86 kb)

Background Each year in Canada there are 5 million episodes of acute gastroenteritis (AGE) with up to 70 % attributed to an unidentified pathogen. Moreover, 90 % of individuals with AGE do not seek care when ill, thus, burden of disease estimates are limited by under-diagnosing and under-reporting. Further, little is known about the pathogens causing AGE as the majority of episodes are attributed to an “unidentified” etiology. Our team has two main objectives: 1) to improve health through enhanced enteric pathogen identification; 2) to develop economic models incorporating pathogen burden and societal preferences to inform enteric vaccine decision making. Methods/Design This project involves multiple stages: 1) Molecular microbiology experts will participate in a modified Delphi process designed to define criteria to aid in interpreting positive molecular enteric pathogen test results. 2) Clinical data and specimens will be collected from children aged 0–18 years, with vomiting and/or diarrhea who seek medical care in emergency departments, primary care clinics and from those who contact a provincial medical advice line but who do not seek care. Samples to be collected will include stool, rectal swabs (N = 2), and an oral swab. Specimens will be tested employing 1) stool culture; 2) in-house multiplex (N = 5) viral polymerase chain reaction (PCR) panel; and 3) multi-target (N = 15) PCR commercially available array. All participants will have follow-up data collected 14 days later to enable calculation of a Modified Vesikari Scale score and a Burden of Disease Index. Specimens will also be collected from asymptomatic children during their well child vaccination visits to a provincial public health clinic. Following the completion of the initial phases, discrete choice experiments will be conducted to enable a better understanding of societal preferences for diagnostic testing and vaccine policy. All of the results obtained will be integrated into economic models. Discussion This study is collecting novel samples (e.g., oral swabs) from previously untested groups of children (e.g., those not seeking medical care) which are then undergoing extensive molecular testing to shed a new perspective on the epidemiology of AGE. The knowledge gained will provide the broadest understanding of the epidemiology of vomiting and diarrhea of children to date.

Background ProvLab Alberta provides all laboratory testing for Bordetella pertussis including sporadic cases and outbreak investigations through collaborations with provincial public health partners. We describe B. pertussis activity in Alberta from July 2004 to December 2012. Methods Laboratory testing for pertussis was analyzed using interpreted laboratory data that was generated by DIAL, a secure web-based platform. Duplicate specimens from the same individual ≤90 days were excluded to generate a case-based dataset. Immunization status of confirmed pertussis cases from the provincial immunization repository was reviewed. Results Overall, 7.1% of suspected pertussis cases tested positive with a higher positivity rate in outbreak as compared to sporadic setting. Annual variations in sporadic pertussis cases were observed across the province with higher positivity rates in 2005, 2008, 2009 and 2012. A significantly higher positivity rate was observed in a northern region of Alberta. While the positivity rate in sporadic setting was highest in adolescents aged 10 to

Lack of automated and integrated data collection and management, and poor linkage of clinical, epidemiological and laboratory data during an outbreak can inhibit effective and timely outbreak investigation and response. This paper describes an innovative web-based technology, referred to as Web Data, developed for the rapid set-up and provision of interactive and adaptive data management during outbreak situations. We also describe the benefits and limitations of the Web Data technology identified through a questionnaire that was developed to evaluate the use of Web Data implementation and application during the 2009 H1N1 pandemic by Winnipeg Regional Health Authority and Provincial Laboratory for Public Health of Alberta. Some of the main benefits include: improved and secure data access, increased efficiency and reduced error, enhanced electronic collection and transfer of data, rapid creation and modification of the database, conversion of specimen-level to case-level data, and user-defined data extraction and query capabilities. Areas requiring improvement include: better understanding of privacy policies, increased capability for data sharing and linkages between jurisdictions to alleviate data entry duplication.