Covert video surveillance: the Staffordshire Protocol--a response to Dr Shinebourne.

This paper is a response to Dr Shinebourne's response to my recent paper assessing the relative merits of the Staffordshire Protocol on covert video surveillance. Dr Shinebourne does not take the opportunity to rebut the criticisms made of the text of the protocol. It is further suggested that judicial oversight of the use of CVS might accord the process a degree of proportionality.     

The investigation of life-threatening child abuse and Munchausen syndrome by proxy.

The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment.     

Some ethical issues surrounding covert video surveillance--a response.

In a recent article in this journal our unit was accused of a number of errors of judgment in applying covert video surveillance (CVS) to infants and children suspected of life-threatening abuse. The article implied, that on moving from the Royal Brompton Hospital in London to North Staffordshire Hospital, we failed to present our work to the Research Ethics Committee (REC). We did send our protocol to the REC though we did not consider that, after a total of 16 patients had been documented as being the subject of life-threatening abuse, this was research. The REC in Staffordshire agreed with us. We were also accused of undertaking work that should be pursued by the Police. We agree with this. However, unlike the Metropolitan Police the Staffordshire Police would not undertake CVS. We fail to agree that 'working together' with parents is necessarily practical or safe when trying to protect children from life-threatening abuse of this kind.     

Covert video surveillance -- a response to Professor Southall and Dr. Samuels.

In their reply to my recent paper on Munchausen's syndrome by proxy, Professor Southall and Dr. Samuels concede that some things may be learned from my observations. They do not attend to the main argument of the paper, however, that the proportion of research interest in their use of covert video surveillance merits consideration of the research protocol by an independent research ethics committee. It will not do simply to assert that the use of this technology for the purposes outlined in their accounts is not research. I formulated arguments based on facts divulged in those published accounts for regarding their work as containing a considerable proportion of research activity. Unfortunately their reply did not address these arguments. Until such points are adequately answered the protection of patients calls for satisfactory judgments to be made on certain important issues which any research ethics committee would be obliged to consider in an evaluation of their activities. I suggest that some of these features will create more difficulties for approval of such a protocol than others.     

Report of the review into the research framework in North Staffordshire

This review began because of complaints about the conduct of research studies in the paediatric department of the North Staffordshire Hospital in Stroke-on-Trent. As it progressed other issues were also examined such as diagnosing Munchausen's Syndrome by Proxy by the use of covert video surveillance. The following extracts concentrate on research issues, and include the whole of the framework for research governance outlined in the report.     

Apnoeic episodes induced by smothering: two cases identified by covert video surveillance

Recurrent cyanotic episodes associated on some occasions with loss of consciousness due to cerebral hypoxia were investigated by long term tape recordings of breathing activity, oxygen saturation, air flow, electrocardiographic activity, and in some cases electroencephalographic activity. In 51 infants and children the mechanisms for the cyanotic episodes were identified (prolonged expiratory apnoea in 45, sleep related airway obstruction in three, seizure induced apnoea in one, behaviour induced apnoea in one). In one child apnoea was suspected as being caused by suffocation (smothering) by the mother. This was confirmed after enlisting the help of the police, who undertook covert video surveillance during cyanotic episodes. Each cyanotic episode was associated with a pattern of disturbance on the multichannel tape recordings which may be pathognomonic of this type of apnoea. A second infant with cyanotic episodes in whom smothering was suspected was referred for similar investigation after the availability of video recordings became established. Maternal smothering was again supported by specific patterns on multichannel tape recordings and confirmed by video surveillance. Diagnosis by video surveillance produces unequivocal evidence in these cases and avoids the need for medical and nursing staff to confront the mother with a possibly incorrect suspicion or in a court of law.     

Surveillance of patients post-endovascular aneurysm repair

Endovascular aneurysm repair (EVAR) is increasingly being employed as an alternative to open surgical repair for patients with abdominal aortic aneurysms. The surveillance of patients post-EVAR has traditionally been carried out with regular computed tomographic scans which have in part been responsible for the high costs associated with this procedure. Duplex has been proposed as an alternative, but researchers have so far been unable to devise a standardised protocol for this surveillance. This review aims to provide a clear understanding of currently employed imaging modalities and discuss future surveillance possibilities for this patient group.     

南京军区“医云工程”视频技术架构与应用实践研究

目的：探讨医院云视频技术框架的建立和实践经验。方法：以我院视频监控为例,阐述医院云视频平台的建立和部署过程。结果：云视频平台较好地整合了不同视频系统的信息资源,实现了视频资源的动态存储和按需分配,有利于系统的统一管理、高效运维及业务扩展。结论：云视频建设作为“医云工程”建设的一个新分支,符合医院视频平台建设的发展趋势,前景广阔。     

Guidelines for the investigation of individuals who were place under surveillance for tuberculosis post-landing in Canada. Canadian Thoracic Society, the Tuberculosis Directors of Canada and the Department of National Health and Welfare.

There are 2 parts to this article. Part 1 is a preamble, jointly prepared by Immigration and Overseas Health Services, Medical Services Branch and the Bureau of Communicable Disease Epidemiology, LCDC, Department of National Health and Welfare, to provide background information regarding the medical assessment of immigrants prior to landing in Canada. Part 2 is a set of guidelines for the investigation of individuals who were placed under surveillance for tuberculosis post-landing in Canada. It was jointly prepared by the Canadian Thoracic Society, the Tuberculosis Directors of Canada and the Department of National Health and Welfare in consultation with the provincial and territorial epidemiologists and has been approved by the Canadian Lung Association and the Canadian Thoracic Society.     

医疗视频监控系统集成平台设计

医院内部各种独立视频监控系统采用不同的硬件设备和通信协议,需要集中管理和共享资源.通过建立基于IP网络的视频监控系统集成平台,利用通用通信驱动程序与前端监控子系统交换数据,实现对所有相关医疗视频信息的统一管理,从而保护现有系统投资,节约管理成本.     

一种无参考监控视频图像清晰度评价方法

监控视频调焦时容易出现镜头离焦,导致输出图像模糊。为了降低人工检测成本,提出了一种基于结构相似度的无参考图像清晰度评价算法,用于评价监控安防设备视频图像的清晰度。在无参考的情况下,首先利用Sobel算子和高斯滤波器对待评价图像构造参考图,在此基础上计算分块后的图像结构相似度SSIM,为了更好地与人眼习惯吻合,利用权值加成各子块SSIM值,最后根据计算值评价图像的清晰度。实验结果表明：本文方法对图像模糊敏感度高,检测准确性优于传统检测方法,可以应用于实时的监控视频图像诊断。     

Health education on the six-o'clock news. Motivating television coverage of news in medicine

Prepackaged video news releases are being increasingly used to motivate television stations to cover stories in medicine and public health in their news programs. On Feb 26, 1987, the Office on Smoking and Health, US Department of Health and Human Services, distributed a prepackaged video news release to television stations across the country, calling attention to the new health warnings required on smokeless tobacco packages and advertisements. The video was sent by satellite as well as by overnight mail to selected stations. To assess the use of the video, we surveyed 76 stations that had been targeted by special intervention. These stations were in major metropolitan areas in states with a higher prevalence of smokeless tobacco use. Seventeen (22.4%) of the stations aired the story using our video during the six days following the satellite feed, reaching an estimated 2.8 million households. Another 20 stations reported that they were holding the video for use in the near future or for file footage. We conclude that the distribution of prepackaged video news stories can be an effective, relatively inexpensive technique to communicate health information to a large audience.     

Acquired immunodeficiency syndrome in New York City. Evaluation of an active surveillance system

In January 1983, the New York City Department of Health initiated an active surveillance program for acquired immunodeficiency syndrome (AIDS) in 19 hospitals and a modified-active surveillance program in the remaining 69 hospitals. We reviewed hospital laboratory and autopsy records in 12 active surveillance hospitals and three modified-active surveillance hospitals six months later. Patients who had opportunistic diseases characteristic of AIDS diagnosed in 1982 (before active surveillance) and 1983 (after implementation of active surveillance) were matched against health department AIDS surveillance reports. For the 16 months we evaluated, 96% of patients identified with AIDS in the 12 active surveillance hospitals and 100% of those in the three modified-active surveillance hospitals had been reported to the health department. The delay between diagnosing a case and reporting it to the health department significantly decreased between 1981 and the first six months of 1983 in all hospitals. The proportion of cases reported within one month of diagnosis increased from 45% to 69% during this period. We conclude that the current surveillance program for AIDS in New York City is effective and that case reporting is sufficiently complete for accurate analysis of disease trends.     

2012年湖北省血吸虫病国家级监测点疫情分析

目的了解2012年湖北省16个血吸虫病国家级监测点疫情变化趋势,为制定血吸虫病防治对策提供科学依据。方法收集2012年16个监测点人畜查病、螺情、防治工作及其监测点所在县晚期血吸虫病临床路径工作实施的调查数据,统计分析各项疫情指标及变化情况。结果湖北省16个监测点人群感染率为0.42%,耕牛感染率为0.58%,有螺地带耕牛平均敞放率为78.35%,活螺平均密度为0.196只/0.11 m2,16个监测点均未发现感染性钉螺;15个监测点所在县已开展晚期血吸虫病临床路径工作,入径率11.33%。结论以传染源为主的综合防治策略取得了成效,应加强钉螺控制新技术和控制耕牛这一传染源长效机制的研究;晚期血吸虫病临床路径入径率偏低,下一步要加强临床路径培训和领导重视力度。     

Development of an Emergency Medical Video Multiplexing Transport System (EMTS): aiming at the nation-wide prehospital care in ambulance

The Emergency Medical Video Multiplexing Transport System (EMTS) is designed to support prehospital care by delivering high quality patient's live video streams in an ambulance to emergency doctors in a remote hospital on the basis of satellite communications. The feature is that EMTS divides a patient's live video scene into four pieces and transports the four video streams on four separate network channels. By multiplexing the four video streams, EMTS is able to transport high quality videos through low data transmission rate networks such as satellite communications and cellular phone networks. In order to transport live video streams constantly, EMTS adopts Real-Time Transport Protocol/Real-Time Control Protocol as a network protocol, and video stream data are compressed by Moving Picture Experts Group 4 format. As EMTS combines four video streams with checking video frame numbers, it uses a refresh packet that initializes server's frame numbers to synchronize the four video streams.     

Development of an emergency medical video multiplexing transport system. Aiming at the nation wide prehospital care on ambulance

The Emergency Medical Video Multiplexing Transport System (EMTS) is designed to support prehospital cares by delivering high quality live video streams of patients in an ambulance to emergency doctors in a remote hospital via satellite communications. The important feature is that EMTS divides a patient's live video scene into four pieces and transports the four video streams on four separate network channels. By multiplexing four video streams, EMTS is able to transport high quality videos through low data transmission rate networks such as satellite communications and cellular phone networks. In order to transport live video streams constantly, EMTS adopts Real-time Transport Protocol/Real-time Control Protocol as a network protocol and video stream data are compressed by Moving Picture Experts Group 4 format. As EMTS combines four video streams with checking video frame numbers, it uses a refresh packet that initializes server's frame numbers to synchronize the four video streams.     

Tuberculosis in New South Wales

Surveillance of tuberculosis in New South Wales depends on notification of cases by medical practitioners and careful follow-up by public health nurses dedicated to the control of tuberculosis. Evaluation of tuberculosis surveillance data enables identification of patterns of infection, highlighting areas requiring specific interventions. In 1986, 290 cases of tuberculosis were notified to the Department of Health, New South Wales. The majority of patients (72.8%) were diagnosed as having pulmonary disease. The highest rates of infection were in people from Southeast Asian countries. Whereas 5.2% of cases were identified when the patients entered Australia, a substantial proportion of diagnoses (23.1%) were made in people who had been resident in Australia for 10 or more years. This article highlights the need to continue efforts to improve tuberculosis surveillance and control programmes in New South Wales.     

基于HOG3D描述器与稀疏编码的异常行为检测方法

提出了一种基于稀疏编码理论的视频异常行为检测方法,并使用HOG3D空-时描述器表征视频序列的形态及运动信息。首先,从正常视频序列中提取空-时兴趣点,获得其特征向量作为训练样本。通过K-SVD字典训练算法构建过完备字典,使得正常样本在所构建字典上的表达具有很好的稀疏性。在稀疏编码过程中,按视频段读取测试视频序列,求解特征信息在字典上的关于其稀疏系数的凸优化问题,然后根据稀疏编码改进公式求得重构误差数值。最后的判断阶段,计算视频段的相对重构误差,相对重构误差为正表明为异常视频段,否则为正常视频段。在UMN数据库3个场景及Weizmann数据库上进行实验,验证了本文算法的有效性。将实验拓展到现实监控视频中,结果表明本文方法在实践中同样具有较好的应用价值。     

基于类Haar特征和AdaBoost的车辆识别技术

在海量的监控视频中,快速、准确地识别车辆对公安破案和追踪具有重要的研究意义。通过提取车辆的类Haar特征,采用AdaBoost方法构建分类器可以实现监控视频中的车辆识别。针对原始算法误检率较高的问题,提出了采用背景差分去除背景干扰,以及采用目标对象差分法进行二次识别的两种改进算法。实验结果表明,两种改进算法都能够有效地降低误检率,提高检测率,并且对不同交通场景下的监控视频具有很好的检测效果。     

Balancing the scales of public interest: medical research and privacy

Guidelines for the protection of privacy in the conduct of medical research have been issued by the National Health and Medical Research Council, approved by the Commonwealth Privacy Commissioner, and gazetted on 1 July 1991 (Commonwealth of Australia Gazette No. P19) to remain in force until 30 June 1994. This paper examines the guidelines and seeks to inform researchers, institutional ethics committees and the institutions those committees represent of their content. Responsibilities are placed upon those engaged in the conduct of research and those involved in undertaking ethical review who now have to decide that the public interest in conducting the research substantially outweighs the public interest in privacy. There is also an emphasis on the requirement for surveillance of research projects by institutional ethics committees which has not previously been apparent. Questions are posed to assist in deciding whether a particular research protocol is subject to the guidelines.