The Boston Collaborative Drug Surveillance Program started in 1966 and conducted epidemiologic research to quantify the potential adverse effects of prescription drugs, utilizing in-hospital monitoring.
Ji, Yanqing; Ying, Hao; Farber, Margo S.; Yen, John; Dews, Peter; Miller, Richard E.; Massanari, R. Michael
Discovering unknown adverse drug reactions (ADRs) in postmarketing surveillance as early as possible is of great importance. The current approach to postmarketing surveillance primarily relies on spontaneous reporting. It is a passive surveillance system and limited by gross underreporting (<10% reporting rate), latency, and inconsistent reporting. We propose a novel team-based intelligent agent software system approach for proactively monitoring and detecting potential ADRs of interest using electronic patient records. We designed such a system and named it ADRMonitor. The intelligent agents, operating on computers located in different places, are capable of continuously and autonomously collaborating with each other and assisting the human users (e.g., the food and drug administration (FDA), drug safety professionals, and physicians). The agents should enhance current systems and accelerate early ADR identification. To evaluate the performance of the ADRMonitor with respect to the current spontaneous reporting approach, we conducted simulation experiments on identification of ADR signal pairs (i.e., potential links between drugs and apparent adverse reactions) under various conditions. The experiments involved over 275 000 simulated patients created on the basis of more than 1000 real patients treated by the drug cisapride that was on the market for seven years until its withdrawal by the FDA in 2000 due to serious ADRs. Healthcare professionals utilizing the spontaneous reporting approach and the ADRMonitor were separately simulated by decision-making models derived from a general cognitive decision model called fuzzy recognition-primed decision (RPD) model that we recently developed. The quantitative simulation results show that 1) the number of true ADR signal pairs detected by the ADRMonitor is 6.6 times higher than that by the spontaneous reporting strategy; 2) the ADR detection rate of the ADRMonitor agents with even moderate decision-making skills is five
Greenblatt, D J; Allen, M D
1 To assess the potential hazards of nitrazepam therapy of insomnia in the elderly, adverse reactions to nitrazepam were studied in 2111 hospitalized medical patients who received the drug. 2 Manifestations of unwanted central nervous system (CNS) depression (such as drowsiness or 'hangover') were reported in 49 nitrazepam recipients (2.3%), and signs of unwanted CNS stimulation (such as nightmares, insomnia, agitation, etc.) in 15 (0.7%). None of the adverse reactions were considered serious. 3 Physician-rated clinical efficacy of nitrazepam was not related to dose, but the frequency of both types of adverse reactions increased significantly at higher daily doses. CNS depression also was significantly more frequent in the elderly, being reported in 11% of those aged 80 years or older, whereas the frequency of CNS stimulation was not correlated with age. 4 The effect of age on the reported rate of unwanted CNS depression was most striking at high doses. Among patients aged 80 years or over whose daily dose averaged 10 mg or more, 55% experienced unwanted CNS depression attributed to nitrazepam. 5 Low doses of nitrazepam are safe for elderly individuals, but the elderly are readily susceptible to excessive CNS depression at high doses. The findings suggest that there is little reason to exceed 5mg doses of nitrazepam for most patients, particularly those who are elderly.
This article argues that current regulations governing the licensing of drugs, particularly in the U.S., need to be changed and replaced by a system of provisional or conditional licensing and increased postmarketing surveillance of drug use. In terms of research and development of new forms of contraception, this proposal would have great impact. It is believed that the U.S./Food and Drug Administration (FDA) requirements--animal experiments and Phase 1 and 2 clinical trials--not only put an unacceptable financial burden on any institution attempting to develop new contraceptives, but do not demonstrably contribute to the reduction of risks. The author questions whether even if oral contraceptives introduced prior to new U.S./FDA regulations had been subject to these current regulations that convincing evidence would have been found to alert anyone to the now-known rare adverse effects, such as risk of thromboembolism. It is pointed out that these sorts of rare risks were uncovered by continuous screening processes which are not now a part of the FDA drug regulation requirements. The author also questions the politics of "conpulsory safety," such as might be legislated for regulated car safety belt use. Citing a partnership already established between government and private industry in high-risk/low cost ventures in the aerospace industry, the author sees no reason why such a relationship could not evolve in the pharmaceutical industry. In Britain, proposals have been made to establish a fund to compensate patients adversely affected by drugs which pharmaceutical companies would reimburse if proved negligent; such a fund may work in the U.S. under new regulations which stress postmarketing surveillance.
Lorberbaum, T; Nasir, M; Keiser, M J; Vilar, S; Hripcsak, G; Tatonetti, N P
Small molecule drugs are the foundation of modern medical practice, yet their use is limited by the onset of unexpected and severe adverse events (AEs). Regulatory agencies rely on postmarketing surveillance to monitor safety once drugs are approved for clinical use. Despite advances in pharmacovigilance methods that address issues of confounding bias, clinical data of AEs are inherently noisy. Systems pharmacology-the integration of systems biology and chemical genomics-can illuminate drug mechanisms of action. We hypothesize that these data can improve drug safety surveillance by highlighting drugs with a mechanistic connection to the target phenotype (enriching true positives) and filtering those that do not (depleting false positives). We present an algorithm, the modular assembly of drug safety subnetworks (MADSS), to combine systems pharmacology and pharmacovigilance data and significantly improve drug safety monitoring for four clinically relevant adverse drug reactions.
McKenna, Verna B; Gunn, Julia E; Auerbach, John; Brinsfield, Kathryn H; Dyer, K Sophia; Barry, M Anita
The Boston Public Health Commission developed and implemented an active surveillance system for bioterrorism and other infectious disease emergencies. A bioterrorism Surveillance Task Force was formed with representatives from local emergency medicine, infection control, infectious diseases, public health, and emergency medical services. These local agencies worked together to develop a reliable, easy to use electronic surveillance system. Collaboration at the local level and building on existing relationships is a key component of this system. Effective follow-up systems and technology back-up plans are essential. Improved communication networks and increased bioterrorism education for clinicians and the general public have also been achieved.
Schwoebel, V; Lambregts, C.S.B.; Moro, M.L.; Drobniewski, F; Hoffner, S.E.; Raviglione, M.C.; Rieder, H.L.
Antituberculosis drug resistance, whose extent in Europe is not well documented, is a serious threat to tuberculosis control. The aim of the recent European recommendations on antituberculosis drug resistance surveillance, issued by a working group compos
Lortie, F M
The surveillance of adverse drug reactions (ADRs) is an unqualified must. However, the optimal means of surveillance is still unclear. Although anecdotal reports are the backbone of an ADR surveillance system, they are not enough. The pharmaceutical industry, academics and regulatory agencies need to expand their efforts in monitoring ADRs. The author discusses the various techniques for counting and evaluating adverse reactions and suggests ways in which the system could be improved. PMID:3719483
de Bie, Sandra; Coloma, Preciosa M; Ferrajolo, Carmen; Verhamme, Katia M C; Trifirò, Gianluca; Schuemie, Martijn J; Straus, Sabine M J M; Gini, Rosa; Herings, Ron; Mazzaglia, Giampiero; Picelli, Gino; Ghirardi, Arianna; Pedersen, Lars; Stricker, Bruno H C; van der Lei, Johan; Sturkenboom, Miriam C J M
Aim Electronic healthcare record (EHR)-based surveillance systems are increasingly being developed to support early detection of safety signals. It is unknown what the power of such a system is for surveillance among children and adolescents. In this paper we provide estimates of the number and classes of drugs, and incidence rates (IRs) of events, that can be monitored in children and adolescents (0–18 years). Methods Data were obtained from seven population-based EHR databases in Denmark, Italy, and the Netherlands during the period 1996–2010. We estimated the number of drugs for which specific adverse events can be monitored as a function of actual drug use, minimally detectable relative risk (RR) and IRs for 10 events. Results The population comprised 4 838 146 individuals (25 575 132 person years (PYs)), who were prescribed 2170 drugs (1 610 631 PYs drug-exposure). Half of the total drug-exposure in PYs was covered by only 18 drugs (0.8%). For a relatively frequent event like upper gastrointestinal bleeding there were 39 drugs for which an association with a RR ≥4, if present, could be investigated. The corresponding number of drugs was eight for a rare event like anaphylactic shock. Conclusion Drug use in children is rare and shows little variation. The number of drugs with enough exposure to detect rare adverse events in children and adolescents within an EHR-based surveillance system such as EU-ADR is limited. Use of additional sources of paediatric drug exposure information and global collaboration are imperative in order to optimize EHR data for paediatric safety surveillance. PMID:25683723
Litterman, Nadia K; Rhee, Michele; Swinney, David C; Ekins, Sean
Rare disease research has reached a tipping point, with the confluence of scientific and technologic developments that if appropriately harnessed, could lead to key breakthroughs and treatments for this set of devastating disorders. Industry-wide trends have revealed that the traditional drug discovery research and development (R&D) model is no longer viable, and drug companies are evolving their approach. Rather than only pursue blockbuster therapeutics for heterogeneous, common diseases, drug companies have increasingly begun to shift their focus to rare diseases. In academia, advances in genetics analyses and disease mechanisms have allowed scientific understanding to mature, but the lack of funding and translational capability severely limits the rare disease research that leads to clinical trials. Simultaneously, there is a movement towards increased research collaboration, more data sharing, and heightened engagement and active involvement by patients, advocates, and foundations. The growth in networks and social networking tools presents an opportunity to help reach other patients but also find researchers and build collaborations. The growth of collaborative software that can enable researchers to share their data could also enable rare disease patients and foundations to manage their portfolio of funded projects for developing new therapeutics and suggest drug repurposing opportunities. Still there are many thousands of diseases without treatments and with only fragmented research efforts. We will describe some recent progress in several rare diseases used as examples and propose how collaborations could be facilitated. We propose that the development of a center of excellence that integrates and shares informatics resources for rare diseases sponsored by all of the stakeholders would help foster these initiatives.
Litterman, Nadia K.; Rhee, Michele; Swinney, David C.; Ekins, Sean
Rare disease research has reached a tipping point, with the confluence of scientific and technologic developments that if appropriately harnessed, could lead to key breakthroughs and treatments for this set of devastating disorders. Industry-wide trends have revealed that the traditional drug discovery research and development (R&D) model is no longer viable, and drug companies are evolving their approach. Rather than only pursue blockbuster therapeutics for heterogeneous, common diseases, drug companies have increasingly begun to shift their focus to rare diseases. In academia, advances in genetics analyses and disease mechanisms have allowed scientific understanding to mature, but the lack of funding and translational capability severely limits the rare disease research that leads to clinical trials. Simultaneously, there is a movement towards increased research collaboration, more data sharing, and heightened engagement and active involvement by patients, advocates, and foundations. The growth in networks and social networking tools presents an opportunity to help reach other patients but also find researchers and build collaborations. The growth of collaborative software that can enable researchers to share their data could also enable rare disease patients and foundations to manage their portfolio of funded projects for developing new therapeutics and suggest drug repurposing opportunities. Still there are many thousands of diseases without treatments and with only fragmented research efforts. We will describe some recent progress in several rare diseases used as examples and propose how collaborations could be facilitated. We propose that the development of a center of excellence that integrates and shares informatics resources for rare diseases sponsored by all of the stakeholders would help foster these initiatives. PMID:25685324
Robb, Melissa A; Racoosin, Judith A; Worrall, Chris; Chapman, Summer; Coster, Trinka; Cunningham, Francesca E
After half a century of monitoring voluntary reports of medical product adverse events, the Food and Drug Administration (FDA) has launched a long-term project to build an adverse events monitoring system, the Sentinel System, which can access and evaluate electronic health care data to help monitor the safety of regulated medical products once they are marketed. On the basis of experience gathered through a number of collaborative efforts, the Federal Partners' Collaboration pilot project, involving FDA, the Centers for Medicare & Medicaid Services, the Department of Veteran Affairs, and the Department of Defense, is already enabling FDA to leverage the power of large public health care databases to assess, in near real time, the utility of analytical tools and methodologies that are being developed for use in the Sentinel System. Active medical product safety surveillance is enhanced by use of these large public health databases because specific populations of exposed patients can be identified and analyzed, and can be further stratified by key variables such as age, sex, race, socioeconomic status, and basis for eligibility to examine important subgroups.
Pivette, Mathilde; Mueller, Judith E; Crépey, Pascal; Bar-Hen, Avner
Drug sales data have increasingly been used for disease surveillance during recent years. Our objective was to assess the value of drug sales data as an operational early detection tool for gastroenteritis epidemics at national and regional level in France. For the period 2008-2013, we compared temporal trends of drug sales for the treatment of gastroenteritis with trends of cases reported by a Sentinel Network of general practitioners. We benchmarked detection models to select the one with the best sensitivity, false alert proportion and timeliness, and developed a prospective framework to assess the operational performance of the system. Drug sales data allowed the detection of seasonal gastrointestinal epidemics occurring in winter with a distinction between prescribed and non-prescribed drugs. Sales of non-prescribed drugs allowed epidemic detection on average 2.25 weeks earlier than Sentinel data. These results confirm the value of drug sales data for real-time monitoring of gastroenteritis epidemic activity.
Brendtro, Larry K.; Martin, Gordon A., Jr.
This launches a new periodic feature in Reclaiming Children and Youth. "Justice Alerts" examines current laws and policies against the twofold standards of solid science and moral values. This inaugural article explores the legal issues and political rhetoric surrounding random drug testing in schools and describes how science is being…
Collaborative learning has been widely endorsed in education. This qualitative research examines instances of collaborative learning during mathematics that were seen to be predominantly non-collaborative despite the pedagogical efforts and intentions of the teacher and the task. In an effort to disrupt the non-collaborative learning, small groups…
Hinckley, Alison; Hook, Sarah; Beard, C. Ben
TickNET, a public health network, was created in 2007 to foster greater collaboration between state health departments, academic centers, and the Centers for Disease Control and Prevention on surveillance and prevention of tickborne diseases. Research activities are conducted through the Emerging Infections Program and include laboratory surveys, high-quality prevention trials, and pathogen discovery. PMID:26291549
Chaudet, Hervé; Meynard, Jean-Baptiste; Texier, Gaëtan; Tournebize, Olivier; Pellegrin, Liliane; Queyriaux, Benjamin; Boutin, Jean-Paul
This paper presents a pilot project of a real time syndromic surveillance system in French armed forces for early warning of biological attack by mass destruction weapons. For simulating the situation of a theatre of operations and its organisation, an electronic syndromic surveillance system covering all branches of service in French Guiana (about 3,000 persons) has been deployed and connected to a surveillance centre in France. This system has been design taking in account a collaborative view of epidemiological surveillance and the mobility of forces in extreme conditions. Several kinds of hardware, from rugged personal digital assistant to desktop computer, and several telecommunication links, from PSTN to satellite data links, are used. This system allows a quick report of cases, which are georeferenced. In the first results, some problems associated with the human and the technical aspects have been reported, in association with some immediate advantages.
The number of available antiviral drugs is growing fast. The emergence of drug-resistant viruses is well documented as a cause for drug failure. Such viruses also carry the potential for transmission, the risks for which vary according to specific viral transmission dynamics. This potential is best described for HIV and influenza. Resistance to the new generation of hepatitis C virus inhibitors is also likely to become a cause for concern. The priorities for future action to limit resistance include application of sophisticated surveillance mechanisms linked to detailed virological data, development of optimal treatment regimens (e.g. combination therapies) to limit emergence of resistance, and a focus on prevention strategies to prevent transmission.
Maeda, Kazuki; Katashima, Rumi; Ishizawa, Keisuke; Yanagawa, Hiroaki
Background Registration trials leading to the approval of drugs are paramount in drug development. After approval, continuous efforts are necessary to ensure proper use of the approved drugs. In Japan, post-marketing surveillance (PMS) by drug companies is conducted in accordance with good post-marketing study practice (GPSP). Although the global standard for pharmacovigilance is incorporated into GPSP, attention has recently been focused on disassociating them. In this study, we examined physicians’ views on PMS with the aim of conducting PMS more effectively. Methods We retrospectively reviewed records between 2009 and 2013 from the institutional review board of Tokushima University Hospital, an academic hospital in rural Japan. The annual number of times PMS was performed was then determined. Next, we assessed physicians’ attitudes toward drug PMS, including ethical issues, in a cross-sectional study using a questionnaire designed for this study. Five- and two-point scales were used. The questionnaire was distributed in 2014 to 221 physicians listed as investigators in PMS contracts. Results Of the 221 physicians, 103 (46.6%) responded to the questionnaire. About 50% of the respondents had experience writing PMS reports. Many of the physicians considered PMS to be important but burdensome. Furthermore, from the viewpoint of research ethics, many physicians considered it improper within the present PMS framework to collect and provide data beyond the scope of routine clinical practice without obtaining informed consent in the case of extra blood sampling, provision of images, monitoring and controlled studies. Conclusions Beyond practical factors such as workload, attention should be given to establishing an ethical infrastructure and globally harmonized system with regard to the Japanese PMS system. Given the limitations of this single-institution study, further research is needed to collect information for developing a suitable infrastructure. PMID:26566409
Kadner, S.P.; Ondrik, M.; Reisman, A.
Collaborative efforts between the International Projects Division (IPD) of the Department of Advanced Technology at Brookhaven National Laboratory, Aquila Technologies Group, Inc. (Aquila), and the General Physics Institute (GPI) in Moscow have developed object recognition technologies to provide real-time intrusion detection capabilities for Aquila`s GEMINI Digital Surveillance System. The research, development and testing for integrating enhanced surveillance capabilities into Aquila`s GEMINI system will receive support from the US Industry Coalition (USIC), an initiative funded by the Initiatives for Proliferation Prevention (IPP), in the coming year. Oversight of the research and development effort is being provided by the IPD staff to ensure that the technical standards of safeguards systems for use by the International Atomic Energy Agency (IAEA) are met. The scientific expertise at GPI is providing breakthroughs in the realm of motion detection for surveillance. Aquila`s contribution to the project focuses on the integration of authenticated digital camera technology for front-end detection. This project illustrates how the application of technology can increase efficiency and reliability of remote monitoring, as well as the timely detection of Safeguards-significant events.
Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa
With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…
Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle
It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities.
McBane, Sarah E; Dopp, Anna L; Abe, Andrew; Benavides, Sandra; Chester, Elizabeth A; Dixon, Dave L; Dunn, Michaelia; Johnson, Melissa D; Nigro, Sarah J; Rothrock-Christian, Tracie; Schwartz, Amy H; Thrasher, Kim; Walker, Scot
The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throughout the United States. CDTM is well suited to facilitate the delivery of comprehensive medication management (CMM) by clinical pharmacists. CMM, defined by ACCP as a core component of the standards of practice for clinical pharmacists, is designed to optimize medication-related outcomes in collaborative practice environments. New models of care delivery emphasize patient-centered, team-based care and increasingly link payment to the achievement of positive economic, clinical, and humanistic outcomes. Hence clinical pharmacists practicing under CDTM agreements or through other privileging processes are well positioned to provide CMM. The economic value of clinical pharmacists in team-based settings is well documented. However, patient access to CMM remains limited due to lack of payer recognition of the value of clinical pharmacists in collaborative care settings and current health care payment policy. Therefore, the clinical pharmacy discipline must continue to establish and expand its use of CDTM agreements and other collaborative privileging mechanisms to provide CMM. Continued growth in the provision of CMM by appropriately qualified clinical pharmacists in collaborative practice settings will enhance recognition of their positive impact on medication-related outcomes.
Aldana-Espinal, Josefa María; García-León, Francisco Javier
The Andalusian Regional Ministry of Health is implementing an Alert Integrated System (SIA) in order to improve the health protection of the population by means of the appropriate response to the sanitary alerts.
The evolution of antibiotic resistance was studied among common respiratory tract pathogens in five countries of the European Union and in the USA during 1992-1993. The data obtained from a collaborative surveillance study were submitted to population analysis, to detect possible shifts in antibiotic susceptibility and, therefore, associated mechanisms of resistance. Among the emerging haemophilus influenzae phenotypes were isolates that did not correspond to the beta-lactamase negative, amino-penicillin resistant (BLNAR) phenotype, but were beta-lactamase producers showing low level ceftriaxone resistance (early extended spectrum beta-lactamases?) amoxycillin susceptible strains with low level ceftriaxone resistance (PBP modification?) and isolates with high-level fluoroquinolone resistance. Moraxella catarrhalis resistance to ceftriaxone erythromycin or fluoroquinolones was noted. The quantitative evolution of antibiotic resistance may reach saturation in some countries with a very high proportion of resistant strains, for example, Spain and France. Qualitatively, resistant strains may be selected that have broader or more effective mechanisms of resistance, particularly under the recently introduced pressure of more active antibiotics of the same family. In countries with modest levels of antibiotic resistance (UK, Germany, Italy), attention should be paid to the misuse of antibiotics with a propensity to select low-level resistant strains. In this respect, the relative prescribing of aminopenicillins and oral cephalosporins in the UK (a high ratio and low prevalence of Streptococcus pneumoniae) and resistance to penicillin in the USA (a low ratio and high prevalence of resistance) is of potential importance.
Pastor, Manuel; Benedetti, Paolo; Carotti, Angelo; Carrieri, Antonio; Díaz, Carlos; Herráiz, Cristina; Höltje, Hans-Dieter; Loza, M. Isabel; Oprea, Tudor; Padín, Fernando; Pubill, Francesc; Sanz, Ferran; Stoll, Friederike; the LINK3D Consortium
The work describes the development of novel software supporting synchronous distant collaboration between scientists involved in drug discovery and development projects. The program allows to visualize and share data as well as to interact in real time using standard intranets and Internet resources. Direct visualization of 2D and 3D molecular structures is supported and original tools for facilitating remote discussion have been integrated. The software is multiplatform (MS-Windows, SGI-IRIX, Linux), allowing for a seamless integration of heterogeneous working environments. The project aims to support collaboration both within and between academic and industrial institutions. Since confidentiality is very important in some scenarios, special attention has been paid to security aspects. The article presents the research carried out to gather the requirements of collaborative software in the field of drug discovery and development and describes the features of the first fully functional prototype obtained. Real-world testing activities carried out on this prototype in order to guarantee its adequacy in diverse environments are also described and discussed.
Hennessy, Sean; Strom, Brian L.
Adverse drug events (ADEs) are an important public health concern, accounting for 5% of all hospital admissions and two-thirds of all complications occurring shortly after hospital discharge. There are often long delays between when a drug is approved and when serious ADEs are identified. Recent and ongoing advances in drug safety surveillance include establishment of government-sponsored networks of population databases, use of data mining approaches, and formal integration of diverse sources of drug safety information. These advances promise to reduce delays in identifying drug-related risks, allowing earlier identification of risks as well as reassurance about the absence of specific risks. PMID:25292435
Bhardwaj, Anshu; Scaria, Vinod; Raghava, Gajendra Pal Singh; Lynn, Andrew Michael; Chandra, Nagasuma; Banerjee, Sulagna; Raghunandanan, Muthukurussi V; Pandey, Vikas; Taneja, Bhupesh; Yadav, Jyoti; Dash, Debasis; Bhattacharya, Jaijit; Misra, Amit; Kumar, Anil; Ramachandran, Srinivasan; Thomas, Zakir; Brahmachari, Samir K
It is being realized that the traditional closed-door and market driven approaches for drug discovery may not be the best suited model for the diseases of the developing world such as tuberculosis and malaria, because most patients suffering from these diseases have poor paying capacity. To ensure that new drugs are created for patients suffering from these diseases, it is necessary to formulate an alternate paradigm of drug discovery process. The current model constrained by limitations for collaboration and for sharing of resources with confidentiality hampers the opportunities for bringing expertise from diverse fields. These limitations hinder the possibilities of lowering the cost of drug discovery. The Open Source Drug Discovery project initiated by Council of Scientific and Industrial Research, India has adopted an open source model to power wide participation across geographical borders. Open Source Drug Discovery emphasizes integrative science through collaboration, open-sharing, taking up multi-faceted approaches and accruing benefits from advances on different fronts of new drug discovery. Because the open source model is based on community participation, it has the potential to self-sustain continuous development by generating a storehouse of alternatives towards continued pursuit for new drug discovery. Since the inventions are community generated, the new chemical entities developed by Open Source Drug Discovery will be taken up for clinical trial in a non-exclusive manner by participation of multiple companies with majority funding from Open Source Drug Discovery. This will ensure availability of drugs through a lower cost community driven drug discovery process for diseases afflicting people with poor paying capacity. Hopefully what LINUX the World Wide Web have done for the information technology, Open Source Drug Discovery will do for drug discovery.
Werb, Dan; Kerr, Thomas; Nosyk, Bohdan; Strathdee, Steffanie; Montaner, Julio; Wood, Evan
Objectives Illegal drug use continues to be a major threat to community health and safety. We used international drug surveillance databases to assess the relationship between multiple long-term estimates of illegal drug price and purity. Design We systematically searched for longitudinal measures of illegal drug supply indicators to assess the long-term impact of enforcement-based supply reduction interventions. Setting Data from identified illegal drug surveillance systems were analysed using an a priori defined protocol in which we sought to present annual estimates beginning in 1990. Data were then subjected to trend analyses. Main outcome measures Data were obtained from government surveillance systems assessing price, purity and/or seizure quantities of illegal drugs; systems with at least 10 years of longitudinal data assessing price, purity/potency or seizures were included. Results We identified seven regional/international metasurveillance systems with longitudinal measures of price or purity/potency that met eligibility criteria. In the USA, the average inflation-adjusted and purity-adjusted prices of heroin, cocaine and cannabis decreased by 81%, 80% and 86%, respectively, between 1990 and 2007, whereas average purity increased by 60%, 11% and 161%, respectively. Similar trends were observed in Europe, where during the same period the average inflation-adjusted price of opiates and cocaine decreased by 74% and 51%, respectively. In Australia, the average inflation-adjusted price of cocaine decreased 14%, while the inflation-adjusted price of heroin and cannabis both decreased 49% between 2000 and 2010. During this time, seizures of these drugs in major production regions and major domestic markets generally increased. Conclusions With few exceptions and despite increasing investments in enforcement-based supply reduction efforts aimed at disrupting global drug supply, illegal drug prices have generally decreased while drug purity has generally
Levin, B.; Lennard-Jones, J.; Riddell, R. H.; Sachar, D.; Winawer, S. J.
In chronic ulcerative colitis, the object of surveillance is prevention of cancer or at least prevention of death from cancer by diagnosis at an early curable stage or by detection at a pre-malignant phase. Patients must be informed about their cancer risk as well as the limitations of endoscopic surveillance and the availability of surgical alternatives. Physicians must bear in mind the risks, benefits and costs of surveillance procedures. Patients at greatest risk of cancer for whom endoscopic surveillance is warranted are those with extensive colitis of greater than 8 years duration. Colonoscopy should be performed every 1 to 2 years at which time multiple biopsies are obtained from every 10-12 cm of normal-appearing mucosa. Targeted biopsies should also be obtained from areas where the surface appears raised as a broad-based polyp, low irregular plaque or villiform elevation, or from an unusual ulcer, particularly one with raised edges, or from a stricture. Typical inflammatory polyps need not be sampled. Colectomy is recommended in the presence of multifocal high-grade dysplasia if confirmed by an experienced pathologist. The identification of a mass lesion associated with any degree of overlying dysplasia is also a generally accepted indication for colectomy, while persistent low-grade dysplasia without a mass is somewhat more controversial. Recently introduced biomarkers may replace or supplement dysplasia in surveillance programmes as well as provide new information about malignant transformation. PMID:1905205
In principle, a new drug is approved via the assessments of safety and efficacy by the Ministry of Health, Labor and Welfare (MHLW). After approval, conduct of post-marketing surveillance is requested by law in order to assess the safety and efficacy of the drug in a large number of patients. Before initiating a surveillance, submission to MHLW of a document on the plan of survey is necessary in the purpose of inspection if it includes any ethical or regulatory problem or not. Through the inspections of the plans submitted during the period of April 1998 and March 2000, many problems have been pointed out. In this report, the author introduces some of the concrete problems noted in the plans on drugs for infectious diseases and shows some of the guidance made by the authority how to improve them. It is expected that such practical analyses of cases may be useful for future planning of post-marketing surveillance on drugs for infectious diseases.
Trifirò, G; Coloma, P M; Rijnbeek, P R; Romio, S; Mosseveld, B; Weibel, D; Bonhoeffer, J; Schuemie, M; van der Lei, J; Sturkenboom, M
A growing number of international initiatives (e.g. EU-ADR, Sentinel, OMOP, PROTECT and VAESCO) are based on the combined use of multiple healthcare databases for the conduct of active surveillance studies in the area of drug and vaccine safety. The motivation behind combining multiple healthcare databases is the earlier detection and validation, and hence earlier management, of potential safety issues. Overall, the combination of multiple healthcare databases increases statistical sample size and heterogeneity of exposure for postmarketing drug and vaccine safety surveillance, despite posing several technical challenges. Healthcare databases generally differ by underlying healthcare systems, type of information collected, drug/vaccine and medical event coding systems and language. Therefore, harmonization of medical data extraction through homogeneous coding algorithms across highly different databases is necessary. Although no standard procedure is currently available to achieve this, several approaches have been developed in recent projects. Another main challenge involves choosing the work models for data management and analyses whilst respecting country-specific regulations in terms of data privacy and anonymization. Dedicated software (e.g. Jerboa) has been produced to deal with privacy issues by sharing only anonymized and aggregated data using a common data model. Finally, storage and safe access to the data from different databases requires the development of a proper remote research environment. The aim of this review is to provide a summary of the potential, disadvantages, methodological issues and possible solutions concerning the conduct of postmarketing multidatabase drug and vaccine safety studies, as demonstrated by several international initiatives.
Blanc, P D; Jones, M R; Olson, K R
There is no gold standard for determining poisoning incidence. We wished to compare four measures of poisoning incidence: International Classification of Diseases 9th Revision (ICD-9) principal (N-code) and supplemental external cause of injury (E-code) designations, poison control center (PCC) reporting, and detection by the Drug Abuse Warning Network (DAWN). We studied a case series at two urban hospitals. We assigned ICD-9 N-code and E-code classifications, determining whether these matched with medical records. We ascertained PCC and DAWN system reporting. A total of 724 subjects met entry criteria; 533 were studied (74%). We matched poisoning N-codes for 278 patients (52%), E-code by cause in 306 patients (57%), and E-code by intent in 171 patients (32%). A total of 383 patients (72%) received any poisoning N-code or any E-code. We found that PCC and DAWN reporting occurred for 123 of all patients (23%) and 399 of 487 eligible patients (82%), respectively. In multiple logistic regression, factors of age, hospital admission, suicidal intent, principal poisoning or overdose type, and mixed drug overdose were statistically significant predictors of case match or report varying by surveillance measure. Our findings indicate that common surveillance measures of poisoning and drug overdose may systematically undercount morbidity.
Nordstrom, David L.; Yokoi-Shelton, Mieko L.; Zosel, Amy
Context Many state and local areas are affected by the national epidemic of drug-related mortality, which recently has shown signs of a rising licit-to-illicit drug death ratio. Appropriate local public health surveillance can help to monitor and control this epidemic. Objective Using our state as an example, we sought to illustrate how to describe the changes in drug death rates, causes, and circumstances. In contrast to most other surveillance reports, our approach includes both drug-induced and drug-related deaths and both demographic and socioeconomic decedent characteristics. Design Cross-sectional study. Setting All residents of the State of Wisconsin. Participants Decedents from 1999–2008. Main outcome measure Annual numbers and population-based rates of deaths due to drugs, including both identified and unidentified drugs. Information was obtained from death certificates with any of approximately 270 underlying, immediate, or contributing cause of death codes from the International Classification of Diseases 10th Revision. Results Drug-related death rates increased during much of the 10-year study period, and the ratio of male to female deaths rose. The median age at death from drug-related causes was 43 years. Opioid analgesic poisoning surpassed cocaine and heroin poisoning as the most frequent type of fatal drug poisoning. Of all 4828 deaths from drug-related causes--virtually all of which were certified by a county medical examiner or coroner--3,410 (71%) were unintentional, and 1,053 (22%) were suicide. The unintentional-to-suicide death rate ratio grew from 1.6 to 3.5 during the study period. Methadone-related deaths increased from 10 in 1999 to 118 in 2008 (1080%), while benzodiazepine-related deaths rose from 23 to 106 (361%). Conclusions Although premature deaths from drug use and abuse continue to rise, in some states even surpassing motor vehicle crash deaths, multiple cause of death information from death certificates is available to monitor
Beltrán-Alzate, Camilo; López Díaz, Fernando; Romero-Montoya, Marcela; Sakamuri, Rama; Li, Wei; Kimura, Miyako; Brennan, Patrick
An active search for Mycobacterium leprae drug resistance was carried out, 243 multibacillary patients from endemic regions of Colombia were included from 2004 to 2013 in a surveillance program. This program was a World Health Organization initiative for drug resistance surveillance in leprosy, where Colombia is a sentinel country. M. leprae DNA from slit skin smear and/or skin biopsy samples was amplified and sequenced to identify mutations in the drug resistance determining region (DRDR) in rpoB, folP1, gyrA, and gyrB, the genes responsible for rifampicin, dapsone and ofloxacin drug-resistance, respectively. Three isolates exhibited mutations in the DRDR rpoB gene (Asp441Tyr, Ser456Leu, Ser458Met), two in the DRDR folP1 gene (Thr53Ala, Pro55Leu), and one isolate exhibited mutations in both DRDR rpoB (Ser456Met) and DRDR folP1 (Pro55Leu), suggesting multidrug resistance. One isolate had a double mutation in folP1 (Thr53Ala and Thr88Pro). Also, we detected mutations outside of DRDR that required in vivo evaluation of their association or not with drug resistance: rpoB Arg505Trp, folP1 Asp91His, Arg94Trp, and Thr88Pro, and gyrA Ala107Leu. Seventy percent of M. leprae mutations were related to drug resistance and were isolated from relapsed patients; the likelihood of relapse was significantly associated with the presence of confirmed resistance mutations (OR range 20.1–88.7, p < 0.05). Five of these relapsed patients received dapsone monotherapy as a primary treatment. In summary, the current study calls attention to M. leprae resistance in Colombia, especially the significant association between confirmed resistance mutations and relapse in leprosy patients. A high frequency of DRDR mutations for rifampicin was seen in a region where dapsone monotherapy was used extensively. PMID:27706165
R. and Murray, R.M. (2004). Consensus problems in networks of agents with switching topology and time -delays. IEEE Trans. Autom. Control, 49(9), 1520... consensus tracking problem on a time -varying graph with incomplete data and noisy communications links. We propose a distributed and collaborative framework...proposed distributed tracking with consensus algorithm. The performance results show that the proposed algorithm indeed performs very well under conditions
Sims, Shannon A; Snow, Laverne A; Porucznik, Christina A
Healthcare safety and quality surveillance is increasingly conducted by public health agencies. We describe a biomedical informatics method that uses multiple public health data sources to perform surveillance of methadone-related adverse drug events. Data from Utah medical examiner records, vital statistics, emergency department encounter administrative data and a database of controlled substances prescriptions are used to examine trends in state-wide adverse events related to methadone. From 1997 to 2004, population-adjusted methadone prescriptions increased 727%, with evidence to suggest the rise in the methadone prescription rate is for treatment of pain, not addiction therapy. During the same period of time, population adjusted, accidental methadone-related deaths in medical examiner data increased 1770%. Population adjusted methadone-related emergency department encounters rose 612% from 1997 to 2003. Our results suggest that the increase in methadone prescription rates from 1997 to 2004 was accompanied by a concurrent increase in methadone-related morbidity and mortality. Although patient data is not linked between data sources, our results demonstrate that utilizing multiple public health data sources captures more cases and provides more clinical detail than individual data sources alone. Our approach is a successful biomedical informatics approach for surveillance of adverse events and utilizes widely available public health data sources, as well as an emerging source of public health data, controlled substance prescription registries.
Silva, I R; Kulldorff, M
The use of sequential statistical analysis for post-market drug safety surveillance is quickly emerging. Both continuous and group sequential analysis have been used, but consensus is lacking as to when to use which approach. We compare the statistical performance of continuous and group sequential analysis in terms of type I error probability; statistical power; expected time to signal when the null hypothesis is rejected; and the sample size required to end surveillance without rejecting the null. We present a mathematical proposition to show that for any group sequential design there always exists a continuous sequential design that is uniformly better. As a consequence, it is shown that more frequent testing is always better. Additionally, for a Poisson based probability model and a flat rejection boundary in terms of the log likelihood ratio, we compare the performance of various continuous and group sequential designs. Using exact calculations, we found that, for the parameter settings used, there is always a continuous design with shorter expected time to signal than the best group design. The two key conclusions from this article are (i) that any post-market safety surveillance system should attempt to obtain data as frequently as possible, and (ii) that sequential testing should always be performed when new data arrives without deliberately waiting for additional data.
Cadierno, Juan Pedro García; Renedo, J I Serrano; Lopez, E Gil
The presence of radioactive materials in scrap metal has been detected relatively often in recent years. As a result of an accidental melting of a 137Cs source in a Spanish steel mill (Acerinox) in 1998, the national authorities, the involved private companies, and the main trade unions drafted a protocol for prevention of and responding to such events ("Spanish Protocol"). The Protocol was signed in 1999. The number of subscribing companies is 90. The Protocol is a voluntary agreement defining the radiological surveillance of scrap metal and its products and the duties and rights of the signatories. From the effective date of the Protocol to December 2004, 461 pieces of ferric scrap were detected including sources of radiation and contaminated metal. Four melting incidents have happened in different companies.
Kozma, Robert; Wang, Lan; Iftekharuddin, Khan; McCracken, Ernest; Khan, Muhammad; Islam, Khandakar; Bhurtel, Sushil R; Demirer, R Murat
The feasibility of using Commercial Off-The-Shelf (COTS) sensor nodes is studied in a distributed network, aiming at dynamic surveillance and tracking of ground targets. Data acquisition by low-cost (<$50 US) miniature low-power radar through a wireless mote is described. We demonstrate the detection, ranging and velocity estimation, classification and tracking capabilities of the mini-radar, and compare results to simulations and manual measurements. Furthermore, we supplement the radar output with other sensor modalities, such as acoustic and vibration sensors. This method provides innovative solutions for detecting, identifying, and tracking vehicles and dismounts over a wide area in noisy conditions. This study presents a step towards distributed intelligent decision support and demonstrates effectiveness of small cheap sensors, which can complement advanced technologies in certain real-life scenarios.
Kozma, Robert; Wang, Lan; Iftekharuddin, Khan; McCracken, Ernest; Khan, Muhammad; Islam, Khandakar; Bhurtel, Sushil R.; Demirer, R. Murat
The feasibility of using Commercial Off-The-Shelf (COTS) sensor nodes is studied in a distributed network, aiming at dynamic surveillance and tracking of ground targets. Data acquisition by low-cost (<$50 US) miniature low-power radar through a wireless mote is described. We demonstrate the detection, ranging and velocity estimation, classification and tracking capabilities of the mini-radar, and compare results to simulations and manual measurements. Furthermore, we supplement the radar output with other sensor modalities, such as acoustic and vibration sensors. This method provides innovative solutions for detecting, identifying, and tracking vehicles and dismounts over a wide area in noisy conditions. This study presents a step towards distributed intelligent decision support and demonstrates effectiveness of small cheap sensors, which can complement advanced technologies in certain real-life scenarios. PMID:22438713
Huang, Yu; Wu, Qingqing; Xu, Shuiyang; Zhong, Jieming; Chen, Songhua; Xu, Jinghang; Zhu, Liping; He, Haibo; Wang, Xiaomeng
With 25% of the global burden, China has the highest incidence of drug-resistant tuberculosis (TB) in the world. However, surveillance data on extensively drug-resistant TB (XDR-TB) from China are scant. To estimate the prevalence of XDR-TB in Zhejiang, Eastern China, 30 of 90 TB treatment centers in Zhejiang were recruited. Patients with suspected TB who reported to the clinics for diagnosis were requested to undergo a smear sputum test. Positive sputum samples were tested for drug susceptibility. Data on anti-TB drug resistance from 1999 to 2008 were also collected to assess drug resistance trends. A total of 931 cases were recruited for drug susceptibility testing (DST). Among these, 23.6% (95% confidence interval [CI], 18.8-24.4) were resistant to any of the following drugs: isoniazid, rifampin, streptomycin, and ethambutol. Multidrug resistant (MDR) strains were identified in 5.1% of all cases (95% CI, 3.61-6.49). Among MDR-TB cases, 6.4% were XDR (95% CI, 1.7-18.6) and 8.9% (95% CI, 7.0-10.8) of all cases were resistant to either isoniazid or rifampin (but not both). Among MDR-TB cases, 23.4% (95% CI, 12.8-38.4) were resistant to either fluoroquinolones or a second-line anti-TB injectable drug, but not both. From 1999 to 2014, the percentage of MDR cases decreased significantly, from 8.6% to 5.1% (p = 0.00). The Global Fund to Fight TB program showed signs of success in Eastern China. However, drug-resistant TB, MDR-TB, and XDR-TB still pose a challenge for TB control in Eastern China. High-quality directly observed treatment, short-course, and universal DST for TB cases to determine appropriate treatment regimens are urgently needed to prevent acquired drug resistance.
Wang, S F; Zhan, S Y
Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China.
Permana, A. R.; Aryanti, T.; Rahmanullah, F.
The increase of drug addicts in Indonesia has not been supported by adequate facilities, both quantitatively and qualitatively. Despite being treated in a rehabilitation center, drug addicts may still use drugs surreptitiously and put themselves in danger. Architectural design may contribute to this either positively or negatively. This article elaborates a therapeutic design of a male rehabilitation center in the borderland of Bandung city, Indonesia. Employing the notion of natural surveillance, the rehabilitation center is designed to allow continual control over attendees without them feeling suppressed. The center design uses the behavioral approach to consider both attendees’ physical and psychological comforts, as well as their security. Building masses are designed in a way that forms an inward orientation and are laid out circularly according to the therapy processes that attendees must undertake. Moreover, rooms are planned differently in response to attendees’ unique conditions and restrictive physical requirements, such as their restriction on lighting and requirement of water for treatment. The landscape uses shady trees and vegetations as natural borders to demarcate the private zone, where attendees live, from the public area, where visitors may enter. The design is intended to provide a model for a responsive drug rehabilitation center that facilitates drug addicts’ recovery.
Cabibbe, A M; Cirillo, D M
In 2014, the World Health Organization (WHO) recommendation to include the endorsed rapid molecular technologies (Xpert MTB/RIF, line probe assays) into surveillance systems and surveys allowed the testing of more tuberculosis (TB) patients for drug resistance at country level than ever before. The whole genome sequencing (WGS) approach is emerging as a more powerful tool for epidemiological and drug-resistant routine surveillances, promising a rapid and simultaneous screening of all the clinically-relevant mutations for the determination of resistance to the first-, second-line, and new anti-TB drugs. In addition, WGS can support the conventional contact tracing for epidemiological studies with high discriminatory power by tracking the circulating strains and their relatedness. These features make WGS, moreso than the conventional molecular tools, an ideal tool to monitor transmission and drug resistance trends in countries, providing deep and wide information in a standardized way. WGS technologies have already been adopted in many supranational and reference laboratories at the centralized level, and several research groups are working to reduce the complexity and costs of these platforms, from sample preparation to the downstream analysis and interpretation of sequencing reads, with the final aim to expand the use of WGS to all laboratory levels. The landscape of the platforms available for next-generation sequencing (NGS) is rapidly enriching. It includes high-throughput instruments that can be used for centralized surveillance studies on a large scale, and "benchtop" sequencers that conversely can reach more peripheral settings for rapid and non-extensive surveys. Traditionally, WGS is performed on genomic DNA samples extracted from clinical isolates to ensure the required high DNA quality and quantity for the following library preparation and sequencing reaction steps. Nevertheless, the researchers are trying to apply the WGS to early primary cultures and in
Traversa, Giuseppe; Sagliocca, Luciano; Magrini, Nicola; Venegoni, Mauro
The aim of this article is to provide an introduction to issue of Recenti Progressi in Medicina, devoted to the role of drug registries in the post-marketing surveillance. We first motivate the need to implement registries as a tool in promoting the appropriateness of drug use and acquiring additional information on the risk-benefit profile of drugs. Then, the different role that can be played by registries in comparison with prescription monitoring systems and observational studies is clarified. The presentation of some of the most relevant registries established in Italy since the end of the '90s, with the analysis of their strengths and weaknesses, helps to understand some of the crucial issues that should be taken into account before a new registry is adopted. Specifically, we deal with the relationship between objectives - of appropriateness, effectiveness and safety - and methods; the overlapping between drug-based registries and disease-based ones; the duration and extension of data collection, which may be either exhaustive or based on a sampling frame; the importance of ensuring the quality of the data and to minimize the number of subjects who are lost to follow-up; the importance of infrastructures, and of ad hoc funding, for the functioning of a registry; the independence in data analysis and publication of findings.
Raza, Afsheen; Beg, Mohammad Asim
Plasmodium (P.) vivax is the prevalent malarial species accounting for 70% of malaria cases in Pakistan. However, baseline epidemiological data on P. vivax population structure and drug resistance are lacking from Pakistan. For population structure studies, molecular genetic markers, circumsporozoite protein (csp) and merozoite surface protein-1 (msp-1) are considered useful as these play an important role in P. vivax survival under immune and environmental pressure. Furthermore, these genes have also been identified as suitable candidates for vaccine development. While efforts for effective vaccine are underway, anti-malarial agents remain the mainstay for control. Evidence of resistance against commonly used anti-malarial agents, particularly Sulphadoxine-Pyrimethamine (SP) is threatening to make this form of control defunct. Therefore, studies on drug resistance are necessary so that anti-malarial treatment strategies can be structured and implemented accordingly by the Malaria Control Program, Pakistan. This review aims to provide information on genetic markers of P. vivax population structure and drug resistance and comment on their usefulness in molecular surveillance and control.
He, Amy S
The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs.
This article explores different approaches that facilitate online collaboration. The newest efforts in collaboration revolve around wikis. These websites allow visitors to add, remove, edit, and change content directly online. Another fairly affordable approach involves open source, a programming language that is, in many ways, collaborative…
Altshuler, Sandra J.
The United States is facing an epidemic of the use of methamphetamine drugs. Child welfare has not yet addressed the needs of the children living in so-called "meth homes." These children are endangered not only from the chemicals involved, but also from parental abuse and neglect. Communities are recognizing the need for interagency…
Adhin, Malti R; Labadie-Bracho, Mergiory; Bretas, Gustavo
The aim of this translational study was to show the use of molecular surveillance for polymorphisms and copy number as a monitoring tool to track the emergence and dynamics of Plasmodium falciparum drug resistance. A molecular baseline for Suriname was established in 2005, with P. falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance (pfmdr1) markers and copy number in 40 samples. The baseline results revealed the existence of a uniformly distributed mutated genotype corresponding with the fully mefloquine-sensitive 7G8-like genotype (Y184F, S1034C, N1042D, and D1246Y) and a fixed pfmdr1 N86 haplotype. All samples harbored the pivotal pfcrtK76T mutation, showing that chloroquine reintroduction should not yet be contemplated in Suriname. After 5 years, 40 samples were assessed to trace temporal changes in the status of pfmdr1 polymorphisms and copy number and showed minor genetic alterations in the pfmdr1 gene and no significant changes in copy number, thus providing scientific support for prolongation of the current drug policy in Suriname.
Snyder, Margie E; Earl, Tara R; Gilchrist, Siobhan; Greenberg, Michael; Heisler, Holly; Revels, Michelle; Matson-Koffman, Dyann
Collaborative drug therapy management agreements are a strategy for expanding the role of pharmacists in team-based care with other providers. However, these agreements have not been widely implemented. This study describes the features of existing provider-pharmacist collaborative drug therapy management practices and identifies the facilitators and barriers to implementing such services in community settings. We conducted in-depth, qualitative interviews in 2012 in a federally qualified health center, an independent pharmacy, and a retail pharmacy chain. Facilitators included 1) ensuring pharmacists were adequately trained; 2) obtaining stakeholder (eg, physician) buy-in; and 3) leveraging academic partners. Barriers included 1) lack of pharmacist compensation; 2) hesitation among providers to trust pharmacists; 3) lack of time and resources; and 4) existing informal collaborations that resulted in reduced interest in formal agreements. The models described in this study could be used to strengthen clinical-community linkages through team-based care, particularly for chronic disease prevention and management.
Tinto, Halidou; Valea, Innocent; Ouédraogo, Jean-Bosco; Guiguemdé, Tinga Robert
The history of drug resistance to the previous antimalarial drugs, and the potential for resistance to evolve to Artemisinin-based combination therapies, demonstrates the necessity to set-up a good surveillance system in order to provide early warning of the development of resistance. Here we report a review summarizing the history of the surveillance of drug resistance that led to the policy change in Burkina Faso. The first Plasmodium falciparum Chloroquine-Resistance strain identified in Burkina Faso was detected by an in vitro test carried out in Koudougou in 1983. Nevertheless, no further cases were reported until 1987, suggesting that resistant strains had been circulating at a low prevalence before the beginning of the systematic surveillance system from 1984. We observed a marked increase of Chloroquine-Resistance in 2002-2003 probably due to the length of follow-up as the follow-up duration was 7 or 14 days before 2002 and 28 days from 2002 onwards. Therefore, pre-2002 studies have probably under-estimated the real prevalence of Chloroquine-Resistance by not detecting the late recrudescence. With a rate of 8.2% treatment failure reported in 2003, Sulfadoxine-Pyrimethamine was still efficacious for the treatment of uncomplicated malaria in Burkina Faso but this rate might rapidly increase as the result of its spreading from neighboring countries and due to its current use for both the Intermittent Preventive Treatment in pregnant women and Seasonal Malaria Chemoprophylaxis. The current strategy for the surveillance of the Artemisinin-based combination treatments resistance should build on lessons learnt under the previous period of 20 years surveillance of Chloroquine and Sulfadoxine-Pyrimethamine resistance (1994-2004). The most important aspect being to extend the number of sentinel sites so that data would be less patchy and could help understanding the dynamic of the resistance.
Friedmann, Peter D.; Katz, Elizabeth C.; Rhodes, Anne G.; Taxman, Faye S.; O'Connell, Daniel J.; Frisman, Linda K.; Burdon, William M.; Fletcher, Bennett W.; Litt, Mark D.; Clarke, Jennifer; Martin, Steven S.
This article describes the rationale, study design, and implementation for the Step'n Out study of the Criminal Justice Drug Abuse Treatment Studies. Step'n Out tests the relative effectiveness of collaborative behavioral management of drug-involved parolees. Collaborative behavioral management integrates the roles of parole officers and treatment…
Sinaci, A. Anil; Laleci Erturkmen, Gokce B.; Gonul, Suat; Yuksel, Mustafa; Invernizzi, Paolo; Thakrar, Bharat; Pacaci, Anil; Cinar, H. Alper; Cicekli, Nihan Kesim
Postmarketing drug surveillance is a crucial aspect of the clinical research activities in pharmacovigilance and pharmacoepidemiology. Successful utilization of available Electronic Health Record (EHR) data can complement and strengthen postmarketing safety studies. In terms of the secondary use of EHRs, access and analysis of patient data across different domains are a critical factor; we address this data interoperability problem between EHR systems and clinical research systems in this paper. We demonstrate that this problem can be solved in an upper level with the use of common data elements in a standardized fashion so that clinical researchers can work with different EHR systems independently of the underlying information model. Postmarketing Safety Study Tool lets the clinical researchers extract data from different EHR systems by designing data collection set schemas through common data elements. The tool interacts with a semantic metadata registry through IHE data element exchange profile. Postmarketing Safety Study Tool and its supporting components have been implemented and deployed on the central data warehouse of the Lombardy region, Italy, which contains anonymized records of about 16 million patients with over 10-year longitudinal data on average. Clinical researchers in Roche validate the tool with real life use cases. PMID:26543873
Aldworth, Jeremy; Colpe, Lisa J; Gfroerer, Joseph C; Novak, Scott P; Chromy, James R; Barker, Peggy R; Barnett-Walker, Kortnee; Karg, Rhonda S; Morton, Katherine B; Spagnola, Katherine
The Mental Health Surveillance Study (MHSS) is an ongoing initiative by the Substance Abuse and Mental Health Services Administration to develop and implement methods for measuring the prevalence of serious mental illness (SMI) among adults in the USA. The 2008 MHSS used data from clinical interviews administered to a sub-sample of respondents to calibrate mental health screening scale data from the National Survey on Drug Use and Health (NSDUH) for estimating the prevalence of SMI in the full NSDUH sample. The mental health scales included the K6 screening scale of psychological distress (administered to all respondents) along with two measures of functional impairment (each administered to a random half-sample of respondents): the World Health Organization Disability Assessment Schedule (WHODAS) and the Sheehan Disability Scale (SDS). The Structured Clinical Interview for DSM-IV (SCID) was administered to a sub-sample of 1506 adult NSDUH respondents within 4 weeks of completing the NSDUH interview. Results indicate that while SMI prediction accuracy of the K6 is improved by adding either the WHODAS or the SDS to the prediction equation, the models with the WHODAS are more robust. The results of the calibration study and methods used to derive prevalence estimates of SMI are presented.
Bunch, E A
A normal phase liquid chromatographic method for the determination of dexamethasone in bulk drugs and elixirs was collaboratively studied by 6 laboratories. The method uses a silica column, water-modified acetic acid-methanol-methylene chloride mobile phase, cortisone internal standard, and photometric detection at 254 nm. Collaborators were supplied blind duplicate samples of 3 bulk drugs, 2 commercial elixirs, and 1 authentic elixir. Dexamethasone elixir dosage level is 0.5 mg/5 mL. Mean recovery of dexamethasone from the authentic elixir formulated to contain 0.471 mg/5 mL was 94.5%. (Authentic elixirs were found to stabilize about 6% below the theoretical concentration.) Mean recovery for the bulk drugs was between 97.1 and 100.1%. Mean coefficients of variation for bulk drug and elixir samples were less than 0.8% and 3.6%, respectively. Identification tests for dexamethasone by thin-layer chromatography, infrared spectroscopy, and relative LC retention times, as well as the gas chromatographic determination of alcohol in the elixirs were also collaboratively studied. Mean recovery of alcohol from the synthetic elixir was 98.6%. The mean coefficient of variation for alcohol for all samples analyzed was less than 1.4%. The LC method for dexamethasone in drug substance and elixirs, the identification tests, and the GC method for alcohol in dexamethasone elixirs have been adopted official first action.
Ekins, Sean; Clark, Alex M; Williams, Antony J
Abstract The Open Drug Discovery Teams (ODDT) project provides a mobile app primarily intended as a research topic aggregator of predominantly open science data collected from various sources on the internet. It exists to facilitate interdisciplinary teamwork and to relieve the user from data overload, delivering access to information that is highly relevant and focused on their topic areas of interest. Research topics include areas of chemistry and adjacent molecule-oriented biomedical sciences, with an emphasis on those which are most amenable to open research at present. These include rare and neglected diseases, and precompetitive and public-good initiatives such as green chemistry. The ODDT project uses a free mobile app as user entry point. The app has a magazine-like interface, and server-side infrastructure for hosting chemistry-related data as well as value added services. The project is open to participation from anyone and provides the ability for users to make annotations and assertions, thereby contributing to the collective value of the data to the engaged community. Much of the content is derived from public sources, but the platform is also amenable to commercial data input. The technology could also be readily used in-house by organizations as a research aggregator that could integrate internal and external science and discussion. The infrastructure for the app is currently based upon the Twitter API as a useful proof of concept for a real time source of publicly generated content. This could be extended further by accessing other APIs providing news and data feeds of relevance to a particular area of interest. As the project evolves, social networking features will be developed for organizing participants into teams, with various forms of communication and content management possible. PMID:23198003
Ledwaba, J.; Basson, A. E.; Moyes, J.; Cohen, C.; Singh, B.; Bertagnolio, S.; Jordan, M. R.; Puren, A.; Morris, L.
Surveillance of human immunodeficiency virus type 1 transmitted drug resistance (TDR) was conducted among pregnant women in South Africa over a 5-year period after the initiation of a large national antiretroviral treatment program. Analysis of TDR data from 9 surveys conducted between 2005 and 2009 in 2 provinces of South Africa suggests that while TDR remains low (<5%) in Gauteng Province, it may be increasing in KwaZulu-Natal, with the most recent survey showing moderate (5%–15%) levels of resistance to the nonnucleoside reverse transcriptase inhibitor drug class. PMID:22544199
FRIEDMANN, PETER D.; KATZ, ELIZABETH C.; RHODES, ANNE G.; TAXMAN, FAYE S.; O'CONNELL, DANIEL J.; FRISMAN, LINDA K.; BURDON, WILLIAM M.; FLETCHER, BENNETT W.; LITT, MARK D.; CLARKE, JENNIFER; MARTIN, STEVEN S.
This article describes the rationale, study design, and implementation for the Step'n Out study of the Criminal Justice Drug Abuse Treatment Studies. Step'n Out tests the relative effectiveness of collaborative behavioral management of drug-involved parolees. Collaborative behavioral management integrates the roles of parole officers and treatment counselors to provide role induction counseling, contract for pro-social behavior, and deliver contingent reinforcement of behaviors consistent with treatment objectives. The Step'n Out study will randomize 450 drug-involved parolees to collaborative behavioral management or usual parole. Follow-up at 3-and 9-months will assess primary outcomes of rearrest, crime and drug use. If collaborative behavioral management is effective, its wider adoption could improve the outcomes of community reentry of drug-involved ex-offenders. PMID:19809591
Bambery, R. J.; Helin, E. F.; Pravdo, S. H.; Lawrence, K. J.; Hicks, M. D.
Jet Propulsion Laboratory's (JPL) Near-Earth Asteroid Tracking (NEAT) program has two simultaneously-operating, autonomous search systems on two geographically-separated 1.2-m telescopes; one at the Maui Space Surveillance System (NEAT/MSSS) and the other on the Palomar Observatory's Oschin telescope (NEAT/Palomar). This paper will focus exclusively on the NEAT/MSSS system.
In order to successfully apply drug delivery systems (DDS) to new chemical entities (NCEs), collaboration between medicinal chemists and formulation scientists is critical for efficient drug discovery. Formulation scientists have to use 'language' that medicinal chemists understand to help promote mutual understanding, and medicinal chemists and formulation scientists have to set up strategies to use suitable DDS technologies at the discovery phase of the programmes to ensure successful transfer into the development phase. In this review, strategies of solubilisation formulation for oral delivery, inhalation delivery, nasal delivery and bioconjugation are all discussed. For example, for oral drug delivery, multiple initiatives can be proposed to improve the process to select an optimal delivery option for an NCE. From a technical perspective, formulation scientists have to explain the scope and limitations of formulations as some DDS technologies might be applicable only to limited chemical spaces. Other limitations could be the administered dose and, cost, time and resources for formulation development and manufacturing. Since DDS selection is best placed as part of lead-optimisation, formulation scientists need to be involved in discovery projects at lead selection and optimisation stages. The key to success in their collaboration is to facilitate communication between these two areas of expertise at both a strategic and scientific level. Also, it would be beneficial for medicinal chemists and formulation scientists to set common goals to improve the process of collaboration and build long term partnerships to improve DDS.
2Drug Control: Status Report on DOD Support to Counternarcotics Activities (GAO/NSIAD-91-117 June 12, 1991); Drug Control: Cormnunications Network...Monitoring on Cocaine Flow (GAO/NSIAD-91-297 Sept. 19,1991). 2Drug Control: Increased Interdiction and Its Contribution to the War on Drugs (GAO/T-NSIAD-934...shift their landing zones southward, the majority of drug shipments continue to successfully transit Mexico.2 2Drug Control: Revised Drug Interdiction
Heffron, Mary Claire; Purcell, Arlene; Schalit, Jackie
Families In Recovery Staying Together (FIRST) is a team from Children's Hospital and Research Center at Oakland that has joined in collaboration with two local perinatal residential drug treatment programs to create early childhood mental health services at those sites. The authors highlight the collaboration strategies and challenges the partners…
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Request for Information: Establish a Public-Private Collaboration, ``Drug Development Initiative'' (DDI), for New Pharmacological Treatments for Post-Traumatic Stress Disorder (PTSD) AGENCY: Office...
Arvidsson, Per I; Sandberg, Kristian; Forsberg-Nilsson, Karin
The Science for Life Laboratory Drug Discovery and Development (SciLifeLab DDD) platform reaches out to Swedish academia with an industry-standard infrastructure for academic drug discovery, supported by earmarked funds from the Swedish government. In this review, we describe the build-up and operation of the platform, and reflect on our first two years of operation, with the ambition to share learnings and best practice with academic drug discovery centers globally. We also discuss how the Swedish Teacher Exemption Law, an internationally unique aspect of the innovation system, has shaped the operation. Furthermore, we address how this investment in infrastructure and expertise can be utilized to facilitate international collaboration between academia and industry in the best interest of those ultimately benefiting the most from translational pharmaceutical research - the patients.
Inoue, Tsuyoshi; Kado, Yuji; Tokuoka, Keiji; Matsumura, Hiroyoshi; Kai, Yasushi; Mori, Yusuke; Adachi, Hiroaki; Takano, Kazufumi; Murakami, Satoshi; Fukunishi, Yoshifumi; Nakamura, Haruki; Kinoshita, Takayoshi; Nakanishi, Isao; Okuno, Yasushi; Minakata, Seiji; Sakata, Tsuneaki
We recently established a drug development value chain collaborated by The SOSHO project (http://www.sosho.jp) and The BioGrid Project (http://www.biogrid.jp/) to accelerate new drug development. The SOSHO project provides new crystal growth methods including handling of protein crystals, and The BioGrid Project their developing software necessary for the in silico screening of promising drugs and the simulation of biological responses to proteins. We selected the two target enzymes; human hematopoietic prostaglandin D synthase (H-PGDS) and orotidine 5'-monophosphate decarboxylase from human malaria parasite plasmodium falciparum (PfOMPDC). The optimizing of HQL-79, the inhibitor for human H-PGDS and the screening of a lead compound for PfOMPDC by using in silico method are in study.
Huang, Ying; Ma, Jing; Porter, Alan L; Kwon, Seokbeom; Zhu, Donghua
The rapid development of new and emerging science & technologies (NESTs) brings unprecedented challenges, but also opportunities. In this paper, we use bibliometric and social network analyses, at country, institution, and individual levels, to explore the patterns of scientific networking for a key nano area - nano-enabled drug delivery (NEDD). NEDD has successfully been used clinically to modulate drug release and to target particular diseased tissues. The data for this research come from a global compilation of research publication information on NEDD directed at brain cancer. We derive a family of indicators that address multiple facets of research collaboration and knowledge transfer patterns. Results show that: (1) international cooperation is increasing, but networking characteristics change over time; (2) highly productive institutions also lead in influence, as measured by citation to their work, with American institutes leading; (3) research collaboration is dominated by local relationships, with interesting information available from authorship patterns that go well beyond journal impact factors. Results offer useful technical intelligence to help researchers identify potential collaborators and to help inform R&D management and science & innovation policy for such nanotechnologies.
Clark, Alex M.; Swamidass, S. Joshua; Litterman, Nadia; Williams, Antony J.
Over the past decade we have seen a growth in the provision of chemistry data and cheminformatics tools as either free websites or software as a service (SaaS) commercial offerings. These have transformed how we find molecule-related data and use such tools in our research. There have also been efforts to improve collaboration between researchers either openly or through secure transactions using commercial tools. A major challenge in the future will be how such databases and software approaches handle larger amounts of data as it accumulates from high throughput screening and enables the user to draw insights, enable predictions and move projects forward. We now discuss how information from some drug discovery datasets can be made more accessible and how privacy of data should not overwhelm the desire to share it at an appropriate time with collaborators. We also discuss additional software tools that could be made available and provide our thoughts on the future of predictive drug discovery in this age of big data. We use some examples from our own research on neglected diseases, collaborations, mobile apps and algorithm development to illustrate these ideas. PMID:24943138
Ekins, Sean; Clark, Alex M.; Swamidass, S. Joshua; Litterman, Nadia; Williams, Antony J.
Over the past decade we have seen a growth in the provision of chemistry data and cheminformatics tools as either free websites or software as a service commercial offerings. These have transformed how we find molecule-related data and use such tools in our research. There have also been efforts to improve collaboration between researchers either openly or through secure transactions using commercial tools. A major challenge in the future will be how such databases and software approaches handle larger amounts of data as it accumulates from high throughput screening and enables the user to draw insights, enable predictions and move projects forward. We now discuss how information from some drug discovery datasets can be made more accessible and how privacy of data should not overwhelm the desire to share it at an appropriate time with collaborators. We also discuss additional software tools that could be made available and provide our thoughts on the future of predictive drug discovery in this age of big data. We use some examples from our own research on neglected diseases, collaborations, mobile apps and algorithm development to illustrate these ideas.
Snyder, Margie E.; Earl, Tara R.; Greenberg, Michael; Heisler, Holly; Revels, Michelle; Matson-Koffman, Dyann
Collaborative drug therapy management agreements are a strategy for expanding the role of pharmacists in team-based care with other providers. However, these agreements have not been widely implemented. This study describes the features of existing provider–pharmacist collaborative drug therapy management practices and identifies the facilitators and barriers to implementing such services in community settings. We conducted in-depth, qualitative interviews in 2012 in a federally qualified health center, an independent pharmacy, and a retail pharmacy chain. Facilitators included 1) ensuring pharmacists were adequately trained; 2) obtaining stakeholder (eg, physician) buy-in; and 3) leveraging academic partners. Barriers included 1) lack of pharmacist compensation; 2) hesitation among providers to trust pharmacists; 3) lack of time and resources; and 4) existing informal collaborations that resulted in reduced interest in formal agreements. The models described in this study could be used to strengthen clinical–community linkages through team-based care, particularly for chronic disease prevention and management. PMID:25811494
Stanley, A G; Jackson, D; Barnett, D B
Collaboration between the medical school at Leicester and a local pharmaceutical company, AstraZeneca, led to the design and implementation of an optional third year special science skills module teaching medical students about drug discovery and development. The module includes didactic teaching about the complexities of the drug discovery process leading to development of candidate drugs for clinical investigation as well as practical experience of the processes involved in drug evaluation preclinically and clinically. It highlights the major ethical and regulatory issues concerned with the production and testing of novel therapies in industry and the NHS. In addition it helps to reinforce other areas of the medical school curriculum, particularly the understanding of clinical study design and critical appraisal. The module is assessed on the basis of a written dissertation and the critical appraisal of a drug advertisement. This paper describes the objectives of the module and its content. In addition we outline the results of an initial student evaluation of the module and an assessment of its impact on student knowledge and the opinion of the pharmaceutical industry partner. This module has proven to be popular with medical students, who acquire a greater understanding of the work required for drug development and therefore reflect more favourably on the role of pharmaceutical companies in the UK. PMID:15801942
Pontes Junior, Durval Martins; Pepe, Vera Lúcia Edais; Osorio-de-Castro, Claudia Garcia Serpa; Massena, Elisa Prestes; Portela, Margareth Crisóstomo; Miranda, Maria do Carmo; Silva, Raulino Sabino da
A key objective of the Brazilian National Drug Policy is the quality of medicines supplied to the population. This study aimed to set priorities for the analysis of the National Program for Quality Control of Medicines. The main criterion was the drug's presence in at least three Pharmaceutical Care Programs under the Ministry of Health. Additional criteria were presence on the National List of Essential Drugs (RENAME) in 2002 and its indication for the 20 main causes of disability-adjusted life years (DALY). The sources were data from the Ministry of Health and related legislation. The drugs were classified according to the Anatomical Therapeutic Chemical Classification System (ATC) of the WHO. The 13 pharmaceutical care programs included 893 products classified in 449 different ATC codes. Twenty-eight drugs were considered priorities, 26 of which were listed on the RENAME and 12 indicated as causes of DALY. It is recommended that the National Health Surveillance Agency and Secretariat of Science, Technology, and Strategic Inputs establish an integrated strategy to guarantee comprehensive quality of these drugs, including laboratory quality, registration, good manufacturing practices, and information for health professionals and the general population.
This study explores the origins and consequences of a unique, secret, French-American collaboration to prospect for uranium in 1950s Morocco. This collaboration permitted mediation between the United States and France. The appearance of France in an American-supported project for raw nuclear materials signalled American willingness to accept a new nuclear global order in which the French assumed a new, higher position as regional nuclear ally as opposed to suspicious rival. This collaboration also permitted France and the United States to agree tacitly to the same geopolitical status for the French Moroccan Protectorate, a status under dispute both in Morocco and outside it. The secret scientific effort reassured the French that, whatever the Americans might say publicly, they stood behind the maintenance of French hegemony in the centuries-old kingdom. But Moroccan independence proved impossible to deny. With its foreseeable arrival, the collaboration went from seductive to dangerous, and the priority of American and French geologists shifted from finding a major uranium lode to making sure that nothing was readily available to whatever post-independence interests might prove most powerful. Ultimately, the Kingdom of Morocco took a page out of the French book, using uranium exploration to assert sovereignty over a different disputed territory, its de facto colony of the Western Sahara.
Cellular therapy products are an emerging medical product class undergoing rapid scientific and clinical innovation worldwide. These products pose unique regulatory challenges both for countries with existing regulatory frameworks and for countries where regulatory frameworks for cellular therapy products are under development. The United States Food and Drug Administration (US FDA) has a history of productive working relationships with international regulatory authorities, and seeks to extend this to the cellular therapy field. The US FDA and its global regulatory counterparts are engaged in collaborations focused on the convergence of scientific and regulatory approaches, and the education of scientists, clinicians, regulators, and the public at large on the development of cellular therapies. PMID:23021082
Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong
Introduction Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust
MUTCHINICK, OSVALDO M.; LUNA-MUÑOZ, LEONORA; AMAR, EMMANUELLE; BAKKER, MARIAN K.; CLEMENTI, MAURIZIO; COCCHI, GUIDO; DUTRA, MARIA DA GRAÇA; FELDKAMP, MARCIA L.; LANDAU, DANIELLE; LEONCINI, EMANUELE; LI, ZHU; LOWRY, BRIAN; MARENGO, LISA K.; MARTÍNEZ-FRÍAS, MARÍA-LUISA; MASTROIACOVO, PIERPAOLO; MÉTNEKI, JULIA; MORGAN, MARGERY; PIERINI, ANNA; RISSMAN, ANKE; RITVANEN, ANNUKKA; SCARANO, GIOACCHINO; SIFFEL, CSABA; SZABOVA, ELENA; ARTEAGA-VÁZQUEZ, JAZMÍN
Conjoined twins (CT) are a very rare developmental accident of uncertain etiology. Prevalence has been previously estimated to be 1 in 50,000 to 1 in 100,000 births. The process by which monozygotic twins do not fully separate but form CT is not well understood. The purpose of the present study was to analyze diverse epidemiological aspects of CT, including the different variables listed in the Introduction Section of this issue of the Journal. The study was made possible using the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR) structure. This multicenter worldwide research includes the largest sample of CT ever studied. A total of 383 carefully reviewed sets of CT obtained from 26,138,837 births reported by 21 Clearinghouse Surveillance Programs (SP) were included in the analysis. Total prevalence was 1.47 per 100,000 births (95% CI: 1.32–1.62). Salient findings including an evident variation in prevalence among SPs: a marked variation in the type of pregnancy outcome, a similarity in the proportion of CT types among programs: a significant female predominance in CT: particularly of the thoracopagus type and a significant male predominance in parapagus and parasitic types: significant differences in prevalence by ethnicity and an apparent increasing prevalence trend in South American countries. No genetic, environmental or demographic significant associated factors were identified. Further work in epidemiology and molecular research is necessary to understand the etiology and pathogenesis involved in the development of this fascinating phenomenon of nature. PMID:22002822
Catelan, Dolores; Buzzoni, Carlotta; Coviello, Enzo; Crocetti, Emanuele; Pasetto, Roberto; Pirastu, Roberta; Biggeri, Annibale
Epidemiological surveillance on high risk environmental areas or areas covered by cancer registration yields long inventories of relative risks. Summaries of the results' tables must be produced to identify priorities and tailor public health actions. The aim is, therefore, to draw conclusions from each area's disease profile, or from the area signature of each disease.With this inmind, we used data on cancer incidence from 17 Cancer Registries that participated in the ISS-AIRTUM (National Institute of Health-Italian Network of Cancer Registries) study, and we produced conditional and marginal rankings of areas/diseases using a multivariate hierarchical Bayesian model. In this context, it is important to obtain an uncertainty evaluation by calculating the credibility intervals of ranks. The areas marginal ranking shows a large overlapping of credibility intervals, such that it is not possible to speak of a limited number of ISS-AIRTUM areas as being particularly affected. Every ISS-AIRTUMarea, therefore,must be considered individually and ordering themby ranking of cancer incidence wouldn't be appropriate. Instead,marginal ranking of diseases highlights the impact of asbestos exposure in all the analyzed areas.
Kelley, Karen F; Caudwell, Emily; Xueref, Serge; Ha, Thuy Huong; Bertagnolio, Silvia
The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is the largest funder of human immunodeficiency virus (HIV) prevention and treatment programs worldwide. Since 2002, the Global Fund has encouraged grant recipients to implement drug resistance surveillance (DRS) as part of treatment programs. We reviewed documentation of 147 grants funded in 2004-2008 (funding rounds 4-8) to assess grantees' use of funds to support HIV DRS. Overall, 94 grants (64%) described HIV DRS as part of the national treatment program. However, only 32 grants (22%) specifically documented DRS as a grant-funded activity. This review provides baseline information suggesting limited use by countries of Global Fund financing to support HIV DRS. Additional assessment is required to evaluate barriers to using Global Fund grants to support DRS.
Ahn, Hee-Jung; Park, Hyeoun-Ae
The purpose of this study was to determine whether the frequency of adverse drug events can be extracted by analyzing narrative nursing statements documented in standardized terminology-based electronic nursing records. For this study, we reviewed the narrative nursing documentations of 487 admissions of 355 cancer patients who were treated with cisplatin at a tertiary-care hospital in Korea. Narrative nursing statements with the terms "adverse drug reaction," "allergy," "hypersensitivity," and other adverse drug events listed in the safety information were analyzed. In addition, nausea, one of the most frequent adverse drug events, was further examined. Narrative statements documenting the presence or absence of an "adverse drug reaction," "allergy," and "hypersensitivity" were found in 162 admissions (33.3%). The presence or absence of adverse drug events due to cisplatin was documented in 476 admissions (97.7%). At least one adverse drug event was noted in 258 admissions (53.0%). The presence of nausea was documented in 214 admissions (43.9%), and the mean duration of nausea was 5.2 days. The results of this study suggest that adverse drug events can be monitored using narrative nursing statements documented in standardized terminology-based electronic nursing records.
Khajehkazemi, Razieh; Osooli, Mehdi; Sajadi, Leily; Karamouzian, Mohammad; Sedaghat, Abbas; Fahimfar, Noushin; Safaie, Afshin; Mostafavi, Ehsan; Haghdoost, Ali-Akbar
Objectives To assess the prevalence of HIV and related risk behaviours among people who inject drugs (PWID) in Iran. Methods We conducted a national cross-sectional bio-behavioural surveillance survey between March and July 2010, interviewing male PWID from a geographically dispersed sample through a facility-based sampling method. Results We recruited 2480, and tested 2290 PWID. The overall prevalence of HIV was 15.2% (95% CI 9.7% to 23.1%). Among those who had injected drugs over the last month, 36.9% had used a non-sterile needle, and 12.6% had practiced shared injection. Over the past 12 months preceding the interview, 30.4% had sold sex for money, drugs, goods or a favour. In the multivariate analysis, the prevalence of HIV had a positive association with age, while having above high school education, and permanent job were protective. Conclusions Unsafe injection, and sexual risk behaviours are still frequent and the prevalence of HIV among PWID remains high. Intensified efforts are needed to prevent the further spread of HIV among Iranian PWID and their sexual partners. PMID:24037249
Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick
Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all…
You, Han; Ni, Jingyun; Barber, Michael; Scherngell, Thomas
Objective Better understanding of China’s landscape in oncology drug research is of great significance for discovering anti-cancer drugs in future. This article differs from previous studies by focusing on Chinese oncology drug research communities in co-publication networks at the institutional level. Moreover, this research aims to explore structures and behaviors of relevant research units by thematic community analysis and to address policy recommendations. Methods This research used social network analysis to define an institutions network and to identify a community network which is characterized by thematic content. Results A total of 675 sample articles from 2008 through 2012 were retrieved from the Science Citation Index Expanded (SCIE) database of Web of Science, and top institutions and institutional pairs are highlighted for further discussion. Meanwhile, this study revealed that institutions based in the Chinese mainland are located in a relatively central position, Taiwan’s institutions are closely assembled on the side, and Hong Kong’s units located in the middle of the Chinese mainland’s and Taiwan’s. Spatial division and institutional hierarchy are still critical barriers to research collaboration in the field of anti-cancer drugs in China. In addition, the communities focusing on hot research areas show the higher nodal degree, whereas communities giving more attention to rare research subjects are relatively marginalized to the periphery of network. Conclusions This paper offers policy recommendations to accelerate cross-regional cooperation, such as through developing information technology and increasing investment. The brokers should focus more on outreach to other institutions. Finally, participation in topics of common interest is conducive to improved efficiency in research and development (R&D) resource allocation. PMID:25937775
Nelson, Jennifer C.; Wellman, Robert; Yu, Onchee; Cook, Andrea J.; Maro, Judith C.; Ouellet-Hellstrom, Rita; Boudreau, Denise; Floyd, James S.; Heckbert, Susan R.; Pinheiro, Simone; Reichman, Marsha; Shoaibi, Azadeh
Introduction: The large-scale assembly of electronic health care data combined with the use of sequential monitoring has made proactive postmarket drug- and vaccine-safety surveillance possible. Although sequential designs have been used extensively in randomized trials, less attention has been given to methods for applying them in observational electronic health care database settings. Existing Methods: We review current sequential-surveillance planning methods from randomized trials, and the Vaccine Safety Datalink (VSD) and Mini-Sentinel Pilot projects—two national observational electronic health care database safety monitoring programs. Future Surveillance Planning: Based on this examination, we suggest three steps for future surveillance planning in health care databases: (1) prespecify the sequential design and analysis plan, using available feasibility data to reduce assumptions and minimize later changes to initial plans; (2) assess existing drug or vaccine uptake, to determine if there is adequate information to proceed with surveillance, before conducting more resource-intensive planning; and (3) statistically evaluate and clearly communicate the sequential design with all those designing and interpreting the safety-surveillance results prior to implementation. Plans should also be flexible enough to accommodate dynamic and often unpredictable changes to the database information made by the health plans for administrative purposes. Conclusions: This paper is intended to encourage dialogue about establishing a more systematic, scalable, and transparent sequential design-planning process for medical-product safety-surveillance systems utilizing observational electronic health care databases. Creating such a framework could yield improvements over existing practices, such as designs with increased power to assess serious adverse events. PMID:27713904
Huang, Yu-Lin; Moon, Jinhee; Segal, Jodi B
Post-marketing drug surveillance for adverse drug events (ADEs) has typically relied on spontaneous reporting. Recently, regulatory agencies have turned their attention to more preemptive approaches that use existing data for surveillance. We conducted an environmental scan to identify active surveillance systems worldwide that use existing data for the detection of ADEs. We extracted data about the systems' structures, data, and functions. We synthesized the information across systems to identify common features of these systems. We identified nine active surveillance systems. Two systems are US based-the FDA Sentinel Initiative (including both the Mini-Sentinel Initiative and the Federal Partner Collaboration) and the Vaccine Safety Datalink (VSD); two are Canadian-the Canadian Network for Observational Drug Effect Studies (CNODES) and the Vaccine and Immunization Surveillance in Ontario (VISION); and two are European-the Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR) Alliance and the Vaccine Adverse Event Surveillance and Communication (VAESCO). Additionally, there is the Asian Pharmacoepidemiology Network (AsPEN) and the Shanghai Drug Monitoring and Evaluative System (SDMES). We identified two systems in the UK-the Vigilance and Risk Management of Medicines (VRMM) Division and the Drug Safety Research Unit (DSRU), an independent academic unit. These surveillance systems mostly use administrative claims or electronic medical records; most conduct pharmacovigilance on behalf of a regulatory agency. Either a common data model or a centralized model is used to access existing data. The systems have been built using national data alone or via partnership with other countries. However, active surveillance systems using existing data remain rare. North America and Europe have the most population coverage; with Asian countries making good advances.
Scarth, James P; Spencer, Holly A; Timbers, Sarah E; Hudson, Simon C; Hillyer, Lynn L
The detection of drug abuse in horseracing often requires knowledge of drug metabolism, especially if urine is the matrix of choice. In this study, equine liver/lung microsomes/S9 tissue fractions were used to study the phase I metabolism of eight drugs of relevance to equine drug surveillance (acepromazine, azaperone, celecoxib, fentanyl, fluphenazine, mepivacaine, methylphenidate and tripelennamine). In vitro samples were analyzed qualitatively alongside samples originating from in vivo administrations using LC-MS on a high resolution accurate mass Thermo Orbitrap Discovery instrument and by LC-MS/MS on an Applied Biosystems Sciex 5500 Q Trap.Using high resolution accurate mass full-scan analysis on the Orbitrap, the in vitro systems were found to generate at least the two most abundant phase I metabolites observed in vitro for all eight drugs studied. In the majority of cases, in vitro experiments were also able to generate the minor in vivo metabolites and sometimes metabolites that were only observed in vitro. More detailed analyses of fentanyl incubates using LC-MS/MS showed that it was possible to generate good quality spectra from the metabolites generated in vitro. These data support the suggestion of using in vitro incubates as metabolite reference material in place of in vivo post-administration samples in accordance with new qualitative identification guidelines in the 2009 International Laboratory Accreditation Cooperation-G7 (ILAC-G7) document.In summary, the in vitro and in vivo phase I metabolism results reported herein compare well and demonstrate the potential of in vitro studies to compliment, refine and reduce the existing equine in vivo paradigm.
Ito, Akira; Wandra, Toni; Sato, Marcello O; Mamuti, Wulamu; Xiao, Ning; Sako, Yasuhito; Nakao, Minoru; Yamasaki, Hiroshi; Nakaya, Kazuhiro; Okamoto, Munehiro; Craig, Philip S
for further collaboration in the future.
Danaviah, Siva; Lessells, Richard; Elshareef, Muna; Tanser, Frank; Wilkinson, Eduan; Pillay, Sureshnee; Mthiyane, Hloniphile; Mwambi, Henry; Pillay, Deenan; de Oliveira, Tulio
Abstract As more human immunodeficiency virus (HIV)–infected patients access combination antiretroviral therapy (cART), higher proportions of newly infected patients may be infected with drug-resistant viruses. Regular surveillance of transmitted drug resistance (TDR) is required in southern Africa where high rates of transmission persist despite rapid expansion of ART. Dried blood spot samples from cART-naive participants from two rounds of an annual population-based HIV surveillance program in rural KwaZulu-Natal were tested for HIV RNA, and samples with HIV RNA >10,000 copies/ml were genotyped for drug resistance. The 2009 surveillance of drug resistance mutation (SDRM) list was used for drug resistance interpretation. The data were added to previously published data from the same program, and the χ2 test for trend was used to test for trend in estimated prevalence of any TDR. Seven hundred and one participants' data were analyzed: 67 (2010), 381 (2011), and 253 (2012). No TDR was detected in 2010. Years 2011 and 2012 had 18 participants with SDRMs 4.7% and 7.1%, respectively (p = .02, χ2 test for trend). The nonnucleoside reverse transcriptase inhibitor mutation, K103N, was the most common mutation, occurring in 27 (3.8%) of the participants, while nucleoside reverse transcriptase inhibitor (NRTI) SDRMs were detected in 10 (1.4%) of the participants, of whom eight had only a single NRTI SDRM. The increase in levels of drug resistance observed in this population could be a signal of increasing transmission of drug-resistant HIV. Thus, continued surveillance is critical to inform public health policies around HIV treatment and prevention. PMID:27002368
Traversa, Giuseppe; Sagliocca, Luciano; Magrini, Nicola; Venegoni, Mauro
Drug registries are implemented after the authorization of new products and represent a tool for systematic collection of data aimed at obtaining additional knowledge on appropriateness, effectiveness and safety. The design of registries needs to be coherent with the main objective and a study protocol is required before the implementation. A registry aimed at the appropriateness of drug use should be primarily considered for high cost drugs when there is a risk, either for the patients' safety or for public expenditure, in using the drug outside the approved indications. Since the registry is a condition for the access to drugs, and all users are included, an extremely simplified data collection is required. However, the data should be available at regional level to allow record linkage procedures with other databases for conducting outcome studies. When registries are aimed at acquiring new information on the risk profile, the duration and the regional extension of data collection should be coherent with the expected incidence of events of interest. A great attention should be devoted in preventing that patients are lost to follow-up, since the reasons for being lost are frequently associated with harmful outcomes, such as adverse drug reactions. In a registry focused on effectiveness, the main aim consists in ascertaining the reasons (the prognostic factors), for possible discrepancies between premarketing studies and clinical practice. Taking into account the greater incidence of the expected events, there are fewer reasons for extending data collection to all users, whereas the main attention should focus on quality controls and the ascertainment of confounding factors. Given the relevance of the validity issues, in the set out of a registry it is important to think about ad hoc resources and the adequacy of infrastructures. As for any epidemiological study, an adequate qualification of the researcher/clinician in charge of conducting a registry should be
Yacoubian, George S., Jr.
Anecdotal reports have suggested that the use of 3,4-methylenedioxymeth-amphetamine (MDMA or "ecstasy") is a prodigious problem across the United States. Unfortunately, no longitudinal evidence exists to support this contention. In the current study, data from the Drug Abuse Warning Network (DAWN), Monitoring the Future (MTF), and…
Bucher, Heiner C.; Achermann, Rita; Stohler, Nadja; Meier, Christoph R.
Objectives We analysed potential drug-drug interactions (DDI) in ambulatory care in Switzerland based on claims data from three large health insurers in 2010 to identify physicians with peculiar prescription behaviour differing from peers of the same specialty. Methods We analysed contraindicated or potentially contraindicated DDI from the national drug formulary and calculated for each physician the ratios of the number of patients with a potential DDI divided by the number of patients at risk and used a zero inflated binomial distribution to correct for the inflated number of observations with no DDI. We then calculated the probability that the number of caused potential DDI of physicians was unlikely (p-value < 0.05 and ≥0.01) and very unlikely (p-value <0.01) to be due to chance. Results Of 1'607'233 females and 1'525'307 males 1.3% and 1.2% were exposed to at least one potential DDI during 12 months. When analysing the 40 most common DDI, 598 and 416 of 18,297 physicians (3.3% and 2.3%) were causing potential DDI in a frequency unlikely (p<0.05 and p≥0.01) and very unlikely (p<0.01) to be explained by chance. Patients cared by general practitioners and cardiologists had the lowest probability (0.20 and 0.26) for not being exposed to DDI. Conclusions Contraindicated or potentially contraindicated DDI are frequent in ambulatory care in Switzerland, with a small proportion of physicians causing potential DDI in a frequency that is very unlikely to be explained by chance when compared to peers of the same specialty. PMID:26808430
Abubakar, Abdullahi Rabiu; Ismail, Salwani; Rahman, Nor Iza A; Haque, Mainul
Background Internationally, there is a remarkable achievement in the areas of drug discovery, drug design, and clinical trials. New and efficient drug formulation techniques are widely available which have led to success in treatment of several diseases. Despite these achievements, large number of patients continue to experience adverse drug reactions (ADRs), and majority of them are yet to be on record. Objectives The purpose of this survey is to compare knowledge, attitude, and practice with respect to ADRs and pharmacovigilance (PV) between medical students of Malaysia and Nigeria and to determine if there is a relationship between their knowledge and practice. Method A cross-sectional, questionnaire-based survey involving year IV and year V medical students of the Department of Medicine, Universiti Sultan Zainal Abidin and Bayero University Kano was carried out. The questionnaire which comprised 25 questions on knowledge, attitude, and practice was adopted, modified, validated, and administered to them. The response was analyzed using SPSS version 20. Results The response rate from each country was 74%. There was a statistically significant difference in mean knowledge and practice score on ADRs and PV between medical students of Malaysia and Nigeria, both at P<0.000. No significance difference in attitude was observed at P=0.389. Also, a statistically significant relationship was recorded between their knowledge and practice (r=0.229, P=0.001), although the relationship was weak. Conclusion Nigerian medical students have better knowledge and practice than those of Malaysia, although they need improvement. Imparting knowledge of ADRs and PV among medical students will upgrade their practice and enhance health care delivery services in the future. PMID:26170680
Tubach, Florence; Lamarque-Garnier, Véronique; Castot, Anne
Studies conducted after the marketing authorisation with the objective of identification, characterization or quantification of one or more risks (called PASS "Post-Authorisation Safety Studies"), have been strengthened in the past years with the implementation of the concept of risk management plans (RMPs), established in 2005 in the European regulatory framework and recently amended as part of the community revision. These safety studies, interventional or not, are related to a marketed drug, whether or not the drug is used within the market authorisation conditions. Apart from these safety studies, other studies whose primary objective is not risk assessment, including assessment of efficacy, description of prescription data and use in real life, pharmacokinetics, public health impact ... can complete available safety data.The Giens Round Table examined PASS from the risk management plans of a sample of marketing authorisation holders (participants to the Round Table) and identified the main characteristics of proposed actions. Concerning the specifications and the choice of methodology, only a general outline has been sketched in view of the complexity and diversity of drug risks situations.
Fan, Shin-Yuan; Lin, Keng-Yu; Jou, Ruwen
Objective To determine the extent of drug resistance in multidrug-resistant tuberculosis (MDR-TB) cases, we conducted a retrospective, population-based analysis using drug susceptibility testing (DST) results of MDR Mycobacterium tuberculosis complex isolates obtained from 2007–2014 in Taiwan. Methods M. tuberculosis isolates collected from 1,331 MDR-TB cases were included in this survey. Treatment histories, age, sex, chest radiograph and bacteriological results of patients were analyzed. Standard DST was performed to assess resistance to the following drugs: isoniazid (INH), rifampicin (RIF), streptomycin (SM), ethambutol (EMB), amikacin (AM), kanamycin (KM), capreomycin (CAP), ofloxacin (OFX), moxifloxacin (MOX), levofloxacin (LVX), gatifloxacin (GAT), para-aminosalicylate (PAS), ethionamide (EA), and pyrazinamide (PZA). The Cochran-Armitage trend test was used for statistical analysis. Results We observed a significant increasing trend in portion of new MDR-TB cases, from 59.5% to 80.2% (p < 0.0001), and significant decreasing trend of portion in the 15-44-year-old age group (p < 0.05). Of the MDR M. tuberculosis isolates tested, 6.2% were resistant to AM, 8.6% were resistant to KM, 4.6% were resistant to CAP, 19.5% were resistant to OFX, 17.1% were resistant to MOX, 16.0% were resistant to LVX, 5.8% were resistant to GAT, 9.5% were resistant to PAS, 28.5% were resistant to EA and 33.3% were resistant to PZA. Fifty (3.8%) extensively drug-resistant TB cases were identified. No significant differences were found in drug resistance frequencies between new and previously treated MDR cases. However, we observed significant decreases in the rates of AM resistance (p < 0.05), OFX resistance (p < 0.00001), PAS resistance (p < 0.00001), EA resistance (p < 0.05) and PZA resistance (p < 0.05). Moreover, younger age groups had higher rates of resistance to fluoroquinolones. Conclusion A policy implemented in 2007 to restrict the prescription of fluoroquinolones was
Kuroki, Ryota; Tamada, Taro; Kurihara, Kazuo; Ohhara, Takashi; Adachi, Motoyasu
Crystallography enables us to obtain accurate atomic positions within proteins. High resolution X-ray crystallography provides information for most of the atoms comprising a protein, with the exception of hydrogens. Neutron diffraction data can provide information of the location of hydrogen atoms, and is complementary to the structural information determined by X-ray crystallography. Here, we show the recent result of the structural determination of drug-target proteins, porcine pancreatic elastase and human immuno-deficiency virus type-1 protease by both X-ray and neutron diffraction. The structure of porcine pancreatic elastase with its potent inhibitor was determined to 0.94 A resolution by X-ray diffraction and 1.65 A resolution by neutron diffraction. The structure of HIV-PR with its potent inhibitor was also determined to 0.93 A resolution by X-ray diffraction and 1.9 A resolution by neutron diffraction. The ionization state and the location of hydrogen atoms of the catalytic residue in these enzymes were determined by neutron diffraction. Furthermore, collaborative use of both X-ray and neutron to identify the location of ambiguous hydrogen atoms will be shown.
Akers, Julie M.; Czapinski, Jennifer C.; Robinson, Jennifer D.
Objective. To assess the impact of a new course designed to train student pharmacists to provide clinical patient care services delivered through collaborative drug practice agreements. Design. An intensive two-credit, one-week course with a combined self-study and interactive pedagogical approach was developed. Content from the online Washington State Pharmacy Association Clinical Community Pharmacist training program was integrated with a live, eight-hour seminar. Assessment. Student-pharmacist learning, effectiveness of content presented, and perceived value of the material were evaluated. Scores on quizzes, a knowledge assessment, a patient-case examination, pre- and post-seminar surveys, and voluntary student certification rate were collected and analyzed. Of 132 student pharmacists enrolled in the course, 121 students met competency on their first attempt at completing the knowledge assessment and 126 students met competency on their first attempt at completing the practical examination. A pre- and post-training survey found that student pharmacists were significantly more comfortable performing and recommending implementation of services after completing the course. Conclusions. Training student pharmacists who are competent and comfortable providing clinical patient care services can improve access to care and reduce the impact of the impending physician shortage. PMID:28381891
Pereira, M.; Assaad, F. A.; Delon, P. J.
The main objectives of influenza surveillance are: to measure the impact of the disease by collection and analysis of epidemiological information on morbidity and mortality, and to anticipate future epidemics and pandemics by the collection and analysis of influenza viruses. The World Health Organization's influenza programme is based on the collaboration of 98 national influenza centres in 70 countries and the 2 WHO Collaborating Centres in Atlanta and London. Epidemiological information may be based on morbidity figures derived from a variety of sources such as returns from physicians or hospitals; mortality statistics or new claims for sickness benefit; school or industrial absenteeism, etc. The laboratory aspects of influenza epidemiology are certainly more uniformly covered than the statistical aspects. Since the advent of the A/Hong Kong/1/68 (H3N2) influenza virus A subtype there have been a number of variants with antigenic ”drift” but only three succeeded in causing widespread epidemics: A/England/42/72, A/Port Chalmers/1/73, and A/Victoria/3/75. In 1972, the influenza B virus also showed some antigenic ”drift”, the new variants being characterized by B/Hong Kong/5/72. Whenever a new variant appears, the degree of protection afforded to the population by the available vaccine is assessed. In the light of these data, WHO publishes annually in the Weekly epidemiological record recommendations formulated by the WHO Collaborating Centres on vaccine composition. PMID:78771
Tapia-Trejo, Daniela; Meza, Rita I.; Nuñez, Sandra M.; Parham, Leda; Flores, Norma A.; Valladares, Diana; Pineda, Luisa M.; Flores, Dixiana; Motiño, Roxana; Umanzor, Víctor; Carbajal, Candy; Murillo, Wendy; Lorenzana, Ivette; Palou, Elsa Y.; Reyes-Terán, Gustavo
Introduction We assessed HIV drug resistance (DR) in individuals failing ART (acquired DR, ADR) and in ART-naïve individuals (pre-ART DR, PDR) in Honduras, after 10 years of widespread availability of ART. Methods 365 HIV-infected, ART-naïve, and 381 ART-experienced Honduran individuals were enrolled in 5 reference centres in Tegucigalpa, San Pedro Sula, La Ceiba, and Choluteca between April 2013 and April 2015. Plasma HIV protease-RT sequences were obtained. HIVDR was assessed using the WHO HIVDR mutation list and the Stanford algorithm. Recently infected (RI) individuals were identified using a multi-assay algorithm. Results PDR to any ARV drug was 11.5% (95% CI 8.4–15.2%). NNRTI PDR prevalence (8.2%) was higher than NRTI (2.2%) and PI (1.9%, p<0.0001). No significant trends in time were observed when comparing 2013 and 2014, when using a moving average approach along the study period or when comparing individuals with >500 vs. <350 CD4+ T cells/μL. PDR in recently infected individuals was 13.6%, showing no significant difference with PDR in individuals with longstanding infection (10.7%). The most prevalent PDR mutations were M46IL (1.4%), T215 revertants (0.5%), and K103NS (5.5%). The overall ADR prevalence in individuals with <48 months on ART was 87.8% and for the ≥48 months on ART group 81.3%. ADR to three drug families increased in individuals with longer time on ART (p = 0.0343). M184V and K103N were the most frequent ADR mutations. PDR mutation frequency correlated with ADR mutation frequency for PI and NNRTI (p<0.01), but not for NRTI. Clusters of viruses were observed suggesting transmission of HIVDR both from ART-experienced to ART-naïve individuals and between ART-naïve individuals. Conclusions The global PDR prevalence in Honduras remains at the intermediate level, after 10 years of widespread availability of ART. Evidence of ADR influencing the presence of PDR was observed by phylogenetic analyses and ADR/PDR mutation frequency correlations
Süsskind, M.; Thürmann, P. A.; Lüke, C.; Jeschke, E.; Tabali, M.; Matthes, H.; Ostermann, T.
Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs) caused by anthroposophical medicines (AMEDs) in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code), causality (according to the Uppsala Monitoring Centre WHO criteria), and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6%) experienced 211 ADRs (CTCAE grade 2/3 n = 191, 90.5%, CTCAE grade 4/5 n = 20, 9.5%) of which 57 ADRs (27.0%) were serious. The median age of patients with ADRs (62.1% females) was 72.0 (IQR: 61.0; 80.0). Six patients (0.2%) experienced six ADRs (2.8% of ADRs) caused by eight suspected AMEDs, all of which were mild reactions (grade 2). Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms. PMID:22315630
Welsh, Chelsea; Miah, Rukshana
OBJECTIVES: The purpose of this study is to determine how frequently children's hospitals in the United States are using pharmacist-physician collaborative drug therapy management (CDTM), and to characterize their use in this population. METHODS: A phone survey was created to collect data regarding the use of pharmacist-physician CDTM at children's hospitals. Children's hospitals were called between February 2014 and April 2014. Data were collected from either a clinical pharmacist or pharmacy director. Pharmacists were asked to answer questions regarding hospital demographics as well as to what extent and for which medications they use CDTM. Differences between types of hospitals were evaluated using Fisher exact test. RESULTS: A total of 171 children's hospitals were identified; 51.5% hospitals (n = 88) completed the survey. Of the 88 hospitals that completed the survey, 32 (31.7%) had some level of CDTM in place. Of the 28 children's hospitals with CDTM in place that completed the survey, all allowed pharmacists to modify doses and monitor therapy, and 75% provided pharmacists with the ability to initiate the first dose. The specific medications that were included in the CDTM protocols in children's hospitals included vancomycin (n = 23), aminoglycosides (n = 22), anticoagulation medications (n = 7), and total parenteral nutrition (n = 3). Training was required for pharmacists to participate in CDTM protocols at most hospitals (n = 26). Lack of support from medical staff was the most common perceived barrier. No differences were identified between types of children's hospitals. CONCLUSION: CDTM protocols are practiced in about one third of the children's hospitals. Pharmacists commonly initiate, monitor, and modify therapies as part of these protocols. The most frequently included medications were vancomycin and aminoglycosides. PMID:28018151
Nachshon, Aharon; Abu-Toamih Atamni, Hanifa J.; Steuerman, Yael; Sheikh-Hamed, Roa'a; Dorman, Alexandra; Mott, Richard; Dohm, Juliane C.; Lehrach, Hans; Sultan, Marc; Shamir, Ron; Sauer, Sascha; Himmelbauer, Heinz; Iraqi, Fuad A.; Gat-Viks, Irit
A central challenge in pharmaceutical research is to investigate genetic variation in response to drugs. The Collaborative Cross (CC) mouse reference population is a promising model for pharmacogenomic studies because of its large amount of genetic variation, genetic reproducibility, and dense recombination sites. While the CC lines are phenotypically diverse, their genetic diversity in drug disposition processes, such as detoxification reactions, is still largely uncharacterized. Here we systematically measured RNA-sequencing expression profiles from livers of 29 CC lines under baseline conditions. We then leveraged a reference collection of metabolic biotransformation pathways to map potential relations between drugs and their underlying expression quantitative trait loci (eQTLs). By applying this approach on proximal eQTLs, including eQTLs acting on the overall expression of genes and on the expression of particular transcript isoforms, we were able to construct the organization of hepatic eQTL-drug connectivity across the CC population. The analysis revealed a substantial impact of genetic variation acting on drug biotransformation, allowed mapping of potential joint genetic effects in the context of individual drugs, and demonstrated crosstalk between drug metabolism and lipid metabolism. Our findings provide a resource for investigating drug disposition in the CC strains, and offer a new paradigm for integrating biotransformation reactions to corresponding variations in DNA sequences. PMID:27761138
Cho, H-J; Kim, Y J
Citicoline is an essential precursor in the synthesis of phosphatidylcholine, a key cell membrane phospholipid, and is known to have neuroprotective effects in acute ischemic stroke. The aim of this study was to determine the efficacy and safety of oral citicoline in Korean patients with acute ischemic stroke. A drug surveillance study was carried out in 4,191 patients with a diagnosis of acute ischemic stroke. Oral citicoline (500-4000 mg/day) was administered within less than 24 h after acute ischemic stroke in 3,736 patients (early group) and later than 24 h after acute ischemic stroke in 455 patients (late group) for at least 6 weeks. For efficacy assessment, primary outcomes were patients' scores obtained with a short form of the National Institutes of Health Stroke Scale (s-NIHSS), a short form of the Barthel Index of activities of daily living (s-BI) and a modified Rankin Scale (mRS) at enrollment, after 6 weeks and at the end of therapy for those patients with extended treatment. All adverse reactions were monitored during the study period for safety assessment. All measured outcomes, including s-NIHSS, s-BI and mRS, were improved after 6 weeks of therapy (P < 0.05). Further improvement was observed in 125 patients who continued citicoline therapy for more than 12 weeks when compared with those who ended therapy at week 6. Improvements were more significant in the higher dose group (> or = 2000 mg/day) (P < 0.001). s-BI scores showed no differences between the early and late groups at the end of therapy. Citicoline safety was excellent; 37 side effects were observed in 31 patients (0.73%). The most frequent findings were nervous system-related symptoms (8 of 37, 21.62%), followed by gastrointestinal symptoms (5 of 37, 13.5%). Oral citicoline improved neurological, functional and global outcomes in patients with acute ischemic stroke without significant safety concerns.
Jones, Virginia H.; Hutchins, Ellen
This manual assists state agencies in developing public policy and programs to address prevention and treatment for the abuse of alcohol and other drugs by women during pregnancy. It stresses the importance of collaborative action among the many agencies involved. The first chapter is a specific call for collaboration, noting several federal…
Gao, Lei; Lyu, Yuan; Li, Yun
Background: Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. Methods: Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China. Minimum inhibitory concentrations (MICs) were determined by a 2-fold agar dilution method, and antimicrobial susceptibility was established using the 2014 Clinical Laboratory Standards Institute-approved breakpoints. Isolates not susceptible to all the tested aminoglycosides, fluoroquinolones, β-lactams, β-lactam/β-lactam inhibitors and carbapenems were defined as extensively drug resistant. Results: The rates of nonsusceptibility to common antimicrobial agents remained high (>65%) over the years with some fluctuations to certain agents. The prevalence of imipenem-resistant A. baumannii (IRAB) increased from 13.3% in 2004 to 70.5% in 2014 and that of extensively drug-resistant A. baumannii (XDRAB) increased from 11.1% in 2004 to 60.4% in 2014. The activity of tigecycline was stable with MIC90 ≤4 mg/L against A. baumannii from 2009 to 2014. Susceptibility to colistin remained high (97.0%) from 2009 to 2014. The prevalence of XDRAB increased in all the three surveillance regions over the years and was significantly higher in Intensive Care Unit (ICU) wards than non-ICU wards. Conclusions: This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more
Avila-Rios, Santiago; Sued, Omar; Rhee, Soo-Yon; Shafer, Robert W.; Reyes-Teran, Gustavo; Ravasi, Giovanni
Background HIV transmitted drug resistance (TDR) remains at moderate level in Latin America and the Caribbean (LAC). However, different epidemiologic scenarios could influence national and sub-regional TDR levels and trends. Methods and Findings We performed a systematic review of currently available publications on TDR in antiretroviral treatment-naïve adults in LAC. Ninety-eight studies published between January 2000 and June 2015 were included according to critical appraisal criteria and classified by sub-region: Brazil (50), Mesoamerica (17), Southern Cone (16), Andean (8) and Caribbean (7). From these, 81 studies encompassing 11,441 individuals with data on DR mutation frequency were included in a meta-analysis. Overall TDR prevalence in LAC was 7.7% (95% CI: 7.2%-8.2%). An increasing trend was observed for overall TDR when comparing 2000–2005 (6.0%) and 2006–2015 (8.2%) (p<0.0001), which was associated with significant NNRTI TDR increase (p<0.0001). NRTI TDR decreased (4.5% vs. 2.3%, p<0.0001). NNRTI TDR increase was associated mainly with K101E, K103N and G190A. NRTI TDR decrease was associated mainly with M184V, K70R and T215Y. All sub-regions reached moderate overall TDR levels. The rapid increase in TDR to all antiretroviral classes in the Caribbean is notable, as well as the significant increase in NNRTI TDR reaching moderate levels in the Southern Cone. NRTI TDR was dominant in 2000–2005, mainly in the Caribbean, Mesoamerica and Brazil. This dominance was lost in 2006–2015 in all sub-regions, with the Southern Cone and the Caribbean switching to NNRTI dominance. PI TDR remained mostly constant with a significant increase only observed in the Caribbean. Conclusions Given the high conceptual and methodological heterogeneity of HIV TDR studies, implementation of surveys with standardized methodology and national representativeness is warranted to generate reliable to inform public health policies. The observed increasing trend in NNRTI TDR
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...
This study examined the factors that are related to collaboration between high school social workers and substance abuse prevention/intervention counselors in New York State high schools (except for New York City high schools). Constructs that were analyzed were high school social workers' perceived adequacy in working with high school students'…
A total of 151 patients on chronic treatment with amiodarone and other antiarrhythmic drugs were subjected to standard clinical and electrophysiological investigation to assess the prevalence and specificity of polyneuropathy. Twenty two untreated patients with cardiac disorders and 246 normal subjects served as controls. Abnormal electrophysiological findings supporting the diagnosis of polyneuropathy were present in 38 subjects (25%) given antiarrhythmic drugs, with even distribution among drugs, and four untreated patients (18%). Concurrent clinical abnormalities were present in five treated patients (one each with amiodarone, propafenone, and flecainide, and two with multiple drugs). Therefore, electrophysiological abnormalities are a common, although non-specific, feature in patients taking antiarrhythmic drugs. Amiodarone users do not seem at higher risk of polyneuropathy than subjects treated with other drugs or even untreated patients with cardiac disorders. PMID:8158183
Davis, Allan Peter; Wiegers, Thomas C; Roberts, Phoebe M; King, Benjamin L; Lay, Jean M; Lennon-Hopkins, Kelley; Sciaky, Daniela; Johnson, Robin; Keating, Heather; Greene, Nigel; Hernandez, Robert; McConnell, Kevin J; Enayetallah, Ahmed E; Mattingly, Carolyn J
Improving the prediction of chemical toxicity is a goal common to both environmental health research and pharmaceutical drug development. To improve safety detection assays, it is critical to have a reference set of molecules with well-defined toxicity annotations for training and validation purposes. Here, we describe a collaboration between safety researchers at Pfizer and the research team at the Comparative Toxicogenomics Database (CTD) to text mine and manually review a collection of 88,629 articles relating over 1,200 pharmaceutical drugs to their potential involvement in cardiovascular, neurological, renal and hepatic toxicity. In 1 year, CTD biocurators curated 254,173 toxicogenomic interactions (152,173 chemical-disease, 58,572 chemical-gene, 5,345 gene-disease and 38,083 phenotype interactions). All chemical-gene-disease interactions are fully integrated with public CTD, and phenotype interactions can be downloaded. We describe Pfizer's text-mining process to collate the articles, and CTD's curation strategy, performance metrics, enhanced data content and new module to curate phenotype information. As well, we show how data integration can connect phenotypes to diseases. This curation can be leveraged for information about toxic endpoints important to drug safety and help develop testable hypotheses for drug-disease events. The availability of these detailed, contextualized, high-quality annotations curated from seven decades' worth of the scientific literature should help facilitate new mechanistic screening assays for pharmaceutical compound survival. This unique partnership demonstrates the importance of resource sharing and collaboration between public and private entities and underscores the complementary needs of the environmental health science and pharmaceutical communities. Database URL: http://ctdbase.org/
Randhawa, Amarita S.; Babalola, Olakiitan; Henney, Zachary; Miller, Michele; Nelson, Tanya; Oza, Meerat; Patel, Chandni; Randhawa, Anupma S.; Riley, Joyce; Snyder, Scott; So, Sherri
Background: Online drug information compendia (ODIC) are valuable tools that health care professionals (HCPs) and consumers use to educate themselves on pharmaceutical products. Research suggests that these resources, although informative and easily accessible, may contain misinformation, posing risk for product misuse and patient harm. Objective: Evaluate drug summaries within ODIC for accuracy and completeness and identify product-specific misinformation. Methods: Between August 2014 and January 2015, medical information (MI) specialists from 11 pharmaceutical/biotechnology companies systematically evaluated 270 drug summaries within 5 commonly used ODIC for misinformation. Using a standardized approach, errors were identified; classified as inaccurate, incomplete, or omitted; and categorized per sections of the Full Prescribing Information (FPI). On review of each drug summary, content-correction requests were proposed and supported by the respective product’s FPI. Results: Across the 270 drug summaries reviewed within the 5 compendia, the median of the total number of errors identified was 782, with the greatest number of errors occurring in the categories of Dosage and Administration, Patient Education, and Warnings and Precautions. The majority of errors were classified as incomplete, followed by inaccurate and omitted. Conclusion: This analysis demonstrates that ODIC may contain misinformation. HCPs and consumers should be aware of the potential for misinformation and consider more than 1 drug information resource, including the FPI and Medication Guide as well as pharmaceutical/biotechnology companies’ MI departments, to obtain unbiased, accurate, and complete product-specific drug information to help support the safe and effective use of prescription drug products. PMID:26917822
Griffin, John B., Jr.
Medical students performed less well on examinations about drug abuse problems and patient management than on traditional medical board examinations. The best knowledge was of pharmacology of drug abuse, Alcoholics Anonymous, and treatment of delirium tremens. Students knew less about metabolic and biochemical areas, emergency-room treatment, and…
Vega, Yolanda; Delgado, Elena; Fernández-García, Aurora; Cuevas, Maria Teresa; Thomson, Michael M.; Montero, Vanessa; Sánchez, Monica; Sánchez, Ana Maria; Pérez-Álvarez, Lucia
Our objectives were to carry out an epidemiological surveillance study on transmitted drug resistance (TDR) among individuals newly diagnosed of HIV-1 infection during a nine year period in Spain and to assess the role of transmission clusters (TC) in the propagation of resistant strains. An overall of 1614 newly diagnosed individuals were included in the study from January 2004 through December 2012. Individuals come from two different Spanish regions: Galicia and the Basque Country. Resistance mutations to reverse transcriptase inhibitors (RTI) and protease inhibitors (PI) were analyzed according to mutations included in the surveillance drug-resistance mutations list updated in 2009. TC were defined as those comprising viruses from five or more individuals whose sequences clustered in maximum likelihood phylogenetic trees with a bootstrap value ≥90%. The overall prevalence of TDR to any drug was 9.9%: 4.9% to nucleoside RTIs (NRTIs), 3.6% to non-nucleoside RTIs (NNRTIs), and 2.7% to PIs. A significant decrease of TDR to NRTIs over time was observed [from 10% in 2004 to 2% in 2012 (p=0.01)]. Sixty eight (42.2%) of 161 sequences with TDR were included in 25 TC composed of 5 or more individuals. Of them, 9 clusters harbored TDR associated with high level resistance to antiretroviral drugs. T215D revertant mutation was transmitted in a large cluster comprising 25 individuals. The impact of epidemiological networks on TDR frequency may explain its persistence in newly diagnosed individuals. The knowledge of the populations involved in TC would facilitate the design of prevention programs and public health interventions. PMID:26010948
Vega, Yolanda; Delgado, Elena; Fernández-García, Aurora; Cuevas, Maria Teresa; Thomson, Michael M; Montero, Vanessa; Sánchez, Monica; Sánchez, Ana Maria; Pérez-Álvarez, Lucia
Our objectives were to carry out an epidemiological surveillance study on transmitted drug resistance (TDR) among individuals newly diagnosed of HIV-1 infection during a nine year period in Spain and to assess the role of transmission clusters (TC) in the propagation of resistant strains. An overall of 1614 newly diagnosed individuals were included in the study from January 2004 through December 2012. Individuals come from two different Spanish regions: Galicia and the Basque Country. Resistance mutations to reverse transcriptase inhibitors (RTI) and protease inhibitors (PI) were analyzed according to mutations included in the surveillance drug-resistance mutations list updated in 2009. TC were defined as those comprising viruses from five or more individuals whose sequences clustered in maximum likelihood phylogenetic trees with a bootstrap value ≥90%. The overall prevalence of TDR to any drug was 9.9%: 4.9% to nucleoside RTIs (NRTIs), 3.6% to non-nucleoside RTIs (NNRTIs), and 2.7% to PIs. A significant decrease of TDR to NRTIs over time was observed [from 10% in 2004 to 2% in 2012 (p=0.01)]. Sixty eight (42.2%) of 161 sequences with TDR were included in 25 TC composed of 5 or more individuals. Of them, 9 clusters harbored TDR associated with high level resistance to antiretroviral drugs. T215D revertant mutation was transmitted in a large cluster comprising 25 individuals. The impact of epidemiological networks on TDR frequency may explain its persistence in newly diagnosed individuals. The knowledge of the populations involved in TC would facilitate the design of prevention programs and public health interventions.
The Frederick National Lab has begun to assist several major pharmaceutical companies in adopting nanotechnologies in early stage drug development, when the approach is most efficient and cost-effective.
Lynch, J A; Silva, P
Surveillance at the slaughterhouse level for animal health and food safety purposes encompasses examination for the presence of pathology, pathogens, drug residues, chemical contaminants and antimicrobial resistance. Government, industry and academia are the primary proponents of such surveillance. A variety of policies and policy instruments from voluntary to legislative may be applied to promote or obligate participation. Efforts to integrate data across such diverse organisations encounter significant legal, logistical and financial challenges. Enhancement of policies to encourage effective integration of animal health and food safety surveillance data from slaughterhouse control should promote: a long-term approach; collaboration among government, industry and academia; application of a risk-based scheme; and transparent public access to data, with generation of consumer-oriented communications derived from the data. A strong case can be made that the complementary pursuit of both sustainable animal health and food safety can continue to be aided by surveillance at the slaughterhouse level.
The National Antimicrobial Resistance Monitoring System (NARMS) is a collaborative program between the Food and Drug Administration (FDA), the Centers for Disease Control (CDC), and the United States Department of Agriculture to prospectively monitor changes in antimicrobial susceptibilities of zoon...
Pierce, Anna B; El-Hayek, Carol; McCarthy, Damien; Armishaw, Jude; Watson, Kerrie; Wilkinson, Anna; Price, Brian; Wright, Edwina J; Hoy, Jennifer F; Stoové, Mark A
Background: International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013. The primary outcome was NPEP failure following NPEP presentation among MSM reporting RAIU, stratified by the number of drugs prescribed. Results: Among 1482 MSM reporting 2002 episodes of RAIU and prescribed two- or three-drug NPEP, 70 seroconverted to HIV, but only 19 were considered possible NPEP failures. HIV diagnosis incidence among men reporting RAIU was 1.2/100 person years (PY) (95%CI=1.0-1.6); 1.1/100 PY (95%CI=0.8-1.4) among MSM prescribed two drugs and 2.2/100 PY (95%CI=1.4-3.7) among MSM prescribed three drugs (P<0.01). Of the 19 possible NPEP failures, 13 (0.7%) were prescribed two drugs and six (2.7%) three drugs (P<0.001). Conclusions: This study suggests that two-drug NPEP regimens do not result in excess seroconversions compared with three-drug regimens when used following RAIU. Clinical services should carefully consider their use of three drug NPEP and whether resources might be better invested in other prevention strategies, particularly pre-exposure prophylaxis (PrEP).
Karawajczyk, Anna; Giordanetto, Fabrizio; Benningshof, Jorg; Hamza, Daniel; Kalliokoski, Tuomo; Pouwer, Kees; Morgentin, Remy; Nelson, Adam; Müller, Gerhard; Piechot, Alexander; Tzalis, Dimitrios
High-throughput screening (HTS) represents a major cornerstone of drug discovery. The availability of an innovative, relevant and high-quality compound collection to be screened often dictates the final fate of a drug discovery campaign. Given that the chemical space to be sampled in research programs is practically infinite and sparsely populated, significant efforts and resources need to be invested in the generation and maintenance of a competitive compound collection. The European Lead Factory (ELF) project is addressing this challenge by leveraging the diverse experience and know-how of academic groups and small and medium enterprises (SMEs) engaged in synthetic and/or medicinal chemistry. Here, we describe the novelty, diversity, structural complexity, physicochemical characteristics and overall attractiveness of this first batch of ELF compounds for HTS purposes.
Bhinder, Bhavneet; Antczak, Christophe; Shum, David; Radu, Constantin; Mahida, Jeni P.; Liu-Sullivan, Nancy; Ibáñez, Glorymar; Raja, Balajee Somalinga; Calder, Paul A.; Djaballah, Hakim
Memorial Sloan-Kettering Cancer Center (MSKCC) has implemented the creation of a full service state-of-the-art High-throughput Screening Core Facility (HTSCF) equipped with modern robotics and custom-built screening data management resources to rapidly store and query chemical and RNAi screening data outputs. The mission of the facility is to provide oncology clinicians and researchers alike with access to cost-effective HTS solutions for both chemical and RNAi screening, with an ultimate goal of novel target identification and drug discovery. HTSCF was established in 2003 to support the institution’s commitment to growth in molecular pharmacology and in the realm of therapeutic agents to fight chronic diseases such as cancer. This endeavor required broad range of expertise in technology development to establish robust and innovative assays, large collections of diverse chemical and RNAi duplexes to probe specific cellular events, sophisticated compound and data handling capabilities, and a profound knowledge in assay development, hit validation, and characterization. Our goal has been to strive for constant innovation, and we strongly believe in shifting the paradigm from traditional drug discovery towards translational research now, making allowance for unmet clinical needs in patients. Our efforts towards repurposing FDA-approved drugs fructified when digoxin, identified through primary HTS, was administered in the clinic for treatment of stage Vb retinoblastoma. In summary, the overall aim of our facility is to identify novel chemical probes, to study cellular processes relevant to investigator’s research interest in chemical biology and functional genomics, and to be instrumental in accelerating the process of drug discovery in academia. PMID:24661215
Silva, Carla; Perdigão, João; Jordão, Luísa; Portugal, Isabel
Multidrug tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) cases constitute a serious health problem in Portugal, of which the majority of isolates belong to the Lisboa family and the Q1 cluster, highly related to the Lisboa family. Here we sought to investigate the molecular basis of resistant TB as well as to determine the prevalence of specific drug resistance mutations and their association with MDR-TB and/or XDR-TB. In total, 74 Mycobacterium tuberculosis clinical isolates collected in Lisbon Health Region were genotyped by 24-loci mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR), and the mutational profile associated with first- and second-line drug resistance was studied. Seven new mutations were found, whilst the remaining 28 mutations had been previously associated with drug resistance. None of the mutations was specifically associated with MDR-TB. The mutational patterns observed among isolates belonging to Lisboa3 and Q1 clusters were also observed in isolates with unique MIRU-VNTR patterns but closely related to these strains. Such data suggest that the genotyping technique employed discriminates isolates with the same mutational profile. To establish the most adequate genotyping technique, the discriminatory power of three different MIRU-VNTR sets was analysed. The 15-loci MIRU-VNTR set showed adequate discriminatory power, comparable with the 24-loci set, allowing clustering of 60% and 86% of the MDR-TB and XDR-TB isolates, respectively, the majority of which belonged to the Lisboa3 and Q1 clusters. From an epidemiological standpoint, this study suggests combined mutational and genotyping analysis as a valuable tool for drug resistance surveillance.
Zhang, Xinji; Zhang, Yuan; Ye, Xiaofei; Guo, Xiaojing; Zhang, Tianyi; He, Jia
Objective Phase IV trials are often used to investigate drug safety after approval. However, little is known about the characteristics of contemporary phase IV clinical trials and whether these studies are of sufficient quality to advance medical knowledge in pharmacovigilance. We aimed to determine the fundamental characteristics of phase IV clinical trials that evaluated drug safety using the ClinicalTrials.gov registry data. Methods A data set of 19 359 phase IV clinical studies registered in ClinicalTrials.gov was downloaded. The characteristics of the phase IV trials focusing on safety only were compared with those evaluating both safety and efficacy. We also compared the characteristics of the phase IV trials in three major therapeutic areas (cardiovascular diseases, mental health and oncology). Multivariable logistic regression was used to evaluate factors associated with the use of blinding and randomisation. Results A total of 4772 phase IV trials were identified, including 330 focusing on drug safety alone and 4392 evaluating both safety and efficacy. Most of the phase IV trials evaluating drug safety (75.9%) had enrolment <300 with 96.5% <3000. Among these trials, 8.2% were terminated or withdrawn. Factors associated with the use of blinding and randomisation included the intervention model, clinical specialty and lead sponsor. Conclusions Phase IV trials evaluating drug safety in the ClinicalTrials.gov registry were dominated by small trials that might not have sufficient power to detect less common adverse events. An adequate sample size should be emphasised for phase IV trials with safety surveillance as main task. PMID:27881517
Brandão, M G; Freire, N; Vianna-Soares, C D
Marketing of medicinal plants and phytotherapeutic products is spreading all over the world. In order to assess the commercialization of medicinal plants and phytotherapeutic products in the State of Minas Gerais, we identified and tested for the presence of adulterants and active ingredients in 27 samples of chamomile. All the samples consisted of Matricaria recutita flowers, but they were badly fragmented, a result of excessive handling and poor preservation. All samples contained contaminants, and insects were observed in 63% of the samples sold in drugstores. Only 50% of the samples in each group had the essential oils needed to produce antiinflammatory activity. Flavonoids and other phenolic constituents with a spasmolytic effect were detected in only 20% of the samples from each group. Results with chamomile indicated the poor quality with which medicinal plants and phytotherapeutic products are marketed and confirm the need for surveillance of such products in Brazil.
Stettler, Christoph; Allemann, Sabin; Wandel, Simon; Kastrati, Adnan; Morice, Marie Claude; Schömig, Albert; Pfisterer, Matthias E; Stone, Gregg W; Leon, Martin B; de Lezo, José Suárez; Goy, Jean-Jacques; Park, Seung-Jung; Sabaté, Manel; Suttorp, Maarten J; Kelbaek, Henning; Spaulding, Christian; Menichelli, Maurizio; Vermeersch, Paul; Dirksen, Maurits T; Cervinka, Pavel; Carlo, Marco De; Erglis, Andrejs; Chechi, Tania; Ortolani, Paolo; Schalij, Martin J; Diem, Peter; Meier, Bernhard; Windecker, Stephan
Objective To compare the effectiveness and safety of three types of stents (sirolimus eluting, paclitaxel eluting, and bare metal) in people with and without diabetes mellitus. Design Collaborative network meta-analysis. Data sources Electronic databases (Medline, Embase, the Cochrane Central Register of Controlled Trials), relevant websites, reference lists, conference abstracts, reviews, book chapters, and proceedings of advisory panels for the US Food and Drug Administration. Manufacturers and trialists provided additional data. Review methods Network meta-analysis with a mixed treatment comparison method to combine direct within trial comparisons between stents with indirect evidence from other trials while maintaining randomisation. Overall mortality was the primary safety end point, target lesion revascularisation the effectiveness end point. Results 35 trials in 3852 people with diabetes and 10 947 people without diabetes contributed to the analyses. Inconsistency of the network was substantial for overall mortality in people with diabetes and seemed to be related to the duration of dual antiplatelet therapy (P value for interaction 0.02). Restricting the analysis to trials with a duration of dual antiplatelet therapy of six months or more, inconsistency was reduced considerably and hazard ratios for overall mortality were near one for all comparisons in people with diabetes: sirolimus eluting stents compared with bare metal stents 0.88 (95% credibility interval 0.55 to 1.30), paclitaxel eluting stents compared with bare metal stents 0.91 (0.60 to 1.38), and sirolimus eluting stents compared with paclitaxel eluting stents 0.95 (0.63 to 1.43). In people without diabetes, hazard ratios were unaffected by the restriction. Both drug eluting stents were associated with a decrease in revascularisation rates compared with bare metal stents in people both with and without diabetes. Conclusion In trials that specified a duration of dual antiplatelet therapy of six
Pichini, Simona; Rotolo, Maria Concetta; Bellotti, Pasquale; Minutillo, Adele; Mastrobattista, Luisa; Pacifici, Roberta
A pilot study of market surveillance in Senegal has been performed analyzing best selling drugs from an official pharmacy and a street market in two principal cities of Senegal and some traditional preparations from herbal medicine from the same market. A simple and rapid gas chromatography method with mass spectrometry detection has been applied after a liquid-liquid extraction of pharmaceutical products and traditional preparations at acidic, neutral and basic pH with chloroform-isopropanol (9:1, v/v). The assay was validated in the range from 10mg to 250 mg/g powder preparations with good determination coefficients (r(2)≥ 0.99) for the calibration curves. At three concentrations spanning the linear dynamic ranges of the calibration curves, mean recoveries of substances under investigation were always higher than 90% and intra-assay and inter-assay precision and accuracy were always better than 15%. The four best selling drugs purchased from a Dakar local pharmacy exactly contained the amount of active principles reported in the respective labels while the best selling drugs freely purchased from Kaolack market contained an amount of active ingredients lower than that declared on the label. No pharmacological active compound, but salicylic acid was found in one of the traditional herbal preparations. This pilot study showed that whereas official drugs sold in pharmacies at prices accessible for a very few portion of the population contained the amount of active principles as reported in the labels, those from street market bought by the majority of population contained an amount of active ingredients lower than that declared on the label and finally traditional herbal preparations seldom contain pharmacological active principles.
Lu, Xinli; Kang, Xianjiang; Chen, Suliang; Zhao, Hongru; Liu, Yongjian; Zhao, Cuiying; Zhang, Yuqi; Li, Jingyun; Cui, Ze; Wang, Xianfeng
For this study, 50 HIV-1 plasma samples of recently infected men who have sex with men (MSM) were amplified and sequenced. Multiple subtypes were identified by phylogenetic analyses of HIV-1 gag, env, and pol gene regions, including CRF01_AE (56.0%), CRF07_BC (30.0%), subtype B (12.0%), and unique recombinant forms (URFs, 6.0%). CRF01_AE was the most frequent genotype in the epidemic. Three recombination patterns of URFs were identified: 01BC, 01B, and 01C. The rate of HIV-1 transmitted drug resistance (TDR) mutation (M46L) was 2.08% (1/48). URFs and TDR first identified in this study suggest that HIV-1 prevalence is more and more complicated, and HIV-1 drug-resistant strains have begun to spread among at risk populations in Hebei. Our findings can provide vital information for an efficient surveillance system and strategic HIV prevention and control measures in China by revealing the evolutionary status and HIV-1 TDR of HIV-1 strains among recently infected MSM in Hebei Province.
Roche, Jesús; Guerra-Neira, Ana; Raso, José; Benito, Agustîn
From 1992-1999, we have assessed the therapeutic efficacy of three malaria treatment regimens (chloroquine 25 mg/kg over three days, pyrimethamine/sulfadoxine 1.25/25 mg/kg in one dose, and quinine 25-30 mg/kg daily in three oral doses over a four-, five-, or seven-day period) in 1,189 children under age 10 at Malabo Regional Hospital in Equatorial Guinea. Of those children, 958 were followed up clinically and parasitologically for 14 days. With chloroquine, the failure rate varied from 55% in 1996 to 40% in 1999; the early treatment failure rate increased progressively over the years, from 6% in 1992 to 30% in 1999. With pyrimethamine/sulfadoxine, the failure rate varied from 0% in 1996 to 16% in 1995. The short quinine treatment regimens used in 1992 and 1993 (4 and 5 days, respectively) resulted in significantly higher failure rates (19% and 22%, respectively) than the 7d regimen (3-5.5%). We conclude that: a) failure rates for chloroquine are in the change period (> 25%), and urgent action is needed; b) pyrimethamine/ sulfadoxine failure rates are in the alert period (6-15%), and surveillance must be continued; and c) quinine failure rates are in the grace period (< 6%), so quinine can be recommended.
Basco, Leonardo K
Chloroquine-proguanil combination is one of the options for chemoprophylaxis. The rapid evolution of drug resistance status requires a constant upgrade of epidemiologic data. Due to various difficulties in conducting prospective clinical studies on the prophylactic efficacy of the drug combination, especially in highly chloroquine-resistant zones, in vitro drug sensitivity assays and specific molecular markers for chloroquine (Plasmodium falciparum chloroquine-resistance transporter, pfcrt) and cycloguanil (a biologically active metabolite of proguanil; dihydrofolate reductase, dhfr) resistance were evaluated as an alternative approach in this study. Of 116 isolates, 62 (53.4%) were doubly resistant in vitro to chloroquine (IC50 > or = 100 nM) and cycloguanil (IC50 > or = 15 nM). Likewise, 62 of 118 isolates (52.5%) carried both the mutant Thr-76 pfcrt allele and at least one dhfr mutant allele (1 with a single Asn-108 allele, 8 with double Arg-59 and Asn-108 mutations, and 53 with triple Ile-51, Arg-59, and Asn-108 mutations). The in vitro drug response corresponded with the presence or absence of key mutation(s) in the pfcrt and dhfr genes. These results suggest the high proportion of P. falciparum isolates in southern Cameroon that may not respond to chloroquine-proguanil combination.
Dennis, Ann M.; Nelson, Julie A.E.; Weir, Sharon S.; Figueroa, J. Peter
Abstract The prevalence of human immunodeficiency virus type 1 (HIV-1) is highest among men who have sex with men (MSM) in Jamaica but no genotypic data are available on the virus strains that are responsible for the epidemic among this key population. HIV-1 polymerase (pol) genes from 65 MSM were sequenced and used to predict drug resistance mutations. An HIV drug resistance prevalence of 28% (minimum 13%) was observed among this cohort, with the most frequent mutations conferring resistance to efavirenz, nevirapine, and lamivudine. Phylogenetic analysis of the sequences revealed 10 times the number of linked HIV infections among this cohort than respondent reporting. HIV treatment and prevention efforts in Jamaica could benefit significantly from Pol genotyping of the HIV strains infecting socially vulnerable MSM prior to initiating antiretroviral therapy (ART), as this would guide suppressive ART and unearth HIV transmission clusters to enable more effective delivery of treatment and prevention programs. PMID:26133540
Assessment of Assistance in Smoking Cessation Therapy by Pharmacies in Collaboration with Medical Institutions- Implementation of a Collaborative Drug Therapy Management Protocol Based on a Written Agreement between Physicians and Pharmacists.
Watanabe, Fumiyuki; Shinohara, Kuniko; Dobashi, Akira; Amagai, Kenji; Hara, Kazuo; Kurata, Kaori; Iizima, Hideo; Shimakawa, Kiyoshi; Shimada, Masahiko; Abe, Sakurako; Takei, Keiji; Kamei, Miwako
This study built a protocol for drug therapy management (hereinafter "the protocol") that would enable continuous support from the decision making of smoking cessation therapy to the completion of therapy through the collaboration of physicians and community pharmacists, after which we evaluated whether the use of this protocol would be helpful to smoking cessation therapy. This study utilized the "On the Promotion of Team-Based Medical Care", a Notification by the Health Policy Bureau as one of the resources for judgment, and referred to collaborative drug therapy management (CDTM) in the United States. After the implementation of this protocol, the success rate of smoking cessation at the participating medical institutions rose to approximately 70%, approximately 28-point improvement compared to the rate before the implementation. In addition to the benefits of the standard smoking cessation program, this result may have been affected by the intervention of pharmacists, who assisted in continuing cessation by advising to reduce drug dosage as necessary approximately one week after the smoking cessation, when side effects and the urge to smoke tend to occur. Additionally, the awareness survey for the intervention group revealed that all respondents, including patients who failed to quit smoking, answered that they were satisfied to the question on general satisfaction. The question about the reason for successful cessation revealed that the support by pharmacists was as important as, or more important than, that by physicians and nurses. This infers that the pharmacists' active engagement in drug therapy for individual patients was favorably acknowledged.
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Procedures for urine surveillance. 550.42... DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.42 Procedures for urine surveillance. (a) Contractor authorized personnel of the same sex as...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Procedures for urine surveillance. 550.42... DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.42 Procedures for urine surveillance. (a) Contractor authorized personnel of the same sex as...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures for urine surveillance. 550.42... DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.42 Procedures for urine surveillance. (a) Contractor authorized personnel of the same sex as...
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Procedures for urine surveillance. 550.42... DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.42 Procedures for urine surveillance. (a) Contractor authorized personnel of the same sex as...
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Procedures for urine surveillance. 550.42... DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.42 Procedures for urine surveillance. (a) Contractor authorized personnel of the same sex as...
KHUÊ, P. M.; MALLET, A.; VEZIRIS, N.; JARLIER, V.; ROBERT, J.
SUMMARY In France, surveillance of anti-tuberculosis drug resistance is performed by the Azay-Mycobacteria network, representing 30% of all culture-positive cases. We sought to validate administrative and clinical data gathered by the network in 2004 and to produce corrected resistance rates accounting for the observed misclassification. We reviewed a 10% sample of patients' records diagnosed in 2004 and measured the agreement between controlled data and data collected by the network by using the kappa (κ) statistic. A re-sampling bootstrap-based method was used to investigate the impact of bias found on resistance rates. Most of data collected by the network, such as demographic data, and country of birth had an excellent agreement (κ>0·8) with controlled data. The concordance was good (κ>0·6) for HIV status and tuberculosis site. The only variable slightly discordant with controlled data was prior history of treatment (κ=0·52). However, after correcting crude resistance rates for the observed misclassification, all estimated rates were within confidence intervals based on reported rates. This validation study is in favour of a good quality of data produced by the network, even though corrected rates are slightly different from observed rates. Therefore, data collected through the network may be used for policy making and tuberculosis programme evaluation. However, improvement in data collection regarding prior history of treatment should be considered. PMID:18028573
Marquet, P; Delpla, P A; Kerguelen, S; Bremond, J; Facy, F; Garnier, M; Guery, B; Lhermitte, M; Mathé, D; Pelissier, A L; Renaudeau, C; Vest, P; Seguela, J P
The collaborative, anonymous, case-control study was intended to determine the prevalence of opiates, cocaine metabolites, cannabinoids and amphetamines in the urine of drivers injured in road accidents and to compare these values with those of non-accident subjects ("patients") in France. Recruitment was performed nationwide in the emergency departments of five hospitals and comprised 296 "drivers" aged 18 to 35 and 278 non-traumatic "patients" in the same age range. Females represented 28.4% of "drivers" and 44.2% of "patients." Screening for drugs in urine was performed by fluorescence polarization immunoassays in each center. Each positive result was verified using gas chromatography-mass spectrometry (GC-MS), in a single laboratory. Statistical analysis comprised single-step logistic regression and simultaneously took account of confounding factors and the final differences in prevalence values between the two populations or different subgroups. Cannabinoids were found in 13.9% of drivers (16.0% of males and 8.3% of females, p < 0.05) and 7.5% of patients (12.3% of males, 1.6% of females, p < 0.0001); only in females was this prevalence higher in injured drivers than in patients (p < 0.05). Opiates were present in 10.5% of drivers' and 10.4% of patients' urine samples (NS), and were more frequent in urine samples positive for cannabinoids, in drivers (p < 0.01) as well as in patients (p < 0.001). The prevalence of cocaine metabolites in drivers and patients was 1.0 and 1.1% and that of amphetamines 1.4 and 2.5%, respectively. No causal relationship between drugs and accidents should be inferred from this retrospective study. Nevertheless, the high prevalence of cannabis and opiate (licit or illicit) use in young people, whether injured drivers or patients, has potential implications for road traffic safety in France. Cocaine and amphetamines did not appear to be a major problem, unlike the experience in other countries.
Maman, David; Auma, Erick; Were, Kennedy; Fredrick, Harrison; Owiti, Prestone; Opollo, Valarie; Etard, Jean-François; Mukui, Irene; Kim, Andrea A.; Zeh, Clement
HIV-1 transmitted drug resistance (TDR) is of increasing public health concern in sub-Saharan Africa with the rollout of antiretroviral (ARV) therapy. Such data are, however, limited in Kenya, where HIV-1 drug resistance testing is not routinely performed. From a population-based household survey conducted between September and November 2012 in rural western Kenya, we retrospectively assessed HIV-1 TDR baseline rates, its determinants, and genetic diversity among drug-naïve persons aged 15–59 years with acute HIV-1 infections (AHI) and recent HIV-1 infections (RHI) as determined by nucleic acid amplification test and both Limiting Antigen and BioRad avidity immunoassays, respectively. HIV-1 pol sequences were scored for drug resistance mutations using Stanford HIVdb and WHO 2009 mutation guidelines. HIV-1 subtyping was computed in MEGA6. Eighty seven (93.5%) of the eligible samples were successfully sequenced. Of these, 8 had at least one TDR mutation, resulting in a TDR prevalence of 9.2% (95% CI 4.7–17.1). No TDR was observed among persons with AHI (n = 7). TDR prevalence was 4.6% (95% CI 1.8–11.2) for nucleoside reverse transcriptase inhibitors (NRTIs), 6.9% (95% CI 3.2–14.2) for non- nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.2% (95% CI 0.2–6.2) for protease inhibitors. Three (3.4% 95% CI 0.8–10.1) persons had dual-class NRTI/NNRTI resistance. Predominant TDR mutations in the reverse transcriptase included K103N/S (4.6%) and M184V (2.3%); only M46I/L (1.1%) occurred in the protease. All the eight persons were predicted to have different grades of resistance to the ARV regimens, ranging from potential low-level to high-level resistance. HIV-1 subtype distribution was heterogeneous: A (57.5%), C (6.9%), D (21.8%), G (2.3%), and circulating recombinant forms (11.5%). Only low CD4 count was associated with TDR (p = 0.0145). Our findings warrant the need for enhanced HIV-1 TDR monitoring in order to inform on population
Brown, S Lori; Todd, Joan Ferlo; Cope, Judith U; Sachs, Hari Cheryl
There is continuing concern that women who receive breast implants may be at increased risk for adverse reproductive outcomes or experience problems with breastfeeding. It is unknown whether exposure to biomaterials in breast implants may have teratogenic effects or leach into breast milk causing postnatalproblems. We studied the Food and Drug Administration (FDA) experience by analyzing a case series of adverse event reports received and entered into the FDA's Manufacturer and User Facility Device Experience (MAUDE) database or the Device Experience Network (DEN) database by December 31, 2002 regarding women with breast implants. Reports were critically reviewed for lactation difficulties, reproductive problems (spontaneous abortion, delayed conception) and medical conditions among offspring, including neonatal, infant, and childhood diseases and congenital defects that were attributed to implants. We identified 339 reports that described maternal-child adverse events. Nearly half of these reports (46%) described actual problems with breastfeeding or expressed concern that implants would be unsafe or interfere with breastfeeding. Forty-four percent of reports (n=149) described either nonspecific or specific signs, symptoms, or illnesses in children. An additional 3.5% of reports (n=12) detailed a congenital anomaly believed by the reporter to be caused by breast implants.
Boyle, Coleen A.; Bertrand, Jacquelyn; Yeargin-Allsopp, Marshalyn
This article describes the autism surveillance activities of the Center for Disease Control and Prevention. It considers why surveillance to track prevalence of autistic disorders is needed, how such surveillance is conducted, and the special challenges of autism surveillance. (DB)
Chahine, Mohamad A.; Glenn, LaShanda M.; Ake, Julie A.; Su, Wanwen; Nikolich, Mikeljon P.; Lesho, Emil P.
Background Gram-negative multidrug-resistant (MDR) bacteria are major causes of nosocomial infections, and antibiotic resistance in these organisms is often plasmid mediated. Data are scarce pertaining to molecular mechanisms of antibiotic resistance in resource constrained areas such as Iraq. Methodology/Principal Findings In this study, all MDR Enterobacteriaceae (n = 38) and randomly selected non-MDR counterparts (n = 41) isolated from patients, healthcare workers and environmental surfaces in a newly opened hospital in Iraq were investigated to characterize plasmids found in these isolates and determine their contribution to antibiotic resistance. Our results demonstrated that MDR E. coli and K. pneumoniae isolates harbored significantly more (≥3) plasmids compared to their non-MDR counterparts, which carried ≤2 plasmids (p<0.01). Various large plasmids (∼52 to 100 kb) from representative isolates were confirmed to contain multiple resistance genes by DNA microarray analysis. Aminoglycoside (acc, aadA, aph, strA/B, and ksgA), β-lactam (blaTEM1, blaAMPC, blaCTX-M-15, blaOXA-1, blaVIM-2 and blaSHV), sulfamethoxazole/trimethoprim (sul/dfr), tetracycline (tet) and chloramphenicol (cat) resistance genes were detected on these plasmids. Additionally, multiple plasmids carrying multiple antibiotic resistance genes were found in the same host strain. Genetic transfer-associated genes were identified on the plasmids from both MDR and non-MDR isolates. Seven plasmid replicon types (FII, FIA, FIB, B/O, K, I1 and N) were detected in the isolates, while globally disseminated IncA/C and IncHI1 plasmids were not detected in these isolates. Conclusions/Significance This is the first report of the characteristics of the plasmids found in Enterobacteriaceae isolated following the opening of a new hospital in Iraq. The information provided here furthers our understanding of the mechanisms of drug resistance in this specific region and their evolutionary
Mbogning, Cyprien; Link, Jenny; Ryner, Malin; Ramanujam, Ryan; Auer, Michael; Hyldgaard Jensen, Poul Erik; Koch-Henriksen, Nils; Warnke, Clemens; Ingenhoven, Kathleen; Buck, Dorothea; Grummel, Verena; Lawton, Andy; Donnellan, Naoimh; Hincelin-Mery, Agnès; Sikkema, Dan; Pallardy, Marc; Kieseier, Bernd; Hemmer, Bernard; Hartung, Hans Peter; Soelberg Sorensen, Per; Deisenhammer, Florian; Dönnes, Pierre; Davidson, Julie; Fogdell-Hahn, Anna; Broët, Philippe
Immunogenicity of biopharmaceutical products in multiple sclerosis is a frequent side effect which has a multifactorial etiology. Here we study associations between anti-drug antibody (ADA) occurrence and demographic and clinical factors. Retrospective data from routine ADA test laboratories in Sweden, Denmark, Austria and Germany (Dusseldorf group) and from one research study in Germany (Munich group) were gathered to build a collaborative multi-cohort dataset within the framework of the ABIRISK project. A subset of 5638 interferon-beta (IFNβ)-treated and 3440 natalizumab-treated patients having data on at least the first two years of treatment were eligible for interval-censored time-to-event analysis. In multivariate Cox regression, IFNβ-1a subcutaneous and IFNβ-1b subcutaneous treated patients were at higher risk of ADA occurrence compared to IFNβ-1a intramuscular-treated patients (pooled HR = 6.4, 95% CI 4.9–8.4 and pooled HR = 8.7, 95% CI 6.6–11.4 respectively). Patients older than 50 years at start of IFNβ therapy developed ADA more frequently than adult patients younger than 30 (pooled HR = 1.8, 95% CI 1.4–2.3). Men developed ADA more frequently than women (pooled HR = 1.3, 95% CI 1.1–1.6). Interestingly we observed that in Sweden and Germany, patients who started IFNβ in April were at higher risk of developing ADA (HR = 1.6, 95% CI 1.1–2.4 and HR = 2.4, 95% CI 1.5–3.9 respectively). This result is not confirmed in the other cohorts and warrants further investigations. Concerning natalizumab, patients older than 45 years had a higher ADA rate (pooled HR = 1.4, 95% CI 1.0–1.8) and women developed ADA more frequently than men (pooled HR = 1.4, 95% CI 1.0–2.0). We confirmed previously reported differences in immunogenicity of the different types of IFNβ. Differences in ADA occurrence by sex and age are reported here for the first time. These findings should be further investigated taking into account other exposures and biomarkers. PMID
This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).
Fokam, Joseph; Takou, Désiré; Santoro, Maria Mercedes; Akonie, Haniel Ze; Kouanfack, Charles; Ceccherini-Silberstein, Francesca; Colizzi, Vittorio; Perno, Carlo-Federico; Ndjolo, Alexis
With ongoing earlier enrollment on and rapid scale-up of antiretroviral therapy (ART) in Cameroon, there are increasing risks of transmitted HIV drug resistance (HIVDR) at population levels. We, therefore, evaluated the threshold of HIVDR in a population initiating ART, to inform on the effectiveness of first-line regimens, considering HIV-1 diversity, plasma viral load (PVL), and CD4-based disease progression. A total of 53 adults [median (interquartile range, IQR) CD4: 162 cell/mm(3) (48-284); median (IQR) PVL: 5.34 log10 RNA (4.17-6.42) copies/ml] initiating ART in 2014 at the Yaoundé Central Hospital were enrolled for HIV-1 protease-reverse transcriptase sequencing. Drug resistance mutations (DRMs) were interpreted using the 2009 World Health Organization (WHO) list versus the Stanford HIVdb algorithm version 7.0. Level of DRMs was low (3.77%) versus moderate (7.55%), respectively, following the WHO list (T69D, K103N) versus Stanford HIVdb (T69D, A98G, K103N, K238T), respectively. Prevailing clade was CRF02_AG (71.70%). Based on Stanford HIVdb, a slightly higher proportion of patients with DRMs were found among ones infected with CRF02_AG than in those non-CRF02_AG infected (7.89% vs. 6.67%, p = 1.000), with lower PVL (7.69% <5.5 vs. 0% ≥5.5 log10 RNA copies/ml, p = .488) and with higher CD4 counts (9.52% CD4 ≥200 vs. 3.33% CD4 <200 cells/mm(3), p = .749). Thresholds of DRMs suggest that standard first-line regimens currently used in Cameroon may remain effective at population levels, despite scale-up of ART in the country, pending adherence, and closed virological monitoring. With an intent-to-diagnose approach, the discrepant levels of DRMs support using Stanford HIVdb to evaluate initial ART, while revising the WHO list for surveillance.
rangefinder. Options include an autotracker, a target accumulator; laser spot tracker, digital video output and night vision goggle compatibility...The BRITEStar is used on the UH-1N. Mariner - low-cost thermal imager mounted in rugged pan/tilt housing. Superior to night vision devices, it...infrared imager and 18x low-light TV camera can be combined with an optional Class III3b laser. Ground forces equipped with night vision goggles can
Options include an autotracker, a target accumulator; laser spot tracker, digital video output and night vision goggle compatibility. The BRITEStar is...used on the UH-1N. Mariner - low-cost thermal imager mounted in rugged pan/tilt housing. Superior to night vision devices, it uses the same thermal...an optional Class III3b laser. Ground forces equipped with night vision goggles can clearly see the 30 mw laser’s beam and spot, though it remains
Waterman, Stephen; Lucas, Carlos Alvarez; Falcon, Veronica Carrion; Morales, Pablo Kuri; Lopez, Luis Anaya; Peter, Chris; Gutiérrez, Alejandro Escobar; Gonzalez, Ernesto Ramirez; Flisser, Ana; Bryan, Ralph; Valle, Enrique Navarro; Rodriguez, Alfonso; Hernandez, Gerardo Alvarez; Rosales, Cecilia; Ortiz, Javier Arias; Landen, Michael; Vilchis, Hugo; Rawlings, Julie; Leal, Francisco Lopez; Ortega, Luis; Flagg, Elaine; Conyer, Roberto Tapia; Cetron, Martin
In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. During a 3-year period, a binational team implemented an active, sentinel surveillance system for hepatitis and febrile exanthems at 13 clinical sites. The network developed surveillance protocols, trained nine surveillance coordinators, established serologic testing at four Mexican border laboratories, and created agreements for data sharing and notification of selected diseases and outbreaks. BIDS facilitated investigations of dengue fever in Texas-Tamaulipas and measles in California–Baja California. BIDS demonstrates that a binational effort with local, state, and federal participation can create a regional surveillance system that crosses an international border. Reducing administrative, infrastructure, and political barriers to cross-border public health collaboration will enhance the effectiveness of disease prevention projects such as BIDS. PMID:12533288
McDonald, Peter R; Roy, Anuradha; Chaguturu, Rathnam
The University of Kansas High-Throughput Screening (KU HTS) core is a state-of-the-art drug-discovery facility with an entrepreneurial open-service policy, which provides centralized resources supporting public- and private-sector research initiatives. The KU HTS core was established in 2002 at the University of Kansas with support from an NIH grant and the state of Kansas. It collaborates with investigators from national and international academic, nonprofit and pharmaceutical organizations in executing HTS-ready assay development and screening of chemical libraries for target validation, probe selection, hit identification and lead optimization. This is part two of a contribution from the KU HTS laboratory.
Brady, Linda S.; Winsky, Lois; Goodman, Wayne; Oliveri, Mary Ellen; Stover, Ellen
There is an urgent need to transform basic research discoveries into tools for treatment and prevention of mental illnesses. This article presents an overview of the National Institute of Mental Health (NIMH) programs and resources to address the challenges and opportunities in psychiatric drug development starting at the point of discovery through the early phases of translational research. We summarize NIMH and selected National Institutes of Health (NIH) efforts to stimulate translation of basic and clinical neuroscience findings into novel targets, models, compounds, and strategies for the development of innovative therapeutics for psychiatric disorders. Examples of collaborations and partnerships between NIMH/NIH, academia, and industry are highlighted. PMID:18800066
Influenza is a major public health problem. The national influenza surveillance system is based on the collaboration of sentinel general practitioners who collect nose and throat swabs from their patients and report the percentage of consultations which concern influenza-like illness or acute respiratory infections. During the influenza season, a report is published each week on the website http://www.lph.fgov.be/epidemio. Belgium participates in the European Influenza Surveillance Scheme and the global Influenza surveillance system of the W.H.O.
NASA's 2003-2004 Leadership Development Program class recognized that effective collaborations are often the key to achieving mission success. Personal connections and common goals were key elements of their work together and key findings of their collaboration benchmarking within the agency.
Lawson, Becki; Petrovan, Silviu O; Cunningham, Andrew A
Achieving effective wildlife disease surveillance is challenging. The incorporation of citizen science (CS) in wildlife health surveillance can be beneficial, particularly where resources are limited and cost-effectiveness is paramount. Reports of wildlife morbidity and mortality from the public facilitate large-scale surveillance, both in time and space, which would otherwise be financially infeasible, and raise awareness of incidents occurring on privately owned land. CS wildlife disease surveillance schemes benefit scientists, the participating public and wildlife alike. CS has been employed for targeted, scanning and syndromic surveillance of wildlife disease. Whilst opportunistic surveillance is most common, systematic observations enable the standardisation of observer effort and, combined with wildlife population monitoring schemes, can allow evaluation of disease impacts at the population level. Near-universal access to digital media has revolutionised reporting modalities and facilitated rapid and economical means of sharing feedback with participants. Here we review CS schemes for wildlife disease surveillance and highlight their scope, benefits, logistical considerations, financial implications and potential limitations. The need to adopt a collaborative and multidisciplinary approach to wildlife health surveillance is increasingly recognised and the general public can make a significant contribution through CS.
Poleksic, Aleksandar; Yao, Yuan; Tong, Hanghang; Meng, Patrick; Xie, Lei
Target-based screening is one of the major approaches in drug discovery. Besides the intended target, unexpected drug off-target interactions often occur, and many of them have not been recognized and characterized. The off-target interactions can be responsible for either therapeutic or side effects. Thus, identifying the genome-wide off-targets of lead compounds or existing drugs will be critical for designing effective and safe drugs, and providing new opportunities for drug repurposing. Although many computational methods have been developed to predict drug-target interactions, they are either less accurate than the one that we are proposing here or computationally too intensive, thereby limiting their capability for large-scale off-target identification. In addition, the performances of most machine learning based algorithms have been mainly evaluated to predict off-target interactions in the same gene family for hundreds of chemicals. It is not clear how these algorithms perform in terms of detecting off-targets across gene families on a proteome scale. Here, we are presenting a fast and accurate off-target prediction method, REMAP, which is based on a dual regularized one-class collaborative filtering algorithm, to explore continuous chemical space, protein space, and their interactome on a large scale. When tested in a reliable, extensive, and cross-gene family benchmark, REMAP outperforms the state-of-the-art methods. Furthermore, REMAP is highly scalable. It can screen a dataset of 200 thousands chemicals against 20 thousands proteins within 2 hours. Using the reconstructed genome-wide target profile as the fingerprint of a chemical compound, we predicted that seven FDA-approved drugs can be repurposed as novel anti-cancer therapies. The anti-cancer activity of six of them is supported by experimental evidences. Thus, REMAP is a valuable addition to the existing in silico toolbox for drug target identification, drug repurposing, phenotypic screening, and
Varan, Aiden K.; Bruniera-Oliveira, Robson; Peter, Christopher R.; Fonseca-Ford, Maureen; Waterman, Stephen H.
Cross-border surveillance for emerging diseases such as Ebola and other infectious diseases requires effective international collaboration. We surveyed representatives from 12 multinational disease surveillance programs between January 2013 and April 2014. Our survey identified programmatic similarities despite variation in health priorities, geography, and socioeconomic context, providing a contemporary perspective on infectious disease surveillance networks. PMID:26033019
Varan, Aiden K; Bruniera-Oliveira, Robson; Peter, Christopher R; Fonseca-Ford, Maureen; Waterman, Stephen H
Cross-border surveillance for emerging diseases such as Ebola and other infectious diseases requires effective international collaboration. We surveyed representatives from 12 multinational disease surveillance programs between January 2013 and April 2014. Our survey identified programmatic similarities despite variation in health priorities, geography, and socioeconomic context, providing a contemporary perspective on infectious disease surveillance networks.
Haggerty, K D; Ericson, R V
George Orwell's 'Big Brother' and Michel Foucault's 'panopticon' have dominated discussion of contemporary developments in surveillance. While such metaphors draw our attention to important attributes of surveillance, they also miss some recent dynamics in its operation. The work of Gilles Deleuze and Felix Guattari is used to analyse the convergence of once discrete surveillance systems. The resultant 'surveillant assemblage' operates by abstracting human bodies from their territorial settings, and separating them into a series of discrete flows. These flows are then reassembled in different locations as discrete and virtual 'data doubles'. The surveillant assemblage transforms the purposes of surveillance and the hierarchies of surveillance, as well as the institution of privacy.
Antman, Karen H; Berman, Harris A; Flotte, Terence R; Flier, Jeffrey; Dimitri, Dennis M; Bharel, Monica
Drug overdose has become the leading cause of injury death in the United States. More than half of those deaths involve prescription drugs, specifically opioids. A key component of addressing this national epidemic is improving prescriber practices.A review of the curricula at the four medical schools in Massachusetts revealed that, although they taught components of addiction medicine, no uniform standard existed to ensure that all students were taught prevention and management strategies for prescription drug misuse. To fill this gap, the governor and the secretary of health and human services invited the deans of the state's four medical schools to convene to develop a common educational strategy for teaching safe and effective opioid-prescribing practices. With leadership from the Department of Public Health and Massachusetts Medical Society, the deans formed the Medical Education Working Group in 2015. This group reviewed the relevant literature and current standards for treating substance use disorders and defined 10 core competencies for the prevention and management of prescription drug misuse.The medical schools have incorporated these competencies into their curricula and have committed to assessing students' competence in these areas. The members of the Medical Education Working Group have agreed to continue to work together on key next steps, including connecting these competencies to those for residents, equipping interprofessional teams to address prescription drug misuse, and developing materials in pain management and opioid misuse for practicing physicians. This first-in-the-nation partnership has yielded cross-institutional competencies that aim to address a public health emergency in real time.
He, Amy S; Traube, Dorian E; Young, Nancy K
Cross-system collaboration among child welfare (CW), alcohol and other drugs (AOD), and court organizations shows promise in addressing the many needs of CW-involved families experiencing parental substance use disorders (SUDs). Research has suggested that differing perceptions of parents with SUDs among staff in these organizations may hinder the collaborative process. Using a sequential explanatory mixed-method approach, this study explored staff perceptions of parental SUDs among CW, AOD, and court organizations. Logistic regression analyses indicated that, compared to CW respondents, AOD respondents were: (a) less likely to believe that parents could provide effective parenting; (b) more likely to believe that abstinence should be a criterion for reunification; (c) more likely to agree that parents should receive jail time as a consequence for noncompliance with court orders; and (d) more likely to believe that parents could succeed in treatment. Thematic analyses of these focal areas identified two core themes (focus on the primary client and mandated time frames for permanency), as well as multiple subthemes, that provided a nuanced understanding of differing perceptions on these matters. Suggestions for the development of anticipatory cross-system training and practices and implications for policy evaluation are discussed.
McNamara, Lucy A; Schafer, Ilana J; Nolen, Leisha D; Gorina, Yelena; Redd, John T; Lo, Terrence; Ervin, Elizabeth; Henao, Olga; Dahl, Benjamin A; Morgan, Oliver; Hersey, Sara; Knust, Barbara
Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.
Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.
Eke, Paul I; Genco, Robert J
This supplement contains papers presented at the 2006 International Association of Dental Research (IADR) symposium entitled "Development of Self-Reported Measures for Population-Based Surveillance of Periodontitis." These papers highlight activities of an independent periodontal disease surveillance workgroup convened by the Division of Oral Health (DOH), Centers for Disease Control and Prevention (CDC), in collaboration with the American Academy of Periodontology, to examine the feasibility of using self-reported measures for population-based surveillance of periodontal disease in the United States. This workgroup was convened in 2003 as part of a CDC periodontal disease surveillance project.
Chung, Thomas D Y
competencies of its fully integrated drug discovery expertise, best practices adopted in our day-to-day operations, and finally some of our current funding and collaboration and/or strategic alliance models for pre-competitive drug discovery with other academic/clinical partners, other governmental agencies, and with pharmaceutical and biotechnology companies.
The Collaborative Radiological Health Laboratory (CRHL) was established in 1962 by the U.S. Public Health Service and Colorado State University for the purpose of determining in a carefully controlled experiment the lifetime hazards associated with prenatal and early postnatal exposure to ionizing radiation. The CRHL study is designed to provide information that will facilitate the evaluation of risks to humans from medical exposure during early development. The study is a long-term (lifespan) study of a moderately large and long-lived mammal exposed at one of several times during development to a relatively small and discrete dose of external radiation. Ages at irradiation selected for comparison reflect the primary concern with medical exposures during the developmental period. The basic experiment under this contract contains 1680 beagles that will be maintained and evaluated for most of their natural lives. Commitment of animals began in December 1967 and was completed in October 1972. This annual report summarizes the current status of the study for the reporting period of January 1 through December 31, 1981.
Babo Martins, S; Rushton, J; Stärk, K D C
Cross-sectorial surveillance and general collaboration between the animal and the public health sectors are increasingly recognized as needed to better manage the impacts of zoonoses. From 2009, the Swiss established a Campylobacter mitigation system that includes human and poultry surveillance data-sharing within a multi-sectorial platform, in a 'One Health' approach. The objective of this study was to explore the economics of this cross-sectorial approach, including surveillance and triggered interventions. Costs and benefits of the One Health and of the uni-sectorial approach to Campylobacter surveillance were identified using an economic assessment framework developed earlier. Cost information of surveillance activities and interventions was gathered and disability-adjusted life years (DALYs) associated with the disease estimated for 2008 and 2013. In the first 5 years of this One Health approach to Campylobacter mitigation, surveillance contributed with information mainly used to perform risk assessments, monitor trends and shape research efforts on Campylobacter. There was an increase in costs associated with the mitigation activities following integration, due mainly to the allocation of additional resources to research and implementation of poultry surveillance. The overall burden of campylobacteriosis increased by 3·4-8·8% to 1751-2852 DALYs in 2013. In the timing of the analysis, added value associated with this cross-sectorial approach to surveillance of Campylobacter in the country was likely generated through non-measurable benefits such as intellectual capital and social capital.
Hurtado, Renato Lopes; Lasmar, Marcelo Carvalho
The problem of counterfeit medicines is increasing rapidly, aggravated by globalization and the lure of profit from this illegal activity. Various types of drugs have been counterfeited, posing a serious public health and safety problem. The current article provides an overview of the issue in Brazil and the resulting measures taken by the National Health Surveillance Agency (ANVISA) in collaboration with the Federal Police from 2007 to March 2011. The study analyzed seizures of counterfeit drugs, arrests, and other factors. No professional pharmacist was present in 90% of the establishments were some type of crime occurred (sale of counterfeit drugs and lack of control of narcotics and other drugs). Among the products seized, most were drugs for erectile dysfunction. The study showed the importance of inter-agency collaboration for combatting this type of irregular drug sales.
Levy-Reiner, Sherry, Ed.
Descriptions of 10 college programs involving collaborative learning are presented, along with Karen T. Romer's essay, "Collaboration: New Forms of Learning, New Ways of Thinking." The essay identifies various kinds of collaborative learning as well as the benefits of collaborative models. The following programs and schools are…
Martinez, Marilyn N; McGilveray, Iain
Globalization of the pharmaceutical industry has led to a need to harmonize the regulatory requirements governing the marketing of medicinal products. To minimize the barriers impeding global drug product registration, the International Conference on the Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) was established in 1990. The ICH has developed a series of guidelines that reflect agreements reached by participating nations on aspects of the chemistry and clinical technical sections that will fulfill the regulatory requirements of these various jurisdications. Nevertheless, there continue to be points of divergent perspectives and barriers that can impede the use of foreign clinical data. Given the importance of these issues, the Regulatory Science (RS) section of the American Association of Pharmaceutical Scientists (AAPS), in conjunction with the Regulatory Affairs Professional Society (RAPS) and the Canadian Association of Professional Regulatory Affairs (CAPRA) cosponsored a public forum on this topic. This manuscript provides a summary of the speaker presentations and audience discussions regarding the design of clinical trials and the extrapolation of results from these trials to support international drug registration.
Special surveillance list of chemicals, products, materials and equipment used in the clandestine production of controlled substances or listed chemicals. Drug Enforcement Administration (DEA), Justice. Final notice.
On October 3, 1996, the Comprehensive Methamphetamine Control Act of 1996 (MCA) was signed into law. The MCA makes it unlawful for any person to distribute a laboratory supply to a person who uses, or attempts to use, that laboratory supply to manufacture a controlled substance or a listed chemical, with reckless disregard for the illegal uses to which such laboratory supply will be put. Individuals who violate this provision are subject to a civil penalty of not more than $25,000; businesses which violate this provision are subject to a civil penalty of not more than $250,000. The term "laboratory supply" is defined as "a listed chemical or any chemical, substance, or item on a special surveillance list published by the Attorney General, which contains chemicals, products, materials, or equipment used in the manufacture of controlled substances and listed chemicals." This final notice contains the list of "laboratory supplies" which constitutes the Special Surveillance List that was required to be published by the Attorney General pursuant to Title 21, United States Code, Section 842(a).
Background on the General Medical Surveillance Program at LeRC is presented. The purpose of the General Medical Surveillance Program at LeRC is outlined, and the specifics of the program are discussed.
Syukri, Yandi; Nugroho, Bambang Hernawan
The course of Drug Delivery Systems is an elective that supports the development of new products in pharmaceutical industry. The existing learning process has been in the form of one-direction face-to-face lecturing. During the lecture, students find it difficult to follow or understand the materials, so they become passive. Also, class effectiveness is low because it cannot develop students' active participation during the learning process. To improve the learning outcomes and to achieve the desired competence, innovations in the learning process should be attempted. This learning model aimed to improve students' understanding of and soft skills in the course of Drug Delivery Systems through a cooperative learning method and collaboration with foreign lecturers. The order of cooperative learning included explaining the desired learning outcomes of each topic, providing reading materials for students to learn when preparing their papers, instructing students to work on group assignments and to help each other to master the lesson through question-answer sessions and discussions among group members, encouraging group presentations, and evaluating through quizzes. The foreign lecturers played a role in enriching teaching materials and providing an international class atmosphere. The students' hard skills assessed from the quiz, midterm exam, and final semester exam showed a minimum score of 70 > 80% in the quiz and final semester exam components, while the midterm exam value with a minimum of 70 > 80% was only 6%. The assessment of soft skills obtained from the students' independence in constructing knowledge to complete assignments and resolve problems indicated such outcomes as each group's better ability to access relevant journals, their active participation in group discussions, discipline to submit assignments, discipline to be punctual, and good communication skills. It can be concluded that cooperative learning method could improve the soft skills of students
Klonoff, David C; Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B; Kirkman, M Sue; Kovatchev, Boris
Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to
Gresham, Louise S; Smolinski, Mark S; Suphanchaimat, Rapeepong; Kimball, Ann Marie; Wibulpolprasert, Suwit
Connecting Organizations for Regional Disease Surveillance (CORDS) is an international non-governmental organization focused on information exchange between disease surveillance networks in different areas of the world. By linking regional disease surveillance networks, CORDS builds a trust-based social fabric of experts who share best practices, surveillance tools and strategies, training courses, and innovations. CORDS exemplifies the shifting patterns of international collaboration needed to prevent, detect, and counter all types of biological dangers - not just naturally occurring infectious diseases, but also terrorist threats. Representing a network-of-networks approach, the mission of CORDS is to link regional disease surveillance networks to improve global capacity to respond to infectious diseases. CORDS is an informal governance cooperative with six founding regional disease surveillance networks, with plans to expand; it works in complement and cooperatively with the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the Food and Animal Organization of the United Nations (FAO). As described in detail elsewhere in this special issue of Emerging Health Threats, each regional network is an alliance of a small number of neighboring countries working across national borders to tackle emerging infectious diseases that require unified regional efforts. Here we describe the history, culture and commitment of CORDS; and the novel and necessary role that CORDS serves in the existing international infectious disease surveillance framework.
Gresham, Louise S.; Smolinski, Mark S.; Suphanchaimat, Rapeepong; Kimball, Ann Marie; Wibulpolprasert, Suwit
Connecting Organizations for Regional Disease Surveillance (CORDS) is an international non-governmental organization focused on information exchange between disease surveillance networks in different areas of the world. By linking regional disease surveillance networks, CORDS builds a trust-based social fabric of experts who share best practices, surveillance tools and strategies, training courses, and innovations. CORDS exemplifies the shifting patterns of international collaboration needed to prevent, detect, and counter all types of biological dangers – not just naturally occurring infectious diseases, but also terrorist threats. Representing a network-of-networks approach, the mission of CORDS is to link regional disease surveillance networks to improve global capacity to respond to infectious diseases. CORDS is an informal governance cooperative with six founding regional disease surveillance networks, with plans to expand; it works in complement and cooperatively with the World Health Organization (WHO), the World Organization for Animal Health (OIE), and the Food and Animal Organization of the United Nations (FAO). As described in detail elsewhere in this special issue of Emerging Health Threats, each regional network is an alliance of a small number of neighboring countries working across national borders to tackle emerging infectious diseases that require unified regional efforts. Here we describe the history, culture and commitment of CORDS; and the novel and necessary role that CORDS serves in the existing international infectious disease surveillance framework. PMID:23362412
Hurst, Hunter, Ed.; And Others
This document contains the third volume of "Today's Delinquent," an annual publication of the National Center for Juvenile Justice. This volume deals with the issue of drugs and includes articles by leading authorities in delinquency and substance abuse who share their views on causes and cures for the drug problem among youth in this country.…
This paper highlights several current collaborative activities of the National Early Childhood Technical Assistance Center (NECTAC). There are many specific examples of TA (Technical Assistance) collaborations that take place on a regular basis; the seven examples presented here were selected to represent different types of collaboration. The…
David, Jane L.
Teachers can make better use of data when they work together than when they do it alone. Creating the conditions for such collaboration is a tall order. This article describes the idea behind the collaborative inquiry approach. It also mentions several studies that indicate its effectiveness. Tips on how collaborative inquiry can be implemented…
Cota-Robles, Eugene; Doby, Winston
Two conference papers describing various collaborative arrangements within the educational community among teachers, students and others are presented in this document. The first paper, "Successful Collaborations" (Eugene Cota-Robles), describes the following projects in California that seek to forge collaborations to improve the…
Anraku, Makoto; Tomida, Hisao; Sato, Eiji; Tabuchi, Norihiko; Yoshitomi, Hironori; Okamura, Nobuyuki; Taguchi, Katsuhide; Kondo, Yuko; Murakami, Nobuyuki
In recent years, it is necessary to acquire knowledge not only about medicine but also over-the-counter (OTC) drugs and health food for children, because lowering trend in the age of the health hazard by improper use of health food is reported. Therefore, in order to estimate the extent of use of OTC drugs and health food, the school pharmacists administered a questionnaire to students in grade-school (n=123), junior high school (n=303), and high school (n=115) in Fukuyama city. As a result of the questionnaire survey, surprisingly, the usage ratio of OTC drugs and health food showed the most increase in grade-schooler. The trigger of use of health food is "parents' recommendations" in the lower grades, otherwise the ratio of "use by themselves" was increased in the higher grades. Moreover, a remarkable difference was observed by the kinds of use in students with or without exercise. Interestingly, exercise group expected "physical strength" effects than no exercise group. In addition, the ratio of consultation to the pharmacist at the time of purchase of OTC drugs and health food was low in all grade students. In particular, the ratio of consultation to the pharmacist at the time of purchase of health food was very low in high school students. Therefore, to provide accurate information of medicine and health food for students, the school pharmacist should engage not only in routine work but also in positive guidance about OTC drugs and health food in the future.
Tabernero, Nathaniel R; Loschen, Wayne A; Jorgensen, Joel; Suereth, Joshua; Coberly, Jacqueline S; Holtry, Rekha S; Sikes, Marvin L; Babin, Steven M; Lewis, Sheryl L Happel
Automated disease surveillance systems are becoming widely used by the public health community. However, communication among non-collocated and widely dispersed users still needs improvement. A web-based software tool for enhancing user communications was completely integrated into an existing automated disease surveillance system and was tested during two simulated exercises and operational use involving multiple jurisdictions. Evaluation of this tool was conducted by user meetings, anonymous surveys, and web logs. Public health officials found this tool to be useful, and the tool has been modified further to incorporate features suggested by user responses. Features of the automated disease surveillance system, such as alerts and time series plots, can be specifically referenced by user comments. The user may also indicate the alert response being considered by adding a color indicator to their comment. The web-based event communication tool described in this article provides a common ground for collaboration and communication among public health officials at different locations.
Surveillance of Salmonella enteritidis in layer houses: a retrospective comparison of the Food and Drug Administration's egg safety rule (2010-2011) and the California Egg Quality Assurance Program (2007-2011).
Pitesky, Maurice; Charlton, Bruce; Bland, Mark; Rolfe, Dan
Between July 2007 and December 2011, 2660 environmental drag swab samples were collected in total from California layer flocks on behalf of the California Egg Quality Assurance Program (CEQAP), the egg safety rule (21 CFR Parts 16 and 118) of the Food and Drug Administration (FDA), or both. The samples were processed by the California Animal Health and Food Safety Lab, and positive or negative results for Salmonella enterica serovar Enteritidis (SE) were recorded. This study retrospectively compares the differences between the FDA and CEQAP programs with respect to their SE environmental sampling surveillance results. To accomplish this comparison, two different CEQAP (new and old) data sets representing different SE environmental surveillance approaches in the life of the flock were compared against each other and against the FDA's SE environmental testing plan. Significant differences were noted between the CEQAP and FDA programs with respect to the prevalence of SE in the farm environment. Analyses of the prevalence of SE at different stages in the flock's life cycle (chick papers, preproduction, midproduction, postmolt, and premarket) found the highest prevalence of SE in premarket (11.9%), followed by postmolt (3.5%) and midproduction (3.4%), and there was a tie between chick papers and preproduction (2.1%). To assess the main effects of the presence of SE in the farm environment, backwards binary logistic regression was used. Of six independent variables examined (age of flock, year, season, owner, CEQAP membership, and analysis of pooled samples vs. individual swabs), only age of flock, owner, and year were determined to be significant factors in the final model. Although CEQAP membership and pooling vs. individuals swabs were not included in the final model, Pearson chi-square tests did show significantly higher odds of SE for non-CEQAP member farms and higher odds of SE in pooled samples vs. individual swabs.
Discusses collaboration in the peer writing center. Suggests that applying hierarchical and dialogic collaboration to writing centers can help to sketch out the forms of collaboration in peer tutoring, but a more fine-grained rhetorical analysis will result in richer and more precise descriptions and avoid hardbound categories and stereotypes. (RS)
Eke, Paul I; Thornton-Evans, Gina; Dye, Bruce; Genco, Robert
The Centers for Disease Control and Prevention (CDC) has as one of its strategic goals to support and improve surveillance of periodontal disease. In 2003, the CDC initiated the CDC Periodontal Disease Surveillance Project in collaboration with the American Academy of Periodontology to address population-based surveillance of periodontal disease at the local, state, and national levels. This initiative has made significant advancements toward the goal of improved surveillance, including developing valid self-reported measures that can be obtained from interview-based surveys to predict prevalence of periodontitis in populations. This will allow surveillance of periodontitis at the state and local levels and in countries where clinical resources for surveillance are scarce. This work has produced standard case definitions for surveillance of periodontitis that are now widely recognized and applied in population studies and research. At the national level, this initiative has evaluated the validity of previous clinical examination protocols and tested new protocols on the National Health and Nutrition Examination Survey (NHANES), recommending and supporting funding for the gold-standard full-mouth periodontal examination in NHANES 2009 to 2012. These examinations will generate accurate estimates of the prevalence of periodontitis in the US adult population and provide a superior dataset for surveillance and research. Also, this data will be used to generate the necessary coefficients for our self-report questions for use in subsets of the total US population. The impact of these findings on population-based surveillance of periodontitis and future directions of the project are discussed along with plans for dissemination and translation efforts for broader public health use.
CollAborative care and active surveillance for Screen-Positive EldeRs with subthreshold depression (CASPER): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness.
Lewis, Helen; Adamson, Joy; Atherton, Katie; Bailey, Della; Birtwistle, Jacqueline; Bosanquet, Katharine; Clare, Emily; Delgadillo, Jaime; Ekers, David; Foster, Deborah; Gabe, Rhian; Gascoyne, Samantha; Haley, Lesley; Hargate, Rebecca; Hewitt, Catherine; Holmes, John; Keding, Ada; Lilley-Kelly, Amanda; Maya, Jahnese; McMillan, Dean; Meer, Shaista; Meredith, Jodi; Mitchell, Natasha; Nutbrown, Sarah; Overend, Karen; Pasterfield, Madeline; Richards, David; Spilsbury, Karen; Torgerson, David; Traviss-Turner, Gemma; Trépel, Dominic; Woodhouse, Rebecca; Ziegler, Friederike; Gilbody, Simon
BACKGROUND Efforts to reduce the burden of illness and personal suffering associated with depression in older adults have focused on those with more severe depressive syndromes. Less attention has been paid to those with mild disorders/subthreshold depression, but these patients also suffer significant impairments in their quality of life and level of functioning. There is currently no clear evidence-based guidance regarding treatment for this patient group. OBJECTIVES To establish the clinical effectiveness and cost-effectiveness of a low-intensity intervention of collaborative care for primary care older adults who screened positive for subthreshold depression. DESIGN A pragmatic, multicentred, two-arm, parallel, individually randomised controlled trial with a qualitative study embedded within the pilot. Randomisation occurred after informed consent and baseline measures were collected. SETTING Thirty-two general practitioner (GP) practices in the north of England. PARTICIPANTS A total of 705 participants aged ≥ 75 years during the pilot phase and ≥ 65 years during the main trial with subthreshold depression. INTERVENTIONS Participants in the intervention group received a low-intensity intervention of collaborative care, which included behavioural activation delivered by a case manager for an average of six sessions over 7-8 weeks, alongside usual GP care. Control-arm participants received only usual GP care. MAIN OUTCOME MEASURES The primary outcome measure was a self-reported measure of depression severity, the Patient Health Questionnaire-9 items PHQ-9 score at 4 months post randomisation. Secondary outcome measures included the European Quality of Life-5 Dimensions, Short Form questionnaire-12 items, Patient Health Questionnaire-15 items, Generalised Anxiety Disorder seven-item scale, Connor-Davidson Resilience Scale two-item version, a medication questionnaire and objective data. Participants were followed up for 12 months. RESULTS In total, 705
We have witnessed many attacks in the cyberspace. However, most attacks are launched by individual attackers even though an attack may involve many compromised computers. In this paper, we envision what we believe to be the next generation cyber attacks — collaborative attacks. Collaborative attacks can be launched by multiple attackers (i.e., human attackers or criminal organizations), each of which may have some specialized expertise. This is possible because cyber attacks can become very sophisticated and specialization of attack expertise naturally becomes relevant. To counter collaborative attacks, we might need collaborative defense because each “chain” in a collaborative attack may be only adequately dealt with by a different defender. In order to understand collaborative attack and collaborative defense, we present a high-level abstracted framework for evaluating the effectiveness of collaborative defense against collaborative attacks. As a first step towards realizing and instantiating the framework, we explore a characterization of collaborative attacks and collaborative defense from the relevant perspectives.
identification. Malaria Journal 2013, 12:113 Enterics: Enteric pathogen surveillance in a case- control study of acute diarrhoea in the town of...comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS...areas in which work is performed include respiratory illness surveillance (particularly influenza), acute febrile illness surveillance, malaria
Lysons, R E; Gibbens, J C; Smith, L H
The UK has experienced various animal health events that have had national impact in recent years. In response, a ;Veterinary Surveillance Strategy' (VSS) was published in 2003, with the objective of enhancing and coordinating national veterinary surveillance practice in a way that would enable important animal health events to be detected and assessed more rapidly and reliably. The VSS adopts an integrated UK-wide approach, which includes widespread engagement with interested parties both within government and beyond. It proposes enhancing surveillance through improved collaboration; transparent and defensible prioritisation of government resources to surveillance; deriving better value from existing resources, and assuring quality of the surveillance reports and source data. This article describes progress with implementing the VSS, in particular the methodology for developing a functional network and creating an effective, quality-assured, information management system, RADAR.
This special section of The Sociological Quarterly explores research on “surveillance as cultural practice,” which indicates an orientation to surveillance that views it as embedded within, brought about by, and generative of social practices in specific cultural contexts. Such an approach is more likely to include elements of popular culture, media, art, and narrative; it is also more likely to try to comprehend people's engagement with surveillance on their own terms, stressing the production of emic over etic forms of knowledge. This introduction sketches some key developments in this area and discusses their implications for the field of “surveillance studies” as a whole.
Bobadilla-del Valle, Miriam; Torres-González, Pedro; Cervera-Hernández, Miguel Enrique; Martínez-Gamboa, Areli; Crabtree-Ramirez, Brenda; Chávez-Mazari, Bárbara; Ortiz-Conchi, Narciso; Rodríguez-Cruz, Luis; Cervantes-Sánchez, Axel; Gudiño-Enríquez, Tomasa; Cinta-Severo, Carmen; Sifuentes-Osornio, José; Ponce de León, Alfredo
Background Mycobacterium tuberculosis causes the majority of tuberculosis (TB) cases in humans; however, in developing countries, human TB caused by M. bovis may be frequent but undetected. Human TB caused by M. bovis is considered a zoonosis; transmission is mainly through consumption of unpasteurized dairy products, and it is less frequently attributed to animal-to-human or human-to-human contact. We describe the trends of M. bovis isolation from human samples and first-line drug susceptibility during a 15-year period in a referral laboratory located in a tertiary care hospital in Mexico City. Methodology/Principal Findings Data on mycobacterial isolates from human clinical samples were retrieved from the laboratory’s database for the 2000–2014 period. Susceptibility to first-line drugs: rifampin, isoniazid, streptomycin (STR) and ethambutol was determined. We identified 1,165 isolates, 73.7% were M. tuberculosis and 26.2%, M. bovis. Among pulmonary samples, 16.6% were M. bovis. The proportion of M. bovis isolates significantly increased from 7.8% in 2000 to 28.4% in 2014 (X2trend, p<0.001). Primary STR resistance was higher among M. bovis compared with M. tuberculosis isolates (10.9% vs.3.4%, p<0.001). Secondary multidrug resistance (MDR) rates were 38.5% and 34.4% for M. bovis and M. tuberculosis, respectively (p = 0.637). A rising trend of primary STR monoresistance was observed for both species (3.4% in 2000–2004 vs. 7.6% in 2010–2014; p = 0.02). Conclusions/Significance There is a high prevalence and a rising trend of M. bovis isolates in our region. The proportion of pulmonary M. bovis isolates is higher than in previous reports. Additionally, we report high rates of primary anti-tuberculosis resistance and secondary MDR in both M. tuberculosis and M. bovis. This is one of the largest reports on drug susceptibility of M. bovis from human samples and shows a significant proportion of first-line anti-tuberculosis drug resistance. PMID:26421930
Background on asbestos is presented including the different types and the important medical distinctions between those different types. The four diseases associated with asbestos exposure are discussed: mesothelioma, lung cancer, asbestosis, and benign pleural disorders. The purpose of the LeRC Asbestos Surveillance Program is outlined, and the specifics of the Medical Surveillance Program for Asbestos Monitoring at LeRC are discussed.
Background on mercury exposure is presented including forms, sources, permissible exposure limits, and physiological effects. The purpose of the Mercury Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Mercury Exposure at LeRC are discussed.
Background information about arsenic is presented including forms, common sources, and clinical symptoms of arsenic exposure. The purpose of the Arsenic Surveillance Program and LeRC is outlined, and the specifics of the Medical Surveillance Program for Arsenic Exposure at LeRC are discussed.
Background on lead exposure is presented including forms of lead, sources, hematologic effects, neurologic effects, endocrine effects, renal effects, and reproductive and developmental effects. The purpose of the Lead Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Lead Exposure at LeRC are discussed.
Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.
Brodie, Carolyn S.
Collaborative practices of library media specialists and teachers as set forth in "Information Power" and implemented by the Institute for Library and Information Literacy Education (ILILE) are the focus of this article. Much has been written about collaboration in the past and much is still to be learned. "Information Power" tells everyone that…
Problem/Condition: Since 1971, the Centers for Disease Control and Prevention (CDC), the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting da...
Problem/Condition: Since 1971, the Centers for Disease Control and Prevention (CDC), the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreak Surveillance System (WBDOS...
Molecular surveillance of Plasmodium falciparum drug resistance markers reveals partial recovery of chloroquine susceptibility but sustained sulfadoxine-pyrimethamine resistance at two sites of different malaria transmission intensities in Rwanda.
Kateera, Fredrick; Nsobya, Sam L; Tukwasibwe, Steven; Hakizimana, Emmanuel; Mutesa, Leon; Mens, Petra F; Grobusch, Martin P; van Vugt, Michèle; Kumar, Nirbhay
and 14 years of drug withdrawal from use, respectively. Most likely, the sustained high prevalence of resistant parasites is due to the use of DHFR/DHPS inhibitors like trimethoprim-sulfamethoxazole (TS) for the treatment of and prophylaxis against bacterial infections among HIV infected individuals as well as the continued use of IPTp-SP within the East and Central African regions for malaria prevention among pregnant women. With regard to CQ, the slow recovery of CQ susceptible parasites may have been caused partly by the continued use of CQ and/or CQ mimicking antimalarial drugs like AQ in spite of policies to withdraw it from Rwanda and the neighbouring countries of Uganda and Tanzania. Continued surveillance of P. falciparum CQ and SP associated polymorphisms is recommended for guiding future rational drug policy-making and mitigation of future risk of anti-malaria drug resistance development.
Yozwiak, Nathan L.; Happi, Christian T.; Grant, Donald S.; Schieffelin, John S.; Garry, Robert F.; Sabeti, Pardis C.; Andersen, Kristian G.
Summary Recent infectious disease epidemics illustrate how health systems failures anywhere can create disease vulnerabilities everywhere. We must therefore prioritize investments in health care infrastructure in outbreak-prone regions of the world. We describe how ‘rooted’ research collaborations can establish capacity for pathogen surveillance and facilitate rapid outbreak responses. PMID:27368093
Steel, Cathy; Golden, Allison; Kubofcik, Joseph; LaRue, Nicole; de Los Santos, Tala; Domingo, Gonzalo J; Nutman, Thomas B
The Global Programme to Eliminate Lymphatic Filariasis has an urgent need for rapid assays to detect ongoing transmission of lymphatic filariasis (LF) following multiple rounds of mass drug administration (MDA). Current WHO guidelines support using the antigen card immunochromatographic test (ICT), which detects active filarial infection but does not detect early exposure to LF. Recent studies found that antibody-based assays better serve this function. In the present study, two tests, a rapid IgG4 enzyme-linked immunosorbent assay (ELISA) and a lateral-flow strip immunoassay, were developed based on the highly sensitive and specific Wuchereria bancrofti antigen Wb123. A comparison of W. bancrofti-infected and -uninfected patients (with or without other helminth infections) demonstrated that both tests had high sensitivities and specificities (93 and 97% [ELISA] and 92 and 96% [strips], respectively). When the W. bancrofti-uninfected group was separated into those with other filarial/helminth infections (i.e., onchocerciasis, loiasis, and strongyloidiasis) and those who were parasite uninfected, the specificities of the assays varied between 91 and 100%. In addition, the geometric mean response by ELISA of W. bancrofti-infected patients was significantly higher than the response of those without W. bancrofti infection (P < 0.0001). Furthermore, the Wb123 ELISA and the lateral-flow strips had high positive and negative predictive values, giving valuable information on the size of survey population needed to be reasonably certain whether or not transmission is ongoing. These highly sensitive and specific IgG4 tests to the W. bancrofti Wb123 protein give every indication that they will serve as useful tools for post-MDA monitoring.
Dart, Richard C
The primary goal of postmarketing surveillance is to provide information for risk assessment of a drug. Drugs affecting the central nervous system form a unique group of products for surveillance because they are often misused, abused, and diverted. These medications include opioid analgesics, stimulants, sedative-hypnotics, muscle relaxants, anticonvulsants and other drug classes. Their adverse events are difficult to monitor because the perpetrator often attempts to conceal the misuse, abuse and diversion of the product. A postmarketing surveillance system for prescription drugs of abuse in the U.S. should include product specific information that is accurate, immediately available, geographically specific and includes all areas of the country. Most producers of branded opioid analgesic products have created systems that measure abuse from multiple vantage points: criminal justice, treatment professionals, susceptible patient populations and acute health events. In the past, the U.S. government has not established similar requirements for the same products produced by generic manufacturers. However, the Food and Drug Administration Amendments Act of 2007 includes generic opioid analgesic products by requiring that all products containing potent opioid drugs perform rigorous surveillance and risk management. While general risk management guidance has been developed by FDA, more specific analyses and guidance are needed to improve surveillance methodology for drugs which are misused, abused, diverted.
Abelev, B.; Adam, J.; Adamová, D.; Aggarwal, M. M.; Aglieri Rinella, G.; Agnello, M.; Agostinelli, A.; Agrawal, N.; Ahammed, Z.; Ahmad, N.; Ahmed, I.; Ahn, S. U.; Ahn, S. A.; Aimo, I.; Aiola, S.; Ajaz, M.; Akindinov, A.; Alam, S. N.; Aleksandrov, D.; Alessandro, B.; Alexandre, D.; Alici, A.; Alkin, A.; Alme, J.; Alt, T.; Altinpinar, S.; Altsybeev, I.; Alves Garcia Prado, C.; Andrei, C.; Andronic, A.; Anguelov, V.; Anielski, J.; Antičić, T.; Antinori, F.; Antonioli, P.; Aphecetche, L.; Appelshäuser, H.; Arcelli, S.; Armesto, N.; Arnaldi, R.; Aronsson, T.; Arsene, I. C.; Arslandok, M.; Augustinus, A.; Averbeck, R.; Awes, T. C.; Azmi, M. D.; Bach, M.; Badalà, A.; Baek, Y. W.; Bagnasco, S.; Bailhache, R.; Bala, R.; Baldisseri, A.; Baltasar Dos Santos Pedrosa, F.; Baral, R. C.; Barbera, R.; Barile, F.; Barnaföldi, G. G.; Barnby, L. S.; Barret, V.; Bartke, J.; Basile, M.; Bastid, N.; Basu, S.; Bathen, B.; Batigne, G.; Batista Camejo, A.; Batyunya, B.; Batzing, P. C.; Baumann, C.; Bearden, I. G.; Beck, H.; Bedda, C.; Behera, N. K.; Belikov, I.; Bellini, F.; Bellwied, R.; Belmont, R.; Belmont-Moreno, E.; Belyaev, V.; Bencedi, G.; Beole, S.; Berceanu, I.; Bercuci, A.; Berdnikov, Y.; Berenyi, D.; Berger, M. E.; Bertens, R. A.; Berzano, D.; Betev, L.; Bhasin, A.; Bhat, I. R.; Bhati, A. K.; Bhattacharjee, B.; Bhom, J.; Bianchi, L.; Bianchi, N.; Bianchin, C.; Bielčík, J.; Bielčíková, J.; Bilandzic, A.; Bjelogrlic, S.; Blanco, F.; Blau, D.; Blume, C.; Bock, F.; Bogdanov, A.; Bøggild, H.; Bogolyubsky, M.; Böhmer, F. V.; Boldizsár, L.; Bombara, M.; Book, J.; Borel, H.; Borissov, A.; Bossú, F.; Botje, M.; Botta, E.; Böttger, S.; Braun-Munzinger, P.; Bregant, M.; Breitner, T.; Broker, T. A.; Browning, T. A.; Broz, M.; Bruna, E.; Bruno, G. E.; Budnikov, D.; Buesching, H.; Bufalino, S.; Buncic, P.; Busch, O.; Buthelezi, Z.; Caffarri, D.; Cai, X.; Caines, H.; Calero Diaz, L.; Caliva, A.; Calvo Villar, E.; Camerini, P.; Carena, F.; Carena, W.; Castillo Castellanos, J.; Casula, E. A. R.; Catanescu, V.; Cavicchioli, C.; Ceballos Sanchez, C.; Cepila, J.; Cerello, P.; Chang, B.; Chapeland, S.; Charvet, J. L.; Chattopadhyay, S.; Chattopadhyay, S.; Chelnokov, V.; Cherney, M.; Cheshkov, C.; Cheynis, B.; Chibante Barroso, V.; Chinellato, D. D.; Chochula, P.; Chojnacki, M.; Choudhury, S.; Christakoglou, P.; Christensen, C. H.; Christiansen, P.; Chujo, T.; Chung, S. U.; Cicalo, C.; Cifarelli, L.; Cindolo, F.; Cleymans, J.; Colamaria, F.; Colella, D.; Collu, A.; Colocci, M.; Conesa Balbastre, G.; Conesa del Valle, Z.; Connors, M. E.; Contreras, J. G.; Cormier, T. M.; Corrales Morales, Y.; Cortese, P.; Cortés Maldonado, I.; Cosentino, M. R.; Costa, F.; Crochet, P.; Cruz Albino, R.; Cuautle, E.; Cunqueiro, L.; Dainese, A.; Danu, A.; Das, D.; Das, I.; Das, K.; Das, S.; Dash, A.; Dash, S.; De, S.; Delagrange, H.; Deloff, A.; Dénes, E.; D'Erasmo, G.; De Caro, A.; de Cataldo, G.; de Cuveland, J.; De Falco, A.; De Gruttola, D.; De Marco, N.; De Pasquale, S.; de Rooij, R.; Diaz Corchero, M. A.; Dietel, T.; Dillenseger, P.; Divià, R.; Di Bari, D.; Di Liberto, S.; Di Mauro, A.; Di Nezza, P.; Djuvsland, Ø.; Dobrin, A.; Dobrowolski, T.; Domenicis Gimenez, D.; Dönigus, B.; Dordic, O.; Dørheim, S.; Dubey, A. K.; Dubla, A.; Ducroux, L.; Dupieux, P.; Dutta Majumdar, A. K.; Hilden, T. E.; Ehlers, R. J.; Elia, D.; Engel, H.; Erazmus, B.; Erdal, H. A.; Eschweiler, D.; Espagnon, B.; Esposito, M.; Estienne, M.; Esumi, S.; Evans, D.; Evdokimov, S.; Fabris, D.; Faivre, J.; Falchieri, D.; Fantoni, A.; Fasel, M.; Fehlker, D.; Feldkamp, L.; Felea, D.; Feliciello, A.; Feofilov, G.; Ferencei, J.; Fernández Téllez, A.; Ferreiro, E. G.; Ferretti, A.; Festanti, A.; Figiel, J.; Figueredo, M. A. S.; Filchagin, S.; Finogeev, D.; Fionda, F. M.; Fiore, E. M.; Floratos, E.; Floris, M.; Foertsch, S.; Foka, P.; Fokin, S.; Fragiacomo, E.; Francescon, A.; Frankenfeld, U.; Fuchs, U.; Furget, C.; Furs, A.; Fusco Girard, M.; Gaardhøje, J. J.; Gagliardi, M.; Gago, A. M.; Gallio, M.; Gangadharan, D. R.; Ganoti, P.; Gao, C.; Garabatos, C.; Garcia-Solis, E.; Gargiulo, C.; Garishvili, I.; Gerhard, J.; Germain, M.; Gheata, A.; Gheata, M.; Ghidini, B.; Ghosh, P.; Ghosh, S. K.; Gianotti, P.; Giubellino, P.; Gladysz-Dziadus, E.; Glässel, P.; Gomez Ramirez, A.; González-Zamora, P.; Gorbunov, S.; Görlich, L.; Gotovac, S.; Graczykowski, L. K.; Grelli, A.; Grigoras, A.; Grigoras, C.; Grigoriev, V.; Grigoryan, A.; Grigoryan, S.; Grinyov, B.; Grion, N.; Grosse-Oetringhaus, J. F.; Grossiord, J.-Y.; Grosso, R.; Guber, F.; Guernane, R.; Guerzoni, B.; Guilbaud, M.; Gulbrandsen, K.; Gulkanyan, H.; Gumbo, M.; Gunji, T.; Gupta, A.; Gupta, R.; Khan, K. H.; Haake, R.; Haaland, Ø.; Hadjidakis, C.; Haiduc, M.; Hamagaki, H.; Hamar, G.; Hanratty, L. D.; Hansen, A.; Harris, J. W.; Hartmann, H.; Harton, A.; Hatzifotiadou, D.; Hayashi, S.; Heckel, S. T.; Heide, M.; Helstrup, H.; Herghelegiu, A.; Herrera Corral, G.; Hess, B. A.; Hetland, K. F.; Hippolyte, B.; Hladky, J.; Hristov, P.; Huang, M.; Humanic, T. J.; Hussain, N.; Hussain, T.; Hutter, D.; Hwang, D. S.; Ilkaev, R.; Ilkiv, I.; Inaba, M.; Innocenti, G. M.; Ionita, C.; Ippolitov, M.; Irfan, M.; Ivanov, M.; Ivanov, V.; Jachołkowski, A.; Jacobs, P. M.; Jahnke, C.; Jang, H. J.; Janik, M. A.; Jayarathna, P. H. S. Y.; Jena, C.; Jena, S.; Jimenez Bustamante, R. T.; Jones, P. G.; Jung, H.; Jusko, A.; Kadyshevskiy, V.; Kalinak, P.; Kalweit, A.; Kamin, J.; Kang, J. H.; Kaplin, V.; Kar, S.; Karasu Uysal, A.; Karavichev, O.; Karavicheva, T.; Karpechev, E.; Kebschull, U.; Keidel, R.; Keijdener, D. L. D.; Keil SVN, M.; Khan, M. M.; Khan, P.; Khan, S. A.; Khanzadeev, A.; Kharlov, Y.; Kileng, B.; Kim, B.; Kim, D. W.; Kim, D. J.; Kim, J. S.; Kim, M.; Kim, M.; Kim, S.; Kim, S. H.; Kim, T.; Kirsch, S.; Kisel, I.; Kiselev, S.; Kisiel, A.; Kiss, G.; Klay, J. L.; Klein, J.; Klein-Bösing, C.; Kluge, A.; Knichel, M. L.; Knospe, A. G.; Kobdaj, C.; Kofarago, M.; Köhler, M. K.; Kollegger, T.; Kolojvari, A.; Kondratiev, V.; Kondratyeva, N.; Konevskikh, A.; Kovalenko, V.; Kowalski, M.; Kox, S.; Koyithatta Meethaleveedu, G.; Kral, J.; Králik, I.; Kravčáková, A.; Krelina, M.; Kretz, M.; Krivda, M.; Krizek, F.; Kryshen, E.; Krzewicki, M.; Kučera, V.; Kucheriaev, Y.; Kugathasan, T.; Kuhn, C.; Kuijer, P. G.; Kulakov, I.; Kumar, J.; Kurashvili, P.; Kurepin, A.; Kurepin, A. B.; Kuryakin, A.; Kushpil, S.; Kweon, M. J.; Kwon, Y.; Ladron de Guevara, P.; Lagana Fernandes, C.; Lakomov, I.; Langoy, R.; Lara, C.; Lardeux, A.; Lattuca, A.; La Pointe, S. L.; La Rocca, P.; Lea, R.; Leardini, L.; Lee, G. R.; Legrand, I.; Lehnert, J.; Lemmon, R. C.; Lenti, V.; Leogrande, E.; Leoncino, M.; León Monzón, I.; Lévai, P.; Li, S.; Lien, J.; Lietava, R.; Lindal, S.; Lindenstruth, V.; Lippmann, C.; Lisa, M. A.; Ljunggren, H. M.; Lodato, D. F.; Loenne, P. I.; Loggins, V. R.; Loginov, V.; Lohner, D.; Loizides, C.; Lopez, X.; López Torres, E.; Lu, X.-G.; Luettig, P.; Lunardon, M.; Luparello, G.; Ma, R.; Maevskaya, A.; Mager, M.; Mahapatra, D. P.; Mahmood, S. M.; Maire, A.; Majka, R. D.; Malaev, M.; Maldonado Cervantes, I.; Malinina, L.; Mal'Kevich, D.; Malzacher, P.; Mamonov, A.; Manceau, L.; Manko, V.; Manso, F.; Manzari, V.; Marchisone, M.; Mareš, J.; Margagliotti, G. V.; Margotti, A.; Marín, A.; Markert, C.; Marquard, M.; Martashvili, I.; Martin, N. A.; Martinengo, P.; Martínez, M. I.; Martínez García, G.; Martin Blanco, J.; Martynov, Y.; Mas, A.; Masciocchi, S.; Masera, M.; Masoni, A.; Massacrier, L.; Mastroserio, A.; Matyja, A.; Mayer, C.; Mazer, J.; Mazzoni, M. A.; Meddi, F.; Menchaca-Rocha, A.; Meninno, E.; Mercado Pérez, J.; Meres, M.; Miake, Y.; Mikhaylov, K.; Milano, L.; Milosevic, J.; Mischke, A.; Mishra, A. N.; Miśkowiec, D.; Mitra, J.; Mitu, C. M.; Mlynarz, J.; Mohammadi, N.; Mohanty, B.; Molnar, L.; Montaño Zetina, L.; Montes, E.; Morando, M.; Moreira De Godoy, D. A.; Moretto, S.; Morreale, A.; Morsch, A.; Muccifora, V.; Mudnic, E.; Mühlheim, D.; Muhuri, S.; Mukherjee, M.; Müller, H.; Munhoz, M. G.; Murray, S.; Musa, L.; Musinsky, J.; Nandi, B. K.; Nania, R.; Nappi, E.; Naru, M. U.; Nattrass, C.; Nayak, K.; Nayak, T. K.; Nazarenko, S.; Nedosekin, A.; Nicassio, M.; Niculescu, M.; Niedziela, J.; Nielsen, B. S.; Nikolaev, S.; Nikulin, S.; Nikulin, V.; Nilsen, B. S.; Noferini, F.; Nomokonov, P.; Nooren, G.; Norman, J.; Nyanin, A.; Nystrand, J.; Oeschler, H.; Oh, S.; Oh, S. K.; Okatan, A.; Okubo, T.; Olah, L.; Oleniacz, J.; Oliveira Da Silva, A. C.; Onderwaater, J.; Oppedisano, C.; Ortiz Velasquez, A.; Oskarsson, A.; Otwinowski, J.; Oyama, K.; Ozdemir, M.; Sahoo, P.; Pachmayer, Y.; Pachr, M.; Pagano, P.; Paić, G.; Pajares, C.; Pal, S. K.; Palmeri, A.; Pant, D.; Papikyan, V.; Pappalardo, G. S.; Pareek, P.; Park, W. J.; Parmar, S.; Passfeld, A.; Patalakha, D. I.; Paticchio, V.; Paul, B.; Pawlak, T.; Peitzmann, T.; Pereira Da Costa, H.; Pereira De Oliveira Filho, E.; Peresunko, D.; Pérez Lara, C. E.; Pesci, A.; Peskov, V.; Pestov, Y.; Petráček, V.; Petran, M.; Petris, M.; Petrovici, M.; Petta, C.; Piano, S.; Pikna, M.; Pillot, P.; Pinazza, O.; Pinsky, L.; Piyarathna, D. B.; Płoskoń, M.; Planinic, M.; Pluta, J.; Pochybova, S.; Podesta-Lerma, P. L. M.; Poghosyan, M. G.; Pohjoisaho, E. H. O.; Polichtchouk, B.; Poljak, N.; Pop, A.; Porteboeuf-Houssais, S.; Porter, J.; Potukuchi, B.; Prasad, S. K.; Preghenella, R.; Prino, F.; Pruneau, C. A.; Pshenichnov, I.; Puccio, M.; Puddu, G.; Pujahari, P.; Punin, V.; Putschke, J.; Qvigstad, H.; Rachevski, A.; Raha, S.; Rajput, S.; Rak, J.; Rakotozafindrabe, A.; Ramello, L.; Raniwala, R.; Raniwala, S.; Räsänen, S. S.; Rascanu, B. T.; Rathee, D.; Rauf, A. W.; Razazi, V.; Read, K. F.; Real, J. S.; Redlich, K.; Reed, R. J.; Rehman, A.; Reichelt, P.; Reicher, M.; Reidt, F.; Renfordt, R.; Reolon, A. R.; Reshetin, A.; Rettig, F.; Revol, J.-P.; Reygers, K.; Riabov, V.; Ricci, R. A.; Richert, T.; Richter, M.; Riedler, P.; Riegler, W.; Riggi, F.; Rivetti, A.; Rocco, E.; Rodríguez Cahuantzi, M.; Rodriguez Manso, A.; Røed, K.; Rogochaya, E.; Rohni, S.; Rohr, D.; Röhrich, D.; Romita, R.; Ronchetti, F.; Ronflette, L.; Rosnet, P.; Rossi, A.; Roukoutakis, F.; Roy, A.; Roy, C.; Roy, P.; Rubio Montero, A. J.; Rui, R.; Russo, R.; Ryabinkin, E.; Ryabov, Y.; Rybicki, A.; Sadovsky, S.; Šafařík, K.; Sahlmuller, B.; Sahoo, R.; Sahu, P. K.; Saini, J.; Sakai, S.; Salgado, C. A.; Salzwedel, J.; Sambyal, S.; Samsonov, V.; Sanchez Castro, X.; Sánchez Rodríguez, F. J.; Šándor, L.; Sandoval, A.; Sano, M.; Santagati, G.; Sarkar, D.; Scapparone, E.; Scarlassara, F.; Scharenberg, R. P.; Schiaua, C.; Schicker, R.; Schmidt, C.; Schmidt, H. R.; Schuchmann, S.; Schukraft, J.; Schulc, M.; Schuster, T.; Schutz, Y.; Schwarz, K.; Schweda, K.; Scioli, G.; Scomparin, E.; Scott, R.; Segato, G.; Seger, J. E.; Sekiguchi, Y.; Selyuzhenkov, I.; Senosi, K.; Seo, J.; Serradilla, E.; Sevcenco, A.; Shabetai, A.; Shabratova, G.; Shahoyan, R.; Shangaraev, A.; Sharma, A.; Sharma, N.; Sharma, S.; Shigaki, K.; Shtejer, K.; Sibiriak, Y.; Siddhanta, S.; Siemiarczuk, T.; Silvermyr, D.; Silvestre, C.; Simatovic, G.; Singaraju, R.; Singh, R.; Singha, S.; Singhal, V.; Sinha, B. C.; Sinha, T.; Sitar, B.; Sitta, M.; Skaali, T. B.; Skjerdal, K.; Slupecki, M.; Smirnov, N.; Snellings, R. J. M.; Søgaard, C.; Soltz, R.; Song, J.; Song, M.; Soramel, F.; Sorensen, S.; Spacek, M.; Spiriti, E.; Sputowska, I.; Spyropoulou-Stassinaki, M.; Srivastava, B. K.; Stachel, J.; Stan, I.; Stefanek, G.; Steinpreis, M.; Stenlund, E.; Steyn, G.; Stiller, J. H.; Stocco, D.; Stolpovskiy, M.; Strmen, P.; Suaide, A. A. P.; Sugitate, T.; Suire, C.; Suleymanov, M.; Sultanov, R.; Šumbera, M.; Susa, T.; Symons, T. J. M.; Szabo, A.; Szanto de Toledo, A.; Szarka, I.; Szczepankiewicz, A.; Szymanski, M.; Takahashi, J.; Tangaro, M. A.; Tapia Takaki, J. D.; Tarantola Peloni, A.; Tarazona Martinez, A.; Tariq, M.; Tarzila, M. G.; Tauro, A.; Tejeda Muñoz, G.; Telesca, A.; Terasaki, K.; Terrevoli, C.; Thäder, J.; Thomas, D.; Tieulent, R.; Timmins, A. R.; Toia, A.; Trubnikov, V.; Trzaska, W. H.; Tsuji, T.; Tumkin, A.; Turrisi, R.; Tveter, T. S.; Ullaland, K.; Uras, A.; Usai, G. L.; Vajzer, M.; Vala, M.; Valencia Palomo, L.; Vallero, S.; Vande Vyvre, P.; Van Der Maarel, J.; Van Hoorne, J. W.; van Leeuwen, M.; Vargas, A.; Vargyas, M.; Varma, R.; Vasileiou, M.; Vasiliev, A.; Vechernin, V.; Veldhoen, M.; Velure, A.; Venaruzzo, M.; Vercellin, E.; Vergara Limón, S.; Vernet, R.; Verweij, M.; Vickovic, L.; Viesti, G.; Viinikainen, J.; Vilakazi, Z.; Villalobos Baillie, O.; Vinogradov, A.; Vinogradov, L.; Vinogradov, Y.; Virgili, T.; Vislavicius, V.; Viyogi, Y. P.; Vodopyanov, A.; Völkl, M. A.; Voloshin, K.; Voloshin, S. A.; Volpe, G.; von Haller, B.; Vorobyev, I.; Vranic, D.; Vrláková, J.; Vulpescu, B.; Vyushin, A.; Wagner, B.; Wagner, J.; Wagner, V.; Wang, M.; Wang, Y.; Watanabe, D.; Weber, M.; Weber, S. G.; Wessels, J. P.; Westerhoff, U.; Wiechula, J.; Wikne, J.; Wilde, M.; Wilk, G.; Wilkinson, J.; Williams, M. C. S.; Windelband, B.; Winn, M.; Yaldo, C. G.; Yamaguchi, Y.; Yang, H.; Yang, P.; Yang, S.; Yano, S.; Yasnopolskiy, S.; Yi, J.; Yin, Z.; Yoo, I.-K.; Yushmanov, I.; Zaborowska, A.; Zaccolo, V.; Zach, C.; Zaman, A.; Zampolli, C.; Zaporozhets, S.; Zarochentsev, A.; Závada, P.; Zaviyalov, N.; Zbroszczyk, H.; Zgura, I. S.; Zhalov, M.; Zhang, H.; Zhang, X.; Zhang, Y.; Zhao, C.; Zhigareva, N.; Zhou, D.; Zhou, F.; Zhou, Y.; Zhou, Zhuo; Zhu, H.; Zhu, J.; Zhu, X.; Zichichi, A.; Zimmermann, A.; Zimmermann, M. B.; Zinovjev, G.; Zoccarato, Y.; Zyzak, M.
The ALICE Collaboration would like to thank all its engineers and technicians for their invaluable contributions to the construction of the experiment and the CERN accelerator teams for the outstanding performance of the LHC complex.
Maro, Judith C; Brown, Jeffrey S; Kulldorff, Martin
Large linked database networks, like the US Food and Drug Administration's Sentinel System, are being built for medical product surveillance. One use of these networks is for "near real-time" sequential database surveillance of prespecified medical product-adverse event pairs, which may result in a "safety signal" when a statistical excess risk is detected. Sequential database surveillance requires the investigator to manage surveillance in both information time (ie, how sample size accrues) and calendar time. Calendar time is important because people external to the surveillance population may be affected by the speed with which a safety signal is detected or ruled out. Optimal design and analysis aspects of sequential database surveillance are not well developed, but are gaining in importance as observational database networks grow. Using information time concepts, we show how to calculate sample sizes when performing sequential database surveillance, illustrating the relationships between statistical power, the time to detect a signal, and the maximum sample size for various true effect sizes. Then, using a vaccine example, we demonstrate a four-step planning process that allows investigators to translate information time into calendar time. Given the calendar time for surveillance, the process focuses on choosing observational database configurations consistent with the investigator's preferences for timeliness and statistical power. Although the planning process emphasizes sample size considerations, the influence of secondary database attributes such as delay times, measurement error, and cost are also discussed. Appropriate planning allows the most efficient use of public health dollars dedicated to medical product surveillance efforts.
Ford, Laura; Miller, Megge; Cawthorne, Amy; Fearnley, Emily; Kirk, Martyn
Foodborne disease surveillance aims to reduce the burden of illness due to contaminated food. There are several different types of surveillance systems, including event-based surveillance, indicator-based surveillance, and integrated food chain surveillance. These approaches are not mutually exclusive, have overlapping data sources, require distinct capacities and resources, and can be considered a hierarchy, with each level being more complex and resulting in a greater ability to detect and control foodborne disease. Event-based surveillance is generally the least resource-intensive system and makes use of informal data sources. Indicator-based surveillance is seen as traditional notifiable disease surveillance and consists of routinely collected data. Integrated food chain surveillance is viewed as the optimal practice for conducting continuous risk analysis for foodborne diseases, but also requires significant ongoing resources and greater multisectoral collaboration compared to the other systems. Each country must determine the most appropriate structure for their surveillance system for foodborne diseases based on their available resources. This review explores the evidence on the principles, minimum capabilities, and minimum requirements of each type of surveillance and discusses examples from a range of countries. This review forms the evidence base for the Strengthening the Surveillance and Response for Foodborne Diseases: A Practical Manual.
Public health surveillance has played a key role in controlling the spread of communicable disease and identifying the need for specific publich health practices, such as the filteration and chlorination of drinking water supplies. However, the characteristics of waterborne ou...
Hersey, D. R.
The paper presents a general and functional description of a low-cost surveillance station designed as the first phase of NASA's program to develop a radio spectrum surveillance capability for deep space stations for identifying radio frequency interference sources. The station described has identified several particular interferences and is yielding spectral signature data which, after cataloging, will serve as a library for rapid identification of frequently observed interference. Findings from the use of the station are discussed.
Bonnetblanc, J M
Some types of hypersensitivity to drugs are defined either by the generic name of the drug or descriptive terms. They are sometimes assimilated to pseudolymphoma because the causative drugs are often the same, although the eruption lacks clinical and histopathological criteria of pseudolymphoma. It is then suggested to use 'idiosyncratic drug hypersensitivity syndrome' to define this type of drug reaction. As the skin and other organs may be involved, a generic name would help to determine a better definition and a surveillance program.
Osemek, Paweł; Kocik, Janusz; Paśnik, Krzysztof
This article provides a short review about trends of developing current syndromic surveillance systems. To improve methods of early detection of natural or bioterrorism-related outbreaks, it has to be established a new way of epidemiological thinking, which uses innovative real-time surveillance systems. Syndromic surveillance has been created for an early detection, to monitor the temporo-spatial spread of an outbreak, and to provide prompt data for immediate analysis and feedback to public health authorities. It supports timely decision making process for countermeasure procedures. Framework of syndromic surveillance system requires a proper electronic infrastructure to be build up. Optimal syndrome definitions and data sources for continuing specific diseases outbreak surveillance have not been determined so far. Systems of interest might enhance collaboration among clinical providers, primary care providers, emergency services, information-systems professionals and public health agencies. However economic scope of this undertakings effectively limits ability to implement it in Polish public health service right now. Besides, syndromic surveillance cannot replace traditional public health surveillance with a post-factum epidemiological investigation and laboratory analysis. It can be a useful supplement.
Starks, Angela M.; Avilés, Enrique; Cirillo, Daniela M.; Denkinger, Claudia M.; Dolinger, David L.; Emerson, Claudia; Gallarda, Jim; Hanna, Debra; Kim, Peter S.; Liwski, Richard; Miotto, Paolo; Schito, Marco; Zignol, Matteo
Continued progress in addressing challenges associated with detection and management of tuberculosis requires new diagnostic tools. These tools must be able to provide rapid and accurate information for detecting resistance to guide selection of the treatment regimen for each patient. To achieve this goal, globally representative genotypic, phenotypic, and clinical data are needed in a standardized and curated data platform. A global partnership of academic institutions, public health agencies, and nongovernmental organizations has been established to develop a tuberculosis relational sequencing data platform (ReSeqTB) that seeks to increase understanding of the genetic basis of resistance by correlating molecular data with results from drug susceptibility testing and, optimally, associated patient outcomes. These data will inform development of new diagnostics, facilitate clinical decision making, and improve surveillance for drug resistance. ReSeqTB offers an opportunity for collaboration to achieve improved patient outcomes and to advance efforts to prevent and control this devastating disease. PMID:26409275
Bierbaum, R; Hamada, M; Robertson, A
In September of 2009, a Tri-Lab team was formed to develop a set of metrics relating to the NNSA nuclear weapon surveillance program. The purpose of the metrics was to develop a more quantitative and/or qualitative metric(s) describing the results of realized or non-realized surveillance activities on our confidence in reporting reliability and assessing the stockpile. As a part of this effort, a statistical sub-team investigated various techniques and developed a complementary set of statistical metrics that could serve as a foundation for characterizing aspects of meeting the surveillance program objectives. The metrics are a combination of tolerance limit calculations and power calculations, intending to answer level-of-confidence type questions with respect to the ability to detect certain undesirable behaviors (catastrophic defects, margin insufficiency defects, and deviations from a model). Note that the metrics are not intended to gauge product performance but instead the adequacy of surveillance. This report gives a short description of four metrics types that were explored and the results of a sensitivity study conducted to investigate their behavior for various inputs. The results of the sensitivity study can be used to set the risk parameters that specify the level of stockpile problem that the surveillance program should be addressing.
Hamada, Michael S.; Bierbaum, Rene Lynn; Robertson, Alix A.
In September of 2009, a Tri-Lab team was formed to develop a set of metrics relating to the NNSA nuclear weapon surveillance program. The purpose of the metrics was to develop a more quantitative and/or qualitative metric(s) describing the results of realized or non-realized surveillance activities on our confidence in reporting reliability and assessing the stockpile. As a part of this effort, a statistical sub-team investigated various techniques and developed a complementary set of statistical metrics that could serve as a foundation for characterizing aspects of meeting the surveillance program objectives. The metrics are a combination of tolerance limit calculations and power calculations, intending to answer level-of-confidence type questions with respect to the ability to detect certain undesirable behaviors (catastrophic defects, margin insufficiency defects, and deviations from a model). Note that the metrics are not intended to gauge product performance but instead the adequacy of surveillance. This report gives a short description of four metrics types that were explored and the results of a sensitivity study conducted to investigate their behavior for various inputs. The results of the sensitivity study can be used to set the risk parameters that specify the level of stockpile problem that the surveillance program should be addressing.
This practitioner research study investigates the power of multimodal texts within a real-world context and argues that a participatory culture focused on literary arts offers marginalized high school students opportunities for collaborative design and authoring. Additionally, this article invites educators to rethink the at-risk label. This…
Lippman, Peter C.
When architects discuss the educational facilities of the next century and beyond, the conversation turns to collaborative spaces. They envision flexible and fluid spaces that will encourage creative and critical thinking, and free students to communicate clearly about the task at hand. While these are admirable ideals, there are some fundamental…
Rama, Mylapuram; Viswanathan, Gayathri; Acharya, Leelavathi D; Attur, R P; Reddy, P N; Raghavan, S V
Polypharmacy is common in drug prescriptions of chronic kidney disease patients. A study of the prescription patterns of drugs with potential interactions would be of interest to prevent drug related adverse events. A prospective observational study of six months (Dec 2009-May 2010) was carried out among the chronic kidney disease patients admitted to the nephrology ward of a South Indian tertiary care hospital. The pattern and rates of drug-drug interactions seen in the prescriptions of these patients was studied. Among the 205 prescriptions included, a total of 474 interactions were reported, making 2.7 interactions per prescription with incidence rates of 76.09%. Around 19.62% of interactions were of major severity. Most common interactions were found between ascorbic acid and cyanocobalamine (12.45%), clonidine and metoprolol (3.80%) respectively. Hypo or hypertension (31.65%), decreased drug efficacy (29.11%) and hypo or hyperglycemia (14.14%), were the most commonly reported clinical outcomes of the drug interactions. Cardiovascular drugs (calcium channel blockers and beta blockers; 52%) constitute the major class of drugs involved in interactions. As most of the interactions had a delayed onset, long term follow-up is essential to predict the clinically significant outcomes of these interactions. Hence, drug interactions are commonly seen in the prescriptions of chronic kidney disease patients which can lead to serious adverse events if not detected early. Need for collaboration with a clinical pharmacist and electronic surveillance, which are absent in developing countries like India, is emphatic.
This paper is part of a broader discussion on the need for more in-depth study of workers' health surveillance practices, which are most often developed empirically, without well-defined theoretical or technical foundations. The paper presents a concept of surveillance in workers' health as a fulcrum for actions in the relationship between the work process and health. It emphasizes the exposure-based perspective involved in the epidemiological approach. Risk situations and effects are placed in spatial and technological context. The model provides an interdisciplinary approach with a technological, social, and epidemiological basis in a three-dimensional structure. A matrix for planning actions in workers' health surveillance is also presented, focusing on the connections between effects, risks, territory, and activities.
Galdoz, Erwin G. , Rio de Janeiro, Brazil); Pinkalla, Mark
The Secure Video Surveillance System (SVSS) is a collaborative effort between the U.S. Department of Energy (DOE), Sandia National Laboratories (SNL), and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The joint project addresses specific requirements of redundant surveillance systems installed in two South American nuclear facilities as a tool to support unannounced inspections conducted by ABACC and the International Atomic Energy Agency (IAEA). The surveillance covers the critical time (as much as a few hours) between the notification of an inspection and the access of inspectors to the location in facility where surveillance equipment is installed. ABACC and the IAEA currently use the EURATOM Multiple Optical Surveillance System (EMOSS). This outdated system is no longer available or supported by the manufacturer. The current EMOSS system has met the project objective; however, the lack of available replacement parts and system support has made this system unsustainable and has increased the risk of an inoperable system. A new system that utilizes current technology and is maintainable is required to replace the aging EMOSS system. ABACC intends to replace one of the existing ABACC EMOSS systems by the Secure Video Surveillance System. SVSS utilizes commercial off-the shelf (COTS) technologies for all individual components. Sandia National Laboratories supported the system design for SVSS to meet Safeguards requirements, i.e. tamper indication, data authentication, etc. The SVSS consists of two video surveillance cameras linked securely to a data collection unit. The collection unit is capable of retaining historical surveillance data for at least three hours with picture intervals as short as 1sec. Images in .jpg format are available to inspectors using various software review tools. SNL has delivered two SVSS systems for test and evaluation at the ABACC Safeguards Laboratory. An additional 'proto-type' system remains
Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona A; Masters, Collin L; Collins, Stephen J
Nation-wide surveillance of transmissible spongiform encephalopathies including Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Surveillance has been undertaken since 1993. Over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements, the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness and understanding of Creutzfeldt-Jakob disease and other transmissible spongiform encephalopathies in the health care setting. In 2013, routine surveillance continued and this brief report provides an update of the surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2013, and retrospectively to 1970. The report highlights the recent multi-national collaborative study published that has verified the correlation between surveillance intensity and reported disease incidence.
Background: Since 1978, CDC, EPA, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) to capture data on waterborne disease outbreaks associated with recreational water. WBDOSS is the prima...
Ford, Mike; Klein, Allen; Smith, Stan; Jones, John Paul
Inflation combined with the added burden of homeland security requirements, is increasing pressure on local law enforcement budgets and manpower resources. The problem is: how can law enforcement agencies fulfill all of their requirements? How can they respond to these requirements, including homeland security, with limited manpower? Civil Rights considerations also place constraints on law enforcement. One possible solution is the Remote Law Enforcement Surveillance System (RLESS) concept. RLESS makes more efficient use of existing manpower while avoiding infringement on civil liberties. RLESS provides the capability for unattended stakeout and surveillance. Many stakeout or surveillance operations are conducted by vice, homicide, organized crime or other task forces. Lasting from days to weeks. Many large drug stings last months involving many persons of interest. A single surveillance mission usually involves a minimum of two persons X 3 shifts per day conducting active observation, equating to 48 man-hours per day. Their tasks include watching, listening, and documenting with photography. Recent military developments have included new technologies and techniques that enable remote unattended observation of areas or points of interest. This capability is now available to support law enforcement stakeouts, thereby significantly minimizes the stresses on manpower.
Detection and diagnosis of influenza A virus (IAV) infection in animals requires a laboratory test since disease from IAV presents no pathognomonic signs. Diagnosis and surveillance of animal influenza focuses on the detection of virus or type specific antibodies. Whether one targets the virus or ...
Fully Adaptive Radar” Sensor Processing including MIMO Sensing for Object Identification: Analysis and Synthesis of Invariants Integrated...Operators are overwhelmed by massive volumes of high dimensional multi-sensor data • Challenges -Efficiently process data to extract inherent...Sensing & Surveillance Systems • Develop toolkit for matrix treatment of MIMO radar wave-forms • Multiple-Input/Multiple-Output • enable performance
category of “other.” The “other” cat - egory included cancers of unspecified sites or unknown behavior (n=56), myeloma and malignant plasma cell...the completeness and accuracy of case finding. In turn, the criteria used to detect and cat - egorize cases for surveillance purposes (e.g., as
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL) for the US Department of Energy (DOE). This document contains the planned 1996 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project.
In this plenary talk given at the annual meeting of the Association for Politics and the Life Sciences at Texas Tech University last October, Professor Sophal Ear, then of the U.S. Naval Postgraduate School in Monterey, discussed his research on the political economy of emerging infectious disease (EID) surveillance programs. His talk reviews lessons learned for U.S. military medical research laboratories collaborating with developing countries and is comprised of three case studies: Cambodia (U.S. Naval Area Medical Research Unit 2 or NAMRU-2), Indonesia (also NAMRU-2 in the context of H5N1 or Highly Pathogenic Avian Influenza), (1) and Mexico (that country's handling of A/H1N1 or Swine Flu in 2009). (2) Professor Ear's research provides policymakers with tools for improving the effectiveness of new or existing EID surveillance programs. His work also offers host countries the opportunity to incorporate ideas, provide opinions, and debate the management of political and economic constraints facing their programs. In this analysis, constraints are found for each case study and general recommendations are given for improving global emerging infectious disease surveillance across political, economic, and cultural dimensions.
... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Regulatory collaboration. 26.18 Section 26.18 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT...
Hsu, Charles; Szu, Harold
The next generation surveillance system will equip with versatile sensor devices and information focus capable of conducting regular and irregular surveillance and security environments worldwide. The community of the persistent surveillance must invest the limited energy and money effectively into researching enabling technologies such as nanotechnology, wireless networks, and micro-electromechanical systems (MEMS) to develop persistent surveillance applications for the future. Wireless sensor networks can be used by the military for a number of purposes such as monitoring militant activity in remote areas and force protection. Being equipped with appropriate sensors these networks can enable detection of enemy movement, identification of enemy force and analysis of their movement and progress. Among these sensor network technologies, covert communication is one of the challenging tasks in the persistent surveillance because it is highly demanded to provide secured sensor nodes and linkage for fear of deliberate sabotage. Due to the matured VLSI/DSP technologies, affordable COTS of UWB technology with noise-like direct sequence (DS) time-domain pulses is a potential solution to support low probability of intercept and low probability of detection (LPI/LPD) data communication and transmission. This paper will describe a number of technical challenges in wireless persistent surveillance development include covert communication, network control and routing, collaborating signal and information processing, and etc. The paper concludes by presenting Hermitian Wavelets to enhance SNR in support of secured communication.
Babo Martins, S; Rushton, J; Stärk, K D C
Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross-sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross-sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non-monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision-making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.
Brown, Bertram S., Ed.; Torrey, E. Fuller, Ed.
Presented in five parts on research, services, training, drug abuse, and alcohol abuse are 31 reports of mental health studies and programs supported by the U.S. and other countries. Explained in the introduction are reasons the National Institute of Mental Health (NIMH) has supported international collaboration. The following are among subjects…
Bourgeois, Annie-Claude; Zulz, Tammy; Soborg, Bolette; Koch, Anders
Background Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey – representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion This review successfully establishes baseline knowledge
Bourgeois, Annie-Claude; Zulz, Tammy; Soborg, Bolette; Koch, Anders; On Behalf Of The International Circumpolar Surveillance-Tuberculosis Working Group
Background Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey - representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion This review successfully establishes baseline knowledge on
During 1988, the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED) coordinated a pilot study aimed at evaluating the feasibility of a system for spontaneous monitoring of adverse drug reactions in dermatological practice in Italy. Approximately 400 dermatologists were asked to collaborate, and 141 agreed to the study. Procedures similar to those well established in other surveillance programs (including the use of standard forms and standardized assessment procedure) were adopted. In a 2-month period 775 reports were collected, of which 711 were maintained after careful evaluation. The general profile of the adverse reactions reported was in accordance with the experience derived by other spontaneous surveillance programs. The main purpose of spontaneous reporting systems is the identification of new reactions, and a model analysis was proposed, in our study, with reference to skin reactions to bamifylline. The demonstration of the feasibility of a drug-monitoring program in Italy, where little tradition exists in the area, is the most important result of our study.
Saldi, K.A.; Dirkes, R.L.; Blanton, M.L.
This section of the 1994 Hanford Site Environmental Report summarizes the Surface water on and near the Hanford Site is monitored to determine the potential effects of Hanford operations. Surface water at Hanford includes the Columbia River, riverbank springs, ponds located on the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site, and offsite water systems directly east and across the Columbia River from the Hanford Site. Columbia River sediments are also included in this discussion. Tables 5.3.1 and 5.3.2 summarize the sampling locations, sample types, sampling frequencies, and sample analyses included in surface-water surveillance activities during 1994. Sample locations are also identified in Figure 5.3.1. This section describes the surveillance effort and summarizes the results for these aquatic environments. Detailed analytical results are reported by Bisping (1995).
Cooper, Lynne P.
Collaboration is a critical competency for modern organizations as they struggle to compete in an increasingly complex, global environment. A large body of research on collaboration in the workplace focuses both on teams, investigating how groups use teamwork to perform their task work, and on the use of information systems to support team processes ("collaboration engineering"). This research essay presents collaboration from an engineering perspective ("collaborative engineering"). It uses examples from professional and student engineering teams to illustrate key differences in collaborative versus collaboration engineering and investigates how challenges in the former can inform opportunities for the latter.
Soviet and U.S. programs involving satellites for surveillance of ships and submarines are discussed, considering differences in approaches. The Soviet program began with the Cosmos 198 in 1967 and the latest, the Cosmos 1400 series, 15 m long and weighing 5 tons, carry radar for monitoring ships and a nuclear reactor for a power supply. Other Soviet spacecraft carrying passive microwave sensors and ion drives powered by solar panels have recently been detonated in orbit for unknown reasons. It has also been observed that the Soviet satellites are controlled in pairs, with sequential orbital changes for one following the other, and both satellites then overflying the same points. In contrast, U.S. surveillance satellites have been placed in higher orbits, thus placing greater demands on the capabilities of the on-board radar and camera systems. Project White Cloud and the Clipper Bow program are described, noting the continued operation of the White Cloud spacecraft, which are equipped to intercept radio signals from surface ships. Currently, the integrated tactical surveillance system program has completed its study and a decision is expected soon.
Romero-Otero, Javier; García-Gómez, Borja; Duarte-Ojeda, José M; Rodríguez-Antolín, Alfredo; Vilaseca, Antoni; Carlsson, Sigrid V; Touijer, Karim A
It is worth distinguishing between the two strategies of expectant management for prostate cancer. Watchful waiting entails administering non-curative androgen deprivation therapy to patients on development of symptomatic progression, whereas active surveillance entails delivering curative treatment on signs of disease progression. The objectives of the two management strategies and the patients enrolled in either are different: (i) to review the role of active surveillance as a management strategy for patients with low-risk prostate cancer; and (ii) review the benefits and pitfalls of active surveillance. We carried out a systematic review of active surveillance for prostate cancer in the literature using the National Center for Biotechnology Information's electronic database, PubMed. We carried out a search in English using the terms: active surveillance, prostate cancer, watchful waiting and conservative management. Selected studies were required to have a comprehensive description of the demographic and disease characteristics of the patients at the time of diagnosis, inclusion criteria for surveillance, and a protocol for the patients' follow up. Review articles were included, but not multiple papers from the same datasets. Active surveillance appears to reduce overtreatment in patients with low-risk prostate cancer without compromising cancer-specific survival at 10 years. Therefore, active surveillance is an option for select patients who want to avoid the side-effects inherent to the different types of immediate treatment. However, inclusion criteria for active surveillance and the most appropriate method of monitoring patients on active surveillance have not yet been standardized.
Calvo, Isabel A; García, Patricia; Ayté, José; Hidalgo, Elena
In response to hydrogen peroxide (H(2)O(2)), the transcription factor Pap1 from Schizosaccharomyces pombe regulates transcription of genes required for adaptation to oxidative stress and for tolerance to toxic drugs. H(2)O(2) induces oxidation of Pap1, its nuclear accumulation and expression of more than fifty Pap1-dependent genes. Oxidation and nuclear accumulation of Pap1 can also be accomplished by genetic inhibition of thioredoxin reductase. Furthermore, genetic alteration of the nuclear export pathway, or mutations in Pap1 nuclear export signal trigger nuclear accumulation of reduced Pap1. We show here that a subset of Pap1-dependent genes, such as those coding for the efflux pump Caf5, the ubiquitin-like protein Obr1 or the dehydrogenase SPCC663.08c, only require nuclear Pap1 for activation, whereas another subset of genes, those coding for the antioxidants catalase, sulfiredoxin or thioredoxin reductase, do need oxidized Pap1 to form a heterodimer with the constitutively nuclear transcription factor Prr1. The ability of Pap1 to bind and activate drug tolerance promoters is independent on Prr1, whereas its affinity for the antioxidant promoters is significantly enhanced upon association with Prr1. This finding suggests that the activation of both antioxidant and drug resistance genes in response to oxidative stress share a common inducer, H(2)O(2), but alternative effectors.
... Postmarket Surveillance and Evidence Appraisal Throughout the Total Product Life Cycle AGENCY: Food and Drug... Device Data for Postmarket Surveillance and Evidence Appraisal Throughout the Total Product Life Cycle... relatively short, product life-cycle. For these reasons, FDA's Center for Devices and Radiological...
Cha, Daehyun; Hwang, Chansik
Previous vehicle surveillance researches on distributed sensor network focused on overcoming power limitation and communication bandwidth constraints in sensor node. In spite of this constraints, vehicle surveillance sensor node must have signal compression, feature extraction, target localization, noise cancellation and collaborative signal processing with low computation and communication energy dissipation. In this paper, we introduce an algorithm for light-weight wireless sensor node signal processing based on lifting scheme wavelet analysis feature extraction in distributed sensor network.
Alary, M; Castel, J
The surveillance of AIDS (acquired immune deficiency syndrome) through case reporting only reflects the epidemiologic features of HIV (human immunodeficiency virus) transmission a few years earlier and not the prevalence of HIV seropositivity. HIV infection is not a notifiable condition in Quebec. We were asked by the ministère de la Santé et des Services sociaux du Québec to perform a pilot project for the surveillance of HIV seropositivity using a network of sentinel physicians. From May 15, 1988, to Sept. 30, 1989, physicians from four collaborating centres collected data on the serologic status, demographic characteristics and risk factors for 4209 patients who underwent HIV antibody testing. Of the 3899 subjects included in the study 7.9% were HIV positive. Through logistic regression analysis the following variables were found to be significantly associated with HIV seropositivity: presence of HIV-related symptoms (prevalence odds ratio [POR] 36.5), origin from an endemic area (POR 9.1), homosexuality or bisexuality (POR 8.4), intravenous drug use (POR 4.2), male sex (POR 2.8), previous HIV antibody testing (POR 2.5) and previous sexually transmitted disease (POR 1.8). Over the study period we found a large increase in HIV seroprevalence among intravenous drug users (4.2% in 1988 to 19.0% in 1989) (p = 0.02). This increase might reflect a recent change in the epidemiologic pattern of HIV transmission in Quebec. Surveillance of HIV seropositivity through a network of sentinel physicians may be a reasonable alternative to mandatory reporting. PMID:2357678
Foley, M E; Ehr, A P; Raza, B; Devlin, C J
Tuberculosis, a chronic communicable bacterial infection of epidemic proportions in the United States, is more common among debilitated and immunocompromised persons, for example, alcoholics, drug abusers, and HIV/AIDS patients, than among the general population. Daytop Village Inc., a drug free therapeutic community for chemical dependency treatment, initiated a program of tuberculosis (TB) surveillance and prevention education with grant support. Continuous educational sessions for staff and residents have raised awareness of the threat of TB. From March 1991 until September 1992, 2,932 clients screened for TB found 272 (9.2%) PPD positive. Of these 272, 125 also tested for HIV found 28 (22.4%) HIV positive. The TB screening program had no negative impact on the retention rate of Daytop residents. With sufficient fiscal and personnel support, tuberculosis education, screening, and treatment has been naturally integrated into the primary care agenda within the therapeutic community model of drug abuse rehabilitation.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false What must I do if I want to make changes to my postmarket surveillance plan after you have approved it? 822.21 Section 822.21 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES POSTMARKET SURVEILLANCE...
Maas, M; Gröne, A; Kuiken, T; Van Schaik, G; Roest, H I J; Van Der Giessen, J W B
The surveillance of (emerging) wildlife diseases can provide important, objective evidence of the circulation of pathogens of interest for veterinary and/or public health. The involvement of multiple research institutions in wildlife disease surveillance can ensure the best use of existing knowledge and expertise, but can also complicate or add challenges to the integration of wildlife disease surveillance components into a national programme. Documenting the existing efforts in a country's surveillance of wildlife diseases, including the institutes in which it takes place, provides a basis for policy-makers and authorities to identify gaps and priorities in their current surveillance programmes. This paper describes the wildlife disease surveillance activities taking place in the Netherlands. The authors recommend that, in addition to funding these current activities, surveillance resources should be allocated with the flexibility to allow for additional targeted surveillance, to detect and adequately respond to newly introduced or emerging pathogens. Similar structured overviews of wildlife disease surveillance in other countries would be very useful to facilitate international collaboration.
The National Electronic Disease Surveillance System (NEDSS) is a web-based system that uses standard health information technology (IT) codes to integrate disease surveillance systems, enabling them to transfer public health, laboratory, and clinical data securely from health-care providers to public health departments. Each jurisdictions' system consists of a base system and modules that can be used for specific surveillance purposes. States also use NEDSS-like or other electronic systems to conduct surveillance on specific diseases or conditions. Until recently, no assessment had been done to describe the status and characteristics of state electronic disease surveillance systems. The Council of State and Territorial Epidemiologists (CSTE) conducted such an assessment in August 2007 in all 50 states. This report presents the results of that assessment, which indicated that, in 2007, state electronic disease surveillance systems varied widely and were in various stages of implementation. Each state had either custom-built systems or purchased systems that were customizable, with associated disease modules to meet its own surveillance needs. As interoperability becomes the standard for electronic data sharing, more states will face customization costs and the need to hire more technical specialists who can manage health information and exchange. Further collaboration and support from surveillance and health-care IT stakeholders with public health will be needed to improve the efficacy and quality of electronic disease surveillance systems.
reconnaissance (ISR) model for coastal surveillance. The model needs to be developed in the System Toolkit (STK) software package version 10.0 (or...reconnaissance (ISR) model for coastal surveillance. The model needs to be developed in the System Toolkit (STK) software package version 10.0 (or...Catalogue STK System Toolkit TA Technical Authority DRDC CORA Task #185 Coastal Surveillance Baseline Model Development 27 February 2015 F-1 5758-001
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). Samples are routinely collected and analyzed to determine the quality of air, surface water, ground water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Drinking Water Project, and Ground-Water Surveillance Project.
Scotch, Matthew; Mattocks, Kristin; Rabinowitz, Peter; Brandt, Cynthia
Summary Zoonotic diseases are infectious diseases transmittable between animals and humans and outbreaks of these diseases in animals can signify that humans are also infected (or vice-versa). Thus, communication between animal and human health agencies is critical for surveillance. Understanding how these agencies conduct surveillance and share information is important for development of successful automated zoonotic monitoring systems. Individual interviews were conducted with 13 professionals who perform animal or human zoonotic disease surveillance in one of the New England states. Questions centered on existing surveillance methods, collaborations between animal and human health agencies, and technological and data needs. The results showed that agencies routinely communicate over suspected zoonotic disease cases yet there are barriers preventing automated electronic linking of health data of animals and humans. These include technological barriers and barriers due sensitivity and confidentiality of information. Addressing these will facilitate development of electronic systems for integrating animal and human zoonotic disease surveillance data. PMID:20163575
bacteriological surveillance and evaluation of drinking water quality. A separate information paper will address microbiological contaminants of a nonbacterial nature (e.g., Cryptosporidium, Giardia lamblia , and viruses).
Smith, Donna C.
Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.
Grenier, D; Elliott, E J; Zurynski, Y; Pereira, R Rodrigues; Preece, M; Lynn, R; von Kries, R; Zimmermann, H; Dickson, N P; Virella, D
Paediatric Surveillance Units (PSUs) have been established in 14 countries and facilitate national, prospective, active surveillance for a range of conditions, with monthly reporting by child health specialists. The International Network of Paediatric Surveillance Units (INoPSU) was established in 1998 and facilitates international collaboration among member PSUs and allows for sharing of resources, simultaneous data collection and hence comparison of data from different geographical regions. The impact of data collected by PSUs, both individually and collectively as members of INoPSU, on public health outcomes, clinical care and research is described. PMID:17158859
Stacey, Susan; Eaton, Deborah E.; Albrecht, Kay; Bergman, Roberta
Presents four articles on collaboration for use in staff development in childcare settings: (1) "Facilitating Collaborations among Children" (Susan Stacey); (2) "One Size Doesn't Fit All in Collaborations with Parents" (Deborah E. Eaton); (3) "Supporting Collaboration among Teachers" (Kay Albrecht); and (4) "Building Collaborations between…
Kelly, Michael P.
Topics covered include: Develop Program/Project Quality Assurance Surveillance Plans The work activities performed by the developer and/or his suppliers are subject to evaluation and audit by government-designated representatives. CSO supports project by selecting on-site supplier representative s by one of several methods: (1) a Defense Contract Management Agency (DCMA) person via a Letter Of Delegation (LOD), (2) an independent assurance contractor (IAC) via a contract Audits, Assessments, and Assurance (A3) Contract Code 300 Mission Assurance Support Contract (MASC)
Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi
This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.
Pennington, D M
Sonoma offers the first cost-effective, broad-area, high-resolution, real-time motion imagery system for surveillance applications. Sonoma is unique in its ability to provide continuous, real-time video imagery of an area the size of a small city with resolutions sufficient to track 8,000 moving objects in the field of view. At higher resolutions and over smaller areas, Sonoma can even track the movement of individual people. The visual impact of the data available from Sonoma is already causing a paradigm shift in the architecture and operation of other surveillance systems. Sonoma is expected to cost just one-tenth the price of comparably sized sensor systems. Cameras mounted on an airborne platform constantly monitor an area, feeding data to the ground for real-time analysis. Sonoma was designed to provide real-time data for actionable intelligence in situations such as monitoring traffic, special events, border security, and harbors. If a Sonoma system had been available in the aftermath of the Katrina and Rita hurricanes, emergency responders would have had real-time information on roads, water levels, and traffic conditions, perhaps saving many lives.
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false How long must I conduct postmarket surveillance of my device? 822.15 Section 822.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Radiological Health's (CDRH') Web site...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false How long must I conduct postmarket surveillance of my device? 822.15 Section 822.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Radiological Health's (CDRH') Web site (www.fda.gov/cdrh/ombudsman/). The 36-month period refers to...
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false How long must I conduct postmarket surveillance of my device? 822.15 Section 822.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Radiological Health's (CDRH') Web site...
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false How long must I conduct postmarket surveillance of my device? 822.15 Section 822.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Radiological Health's (CDRH') Web site (www.fda.gov/cdrh/ombudsman/). The 36-month period refers to...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false How long must I conduct postmarket surveillance of my device? 822.15 Section 822.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Radiological Health's (CDRH') Web site (www.fda.gov/cdrh/ombudsman/). The 36-month period refers to...
Wartenberg, Daniel; Thompson, W Douglas; Fitzgerald, Edward F; Gross, Hillary J; Condon, Suzanne K; Kim, Nancy; Goun, Barbara D; Opiekun, Richard E
Environmental exposures cause substantial morbidity and mortality in the United States. A major goal of Centers for Disease Control and Prevention Environmental Public Health Tracking program is the development of a national network of health and environmental data with analytic tools for rapid evaluation of specific national or regional environmental health concerns. A six-state collaborative project in the northeast United States was established to assess the feasibility of such a system, assessing the possible association between ambient air quality and adverse birth outcomes. For this regional surveillance project, issues were discussed surrounding the design of a mutually acceptable protocol, obtaining human subjects' protection approvals, obtaining and organizing both the exposure and outcome data, analyzing the data both locally and regionally, and planning subsequent interventions to address identified public health concerns.
Wallace, Brad; Pinkney, Frank L.; Scott, Robert; Bedard, Donald; Rody, Jim; Levesque, Martin P.; Buteau, Sylvie; Racey, Tom; Burrell, Doug; Spaans, Aaron; Hildebrand, Alan
Defence Research and Development Canada (DRDC) and the Canadian Space Agency (CSA) are collaborating to place a microsatellite in low earth orbit to perform optical detection and tracking of both inner-earth orbiting asteroids and earth-orbiting satellites and debris (i.e., "Resident Space Objects", RSOs). The "Near Earth Object Surveillance Satellite (NEOSSat)" will be the first mission for the CSA multi-mission microsatellite bus program, and is intended by DRDC to demonstrate the military utility of this small and inexpensive class of spacecraft. The mission will obtain metric positions, for geosynchronous satellites, to within Â±500 m, timestamps accurate to within a millisecond, and be sensitive to objects in geosynchronous orbit down to 14th magnitude. The asteroid tracking mission will repeatedly survey the area from Â±45-70Â° solar elongation with the aim of finding >50% of all inner-earth asteroids having diameters greater than 1 km.
Gater, R; Chisholm, D; Dowrick, C
Routine information systems for mental health in many Eastern Mediterranean Region countries are rudimentary or absent, making it difficult to understand the needs of local populations and to plan accordingly. Key components for mental health surveillance and information systems are: national commitment and leadership to ensure that relevant high quality information is collected and reported; a minimum data set of key mental health indicators; intersectoral collaboration with appropriate data sharing; routine data collection supplemented with periodic surveys; quality control and confidentiality; and technology and skills to support data collection, sharing and dissemination. Priority strategic interventions include: (1) periodically assessing and reporting the mental health resources and capacities available using standardized methodologies; (2) routine collection of information and reporting on service availability, coverage and continuity, for priority mental disorders disaggregated by age, sex and diagnosis; and (3) mandatory recording and reporting of suicides at the national level (using relevant ICD codes).
Maclay, W P; Crowder, D; Spiro, S; Turner, P
In a postmarketing surveillance of ketotifen (Zaditen), an oral preparation for the prophylaxis of bronchial asthma, 8291 patients completed records every three months for one year. The objectives were to record adverse events and efficacy and to communicate appropriate information to participating doctors and regulatory authorities. The patients recruited appeared to represent a typical cross section of patients with asthma in the United Kingdom. By subjective assessment 70% of patients found the medication efficacious. There were no unexpected or unacceptable side effects and those found were similar to those reported in clinical trials of ketotifen. Though this exercise showed that the pharmaceutical industry, regulatory authorities, and prescribing doctors were able to collaborate, the major outcome of the survey was already known. It remains to be seen whether this type of survey is of value in the continuing search for control and safety in prescribing. PMID:6423140
Moellman, Dennis E.
Video sensors represent one facet of the unattended ground sensors family used to support military operations. This paper provides technical details on a modular, automated video surveillance (AVS) system concept that provides a 4D modeling and segmentation capability. This capability, combining 3D imaging and embedded information processing, enables the AVS to reliably detect and roughly classify objects and activities with a high probable certainty and minimal false alarms. The beneficial result is an elimination of the need for human monitoring and reduction in data transmission requirements by several orders of magnitude. This modular, forward observer AVS sensor package is comprised of integrated CMOS arrays and lenses (one for monoscopic view and two rigidly fixed for stereo), image processing, communication, GPS chips, and battery. This smart sensor is inexpensive, miniature, self-contained, and man-packable. Real-time video processing onboard the sensor provides: analysis and automatic target recognition algorithms enabling robust moving object detection; tracking and delimitation; and target characterization based on motion, size, form factor, texture, and specific identifying characteristics of objects. Automation of video screening tasks provides the benefits of visual surveillance without the associated burden or distraction from the mission. Because of its size and simplicity the AVS requires minimal man-in-the-field set up and lends itself to clandestine deployment.. In the future it may be possible to reliably and cost effectively air deploy the AVS. Each method offers great benefits as unmanned forward observers and sophisticated `tripwires' for battlefield awareness. While well suited for military reconnaissance, surveillance, and target acquisition missions for peacetime and/or wartime applications, the AVS also lends itself to other clandestine applications such as drug interdiction surveillance, monitoring, and tip off.
Nelson, E A S; Bresee, J S; Parashar, U D; Widdowson, M-A; Glass, R I
Availability of new rotavirus vaccines has highlighted the need to collect local disease and economic burden data to aid decision makers at global, regional and country level. The World Health Organization and the GAVI Alliance recommended that generic protocols be used and that regional surveillance networks be established to collect these data, thereby helping to fast-track the introduction of these new vaccines into developing countries. Nine countries and regions participated in the first phase of the Asian Rotavirus Surveillance Network (ARSN), which collected data over a 2-year period during 2001-2003. Overall 45% of diarrhoea admissions in the region were positive for rotavirus, which was higher than had been anticipated. Significant rotavirus strain diversity was noted during the surveillance period. Data collection for a second phase of the ARSN commenced in 2004 and included a greater proportion of poorer countries that would in future be eligible for funding support for rotavirus immunization from GAVI. Limited economic evaluations in Asia have demonstrated the potential for new rotavirus vaccines to be cost-effective but more local analyses are required. Despite the ARSN's comprehensive data from a mix of developed and developing countries, Asia has lagged the Americas in terms of the introduction of rotavirus vaccines into National Immunization Programmes (NIPs). Lack on rotavirus vaccine efficacy data in Asia, particularly in poorer populations, will have contributed to this delay. Thus ensuring that all global regions are simultaneously involved in the evaluation of new vaccines from the beginning and also encouraging more regional collaborations of Ministry of Health representatives could help to accelerate the introduction of new vaccines into NIPs.
St. John, Elizabeth P.; Simen, Birgitte B.; Turenchalk, Gregory S.; Braverman, Michael S.; Abbate, Isabella; Aerssens, Jeroen; Bouchez, Olivier; Gabriel, Christian; Izopet, Jacques; Meixenberger, Karolin; Di Giallonardo, Francesca; Schlapbach, Ralph; Paredes, Roger; Sakwa, James; Schmitz-Agheguian, Gudrun G.; Thielen, Alexander; Victor, Martin
Background Ultra deep sequencing is of increasing use not only in research but also in diagnostics. For implementation of ultra deep sequencing assays in clinical laboratories for routine diagnostics, intra- and inter-laboratory testing are of the utmost importance. Methods A multicenter study was conducted to validate an updated assay design for 454 Life Sciences’ GS FLX Titanium system targeting protease/reverse transcriptase (RTP) and env (V3) regions to identify HIV-1 drug-resistance mutations and determine co-receptor use with high sensitivity. The study included 30 HIV-1 subtype B and 6 subtype non-B samples with viral titers (VT) of 3,940–447,400 copies/mL, two dilution series (52,129–1,340 and 25,130–734 copies/mL), and triplicate samples. Amplicons spanning PR codons 10–99, RT codons 1–251 and the entire V3 region were generated using barcoded primers. Analysis was performed using the GS Amplicon Variant Analyzer and geno2pheno for tropism. For comparison, population sequencing was performed using the ViroSeq HIV-1 genotyping system. Results The median sequencing depth across the 11 sites was 1,829 reads per position for RTP (IQR 592–3,488) and 2,410 for V3 (IQR 786–3,695). 10 preselected drug resistant variants were measured across sites and showed high inter-laboratory correlation across all sites with data (P<0.001). The triplicate samples of a plasmid mixture confirmed the high inter-laboratory consistency (mean% ± stdev: 4.6 ±0.5, 4.8 ±0.4, 4.9 ±0.3) and revealed good intra-laboratory consistency (mean% range ± stdev range: 4.2–5.2 ± 0.04–0.65). In the two dilutions series, no variants >20% were missed, variants 2–10% were detected at most sites (even at low VT), and variants 1–2% were detected by some sites. All mutations detected by population sequencing were also detected by UDS. Conclusions This assay design results in an accurate and reproducible approach to analyze HIV-1 mutant spectra, even at variant frequencies
Midyear Commentary on Trends in Drug Delivery and Clinical Translational Medicine: Growth in Biosimilar (Complex Injectable Drug Formulation) Products Within Evolving Collaborative Regulatory Interagency (FDA, FTC, and DOJ) Practices and Enforcement.
Ho, Rodney J Y
Before the 2009 Biologics Price Competition and Innovation Act that enabled the U.S. Federal Drug Administration (FDA) to create the 351(k) Biologic License Application-an abbreviated biosimilar approval process, FDA approved follow-on biomolecule products such as beta-interferon, glucagon, hyaluronidase, and somatropin (human growth hormone) under varying and evolving rules. With the 351(k) Biologic License Application biosimilar approval process in place, currently, there are 4 (licensed in 2015-2016) biosimilars available, namely Neupogen (filgrastim; $1 B/y), Humira (adalumumab; $14.2 B/y), Enbrel (etanercept; $8.7 B/y), and Remicade (infliximab; $6.5 B/y). With well-established product market capitalization of these and other top income producers-such as Rituxan (rituximab; $6.8 B/y), Herceptin (trastuzumab; $6.5 B/y), and Avastin (bevacizumab; $5.8 B/y), and a price differential of 15%-30% compared to branded products, there is an intense interest in development of biosimilars by established pharmaceutical companies. Currently, there are 160 biosimilar candidates in clinical studies, many of which are sponsored by large pharmaceutical companies known for product innovation. This trend will likely continue. Additional information on a biomolecule platform is presented in the Journal of Pharmaceutical Sciences Drug Delivery Clinical Trials Database (jpharmscidatabase.org). There are 44,789, 18,456, and 12,897 clinical trials registered to evaluate (1) drug delivery technology, (2) biomolecule platform, and (3) drug metabolism and pharmacokinetic-pharmacodynamic interactions; representing 19%-60% increase over the last 3 years.
Huertas, Jancy Andrea
Environmental pollution is a growing problem that negatively impacts health with social and economic high costs. In this sense, coordinated surveillance of conditions, risks, exposures and health effects related to pollution is a useful tool to guide decision-making processes. The objective of this essay was to describe a surveillance system for environmental contaminants in Colombia and its design background. Using the technical guidelines proposed by the Pan American Health Organization, a literature review was conducted to identify the key elements to be included in such surveillance system and to establish which of these elements were already present in the Colombian context. Moreover, these findings were compared with successful experiences in Latin America. The surveillance system includes five components: Epidemiological, environmental and biological surveillance, clinical monitoring and recommendations to guide policies or interventions. The key factors for a successful surveillance system are: interdisciplinary and inter-sector work, clear definition of functions, activities, data sources and information flow. The implementation of the system will be efficient if the structures and tools existing in each country are taken into account. The most important stakeholders are inter-sector public health and environmental commissions and government institutions working in research and surveillance issues related to health, sanitation, environment, drugs and food regulation and control. In conclusion, Colombia has the technical resources and a normative framework to design and implement the surveillance system. However, stakeholders´ coordination is essential to ensure the efficacy of the system so it may guide the implementation of cost-effective actions in environmental health.
Evans, Philip; Wolf, Bob
Corporate leaders seeking to boost growth, learning, and innovation may find the answer in a surprising place: the Linux open-source software community. Linux is developed by an essentially volunteer, self-organizing community of thousands of programmers. Most leaders would sell their grandmothers for workforces that collaborate as efficiently, frictionlessly, and creatively as the self-styled Linux hackers. But Linux is software, and software is hardly a model for mainstream business. The authors have, nonetheless, found surprising parallels between the anarchistic, caffeinated, hirsute world of Linux hackers and the disciplined, tea-sipping, clean-cut world of Toyota engineering. Specifically, Toyota and Linux operate by rules that blend the self-organizing advantages of markets with the low transaction costs of hierarchies. In place of markets' cash and contracts and hierarchies' authority are rules about how individuals and groups work together (with rigorous discipline); how they communicate (widely and with granularity); and how leaders guide them toward a common goal (through example). Those rules, augmented by simple communication technologies and a lack of legal barriers to sharing information, create rich common knowledge, the ability to organize teams modularly, extraordinary motivation, and high levels of trust, which radically lowers transaction costs. Low transaction costs, in turn, make it profitable for organizations to perform more and smaller transactions--and so increase the pace and flexibility typical of high-performance organizations. Once the system achieves critical mass, it feeds on itself. The larger the system, the more broadly shared the knowledge, language, and work style. The greater individuals' reputational capital, the louder the applause and the stronger the motivation. The success of Linux is evidence of the power of that virtuous circle. Toyota's success is evidence that it is also powerful in conventional companies.
Sanmarti-Vila, Lydia; García-Matos, Marta; Beduini, Federica; Carrasco, Silvia
Many research projects and scientific initiatives multiple their impact and relevance through collaborations. It is the contact and exchange with others that often brings a scientist's work to the next level. The same happens with outreach: sharing activities, concepts, materials and knowhow may lead to greater impact, more innovative, inspirational ideas with enough potential to create pioneering outreach activities. A good example for this is the FP7 European project "GoPhoton!", an initiative of ECOP (European Centres of Outreach in Photonics) that ran through 2014 and 2015 and finished at the beginning of 2016 and was directed at the general public, young minds as well as current and future entrepreneurs. This project was based on the idea of sharing activities - which is at the core of ECOP's identity- already existing in other nodes (institutions within the project), or created within GoPhoton! The main concept was the effective leverage of local links such as the networks of educators and professionals in general, industrial clusters, museums, universities, governmental and non-governmental organizations, all from a Pan-European perspective possible through ECOP. This has resulted in over 200 events impacting over two million people. The sharing of activities across institutions that have different resources, facilities, and cultural environments is not straightforward. One of the biggest challenges for the consortium was to be able to extract the concept and identity of each activity, so that it could be realistically adapted to each local context. A crucial point was being able to effectively use the knowhow gained from a partner's activity, in a way that the essence of the activity remained untainted across the participating nodes, while still triggering innovation locally.
Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen
Unattended ground sensor (UGS) networks have been widely used in remote battlefield and other tactical applications over the last few decades due to the advances of the digital signal processing. The UGS network can be applied in a variety of areas including border surveillance, special force operations, perimeter and building protection, target acquisition, situational awareness, and force protection. In this paper, a highly-distributed, fault-tolerant, and energyefficient Smart Sensing Surveillance System (S4) is presented to efficiently provide 24/7 and all weather security operation in a situation management environment. The S4 is composed of a number of distributed nodes to collect, process, and disseminate heterogeneous sensor data. Nearly all S4 nodes have passive sensors to provide rapid omnidirectional detection. In addition, Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR cameras are integrated to selected nodes to track the objects and capture associated imagery. These S4 camera-connected nodes will provide applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. In the S4, all the nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology, which can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The S4 utilizes a Service Oriented Architecture such that remote applications can interact with the S4 network and use the specific presentation methods. The S4 capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded
Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen
An effective public safety sensor system for heavily-populated applications requires sophisticated and geographically-distributed infrastructures, centralized supervision, and deployment of large-scale security and surveillance networks. Artificial intelligence in sensor systems is a critical design to raise awareness levels, improve the performance of the system and adapt to a changing scenario and environment. In this paper, a highly-distributed, fault-tolerant, and energy-efficient Smart Sensing Surveillance System (S4) is presented to efficiently provide a 24/7 and all weather security operation in crowded environments or restricted areas. Technically, the S4 consists of a number of distributed sensor nodes integrated with specific passive sensors to rapidly collect, process, and disseminate heterogeneous sensor data from near omni-directions. These distributed sensor nodes can cooperatively work to send immediate security information when new objects appear. When the new objects are detected, the S4 will smartly select the available node with a Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR camera to track the objects and capture associated imagery. The S4 provides applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. Other imaging processes can be updated to meet specific requirements and operations. In the S4, all the sensor nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology. This UWB RF technology can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The Service Oriented Architecture of S4 enables remote applications to interact with the S4
des radars à courte impulsion et très large bande de fréquence (UWB SP) pour effectuer de la surveillance à travers des murs de ciments . Cette étude...meilleures qualités quand on y inclut le délai de l’onde électromagnétique due au mur de ciments . L’impact de différent paramètre radars ou de traitement...à l’intérieur d’un édifice en ciment . Les murs de ciments ont trois impacts sur les images radars. Les images des cibles sont de- focussées et
Kam, H.J.; Choi, S.; Cho, J.P.; Min, Y.G.; Park, R.W.
Objective In an effort to identify and characterize the environmental factors that affect the number of patients with acute diarrheal (AD) syndrome, we developed and tested two regional surveillance models including holiday and weather information in addition to visitor records, at emergency medical facilities in the Seoul metropolitan area of Korea. Methods With 1,328,686 emergency department visitor records from the National Emergency Department Information system (NEDIS) and the holiday and weather information, two seasonal ARIMA models were constructed: (1) The simple model (only with total patient number), (2) the environmental factor-added model. The stationary R-squared was utilized as an in-sample model goodness-of-fit statistic for the constructed models, and the cumulative mean of the Mean Absolute Percentage Error (MAPE) was used to measure post-sample forecast accuracy over the next 1 month. Results The (1,0,1)(0,1,1)7 ARIMA model resulted in an adequate model fit for the daily number of AD patient visits over 12 months for both cases. Among various features, the total number of patient visits was selected as a commonly influential independent variable. Additionally, for the environmental factor-added model, holidays and daily precipitation were selected as features that statistically significantly affected model fitting. Stationary R-squared values were changed in a range of 0.651-0.828 (simple), and 0.805-0.844 (environmental factor-added) with p<0.05. In terms of prediction, the MAPE values changed within 0.090-0.120 and 0.089-0.114, respectively. Conclusion The environmental factor-added model yielded better MAPE values. Holiday and weather information appear to be crucial for the construction of an accurate syndromic surveillance model for AD, in addition to the visitor and assessment records. PMID:23616829
Liu, Ying; Samuel, Buck S.; Breen, Peter C.; Ruvkun, Gary
Mitochondrial function is challenged by toxic byproducts of metabolism as well as by pathogen attack1,2. Caenorhabditis elegans normally responds to mitochondrial dysfunction with activation of mitochondrial repair, drug detoxification, and pathogen-response pathways1–7. From a genome-wide RNAi screen, we identified 45 C. elegans genes that are required to upregulate detoxification, pathogen-response, and mitochondrial repair pathways after inhibition of mitochondrial function by drugs or genetic disruption. Animals defective in ceramide biosynthesis are deficient in mitochondrial surveillance, and addition of particular ceramides can rescue the surveillance defects. Ceramide can also rescue the mitochondrial surveillance defects of other gene inactivations, mapping these gene activities upstream of ceramide. Inhibition of the mevalonate pathway, either by RNAi or statin drugs also disrupts mitochondrial surveillance. Growth of C. elegans with a significant fraction of bacterial species from their natural habitat causes mitochondrial dysfunction. Other bacterial species inhibit C. elegans defense responses to a mitochondrial toxin, revealing bacterial countermeasures to animal defense. PMID:24695221
Berlinicke, Cynthia A; Ackermann, Christopher F; Chen, Steve H; Schulze, Christoph; Shafranovich, Yakov; Myneni, Sahiti; Patel, Vimla L; Wang, Jian; Zack, Donald J; Lindvall, Mikael; Bova, G Steven
High-content screening (HCS) technology provides a powerful vantage point to approach biological problems; it allows analysis of cell parameters, including changes in cell or protein movement, shape, or texture. As part of a collaborative pilot research project to improve bioscience research data integration, we identified HCS data management as an area ripe for advancement. A primary goal was to develop an integrated data management and analysis system suitable for small- to medium-size HCS programs that would improve research productivity and increase work satisfaction. A system was developed that uses Labmatrix, a Web-based research data management platform, to integrate and query data derived from a Cellomics STORE database. Focusing on user expectations, several barriers to HCS productivity were identified and reduced or eliminated. The impact of the project on HCS research productivity was tested through a series of 18 lab-requested integrated data queries, 7 of which were fully enabled, 7 partially enabled, and 4 enabled through data export to standalone data analysis tools. The results are limited to one laboratory, but this pilot suggests that through an "implementation research" approach, a network of small- to medium-size laboratories involved in HCS projects could achieve greater productivity and satisfaction in drug discovery research.
Paterson, Beverley J; Durrheim, David N
With eradication almost within reach, the importance of detecting every poliomyelitis case has taken on additional significance. The selected surveillance strategy must be effective and efficient. A review of polio surveillance in Australia was conducted to consider whether current strategies were optimal. Document review and semi-structured key informant interviews were used to conduct the review. Interviews were recorded, transcribed and thematically analysed. The review was an iterative process with feedback on the findings sought from interviewees. Since Western Pacific Regional polio-elimination status was certified, one imported adult case was detected in 2007 in Australia, with no evidence of further transmission, and no Australian paediatric cases identified. Respondents reported that: it was not possible to prevent importations; paediatric cases were more likely to be identified than adult cases; and there may be a low level of suspicion among clinicians. Case detection and outbreak mitigation were considered key reasons to undertake polio surveillance. While Australia has not achieved one of the key World Health Organization (WHO) surveillance targets, this did not compromise Australias polio-free status. Identified issues with polio surveillance were the potential for an importation with high attendant investigation and containment costs, low stool sample collection rates, and the opportunity to improve safeguards around the importation and laboratory storage of biological samples containing poliovirus. The review found strong support for ongoing polio surveillance, particularly to detect imported cases and to demonstrate commitment to maintaining a polio-free region. Existing polio surveillance strategies were considered appropriate for Australia.
Russell, Jill F.; Flynn, Richard B.
Examined effective collaborations involving schools and colleges of education and other organizations, identifying commonly voiced reasons for collaboration and factors perceived as important in collaboration. Data come from research, case descriptions, survey responses, and input from collaborators. Willingness to listen, mutual respect,…
Bacon, Pamela S.
School media specialists collaborate with many teachers every day. They are so good that sometimes they even collaborate without realizing it. Sometimes, however, a more formal type of collaboration is needed. Not only does formal collaboration give them a chance to shine as the instructional leader, it also allows them to collect data to show…
Pocatilu, Paul; Ciurea, Cristian
Collaborative systems are widely used today in various activity fields. Their complexity is high and the development involves numerous resources and costs. Testing collaborative systems has a very important role for the systems' success. In this paper we present taxonomy of collaborative systems. The collaborative systems are classified in many…
Backer, L C; Niskar, A S; Rubin, C; Blindauer, K; Christianson, D; Naeher, L; Rogers, H S
Public health surveillance involves the collection, analysis, and dissemination of data for use in public health practice. A surveillance system includes the capacity to collect and analyze data as well as the ability to disseminate the data to public health agencies that can undertake effective prevention and control activities. An emerging issue in environmental public health surveillance involves human exposure to the toxins produced by microorganisms present in oceans and estuaries. One of these organisms is Pfiesteria piscicida Steidinger & Burkholder, a dinoflagellate found in estuaries along the Atlantic and gulf coasts of the United States. There have been reports of both human illness associated with occupational exposures to concentrated laboratory cultures of P. piscicida and massive fill kills associated with the presence of the organism in rivers and estuaries. These reports, and anecdotal reports from people who worked on rivers where the organism has been found, generated concern that environmental exposures to P. piscicida, similar organisms, or perhaps a toxin or toxins produced by the organism(s), could cause adverse human health effects. To begin to evaluate the public health burden associated with P. piscicida, investigators from the National Center for Environmental Health at Centers for Disease Control and Prevention and health agencies from states along the Atlantic coast collaborated to develop a passive surveillance system for collecting, classifying, and tracking public inquiries about the organism. Specifically, the group developed exposure and symptom criteria and developed data collection and reporting capabilities to capture the human health parameters collectively referred to as possible estuary-associated syndrome (PEAS). The surveillance system was implemented in six states (Delaware, Florida, Maryland, North Carolina, South Carolina, Virginia) beginning in June 1998. From 1 June 1998 through 30 June 2001, the six state health
Backer, L C; Niskar, A S; Rubin, C; Blindauer, K; Christianson, D; Naeher, L; Rogers, H S
Public health surveillance involves the collection, analysis, and dissemination of data for use in public health practice. A surveillance system includes the capacity to collect and analyze data as well as the ability to disseminate the data to public health agencies that can undertake effective prevention and control activities. An emerging issue in environmental public health surveillance involves human exposure to the toxins produced by microorganisms present in oceans and estuaries. One of these organisms is Pfiesteria piscicida Steidinger & Burkholder, a dinoflagellate found in estuaries along the Atlantic and gulf coasts of the United States. There have been reports of both human illness associated with occupational exposures to concentrated laboratory cultures of P. piscicida and massive fill kills associated with the presence of the organism in rivers and estuaries. These reports, and anecdotal reports from people who worked on rivers where the organism has been found, generated concern that environmental exposures to P. piscicida, similar organisms, or perhaps a toxin or toxins produced by the organism(s), could cause adverse human health effects. To begin to evaluate the public health burden associated with P. piscicida, investigators from the National Center for Environmental Health at Centers for Disease Control and Prevention and health agencies from states along the Atlantic coast collaborated to develop a passive surveillance system for collecting, classifying, and tracking public inquiries about the organism. Specifically, the group developed exposure and symptom criteria and developed data collection and reporting capabilities to capture the human health parameters collectively referred to as possible estuary-associated syndrome (PEAS). The surveillance system was implemented in six states (Delaware, Florida, Maryland, North Carolina, South Carolina, Virginia) beginning in June 1998. From 1 June 1998 through 30 June 2001, the six state health
Anal squamous cell cancer is most frequently a locoregional disease that is amenable to curative therapy in a majority of fit patients. Complete response rates after chemoradiotherapy (CRT) are good, with up to 75% of patients with no evidence of relapse on surveillance. Relapse is most frequently locoregional and is often amendable to salvage surgery with curative intent. Effective surveillance attempts to improve outcomes by identifying recurrent or persistent disease early, managing both acute and late toxicities, and offering reassurance to patients. This article explores the rationale and evidence for surveillance programs after definitive CRT.
Zhao, Y Q; Ma, W J
Internet data is introduced into public health arena under the features of fast updating and tremendous volume. Mining and analyzing internet data, researchers can model the internet-based surveillance system to assess the distribution of health-related events. There are two main types of internet-based surveillance systems, i.e. active and passive, which are distinguished by the sources of information. Through passive surveillance system, information is collected from search engine and social media while the active system gathers information through provision of the volunteers. Except for serving as a real-time and convenient complementary approach to traditional disease, food safety and adverse drug reaction surveillance program, Internet-based surveillance system can also play a role in health-related behavior surveillance and policy evaluation. Although several techniques have been applied to filter information, the accuracy of internet-based surveillance system is still bothered by the false positive information. In this article, we have summarized the development and application of internet-based surveillance system in public health to provide reference for a better surveillance program in China.
Wang, Xue; Wang, Sheng; Bi, Daowei
A wireless sensor network (WSN) is a powerful unattended distributed measurement system, which is widely used in target surveillance because of its outstanding performance in distributed sensing and signal processing. This paper introduces a multiview visual-target-surveillance system in WSN, which can autonomously implement target classification and tracking with collaborative online learning and localization. The proposed system is a hybrid system of single-node and multinode fusion. It is constructed on a peer-to-peer (P2P)-based computing paradigm and consists of some simple but feasible methods for target detection and feature extraction. Importantly, a support-vector-machine-based semisupervised learning method is used to achieve online classifier learning with only unlabeled samples. To reduce the energy consumption and increase the accuracy, a novel progressive data-fusion paradigm is proposed for online learning and localization, where a feasible routing method is adopted to implement information transmission with the tradeoff between performance and cost. Experiment results verify that the proposed surveillance system is an effective, energy-efficient, and robust system for real-world application. Furthermore, the P2P-based progressive data-fusion paradigm can improve the energy efficiency and robustness of target surveillance.
PROBLEM/CONDITION: Since 1971, CDC and the U.S. Environmental Protection Agency (EPA) have maintained a collaborative surveillance system for collecting and periodically reporting data relating to occurrences and causes of waterborne-disease outbreaks (WBDOs). REPORTING PERIOD CO...
Problem/Condition: Since 1971, CDC, the U.S. Environmental Protection
Agency (EPA), and the Council of State and Territorial Epidemiologists CSTE) have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and cau...
PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have maintained a collaborative surveillance system for the occurrences and causes of waterborne-disease outbreaks (WBDOs).This surv...
... Evaluation FAQs Additional Evaluation Resources Health & Academics Anti-Bullying Policies and Enumeration: An Infobrief for Local Education ... Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the ...
Mulford, Roberta Nancy
This lecture discusses stockpile stewardship efforts and the role surveillance plays in the process. Performance of the RTGs is described, and the question of the absence of anticipated He is addressed.
RW Hanf; TM Poston
Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual.
Tarver, William J.
This slide presentation reviews the importance of longterm occupational health surveillance of astronauts after exposure to the possible hazards of spaceflight. Because there is not much information about long term effects of spaceflight on human health, it is important to identify some of the possible results of exposure to the many possible factors that can influence longterm health impacts. This surveillance also allows for NASA to meet the obligation to care for the astronauts for their lifetime.
Responses were received from 37 HSC medical treatment facilities (100%) regarding their occupational health surveillance programs. The occupational ...personnel determined to be potentially exposed to occupational or job- related hazards, medical surveillance programs are limited, if available at all. An...exposed to occupational or job-related hazards would require more adequate staffing to provide the services. Identification of personnel at risk could be
Friedman, J. D. (Principal Investigator)
The author has identified the following significant results. A systematic aircraft program to monitor changes in the thermal emission from volcanoes of the Cascade Range has been initiated and is being carried out in conjunction with ERTS-1 thermal surveillance experiments. Night overflights by aircraft equipped with thermal infrared scanners sensitive to terrestrial emission in the 4-5.5 and 8-14 micron bands are currently being carried out at intervals of a few months. Preliminary results confirm that Mount Rainier, Mount Baker, Mount Saint Helens, Mount Shasta, and the Lassen area continue to be thermally active, although with the exception of Lassen which erupted between 1914 and 1917, and Mount Saint Helens which had a series of eruptions between 1831 and 1834, there has been no recent eruptive activity. Excellent quality infrared images recorded over Mount Rainier, as recently as April, 1972, show similar thermal patterns to those reported in 1964-1966. Infrared images of Mount Baker recorded in November 1970 and again in April 1972 revealed a distinct array of anomalies 1000 feet below the crater rim and associated with fumaroles or structures permitting convective heat transfer to the surface.
Ope, Maurice; Sonoiya, Stanley; Kariuki, James; Mboera, Leonard E.G.; Gandham, Ramana N.V.; Schneidman, Miriam; Kimura, Mwihaki
The East African Integrated Disease Surveillance Network (EAIDSNet) was formed in response to a growing frequency of cross-border malaria outbreaks in the 1990s and a growing recognition that fragmented disease interventions, coupled with weak laboratory capacity, were making it difficult to respond in a timely manner to the outbreaks of malaria and other infectious diseases. The East Africa Community (EAC) partner states, with financial support from the Rockefeller Foundation, established EAIDSNet in 2000 to develop and strengthen the communication channels necessary for integrated cross-border disease surveillance and control efforts. The objective of this paper is to review the regional EAIDSNet initiative and highlight achievements and challenges in its implementation. Major accomplishments of EAIDSNet include influencing the establishment of a Department of Health within the EAC Secretariat to support a regional health agenda; successfully completing a regional field simulation exercise in pandemic influenza preparedness; and piloting a web-based portal for linking animal and human health disease surveillance. The strategic direction of EAIDSNet was shaped, in part, by lessons learned following a visit to the more established Mekong Basin Disease Surveillance (MBDS) regional network. Looking to the future, EAIDSNet is collaborating with the East, Central and Southern Africa Health Community (ECSA-HC), EAC partner states, and the World Health Organization to implement the World Bank-funded East Africa Public Health Laboratory Networking Project (EAPHLNP). The network has also begun lobbying East African countries for funding to support EAIDSNet activities. PMID:23362409
Tsao, Nicole W.; Lynd, Larry D.; Thomas, Jamie M.; Ferreira, Ema
Background: Hypertensive disorders of pregnancy (HDP) are associated with serious maternal and perinatal complications. For nonsevere hypertension, there is a lack of consensus regarding treatment during pregnancy and while breastfeeding. Further, there is considerable variability in guidelines for antihypertensive drug choices. As part of a Drug Safety and Effectiveness Network (DSEN)–funded project, we piloted a novel surveillance strategy in which community pharmacists recruited pregnant and breastfeeding women to monitor their blood pressure and medication use and to provide education on HDP. Methods: Participating pharmacists were required to complete a certified training program, identify and recruit patients who were pregnant or breastfeeding, obtain informed consent, administer a patient questionnaire and complete an initial case report form for enrolled patients. Study outcomes included the feasibility of community pharmacists to enroll patients and carry out study-related documentation and follow-up. The criteria for success in this pilot study included the ability of pharmacists to recruit 10 participants per pharmacy. Results: 178 community pharmacies across British Columbia agreed to participate in this feasibility study, of which 63 pharmacists completed the study training. Of these, only 21 pharmacists recruited at least 1 patient and 1 pharmacist met the success criteria. Overall, 51 patients were enrolled, 2 withdrew from the study and 7 patients were diagnosed with HDP. Antihypertensive medications used by patients included methyldopa and labetalol. Conclusions: While postmarketing surveillance is an important tool for the assessment of drug safety in the pregnant and breastfeeding patient population, the feasibility of community pharmacists taking on this role was not successfully demonstrated. PMID:25364340
Datta, Arun K; Jackson, Victoria; Nandkumar, Radha; Sproat, Jill; Zhu, Weimo; Krahling, Heidi
CHOIS, the Child Health and Obesity Informatics System, is developed using open source portal technology with three-tiered Open Grid Services Architecture, an accepted standard for accessing Grid Computing and other services under Open Grid Collaborating Environments (OGCE). Its web application provides web based forms with 112 different fields to enter data ranging from demographic, height & weight for BMI, to genomic information. Automatic computation of BMI, BMI percentile and the risk of obesity alert are embedded into this system. After successful testing of the prototype, CHOIS is now ready to be used by the Illinois Department of Human Services (DHS) for obesity surveillance. This HIPAA & FERPA compliant secure system, integrating large databases in a high performance grid computing environment, enables school-nurse to collect data on school children and report statistical and surveillance information on BMI to identify those at-risk and obese for obesity prevention and intervention programs.
Sheikhali, Sami Adel; Abdallat, Mohammed; Mabdalla, Sultan; Qaseer, Bashir Al; Khorma, Rania; Malik, Mamunur; Profili, Maria Cristina; Rø, Gunnar; Haskew, John
Understanding and improving the health status of communities depend on effective public health surveillance. Adoption of new technologies, standardised case definitions and clinical guidelines for accurate diagnosis, and access to timely and reliable data, remains a challenge for public health surveillance systems however and existing public health surveillance systems are often fragmented, disease specific, inconsistent and of poor quality. We describe the application of an enterprise architecture approach to the design, planning and implementation of a national public health surveillance system in Jordan. This enabled a well planned and collaboratively supported system to be built and implemented using consistent standards for data collection, management, reporting and use. The system is case-based and integrated and employs mobile information technology to aid collection of real-time, standardised data to inform and improve decision-making at different levels of the health system. PMID:26878763
Toscano, C.M.; Vijayaraghavan, M.; Salazar-Bolaños, H.M.; Bolaños-Acuña, H.M.; Ruiz-González, A.I.; Barrantes-Solis, T.; Fernández-Vargas, I.; Panero, M.S.; de Oliveira, L.H.; Hyde, T.B.
Introduction Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. Objectives We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. Methods We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. Results During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Conclusions Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and
Beguy, Donatien; Elung'ata, Patricia; Mberu, Blessing; Oduor, Clement; Wamukoya, Marylene; Nganyi, Bonface; Ezeh, Alex
The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first urban-based longitudinal health and demographic surveillance platform in sub-Saharan Africa (SSA). The NUHDSS was established in 2002 to provide a platform to investigate the long-term social, economic and health consequences of urban residence, and to serve as a primary research tool for intervention and impact evaluation studies focusing on the needs of the urban poor in SSA. Since its inception, the NUHDSS has successfully followed every year a population of about 65,000 individuals in 24,000 households in two slum communities--Korogocho and Viwandani--in Nairobi, Kenya. Data collected include key demographic and health information (births, deaths including verbal autopsy, in- and out-migration, immunization) and other information that characterizes living conditions in the slums (livelihood opportunities, household amenities and possessions, type of housing etc.). In addition to the routine data, it has provided a robust platform for nesting several studies examining the challenges of rapid urbanization in SSA and associated health and poverty dynamics. NUHDSS data are shared through internal and external collaborations, in accordance with the Centre's guidelines for publications, data sharing.
Fontecha, Gustavo A; Sanchez, Ana L; Mendoza, Meisy; Banegas, Engels; Mejía-Torres, Rosa E
Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt "CVMNK" genotype in codons 72-76.
Law, Royal K.; Schier, Josh; Schauben, Jay; Wheeler, Katherine; Mulay, Prakash
Objective To describe the use of poison center data for public health surveillance from the poison center, local, state, and federal public health perspectives and to generate meaningful discussion on how to address the challenges to collaboration. Introduction Since 2008, poisoning has become the leading cause of injury-related death in the United States (US); since 1980, the poisoning-related fatality rate in the US has almost tripled.1 Many poison-related injuries and deaths are reported to regional poison centers (PCs) which receive about 2.4 million reports of human chemical and poison exposures annually.2 Federal, state, and local public health (PH) agencies often collaborate with poison centers and use PC data for public health surveillance of poisoning-related health issues. Many state and local PH agencies have partnerships with regional PCs for direct access to local PC data which help them perform this function. At the national level, CDC conducts public health surveillance for exposures and illnesses of public health significance using the National Poison Data System (NPDS), the national PC reporting database. Though most PC and PH officials agree that PC data play an important role in PH practice and surveillance, collaboration between PH agencies and PCs has been hindered by numerous challenges. To address these challenges and bolster collaboration, the Poison Center and Public Health Collaborations Community of Practice (CoP) was created in 2010 by CDC as a means to share experiences, identify best practices, and facilitate relationships among federal, state and local public health agencies and PCs. To date, the Poison Center and Public Health Collaborations CoP includes over 200 members from state and local public health, regional PCs, CDC, the American Association of Poison Control Centers (AAPCC), and the Environmental Protection Agency (EPA). A leadership team was created with representatives of the many stakeholders of the community to drive its
Meabh Kelly, Susan; Smith, Walter
Global Collaborative STEM Education, as the name suggests, simultaneously supports two sets of knowledge and skills. The first set is STEM -- science, technology, engineering and math. The other set of content knowledge and skills is that of global collaboration. Successful global partnerships require awareness of one's own culture, the biases embedded within that culture, as well as developing awareness of the collaborators' culture. Workforce skills fostered include open-mindedness, perseverance when faced with obstacles, and resourceful use of technological "bridges" to facilitate and sustain communication. In respect for the 2016 GIFT Workshop focus, Global Collaborative STEM Education projects dedicated to astronomy research will be presented. The projects represent different benchmarks within the Global Collaborative STEM Education continuum, culminating in an astronomy research experience that fully reflects how the global STEM workforce collaborates. To facilitate wider engagement in Global Collaborative STEM Education, project summaries, classroom resources and contact information for established international collaborative astronomy research projects will be disseminated.
Peterson, Roland L.; And Others
Theme articles discuss environment, food, agriculture, and renewal resources as they relate to science education, learning partnerships, collaboration in Kyrghyzstan, leadership development, opportunities for collaboration, networking, and the creation of a shared course between agribusiness and biology. (JOW)
Briers, Gary E.; And Others
Seven articles present models for collaboration between business and education, agriscience and extension, agribusiness and agricultural education, as well as a collaborative waterfowl refuge project and the political process and public relations. (SK)
Murrell, K D
Humans suffer from several foodborne helminth zoonotic diseases, some of which can be deadly (e.g., trichinellosis, cerebral cysticercosis) while others are chronic and cause only mild illness (e.g., intestinal taeniosis). The route of infection is normally consumption of the parasite's natural host as a human food item (e.g., meat). The risk for infection with these parasites is highest wherever people have an inadequate knowledge of infection and hygiene, poor animal husbandry practices, and unsafe management and disposal of human and animal waste products. The design of surveillance and control strategies for the various foodborne parasite species, and the involvement of veterinary and public health agencies, vary considerably because of the different life cycles of these parasites, and epidemiological features. Trichinella spiralis, which causes most human trichinellosis, is acquired from the consumption of pork, although increasingly cases occur from eating wild game. For cysticercosis, however, the only sources for human infection are pork (Taenia solium) or beef (T. saginata). The chief risk factor for infection of humans with these parasites is the consumption of meat that has been inadequately prepared. For the pig or cow, however, the risk factors are quite different between Trichinella and Taenia. For T. spiralis the major source of infection of pigs is exposure to infected animal meat (which carries the infective larval stage), while for both Taenia species it is human faecal material contaminated with parasite eggs shed by the adult intestinal stage of the tapeworm. Consequently, the means for preventing exposure of pigs and cattle to infective stages of T. spiralis, T. solium, and T. saginata vary markedly, especially the requirements for ensuring the biosecurity of these animals at the farm. The surveillance strategies and methods required for these parasites in livestock are discussed, including the required policy-level actions and the necessary
Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T.; Blyde, David J.; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel
Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases. PMID:24787430
Marilyn Johnston-Parsons writes about collaboration. She describes several university-school collaborations with which she has been involved in terms of the tensions and the dialogue that has been associated with them. While she worries about the state of collaboration in this educational age, she admits to "cautious optimism" that more…
Fleming, Margaret, Ed.
Noting that while collaborative writing is commonplace in the "real" world it is seldom practiced in classrooms, the articles in this focused journal explore the place of collaboration in the writing process and the ways in which collaboration can be fostered in an instructional setting. Following an introduction by the editor, which…
Critics of collaborative learning such as Greg Myers argue that educators might let their enthusiasm for collaborative learning lead them to accepting social construction of knowledge as a good thing in itself. It is important, however, to distinguish between the use of specific collaborative learning activities--such as peer response groups or…
The author's personal history of the research that led to his recognition in economics is described, focusing on the process of collaboration and on the experience of controversy. The author's collaboration with Amos Tversky dealt with 3 major topics: judgment under uncertainty, decision making, and framing effects. A subsequent collaboration,…
Altawalah, Haya; Al-Nakib, Widad
In the early 1980s, the World Health Organization (WHO) designated the Virology Unit of the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, a collaborating centre for AIDS for the Eastern Mediterranean Regional Office (EMRO), recognizing it to be in compliance with WHO guidelines. In this centre, research integral to the efforts of WHO to combat AIDS is conducted. In addition to annual workshops and symposia, the centre is constantly updating and renewing its facilities and capabilities in keeping with current and latest advances in virology. As an example of the activities of the centre, the HIV-1 RNA viral load in plasma samples of HIV-1 patients is determined by real-time PCR using the AmpliPrep TaqMan HIV-1 test v2.0. HIV-1 drug resistance is determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene, using the TRUGENE HIV-1 Genotyping Assay on the OpenGene® DNA Sequencing System. HIV-1 subtypes are determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene using the genotyping assays described above. A fundamental program of Kuwait's WHO AIDS collaboration centre is the national project on the surveillance of drug resistance in human deficiency virus in Kuwait, which illustrates how the centre and its activities in Kuwait can serve the EMRO region of WHO.
Ball, R; Robb, M; Anderson, S A; Dal Pan, G
In May 2008, the Department of Health and Human Services announced the launch of the Sentinel Initiative by the US Food and Drug Administration (FDA) to create the Sentinel System, a national electronic system for medical product safety surveillance. This system complements existing FDA surveillance capabilities that track adverse events reported after the use of FDA regulated products by allowing the FDA to proactively assess the safety of these products.
Lawson, D H
Both randomized controlled clinical trials and observational postmarketing surveillance studies have a place in providing information to physicians and patients on effectiveness and safety of new medicines. Prelicensing is the realm of the basic scientist producing a medicine which is available for investigation by clinical trial. In this context, manufacturers attempt to define the efficacy for desired indications and to establish an appropriate dosage for the drug. To do so, they usually confine attention to idealized standard patients, excluding all complex problems, such as pregnancy, renal or other organ failure, comorbidity, the elderly, the child, and so forth. Postmarketing surveillance covers the range of observational studies undertaken after marketing including cohort studies, case-control studies, and spontaneous reports of suspected adverse drug reactions. These observational studies are less rigorous than clinical trials, but have the potential to provide information from a representative sample of 'real-life' patients. Neither postmarketing surveillance studies nor clinical trials are capable of answering questions fully. In future, record linkage techniques may play a greater role by providing information on data linking drug exposures and outcomes in general practice.
Ohkusa, Yasushi; Yamaguchi, Ryo; Sugiura, Hiroaki; Sugawara, Tamie; Yoshida, Makiko; Shimada, Chie; Hori, Narumi; Sugishita, Yoshiyuki; Yasui, Yoshinori; Sunagawa, Tomimasa; Matsui, Tamano; Taniguchi, Kiyosu; Tada, Yuki; Taya, Keiko; Imamura, Tomoaki; Okabe, Nobuhiko
We conducted syndromic surveillance for the Hokkaido, Japan, Toyako Group of Eight (G8) summit meeting in July 2008 as a counter-measure to bioterrorism attacks and other health emergencies. Surveys were conducted from June 23, two weeks before the summit, to July 23 two weeks after it, with part of those for prescription drugs fully automated, and part by manual input over the World-Wide-Web. Those for ambulance transfer were done similarly. We bought over-the-counter (OTC) sales data from two private research firms in Japan and had the monitor, who had contacts with a private research company, report health conditions via personal computer (PC) or cellphone. We had a virtual conference daily at 9:00 with the local Hokkaido government, local public health center, local Hokkaido public laboratory, the National Institute of Infectious Diseases, and the Ministry of Health, Labor and Welfare to decide whether local public health centers would be required to investigate. Fully automated syndromic surveillance was conducted by 23 pharmacies for prescriptions drugs, and 71 pharmacies provided manual corporate input. One fire department covering Toyako and a VIP support team used fully automated syndromic surveillance and seven Toyako fire departments used manual input. For 79 pharmacies providing OTC sales data, data provision was delayed one day and analysis could not be automated. Four hundred and seventy two households corporate web search for their health conditions. It also automatically analyzed and feed backed. No notable outbreak occurred during the summit, but public health centers investigated seven aberration detected by syndrome surveillance for ambulance transfer. Although a fully automated system was concidered best for early outbreak detection manual input and analysis were also required. Routine, fully automatied syndromic surveillance remains to be realized in Japan.
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false What should I do if I do not agree that postmarket surveillance is appropriate? 822.7 Section 822.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Radiological Health's (CDRH's) Web site...
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false What should I do if I do not agree that postmarket surveillance is appropriate? 822.7 Section 822.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Radiological Health's (CDRH's) Web site (http://www.fda.gov/cdrh/ombudsman/dispute.html)....
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false What should I do if I do not agree that postmarket surveillance is appropriate? 822.7 Section 822.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Radiological Health's (CDRH's) Web site (http://www.fda.gov/cdrh/ombudsman/dispute.html)....
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false What should I do if I do not agree that postmarket surveillance is appropriate? 822.7 Section 822.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Radiological Health's (CDRH's) Web site...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false What should I do if I do not agree that postmarket surveillance is appropriate? 822.7 Section 822.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Radiological Health's (CDRH's) Web site (http://www.fda.gov/cdrh/ombudsman/dispute.html)....
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Drug counseling. 550.43 Section 550.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.43...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Drug counseling. 550.43 Section 550.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.43...
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Drug counseling. 550.43 Section 550.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.43...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Drug counseling. 550.43 Section 550.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.43...
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Drug counseling. 550.43 Section 550.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.43...
Dehcheshmeh, Nayeb Fadaei; Arab, Mohammad; Foroushani, Abbas Rahimi; Farzianpour, Fereshteh
Background: Communicable Disease Surveillance and reporting is one of the key elements to combat against diseases and their control. Fast and timely recognition of communicable diseases can be helpful in controlling of epidemics. One of the main sources of management of communicable diseases reporting is hospitals that collect communicable diseases’ reports and send them to health authorities. One of the focal problems and challenges in this regard is incomplete and imprecise reports from hospitals. In this study, while examining the implementation processes of the communicable diseases surveillance in hospitals, non-medical people who were related to the program have been studied by a qualitative approach. Methods: This study was conducted using qualitative content analysis method. Participants in the study included 36 informants, managers, experts associated with health and surveillance of communicable diseases that were selected using targeted sampling and with diverse backgrounds and work experience (different experiences in primary health surveillance and treatment, Ministry levels, university staff and operations (hospitals and health centers) and sampling was continued until arrive to data saturation. Results: Interviews were analyzed after the elimination of duplicate codes and integration of them. Finally, 73 codes were acquired and categorized in 6 major themes and 21 levels. The main themes included: policy making and planning, development of resources, organizing, collaboration and participation, surveillance process, and monitoring and evaluation of the surveillance system. In point of interviewees, attention to these themes is necessary to develop effective and efficient surveillance system for communicable diseases. Conclusion: Surveillance system in hospitals is important in developing proper macro - policies in health sector, adoption of health related decisions and preventive plans appropriate to the existing situation. Compilation, changing
Malaviya, Paritosh; Picado, Albert; Hasker, Epco; Ostyn, Bart; Kansal, Sangeeta; Singh, Rudra Pratap; Shankar, Ravi; Boelaert, Marleen; Sundar, Shyam
The Muzaffarpur-TMRC Health and Demographic Surveillance System (HDSS), established in 2007, was developed as an enlargement of the scope of a research collaboration on the project Visceral Leishmaniasis in Bihar, which had been ongoing since 2005. The HDSS is located in a visceral leishmaniasis (VL)-endemic area in the Muzaffarpur district of Bihar state in India. It is the only HDSS conducting research on VL, which is a vector-borne infectious disease transmitted by female phlebotomine sandflies and is fatal if left untreated. Currently the HDSS serves a population of over 105 000 in 66 villages. The HDSS collects data on vital events including pregnancies, births, deaths, migration and marriages, as well as other socio-economic indicators, at regular intervals. Incident VL cases are identified. The HDSS team is experienced in conducting both qualitative and quantitative studies, sample collection and rapid diagnostic tests in the field. In each village, volunteers connect the HDSS team with the community members. The Muzaffarpur-TMRC HDSS provides opportunities for studies on VL and other neglected tropical diseases (NTDs) and their interaction with demographic events such as migration. Queries related to research collaborations and data sharing can be sent to Dr Shyam Sundar at [firstname.lastname@example.org]. PMID:25186307
Alabi, Olatunji; Doctor, Henry V; Jumare, Abdulazeez; Sahabi, Nasiru; Abdulwahab, Ahmad; Findley, Sally E; Abubakar, Sani D
The Nahuche Health and Demographic Surveillance System (HDSS) study site, established in 2009 with 137 823 individuals is located in Zamfara State, north western Nigeria. North-West Nigeria is a region with one of the worst maternal and child health indicators in Nigeria. For example, the 2013 Nigeria Demographic and Health Survey estimated an under-five mortality rate of 185 deaths per 1000 live births for the north-west geo-political zone compared with a national average of 128 deaths per 1000 live births. The site comprises over 100 villages under the leadership of six district heads. Virtually all the residents of the catchment population are Hausa by ethnicity. After a baseline census in 2010, regular update rounds of data collection are conducted every 6 months. Data collection on births, deaths, migration events, pregnancies, marriages and marriage termination events are routinely conducted. Verbal autopsy (VA) data are collected on all deaths reported during routine data collection. Annual update data on antenatal care and household characteristics are also collected. Opportunities for collaborations are available at Nahuche HDSS. The Director of Nahuche HDSS, M.O. Oche at [email@example.com] is the contact person for all forms of collaboration.
Chee, Brant W; Berlin, Richard; Schatz, Bruce
Adverse drug events (ADEs) remain a large problem in the United States, being the fourth leading cause of death, despite post market drug surveillance. Much post consumer drug surveillance relies on self-reported "spontaneous" patient data. Previous work has performed datamining over the FDA's Adverse Event Reporting System (AERS) and other spontaneous reporting systems to identify drug interactions and drugs correlated with high rates of serious adverse events. However, safety problems have resulted from the lack of post marketing surveillance information about drugs, with underreporting rates of up to 98% within such systems. We explore the use of online health forums as a source of data to identify drugs for further FDA scrutiny. In this work we aggregate individuals' opinions and review of drugs similar to crowd intelligence3. We use natural language processing to group drugs discussed in similar ways and are able to successfully identify drugs withdrawn from the market based on messages discussing them before their removal.
as critical human resources development, must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses; (ii) harnessing all stakeholders commitment and advocacy in sustained funding, collaboration, communication and networking including community participation to enhance a coordinated responses, as well as tracking and prompt case management to combat challenges; (iii) more research and development in new drug discovery and vaccines; and (iv) understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning, as well as monitoring and evaluation in upholding research-action programmes and innovative interventions. PMID:25120913
Klimenko, N. N.; Nazarov, A. E.
The structure and orbital configuration of the advanced space system for geostationary orbit surveillance, as well as possible approaches to the development of the satellite bus and payload for the geostationary orbit surveillance, are considered.
Lesperance, Ann M.; Mahy, Heidi A.
On June 1, 2006, public health officials working in surveillance, epidemiological modeling, and information technology communities from the Seattle/Tacoma area and State of Washington met with members of the Pacific Northwest National Laboratory (PNNL) to discuss the current state of disease surveillance and gaps and needs to improve the current systems. The meeting also included a discussion of PNNL initiatives that might be appropriate to enhance disease surveillance and the current tools being used for disease surveillance. Participants broke out into two groups to identify critical gaps and needs for improving a surveillance system, and discuss the requirements for developing improved surveillance. Each group developed a list of key priorities summarizing the requirements for improved surveillance. The objective of this meeting was to work towards the development of an improved disease surveillance system.
Wagstaff, K H; Dickson, S L; Bailey, A
The history of WEE surveillance in Utah is reviewed, beginning with the 1933 outbreak involving 3,958 horses. The step by step formation of the Utah Mosquito Abatement Associations surveillance program from 1957 to the present is discussed. Results of an enlarged sentinel chicken flock surveillance program in Utah during 1983 (3 sero-conversions in September), 1984 and 1985 (no sero-conversion) show the lack of WEE activity in the surveillance area.
Centers for Disease Control (DHHS/PHS), Atlanta, GA.
This report summarizes information, including selected indices of nutritional status, as reported from 28 states and the District of Columbia to the Nutritional Status Surveillance System. This system has two components, one addressing nutritional status among high-risk pediatric populations, and the other addressing nutritional status among…
Carrano, Carmen J.; Brase, James M.
A surveillance system looks through the atmosphere along a horizontal or slant path. Turbulence along the path causes blurring. The blurring is corrected by speckle processing short exposure images recorded with a camera. The exposures are short enough to effectively freeze the atmospheric turbulence. Speckle processing is used to recover a better quality image of the scene.
Miller, J. A.; And Others
The role analytical instrumentation performs in the surveillance and control of the quality of water resources is reviewed. Commonly performed analyses may range from simple tests for physical parameters to more highly sophisticated radiological or spectrophotometric methods. This publication explores many of these types of water quality analyses…
Macdoran, P. F.
Passive ground-based radio-interferometry systems (RILS) monitor local air traffic by determining aircraft position in planes defined by surveillance area. Similar RILS arrangements are used to determine aircraft positions in three dimensions when combined with azimuth and range information obtained by radar. Information helps determine three-dimensional aircraft position without expensive encoding altimeters.
Hsu, Charles; Szu, Harold
An intelligent video surveillance system is able to detect and identify abnormal and alarming situations by analyzing object movement. The Smart Sensing Surveillance Video (S3V) System is proposed to minimize video processing and transmission, thus allowing a fixed number of cameras to be connected on the system, and making it suitable for its applications in remote battlefield, tactical, and civilian applications including border surveillance, special force operations, airfield protection, perimeter and building protection, and etc. The S3V System would be more effective if equipped with visual understanding capabilities to detect, analyze, and recognize objects, track motions, and predict intentions. In addition, alarm detection is performed on the basis of parameters of the moving objects and their trajectories, and is performed using semantic reasoning and ontologies. The S3V System capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments. It would be directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.
Wickramasuriya, Jehan; Alhazzazi, Mohanned; Datt, Mahesh; Mehrotra, Sharad; Venkatasubramanian, Nalini
Forms of surveillance are very quickly becoming an integral part of crime control policy, crisis management, social control theory and community consciousness. In turn, it has been used as a simple and effective solution to many of these problems. However, privacy-related concerns have been expressed over the development and deployment of this technology. Used properly, video cameras help expose wrongdoing but typically come at the cost of privacy to those not involved in any maleficent activity. This work describes the design and implementation of a real-time, privacy-protecting video surveillance infrastructure that fuses additional sensor information (e.g. Radio-frequency Identification) with video streams and an access control framework in order to make decisions about how and when to display the individuals under surveillance. This video surveillance system is a particular instance of a more general paradigm of privacy-protecting data collection. In this paper we describe in detail the video processing techniques used in order to achieve real-time tracking of users in pervasive spaces while utilizing the additional sensor data provided by various instrumented sensors. In particular, we discuss background modeling techniques, object tracking and implementation techniques that pertain to the overall development of this system.
Kirkwood, Carl D; Roczo-Farkas, Susie; Bishop, Ruth F; Barnes, Graeme L
This report from the Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, describes the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2012. During the survey period, 1,300 faecal samples were referred to the centre for rotavirus G and P genotype analysis, and of these 748 were confirmed as rotavirus positive. A total of 491 specimens were collected from children under 5 years of age, while 257 were from older children and adults. Genotype analysis revealed that G1P was the dominant type in this reporting period, identified in 35% of strains nationally. Genotype G2P was the second most common strain nationally, representing 28% of samples, followed by genotype G12P (23%). This represents the first report where G12P strains are a major cause of disease in this community. Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G2P was more common in states and territories using Rotarix while G1P was more common in states using RotaTeq. This survey of rotavirus strains circulating in 2012 highlights the continued fluctuations in rotavirus genotypes, with an annual change in dominant genotypes as well as emergence of a previously rare genotype, suggesting a dynamic wild-type population.
... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.12 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.12 Source surveillance. (a) Each subpart identifies the plan provisions for source surveillance which are disapproved, and sets forth...
The growth of surveillance in UK schools in recent years has resulted in the development of what can be labelled as the surveillance curriculum. Operating through the overt and hidden curricula, contemporary surveillance practices and technologies not only engage students in a discourse of control, but also increasingly socialise them into a…
Mneimneh, Allison S; Boulet, Sheree L; Sunderam, Saswati; Zhang, Yujia; Jamieson, Denise J; Crawford, Sara; McKane, Patricia; Copeland, Glenn; Mersol-Barg, Michael; Grigorescu, Violanda; Cohen, Bruce; Steele, JoAnn; Sappenfield, William; Diop, Hafsatou; Kirby, Russell S; Kissin, Dmitry M
Assisted reproductive technology (ART) refers to fertility treatments in which both eggs and sperm are handled outside the body. The Centers for Disease Control and Prevention (CDC) oversees the National ART Surveillance System (NASS), which collects data on all ART procedures performed in the United States. The NASS, while a comprehensive source of data on ART patient demographics and clinical procedures, includes limited information on outcomes related to women's and children's health. To examine ART-related health outcomes, CDC and three states (Massachusetts, Florida, and Michigan) established the States Monitoring ART (SMART) Collaborative to evaluate maternal and perinatal outcomes of ART and improve state-based ART surveillance. To date, NASS data have been linked with states' vital records, disease registries, and hospital discharge data with a linkage rate of 90.2%. The probabilistic linkage methodology used in the SMART Collaborative has been validated and found to be both accurate and efficient. A wide breadth of applied research within the Collaborative is planned or ongoing, including examinations of the impact of insurance mandates on ART use as well as the relationships between ART and birth defects and cancer, among others. The SMART Collaborative is working to improve state-based ART surveillance by developing state surveillance plans, establishing partnerships, and conducting data analyses. The SMART Collaborative has been instrumental in creating linked datasets and strengthening epidemiologic and research capacity for improving maternal and infant health programs and evaluating the public health impact of ART.
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program.
Background In 1985, a bat researcher in Finland died of rabies encephalitis caused by European bat lyssavirus type 2 (EBLV-2), but an epidemiological study in 1986 did not reveal EBLV-infected bats. In 2009, an EBLV-2-positive Daubenton’s bat was detected. The EBLV-2 isolate from the human case in 1985 and the isolate from the bat in 2009 were genetically closely related. In order to assess the prevalence of EBLVs in Finnish bat populations and to gain a better understanding of the public health risk that EBLV-infected bats pose, a targeted active surveillance project was initiated. Results Altogether, 1156 bats of seven species were examined for lyssaviruses in Finland during a 28–year period (1985–2012), 898 in active surveillance and 258 in passive surveillance, with only one positive finding of EBLV-2 in a Daubenton’s bat in 2009. In 2010–2011, saliva samples from 774 bats of seven species were analyzed for EBLV viral RNA, and sera from 423 bats were analyzed for the presence of bat lyssavirus antibodies. Antibodies were detected in Daubenton’s bats in samples collected from two locations in 2010 and from one location in 2011. All seropositive locations are in close proximity to the place where the EBLV-2 positive Daubenton’s bat was found in 2009. In active surveillance, no EBLV viral RNA was detected. Conclusions These data suggest that EBLV-2 may circulate in Finland, even though the seroprevalence is low. Our results indicate that passive surveillance of dead or sick bats is a relevant means examine the occurrence of lyssavirus infection, but the number of bats submitted for laboratory analysis should be higher in order to obtain reliable information on the lyssavirus situation in the country. PMID:24011337
Mendes, Mónica; Ângelo, Pedro; Correia, Nuno; Nisi, Valentina
Arts, Real-Time Video and Interactivity for Sustainability (ARTiVIS) is an ongoing collaborative research project investigating how real-time video, DIY surveillance technologies and sensor data can be used as a tool for environmental awareness, activism and artistic explorations. The project consists of a series of digital contexts for aesthetic contemplation of nature and civic engagement, aiming to foster awareness and empowerment of local populations through DIY surveillance. At the core of the ARTIVIS efforts are a series of interactive installations (namely B-Wind!, Hug@tree and Play with Fire), that make use of surveillance technologies and real-time video as raw material to promote environmental awareness through the emotion generated by real-time connections with nature. Throughout the project development, the surveillance concept has been shifting from the use of surveillance technology in a centralized platform, to the idea of veillance with distributed peer-to-peer networks that can be used for science and environmental monitoring. In this paper we present the history of the ARTiVIS project, related and inspiring work, describe ongoing research work and explore the present and future challenges of appropriating surveillance technology for artistic, educational and civic engagement purposes.
Singh, Sarah; Parker, David; Mark-Carew, Miguella; White, Robert; Fisher, Melanie
Lyme disease case misclassification, a top public health concern, may be attributed to the current disconnect between clinical diagnosis and surveillance. This study examines Lyme disease distribution in West Virginia (WV) and determines clinicians' knowledge of both disease and surveillance. Lyme disease surveillance data for 2013 were obtained from the WV Bureau for Public Health. A validated survey, distributed to clinicians at an academic medical center, assessed clinicians' knowledge of disease diagnosis and surveillance. There were 297 adult Lyme disease cases of which 83 were confirmed. Clinician survey responses resulted in a correct response rate of 70% for Lyme disease knowledge questions. Fewer than half of all clinicians were aware of the surveillance criteria for confirming Lyme disease cases. Neither medical specialty nor previous treatment of patients with Lyme disease were significantly associated with clinicians' knowledge of the disease. Clinicians in WV are familiar with symptoms and clinical management of Lyme disease. However, they are less knowledgeable about diagnosis and public health surveillance comprising reporting and confirming cases of the disease. Clinicians and public health authorities should collaborate more closely to promote education and awareness as a key step to successfully reducing the burden of Lymne disease.
Smart, R.J.; Duda, J.E.
The implementation of a quality surveillance program can be painless and productive. The system described in this report has been in use at the Fast Flux Test Facility (FFTF) for more than a year and effectively fills the void between audits and inspections. Recognized benefits of this system include: minimum administrative overhead; excellent management overview; ease of implementing trending efforts; audit supplement; fully computerization; lower cost than traditional methods; early problem detection, adaptability to other projects and facilities.
Lienhardt, Christian; Raviglione, Mario; Spigelman, Mel; Hafner, Richard; Jaramillo, Ernesto; Hoelscher, Michael; Zumla, Alimuddin; Gheuens, Jan
For the first time in 40 years, a portfolio of promising new compounds for the treatment of tuberculosis is on the horizon. The introduction of new drugs in combination treatment for all forms of tuberculosis raises several issues related to patients' access to novel treatments, programmatic feasibility, cost effectiveness, and implications for monitoring and surveillance, particularly with regard to the development of drug resistance. Particular attention should be given to the identification of optimal drug combination(s) for the treatment of all forms of tuberculosis, particularly in high-risk and vulnerable groups, such as human immunodeficiency virus-coinfected persons and children, and to the rational use of new drugs. Addressing these issues adequately requires the establishment of clear guidelines to assist countries in the development of policies for the proper use of tuberculosis drugs in a way that guarantees access to best treatments for all those in need and avoids inappropriate use of new drugs. After a description of these various challenges, we present activities that will be carried out by the World Health Organization in collaboration with key stakeholders for the development of policy guidelines for optimal treatment of tuberculosis.
Problem/Condition: Since 1978, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data on occurrences and causes...
Erdman, Laura K; Kain, Kevin C
Malaria is the most devastating parasitic infection in the world, annually causing over 1 million deaths and extensive morbidity. The global burden of malaria has increased over the last several decades, as have rates of imported malaria into non-endemic regions. Rapid and accurate diagnostics are a crucial component of malaria control strategies, and epidemiological surveillance is required to monitor trends in malaria prevalence and antimalarial drug resistance. Conventional malaria diagnostic and surveillance tools can be cumbersome and slow with limitations in both sensitivity and specificity. New molecular techniques have been developed in an attempt to overcome these restrictions. These molecular techniques are discussed with regard to their technical advantages and disadvantages, with an emphasis on the practicality of implementation in malaria-endemic and non-endemic regions.
The Elko County School District in Nevada has elementary school librarians that are "solo" librarians. Over the last several years they have worked to collaborate on meeting monthly--even though the district covers 17,100 square miles--and on providing professional development face to face and online. Sharing and collaboration help them…
When teachers and school librarians work together, student achievement increases. Librarians know this and have made sure their teachers and administrators know this as well. But it's a giant leap from knowing the value of collaboration and actually collaborating. The only way to convince teachers to take that step is to convince them that the…
Tumminello, Joanna; Carlshamre, Par
Presents a case study of a year-long collaboration over the Internet between a systems analyst from Sweden and a technical communicator from the United States that resulted in a conference paper. Describes the progress of the collaboration, the major difficulties encountered, and the authors' conclusion about its success. Suggests how to improve…
Schneider, Bertrand; Pea, Roy
We describe preliminary applications of network analysis techniques to eye-tracking data collected during a collaborative learning activity. This paper makes three contributions: first, we visualize collaborative eye-tracking data as networks, where the nodes of the graph represent fixations and edges represent saccades. We found that those…
Espinoza, Sue; McKinzie, LeAnn
This paper describes two collaborative projects conducted with graduate students from Texas A&M University-Commerce and West Texas A&M University during the fall semesters of 1997 and 1998. The instructors, with a history of personal collaboration both in person and online, designed an activity to provide their graduate students with the…
Blake, Canan; Scanlon, Eileen
Online learning environments offer new opportunities for learning and over the last decade or so a variety of online learning environments have been developed by researchers to facilitate collaborative learning among students. In this paper we will present a case study of a successful collaborative learning design. This involves a near synchronous…
Huxham, Chris, Ed.
Although interorganizational collaboration is becoming increasingly significant as a means of achieving organizational objectives, it is not an easy process to implement. Drawing on the work of authors with extensive experience, an accessible introduction to the theory and practice of creating collaborative advantage is presented in this volume.…
Accelerating site cleanup to reduce facility risks to the workers, the public and the environment during a time of declining federal budgets represents a significant technical and economic challenge to U.S. Department of Energy (DOE) Operations Offices and their respective contractors. A significant portion of a facility's recurring annual expenses are associated with routine, long-term surveillance and maintenance (S&M) activities. However, ongoing S&M activities do nothing to reduce risks and basically spend money that could be reallocated towards facility deactivation. This paper discusses the background around DOE efforts to reduce surveillance and maintenance costs, one approach used to perform cost reviews, lessons learned from field implementation and what assistance is available to assist DOE sites in performing these evaluations.
Bisping, L E
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. Samples for radiological analyses include Air-Particulate Filter, gases and vapor; Water/Columbia River, Onsite Pond, Spring, Irrigation, and Drinking; Foodstuffs/Animal Products including Whole Milk, Poultry and Eggs, and Beef; Foodstuffs/Produce including Leafy Vegetables, Vegetables, and Fruit; Foodstuffs/Farm Products including Wine, Wheat and Alfalfa; Wildlife; Soil; Vegetation; and Sediment. Direct Radiation Measurements include Terrestrial Locations, Columbia River Shoreline Locations, and Onsite Roadway, Railway and Aerial, Radiation Surveys.
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL)(a) for the US Department of Energy (DOE). This document contains the planned 1997 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. In addition, Section 3.0, Biota, also reflects a rotating collection schedule identifying the year a specific sample is scheduled for collection. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, General Environmental Protection Program, and DOE Order 5400.5, Radiation Protection of the Public and the Environment. The sampling methods will be the same as those described in the Environmental Monitoring Plan, US Department of Energy, Richland Operations Office, DOE/RL91-50, Rev. 1, US Department of Energy, Richland, Washington.
Lowry, R Brian
Congenital anomalies (CA) are present in approximately 3% of all newborn babies and account for about 12% of paediatric hospital admissions. They represent an important public health problem. Surveillance is especially important so that preventive measures such as folic acid fortification can be properly assessed without resorting to a series of ad hoc studies. Canada's surveillance of CAs is weak, with only Alberta and British Columbia having established sytems. Most provinces have perinatal systems but their CA data are incomplete and they do not capture terminations of pregnancy. The same is true of the Public Health Agency of Canada's system. A new system, the Fetal Alert Network, has been proposed for Ontario, which represents a start but will require additional sources of ascertainment if it is to be a truly population-based system for Ontario.
A technique adapted by Livermore scientists to take the twinkle out of stars is now being used to improve the resolution of long-range surveillance systems trained on earthbound objects. The speckle-imaging technique involves taking tens to hundreds of pictures with short-exposure times and reconstructing a single, sharp image using image-processing software. The technique drew the interest of Livermore engineer Carmen Carrano. She developed a prototype remote-surveillance system that can produce a detailed image of a face from a couple of kilometers away. The system also helps identify vehicles tens of kilometers away and improves the viewing of large structures more than 60 kilometers away.
Australia's geography and technology base got it off to a flying start in the early days of surveillance of space, starting with CSIRO's first radio telescope in the 1940's and climaxing in NASA's establishment of station 43 in the Deep Space Network at Tidbinbilla in 1965. But Britain's exit from space and the subsequent closure of the Woomera launch range and associated space tracking facilities in the early 1970's saw the start of a long draw-down of capability. Programs such as CSIRO's radio astronomy telescopes, Electro-Optic Systems' adoption of laser technology for satellite laser ranging and tracking system, and the exploration of the use of technology developed in Australia's over-the-horizon-radar program for surveillance of space, kept some interest in the problem alive, but there has been no serious national investment in the area for the last thirty years. Recently, however, increased awareness of the vulnerability of space systems and the need to include potential opponents' space capabilities in operations planning has led to a revival of interest in space situational awareness within the Australian Defence Organisation. While firm commitments to new systems must wait on the next Defence White Paper due out at the end of 2007 and the policy directions it formally endorses, discussions have already started with the US on participating in the Space Surveillance Network (SSN) and developing a comprehensive space situational awareness capability. In support of these initiatives the Defence Science and Technology Organisation (DSTO) is drawing up an inventory of relevant Australian capabilities, technologies and activities: the paper will describe the findings of this inventory, and in particular local technologies and systems that might be deployed in Australia to contribute to the SSN. In the optical regime the available options are rather limited; they centre primarily on the satellite laser ranging technology developed by Electro-Optic Systems and
Jobe, John T.
The realignment of international powers, and the formation of new nations has resulted in increasing worldwide concern over border security, an expanding refugee problem, protection of fishery and mineral areas, and smuggling of all types. The focus on military services, to protect or defend against these threats of vital, national interest, is shifting to other government agencies and even commercial contractors to apply innovative and cost effective solutions. Previously, airborne surveillance and reconnaissance platforms have been large, mission dedicated military aircraft. The time has arrived for a smaller, more efficient, and more effective airborne capability. This paper briefly outlines a system of systems approach that smaller nations can afford to incorporate in their budgets, while greatly expanding their surveillance capability. The characteristics of specific cameras and sensors are purposely not addressed, so the emphasis can be placed on the integration of multiple sensors and capabilities.
Davis, R.; Porter, L. C., Jr.
The program effort during this reporting period consisted of laboratory testing of both the Morton Thiokol, Inc./ASPC Minuteman 3 Third Stage Surveillance components and material samples. In addition, bondline aging testing and analysis using samples from previously dissected motors were accomplished. In support of the program, all flight and static tests, for both First and Third Stage Minuteman motors, were reviewed and tabulated for incorporation into reliability and motor historical records.
Fujikawa, Gene (Compiler)
The Integrated Communications, Navigational and Surveillance (ICNS) Technologies Conference and Workshop provides a forum for Government, industry, and academic communities performing research and technology development for advanced digital communications, navigation, and surveillance security systems and associated applications supporting the national and global air transportation systems. The event's goals are to understand current efforts and recent results in near-and far-term research and technology demonstration; identify integrated digital communications, navigation and surveillance research requirements necessary for a safe, high-capacity, advanced air transportation system; foster collaboration and coordination among all stakeholders; and discuss critical issues and develop recommendations to achieve the future integrated CNS vision for the national and global air transportation system.
Ponchak, Denise (Compiler)
The Integrated Communications, Navigation and Surveillance (ICNS) Technologies Conference and Workshop provides a forum for government, industry, and academic communities performing research and technology development for advanced digital communications, navigation, and surveillance security systems and associated applications supporting the national and global air transportation systems. The event s goals are to understand current efforts and recent results in near- and far-term research and technology demonstration; identify integrated digital communications, navigation and surveillance research requirements necessary for a safe, high-capacity, advanced air transportation system; foster collaboration and coordination among all stakeholders; and discuss critical issues and develop recommendations to achieve the future integrated CNS vision for the national and global air transportation system.
Buehler, G.; Arctur, D. K.; Bermudez, L. E.
The mission of the Open Geospatial Consortium (OGC) is to serve as a global forum for the collaboration of developers and users of spatial data products and services, and to advance the development of international standards for geospatial interoperability. The OGC coordinates with over 400 institutions in the development of geospatial standards. OGC has a dedicated staff supported by a Collaborative Web Platform to enable sophisticated and successful coordination among its members. Since its origins in the early 1990s, the OGC Collaborative Web Platform has evolved organically to be the collaboration hub for standards development in the exchange of geospatial and related types of information, among a global network of thousands of technical, scientific and management professionals spanning numerous disparate application domains. This presentation describes the structure of this collaboration hub, the relationships enabled (both among and beyond OGC members), and how this network fits in a broader ecosystem of technology development and information standards organizations.
Gysin, Suzanne; Mandrichenko, Igor; Podstavkov, Vladimir; Vittone, Margherita
In HEP, scientific research is performed by large collaborations of organizations and individuals. The logbook of a scientific collaboration is an important part of the collaboration record. Often it contains experimental data. At Fermi National Accelerator Laboratory (FNAL), we developed an Electronic Collaboration Logbook (ECL) application, which is used by about 20 different collaborations, experiments and groups at FNAL. The ECL is the latest iteration of the project formerly known as the Control Room Logbook (CRL). We have been working on mobile (IOS and Android) clients for the ECL. We will present the history, current status and future plans of the project, as well as design, implementation and support solutions made by the project.
This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring the onsite drinking water falls outside the scope of the SESP. The Hanford Environmental Health Foundation is responsible for monitoring the nonradiological parameters as defined in the National Drinking Water Standards while PNL conducts the radiological monitoring of the onsite drinking water. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize the expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control and reporting. The ground-water sampling schedule identifies ground-water sampling events used by PNL for environmental surveillance of the Hanford Site.
Kimberly, Howard R.; Shipers, Larry R.
Long-term nuclear material storage will require in-vault data verification, sensor testing, error and alarm response, inventory, and maintenance operations. System concept development efforts for a comprehensive nuclear material management system have identified the use of a small flexible mobile automation platform to perform these surveillance and maintenance operations. In order to have near-term wide-range application in the Complex, a mobile surveillance system must be small, flexible, and adaptable enough to allow retrofit into existing special nuclear material facilities. The objective of the Mobile Surveillance and Monitoring Robot project is to satisfy these needs by development of a human scale mobile robot to monitor the state of health, physical security and safety of items in storage and process; recognize and respond to alarms, threats, and off-normal operating conditions; and perform material handling and maintenance operations. The system will integrate a tool kit of onboard sensors and monitors, maintenance equipment and capability, and SNL developed non-lethal threat response technology with the intelligence to identify threats and develop and implement first response strategies for abnormal signals and alarm conditions. System versatility will be enhanced by incorporating a robot arm, vision and force sensing, robust obstacle avoidance, and appropriate monitoring and sensing equipment.
Bruce, Michael G.; Zulz, Tammy
Peoples of the Arctic and sub-Arctic regions live in social and physical environments that differ substantially from those of their more southern-dwelling counterparts. The cold northern climate keeps people indoors, amplifying the effects of household crowding, smoking, and inadequate ventilation on person-to-person spread of infectious disease. The emergence of antimicrobial drug resistance among bacterial pathogens, the reemergence of tuberculosis, the entrance of HIV into Arctic communities, and the specter of pandemic influenza or the sudden emergence and introduction of new viral pathogens such as severe acute respiratory syndrome are of increasing concern to residents, governments, and public health authorities. The International Circumpolar Surveillance system is a network of hospital, public health agencies, and reference laboratories throughout the Arctic linked together to collect, compare, and share uniform laboratory and epidemiologic data on infectious diseases and assist in the formulation of prevention and control strategies. PMID:18258072
Salama, P; Dondero, T J
Many studies have shown a positive association between both migration and temporary expatriation and HIV risk. This association is likely to be similar or even more pronounced for forced migrants. In general, HIV transmission in host-migrant or host-forced-migrant interactions depends on the maturity of the HIV epidemic in both the host and the migrant population, the relative seroprevalence of HIV in the host and the migrant population, the prevalence of other sexually transmitted infections (STIs) that may facilitate transmission, and the level of sexual interaction between the two communities. Complex emergencies are the major cause of mass population movement today. In complex emergencies, additional factors such as sexual interaction between forced-migrant populations and the military; sexual violence; increasing commercial sex work; psychological trauma; and disruption of preventive and curative health services may increase the risk for HIV transmission. Despite recent success in preventing HIV infection in stable populations in selected developing countries, internally displaced persons and refugees (or forced migrants) have not been systematically included in HIV surveillance systems, nor consequently in prevention activities. Standard surveillance systems that rely on functioning health services may not provide useful data in many complex emergency settings. Secondary sources can provide some information in these settings. Little attempt has been made, however, to develop innovative HIV surveillance systems in countries affected by complex emergencies. Consequently, data on the HIV epidemic in these countries are scarce and HIV prevention programs are either not implemented or interventions are not effectively targeted. Second generation surveillance methods such as cross-sectional, population-based surveys can provide rapid information on HIV, STIs, and sexual behavior. The risks for stigmatization and breaches of confidentiality must be recognized
LAW, R. K.; SHEIKH, S.; BRONSTEIN, A.; THOMAS, R.; SPILLER, H. A.; SCHIER, J. G.
Background The Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers conduct national surveillance on data collected by US poison centers to identify incidents of potential public health significance (IPHS). The overarching goals of this collaboration are to improve CDC’s national surveillance capacity for public health threats, identify early markers of public health incidents and enhance situational awareness. The National Poison Data System (NPDS) is used as a surveillance system to automatically identify data anomalies. Purpose To characterize data anomalies and IPHS captured by national surveillance of poison center data over 5 years. Methods Data anomalies are identified through three surveillance methodologies: call-volume, clinical effect, and case-based. Anomalies are reviewed by a team of epidemiologists and clinical toxicologists to determine IPHS using standardized criteria. The authors reviewed IPHS identified by these surveillance activities from 2008 through 2012. Results Call-volume surveillance identified 384 IPHS; most were related to gas and fume exposures (n=229; 59.6%) with the most commonly implicated substance being carbon monoxide (CO) (n=92; 22.8%). Clinical-effect surveillance identified 138 IPHS; the majority were related to gas and fume exposures (n=58; 42.0%) and gastrointestinal complaints (n=84; 16.2%), and the most commonly implicated substance was CO (n=20; 14.4%). Among the 11 case-based surveillance definitions, the botulism case definition yielded the highest percentage of identified agent-specific illness. Conclusions A small proportion of data anomalies were designated as IPHS. Of these, CO releases were the most frequently reported IPHS and gastrointestinal syndromes were the most commonly reported illness manifestations. poison center data surveillance may be used as an approach to identify exposures, illnesses, and incidents of importance at the national and state level
Li, Michael; Bryson, Joe
Collaboratives for energy efficiency have a long and successful history and are currently used, in some form, in more than half of the states. Historically, many state utility commissions have used some form of collaborative group process to resolve complex issues that emerge during a rate proceeding. Rather than debate the issues through the formality of a commission proceeding, disagreeing parties are sent to discuss issues in a less-formal setting and bring back resolutions to the commission. Energy efficiency collaboratives take this concept and apply it specifically to energy efficiency programs—often in anticipation of future issues as opposed to reacting to a present disagreement. Energy efficiency collaboratives can operate long term and can address the full suite of issues associated with designing, implementing, and improving energy efficiency programs. Collaboratives can be useful to gather stakeholder input on changing program budgets and program changes in response to performance or market shifts, as well as to provide continuity while regulators come and go, identify additional energy efficiency opportunities and innovations, assess the role of energy efficiency in new regulatory contexts, and draw on lessons learned and best practices from a diverse group. Details about specific collaboratives in the United States are in the appendix to this guide. Collectively, they demonstrate the value of collaborative stakeholder processes in producing successful energy efficiency programs.
Wiley, H. S.
Collaborations are becoming increasing important in biology because of the need to apply multiple technologies to tackle the most complex current problems. The U.S. National Institutes of Health recognizes this need, and has created the “multi-investigator” granting mechanism to facilitate this process. I have reviewed a number of proposals that utilize the multi-investigator mechanism and have generally found them to be superior to individual investigator grants. Setting up a good collaboration, however, can be extremely difficult. Like any relationship, collaborations take time and energy. Still, there is nothing that can accelerate your research faster or expand your intellectual horizons more.
Singh, Kundan; Wu, Xiaotao; Lennox, Jonathan; Schulzrinne, Henning G.
We describe the architecture and implementation of our comprehensive multi-platform collaboration framework known as Columbia InterNet Extensible Multimedia Architecture (CINEMA). It provides a distributed architecture for collaboration using synchronous communications like multimedia conferencing, instant messaging, shared web-browsing, and asynchronous communications like discussion forums, shared files, voice and video mails. It allows seamless integration with various communication means like telephones, IP phones, web and electronic mail. In addition, it provides value-added services such as call handling based on location information and presence status. The paper discusses the media services needed for collaborative environment, the components provided by CINEMA and the interaction among those components.
Berdondini, Lucia; Elliott, Robert; Shearer, Joan
We offer a view of the nature and role of client-therapist collaboration in experiential psychotherapy, focusing on Gestalt and emotion-focused therapy (EFT). We distinguish between the necessary condition of mutual trust (the emotional bond between client and therapist) and effective collaboration (regarding the goals and tasks of therapy). Using a case study of experiential therapy for social anxiety, we illustrate how the development of collaboration can be both complex and pivotal for therapeutic success, and how it can involve client and therapist encountering one another through taking risks by openly and nonjudgementally disclosing difficult experiences in order to enrich and advance the work.
Zimmer, P.; Ackermann, M.; McGraw, J.
J.T. McGraw and Associates, LLC, in collaboration with the University of New Mexico (UNM), has built and is operating two proof-of-concept wide-field imaging systems to test novel techniques for uncued surveillance of LEO. The imaging systems are built from off-the-shelf optics and detectors resulting in a 350mm aperture and a 6 square degree field of view. For streak detection, field of view is of critical importance because the maximum exposure time on the object is limited by its crossing time and measurements of apparent angular motion are better constrained with longer streaks. The current match of the detector to the optical system is optimized for detection of objects at altitudes above 450km, which for a circular orbit, corresponds to apparent motions of approximately 1 deg./sec. Using our GPU-accelerated detection scheme, the proof-of-concept systems have detected objects fainter than V=12.3, which approximately corresponds to a 24 cm object at 1000 km altitude at better than 6 sigma significance, from sites near and within Albuquerque, NM. This work demonstrates scalable optical systems designed for near real time detection of fast moving objects, which can be then handed off to other instruments capable of tracking and characterizing them. The two proof-of-concept systems, separated by ~30km, work together by taking simultaneous images of the same orbital volume to constrain the orbits of detected objects using parallax measurements. These detections are followed-up by photometric observations taken at UNM to independently assess the objects and the quality of the derived orbits. We believe this demonstrates the potential of small telescope arrays for detecting and cataloguing heretofore unknown LEO objects.
Kirkwood, Carl D; Roczo-Farkas, Suzie
The Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, reports the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis. During the survey period of 1 January to 31 December 2014, 1,022 faecal samples were referred for rotavirus G and P genotype analysis, and of these 733 were confirmed as rotavirus positive. A total of 480 specimens were collected from children under 5 years of age, while 253 were from older children and adults. Genotype analysis of the 733 rotavirus samples collected from both children and adults revealed that G12P was the dominant genotype in this reporting period, identified in 29.6% of strains nationally. Genotype G1P was the 2nd most common strain nationally, representing 22.9% of samples, followed by genotype G3P (14.9%). This report highlights the continued significance of G12P strains as the major cause of disease in this population. The genotype distribution was slightly altered when the analysis was restricted to samples collected from children under 5 years of age, with G1P being the dominant genotype (29%) followed by G12P as the 2nd most common genotype (26%). Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G12P was more common in states and territories using RotaTeq, while G1P was more common in the locations using Rotarix. This survey highlights the yearly fluctuations in rotavirus genotypes observed since vaccine introduction. The continuation of G12P as the dominant genotype further illustrates the dynamic and diversity present in the wild-type rotavirus population evident in the Australian population since vaccine introduction.
Kirkwood, Carl D; Roczo-Farkas, Susie
This report from the Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, describes the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2013. During the survey period, 1,035 faecal samples were referred for rotavirus G and P genotype analysis. Of these 828 were confirmed as rotavirus positive. A total of 503 specimens were collected from children under 5 years of age, while 325 were from older children and adults. Genotype analysis of the 828 rotavirus samples collected from both children and adults revealed that G12P was the dominant genotype in this reporting period, identified in 33% of strains nationally. Genotype G3P was the second most common strain nationally, representing 31% of samples, followed by genotype G2P (14%). This represents the first report where G12P strains are the major cause of disease in this population. The genotype distribution was slightly altered when the analysis was restricted to samples collected from children under 5 years of age, with G3P being the dominant genotype (39.2%) followed by G12P as the second most common genotype (31%). Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G12P was more common in states and territories using RotaTeq, while G3P was more common in the locations using Rotarix. This survey highlights the yearly fluctuations in rotavirus genotypes observed since vaccine introduction, with changes in dominant genotypes an annual event. The emergence of G12P as the dominant genotype further illustrates the ongoing changes in the wild type rotavirus population evident in the Australian population since vaccine introduction.
Roczo-Farkas, Susie; Kirkwood, Carl D; Bines, Julie E
The Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, reports the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2015. During the survey period, 1,383 faecal samples were referred for rotavirus G and P genotype analysis, and of these, 1,031 were confirmed as rotavirus positive. A total of 634 specimens had been collected from children under 5 years of age, while 397 were from older children and adults. Genotype analysis of samples from both children and adults revealed that G12P was the dominant genotype in this reporting period, identified in 48.2% of strains nationally. Genotype G3P was the second most common strain nationally, representing 22.8% of samples, followed by G2P and G1P (9% and 8% respectively). G3P was further divided as equine-like G3P (13.2% of all strains) and other wild-type G3P (9.6%). This report highlights the continued predominance of G12P strains as the major cause of disease in this population. Genotype distribution was distinct between jurisdictions using RotaTeq and Rotarix vaccines. Genotype G12P was more common in states using RotaTeq, while equine-like G3P and G2P were more common in the states and territories using Rotarix. This survey highlights the dynamic change in rotavirus genotypes observed since vaccine introduction, including the emergence of a novel equine-like G3P as a major strain. The prolonged dominance of G12P for a 4th consecutive year further illustrates the unexpected trends in the wild type rotaviruses circulating in the Australian population since vaccine introduction.
GPP's Clean Energy Collaborative Procurement Initiative provides a platform for deploying clean energy technologies across multiple government and educational organizations for maximum impact on installed solar system capacity and local economic activity.
The United States and Israel focus on scientific and technical collaboration to protect the environment, by exchanging scientific and technical information, arranging visits of scientific personnel, cooperating in scientific symposia and workshops, etc.
For the last four years, EPA has been collaborating with Morocco on environmental governance through the Middle East Partnership Initiative (MEPI). Initial work with Morocco focused on water pollution from the textile industry.
EPA works with our Mexican neighbors on the U.S.-Mexico Environmental Program, a collaboration between the United States and Mexico to improve the environment and protect the health of the nearly 12 million people living along the border.
Deverell, Marie; Zurynski, Yvonne A; Elliott, Elizabeth J
This report provides an update on the surveillance conducted by the Australian Paediatric Surveillance Unit (APSU) during the period January to December 2013. The APSU facilitates national active surveillance of uncommon diseases of childhood including selected communicable diseases. This report includes data on the following conditions: acute flaccid paralysis (AFP), congenital cytomegalovirus (cCMV), congenital rubella, perinatal exposure to HIV and paediatric HIV infection, neonatal herpes simplex virus (HSV), congenital varicella, neonatal varicella, severe complications of varicella and juvenile onset recurrent respiratory papillomatosis (JoRRP). Surveillance of severe complications of influenza was undertaken during the influenza season (July to September 2013).
... use of any reliable contractor production control or data management systems. (d) In performing... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Production Surveillance and Reporting...
... use of any reliable contractor production control or data management systems. (d) In performing... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Production Surveillance and Reporting...
... use of any reliable contractor production control or data management systems. (d) In performing... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Production Surveillance and Reporting...
Wang, Yung-Hsuan J.; Andrews, Ross M.; Lambert, Stephen B.
OBJECTIVE: Many countries are implementing measles elimination strategies. In Australia, the State of Victoria has conducted enhanced measles surveillance since 1997 using case interviews and home-based specimen collection for laboratory confirmation. We attempted to identify features of notified cases that would better target surveillance resources. METHODS: We retrospectively classified notifications received from 1998 to 2003 as having been received in an epidemic (one or more laboratory-confirmed cases) or an interepidemic period (no laboratory-confirmed cases). We labelled the first case notified in any epidemic period that was not laboratory-confirmed at the time of notification as a "sentinel case". To maximize detection of sentinel cases while minimizing the follow-up of eventually discarded notifications, we generated algorithms using sentinel cases and interepidemic notifications. FINDINGS: We identified 10 sentinel cases with 422 interepidemic notifications from 1281 Victorian notifications. Sentinel cases were more likely to report fever at rash onset (odds ratio (OR) 15.7, 95% confidence interval (CI) CI: 2.1-688.9), cough (OR 10.4, 95% CI: 1.4-456.7), conjunctivitis (OR 7.9, 95% CI: 1.8-39.1), or year of birth between 1968 and 1981 (OR 31.8, 95% CI: 6.7-162.3). Prospective application of an algorithm consisting of fever at rash onset or born between 1968 and 1981 in the review period would have detected all sentinel cases and avoided the need for enhanced follow-up of 162 of the 422 eventually discarded notifications. CONCLUSION: Elimination strategies should be refined to suit regional and local priorities. The prospective application of an algorithm in Victoria is likely to reduce enhanced measles surveillance resource use in interepidemic periods, while still detecting early cases during measles outbreaks. PMID:16501727
I~D~·L Paper Number Collaborative Robotics Design Considerations ABSTRACT As research advances individual robot capabilities, a logical...progression is the use of multiple robots to complete a task more effectively. Mission performance can be improved by the ability to allocate robots with...diverse capabilities to perform different parts of a complex task. To paraphrase [, there are many advantages to enabling robotic collaborative
Kishamawe, Coleman; Isingo, Raphael; Mtenga, Baltazar; Zaba, Basia; Todd, Jim; Clark, Benjamin; Changalucha, John; Urassa, Mark
The Magu Health and Demographic Surveillance System (Magu HDSS) is part of Kisesa OpenCohort HIV Study located in a rural area of North-Western Tanzania. Since its establishment in 1994, information on pregnancies, births, marriages, migrations and deaths have been monitored and updated between one and three times a year by trained fieldworkers. Other research activities implemented in the cohort include: sero surveys which have been conducted every 2–3 years to collect socioeconomic data, HIV sero status and health knowledge attitude and behaviour in adults aged 15 years or more living in the area; verbal autopsy (VA) interviews conducted to establish cause of death in all deaths encountered in the area; Llnking data collected at health facilities to community-based data; monitoring voluntary counselling and testing (VCT); and assessing uptake of antiretroviral treatment (ART). In addition, within the community, qualitative studies have been conducted to address issues linked to HIV stigma, the perception of ART access and adherence. In 2014, the population was over 35 000 individuals. Magu HDSS has contributed to Tanzanian estimates of fertility and mortality, and is a member of the INDEPTH network. Demographic data for Magu HDSS are available via the INDEPTH Network’s Sharing and Accessing Repository (iSHARE) and applications to access HDSS data for collaborative analysis are encouraged. PMID:26403815
Tellis, Betty; Keeffe, Jill E; Taylor, Hugh R
The National Trachoma Surveillance and Reporting Unit (NTSRU) was established in November 2006 to improve the quality and consistency of data collection and reporting of active trachoma in Australia. Active trachoma data collected in 2006, prior to the commencement of the NTSRU, were reported by the Northern Territory, South Australia and Western Australia. In most regions, Aboriginal children aged 5-9 years were screened for signs of active trachoma, following the World Health Organization simplified trachoma grading system. In the Northern Territory the Healthy School Aged Kids program conducted school-based screening for active trachoma in 74 schools in five regions (n = 2,253). In South Australia Aboriginal school children presented for active trachoma screening when an eye team visited five Aboriginal Community Controlled Health Services (n = 275). In Western Australia population health units in collaboration with staff from population health care services, conducted school based screening for active trachoma in 53 schools in four regions (n = 1,719). Regional active trachoma prevalence for 2006 varied between the states and the Northern Territory with reported prevalences ranging from: Northern Territory = 2.5%-30%, South Australia = 0%-25%, and Western Australia = 18%-53%. Few data were reported on facial cleanliness or other aspects of the SAFE strategy, and no data were reported for trichiasis.
Kishamawe, Coleman; Isingo, Raphael; Mtenga, Baltazar; Zaba, Basia; Todd, Jim; Clark, Benjamin; Changalucha, John; Urassa, Mark
The Magu Health and Demographic Surveillance System (Magu HDSS) is part of Kisesa OpenCohort HIV Study located in a rural area of North-Western Tanzania. Since its establishment in 1994, information on pregnancies, births, marriages, migrations and deaths have been monitored and updated between one and three times a year by trained fieldworkers. Other research activities implemented in the cohort include: sero surveys which have been conducted every 2-3 years to collect socioeconomic data, HIV sero status and health knowledge attitude and behaviour in adults aged 15 years or more living in the area; verbal autopsy (VA) interviews conducted to establish cause of death in all deaths encountered in the area; Llnking data collected at health facilities to community-based data; monitoring voluntary counselling and testing (VCT); and assessing uptake of antiretroviral treatment (ART). In addition, within the community, qualitative studies have been conducted to address issues linked to HIV stigma, the perception of ART access and adherence.In 2014, the population was over 35 000 individuals. Magu HDSS has contributed to Tanzanian estimates of fertility and mortality, and is a member of the INDEPTH network. Demographic data for Magu HDSS are available via the INDEPTH Network's Sharing and Accessing Repository (iSHARE) and applications to access HDSS data for collaborative analysis are encouraged.
Dall’Asta, Luca; Marsili, Matteo; Pin, Paolo
The very notion of social network implies that linked individuals interact repeatedly with each other. This notion allows them not only to learn successful strategies and adapt to them, but also to condition their own behavior on the behavior of others, in a strategic forward looking manner. Game theory of repeated games shows that these circumstances are conducive to the emergence of collaboration in simple games of two players. We investigate the extension of this concept to the case where players are engaged in a local contribution game and show that rationality and credibility of threats identify a class of Nash equilibria—that we call “collaborative equilibria”—that have a precise interpretation in terms of subgraphs of the social network. For large network games, the number of such equilibria is exponentially large in the number of players. When incentives to defect are small, equilibria are supported by local structures whereas when incentives exceed a threshold they acquire a nonlocal nature, which requires a “critical mass” of more than a given fraction of the players to collaborate. Therefore, when incentives are high, an individual deviation typically causes the collapse of collaboration across the whole system. At the same time, higher incentives to defect typically support equilibria with a higher density of collaborators. The resulting picture conforms with several results in sociology and in the experimental literature on game theory, such as the prevalence of collaboration in denser groups and in the structural hubs of sparse networks. PMID:22383559
... medicines and supply chain risks in support of national, sub-regional and global strategies and decision... HUMAN SERVICES Food and Drug Administration Cooperative Agreement To Support Building Global Capacity... agreement to the World Health Organization (WHO) in support of building a global surveillance and...
Hills, Charles R
Surveillance briefing to NNSA to support a tasking memo from NA-12 on Surveillance requirements. This talk presents the process for developing surveillance requirements, discusses the LANL requirements that were issued as part of that tasking memo, and presents recommendations on Component Evaluation and Planning Committee activities for FY11.
O'Toole, Michael J.; Schweizer, Paul H.
The world order has changed and with it, governments are now faced with waging a new type of `ware.' Regional instability, drug trafficking, environmental issues, international terrorism, and illegal immigration are examples of escalating problems that cross international boundaries and threaten the security of nations. The first and most important element in coping with these illegal activities is the ability to detect and monitor events in a timely and secure fashion. Conventional means of gathering intelligence such as large airborne collection systems and satellites lack the flexibility, dwell times, and cost effectiveness to meet many of today's needs. There is a growing requirement for airborne platforms that can covertly perform surveillance missions during either day or night and in a cost effective manner. To meet this need, Schweizer Aircraft has recently developed the RU-38A twin-engine surveillance aircraft. This paper discusses the evolution and principle design concepts of this aircraft and how its unique performance enables the RU-38A to achieve new levels of surveillance capability.
the JCTE project employs a 20 pound helicopter, the Mongoose UAV, as a surrogate for future fielded VTOL UAVs. The Mongoose is a fully autonomous...Technologies. The Mongoose is intended strictly as an R&D platform to demonstrate the AUMS capability, but is equipped with a pan-tilt gimbal that supports an...Electro-Optical (EO) sensor to provide basic intelligence, surveillance, and reconnaissance (ISR). Lessons learned in working with the Mongoose should
Stange, A.W.; Furman, F.J.; Hilmas, D.E.
The Rocky Flats Beryllium Health Surveillance Program (BHSP), initiated in June 1991, was designed to provide medical surveillance for current and former employees exposed to beryllium. The BHSP identifies individuals who have developed beryllium sensitivity using the beryllium lymphocyte proliferation test (BeLPT). A detailed medical evaluation to determine the prevalence of chronic beryllium disease (CBD) is offered to individuals identified as beryllium sensitized or to those who have chest X-ray changes suggestive of CBD. The BHSP has identified 27 cases of CBD and another 74 cases of beryllium sensitization out of 4268 individuals tested. The distribution of BeLPT values for normal, sensitized, and CBD-identified individuals is described. Based on the information collected during the first 3 1/3 years of the BHSP, the BeLPT is the most effective means for the early identification of beryllium-sensitized individuals and to identify individuals who may have CBD. The need for BeLPT retesting is demonstrated through the identification of beryllium sensitization in individuals who previously tested normal. Posterior/anterior chest X-rays were not effective in the identification of CBD. 12 refs., 8 tabs.
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. The routine sampling plan for the SESP has been revised this year to reflect changing site operations and priorities. Some sampling previously performed at least annually has been reduced in frequency, and some new sampling to be performed at a less than annual frequency has been added. Therefore, the SESP schedule reflects sampling to be conducted in calendar year 1991 as well as future years. The ground-water sampling schedule is for 1991. This schedule is subject to modification during the year in response to changes in Site operation, program requirements, and the nature of the observed results. Operational limitations such as weather, mechanical failures, sample availability, etc., may also require schedule modifications. Changes will be documented in the respective project files, but this plan will not be reissued. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford evirons.
Al-Tawfiq, Jaffar A; Zumla, Alimuddin; Gautret, Philippe; Gray, Gregory C; Hui, David S; Al-Rabeeah, Abdullah A; Memish, Ziad A
Several new viral respiratory tract infectious diseases with epidemic potential that threaten global health security have emerged in the past 15 years. In 2003, WHO issued a worldwide alert for an unknown emerging illness, later named severe acute respiratory syndrome (SARS). The disease caused by a novel coronavirus (SARS-CoV) rapidly spread worldwide, causing more than 8000 cases and 800 deaths in more than 30 countries with a substantial economic impact. Since then, we have witnessed the emergence of several other viral respiratory pathogens including influenza viruses (avian influenza H5N1, H7N9, and H10N8; variant influenza A H3N2 virus), human adenovirus-14, and Middle East respiratory syndrome coronavirus (MERS-CoV). In response, various surveillance systems have been developed to monitor the emergence of respiratory-tract infections. These include systems based on identification of syndromes, web-based systems, systems that gather health data from health facilities (such as emergency departments and family doctors), and systems that rely on self-reporting by patients. More effective national, regional, and international surveillance systems are required to enable rapid identification of emerging respiratory epidemics, diseases with epidemic potential, their specific microbial cause, origin, mode of acquisition, and transmission dynamics.
Dufaux, Frederic; Ebrahimi, Touradj
This paper describes a video surveillance system which is composed of three key components, smart cameras, a server, and clients, connected through IP-networks in wired or wireless configurations. The system has been designed so as to protect the privacy of people under surveillance. Smart cameras are based on JPEG 2000 compression where an analysis module allows for events detection and regions of interest identification. The resulting regions of interest can then be encoded with better quality and scrambled. Compressed video streams are scrambled and signed for the purpose of privacy and data integrity verification using JPSEC compliant methods. The same bitstream may also be protected for robustness to transmission errors based on JPWL compliant methods. The server receives, stores, manages and transmits the video sequences on wired and wireless channels to a variety of clients and users with different device capabilities, channel characteristics and preferences. Use of seamless scalable coding of video sequences prevents any need for transcoding operations at any point in the system.
Ireland, Robert J.
The battlefield optical surveillance system (BOSS) was developed for DARPA by the U.S. Air Force's Phillips Laboratory. BOSS is a HMMWV mounted laser surveillance and deterrence system. It is intended to be used to detect and to deter potentially hostile individuals, snipers and groups of agitators. The BOSS integrates the following: (1) a thermal camera (8-12 micrometer FLIR), that detects and cues to possible targets, (2) a 45 watt, 808 nm (near IR), air- cooled laser which provides covert illumination and designation for a day/night camera to acquire said target and attain a high-resolution image using night vision equipment, and (3) a 1 watt, 532 nm (green) laser that overtly illuminates and designates the target. It also has significant deterring effects both physiological and psychological on individuals and crowds. BOSS offers the potential capability to detect snipers before the first shot is fired. Detection of optical augmentations and the thermal characteristics of a sniper allows for this early detection. The integration of BOSS with acoustic sniper detection systems are being explored.
Lo, Shi-Wei; Wu, Jyh-Horng; Lin, Fang-Pang; Hsu, Ching-Han
Regional heavy rainfall is usually caused by the influence of extreme weather conditions. Instant heavy rainfall often results in the flooding of rivers and the neighboring low-lying areas, which is responsible for a large number of casualties and considerable property loss. The existing precipitation forecast systems mostly focus on the analysis and forecast of large-scale areas but do not provide precise instant automatic monitoring and alert feedback for individual river areas and sections. Therefore, in this paper, we propose an easy method to automatically monitor the flood object of a specific area, based on the currently widely used remote cyber surveillance systems and image processing methods, in order to obtain instant flooding and waterlogging event feedback. The intrusion detection mode of these surveillance systems is used in this study, wherein a flood is considered a possible invasion object. Through the detection and verification of flood objects, automatic flood risk-level monitoring of specific individual river segments, as well as the automatic urban inundation detection, has become possible. The proposed method can better meet the practical needs of disaster prevention than the method of large-area forecasting. It also has several other advantages, such as flexibility in location selection, no requirement of a standard water-level ruler, and a relatively large field of view, when compared with the traditional water-level measurements using video screens. The results can offer prompt reference for appropriate disaster warning actions in small areas, making them more accurate and effective.
Lo, Shi-Wei; Wu, Jyh-Horng; Lin, Fang-Pang; Hsu, Ching-Han
Regional heavy rainfall is usually caused by the influence of extreme weather conditions. Instant heavy rainfall often results in the flooding of rivers and the neighboring low-lying areas, which is responsible for a large number of casualties and considerable property loss. The existing precipitation forecast systems mostly focus on the analysis and forecast of large-scale areas but do not provide precise instant automatic monitoring and alert feedback for individual river areas and sections. Therefore, in this paper, we propose an easy method to automatically monitor the flood object of a specific area, based on the currently widely used remote cyber surveillance systems and image processing methods, in order to obtain instant flooding and waterlogging event feedback. The intrusion detection mode of these surveillance systems is used in this study, wherein a flood is considered a possible invasion object. Through the detection and verification of flood objects, automatic flood risk-level monitoring of specific individual river segments, as well as the automatic urban inundation detection, has become possible. The proposed method can better meet the practical needs of disaster prevention than the method of large-area forecasting. It also has several other advantages, such as flexibility in location selection, no requirement of a standard water-level ruler, and a relatively large field of view, when compared with the traditional water-level measurements using video screens. The results can offer prompt reference for appropriate disaster warning actions in small areas, making them more accurate and effective. PMID:25621609
Izurieta, Hector S; Zuber, Patrick; Bonhoeffer, Jan; Chen, Robert T; Sankohg, Osman; Laserson, Kayla F; Sturkenboom, Miriam; Loucq, Christian; Weibel, Daniel; Dodd, Caitlin; Black, Steve
With the advent of new vaccines targeted to highly endemic diseases in low- and middle-income countries (LMIC) and with the expansion of vaccine manufacturing globally, there is an urgent need to establish an infrastructure to evaluate the benefit-risk profiles of vaccines in LMIC. Fortunately the usual decade(s)-long time gap between introduction of new vaccines in high and low income countries is being significantly reduced or eliminated due to initiatives such as the Global Alliance for Vaccines and Immunizations (GAVI) and the Decade of Vaccines for the implementation of the Global Vaccine Action Plan. While hoping for more rapid disease control, this time shift may potentially add risk, unless appropriate capacity for reliable and timely evaluation of vaccine benefit-risk profiles in some LMIC's are developed with external assistance from regional or global level. An ideal vaccine safety and effectiveness monitoring system should be flexible and sustainable, able to quickly detect possible vaccine-associated events, distinguish them from programmatic errors, reliably and quickly evaluate the suspected event and its association with vaccination and, if associated, determine the benefit-risk of vaccines to inform appropriate action. Based upon the demonstrated feasibility of active surveillance in LMIC as shown by the Burkina Faso assessment of meningococcal A conjugate vaccine or that of rotavirus vaccine in Mexico and Brazil, and upon the proof of concept international GBS study, we suggest a sustainable, flexible, affordable and timely international collaborative vaccine safety monitoring approach for vaccines being newly introduced. While this paper discusses only the vaccine component, the same system could also be eventually used for monitoring drug effectiveness (including the use of substandard drugs) and drug safety.
Gutteridge, W E
TDR's research programme was initiated in 1976 at the same time that the pharmaceutical industry began to withdraw from the discovery and development of new drugs for tropical diseases. TDR collaborated with the industry right from the start, its prime objective initially being to ensure that candidate drugs already in the development pipeline, such as praziquantel, mefloquine, ivermectin, halofantrine and atovaquone/proguanil, were not shelved. It became clear during the 1980s that once candidate drugs in these existing pipelines had been processed, that would be it. TDR therefore developed a number of other ways for collaboration, including testing compounds already in development in companies for other therapeutic areas. One candidate identified in this way was an oral formulation of miltefosine, in development in Asta Medica for an antitumour indication. A joint Asta Medica (later Zentaris)/TDR development project was agreed, and despite its fair share of traumas during the development process, miltefosine is now registered for the treatment of visceral leishmaniasis in India, Germany and Colombia. This example of a successful TDR/pharmaceutical industry collaboration lives on in the various Public Private Partnerships such as the new Medicines for Malaria Venture that TDR helped to spawn.
Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N
Objective Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. PMID:24699371
Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig
The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance. PMID:23741397
Kirkwood, Carl D; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L
The Australian Rotavirus Surveillance Program together with 15 collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the genotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2009 to 30 June 2010, the 3rd year of surveillance following introduction of rotavirus vaccines into the National Immunisation Program. Seven hundred and seventy-eight faecal samples were referred to the centre for G and P genotype analysis using hemi-nested multiplex reverse transcription-polymerase chain reaction. Of the 422 confirmed as rotavirus positive, genotype G1P was the dominant type nationally, representing 49.3%, followed by genotype G2P (21.1%). Genotypes G3P, G4P and G9P each represented less than 3% of circulating strains nationally. The dominance of G1P was in part associated with a large outbreak of severe gastroenteritis in the Northern Territory in 2010. The identification of uncommon rotavirus genotype combinations has increased since vaccine introduction, with G1P, G2P and G9P identified during this survey. Single strains of G1P and G4P were identified during this study period. This survey continues to highlight the fluctuations in rotavirus genotypes, and results from this survey suggest there is limited genotype selection based on vaccine usage. However, the large G1P outbreak of gastroenteritis in the Northern Territory may have resulted from vaccine pressure on wild-type strains.
Kirkwood, Carl D; Roczo, Susie; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L
The Australian Rotavirus Surveillance Program together with collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the genotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during 1 July 2010 to 30 June 2011. This report represents the fourth year of surveillance following introduction of rotavirus vaccines into the National Immunisation Program. One thousand one hundred and twenty-seven faecal samples were referred to the centre for G and P genotype analysis using hemi-nested multiplex reverse transcription-polymerase chain reaction. Eight hundred and sixteen samples were confirmed as rotavirus positive. Of these, 551 were collected from children under 5 years of age, while 265 were from older children and adults. Genotype analysis revealed that a change in the dominant type occurred in this reporting period, such that genotype G2P was the dominant type nationally, representing 51% of samples, followed by genotype G1P (26.1%). Genotypes G3P represented 11% of samples while G4P re-emerged as an important genotype, and was identified in 6% of samples. Uncommon rotavirus G and P combinations continue to be identified, with G2P and G9P identified during this survey. Differences in genotype distribution based on vaccine usage continue to be evident in Australian states. This survey continues to highlight the fluctuations in rotavirus genotypes, with an annual change in dominant genotypes suggesting a more dynamic wild-type population.
Huang, Qiu Sue; Turner, Nikki; Baker, Michael G; Williamson, Deborah A; Wong, Conroy; Webby, Richard; Widdowson, Marc-Alain
The 2009 influenza A(H1N1)pdm09 pandemic highlighted the need for improved scientific knowledge to support better pandemic preparedness and seasonal influenza control. The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project, a 5-year (2012-2016) multiagency and multidisciplinary collaboration, aimed to measure disease burden, epidemiology, aetiology, risk factors, immunology, effectiveness of vaccination and other prevention strategies for influenza and other respiratory infectious diseases of public health importance. Two active, prospective, population-based surveillance systems were established for monitoring influenza and other respiratory pathogens among those hospitalized patients with acute respiratory illness and those enrolled patients seeking consultations at sentinel general practices. In 2015, a sero-epidemiological study will use a sample of patients from the same practices. These data will provide a full picture of the disease burden and risk factors from asymptomatic infections to severe hospitalized disease and deaths and related economic burden. The results during the first 2 years (2012-2013) provided scientific evidence to (a) support a change to NZ's vaccination policy for young children due to high influenza hospitalizations in these children; (b) contribute to the revision of the World Health Organization's case definition for severe acute respiratory illness for global influenza surveillance; and (c) contribute in part to vaccine strain selection using vaccine effectiveness assessment in the prevention of influenza-related consultations and hospitalizations. In summary, SHIVERS provides valuable international platforms for supporting seasonal influenza control and pandemic preparedness, and responding to other emerging/endemic respiratory-related infections.
International economic and military dependence on space assets is pervasive and ever-growing in an environment that is now congested, contested, and competitive. There are a number of natural and man-made risks that need to be monitored and characterized to protect and preserve the space environment and the assets within it. Unfortunately, today's space surveillance network (SSN) has gaps in coverage, is not resilient, and has a growing number of objects that get lost. Risks can be efficiently and effectively mitigated, gaps closed, resiliency improved, and performance increased within a next generation space surveillance network implemented as a system-of-systems with modern information architectures and analytic techniques. This also includes consideration for the newest SSN sensors (e.g. Space Fence) which are born Net-Centric out-of-the-box and able to seamlessly interface with the JSpOC Mission System, global information grid, and future unanticipated users. Significant opportunity exists to integrate legacy, traditional, and non-traditional sensors into a larger space system-of-systems (including command and control centers) for multiple clients through low cost sustainment, modification, and modernization efforts. Clients include operations centers (e.g. JSpOC, USSTRATCOM, CANSPOC), Intelligence centers (e.g. NASIC), space surveillance sensor sites (e.g. AMOS, GEODSS), international governments (e.g. Germany, UK), space agencies (e.g. NASA), and academic institutions. Each has differing priorities, networks, data needs, timeliness, security, accuracy requirements and formats. Enabling processes and technologies include: Standardized and type accredited methods for secure connections to multiple networks, machine-to-machine interfaces for near real-time data sharing and tip-and-queue activities, common data models for analytical processing across multiple radar and optical sensor types, an efficient way to automatically translate between differing client and
Griffin, D D; Kirkwood, C D; Parashar, U D; Woods, P A; Bresee, J S; Glass, R I; Gentsch, J R
Rotavirus strains from 964 fecal specimens collected from children at 11 U.S. hospital laboratories from November 1997 to March 1998 and from samples collected at 12 laboratories from November 1998 to March 1999 were typed for G and P proteins. Serotype G1 was the predominant serotype in 1997-1998 (88%), followed by G2 (6.2%), G9 (3.3%), and G3 (1.5%). This pattern was similar to that seen in 1998-1999: G1 (79%), G2 (15%), G9 (3.0%), G4 (1.6%), and G3 (0.3%). Novel P strains were identified in both seasons, and analysis of a 364-nucleotide fragment from gene segment 4 of one of the strains demonstrated 97.3% nucleotide identity with the prototype P3,G3 strain, AU1, isolated in Japan. This is the first report of a human AU1-like strain in the United States. These results reinforce our initial findings that serotype G9 persists in the United States but has not become a predominant strain and that the common serotypes G1 to G4 account for almost 90% of strains in circulation. Other uncommon strains exist in the United States but may have been overlooked before because of their low prevalence and the use of inadequate diagnostic tools.
... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.234 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.234 Source surveillance. (a) Except in... emission data by sources. (1) Amador County APCD. (2) Bay Area AQMD. (3) Calaveras County APCD. (4)...
... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Source surveillance. 52.2075 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Rhode Island § 52.2075 Source surveillance... authority to require owners or operators of stationary sources to maintain records of, and...
... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.2075 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Rhode Island § 52.2075 Source surveillance... authority to require owners or operators of stationary sources to maintain records of, and...
... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.1479 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nevada § 52.1479 Source surveillance. (a) The... adequate legally enforceable procedures for requiring owners or operators of stationary sources to...
... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Source surveillance. 52.2684 Section 52.2684 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2684 Source surveillance. (a)...
... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Source surveillance. 52.794 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Indiana § 52.794 Source surveillance. (a) The... County sources specifically listed in Table 2 of 325 IAC 6-1-10.2 (§ 52.770(c)(57)); for pushing...
... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.479 Section 52.479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.479 Source surveillance. (a)...
... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Source surveillance. 52.1479 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nevada § 52.1479 Source surveillance. (a) The... adequate legally enforceable procedures for requiring owners or operators of stationary sources to...
... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Source surveillance. 52.1077 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Maryland § 52.1077 Source surveillance. (a... procedures for stationary sources to be periodically tested....
... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.794 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Indiana § 52.794 Source surveillance. (a) The... County sources specifically listed in Table 2 of 325 IAC 6-1-10.2 (§ 52.770(c)(57)); for pushing...
... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.130 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Arizona § 52.130 Source surveillance. (a) The... procedures for requiring sources in the Northern Arizona, Mohave-Yuma, Central Arizona, and Southeast...
... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.1077 Section 52...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Maryland § 52.1077 Source surveillance. (a... procedures for stationary sources to be periodically tested....
... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Source surveillance. 52.479 Section 52.479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.479 Source surveillance. (a)...
... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.2684 Section 52.2684 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2684 Source surveillance. (a)...
...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.12 Source surveillance. (a) Each subpart identifies the plan provisions for source surveillance which are disapproved, and sets forth the... procedures for testing, inspection, investigation, or detection, but detailed critiques of such portions...
... production surveillance is required, shall— (A) Conduct a periodic risk assessment of the contractor to... risk assessment shall consider information provided by the contractor and the contracting officer; (B) Develop a production surveillance plan based on the risk level determined during a risk assessment;...
... production surveillance is required, shall— (A) Conduct a periodic risk assessment of the contractor to... risk assessment shall consider information provided by the contractor and the contracting officer; (B) Develop a production surveillance plan based on the risk level determined during a risk assessment;...
... production surveillance is required, shall— (A) Conduct a periodic risk assessment of the contractor to... risk assessment shall consider information provided by the contractor and the contracting officer; (B) Develop a production surveillance plan based on the risk level determined during a risk assessment;...
Many university officials recognize the need to upgrade their older analog video surveillance systems. In a 2010 survey by "Campus Safety" magazine, half of university respondents expressed dissatisfaction with the quality and coverage of their current video surveillance systems. Among the limitations of analog closed-circuit television…
Potential Utility in Developing Countries Syndromic surveillance offers a useful adjunct to diagnosis- based surveillance of emerging infections in...influenza-like illness caused by multiple epidemic-prone tropical infections, could indicate outbreaks requiring laboratory- based investigation and...countries. Computer- based automation of routine data analysis is helpful because, with multiple reporting units and reportable events, the number of
... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Financial surveillance. 38.604... MARKETS Financial Integrity of Transactions § 38.604 Financial surveillance. A designated contract market must monitor members' compliance with the designated contract market's minimum financial standards...
Scarpino, Samuel V.; Meyers, Lauren Ancel
As public health agencies struggle to track and contain emerging arbovirus threats, timely and efficient surveillance is more critical than ever. Using historical dengue data from Puerto Rico, we developed methods for streamlining and designing novel arbovirus surveillance systems with or without historical disease data. PMID:28322711
... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Source surveillance. 52.1479 Section 52.1479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nevada § 52.1479 Source surveillance. (a)...
... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Source surveillance. 52.1479 Section 52.1479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nevada § 52.1479 Source surveillance. (a)...
Kirkwood, Carl D; Cannan, David; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L
The National Rotavirus Reference Centre together with collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the types of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2007 to 30 June 2008, the first complete year of surveillance following introduction of rotavirus into the National Immunisation Program. Six hundred faecal samples from across Australia were examined using a combined approach of monoclonal antibody immunoassays and reverse transcription-polymerase chain reaction. Of the 419 confirmed as rotavirus positive, serotype G1 was the dominant serotype nationally, representing 52% of specimens, followed by serotype G2 (19.8%), serotype G9 (12.2%), and serotype G3 (11%). No serotype G4 strains were identified. All G1, G3 and G9 strains assayed for P genotype contained the P genotype, while all G2 strains contained the P genotype, except one G2 strain which possessed a P. Uncommon rotavirus genotypes, G8 (n = 2) and P (n = 2) were identified during this study period. There was no evidence of unexpected changes in serotype distribution during the first 12 months of rotavirus vaccine use in the National Immunisation Program.
Delaunay, Valerie; Douillot, Laetitia; Diallo, Aldiouma; Dione, Djibril; Trape, Jean-François; Medianikov, Oleg; Raoult, Didier; Sokhna, Cheikh
The Health and Demographic Surveillance System (HDSS) in Niakhar, a rural area of Senegal, is located 135 km east of Dakar. The HDSS was established in 1962 by the Institut de Recherche pour le Développement (IRD) of Senegal to face the shortcomings of the civil registration system and provide demographic indicators. Some 65 villages in the Niakhar area were followed annually by the HDSS from 1962–1969. The study zone was reduced to 8 villages from 1969–1983, and from then on the HDSS was extended to include 22 other villages, covering a total of 30 villages for a population estimated at 43 000 in January 2012. Thus, 8 villages in the Niakhar area have been under demographic surveillance for almost 50 years and 30 villages for 30 years. Vital events, migrations, marital changes, pregnancies, and immunizations are routinely recorded every 4 months. The HDSS data base also includes epidemiological, economic, and environmental information obtained from specific surveys. Data were collected through annual rounds from 1962 to 1987. The rounds became weekly from 1987–1997, followed by routine visits conducted every 3 months between 1997 and 2007 and every 4 months since then. The data collected in the HDSS are not open to access, but can be fairly shared under conditions of collaboration and endowment. PMID:24062286
Mutuel, L.; Baillon, B.; Barnetche, B.; Delpy, P.
With the increasing traffic and the development of business trajectories, there is a widespread need to anticipate any adverse weather conditions that could impact the performance of the flight or to use of atmospheric parameters to optimize trajectories. Current sensors onboard air transport are challenged to provide the required service, while new products for business jets and general aviation open the door to innovative assimilation of weather information in onboard surveillance and navigation. The paper aims at surveying current technology available to air transport aircraft and pointing out their shortcomings in view of the modernization proposed in SESAR and NextGen implementation plans. Foreseen innovations are then illustrated via results of ongoing research like FLYSAFE or standardization efforts, in particular meteorological datalink services and impact on Human-Machine Interface. The paper covers the operational need to avoid adverse weather like thunderstorm, icing, turbulence, windshear and volcanic ash, but also the requirement to control in 4D the trajectory through the integration of wind and temperature grids in the flight management. The former will lead to enhanced surveillance systems onboard the aircraft with new displays and new alerting schemes, ranging from targeted information supporting better re-planning to auto-escape strategies. The latter will be standard in next generation flight management systems. Finally both will rely on ATM products that will also assimilate weather information so that situational awareness is shared and decision is collaborative.
social cohesion.9 West African Trade West Africa has a long history of trade . This was not restricted to the export of slaves and tropical...Kola stimulant, cannabis and alcohol were all legally traded between Europe, the Middle East and the Sahara. Given West Africa’s long history of...West African Membership in Multilateral Anti-Crime Agreements or Bodies West African nations know and understand the problem of illicit trade but
Conducting surveillance of communicable diseases and/or public health surveillance in general, in developing countries such is B&H has some common specific things-health care system is an integral part of organized government services thus, fewer impediments to implementing any part of a surveillance system are recorded. Limited health care providers and laboratories reduce the number of data source and can facilitate quality assurance. An ideal surveillance system is discussed in this paper (what kind of surveillance system an epidemiologist would like to have in future), as well as barriers to the ideal surveillance system and technology of the future. Some elements of computerised public health surveillance system and surveillance of communicable diseases, particularly, are given (e.g. hardware, software, data entry, editing the data, analysis of data, ...) Computerising a surveillance system will results in increasing speed of processing providing graphic capability, enhancing analytic capabilities, improving quality of data of reports and improving quantity of data. The most important step in beginning to conduct computerising a surveillance system is identifying the public health objective such is, for example, surveillance of communicable diseases.
Gregory, Paul A. M.; Austin, Zubin
Background: Trust is integral to effective interprofessional collaboration. There has been scant literature characterizing how trust between practitioners is formed, maintained or lost. The objective of this study was to characterize the cognitive model of trust that exists between pharmacists and family physicians working in collaborative primary care settings. Methods: Pharmacists and family physicians who work collaboratively in primary care were participants in this study. Family health teams were excluded from this study because of the distinct nature of these settings. Through a snowball convenience sampling method, a total of 11 pharmacists and 8 family physicians were recruited. A semistructured interview guide was used to guide discussion around trust, relationships and collaboration. Constant-comparative coding was used to identify themes emerging from these data. Results: Pharmacists and family physicians demonstrate different cognitive models of trust in primary care collaboration. For pharmacists, trust appears to be conferred on physicians based on title, degree, status and positional authority. For family physicians, trust appears to be earned based on competency and performance. These differences may lead to interprofessional tension when expectations of reciprocal trust are not met. Conclusions: Further work in characterizing how trust is developed in interprofessional relationships is needed to support effective team formation and functioning. PMID:27540406
Peskin, A.; Swyler, K.
The college industry relationship has been identified as a key policy issue in Engineering Education. Collaborations between academic institutions and the industrial sector have a long history and a bright future. For Engineering and Engineering Technology programs in particular, industry has played a crucial role in many areas including advisement, financial support, and practical training of both faculty and students. Among the most important and intimate interactions are collaborative projects and formal cooperative education arrangements. Most recently, such collaborations have taken on a new dimension, as advances in technology have made possible meaningful technical collaboration at a distance. There are several obvious technology areas that have contributed significantly to this trend. Foremost is the ubiquitous presence of the Internet. Perhaps almost as important are advances in computer based imaging. Because visual images offer a compelling user experience, it affords greater knowledge transfer efficiency than other modes of delivery. Furthermore, the quality of the image appears to have a strongly correlated effect on insight. A good visualization facility offers both a means for communication and a shared information space for the subjects, which are among the essential features of both peer collaboration and distance learning.
The destruction caused by substance abuse extends to all of Philadelphia's nearly 200,000 students. The greatest damage is incurred through using legal addictive drugs, alcohol, and tobacco. This article describes Philadelphia's collaboration with police, the Drug Enforcement Agency, and the U.S. Attorney's office to combat this problem. (MLH)
Pei, Xiaoyan; Li, Ning; Guo, Yunchang; Liu, Xiumei; Yan, Lin; Li, Ying; Yang, Shuran; Hu, Jing; Zhu, Jianghui; Yang, Dajin
Microbiological food safety surveillance is a system that collects data regarding food contamination by foodborne pathogens, parasites, viruses, and other harmful microbiological factors. It helps to understand the spectrum of food safety, timely detect food safety hazards, and provide relevant data for food safety supervision, risk assessment, and standards-setting. The study discusses the microbiological surveillance of food safety in China, and introduces the policies and history of the national microbiological surveillance system. In addition, the function and duties of different organizations and institutions are provided in this work, as well as the generation and content of the surveillance plan, quality control, database, and achievement of the microbiological surveillance of food safety in China.
Outin-Blenman, Sajata; Moen, Ann C.
During 2004–2009, the Centers for Disease Control and Prevention (CDC) partnered with 39 national governments to strengthen global influenza surveillance. Using World Health Organization data and program evaluation indicators collected by CDC in 2013, we retrospectively evaluated progress made 4–9 years after the start of influenza surveillance capacity strengthening in the countries. Our results showed substantial increases in laboratory and sentinel surveillance capacities, which are essential for knowing which influenza strains circulate globally, detecting emergence of novel influenza, identifying viruses for vaccine selection, and determining the epidemiology of respiratory illness. Twenty-eight of 35 countries responding to a 2013 questionnaire indicated that they have leveraged routine influenza surveillance platforms to detect other pathogens. This additional surveillance illustrates increased health-system strengthening. Furthermore, 34 countries reported an increased ability to use data in decision making; data-driven decisions are critical for improving local prevention and control of influenza around the world. PMID:27192395
Cutaneous reactions to analgesic-antipyretics and nonsteroidal anti-inflammatory drugs. Analysis of reports to the spontaneous reporting system of the Gruppo Italiano Studi Epidemiologici in Dermatologia.
We analyzed the cutaneous reactions to systemic analgesic-antipyretics and non-steroidal anti-inflammatory drugs reported to the spontaneous reporting system of the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED). The system has been active since 1988, with periodic intensive surveillance exercises, and 202 dermatologists have collaborated. Up to December 1991, 2,137 reactions had been collected, of which 713 were reactions to systemic analgesic-antipyretics and nonsteroidal anti-inflammatory drugs. A general profile of the reactions was identifiable. It included, in order of frequency, urticaria/angioedema, fixed eruptions, exanthemas, erythema multiforme and Stevens Johnson syndrome. Fixed eruptions and Stevens Johnson syndrome were reported with exceedingly high frequency in association with feprazone. Our system also revealed previously unreported reactions, including fixed eruption to nimesulide, fixed eruption to piroxicam and fixed eruption to flurbiprofen.
Cheng, Calvin KY; Ip, Dennis KM; Cowling, Benjamin J; Ho, Lai Ming; Leung, Gabriel M
Background Great strides have been made exploring and exploiting new and different sources of disease surveillance data and developing robust statistical methods for analyzing the collected data. However, there has been less research in the area of dissemination. Proper dissemination of surveillance data can facilitate the end user's taking of appropriate actions, thus maximizing the utility of effort taken from upstream of the surveillance-to-action loop. Objective The aims of the study were to develop a generic framework for a digital dashboard incorporating features of efficient dashboard design and to demonstrate this framework by specific application to influenza surveillance in Hong Kong. Methods Based on the merits of the national websites and principles of efficient dashboard design, we designed an automated influenza surveillance digital dashboard as a demonstration of efficient dissemination of surveillance data. We developed the system to synthesize and display multiple sources of influenza surveillance data streams in the dashboard. Different algorithms can be implemented in the dashboard for incorporating all surveillance data streams to describe the overall influenza activity. Results We designed and implemented an influenza surveillance dashboard that utilized self-explanatory figures to display multiple surveillance data streams in panels. Indicators for individual data streams as well as for overall influenza activity were summarized in the main page, which can be read at a glance. Data retrieval function was also incorporated to allow data sharing in standard format. Conclusions The influenza surveillance dashboard serves as a template to illustrate the efficient synthesization and dissemination of multiple-source surveillance data, which may also be applied to other diseases. Surveillance data from multiple sources can be disseminated efficiently using a dashboard design that facilitates the translation of surveillance information to public
Bellgard, Matthew I; Napier, Kathryn R; Bittles, Alan H; Szer, Jeffrey; Fletcher, Sue; Zeps, Nikolajs; Hunter, Adam A; Goldblatt, Jack
Orphan drug clinical trials often are adversely affected by a lack of high quality treatment efficacy data that can be reliably compared across large patient cohorts derived from multiple governmental and country jurisdictions. It is critical that these patient data be captured with limited corporate involvement. For some time, there have been calls to develop collaborative, non-proprietary, patient-centric registries for post-market surveillance of aspects related to orphan drug efficacy. There is an urgent need for the development and sustainable deployment of these 'independent' registries that can capture comprehensive clinical, genetic and therapeutic information on patients with rare diseases. We therefore extended an open-source registry platform, the Rare Disease Registry Framework (RDRF) to establish an Independent Rare Disease Registry (IRDR). We engaged with an established rare disease community for Gaucher disease to determine system requirements, methods of data capture, consent, and reporting. A non-proprietary IRDR model is presented that can serve as autonomous data repository, but more importantly ensures that the relevant data can be made available to appropriate stakeholders in a secure, timely and efficient manner to improve clinical decision-making and the lives of those with a rare disease.
Ghosal, Debnath; Löwe, Jan
It is now well established that prokaryotic cells assemble diverse proteins into dynamic cytoskeletal filaments that perform essential cellular functions. Although most of the filaments assemble on their own to form higher order structures, growing evidence suggests that there are a number of prokaryotic proteins that polymerise only in the presence of a matrix such as DNA, lipid membrane or even another filament. Matrix-assisted filament systems are frequently nucleotide dependent and cytomotive but rarely considered as part of the bacterial cytoskeleton. Here, we categorise this family of filament-forming systems as collaborative filaments and introduce a simple nomenclature. Collaborative filaments are frequent in both eukaryotes and prokaryotes and are involved in vital cellular processes including chromosome segregation, DNA repair and maintenance, gene silencing and cytokinesis to mention a few. In this review, we highlight common principles underlying collaborative filaments and correlate these with known functions.
Agarwal, Deborah; Jackson, Keith; Thompson, Mary
The diverse set of organizations and software components involved in a typical collaboratory make providing a seamless security solution difficult. In addition, the users need support for a broad range of frequency and locations for access to the collaboratory. A collaboratory security solution needs to be robust enough to ensure that valid participants are not denied access because of its failure. There are many tools that can be applied to the task of securing collaborative environments and these include public key infrastructure, secure sockets layer, Kerberos, virtual and real private networks, grid security infrastructure, and username/password. A combination of these mechanisms can provide effective secure collaboration capabilities. In this paper, we discuss the requirements of typical collaboratories and some proposals for applying various security mechanisms to collaborative environments.
Nidumolu, Ram; Ellison, Jib; Whalen, John; Billman, Erin
Addressing global sustainability challenges--including climate change, resource depletion, and ecosystem loss--is beyond the individual capabilities of even the largest companies. To tackle these threats, and unleash new value, companies and other stakeholders must collaborate in new ways that treat fragile and complex ecosystems as a whole. In this article, the authors draw on cases including the Latin American Water Funds Partnership, the Sustainable Apparel Coalition (led by Nike, Patagonia, and Walmart), and Action to Accelerate Recycling (a partnership between Alcoa, consumer packaged goods companies, and local governments, among others) to describe four new collaboration models that create shared value and address environmental protection across the value stream. Optimal collaborations focus on improving either business processes or outcomes. They start with a small group of key organizations, bring in project management expertise, link self-interest to shared interest, encourage productive competition, create quick wins, and, above all, build and maintain trust.
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Procedures for arranging drug counseling. 550.44 Section 550.44 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in...
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Procedures for arranging drug counseling. 550.44 Section 550.44 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures for arranging drug counseling. 550.44 Section 550.44 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Procedures for arranging drug counseling. 550.44 Section 550.44 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in...
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Procedures for arranging drug counseling. 550.44 Section 550.44 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in...
Cheeseman, Susan E
This is the third in a series of columns exploring health information technology (HIT) in the neonatal intensive care unit (NICU). The first column provided background information on the implementation of information technology throughout the health care delivery system, as well as the requisite informatics competencies needed for nurses to fully engage in the digital era of health care. The second column focused on information and resources to master basic computer competencies described by the TIGER initiative (Technology Informatics Guiding Education Reform) as learning about computers, computer networks, and the transfer of data.1 This column will provide additional information related to basic computer competencies, focusing on communication and collaboration technologies. Computers and the Internet have transformed the way we communicate and collaborate. Electronic communication is the ability to exchange information through the use of computer equipment and software.2 Broadly defined, any technology that facilitates linking one or more individuals together is a collaborative tool. Collaboration using technology encompasses an extensive range of applications that enable groups of individuals to work together including e-mail, instant messaging (IM ), and several web applications collectively referred to as Web 2.0 technologies. The term Web 2.0 refers to web applications where users interact and collaborate with each other in a collective exchange of ideas generating content in a virtual community. Examples of Web 2.0 technologies include social networking sites, blogs, wikis, video sharing sites, and mashups. Many organizations are developing collaborative strategies and tools for employees to connect and interact using web-based social media technologies.3.
Ganova-Raeva, Lilia M; Dimitrova, Zoya E; Campo, David S; Khudyakov, Yury
Detection of genotypes and drug resistance mutations are important molecular tools assisting in clinical management of patients with chronic hepatitis B and C. Together with methods for assessment of genetic heterogeneity and relatedness of viral strains, they form the foundation of molecular surveillance. Currently, all these methods are based mainly on DNA sequencing followed by phylogenetic analysis. Mass spectrometry (MS) emerged recently as a rapid, cost-effective, reproducible and accurate alternative approach. MS-based molecular assays are highly amenable to automation and provide a suitable platform for routine application to the surveillance of HBV and HCV infections.
Physicists transcend national boundaries, ethnic differences, and scientific disciplines to address globally shared problems and questions. This talk will highlight how scientists have collaborated across borders - both geographic and scientific - to achieve ground-breaking discoveries through international scientific cooperation. The speaker also will address how international collaborations will be even more crucial for addressing future challenges faced by the physics community, such as building large-scale research facilities, strengthening scientific capacity in developing countries, fostering ''science for diplomacy'' in times of political tensions and other critical issues.
Jackson, Phoebe A.
The United States Space Command (USSPACECOM) is a Unified Command of the Department of Defense with headquarters at Peterson Air Force Base, Colorado Springs, Co. One of the responsibilities of USSPACECOM is to detect, track, identify, and maintain a catalog of all manmade objects in earth orbit. This satellite catalog is the most important tool for space surveillance. The purpose of this paper is threefold. First, to identify why the command does the job of satellite catalog maintenance. Second, to describe what the satellite catalog is and how it is maintained. Third, and finally, to identify the questions that must be addressed if this command is to track small space object debris. This paper's underlying rationale is to describe our catalog maintenance services so that the members of our community can use them with assurance.
Facklam, D P; Gardner, J S; Neidert, G L; Westland, M M
After the Food and Drug Administration approved a topical antibiotic for the treatment of acne, we began a postmarketing surveillance study to measure the frequency of antibiotic-associated colitis and diarrhea in acne patients treated with topical antibiotics and low doses of oral antibiotics. Pharmacists recruited 13,465 patients who presented a prescription for an acne medication, and we obtained detailed information on the use of the medications, perceived acceptability, and the occurrence of new health events from 6,453 with computer-assisted telephone interviews. Three cases (less than 0.1%) of antibiotic-associated diarrhea and one case (less than 0.1%) of antibiotic-associated colitis were confirmed. We conclude that this methodology can provide further information about the safety of a drug once it is in customary use, at a fraction of the cost of Phase III clinical trials. PMID:2136713
Agocs, M.M.; Rudnai, P.; Etzel, R.A. )
In October 1989, the Hungarian National Institute of Hygiene initiated the Children's Acute Respiratory Morbidity (CHARM) Surveillance System to assess the association between nine reportable respiratory diseases and air pollution. The weekly number of physician-diagnosed, reportable respiratory diseases among four age groups of children (less than 1, 1-2, 3-5, and 6-14 years) was tabulated for Sopron, a city with 60,000 residents. We calculated the proportion of diseases occurring during weeks with low, moderate, and high sulfur dioxide (SO2) and nitrogen dioxide (NO2) concentrations. The weekly averages of the 24-hour median SO2 concentrations were divided into thirds at less than or equal to 17.6, greater than 17.6 to less than or equal to 26.3, and greater than 26.3 micrograms/m3 (range: 0.9-79.6 micrograms/m3), and the NO2 concentrations at less than or equal to 29.8, greater than 29.8 to less than or equal to 44.1, and greater than 44.1 micrograms/m3 (range: 4.2-90.1 micrograms/m3). During 1990, 11,474 respiratory disease cases occurred among the 4,020 children less than 15 years of age living in Sopron and monitored by the CHARM system. The two most frequently reported disease categories were rhinitis/tonsillitis/pharyngitis (71.5%) and acute bronchitis (8.5%). Sixty-seven percent of pneumonia cases occurred when SO2 concentrations were highest. We found no association between levels of NO2 and respiratory diseases. The CHARM Surveillance System may characterize more fully which groups of children develop particular respiratory diseases following exposure to air pollution.
Stang, Paul E; Ryan, Patrick B; Racoosin, Judith A; Overhage, J Marc; Hartzema, Abraham G; Reich, Christian; Welebob, Emily; Scarnecchia, Thomas; Woodcock, Janet
The U.S. Food and Drug Administration (FDA) Amendments Act of 2007 mandated that the FDA develop a system for using automated health care data to identify risks of marketed drugs and other medical products. The Observational Medical Outcomes Partnership is a public-private partnership among the FDA, academia, data owners, and the pharmaceutical industry that is responding to the need to advance the science of active medical product safety surveillance by using existing observational databases. The Observational Medical Outcomes Partnership's transparent, open innovation approach is designed to systematically and empirically study critical governance, data resource, and methodological issues and their interrelationships in establishing a viable national program of active drug safety surveillance by using observational data. This article describes the governance structure, data-access model, methods-testing approach, and technology development of this effort, as well as the work that has been initiated.
Prokoski, F. J.
Government agencies, including defense and law enforcement, increasingly make use of video from surveillance systems and camera phones owned by non-government entities.Making advanced and standardized motion imaging technology available to private and commercial users at cost-effective prices would benefit all parties. In particular, incorporating thermal infrared into commercial surveillance systems offers substantial benefits beyond night vision capability. Face rendering is a process to facilitate exploitation of thermal infrared surveillance imagery from the general area of a crime scene, to assist investigations with and without cooperating eyewitnesses. Face rendering automatically generates greyscale representations similar to police artist sketches for faces in surveillance imagery collected from proximate locations and times to a crime under investigation. Near-realtime generation of face renderings can provide law enforcement with an investigation tool to assess witness memory and credibility, and integrate reports from multiple eyewitnesses, Renderings can be quickly disseminated through social media to warn of a person who may pose an immediate threat, and to solicit the public's help in identifying possible suspects and witnesses. Renderings are pose-standardized so as to not divulge the presence and location of eyewitnesses and surveillance cameras. Incorporation of thermal infrared imaging into commercial surveillance systems will significantly improve system performance, and reduce manual review times, at an incremental cost that will continue to decrease. Benefits to criminal justice would include improved reliability of eyewitness testimony and improved accuracy of distinguishing among minority groups in eyewitness and surveillance identifications.
Kochkin, V.; Erak, D.; Makhotin, D.
According to generally accepted world practice, evaluation of the reactor pressure vessel (RPV) material behavior during operation is carried out using tests of surveillance specimens. The main objective of the surveillance program consists in insurance of safe RPV operation during the design lifetime and lifetime-extension period. At present, the approaches of pressure vessels residual life validation based on the test results of their surveillance specimens have been developed and introduced in Russia and are under consideration in other countries where vodo-vodyanoi energetichesky reactors- (VVER-) 1000 are in operation. In this case, it is necessary to ensure leading irradiation of surveillance specimens (as compared to the pressure vessel wall) and to provide uniformly irradiated specimen groups for mechanical testing. Standard surveillance program of VVER-1000 has several significant shortcomings and does not meet these requirements. Taking into account program of lifetime extension of VVER-1000 operating in Russia, it is necessary to carry out upgrading of the VVER-1000 surveillance program. This paper studies the conditions of a surveillance specimen's irradiation and upgrading of existing sets to provide monitoring and prognosis of RPV material properties for extension of the reactor's lifetime up to 60 years or more. (authors)
Lockard, Lea Ann
Describes the impact of technology planning on students' and teachers' learning based on experiences at a high school in Texas that provides academic alternatives to at-risk students. Discusses collaboration among teachers, principals, and district administrators; teachers' professional development; the technology committee; staff development;…
Bruce, Harry; Fidel, Raya
Researchers from the University of Washington, Microsoft Research, Boeing, and Risoe National Laboratory in Denmark have embarked on a project to explore the manifestations of Collaborative Information Retrieval (CIR) in work settings and to propose technological innovations and organizational changes that can support, facilitate, and improve CIR.…
In many districts, the notion of labor groups and district administration working together conjures descriptions of war and battle rather than cooperation and collaboration. However, in San Juan Unified School District, the headline, "Union and District Exhibit Positive Partnership" exemplifies the changing relationship between teacher…
Pfeil, Jessica; Hirsch, Jenna
Leaders in mathematics are responsible for implementing positive change within their school districts and motivating teachers of mathematics to improve their practices. One way mathematics leaders can achieve this goal is by establishing professional collaborations. We analyzed the research and summarized the common attributes found in successful…
McGriff, Nancy; Harvey, Carl A.; Preddy, Leslie B.
Collaboration is considered a key to the survival of the school library media specialist in the 21st century school. It is a measure of a library media specialist's abilities and successes as an educator. It is a means for illustrating the need for a professional in the school's library media center during difficult times when trying to save…
Madigan, Jennifer C.; Schroth-Cavataio, Georganne
Communication and professional dialogue are essential elements of a high-quality education environment in which all students can succeed. Such an environment is especially important for the success of students with special needs. Unfortunately, collaboration between special educators, general educators, and other professionals is often hindered by…
Whether a teacher loves it or dreads it, lesson planning is a crucial step in the teaching process. Done effectively, collaborative lesson planning--in which teachers work together to design lessons--leads to increased professional learning, higher job satisfaction for teachers, and better lesson plans. The process poses challenges for both…
Illinois State Dept. of Human Services, East St. Louis. Head Start State Collaboration Office.
Head Start has a long history of providing comprehensive child and family development services to low-income children and families. Noting that this history can serve as a model as early childhood and care programs work toward greater collaboration with other programs and agencies to improve child well-being and help move families toward…
Martin, Theodora Penny
Collaborative learning, such as student-team learning or work-group learning, has become the focus of inservice workshops for teachers, a theme in professional journals, and the daily routine in an increasing number of classrooms. The women's study clubs in late 19th-century United States used a similar pedagogy. By the early 1900s, perhaps as…
Newtzie, Karen; Smith, Leslie
In higher education, faculty are often encouraged to collaborate with their colleagues, to--as the "American Heritage Dictionary" defines it--"work together in a joint intellectual effort." The authors often think of such projects as occurring within a department or on a particular campus, but they have discovered that even…
Klingner, Janette K.; Vaughn, Sharon
Describes collaborative strategic reading (CSR), a technique for teaching students, such as those with learning disabilities, reading comprehension and vocabulary skills in a cooperative setting. Covers teaching the four strategies of CSR (preview, click and clunk, get the gist, and wrap up), as well as teaching students cooperative learning group…
Sawyer, R. Keith
I draw on two traditions of research: the social psychology of collaborative groups, and the ethnographic study of improvisational performance. I outline a general model of group creativity derived from these traditions. I show how the model can be used to better understand musical competence and performance, and I provide recommendations for how…
Sanahuja-Gavaldà, Josep M.; Olmos-Rueda, Patricia; Morón-Velasco, Mar
Nowadays, in Catalonia, students with autism spectrum disorders (ASD) are increasingly in regular schools although their presence, participation, learning and success are unequal. Barriers towards inclusion often depend on how to organise supporting at regular schools and the teachers' collaboration during this process. In this paper, the support…
Based on a successful scholarly collaboration experience, the writer assigned a group project in a graduate seminar that confronted a wave of resentment. Small clusters of students were to tackle a multi-layered research assignment requiring textual decisions, bibliographic work, critical theory, historical research, and editorial design. As the…
Waters, John K.
Freed from the nuisances of paper-based methods, districts are making creative use of digital tools to move their curricular documents online, where educators can collaborate on course development and lesson planning. Back in 2003, Amarillo Independent School District (Texas) had begun using the Blackboard Content System to provide lessons online.…
Friedman, Lucy N.
Details some ways schools and community-based organizations can form effective school-site after-school collaborative programs. Describes factors exacerbating misperceptions between teachers and youth workers, and offers suggestions for combining both partners' perspectives through joint planning, hiring staff approved by both programs, joint…
Wang, Yeou-Fang; Schrock, Mitchell; Baldwin, John R.; Borden, Charles S.
The Ground Resource Allocation and Planning Environment (GRAPE 1.0) is a Web-based, collaborative team environment based on the Microsoft SharePoint platform, which provides Deep Space Network (DSN) resource planners tools and services for sharing information and performing analysis.
Henrico County Public Schools, Glen Allen, VA. Virginia Vocational Curriculum and Resource Center.
This collection consists of 41 collaborative lesson plans developed by 99 Virginia teachers at 18 primarily High Schools that Work (HSTW) and tech prep sites. It is divided into three sections: career connection, community connection, and consumer connection. Two types of lesson descriptions which support HSTW key practices, and Virginia's Tech…
In this article, the author talks about the conceptualization and creation of "Looking and Learning," a collaborative project that provided an opportunity for her and her curriculum students to become familiar with some wonderful artists and artworks. With the Looking and Learning project, the author and her students emphasized creating curriculum…
CSU-FDA (Colorado State Univ. -Food and Drug Administration) Collaborative Radiological Health Laboratory. Annual report - 1982: health effects of prenatal and postnatal whole-body exposure to ionizing radiation in the beagle dog
The Collaborative Radiological Health Laboratory was established in 1962 by the U.S. Public Health Service and Colorado State University for the purpose of determining in a carefully controlled animal experiment the life-time hazards associated with prenatal and early postnatal exposure to ionizing radiation. The CRHL study is designed to provide information that will facilitate the evaluation of risks to human beings from medical exposure during early development. The study is a long-term (lifespan) study of a moderately large and long-lived mammal exposed at one of several times during development to a relatively small and discrete dose of external radiation. Ages at irradiation selected for comparison reflect the primary concern with medical exposures during the development period. This annual report summarizes the current status of the study for the reporting period of January 1 through December 31, 1982.
Introduction: Framework Convention on Tobacco Control (FCTC) Articles 20, 21, and 22 call for strong monitoring and reporting of tobacco use and factors influencing use and disease (Articles 20 and 21) and for collaboration among the Parties and relevant organizations to share resources, knowledge, and expertise on all relevant tobacco control strategies (Article 22). Methods: This paper provides background information and discusses research strategies that would strengthen these efforts and better inform the Parties. By necessity, Articles 20 and 21 are discussed separately from Article 22, although 1 example that relates to both 20/21 and 22 is discussed at the end. Results: Twelve important research opportunities on surveillance and evaluation are recognized, along with 4 on collaboration. The authors believe that the 6 most important areas for research would study (a) possible underreporting of tobacco use among certain demographic groups in some countries, (b) measures of industry activities, (c) optimal sampling strategies, (d) sentinel surveillance, (e) networks of tobacco companies and their partners as they promote tobacco use and interfere with implementation of the FCTC, and (f) network/relationship factors that impact diffusion of knowledge and decision making on the implementation of the FCTC. In addition, we call for a review process of existing surveillance and evaluation strategies to coordinate activities to make optimal use of existing resources. This activity would involve networking as prescribed in Article 22. Conclusions: Studies and activities such as these would facilitate control of the tobacco epidemic. PMID:23335488
Hovi, Tapani; Blomqvist, Soile; Nasr, Eman; Burns, Cara C; Sarjakoski, Tarja; Ahmed, Nahed; Savolainen, Carita; Roivainen, Merja; Stenvik, Mirja; Laine, Pia; Barakat, Ibrahim; Wahdan, Mohammed H; Kamel, Faten A; Asghar, Humayun; Pallansch, Mark A; Kew, Olen M; Gary, Howard E; deGourville, Esther M; El Bassioni, Laila
Examination of sewage specimens for poliovirus (environmental surveillance) was adopted as a supplementary tool in the surveillance of poliomyelitis in Egypt. Sewage samples were concentrated about 50-fold using a simple two-phase separation technique, and inoculated in cell cultures in two collaborating laboratories in parallel. All but 9 of the 293 (97%) samples collected from January 2001 to December 2002 contained poliovirus and/or other enteroviruses, with polioviruses being detected in 84% of the samples. The proportion of specimens containing type 1 wild poliovirus (PV1W, the North-East African (NEAF) genotype) was less in 2002 (16%) than in 2001 (57%), and further decreased in 2003. While the overall sensitivity to detect PV1W was similar in the two collaborating laboratories, the specimens scored positive were not identical. Parallel cultures inoculated with aliquots of a given specimen very frequently resulted in isolation of different viruses. Moreover, partial sequence analysis occasionally revealed representatives of different genetic lineages of PV1W in a given specimen. These results emphasize the need to use intensive laboratory analysis to optimise sample sensitivity in environmental poliovirus surveillance, and the difficulties in reproducing the isolation results by simple re-inoculation of samples containing a mixture of different viruses.
Gongora, Victor; Trotman, Mark; Thomas, Reginald; Max, Millien; Zamora, Pastor Alfonso; Lepoureau, Maria Teresa Frias; Phanord, Siméon; Quirico, Jocelyn; Douglas, Kirk; Pegram, Rupert; Martinez, Dominique; Petitclerc, Martial; Chouin, Emilie; Marchal, Céline; Chavernac, David; Doyen, David; Vachiéry, Nathalie; Molia, Sophie; Hendrikx, Pascal; Lefrançois, Thierry
The Caribbean Animal Health Network (CaribVET) is a collaboration of veterinary services, diagnostic laboratories, research institutes, universities, and regional/international organizations to improve animal health in the Caribbean. New tools were used by the network to develop regional animal health activities: (1) A steering committee, a coordination unit, and working groups on specific diseases or activities were established. The working group on avian influenza used a collaborative Web site to develop a regionally harmonized avian influenza surveillance protocol and performance indicators. (2) A specific network was implemented on West Nile virus (WNV) to describe the WNV status of the Caribbean countries, to perform a technology transfer of WNV diagnostics, and to establish a surveillance system. (3) The CaribVET Web site (http://www.caribvet.net) encompasses information on surveillance systems, diagnostic laboratories, conferences, bibliography, and diseases of major concern in the region. It is a participatory Web site allowing registered users to add or edit information, pages, or data. An online notification system of sanitary information was set up for Guadeloupe to improve knowledge on animal diseases and facilitate early alert.
Lahra, Monica M
The Australian Gonococcal Surveillance Programme has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae from all states and territories since 1981. In 2013, 4,897 clinical isolates of gonococci from public and private sector sources were tested for in vitro antimicrobial susceptibility by standardised methods. Decreased susceptibility to ceftriaxone (MIC value 0.06-0.125 mg/L) was found nationally in 8.8% of isolates, double that reported in 2012 (4.4%). The highest proportions were reported from New South Wales and Victoria (both states reporting 11.8%), with a high proportion of strains also reported from Tasmania but a low number of isolates were tested. In addition, there was a multi-drug-resistant strain of N. gonorrhoeae isolated from a traveller to Australia, with a ceftraixone MIC value of 0.5 mgL-the highest ever reported in Australia. These antimicrobial resistance data from Australia in 2013 are cause for considerable concern. With the exception of remote Northern Territory where penicillin resistance rates remain low (1.3%) the proportion of strains resistant to penicillin remained high in all jurisdictions ranging from 15.6% in the Australian Capital Territory to 44.1% in Victoria. Quinolone resistance ranged from 16% in the Australian Capital Territory to 46% in Victoria. Azithromycin susceptibility testing was performed in all jurisdictions and resistance ranged from 0.3% in the Northern Territory to 5.7% in Queensland. High level resistance to azithromycin (MIC value was > 256 mg/L) was reported for the first time in Australia, in 4 strains: 2 each from Queensland and Victoria. Azithromycin resistant gonococci were not detected in the Australian Capital Territory, Tasmania or from the remote Northern Territory. Nationally, all isolates remained susceptible to spectinomycin.