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Sample records for antibiotics resources needed

  1. Grievances in cases using antibiotics due to orodental problems and assessment of the need for antibiotics.

    Science.gov (United States)

    Kandemir, S; Ergül, N

    2000-04-01

    To assess the complaints of patients who were prescribed antibiotics following orodental problems and the need for antibiotics prescribed for this purpose. Examinations were carried out in the Department of Oral Diagnosis and Radiology, Ege University, Turkey. A total of 203 patients (129 females and 74 males) between 8-70 years of age (mean age 37.7 +/- 13.9). Examination and report. Frequency of unnecessary antibiotic use. Antibiotic therapy was not necessary for 151 (74.4 per cent) cases. Antibiotics were unnecessarily prescribed in 45 cases of acute irreversible pulpitis, 10 chronic apical abscess, 6 acute apical paradontitis, 7 gingivitis, 10 periodontitis, 4 epulis, 2 TMJ (temporomandibular junction) dysfunction, 2 sharp ridge of alveolar bone, 1 burning mouth syndrome and 1 recurrent aphthous stomatitis. In 108 (53.2 per cent) of the cases, the prescribed antibiotics were found to be penicillins, 102 of which were broad-spectrum. It was also determined that only 6 (7.7 per cent) of the 78 cases diagnosed as acute apical abscess were given drainage as local therapy. Principles for treating dental infections suggest that an antibiotic should only be used to supplement and not substitute for conventional surgical methods. Therefore, in cases with acute apical abscess, mechanical treatment (drainage) should be the first step. Inappropriate antibiotic use is quite widespread in dentistry. Dentists should avoid inappropriate use of antibiotics. To prevent inappropriate administration, necessary precautions need to be taken against dispensing antibiotics without prescription.

  2. Antibiotic innovation for future public health needs.

    Science.gov (United States)

    Theuretzbacher, U

    2017-10-01

    The public health threat of antibiotic resistance has gained attention at the highest political levels globally, and recommendations on how to respond are being considered for implementation. Among the recommended responses being explored for their feasibility is the introduction of economic incentives to promote research and development of new antibiotics. There is broad agreement that public investment should stimulate innovation and be linked to policies promoting sustainable and equitable access to antibiotics. Though commonly used, the term 'innovation' is not based on a common understanding. This article aims to initiate discussion on the meaning of 'innovation' in this context. Literature and expert opinion. As the definition of a novel class (novel scaffold, novel pharmacophore), a novel target (novel binding site) and a novel mode of action-the three traditional criteria for 'innovation' in this context-may be confounded by the complexities of antibacterial drug discovery, a biological and outcome-oriented definition of innovation is presented to initiate discussion. Such an expanded definition of innovation in this specific context is based on the overarching requirement that a drug not be affected by cross-resistance to existing drugs in the organisms and indications for which it is intended to be used, and that it have low potential for high-frequency, high-level single-step resistance if intended as a single drug therapy. Policy makers, public health authorities and funders could use such a comprehensive definition of innovation to prioritize where publicly funded incentives should be applied. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. Inducing optimal substitution between antibiotics under open access to the resource of antibiotic susceptibility.

    Science.gov (United States)

    Herrmann, Markus; Nkuiya, Bruno

    2017-06-01

    This paper designs a bio-economic model to examine the use of substitute antibiotic drugs (analogs) sold by an industry that has open access to the resource of the antibiotic class's susceptibility (treatment effectiveness). Antibiotics are characterized by different expected recovery rates and production costs, which in conjunction with the class's treatment susceptibility determines their relative effectiveness. Our analysis reveals that the high-quality antibiotic drug loses its comparative advantage over time making the low-quality drug the treatment of last resort in the market equilibrium and the social optimum when antibiotic susceptibility cannot replenish. However, when antibiotic susceptibility is renewable, both antibiotics may be used in the long run, and the comparative advantage of the high-quality drug may be restored in the social optimum that allows lowering infection in the long run. We develop the optimal tax/subsidy scheme that would induce antibiotic producers under open access to behave optimally and account for the social cost of infection and value of antibiotic susceptibility. We show that the welfare loss associated with the uncorrected open-access allocation is highest; when the resource of antibiotic susceptibility is non-renewable, high morbidity costs are incurred by individuals, and low social discount rates apply. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Recent development of computational resources for new antibiotics discovery

    DEFF Research Database (Denmark)

    Kim, Hyun Uk; Blin, Kai; Lee, Sang Yup

    2017-01-01

    Understanding a complex working mechanism of biosynthetic gene clusters (BGCs) encoding secondary metabolites is a key to discovery of new antibiotics. Computational resources continue to be developed in order to better process increasing volumes of genome and chemistry data, and thereby better...

  5. What do I need to know about penicillin antibiotics?

    Science.gov (United States)

    Barker, Charlotte I; Germovsek, Eva; Sharland, Mike

    2017-02-01

    The penicillins remain the class of antibiotics most commonly prescribed to children worldwide. In an era when the risks posed by antimicrobial resistance are growing, an understanding of antibiotic pharmacology and how to apply these principles in clinical practice is increasingly important. This paper provides an overview of the pharmacology of penicillins, focusing on those aspects of pharmacokinetics, pharmacodynamics and toxicity that are clinically relevant in paediatric prescribing. Penicillin allergy is frequently reported but a detailed history of suspected adverse reactions is essential to identify whether a clinically relevant hypersensitivity reaction is likely or not. The importance of additional factors such as antibiotic palatability, concordance and stewardship are also discussed, highlighting their relevance to optimal prescribing of the penicillins for children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Antibiotics

    Science.gov (United States)

    Antibiotics are powerful medicines that fight bacterial infections. Used properly, antibiotics can save lives. They either kill bacteria or ... natural defenses can usually take it from there. Antibiotics do not fight infections caused by viruses, such ...

  7. Consolidating and Exploring Antibiotic Resistance Gene Data Resources

    DEFF Research Database (Denmark)

    Xavier, Basil Britto; Das, Anupam J.; Cochrane, Guy

    2016-01-01

    The unrestricted use of antibiotics has resulted in rapid acquisition of antibiotic resistance (AR) and spread of multidrug-resistant (MDR) bacterial pathogens. With the advent of next-generation sequencing technologies and their application in understanding MDR pathogen dynamics, it has become i...

  8. Mankind and energy: Needs - resources - hopes

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    A study-week, promoted by the Pontifical Academy of Sciences (PAS) and held in the Vatican City on 10-15 November 1980, examined thoroughly the theme: ''Mankind and Energy: Needs - Resources - Hopes''. The study-week was sponsored by the PAS, organized by the French physicist Prof. Andre Blanc-Lapierre, and was presided over by the well-known biophysicist Prof. Carlos Chagas, who is also President of the same Pontifical Academy of Sciences. The volume ''Humanite et Energie: Besoins - Ressources - Espoirs'', with all the proceedings of the study-week, may be obtained on request from the Cancelleria della Pontificia Accademia delle Scienze, Casina Pio IV, Citta del Vaticano. (author)

  9. Transforming User Needs into Functional Requirements for an Antibiotic Clinical Decision Support System

    Science.gov (United States)

    Bright, T.J.

    2013-01-01

    Summary Background Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. Objective To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). Methods The approach consisted of five steps: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. Results The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. Conclusion This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an

  10. Sand Needs and Resources Offshore New York

    Science.gov (United States)

    Lashley, J. M.; Flood, R. D.; White, M.; Bokuniewicz, H.; Hinrichs, C.; Wilson, R. E.

    2016-02-01

    "Superstorm" Sandy (October, 2012) accentuated the persistent problem of coastal erosion on New York's ocean coast. The New York state Department of State in cooperation with the Bureau of Ocean Energy Management has initiated further identification and assessment of marine sand reserves required to improve the resiliency of coastal communities and the maintenance of coastal habitats. The historical demand for beach nourishment has been about 1.5 million cubic meters per year, but sea level rise and the occurrence of extreme conditions may increase the demand to over 5 million cubic meters annually. Forty-four historical and proposed borrow sites have been delineated. This inner shelf is both sand rich and data rich. Geophysical and geological data has been compiled and reassessed to support identification, characterization, and delineation of sand resources for potential use in future coastal restoration, beach nourishment, and/or wetland restoration efforts. The South Shore of Long Island is composed in part by the Fire Island National Seashore. Holocene sand ridges extending at an oblique angle to the cross shore in the seaward direction. Borrow pits among the sand ridges, excavated were apparent in the most recent surveys and it appears that natural replenishment of offshore borrow areas has been occurring although the rates need to be determined in order to assess their sustainability. Not only is the area one of intense societal attention, but the use of this resource for coastal resilience must fit into a diverse framework marine spatial planning including not only traditional components, like commercial fishing, but also new factors like the siting of offshore wind-farms. To extend this assessment will include a recent survey, sponsored by the Bureau of Ocean Energy Management and the New York Department of State, providing approximately 700 km of geophysical survey lines located between 3 and 9 nautical miles offshore, and 46 geotechnical samples

  11. Variability in Antibiotic Regimens for Surgical Necrotizing Enterocolitis Highlights the Need for New Guidelines.

    Science.gov (United States)

    Blackwood, Brian P; Hunter, Catherine J; Grabowski, Julia

    antibiotic overuse, our findings highlight the need for guidelines in the antibiotic treatment of NEC and suggest that an abbreviated course of post-operative antibiotics may be safe.

  12. Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis

    Science.gov (United States)

    Jefferis, Joanna; Perera, Rafael; Everitt, Hazel; van Weert, Henk; Rietveld, Remco; Glasziou, Paul; Rose, Peter

    2011-01-01

    Background Acute infective conjunctivitis is a common problem in primary care, traditionally managed with topical antibiotics. A number of clinical trials have questioned the benefit of topical antibiotics for patients with acute infective conjunctivitis Aim To determine the benefit of antibiotics for the treatment of acute infective conjunctivitis in primary care and which subgroups benefit most Design An individual patient data meta-analysis Method Relevant trials were identified and individual patient data gathered for meta-analysis and subgroup analysis Results Three eligible trials were identified. Individual patient data were available from all primary care trials and data were available for analysis in 622 patients. Eighty per cent (246/308) of patients who received antibiotics and 74% (233/314) of controls were cured at day 7. There was a significant benefit of antibiotics versus control for cure at seven days in all cases combined (risk difference 0.08, 95% confidence interval (CI) = 0.01 to 0.14). Subgroups that showed a significant benefit from antibiotics were patients with purulent discharge (risk difference 0.09, 95% CI = 0.01 to 0.17) and patients with mild severity of red eye (risk difference 0.10, 95% CI = 0.02 to 0.18), while the type of control used (placebo drops versus nothing) showed a statistically significant interaction (P=0.03) Conclusion Acute conjunctivitis seen in primary care can be thought of as a self-limiting condition, with most patients getting better regardless of antibiotic therapy. Patients with purulent discharge or a mild severity of red eye may have a small benefit from antibiotics. Prescribing practices need to be updated, taking into account these results PMID:22152728

  13. Determinants of resource needs and utilization among refugees over time.

    Science.gov (United States)

    Wright, A Michelle; Aldhalimi, Abir; Lumley, Mark A; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E; Arnetz, Bengt B

    2016-04-01

    This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.

  14. Teacher Support Resources, Need Satisfaction and Well-Being.

    Science.gov (United States)

    Doménech-Betoret, Fernando; Lloret-Segura, Susana; Gómez-Artiga, Amparo

    2015-03-03

    Based on Job Demands-Resources Model (JD-R), this study examines the relationships among teacher support resources, psychological need satisfaction, engagement and burnout in a sample of 282 Spanish secondary school teachers. Nine teacher psychological needs were identified based on the study of Bess and on the Self-Determination Theory (SDT). Self-report questionnaires were used to measure the constructs selected for this study and their interrelationships were examined by structural equation modeling. The results reveal a good model fit to the data (NNFI = .88; CFI = .90; GFI = .90; RMSEA = .061). The analyses indicate a positive and significant effect of latent variable Psychological Need Satisfaction on engagement (β = .74, p Satisfaction in the relationship between teacher support resources and both engagement and burnout (additional paths did not improve the model fit: Δχ2(2) = 2.428, p = .29). Finally, practical implications of these findings are discussed.

  15. Transforming user needs into functional requirements for an antibiotic clinical decision support system: explicating content analysis for system design.

    Science.gov (United States)

    Bright, T J

    2013-01-01

    Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). THE APPROACH CONSISTED OF FIVE STEPS: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an antibiotic CDS system, resolving unmet antibiotic prescribing

  16. Renewable Energy Resources: Solutions to Nigeria power and energy needs

    International Nuclear Information System (INIS)

    Ladan-Haruna, A.

    2011-01-01

    Power and energy, with particularly electricity remains the pivot of economical and social development of any country. In view of this fact, a research on how renewable energy resources can solve Nigeria power and energy needs was carried out. It has identified main issues such as inconsistence government policies, corruptions and lack of fund hindering the development of renewable and power sectors for sustainable energy supply. The capacity of alternative energy resources and technology [hydropower, wind power, biomass, photovoltaic (solar), and geothermal power] to solve Nigerian energy crisis cannot be over-emphasized as some countries of the world who have no petroleum resources, utilizes other alternatives or options to solves their power and energy requirement. This paper reviews the prospects, challenges and solutions to Nigeria energy needs using renewable sources for development as it boost industrialization and create job opportunities

  17. Human Resource Management: The need for theory and diversity

    OpenAIRE

    Weber, Wolfgang; Kabst, Rüdiger

    2004-01-01

    Human Resource Management as an academic discipline needs to be theoretically grounded, i.e. it requires support through theories, theory-driven empirical research and critiques. In doing so, different theoretical perspectives are addressed suggesting a problem-orientated theory selection which leads inevitably to theoretical diversity.

  18. Actinobacteria and Myxobacteria-Two of the Most Important Bacterial Resources for Novel Antibiotics.

    Science.gov (United States)

    Landwehr, Wiebke; Wolf, Corinna; Wink, Joachim

    Bacteria have been by far the most promising resource for antibiotics in the past decades and will in all undoubtedly remain an important resource of innovative bioactive natural products in the future. Actinobacteria have been screened for many years, whereas the Myxobacteria have been underestimated in the past. Even though Actinobacteria belong to the Gram-positive and Myxobacteria to the Gram-negative bacteria both groups have a number of similar characters, as they both have huge genomes with in some cases more than 10kB and a high GC content and they both can differentiate and have often cell cycles including the formation of spores. Actinobacteria have been used for the antibiotic research for many years, hence it is often discussed whether this resource has now been exhaustively exploited but most of the screening programs from pharmaceutical companies were basing on the cultivation mainly of members of the genus Streptomyces or Streptomyces like strains (e.g., some Saccharopolyspora, Amycolatopsis or Actinomadura species) by use of standard methods so that many of the so called "neglected" Actinobacteria were overlooked the whole time. The present review gives an overview on the state of the art regarding new bioactive compounds with a focus on the marine habitats. Furthermore, the evaluation of Myxobacteria in our ongoing search for novel anti-infectives is highlighted.

  19. Resource competition may lead to effective treatment of antibiotic resistant infections.

    Directory of Open Access Journals (Sweden)

    Antonio L C Gomes

    Full Text Available Drug resistance is a common problem in the fight against infectious diseases. Recent studies have shown conditions (which we call antiR that select against resistant strains. However, no specific drug administration strategies based on this property exist yet. Here, we mathematically compare growth of resistant versus sensitive strains under different treatments (no drugs, antibiotic, and antiR, and show how a precisely timed combination of treatments may help defeat resistant strains. Our analysis is based on a previously developed model of infection and immunity in which a costly plasmid confers antibiotic resistance. As expected, antibiotic treatment increases the frequency of the resistant strain, while the plasmid cost causes a reduction of resistance in the absence of antibiotic selection. Our analysis suggests that this reduction occurs under competition for limited resources. Based on this model, we estimate treatment schedules that would lead to a complete elimination of both sensitive and resistant strains. In particular, we derive an analytical expression for the rate of resistance loss, and hence for the time necessary to turn a resistant infection into sensitive (tclear. This time depends on the experimentally measurable rates of pathogen division, growth and plasmid loss. Finally, we estimated tclear for a specific case, using available empirical data, and found that resistance may be lost up to 15 times faster under antiR treatment when compared to a no treatment regime. This strategy may be particularly suitable to treat chronic infection. Finally, our analysis suggests that accounting explicitly for a resistance-decaying rate may drastically change predicted outcomes in host-population models.

  20. Resource competition may lead to effective treatment of antibiotic resistant infections.

    Science.gov (United States)

    Gomes, Antonio L C; Galagan, James E; Segrè, Daniel

    2013-01-01

    Drug resistance is a common problem in the fight against infectious diseases. Recent studies have shown conditions (which we call antiR) that select against resistant strains. However, no specific drug administration strategies based on this property exist yet. Here, we mathematically compare growth of resistant versus sensitive strains under different treatments (no drugs, antibiotic, and antiR), and show how a precisely timed combination of treatments may help defeat resistant strains. Our analysis is based on a previously developed model of infection and immunity in which a costly plasmid confers antibiotic resistance. As expected, antibiotic treatment increases the frequency of the resistant strain, while the plasmid cost causes a reduction of resistance in the absence of antibiotic selection. Our analysis suggests that this reduction occurs under competition for limited resources. Based on this model, we estimate treatment schedules that would lead to a complete elimination of both sensitive and resistant strains. In particular, we derive an analytical expression for the rate of resistance loss, and hence for the time necessary to turn a resistant infection into sensitive (tclear). This time depends on the experimentally measurable rates of pathogen division, growth and plasmid loss. Finally, we estimated tclear for a specific case, using available empirical data, and found that resistance may be lost up to 15 times faster under antiR treatment when compared to a no treatment regime. This strategy may be particularly suitable to treat chronic infection. Finally, our analysis suggests that accounting explicitly for a resistance-decaying rate may drastically change predicted outcomes in host-population models.

  1. Risk assessment activities at NIOSH: Information resources and needs

    Energy Technology Data Exchange (ETDEWEB)

    Stayner, L.T.; Meinhardt, T.; Hardin, B. [National Institute for Occupational Safety and Health, Cincinnati, OH (United States)

    1990-12-31

    Under the Occupational Safety and Health, and Mine Safety and Health Acts, the National Institute for Occupational Safety and Health (NIOSH) is charged with development of recommended occupational safety and health standards, and with conducting research to support the development of these standards. Thus, NIOSH has been actively involved in the analysis of risk associated with occupational exposures, and in the development of research information that is critical for the risk assessment process. NIOSH research programs and other information resources relevant to the risk assessment process are described in this paper. Future needs for information resources are also discussed.

  2. Antibiotics and Antibiotic Resistance

    Science.gov (United States)

    ... all that ails you. Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. ... Information for Consumers and Health Professionals Information by drug class Antimicrobial Resistance Animal and Veterinary Related Resources Further information ...

  3. Antibiotic prophylaxis at elective cesarean section: a randomized controlled trial in a low resource setting.

    Science.gov (United States)

    Kandil, Mohamed; Sanad, Zakaria; Gaber, Wael

    2014-04-01

    To determine the best time to administer prophylactic antibiotics at Cesarean delivery in order to reduce the postoperative maternal infectious morbidity in a low resource setting. One hundred term primigravidae with singleton pregnancy were recruited and randomly allocated to two equal groups. Each woman received 2 g intravenous Cefazoline. Women in Group I received it prior to skin incision while those in Group II had it immediately after cord clamping. We measured the following outcome parameters: (1) Surgical site wound infection; (2) Endometritis and (3) Urinary tract infection. There was no significant difference in any of the patients' characteristics between both groups. In Group I, three cases developed surgical site infections but four in Group II (p > 0.05). In Group I, the infected cases had Cesarean because of malpresentations while in Group II, two cases had Cesarean because of patients' request, one because of maternal heart disease and one due to intra-uterine growth restriction. Seven and nine cases had urinary tract infection in Groups I and II, respectively, (p > 0.05). Prophylactic antibiotic administration either prior to surgery or after cord clamping is probably equally effective in reducing the postoperative infectious morbidity after Cesarean in low resource settings.

  4. Information needs for water resources decision-making

    International Nuclear Information System (INIS)

    Sellers, J.

    1993-01-01

    Water and related resources planning and decision-making have developed to the state of multiple objective and/or multiple criteria analysis using complicated systems analysis. The objective of this paper is to indicate the major components of information needed to facilitate the planning process for resource utilization, and to provide desirable outputs from management schemes. The process could best be described as the proper development of Management Information Systems (MIS) or Decision Support Systems (DDS). Data and information systems are never completed and must be continually updated and modified. The exact composition of any system depends also upon the general type of decision techniques being used. A brief outline of the decision process is given with the remainder of the paper dealing with the types of information needed to support the decision system. (author). 34 refs

  5. The state of human dimensions capacity for natural resource management: needs, knowledge, and resources

    Science.gov (United States)

    Sexton, Natalie R.; Leong, Kirsten M.; Milley, Brad J.; Clarke, Melinda M.; Teel, Tara L.; Chase, Mark A.; Dietsch, Alia M.

    2013-01-01

    The social sciences have become increasingly important in understanding natural resource management contexts and audiences, and are essential in design and delivery of effective and durable management strategies. Yet many agencies and organizations do not have the necessary resource management. We draw on the textbook definition of HD: how and why people value natural resources, what benefits people seek and derive from those resources, and how people affect and are affected by those resources and their management (Decker, Brown, and Seimer 2001). Clearly articulating how HD information can be used and integrated into natural resource management planning and decision-making is an important challenge faced by the HD field. To address this challenge, we formed a collaborative team to explore the issue of HD capacity-building for natural resource organizations and to advance the HD field. We define HD capacity as activities, efforts, and resources that enhance the ability of HD researchers and practitioners and natural managers and decision-makers to understand and address the social aspects of conservation.Specifically, we sought to examine current barriers to integration of HD into natural resource management, knowledge needed to improve HD capacity, and existing HD tools, resources, and training opportunities. We conducted a needs assessment of HD experts and practitioners, developed a framework for considering HD activities that can contribute both directly and indirectly throughout any phase of an adaptive management cycle, and held a workshop to review preliminary findings and gather additional input through breakout group discussions. This paper provides highlights from our collaborative initiative to help frame and inform future HD capacity-building efforts and natural resource organizations and also provides a list of existing human dimensions tools and resources.

  6. Families of children with special educational needs resources and needs support

    Directory of Open Access Journals (Sweden)

    Danielli Silva Gualda

    2013-06-01

    Full Text Available The goal of this research was to investigate what are the resources and needs of parents of preschool children with special educational needs. The participants were eleven parents of children with special educational needs included in pre-elementary school. Most parents had purchasing power medium to medium low. To meet the objectives, parents filled in the “Inventory of Home Environment Resources - RAF” and “Questionnaire on the needs of families - QNF. The results enabled the RAF to note that this study the majority of children with special educational needs and has a stimulating home environment, whereas the mothers accompanied their children in school affairs and the maintenance of a routine to perform activities, and receive care through resource rooms (41.6% and in the care of APAE (25.0%. the data obtained by QNF parents need help to: (a to obtain more information about services and supports that your child may benefit in the future, (b meet regularly with appropriate persons, as professionals, to talk on the child’s disability, (c explain the child’s other children, friends and neighbors, (d find social support services and educational for the child, (e pay expenses and (f to discuss problems and find solutions.

  7. Do children with uncomplicated severe acute malnutrition need antibiotics? A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gabriel Alcoba

    Full Text Available Current (1999 World Health Organization guidelines recommend giving routine antibiotics (AB for all children with severe acute malnutrition (SAM, even if they have uncomplicated disease with no clinically obvious infections. We examined the evidence behind this recommendation.OVID-MEDLINE, EMBASE, COCHRANE, GLOBAL-HEALTH, CINAHL, POPLINE, AFRICA-WIDE-NiPAD, and LILACS were searched for AB efficacy, bacterial resistance, and infection rates in SAM. Following PRISMA guidelines, a systematic review and meta-analysis were performed. Three randomised controlled trials (RCT, five Cochrane reviews, and 37 observational studies were identified. One cohort-study showed no increase in nutritional-cure and mortality in uncomplicated SAM where no AB were used. (p>0.05. However, an unpublished RCT in this setting did show mortality benefits. Another RCT did not show superiority of ceftriaxone over amoxicilllin for these same outcomes, but adressed SAM children with and without complications (p = 0.27. Another RCT showed no difference between amoxicillin and cotrimoxazole efficacies for pneumonia in underweight, but not SAM. Our meta-analysis of 12 pooled susceptibility-studies for all types of bacterial isolates, including 2767 stricly SAM children, favoured amoxicillin over cotrimoxazole for susceptibility medians: 42% (IQR 27-55% vs 22% (IQR 17-23% and population-weighted-means 52.9% (range 23-57% vs 35.4% (range 6.7-42%. Susceptibilities to second-line AB were better, above 80%. Prevalence of serious infections in SAM, pooled from 24 studies, ranged from 17% to 35.2%. No study infered any association of infection prevalence with AB regimens in SAM.The evidence underlying current antibiotic recommendations for uncomplicated SAM is weak. Susceptibility-studies favour amoxicillin over cotrimoxazole. However, given that these antibiotics have side-effects, costs, and risks as well as benefits, their routine use needs urgent testing. With reliable

  8. Resource competition in plant invasions: emerging patterns and research needs.

    Science.gov (United States)

    Gioria, Margherita; Osborne, Bruce A

    2014-01-01

    Invasions by alien plants provide a unique opportunity to examine competitive interactions among plants. While resource competition has long been regarded as a major mechanism responsible for successful invasions, given a well-known capacity for many invaders to become dominant and reduce plant diversity in the invaded communities, few studies have measured resource competition directly or have assessed its importance relative to that of other mechanisms, at different stages of an invasion process. Here, we review evidence comparing the competitive ability of invasive species vs. that of co-occurring native plants, along a range of environmental gradients, showing that many invasive species have a superior competitive ability over native species, although invasive congeners are not necessarily competitively superior over native congeners, nor are alien dominants are better competitors than native dominants. We discuss how the outcomes of competition depend on a number of factors, such as the heterogeneous distribution of resources, the stage of the invasion process, as well as phenotypic plasticity and evolutionary adaptation, which may result in increased or decreased competitive ability in both invasive and native species. Competitive advantages of invasive species over natives are often transient and only important at the early stages of an invasion process. It remains unclear how important resource competition is relative to other mechanisms (competition avoidance via phenological differences, niche differentiation in space associated with phylogenetic distance, recruitment and dispersal limitation, indirect competition, and allelopathy). Finally, we identify the conceptual and methodological issues characterizing competition studies in plant invasions, and we discuss future research needs, including examination of resource competition dynamics and the impact of global environmental change on competitive interactions between invasive and native species.

  9. Resource competition in plant invasions: emerging patterns and research needs

    Science.gov (United States)

    Gioria, Margherita; Osborne, Bruce A.

    2014-01-01

    Invasions by alien plants provide a unique opportunity to examine competitive interactions among plants. While resource competition has long been regarded as a major mechanism responsible for successful invasions, given a well-known capacity for many invaders to become dominant and reduce plant diversity in the invaded communities, few studies have measured resource competition directly or have assessed its importance relative to that of other mechanisms, at different stages of an invasion process. Here, we review evidence comparing the competitive ability of invasive species vs. that of co-occurring native plants, along a range of environmental gradients, showing that many invasive species have a superior competitive ability over native species, although invasive congeners are not necessarily competitively superior over native congeners, nor are alien dominants are better competitors than native dominants. We discuss how the outcomes of competition depend on a number of factors, such as the heterogeneous distribution of resources, the stage of the invasion process, as well as phenotypic plasticity and evolutionary adaptation, which may result in increased or decreased competitive ability in both invasive and native species. Competitive advantages of invasive species over natives are often transient and only important at the early stages of an invasion process. It remains unclear how important resource competition is relative to other mechanisms (competition avoidance via phenological differences, niche differentiation in space associated with phylogenetic distance, recruitment and dispersal limitation, indirect competition, and allelopathy). Finally, we identify the conceptual and methodological issues characterizing competition studies in plant invasions, and we discuss future research needs, including examination of resource competition dynamics and the impact of global environmental change on competitive interactions between invasive and native species. PMID

  10. Do we need new antibiotics? The search for new targets and new compounds

    Czech Academy of Sciences Publication Activity Database

    Spížek, Jaroslav; Novotná, Jitka; Řezanka, Tomáš; Demain, L. A.

    2010-01-01

    Roč. 37, č. 12 (2010), s. 1241-1248 ISSN 1367-5435 Institutional research plan: CEZ:AV0Z50200510 Keywords : Antibiotics * Infectious diseases * Antibiotic resistance Subject RIV: EE - Microbiology, Virology Impact factor: 2.416, year: 2010

  11. Energy needs, uses, and resources in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Palmedo, P.F.; Nathans, R.; Beardsworth, E.; Hale, S. Jr.

    1978-03-01

    The report identifies the energy needs, uses, and resources in the developing countries of the world and examines the energy options available to them for their continued social and economic growth. If traditional patterns of development are to continue, oil consumption in the non-OPEC LDCs will grow steadily to become comparable with current U.S. consumption between 2000 and 2020. Attempts to exploit indigenous hydrocarbon resources even in those LDCs with untapped reserves will be limited by shortages of capital and technical manpower. In the absence of major actions to replace noncommercial fuels or to increase the effectiveness with which they are used, a large fraction of the 3 to 4 billion LDC rural population in the year 2000 will not be able to raise their energy usage above subsistence levels. There is a wide variety of solutions to these problems, many of them emerging directly from the changed economics of energy. For example, most LDCs have not adequately explored and developed their own indigenous resources; in virtually all energy conversion and utilization processes there are opportunities for improvements in efficiency and substitution of renewable energy forms. In virtually all these areas there are opportunities for effective assistance activities.

  12. Labor of love. A model for planning human resource needs.

    Science.gov (United States)

    Brady, F J

    1989-01-01

    Typically, the annual budgeting process is the hospital's only attempt to forecast human resource requirements. In times of rapid change, this traditional ad hoc approach is incapable of satisfying either the Catholic hospital's ethical obligations as an employer or its responsibilities to provide healthcare to the poor and suffering. Assumptions about future activity, including volume projections on admissions, patient days, and other services, influence the budgeting process to a large degree. Because the amount of work to be done and the number of employees required to do it are related, changes in demand for service immediately and directly affect staffing requirements. A hospital cannot achieve ethical human resource management or provide high-quality healthcare if inadequate planning forces management into a cycle of crisis-coping--reacting to this year's nursing shortage with a major recruiting effort and next year's financial crunch with a traumatic reduction in force. The human resource planning approach outlined here helps the hospital meet legitimate business needs while satisfying its ethical obligations. The model has four phases and covers a charge to the planning committee; committee appointments; announcements; the establishment of ground rules, focus, and task forces; and the work of each task force.

  13. Preparing Future Geoscience Professionals: Needs, Strategies, Programs, and Online Resources

    Science.gov (United States)

    Macdonald, H.; Manduca, C. A.; Ormand, C. J.; Dunbar, R. W.; Beane, R. J.; Bruckner, M.; Bralower, T. J.; Feiss, P. G.; Tewksbury, B. J.; Wiese, K.

    2011-12-01

    Geoscience faculty, departments, and programs play an important role in preparing future geoscience professionals. One challenge is supporting the diversity of student goals for future employment and the needs of a wide range of potential employers. Students in geoscience degree programs pursue careers in traditional geoscience industries; in geoscience education and research (including K-12 teaching); and opportunities at the intersection of geoscience and other fields (e.g., policy, law, business). The Building Strong Geoscience Departments project has documented a range of approaches that departments use to support the development of geoscience majors as professionals (serc.carleton.edu/departments). On the Cutting Edge, a professional development program, supports graduate students and post-doctoral fellows interested in pursuing an academic career through workshops, webinars, and online resources (serc.carleton.edu/NAGTWorkshops/careerprep). Geoscience departments work at the intersection of student interests and employer needs. Commonly cited program goals that align with employer needs include mastery of geoscience content; field experience; skill in problem solving, quantitative reasoning, communication, and collaboration; and the ability to learn independently and take a project from start to finish. Departments and faculty can address workforce issues by 1) implementing of degree programs that develop the knowledge, skills, and attitudes that students need, while recognizing that students have a diversity of career goals; 2) introducing career options to majors and potential majors and encouraging exploration of options; 3) advising students on how to prepare for specific career paths; 4) helping students develop into professionals, and 5) supporting students in the job search. It is valuable to build connections with geoscience employers, work with alumni and foster connections between students and alumni with similar career interests, collaborate with

  14. Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches.

    Science.gov (United States)

    Rousham, Emily K; Unicomb, Leanne; Islam, Mohammad Aminul

    2018-04-11

    Antibiotic resistance (ABR) is recognized as a One Health challenge because of the rapid emergence and dissemination of resistant bacteria and genes among humans, animals and the environment on a global scale. However, there is a paucity of research assessing ABR contemporaneously in humans, animals and the environment in low-resource settings. This critical review seeks to identify the extent of One Health research on ABR in low- and middle-income countries (LMICs). Existing research has highlighted hotspots for environmental contamination; food-animal production systems that are likely to harbour reservoirs or promote transmission of ABR as well as high and increasing human rates of colonization with ABR commensal bacteria such as Escherichia coli However, very few studies have integrated all three components of the One Health spectrum to understand the dynamics of transmission and the prevalence of community-acquired resistance in humans and animals. Microbiological, epidemiological and social science research is needed at community and population levels across the One Health spectrum in order to fill the large gaps in knowledge of ABR in low-resource settings. © 2018 The Author(s).

  15. Investigations needed to stimulate the development of Jordan's mineral resources

    Science.gov (United States)

    McKelvey, V.E.

    1979-01-01

    The level of living that any society can attain is a direct function of the use it makes of all kinds of raw materials (soil, water, metals, nonmetals, etc.), all kinds of energy (both animate and inanimate), and all kinds of human ingenuity; and is an inverse function of the size of the population that must share the collective product. The relation between raw materials, energy and ingenuity is such that use of a large amount of one may offset the need for large amounts of others. The most vital raw materials are water, soil, and construction materials, for these are needed in large quantities and are hard to import. Metals, chemicals, and inanimate energy are necessary for industrialization. The more of these minerals a nation possess, the better, but not nation can hope to be self-sufficient in all of the m and therefore must trade for some essential materials. Jordan’s natural resources have been little explored. The grantitc-metamorphic terrane in the southeastern part of the Kingdom could contain deposits of tungsten, rare earths, feldspar, mica, fluorite etc. and the sedimentary terrane over much of the rest of the county is favorable for the occurrence of oil. Even if none of these minerals is found, however, Jordan’s other mineral resource, if fully explored and developed in the light of modern technology, will support a far higher level of living than her people now enjoy. Very likely she can increase her rainfall by about 10 percent by cloud seeding, and she undeveloped supplies in both surface and ground water that are sufficient to nearly double her usable water supply. Even if she does not have oil or have it in large quantities, she can buy it cheaply from neighboring counties, and in addition has undeveloped sources of hydroelectric power, large reserves of bituminous limestone, large reserves of nuclear power as uranium in phosphate rock, and can use solar and wind power for special purposes. Her large supplies of construction, fertilizer, and

  16. Economic analysis of needs the training of human resources

    Directory of Open Access Journals (Sweden)

    Buha Vesna V.

    2015-01-01

    Full Text Available The issue of lifelong learning is linked to the voluntary and motivated to seek knowledge from personal or organizational reasons. The fact that an individual learns driven by personal career goals, desire for self improvement and motivation refers to the importance of lifelong learning for the entire social inclusion, sustainability, and competitiveness and employment. The common denominator of all the problems of investment in education is an issue of increasing allocations to the social issues, the pace that in this area manifest needs. Relative resource constraints requires that the investment in professional development taking place in accordance with the expected contribution to the creation of new value, increase productivity and social development of society as a whole. Respecting this request, in general, should provide maximum socio-economic effects with minimal investment. Precise measurement is achieved by tools of economic analysis: cost & benefit, economic sensitivity analysis, risk assessment.

  17. Global status of nuclear power and the needed human resources

    International Nuclear Information System (INIS)

    Bernido, Corazon C.

    2009-01-01

    According to projections of the OECD/IEA, the world energy demand will expand by 45% from now until 2030, with coal accounting for more than a third of the overall rise. To reduce greenhouse gases and mitigate climate change, many countries are resorting to renewables and nuclear power. Some statistics about nuclear energy in the global energy mix and about nuclear power plants worldwide, as well as the energy situation in the country are presented. According to sources from the Department of Energy on the Philippine Energy Plan, nuclear power is a long-term energy option and will likely enter the energy mix by 2025. Preparation of the infrastructure for nuclear power has to start ten to fifteen years before the first plant comes online. The needed human resources, the education and training required are present. (Author)

  18. Why Antibiotic Use Data in Animals Needs to Be Collected and How This Can Be Facilitated

    Directory of Open Access Journals (Sweden)

    Jorge Pinto Ferreira

    2017-12-01

    Full Text Available Antimicrobial resistance (AMR is currently recognized as one of the most significant threats to public health worldwide. It is a phenomenon that highlights the interconnectivity between human and animal health since any use of antibiotics in humans can eventually lead to resistance in the microbial populations colonizing animals and vice versa. In recent years, our understanding of the relationship between the use of antibiotics and the consequent development of resistance in microbial populations to these (or similar antibiotics has increased. Having accurate data, ideally in a digital format, on the use of antibiotics are therefore of paramount importance. Current obstacles to having such data include, among others, the lack of consensual and harmonized technical methods and units that represent antimicrobial use (AMU, the insufficient incentives to motivate primary producers to report their use of antibiotics, and the inexistence of user-friendly technologies for the collection of such data, despite the generalized use of Internet and electronic devices. Further development and adoption of the units proposed by the European Surveillance of Veterinary Antimicrobial Consumption will contribute to the long-desired harmonization. Rewarding the animal producers (via tax incentives, for example that use less antibiotics and the development of an app, to which producers could orally report the used antibiotics are among the solutions that could help to overcome the current challenges. I here also argue that having mandatory electronic veterinary prescriptions and awareness campaings, funded via public–private partnerships, should also be considered as methods that could help for the control of societal problems like AMR.

  19. The Need for Inclusion of Human Resources Accounting in the ...

    African Journals Online (AJOL)

    Toshiba

    terms of skill, sex etc. for effective human resources planning, control and management. ... accounting system to provide human resource accounting for its managers. ... A similar effort in disclosing human resource information in the financial ... Estimate the effect of managerial actions on employees' morale, productivity and ...

  20. Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.

    Science.gov (United States)

    Chung, Philip; Currie, Brian; Guo, Yi; Talansky, Moshe; Brown, Shakara; Ostrowsky, Belinda

    2014-10-01

    Antimicrobial exposure remains an important risk factor for developing Clostridium difficile infection (CDI). Efficient method to identify antibiotics associated with CDI is important for formulating strategies to curtail their use. As a prelude to a more extensive Agency for Healthcare Research and Quality-funded project (Evaluation & Research on Antimicrobial Stewardship's Effect on Clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for identifying antibiotic targets for antimicrobial stewardship interventions. The study compared a series of 6 focused case-control studies. Cases consisted of patients with laboratory-confirmed CDI admitted from July-October 2009. Controls were selected from patients without CDI hospitalized during the same period. Five groups of controls were matched to cases (2:1 ratio) using group-specific matching criteria, including admission date, age, type of admission, length of stay (LOS) to discharge, and/or LOS to CDI diagnosis. The final control group was selected from patients who received antibiotics during hospitalization. Data, including demographics and antibiotic usage, were compared between case and control groups. A total of 126 cases were matched to 6 groups of 252 controls. For control groups 1-5, the use of piperacillin and tazobactam, ceftriaxone or cefepime, ciprofloxacin or moxifloxacin, intravenous vancomycin, azithromycin, and antibiotics of last resort were significantly more frequent in case than control patients. For the final control group, the associations between ceftriaxone or cefepime, and ciprofloxacin or moxifloxacin use and CDI no longer persisted. This could in part be explained by differences in comorbidities between case and control patients even with stringent matching criteria. Use of a simple matching strategy to conduct case-control studies is an efficient and feasible compromise strategy, especially in resource-limited settings, to identify high

  1. Needs, resources and climate change: Clean and efficient conversion technologies

    KAUST Repository

    Ghoniem, Ahmed F.

    2011-02-01

    Energy "powers" our life, and energy consumption correlates strongly with our standards of living. The developed world has become accustomed to cheap and plentiful supplies. Recently, more of the developing world populations are striving for the same, and taking steps towards securing their future energy needs. Competition over limited supplies of conventional fossil fuel resources is intensifying, and more challenging environmental problems are springing up, especially related to carbon dioxide (CO 2) emissions. There is strong evidence that atmospheric CO 2 concentration is well correlated with the average global temperature. Moreover, model predictions indicate that the century-old observed trend of rising temperatures could accelerate as carbon dioxide concentration continues to rise. Given the potential danger of such a scenario, it is suggested that steps be taken to curb energy-related CO 2 emissions through a number of technological solutions, which are to be implemented in a timely fashion. These solutions include a substantial improvement in energy conversion and utilization efficiencies, carbon capture and sequestration, and expanding the use of nuclear energy and renewable sources. Some of these technologies already exist, but are not deployed at sufficiently large scale. Others are under development, and some are at or near the conceptual state. © 2010 Elsevier Ltd. All rights reserved.

  2. Did the dutch pneumococcal vaccination campaign decrease the need for antibiotics in children?

    NARCIS (Netherlands)

    Gefenaite, Giedre; Bijlsma, Maarten J.; Bos, Jens; Hak, Eelko

    2013-01-01

    Background: Streptococcus pneumoniae is responsible for a significant amount of respiratory infections and acute otitis media (AOM) and use of antibiotics in children. In June 2006 a four-dose 7-valent pneumococcal vaccination campaign (PVC) was introduced in the Netherlands; 94% of children born

  3. Genomic Microbial Epidemiology Is Needed to Comprehend the Global Problem of Antibiotic Resistance and to Improve Pathogen Diagnosis.

    Science.gov (United States)

    Wyrsch, Ethan R; Roy Chowdhury, Piklu; Chapman, Toni A; Charles, Ian G; Hammond, Jeffrey M; Djordjevic, Steven P

    2016-01-01

    Contamination of waste effluent from hospitals and intensive food animal production with antimicrobial residues is an immense global problem. Antimicrobial residues exert selection pressures that influence the acquisition of antimicrobial resistance and virulence genes in diverse microbial populations. Despite these concerns there is only a limited understanding of how antimicrobial residues contribute to the global problem of antimicrobial resistance. Furthermore, rapid detection of emerging bacterial pathogens and strains with resistance to more than one antibiotic class remains a challenge. A comprehensive, sequence-based genomic epidemiological surveillance model that captures essential microbial metadata is needed, both to improve surveillance for antimicrobial resistance and to monitor pathogen evolution. Escherichia coli is an important pathogen causing both intestinal [intestinal pathogenic E. coli (IPEC)] and extraintestinal [extraintestinal pathogenic E. coli (ExPEC)] disease in humans and food animals. ExPEC are the most frequently isolated Gram negative pathogen affecting human health, linked to food production practices and are often resistant to multiple antibiotics. Cattle are a known reservoir of IPEC but they are not recognized as a source of ExPEC that impact human or animal health. In contrast, poultry are a recognized source of multiple antibiotic resistant ExPEC, while swine have received comparatively less attention in this regard. Here, we review what is known about ExPEC in swine and how pig production contributes to the problem of antibiotic resistance.

  4. The Need for Inclusion of Human Resources Accounting in the ...

    African Journals Online (AJOL)

    Director to place appropriate values on our physical resources so as to maximize utilization of human assets. This paper has attempted to bring the views of different researchers on the concept of human resource accounting into focus and the ...

  5. Resource competition in plant invasions: emerging patterns and research needs

    Czech Academy of Sciences Publication Activity Database

    Gioria, Margherita; Osborne, B. A.

    2014-01-01

    Roč. 5, č. 501 (2014), s. 1-21 ISSN 1664-462X Institutional support: RVO:67985939 Keywords : plant invoasions * resource competition * dominance Subject RIV: EF - Botanics Impact factor: 3.948, year: 2014

  6. Chronic urinary tract infections in patients with spinal cord lesions - biofilm infection with need for long-term antibiotic treatment.

    Science.gov (United States)

    Tofte, Nete; Nielsen, Alex C Y; Trøstrup, Hannah; Andersen, Christine B; Von Linstow, Michael; Hansen, Birgitte; Biering-Sørensen, Fin; Høiby, Niels; Moser, Claus

    2017-04-01

    Patients suffering from spinal cord injuries resulting in complete or incomplete paraplegia or tetraplegia are highly disposed to frequent, recurrent or even chronic urinary tract infections (UTIs). The reason for the increased risk of acquiring UTIs is multifactorial, including reduced sensation of classical UTI symptoms, incomplete bladder emptying, frequent catheterizations or chronic urinary tract catheters. Biofilms in relation to UTIs have been shown both on catheters, on concrements or as intracellular bacterial communities (IBCs). Due to the increased risk of acquiring recurrent or chronic UTIs and frequent antibiotic treatments, patients experience an increased risk of being infected with antibiotic-resistant bacteria like extended-spectrum β-lactamase-producing Escherichia coli or Klebsiella spp., but also bacteria like Pseudomonas aeruginosa inherently resistant to several antibiotics. Diagnosing the UTI can also be challenging, especially distinguishing harmless colonization from pathogenic infection. Based on a previous study showing activation of humoral immune response toward UTI pathogens in patients with spinal cord lesions (SCL), the present mini review is an evaluation of using antibody response as an indicator of chronic biofilm UTI. In addition, we evaluated the effect of long-term treatment with antibiotics in patients with SCLs and chronic UTI, defined by culturing of a uropathogen in the urine and elevated specific precipitating antibodies against the same uropathogen in a blood sample. Elimination of chronic UTI, decrease in specific precipitating antibody values and avoiding selection of new multidrug-resistant (MDR) uropathogens were the primary markers for effect of treatment. The results of this evaluation suggest that the long-term treatment strategy in SCL patients with chronic UTI may be effective; however, randomized prospective results are needed to confirm this. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  7. Beyond Strategic Planning: Tailoring District Resources to Needs.

    Science.gov (United States)

    Bollin, Thomas D.; Eadie, Douglas C.

    1991-01-01

    The strategic management process tries to create and maintain a dynamic balance between an organization's vision, mission, goals, strategies, and resources and its external environment. One Ohio school district's strategic management process succeeded resulting from a highly committed school board, a strong board-superintendent partnership, active…

  8. Information resource use and need in risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Turturro, A. [National Center for Toxicological Research, Jefferson, AR (United States)

    1990-12-31

    The manner in which the Food and Drug Administration (FDA) uses information resources comprises an interesting illustration of federal agency information use. A description of the context in which risk assessment occurs within the FDA is followed by a discussion of information access and use, as well as a practical example.

  9. Distributed Energy Resources Interconnection Systems: Technology Review and Research Needs

    Energy Technology Data Exchange (ETDEWEB)

    Friedman, N. R.

    2002-09-01

    Interconnecting distributed energy resources (DER) to the electric utility grid (or Area Electric Power System, Area EPS) involves system engineering, safety, and reliability considerations. This report documents US DOE Distribution and Interconnection R&D (formerly Distributed Power Program) activities, furthering the development and safe and reliable integration of DER interconnected with our nation's electric power systems. The key to that is system integration and technology development of the interconnection devices that perform the functions necessary to maintain the safety, power quality, and reliability of the EPS when DER are connected to it.

  10. Effects of procalcitonin-guided treatment on antibiotic use and need for mechanical ventilation in patients with acute asthma exacerbation: Meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Wanis H. Ibrahim

    2017-12-01

    Full Text Available Objective: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility or emergency department, or during hospital admission. The secondary outcome was the need for mechanical ventilation. Methods: An extensive literature search was performed to identify randomized controlled clinical trials (published in English that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician’s discretion for adult participants with mild, moderate, or severe acute asthma exacerbations. Results: Four randomized controlled trials evaluating 457 patients were included in this meta-analysis, with significant homogeneity observed among these studies. Procalcitonin-based protocols decreased antibiotic prescriptions (relative risk 0.58, 95% confidence interval 0.50–0.67. The conclusion regarding the difference between the two groups in the need for mechanical ventilation (relative risk 1.10, 95% confidence interval 0.62–1.94 was guarded due to inadequate power and the potential for type II error. The overall quality of evidence was also limited by the lack of double-blinding. Conclusions: These data suggest a potential benefit for the use of serum procalcitonin in guiding antibiotic therapy in patients with an acute asthma exacerbation and advocates the need for more randomized controlled trials. Keywords: Procalcitonin, Asthma, Antibiotic, Exacerbation, Guided

  11. Do weaner pigs need in-feed antibiotics to ensure good health and welfare?

    Science.gov (United States)

    Diana, Alessia; Manzanilla, Edgar G; Calderón Díaz, Julia A; Leonard, Finola C; Boyle, Laura A

    2017-01-01

    Antibiotics (AB) are used in intensive pig production systems to control infectious diseases and they are suspected to be a major source of antibiotic resistance. Following the ban on AB use as growth promoters in the EU, their prophylactic use in-feed is now under review. The aim of this study was to evaluate the effect of removing prophylactic in-feed AB on pig health and welfare indicators. Every Monday for six weeks, a subset of 70 pigs were weaned, tagged and sorted into two groups of 35 pigs according to weight (9.2 ± 0.6 kg). AB were removed from the diet of one group (NO, n = 6) and maintained in the other group (AB, n = 6) for nine weeks. Ten focal pigs were chosen per group. After c. five weeks each group was split into two pens of c.17 pigs for the following 4 weeks. Data were recorded weekly. Skin, tail, ear, flank and limb lesions of focal pigs were scored according to severity. The number of animals per group affected by health deviations was also recorded. The number of fights and harmful behaviours (ear, tail bites) per group was counted during 3×5min observations once per week. Data were analysed using mixed model equations and binomial logistic regression. At group level, AB pigs were more likely to have tail (OR = 1.70; P = 0.05) but less likely to have ear lesions than NO pigs (OR = 0.46; P<0.05). The number of ear bites (21.4±2.15 vs. 17.3±1.61; P<0.05) and fights (6.91±0.91 vs. 5.58±0.72; P = 0.09) was higher in AB than in NO pigs. There was no effect of treatment on health deviations and the frequency of these was low. Removing AB from the feed of weaner pigs had minimal effects on health and welfare indicators.

  12. Technology needs assessment (TNA) resource document for South Africa

    CSIR Research Space (South Africa)

    Taviv, R

    2007-08-01

    Full Text Available TNA(Technology needs assessment) is a requirement of Article 4.5 of the UNFCCC ‘Technology Transfer’ is a broad set of processes covering the flows of know-how, experience and equipment for mitigating or adapting to climate change amongst different...

  13. Determining Resource Needs of Autonomous Agents in Decoupled Plans

    NARCIS (Netherlands)

    Oosterman, J.E.G.; Ravenhorst, R.; Witteveen, C.; Van Leeuwen, P.

    2008-01-01

    At airports, the turnaround process of aircraft is crucial for a timely and efficient handling of air traffic. During this process, a number of services need to be provided during the time the aircraft is at the gate: e.g., de-boarding, cleaning, catering, fuelling, and boarding. These services are

  14. Determining The Information Needs And Resources Provision For ...

    African Journals Online (AJOL)

    It was found that the respondents major information needs has to do with information for formal course of study and practices, information for patient care, and information for research purposes. It was also found that the respondents appreciate the use and relevance of internet, textbooks/monographs and learned journals ...

  15. Situation Aware Assessment of Regulating Power Need and Resource

    DEFF Research Database (Denmark)

    Heussen, Kai

    2009-01-01

    power plants, but have the capability to provide a number of ancillary services. It is envisioned that wind power may at times provide a certain share of system stabilization, but it must also be seen that this contribution is limited to only a part of the required functions and that it fluctuates...... with the available wind. The approach proposed in this paper uses a functional classification to sort out the control requirements of a power system with a high share of fluctuating renewable and distributed energy sources and aims to combine it with a structured quantitative assessment.......Distributed generation and renewable energy sources are both, new disturbance and new regulation resource. Which it is, depends to a large extend on the facilitation of control capabilities, that for example modern wind turbines can provide. Most renewable energy sources are quite unlike classical...

  16. Resources and needs: assessment of the world water situation

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    The global water situation is assessed. Movement and distribution of water in the hydrologic cycle is described. Methods of appraising surface water, precipitation, evapotranspiration, groundwater, and water quality are reviewed. The reliability of such appraisals depends greatly on the adequacy of national water observation networks. Global water supplies and quality of lakes, reservoirs, and groundwater are estimated. The effects of runoff, climate, and human activities on supplies are briefly discussed. The use and demand of water for domestic, industrial, agricultural, hydroelectric, transportation, and recreational needs are assessed. Methods of projecting water demand and quality are reviewed. Demand and supply relationships for various regions of the world are presented. Socioeconomic, financial, technical, administrative, legal, and environmental considerations of these relationships are examined. By using available technology and institutional devices, the world water situation can be improved. (1 diagram, 3 graphs, 8 tables)

  17. Information Resource Needs and Preference of Queensland General Practitioners on Complementary Medicines: Result of a Needs Assessment

    Directory of Open Access Journals (Sweden)

    Tina Janamian

    2011-01-01

    Participants. 463 completed surveys were returned, representing a 58% response rate. Results. The majority of GPs had a positive attitude about incorporating CMs in their clinical practice; however, only 12% perceived they had adequate knowledge to be able to advise patients about CMs. GPs most preferred evidence-based resources for receiving information on CMs (fact sheets, booklets, and journals that contain clinical, pharmacological, and toxicological information. Most GPs perceived a need for an information resource on herbal medicines, vitamins, minerals, and trace elements, and nutritional supplements. Conclusion. GPs are open to integrating CMs into their clinical practice. They identify a current lack of knowledge coupled with a substantive level of interest to learn more. GPs perceive a high level of need for information resources on CMs. These resources should be developed and readily available to GPs to increase their knowledge about CMs and better equip them in communicating with patients about CMs use.

  18. Resources access needs and capabilities as mediators of the relationship between VC firm size and syndication

    NARCIS (Netherlands)

    E. Verwaal (Ernst); J. Bruining (Hans); D.M. Wright (Mike); S. Manigart (Sophie); A. Lockett (Andy)

    2010-01-01

    textabstractDrawing from the resource-based view and transaction costs economics, we develop a theoretical framework to explain why small and large firms face different levels of resource access needs and resource access capabilities, which mediate the relationship between firm size and hybrid

  19. New business models for antibiotic innovation.

    Science.gov (United States)

    So, Anthony D; Shah, Tejen A

    2014-05-01

    The increase in antibiotic resistance and the dearth of novel antibiotics have become a growing concern among policy-makers. A combination of financial, scientific, and regulatory challenges poses barriers to antibiotic innovation. However, each of these three challenges provides an opportunity to develop pathways for new business models to bring novel antibiotics to market. Pull-incentives that pay for the outputs of research and development (R&D) and push-incentives that pay for the inputs of R&D can be used to increase innovation for antibiotics. Financial incentives might be structured to promote delinkage of a company's return on investment from revenues of antibiotics. This delinkage strategy might not only increase innovation, but also reinforce rational use of antibiotics. Regulatory approval, however, should not and need not compromise safety and efficacy standards to bring antibiotics with novel mechanisms of action to market. Instead regulatory agencies could encourage development of companion diagnostics, test antibiotic combinations in parallel, and pool and make transparent clinical trial data to lower R&D costs. A tax on non-human use of antibiotics might also create a disincentive for non-therapeutic use of these drugs. Finally, the new business model for antibiotic innovation should apply the 3Rs strategy for encouraging collaborative approaches to R&D in innovating novel antibiotics: sharing resources, risks, and rewards.

  20. Understanding the information and resource needs of UK health and social care placement students.

    Science.gov (United States)

    Callaghan, Lynne; Doherty, Alan; Lea, Susan J; Webster, Daniel

    2008-12-01

    Students on health and social care degree programmes spend 50% of their time on practice placements. Because of the diversity of settings and the need to evidence their work, it is vital to understand the information and resource needs of placement students. The aim of this investigation was to understand the needs of placement students in terms of accessing resources whilst they are in the field in order to inform a guide to meet these needs. Focus groups were conducted with students on midwifery, social work and post-registration health professions degree programmes on three different sites across the region. Data were analysed using Thematic Content Analysis. Three themes emerged from the data: inequality, user education needs and students' solutions and strategies. It is essential to speak to placement students in order to understand their needs in terms of accessing and using library resources. The timing and content of information skills training is key to meeting student needs while on placement.

  1. Innovative Resources Based on ICTs and Authentic Materials to Improve EFL Students' Communicative Needs

    Science.gov (United States)

    González Otero, Rebeca

    2016-01-01

    Our global society and our current communication needs have put a strain on English as a Foreign Language (EFL) teaching, since common resources such as textbooks may fail to adapt to the needs and interests of our students. The present action research study aims at identifying EFL students' communicative needs and developing their oral skills…

  2. Need for Resourcefulness Training for Women Caregivers of Elders with Dementia.

    Science.gov (United States)

    Zauszniewski, Jaclene A; Lekhak, Nirmala; Yolpant, Wichiya; Morris, Diana L

    2015-01-01

    Nearly ten million American women are caregivers of elders with dementia and may experience overwhelming stress that adversely affects their mental health. Interventions to teach them resourcefulness skills for managing stress can promote optimal mental health and facilitate continued caregiving. However, effectiveness of resourcefulness training (RT) cannot be examined until its need is established. This pilot trial with 138 women caregivers of someone with dementia examined the need for RT using subjective and objective data. Data were collected before and after RT. Data analysis focused on baseline resourcefulness scores (higher scores = lower need); scores in relation to attrition; correlations among resourcefulness, stress, and depressive symptoms; and post-RT evaluation of the need for RT. Baseline resourcefulness scores were normally distributed and showed that 74% of the caregivers had a moderate to high need for RT. Reasons for attrition were unrelated to the need for RT; however, caregivers who dropped out had resourcefulness scores that averaged two points higher than those who remained in the study. Lower resourcefulness was associated greater stress (r = -.37, p women dementia caregivers and support moving forward to test RT's effectiveness for reducing caregiver stress and depressive symptoms.

  3. Low-rank coal study : national needs for resource development. Volume 2. Resource characterization

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    Comprehensive data are presented on the quantity, quality, and distribution of low-rank coal (subbituminous and lignite) deposits in the United States. The major lignite-bearing areas are the Fort Union Region and the Gulf Lignite Region, with the predominant strippable reserves being in the states of North Dakota, Montana, and Texas. The largest subbituminous coal deposits are in the Powder River Region of Montana and Wyoming, The San Juan Basin of New Mexico, and in Northern Alaska. For each of the low-rank coal-bearing regions, descriptions are provided of the geology; strippable reserves; active and planned mines; classification of identified resources by depth, seam thickness, sulfur content, and ash content; overburden characteristics; aquifers; and coal properties and characteristics. Low-rank coals are distinguished from bituminous coals by unique chemical and physical properties that affect their behavior in extraction, utilization, or conversion processes. The most characteristic properties of the organic fraction of low-rank coals are the high inherent moisture and oxygen contents, and the correspondingly low heating value. Mineral matter (ash) contents and compositions of all coals are highly variable; however, low-rank coals tend to have a higher proportion of the alkali components CaO, MgO, and Na/sub 2/O. About 90% of the reserve base of US low-rank coal has less than one percent sulfur. Water resources in the major low-rank coal-bearing regions tend to have highly seasonal availabilities. Some areas appear to have ample water resources to support major new coal projects; in other areas such as Texas, water supplies may be constraining factor on development.

  4. Digital Resources in Instruction and Research: Assessing Faculty Discovery, Use and Needs--Final Summary Report

    Science.gov (United States)

    Tobias, Vicki

    2009-01-01

    In 2008, the Digital Initiatives Coordinating Committee (DICC) requested a comprehensive assessment of the UW Digital Collections (UWDC). The goal of this assessment was to better understand faculty awareness of and expectations for digital library resources, services and tools; obtain faculty feedback on digital resource and service needs that…

  5. Understanding Climate Change Perceptions, Attitudes, and Needs of Forest Service Resource Managers

    Science.gov (United States)

    Carlos Rodriguez-Franco; Tara J. Haan

    2015-01-01

    Surveys were collected to assess Forest Service (FS) resource managers' perceptions, attitudes, and informational needs related to climate change and its potential impacts on forests and grasslands. Resource managers with three background types were surveyed. All participants generally considered themselves to be well-informed on climate change issues, although...

  6. Water-resources programs and hydrologic-information needs, Marion County, Indiana, 1987

    Science.gov (United States)

    Duwelius, R.F.

    1990-01-01

    Water resources are abundant in Marion County, Indiana, and have been developed for public and industrial supply, energy generation, irrigation, and recreation. The largest water withdrawals are from surface water, and the two largest water uses are public supply and cooling water for electrical-generating plants. Water-resources programs in the county are carried out by Federal, State and local agencies to address issues of surface and groundwater availability and quality. The programs of each agency are related to the functions and goals of the agency. Although each agency has specific information needs to fulfill its functions, sometimes these needs overlap, and there are times when the same hydrologic information benefits all. Overlapping information needs and activities create opportunities for interagency coordination and cooperation. Such cooperation could lead to a savings of dollars spent on water-resources programs and could assure an improved understanding of the water resources of the county. Representatives from four agencies-- the Indiana Department of Environmental Management, the Indiana Department of Natural Resources, the Indianapolis Department of Public Works, and the U.S. Geological Survey--met four times in 1987 to describe their own water-resources programs, to identify hydrologic-information needs, and to contact other agencies with related programs. This report presents the interagency findings and is intended to further communication among water resource agencies by identifying current programs and common needs for hydrologic information. Hydrologic information needs identified by the agency representatives include more precise methods for determining the volume of water withdrawals and for determining the volume of industrial and municipal discharges to surface water. Maps of flood-prone areas need to be updated as more of the county is developed. Improved aquifer maps of the inter-till aquifers are needed, and additional observation

  7. Rapid antibiotic susceptibility testing of Mycobacterium tuberculosis : Its utility in resource poor settings

    Directory of Open Access Journals (Sweden)

    Poojary A

    2006-01-01

    Full Text Available Purpose: To compare the rapid colorimetric nitrate reductase based antibiotic susceptibility (CONRAS test performed on Mycobacterium tuberculosis isolates with the conventional method i.e., the proportion method. Methods: One hundred clinical isolates of M. tuberculosis were tested for susceptibility to isoniazid (INH and rifampicin (RIF by the conventional proportion method and CONRAS in Middlebrook 7H9 liquid medium enriched with growth supplements (MB7H9S. Results: The performance of the CONRAS test was evaluated using proportion method as the gold standard. The sensitivity (ability to detect true drug resistance and specificity (ability to detect true drug susceptibility of the CONRAS test to INH was 93.75 and 98.52% and for RIF it was 96.10 and 100% respectively. The mean time for reporting was 6.3 days and the test showed excellent reproducibility. The kappa (k value for INH was 0.92 and for RIF was 0.99, indicating excellent agreement between the two methods. Conclusions: CONRAS test is a rapid and reliable method of drug susceptibility for M. tuberculosis.

  8. Need Assessment of the Digital Archives Industry Human Resources in Taiwan

    Directory of Open Access Journals (Sweden)

    Hsueh-Hua Chen

    2005-03-01

    Full Text Available For an industry to develop successfully, one of the most important factors is to have sufficient and high quality human resources. Digital archives industry will be one of the major industries in Taiwan. We need sufficient human resources in different areas, therefore the job categories, job descriptions, and core technologies of these human resources shall be closely tightened to the need of digital content industry in different development stages. The purpose of this study is to investigate the present status and issues of human resource development of the digital archives industry. It then will study the planning of learning map of the digital archives industry to serve as guideline for Digital Content Institute, educational training and enterprise personnel recruitment. To achieve the above objectives, the method of depth interview is used in this study. We also try to design modular training courses for human resource development of the digital archives industry. [Article Content in Chinese

  9. Ecology and Evolution as Targets: the Need for Novel Eco-Evo Drugs and Strategies To Fight Antibiotic Resistance▿†

    Science.gov (United States)

    Baquero, Fernando; Coque, Teresa M.; de la Cruz, Fernando

    2011-01-01

    In recent years, the explosive spread of antibiotic resistance determinants among pathogenic, commensal, and environmental bacteria has reached a global dimension. Classical measures trying to contain or slow locally the progress of antibiotic resistance in patients on the basis of better antibiotic prescribing policies have clearly become insufficient at the global level. Urgent measures are needed to directly confront the processes influencing antibiotic resistance pollution in the microbiosphere. Recent interdisciplinary research indicates that new eco-evo drugs and strategies, which take ecology and evolution into account, have a promising role in resistance prevention, decontamination, and the eventual restoration of antibiotic susceptibility. This minireview summarizes what is known and what should be further investigated to find drugs and strategies aiming to counteract the “four P's,” penetration, promiscuity, plasticity, and persistence of rapidly spreading bacterial clones, mobile genetic elements, or resistance genes. The term “drug” is used in this eco-evo perspective as a tool to fight resistance that is able to prevent, cure, or decrease potential damage caused by antibiotic resistance, not necessarily only at the individual level (the patient) but also at the ecological and evolutionary levels. This view offers a wealth of research opportunities for science and technology and also represents a large adaptive challenge for regulatory agencies and public health officers. Eco-evo drugs and interventions constitute a new avenue for research that might influence not only antibiotic resistance but the maintenance of a healthy interaction between humans and microbial systems in a rapidly changing biosphere. PMID:21576439

  10. The Effects of Job Demands and Organizational Resources through Psychological Need Satisfaction and Thwarting.

    Science.gov (United States)

    Gillet, Nicolas; Fouquereau, Evelyne; Huyghebaert, Tiphaine; Colombat, Philippe

    2015-05-20

    In Study 1, we tested a model in which two job demands (i.e., changes in tasks and ambiguities about work) and organizational resources (i.e., interpersonal and informational justice) influence work engagement through the satisfaction of individuals' psychological needs for autonomy, competence, and relatedness. In Study 2, we examined the indirect effects of the same job demands and organizational resources on burnout through need thwarting. We also examined the mediating role of organizational resources in the relationships of changes in tasks and ambiguities about work to need satisfaction (Study 1) and need thwarting (Study 2). Structural equation modeling performed on cross-sectional data collected from 461 workers in Study 1 and 708 employees in Study 2 provided support for the hypothesized models. Specifically, results revealed that changes in tasks and ambiguities about work have direct and indirect effects (via organizational resources) on psychological need satisfaction and need thwarting, which in turn positively predicted work engagement and burnout, respectively (p < .05). Research implications and study limitations are discussed.

  11. Scoping study of integrated resource planning needs in the public utility sector

    Energy Technology Data Exchange (ETDEWEB)

    Garrick, C J; Garrick, J M; Rue, D R [NEOS Corp., Lakewood, CO (United States)

    1993-06-01

    Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

  12. Antibiotic susceptibility pattern of genital tract bacteria in pregnant women with preterm premature rupture of membranes in a resource-limited setting.

    Science.gov (United States)

    Eleje, George U; Adinma, Joseph I; Ghasi, Samuel; Ikechebelu, Joseph I; Igwegbe, Anthony O; Okonkwo, John E; Okafor, Charles I; Ezeama, Chukwuemeka O; Ezebialu, Ifeanyichukwu U; Ogbuagu, Chukwuanugo N

    2014-10-01

    To identify microbes prevalent in the genital tract of pregnant women with preterm premature rupture of membranes (PPROM) and to assess the susceptibility of the microbial isolates to a range of antibiotics to determine appropriate antibiotics for treating cases of PPROM in resource-limited settings. A prospective cross-sectional study was undertaken involving women with (n=105) and without (n=105) a confirmed diagnosis of PPROM admitted to Nnamdi Azikiwe University Teaching Hospital, southeast Nigeria, between January 1, 2011, and April 30, 2013. Endocervical swabs were collected from all participants and examined microbiologically. Antibiotic sensitivity testing was performed using Kirby-Bauer disk diffusion. Streptococcus spp., Staphylococcus aureus, and Escherichia coli were significantly more prevalent among women with PPROM than among those without PPROM (P<0.01). Among the antibiotics considered safe to use during pregnancy, the bacteria were most sensitive to ampicillin-sulbactam, cefixime, cefuroxime, and erythromycin. For the first 48hours, women with PPROM should receive an intravenous dose combining ampicillin-sulbactam, cefixime, cefuroxime, or erythromycin with metronidazole followed by oral administration of the chosen antibiotic combination to complete a 7-day course. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Resource manager information needs regarding hydrologic regime shifts for the North Pacific Landscape Conservation

    Science.gov (United States)

    Woodward, Andrea; Jenni, Karen

    2014-01-01

    Landscape Conservation Cooperatives (LCCs) are a network of 22 public-private partnerships, defined by ecoregion, that share and provide science to ensure the sustainability of land, water, wildlife, and cultural resources in North America. LCCs were established by the U.S. Department of the Interior (DOI) in recognition of the fact that response to climate change must be coordinated on a landscape-level basis because important resources, ecosystem processes, and resource management challenges extend beyond most of the boundaries considered in current natural resource management. The North Pacific LCC (NPLCC) covers the range of the Pacific coastal temperate rainforest, including an area of 528,360 km2 spanning 22 degrees of latitude from the Kenai Peninsula, Alaska, to Bodega Bay, California. The coverage area includes parts of four States, two Canadian provinces, and more than 100 Tribes and First Nation language groups. It extends from alpine areas at the crest of coastal mountains across subalpine, montane, and lowland forests to the nearshore marine environment. This wide range of latitudes and elevation zones; terrestrial, freshwater, and marine habitats; and complex jurisdictional boundaries hosts a diversity of natural resources and their corresponding management issues are equally diverse. As evidenced by the Science and Traditional Ecological Knowledge (S-TEK) Strategy guiding principles, identifying and responding to the needs of resource managers is key to the success of the NPLCC. To help achieve this goal of the NPLCC, the U.S. Geological Survey (USGS) has organized several workshops with resource managers and resource scientists to identify management information needs relevant to the priority topics identified in the S-TEK Strategy. Here, we detail the results from a first workshop to address the effects of changes in hydrologic regime on rivers, streams, and riparian corridors. The workshop focused on a subset of the full NPLCC geography and was

  14. Final report: Skills needs in the resource-based sectors in Atlantic Canada

    International Nuclear Information System (INIS)

    Davis, C.; Hulett, L.

    1999-01-01

    Skills requirements in the resource industries in Atlantic Canada were put under the microscope at this conference. One of the objectives was to show that while the resource-based industries may not undertake extensive research and development, they are employing increasingly sophisticated technology which places increasing emphasis on the need for skilled personnel. Participants at the conference concluded that Atlantic Canada has the means to meet increasing demand for skilled workers in the resource sectors, and that the post-secondary educational system appears to have established a good rapport with the industries to ensure that the programs are meeting the sectors' changing needs. The oil and gas sector is an exception in that it is new to the area, combined with the fact that it has placed emphasis not only on skilled but skilled and experienced personnel from the start. There is also a paucity of training programs in sustainable development which is expected to become the dominant issue for resource management personnel in the next century. New skills are required to deal with this issue and post-secondary institutions of learning and the resource-based sectors will have to work together to develop the skills such as understanding ecosystem management problems and communicating with the public. Atlantic Canada cannot afford not to find a path to sustainability through the application of science and technology to management, knowledgeable extraction, and imaginative transformation of natural resources. 28 refs., 2 tabs

  15. Managing Nicaraguan Water Resources Definition and Relative Importance of Information Needs

    Energy Technology Data Exchange (ETDEWEB)

    Engi, D.; Guillen, S.M.; Vammen, K.

    1999-01-01

    This report provides an overview of the results of the Vital the Nicaraguan Water Resources Management Initiative, Issues process as implemented for a collaborative effort between the Nicaraguan Ministry of Environment and Natural Resources and Sandia National Laboratories. This initiative is being developed to assist in the development of an efficient and sustainable water resources management system for Nicamgua. The Vital Issues process was used to provide information for developing a project that will develop and implement an advanced information system for managing Nicaragua's water resources. Three Vital Issues panel meetings were convened to 1) develop a mission statement and evaluation criteria for identifying and ranking the issues vital to water resources management in Nicaragua 2) define and rank the vital issues; and 3) identify a preliminary list of information needed to address the vital issues. The selection of panelists from the four basic institutional perspectives- government, industiy, academe, and citizens' groups (through nongovernmental organizations (NGOs))-ensured a high level of stakeholder representation on the panels. The already existing need for a water resource management information system has been magnified in the aftemnath of Hurricane Mitch. This information system would be beneficial for an early warning system in emergencies, and the modeling and simulation capabilities of the system would allow for advanced planning. Additionally, the outreach program will provide education to help Nicaraguan improve their water hygiene practices.

  16. From Waste Management to Resource Efficiency—The Need for Policy Mixes

    Directory of Open Access Journals (Sweden)

    Henning Wilts

    2016-07-01

    Full Text Available Treating waste as a resource and the design of a circular economy have been identified as key approaches for resource efficiency. Despite ambitious targets, policies and instruments that would enable a transition from a conventional waste management to an integrated and comprehensive resource management are still missing. Moreover, this will require innovative policy mixes which do not only address different end-of-pipe approaches but integrate various resource efficiency aspects from product design to patterns of production and consumption. Based on the results of a project funded by the Seventh Framework Programme for Research and Technological Development named “POLFREE—Policy Options for a resource efficient economy”, this paper addresses several aspects of the conceptualization of policy mixes with regard to waste as a specific resource efficiency challenge. The guiding research interest of this paper is the combination of policies necessary to create a full circular economy. In a first step, the present waste policy frameworks, institutions and existing incentives at national level are examined in order to disclose regulatory and policy gaps. Based on this, the second part of the paper describes and analyses specific waste-related resource efficiency instruments with regard to their potential impacts under the constraints of various barriers. Based on the assessment of the country analyses and the innovative instruments, the paper draws conclusions on waste policy mixes and political needs.

  17. Nonprofit Decision Making and Resource Allocation: The Importance of Membership Preferences, Community Needs, and Interorganizational Ties.

    Science.gov (United States)

    Markham, William T.; Johnson, Margaret A.; Bonjean, Charles M.

    1999-01-01

    Results of a study of community service organizations (n=12) and their communities indicate that distribution of volunteer funds and time was unrelated to community needs as measured by objective indicators. The most important determinants of resource allocation are members' perceptions of the severity of problems and their willingness to work in…

  18. 78 FR 43198 - Flexible and Local Resources Needed for Reliability in the California Wholesale Electric Market...

    Science.gov (United States)

    2013-07-19

    ... auction impact the effectiveness of forward procurement for reliability purposes? Why or why not? 11:15 a... three-year forward resource adequacy obligation backed by a market-based CAISO backstop procurement... development of a durable, market-based mechanism to provide incentives to insure reliability needs are met...

  19. Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

    Science.gov (United States)

    Riley, William; Briggs, Jill; McCullough, Mac

    2011-01-01

    This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

  20. Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals.

    Science.gov (United States)

    Colvin, Jeffrey D; Bettenhausen, Jessica L; Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Plencner, Laura; Krager, Molly; Nelson, Brooke; Donnelly, Sara; Simmons, Julia; Higinio, Valeria; Chung, Paul J

    2016-03-01

    It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. Climate science information needs among natural resource decision-makers in the Northwest US

    Directory of Open Access Journals (Sweden)

    Elizabeth Allen

    2017-01-01

    Full Text Available Managing water resources, air quality, forests, rangelands and agricultural systems in the context of climate change requires a new level of integrated knowledge. In order to articulate a role for university-based research teams as providers of climate services, this paper analyzes environmental change concerns and expectations about climate models among natural resources decision-makers in the Northwest US. Data were collected during a series of workshops organized by researchers from BioEarth, a regional earth systems modeling initiative. Eighty-three stakeholders from industry, government agencies and non-governmental organizations engaged with a team of academic researchers developing integrated biophysical and economic climate modeling tools. Analysis of transcripts of workshop discussions, surveys, and questionnaires reveals diverse attitudes among stakeholders about: 1 preferred modes of engaging in climate science research, 2 specific concerns and questions about climate change impacts, and 3 the most relevant and usable scope and scale of climate change impacts projections. Diverse concerns and information needs among natural resource decision-makers highlight the need for research teams to define clear and precise goals for stakeholder engagement. Utilizing the skills of research team members who have communication and extension expertise is pivotally important. We suggest impactful opportunities for research teams and natural resource decision-makers to interface and learn from one another. Effective approaches include structuring group discussions to identify gaps in existing climate change impacts information, explicitly considering changing policies, technologies and management practices, and exploring possible unintended consequences of decisions.

  2. Managing Senegalese water resources: Definition and relative importance of information needs

    Energy Technology Data Exchange (ETDEWEB)

    Engi, D.

    1998-09-01

    This report provides an overview of the results of the Vital Issues process as implemented for the Senegal Water Resources Management Initiative, a collaborative effort between the Senegalese Ministry of Water Resources and Sandia National Laboratories. This Initiative is being developed to assist in the development of an efficient and sustainable water resources management system for Senegal. The Vital Issues process was used to provide information for the development of a proposal that will recommend actions to address the key management issues and establish a state-of-the-art decision support system (DSS) for managing Senegal`s water resources. Three Vital Issues panel meetings were convened to (1) develop a goal statement and criteria for identifying and ranking the issues vital to water resources management in Senegal; (2) define and rank the issues, and (3) identify and prioritize a preliminary list of information needed to address the vital issues. The selection of panelists from the four basic institutional perspectives (government, industry, academe, and citizens` interest groups) ensured a high level of stakeholder representation on the panels.

  3. Generating opportunity : human resources needs in the bioenergy, biofuels and industrial biotechnology subsectors

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    Canada has a plentiful resource base and a long history of innovation in bioenergy, biofuels and industrial biotechnology. Success of the industry depends on having the required human resources capacity such as the right number of skilled, job-ready professionals to support companies as they develop and commercialize new solutions. This document presented the results of a human resources survey conducted by BioTalent regarding the national and global bioenergy, biofuels and industrial biotechnology subsectors. It addressed a variety of issues, such as the increasing demand for bioenergy; the near-term perspective; growth factors; and the role of public policy. A subsector snapshot of human resources was also presented, with particular reference to the principal areas of need; types of roles required in the bio-economy; human resources capacity and company size; regional variances; skills gaps; reliance on outsourcing; knowledge, learning and connectedness; recruitment, retention and turnover; and the road ahead. Conclusions and recommendations were also offered. It was concluded that once the economy recovers, demand for bioenergy, biofuels and industrial products and services is expected to increase. 3 tabs., 6 figs.

  4. Estimating health workforce needs for antiretroviral therapy in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Fullem Andrew

    2006-01-01

    Full Text Available Abstract Background Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART, for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers. As national treatment programmes are planned, better estimates of human resource needs and improved approaches to assessing the impact of different staffing models are critically needed. However there have been few systematic assessments of staffing patterns in existing programmes or of the estimates being used in planning larger programmes. Methods We reviewed the published literature and selected plans and scaling-up proposals, interviewed experts and collected data on staffing patterns at existing treatment sites through a structured survey and site visits. Results We found a wide range of staffing patterns and patient-provider ratios in existing and planned treatment programmes. Many factors influenced health workforce needs, including task assignments, delivery models, other staff responsibilities and programme size. Overall, the number of health care workers required to provide ART to 1000 patients included 1–2 physicians, 2–7 nurses, Discussion These data are consistent with other estimates of human resource requirements for antiretroviral therapy, but highlight the considerable variability of current staffing models and the importance of a broad range of factors in determining personnel needs. Few outcome or cost data are currently available to assess the effectiveness and efficiency of different staffing models, and it will be important to develop improved methods for gathering this information as treatment programmes are scaled up.

  5. The role of point-of-care tests in antibiotic stewardship for urinary tract infections in a resource-limited setting on the Thailand-Myanmar border.

    Science.gov (United States)

    Chalmers, Lauren; Cross, Jessica; Chu, Cindy S; Phyo, Aung Pyae; Trip, Margreet; Ling, Clare; Carrara, Verena; Watthanaworawit, Wanitda; Keereecharoen, Lily; Hanboonkunupakarn, Borimas; Nosten, François; McGready, Rose

    2015-10-01

    Published literature from resource-limited settings is infrequent, although urinary tract infections (UTI) are a common cause of outpatient presentation and antibiotic use. Point-of-care test (POCT) interpretation relates to antibiotic use and antibiotic resistance. We aimed to assess the diagnostic accuracy of POCT and their role in UTI antibiotic stewardship. One-year retrospective analysis in three clinics on the Thailand-Myanmar border of non-pregnant adults presenting with urinary symptoms. POCT (urine dipstick and microscopy) were compared to culture with significant growth classified as pure growth of a single organism >10(5)  CFU/ml. In 247 patients, 82.6% female, the most common symptoms were dysuria (81.2%), suprapubic pain (67.8%) and urinary frequency (53.7%). After excluding contaminated samples, UTI was diagnosed in 52.4% (97/185); 71.1% (69/97) had a significant growth on culture, and >80% of these were Escherichia coli (20.9% produced extended-spectrum β-lactamase (ESBL)). Positive urine dipstick (leucocyte esterase ≥1 and/or nitrate positive) compared against positive microscopy (white blood cell >10/HPF, bacteria ≥1/HPF, epithelial cells sensitivity (99% vs. 57%) but a lower specificity (47% vs. 89%), respectively. Combined POCT resulted in the best sensitivity (98%) and specificity (81%). Nearly one in ten patients received an antimicrobial to which the organism was not fully sensitive. One rapid, cost-effective POCT was too inaccurate to be used alone by healthcare workers, impeding antibiotic stewardship in a high ESBL setting. Appropriate prescribing is improved with concurrent use and concordant results of urine dipstick and microscopy. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  6. Antibiotics: Precious Goods in Changing Times.

    Science.gov (United States)

    Sass, Peter

    2017-01-01

    Antibiotics represent a first line of defense of diverse microorganisms, which produce and use antibiotics to counteract natural enemies or competitors for nutritional resources in their nearby environment. For antimicrobial activity, nature has invented a great variety of mechanisms of antibiotic action that involve the perturbation of essential bacterial structures or biosynthesis pathways of macromolecules such as the bacterial cell wall, DNA, RNA, or proteins, thereby threatening the specific microbial lifestyle and eventually even survival. However, along with highly inventive modes of antibiotic action, nature also developed a comparable set of resistance mechanisms that help the bacteria to circumvent antibiotic action. Microorganisms have evolved specific adaptive responses that allow appropriately reacting to the presence of antimicrobial agents, ensuring survival during antimicrobial stress. In times of rapid development and spread of antibiotic (multi-)resistance, we need to explore new, resistance-breaking strategies to counteract bacterial infections. This chapter intends to give an overview of common antibiotics and their target pathways. It will also discuss recent advances in finding new antibiotics with novel modes of action, illustrating that nature's repertoire of innovative new antimicrobial agents has not been fully exploited yet, and we still might find new drugs that help to evade established antimicrobial resistance strategies.

  7. Resources from the NASA SMD Astrophysics Forum: Addressing the needs of the higher education community (Invited)

    Science.gov (United States)

    Meinke, B. K.; Schultz, G. R.; Smith, D.; Bianchi, L.; Blair, W. P.; Fraknoi, A.

    2013-12-01

    Four NASA Science Mission Directorate (SMD) Science Education and Public Outreach Forums organize individual SMD-funded E/PO projects and their teams into a coordinated effort. The Forums assist scientists and educators with becoming involved in SMD E/PO and make SMD E/PO resources and expertise accessible to the science and education communities. The Astrophysics Forum and the Astrophysics E/PO community have focused efforts to support and engage the higher education community on enhancing awareness of the resources available to them. To ensure Astrophysics higher education efforts are grounded in audience needs, we held informal conversations with instructors of introductory astronomy courses, convened sessions with higher education faculty and E/PO professionals at conferences, and examined existing literature and findings of the SMD Higher Education Working Group. This work indicates that most Astronomy 101 instructors are not specialists in areas of astrophysics where rapid progress is being made, older textbooks are out of date, and ideas are challenging for students. Instructors are seeking resources and training that support them in effectively teaching the latest science and are in need both basic material and information on new results. In this session, we will discuss our efforts to address these expressed needs, namely through Resource Guides and Slide Sets, and how these are applicable to topics in Heliophysics and Planetary Science. We have collaborated with the Astrophysics E/PO community, researchers, and Astronomy 101 instructors to create two Resource Guides on the topics of cosmology and exoplanets. These fields are ripe with scientific developments that college instructors have told us they find challenging to stay current. Each guide includes a wide variety of sources of background information, links to animations/simulations, classroom activities, and references on teaching each topic. Feedback from Astronomy 101 instructors indicated that the

  8. Dual diagnosis resource needs in Spain: a national survey of professionals.

    Science.gov (United States)

    Szerman, Nestor; Vega, Pablo; Grau-López, Lara; Barral, Carmen; Basurte-Villamor, Ignacio; Mesías, Beatriz; Rodríguez-Cintas, Laia; Martínez-Raga, José; Casas, Miguel; Roncero, Carlos

    2014-01-01

    Since provision of integrated services for patients with dual pathology or dual disorders (coexistence of an addictive disorder and another mental health disorder) is an important challenge in mental health, this study assessed health care professionals' perceptions and knowledge of the current state of specific resources for patients with dual pathology in Spain. We conducted a national survey of health care professionals seeing patients with dual pathology in treatment facilities throughout Spain. Participants completed a specific online questionnaire about the needs of and available resources for patients with dual pathology. A total of 659 professionals, mostly psychologists (n = 286, 43.4%) or psychiatrists (n = 217, 32.9%), participated in the study. Nearly all participants who responded to these items reported that specific resources for dual pathology were needed (n = 592/635, 93.2%); 76.7% (n = 487) identified intermediate resources, 68.8% (n = 437) acute detoxification units, and 64.6% (n = 410) medium-stay rehabilitation units as particularly necessary. In the opinion of 54.0% of respondents (n = 343), integrated mental health and addiction treatment services were available. Of the participants who answered these items, only a small proportion (n = 162/605, 26.8%) reported that there were appropriate outpatient programs for dual pathology, 30.4% (n = 184/605) specific hospitalization units, 16.9% (n = 99/587) subacute inpatient units, 34.2% (n = 201/587) outpatient intermediate resources, 15.5% (n = 91/587) day hospitals, and 21.5% (n = 126/587) day centers. Conversely, 62.5% (n = 378/587) of participants reported a greater presence of specific detoxification/withdrawal units, 47.3% (n = 286/587) psychiatric acute admission units, and 41.9% (n = 246/587) therapeutic communities. In the professionals' opinion, the presence of specialty programs was low; 11.6% of respondents (n = 68/587) reported that vocational programs and 16.7% (n = 98/587) reported

  9. Education and information for practicing school nurses: which technology-supported resources meet their needs?

    Science.gov (United States)

    Anderson, Lori S; Enge, Karmin J

    2012-10-01

    School nurses care for children with a variety of health-related conditions and they need information about managing these conditions, which is accessible, current, and useful. The goal of this literature review was to gather and synthesize information on technology-supported resources and to determine which met the educational needs of school nurses. Successful online educational programs were interactive and self-directed. The most common barriers were lack of time to find educational information, lack of knowledge about computers, technology, the Internet and specific programs, and lack of administrative support from school officials to use technology to access information and evidence for practice. Recommendations for successful use of technology to meet practicing school nurse's educational needs are offered.

  10. Resource needs to support orphans and vulnerable children in sub-Saharan Africa.

    Science.gov (United States)

    Stover, John; Bollinger, Lori; Walker, Neff; Monasch, Roland

    2007-01-01

    In sub-Saharan Africa, 43 million children under the age of 18 have lost one or both parents to AIDS, conflict or other causes. This large number strains systems by which families and communities have traditionally provided care for orphans. Support for some orphans is being provided by a variety of government, community and non-governmental organizations but this assistance reaches only a small percentage of those who need it. This paper estimates the funding required for necessary support to those most in need. We estimate that US$1-4 billion will be required annually by 2010, depending on whether support is provided to all orphans living below the poverty line or just those in most need. This is at least four times current funding and should be a priority topic for donor and national government resource allocation decisions this year.

  11. Challenges in care of the child with special health care needs in a resource limited environment

    Directory of Open Access Journals (Sweden)

    Edwin Ehi Eseigbe

    2013-01-01

    Full Text Available To identify challenges encountered in the care of children with special health care needs in a resource limited environment a 10 year-old child with a diagnosis of Tuberous Sclerosis was studied. Challenges identified were in: making a definitive diagnosis, provision of adequate care, cost of care, meeting parental expectations and accessing community support for the child and family. Available specialist health care and related services, including community rehabilitation, were provided for the child and family. The study highlights the need for improved community awareness, development in the provision of specialist health care services and institution of governmental policies that identify, support and protect children with special health care needs.

  12. Pharmacogenomic knowledge gaps and educational resource needs among physicians in selected specialties

    Directory of Open Access Journals (Sweden)

    Johansen Taber KA

    2014-07-01

    Full Text Available Katherine A Johansen Taber, Barry D Dickinson Department of Science and Biotechnology, American Medical Association, Chicago, IL, USA Background: The use of pharmacogenomic testing in the clinical setting has the potential to improve the safety and effectiveness of drug therapy, yet studies have revealed that physicians lack knowledge about the topic of pharmacogenomics, and are not prepared to implement it in the clinical setting. This study further explores the pharmacogenomic knowledge deficit and educational resource needs among physicians. Materials and methods: Surveys of primary care physicians, cardiologists, and psychiatrists were conducted. Results: Few physicians reported familiarity with the topic of pharmacogenomics, but more reported confidence in their knowledge about the influence of genetics on drug therapy. Only a small minority had undergone formal training in pharmacogenomics, and a majority reported being unsure what type of pharmacogenomic tests were appropriate to order for the clinical situation. Respondents indicated that an ideal pharmacogenomic educational resource should be electronic and include such components as how to interpret pharmacogenomic test results, recommendations for prescribing, population subgroups most likely to be affected, and contact information for laboratories offering pharmacogenomic testing. Conclusion: Physicians continue to demonstrate pharmacogenomic knowledge gaps, and are unsure about how to use pharmacogenomic testing in clinical practice. Educational resources that are clinically oriented and easily accessible are preferred by physicians, and may best support appropriate clinical implementation of pharmacogenomics. Keywords: pharmacogenomics, knowledge gap, drug response, educational resource

  13. Developing a decision support system to meet nurse managers' information needs for effective resource management.

    Science.gov (United States)

    Ruland, C M

    2001-01-01

    This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.

  14. Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward.

    Science.gov (United States)

    Skelton, Felicia; Suda, Katie; Evans, Charlesnika; Trautner, Barbara

    2018-01-11

    Context Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

  15. Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis

    Directory of Open Access Journals (Sweden)

    Mutirua Kauto

    2007-03-01

    Full Text Available Abstract Background The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Methods Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula. Results Comparing the current allocations of public sector health car resources with estimates using a needs based formula showed that regions with higher levels of need currently receive fewer resources than do regions with lower need. Conclusion To address the prevailing inequities in resource allocation, the Ministry of Health and Social Services should abandon the historical incrementalist method of budgeting/resource allocation and adopt a more appropriate allocation mechanism that incorporates measures of need for health care.

  16. Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis.

    Science.gov (United States)

    Zere, Eyob; Mandlhate, Custodia; Mbeeli, Thomas; Shangula, Kalumbi; Mutirua, Kauto; Kapenambili, William

    2007-03-29

    The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula. Comparing the current allocations of public sector health car resources with estimates using a needs based formula showed that regions with higher levels of need currently receive fewer resources than do regions with lower need. To address the prevailing inequities in resource allocation, the Ministry of Health and Social Services should abandon the historical incrementalist method of budgeting/resource allocation and adopt a more appropriate allocation mechanism that incorporates measures of need for health care.

  17. Weather, climate, and resource Information should meet the needs of Sahelian pastoralists

    DEFF Research Database (Denmark)

    Rasmussen, Laura Vang; Mertz, Ole; Rasmussen, Kjeld

    2014-01-01

    There has been an increasing focus on providing better weather, climate, and resource information for decision making in drylands. This study explores what kind of information pastoralists in the Sahel received in 2013 and how they responded to this information. Moreover, the study assesses whether...... the disseminated information corresponds to the actual needs of pastoralists. The overall objective is thus to identify the outcome of providing weather, climate, and resource information to pastoralists and thereby to explore whether and how various products may guide their mobility and decision-making patterns....... Such information could be used to adjust the purchase of supplementary fodder, to make qualified choices on transhumance destinations, and to make changes in herd composition. As pastoralists primarily acquire this information by calling friends and family in nearby areas, the results point to a strong disconnect...

  18. Evaluation of Human Resource Needs for a New Nuclear Power Plant: Armenian Case Study

    International Nuclear Information System (INIS)

    2011-05-01

    Rising expectations of an increased role for nuclear power in providing energy for future national and global sustainable development have become a reality in many Member States of the IAEA. Over the last several years, dozens of Member States have announced plans to embark on or expand nuclear power programmes. Reflecting on these developments, the IAEA has adjusted its priorities to focus more on the nuclear power programmes of newcomers. Specifically, the IAEA has produced publications providing guidance on the development of a national infrastructure for nuclear power (IAEA Nuclear Energy Series No. NG-G-3.1) and on managing human resources in the field of nuclear energy (IAEA Nuclear Energy Series No. NG-G-2.1). Additionally, assistance to eligible Member States through new technical cooperation (TC) projects has been increased, including direct support through on-site assist visits. In 2007-2008, the IAEA carried out a TC project titled 'Feasibility study of nuclear energy development in Armenia: Evaluation of human resource needs in conjunction with new NPP build' (ARM-005). The project analysed the human resource demands required to support work at all stages of the life cycle of a new power unit planned for Armenia. This included drafting proposals for the means, conditions and requirements for development of human resource capabilities needed to carry out the work. This report is intended to complement the previous IAEA publications by providing an in-depth technical consideration into this critical area of human resource development. The report summarizes major findings of the TC project and details the tasks linked to management of the human resources that will be required by a country planning to build a new NPP. Additional guidance on the development of a national nuclear infrastructure can be found in the IAEA publication 'Milestones in the Development of a National Infrastructure for Nuclear Power', IAEA Nuclear Energy Series No. NG-G-3.1. The

  19. Information Needs and Use of Library Resources by Special Needs Students in Selected Government Schools in Kaduna State and Federal Capital Territory, Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Christiana Alami Atabor

    2015-12-01

    Full Text Available This study is on the information needs and use of library resources by special needs students in selected government schools in Kaduna State and Federal Capital Territory, Abuja, Nigeria. The survey technique was employed in the study. Five schools (i.e., Kaduna State Special Education School; Government Technical College, Malali, Kaduna; Alhudahuda College Zaria; Government Secondary School, Kwali and Government Secondary School, Kuje were purposefully selected out of a total of seven. Data were collected using a structured questionnaire for two respondent groups (i.e., special needs students and teachers/librarians. A total of 5 teachers/librarians and 345 special needs students were selected for the study. The data collected were analyzed using descriptive statistics. The findings of the study show that the special needs students have high needs for information on education, employment opportunities, health matter, and human rights. The major information resources in the libraries are books, magazines, newspapers, and few Braille materials. In general, special needs students have a moderate level of satisfaction with the resources in the libraries. The major issue identified by special needs students is insufficient information resources, especially in Braille. On the part of the teachers/librarians, inadequate funds for the acquisition of information resources and the employment of qualified librarians/teachers are found to be the major challenges faced by the libraries.

  20. Universities' expectations of pastoral care: trends, stressors, resource gaps and support needs for teaching staff.

    Science.gov (United States)

    Laws, Thomas A; Fiedler, Brenton A

    2012-10-01

    'emotion work' requiring a greater integration of resources that guide them toward more appropriate and timely student support. Staff require ongoing professional development on the nature of MH problems among students. There is a need for specific orientation programs that better define pastoral care and identify support services for staff and students. Universities need to focus on what is needed to create a well-being environment. Workload allocations must include 'emotion work', and mental health professionals must be employed to improve intervention and support not only for students but also for University staff. With better defined pastoral care roles, academics can more effectively balance their intrinsic and extrinsic motivations toward both personal and corporate objectives. Further research into the efficacy of university resourcing of programs and services is needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. NATURE FACILITATES CONNECTION WITH THE PROFOUND SELF: NEEDS, GOALS AND RESOURCE AWARENESS

    Directory of Open Access Journals (Sweden)

    Nicoleta Răban-Motounu

    2014-11-01

    Full Text Available The present study is based on Kaplan and Kaplan’s (1989 theory explaining the restorative effects that nature has on a person’s psychic. According to this theory, nature exerts a “soft fascination” combining the activation of involuntary attention mechanisms with the reflexive awareness, allowing a spontaneous detachment from stress factors and automatic functioning, and also the feeling of compatibility between personal purposes, and the possibilities for action offered by the environment (a sense of meaning. Our objective was to investigate the effects of nature on Self awareness: the immediate, emotional experience; needs awareness and organization; plans for action, and availability of resources, both personal, and external. We conducted an experiment with an experimental group (persons watching a video with life in nature and an active control group (involved in a psychotherapeutic technique focused on confronting and solving personal difficulties by creative means, accompanied by a short psychological analysis. The effects were assessed in terms of “here and now” emotions and available resources according to a self-evaluation scale, and with open-ended questions regarding personal needs and goals. The results showed that, for the experimental group, the relaxation effects and the awareness of long term goals were stronger, while all the other effects were the same as for the control group. The results suggest that indeed, nature helps a person get in contact with her profound Self, allowing the access to both “here and now” basic needs, and also long term goals (inner sources of meaning, the sense of connection between internal tendencies, personal, and external resources, resulting in increased positive emotions, and decreased negative emotions. Nature contemplation may facilitate a meditative state whit all its positive effects.

  2. Low-rank coal study: national needs for resource development. Volume 6. Peat

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    The requirements and potential for development of US peat resources for energy use are reviewed. Factors analyzed include the occurrence and properties of major peat deposits; technologies for extraction, dewatering, preparation, combustion, and conversion of peat to solid, liquid, or gaseous fuels; environmental, regulatory, and market constraints; and research, development, and demonstration (RD and D) needs. Based on a review of existing research efforts, recommendations are made for a comprehensive national RD and D program to enhance the use of peat as an energy source.

  3. THE INTERDEPENDENCE BETWEEN NEEDS OF RESOURCES, PRODUCTION STRUCTURES, AND SCIENTIFIC AND TECHNOLOGICAL INNOVATION PROCESS

    Directory of Open Access Journals (Sweden)

    Gabriel I. NĂSTASE

    2012-05-01

    Full Text Available At the intersection of three areas of high economic interest, Romania is a vital connecting point between the countries of Eastern Europe, Central Europe and Central Asia through the unique coexistence of a number of elements favorable. In this case, the economy must be understood as a means of achieving a human social purpose, whose growth must be of sociocentric and not economocentric. Hence the need to approach growth processes economical on much larger positions in going beyond the narrow meaning of the growth triangle - resources - environment with a wider perimeter of square economy - technology - social - ecology.

  4. Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis

    OpenAIRE

    Mutirua Kauto; Shangula Kalumbi; Mbeeli Thomas; Mandlhate Custodia; Zere Eyob; Kapenambili William

    2007-01-01

    Abstract Background The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need t...

  5. Priority needs and wisdom strategy for blood transfusion safety in developing low-resource countries.

    Science.gov (United States)

    Abdelrazik, Abeer Mohamed; Ezzat Ahmed, Ghada M

    2016-02-01

    To evaluate the implementation of alternative safety measures that reduce the risk of transfusion transmissible infections as an affordable measure in low resource countries. It is still difficult in developing countries with limited resources to mandate nucleic acid testing due to its high cost. Although NAT reduces the window period of infection, the developing countries are still in need of an efficient and effective transfusion programme before implementing the complex high cost NAT. Two thousand eight hundred eighty sero-negative first-time and repeat donations from Fayoum University Hospital blood bank were individually analysed by NAT for HIV, HBV and HCV. Only discriminatory-positive NAT were classified comparing the non-remunerated and family replacement donations. Significant discriminatory-positive differences were observed for HBV NAT results, 2 remunerated donations compared to 0 non-remunerated sero-negative donations. The discriminatory positive differences were also significant for HCV NAT results, 4 remunerated donations compared to 1 non-remunerated sero-negative donation. No sero-negative, discriminatory-positive NAT HIV case was found. Seven out of 8 discriminatory positive cases were from first time donations. In order to ensure blood safety, the recruitment and retention of voluntary, non-remunerated repeat donors should be a major commitment for low resource countries in which NAT implementation is costly and not feasible. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Using scenarios of North Slope energy and resource development to assess research and monitoring needs

    Science.gov (United States)

    Payne, J. F.

    2016-12-01

    Significant Arctic environmental and socio-economic change has been observed on the North Slope of Alaska, presenting challenges for resident communities and management agencies that need to adapt to future changes that are difficult to model or predict. Continued climate change coupled with new or modified energy development could substantially alter the landscape and ecosystem in the future. The North Slope Science Initiative (NSSI) recognized the value of using a participatory scenarios process to consider plausible future energy and resource development scenarios through the year 2040 to help identify and prioritize research and monitoring needs on the North Slope. The scenarios process engaged diverse stakeholders, including subject matter experts and local knowledge holders. Through identification and ranking of key drivers and uncertainties relevant to the focus of the study, a series of spatially explicit scenarios was developed, analyzed in terms of low, medium and high development activities. Climate change and economic factors were key drivers affecting plausible energy development scenarios. The implications from each of the scenarios were then used to identify important research and monitoring activities and their relevant spatial scales. The scenarios project identified over 40 research and monitoring needs. The top five research needs addressed data gaps and key concerns related to how the scenarios could affect: hunting and trapping on land, health and community well-being, permafrost and hydrology, marine mammal subsistence and potential marine oil spills. The use of a participatory scenarios process was essential for identifying a range of plausible energy and resource development scenarios using a framework that involved a systematic assessment of complex interacting drivers of change, consideration of key uncertainties, and transparency throughout the project.

  7. Climate Change Extreme Events: Meeting the Information Needs of Water Resource Managers

    Science.gov (United States)

    Quay, R.; Garfin, G. M.; Dominguez, F.; Hirschboeck, K. K.; Woodhouse, C. A.; Guido, Z.; White, D. D.

    2013-12-01

    Information about climate has long been used by water managers to develop short term and long term plans and strategies for regional and local water resources. Inherent within longer term forecasts is an element of uncertainty, which is particularly evident in Global Climate model results for precipitation. For example in the southwest estimates in the flow of the Colorado River based on GCM results indicate changes from 120% or current flow to 60%. Many water resource managers are now using global climate model down scaled estimates results as indications of potential climate change as part of that planning. They are addressing the uncertainty within these estimates by using an anticipatory planning approach looking at a range of possible futures. One aspect of climate that is important for such planning are estimates of future extreme storm (short term) and drought (long term) events. However, the climate science of future possible changes in extreme events is less mature than general climate change science. At a recent workshop among climate scientists and water managers in the southwest, it was concluded the science of climate change extreme events is at least a decade away from being robust enough to be useful for water managers in their water resource management activities. However, it was proposed that there are existing estimates and records of past flooding and drought events that could be combined with general climate change science to create possible future events. These derived events could be of sufficient detail to be used by water resource managers until such time that the science of extreme events is able to provide more detailed estimates. Based on the results of this workshop and other work being done by the Decision Center for a Desert City at Arizona State University and the Climate Assessment for the Southwest center at University of Arizona., this article will 1) review what are the extreme event data needs of Water Resource Managers in the

  8. Urban-Rural Differences in School Nurses' Asthma Training Needs and Access to Asthma Resources.

    Science.gov (United States)

    Carpenter, Delesha M; Estrada, Robin Dawson; Roberts, Courtney A; Elio, Alice; Prendergast, Melissa; Durbin, Kathy; Jones, Graceann Clyburn; North, Steve

    Few studies have examined school nurses preferences' for asthma training. Our purpose was to: 1) assess school nurses' perceived asthma training needs, 2) describe nurses' access to asthma educational resources, and 3) identify urban-rural differences in training needs and access to resources in southern states. A convenience sample of school nurses (n=162) from seven counties (two urban and five rural) in North Carolina and South Carolina completed an online, anonymous survey. Chi-square tests were used to examine urban-rural differences. Although most nurses (64%) had received asthma training within the last five years, urban nurses were more likely to have had asthma training than rural nurses (χ 2 =10.84, p=0.001). A majority of nurses (87%) indicated they would like to receive additional asthma training. Approximately half (45%) of nurses reported access to age-appropriate asthma education materials, but only 16% reported that their schools implemented asthma education programs. Urban nurses were more likely than rural nurses to have access to asthma education programs (χ 2 =4.10, p=0.04) and age-appropriate asthma education materials (χ 2 =8.86, p=0.003). Few schools are implementing asthma education programs. Rural nurses may be disadvantaged in terms of receiving asthma training and having access to asthma education programs and materials. Schools are an ideal setting for delivering age-appropriate asthma education. By providing school nurses with access to age-appropriate asthma education resources and additional asthma training, we can help them overcome several of the barriers that impede their ability to deliver asthma care to their students. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Energy needs, tasks and resources in the Sahel: Relevance to woodstoves programmes

    Energy Technology Data Exchange (ETDEWEB)

    Cecelski, E

    1983-01-01

    This article reviews the wood fuels situation in the Sahel and the findings of various needs assessment methodologies, especially as these are relevant to the numerous programmes to introduce improved cooking technologies in the region. Most people in West Africa, especially in poor and rural areas, rely primarily on wood fuels and crop wastes for energy needs, with devastating environmental consequences. Most wood is used in cooking. The quantity of fuel used depends on the type of fireplace, utensils used, how and when food is prepared, food preparation methods, types of fuels, how fuelwood is collected, and special customs surrounding the family fire - all of which are intimately associated with the economic, cultural and social fabric of Sahelian societies. Conventional fuel consumption and resource surveys have yielded useful information about quantitative energy needs in the Sahel, but increasingly sociocultural studies are being used to ensure that stove designs will meet the needs of the end-user. Economic analysis is also necessary to establish the dimensions of wood scarcity, to assess the financial attractiveness to consumers of alternative fuels and stoves, and in evaluating the costs and benefits to society of proposed national woodstoves programmes.

  10. Increased ICU resource needs for an academic emergency general surgery service*.

    Science.gov (United States)

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

  11. Human resource needs and development for the gas industry of the future

    International Nuclear Information System (INIS)

    Klass, D.L.

    1991-01-01

    The natural gas industry will confront many challenges in the 1990s and beyond, one of which is the development of human resources to meet future needs. An efficient, trained work force in this era of environmental concern, high technology, and alternative fuels is essential for the industry to continue to meet the competition and to safely deliver our product and service to all customers. Unfortunately, during this period there will be an increasing shortfall of technical personnel to replace those lost to attrition and a steady decline in the availability of new employees who are able to read, write, and perform simple math. Technological and government developments that will impact the industry and the skill levels needed by the industry employees are reviewed. In-house and external training of professional and nonprofessional personnel and the benefits and disadvantages of selected advanced training methods are discussed. Recommendations are presented that can help improve the training of gas industry employees to meet future needs. 22 refs

  12. Argentina and Brazil's competition over Bolivian's resources, needs and means half a century later

    International Nuclear Information System (INIS)

    Behrens, A.

    1988-01-01

    For fifty years Bolivia has managed to achieve an unstable balance of power between its most powerful neighbours, while still keeping together an ethnically diverse and poorly integrated country. However, prospects are grim. Bolivia's most important trade able goods face receding markets and natural gas exports to Argentina are likely to dwindle as that country develops its own domestic fields. Brazil, could substitute for Argentina but it needs to overcome a bitter legacy of commercial frustration with Bolivia and the opposition of Brazil's national oil company to natural gas imports. Moreover, Argentina may soon be a net exporter of natural gas as well. However, neither Brazil nor Argentina, both of whom share a sizeable frontier with Bolivia should not want to see her under too much distress. Pooling the natural gas resources of Argentina and Bolivia could cater for more orderly and reliable regional trade than in the past. The combined resources could be managed by a private enterprise (Gas del Plata) with all three countries as major shareholders. Reliable natural gas supplies may even help Brazil to revert its autarchic developmental trends. (author)

  13. Research needs to maximize economic producibility of the domestic oil resource

    International Nuclear Information System (INIS)

    Tham, M.K.; Burchfield, T.; Chung, Ting-Horng; Lorenz, P.; Bryant, R.; Sarathi, P.; Chang, Ming Ming; Jackson, S.; Tomutsa, L.; Dauben, D.L.

    1991-10-01

    NIPER was contracted by the US Department of Energy Bartlesville (Okla.) Project Office (DOE/BPO) to identify research needs to increase production of the domestic oil resource, and K ampersand A Energy Consultants, Inc. was subcontracted to review EOR field projects. This report summarizes the findings of that investigation. Professional society and trade journals, DOE reports, dissertations, and patent literature were reviewed to determine the state-of-the-art of enhanced oil recovery (EOR) and drilling technologies and the constraints to wider application of these technologies. The impacts of EOR on the environment and the constraints to the application of EOR due to environmental regulations were also reviewed. A review of well documented EOR field projects showed that in addition to the technical constraints, management factors also contributed to the lower-than-predicted oil recovery in some of the projects reviewed. DOE-sponsored projects were reviewed, and the achievements by these projects and the constraints which these projects were designed to overcome were also identified. Methods of technology transfer utilized by the DOE were reviewed, and several recommendations for future technology transfer were made. Finally, several research areas were identified and recommended to maximize economic producibility of the domestic oil resource. 14 figs., 41 tabs

  14. Research needs to maximize economic producibility of the domestic oil resource

    Energy Technology Data Exchange (ETDEWEB)

    Tham, M.K.; Burchfield, T.; Chung, Ting-Horng; Lorenz, P.; Bryant, R.; Sarathi, P.; Chang, Ming Ming; Jackson, S.; Tomutsa, L. (National Inst. for Petroleum and Energy Research, Bartlesville, OK (United States)); Dauben, D.L. (K and A Energy Consultants, Inc., Tulsa, OK (United States))

    1991-10-01

    NIPER was contracted by the US Department of Energy Bartlesville (Okla.) Project Office (DOE/BPO) to identify research needs to increase production of the domestic oil resource, and K A Energy Consultants, Inc. was subcontracted to review EOR field projects. This report summarizes the findings of that investigation. Professional society and trade journals, DOE reports, dissertations, and patent literature were reviewed to determine the state-of-the-art of enhanced oil recovery (EOR) and drilling technologies and the constraints to wider application of these technologies. The impacts of EOR on the environment and the constraints to the application of EOR due to environmental regulations were also reviewed. A review of well documented EOR field projects showed that in addition to the technical constraints, management factors also contributed to the lower-than-predicted oil recovery in some of the projects reviewed. DOE-sponsored projects were reviewed, and the achievements by these projects and the constraints which these projects were designed to overcome were also identified. Methods of technology transfer utilized by the DOE were reviewed, and several recommendations for future technology transfer were made. Finally, several research areas were identified and recommended to maximize economic producibility of the domestic oil resource. 14 figs., 41 tabs.

  15. Resource needs of an occupational health service to accommodate a hepatitis B vaccination programme.

    Science.gov (United States)

    Jachuck, S J; Jones, C; Nicholls, A; Bartlett, M

    1990-01-01

    The administrative, organizational and clinical commitment of an occupational health department to implement the DHSS recommendation for a hepatitis B vaccination programme for the health care workers in a District General Hospital was reviewed to evaluate the resource implications needed to accommodate the additional workload. The deficiencies observed in the existing DHSS guidance in implementing the plan are described. It is suggested that the Department of Health, while making future recommendations for vaccination, should be more precise in identifying those at risk, in describing the desired titre to be achieved after vaccination, and in describing the follow-up plan for those who accept the vaccination, those who refuse and those who do not seroconvert. The recommendation should describe the commitment of the Health Authorities and must include recommendations for appropriate and adequate resources to support such a programme. Vaccination for 1000 employees at risk required 4000 additional consultations necessitating 16 additional hours of occupational health commitment per week. Eighteen months after initiating the vaccination programme, 677 employees had accepted the vaccine. After receiving 3 vaccines 508 (75 per cent) recipients had protective seroconversion (anti-Hbs greater than 100 I.U.) and a further 61 (9 per cent) converted after the 4th injection, thereby offering protective immunity to 84 per cent of the recipients. During the period 84 (12.4 per cent) were lost to follow-up. Recommendations have been made to accommodate the additional commitment through the vaccination programme to standardize our care and prevent disruption of the existing service.

  16. Utilization of water resources in Pelagonija region to meet the needs of REK 'Bitola'

    International Nuclear Information System (INIS)

    Madzharoski, Atanas; Cvetkovska, Bisera

    2001-01-01

    In this report a complex use of the water resources for water supplying of one the biggest industrial objects in Republic of Macedonia - the thermal power plants at REK-Bitola is shown. Water, beside the coal represents a basic raw material in the technological process for electric power production at the TPP. Three systems are built for water supplying with raw water, that are composed in one part and there is a possibility for them to be enlarged. The way of use and distribution of waters from the systems in accordance with the needs of the company is shown, taking care for rational and economical use of the water. An enlargement is performed on the systems with what safety in water supply is greater the functionality of the systems is better, and with that a rationality and economical effects are obtained. (Original)

  17. Indonesia's present status and needs of human resource development in nuclear field

    International Nuclear Information System (INIS)

    Ruslan, Jeni; Sagala, F.P.

    2000-01-01

    BATAN, started out as a governmental committee established in 1954, has a new organizational structure, based on Presidential Decree of 1998. BATAN has developed its researches in almost practically all-nuclear fields. The situation in Indonesia has been much influenced by the economic crisis, which still being faced by Indonesia. BATAN's strategic planning is described in four areas, those are: 1. Basic human needs, 2. Energy, natural resources and environment, 3. Industry, 4. Socio-cultural and institution. Priority has been given to fulfill, as well as to promote agriculture, health and the industry related to people's welfare, which may develop and improve the immediate needs of the people. In the meantime, we have made considerable investments in manpower development in anticipation of the introduction of nuclear power. BATAN, as of September 1999, has 3889 employees, 26 % of them have bachelor degree, 6 % hold master degrees, and only 2% hold doctoral degree, a total of 34 % employees with university education. Others 11 % have either non-vocational or vocational education beyond High School. The rest of 55 % have high school education or lower, they are administrative clerks (25 %) or technicians (30 %). In the human resources development, BATAN's Education and Training Center, in collaboration with some universities and other national/international institutions, is managing education and training programs for employees. To date, there are 43 BATAN employees studying in various universities in Japan, while another 42 employees are studying in six different countries. Research and Development that have more direct impact to the community will become a priority in the coming years. Without undermining the importance of basic research in advanced fields, we will expect to have more research on application to optimize utilization of research reactors and related facilities for the benefit of both the energy and non-energy sectors. (Tanaka, Y.)

  18. Generating human resources in nuclear engineering in India: need of the hour

    International Nuclear Information System (INIS)

    Roy, Prateep

    2010-01-01

    With the fast growth of energy requirement scenario, particularly, in India with limited dependence on fossil power and increased emphasis on green power we have lots of nuclear power plant and associated projects in pipeline. This requires enormous human resources trained and qualified in nuclear engineering who will be engaged in all aspects of nuclear plant projects right from conceptualization, design, construction, development, operation, maintenance till decommissioning. As on today, Department of Atomic Energy (DAE) in Government of India is almost the only agency catering to this need. DAE grooms graduate engineers from various disciplines and postgraduates from sciences, specially, Physics and Chemistry. But, it takes enough financial resources and full 1-year duration past graduation from Indian Government. Even after imparting training to these freshly recruited DAE employees, sizeable chunk of the population quit DAE for better prospect such as higher studies abroad, management studies, IT profession etc. Also, the people trained in nuclear engineering are fewer in number than required and the gap would be increasingly large as time progresses and increasing number of nuclear plants would be constructed/operational. Comparatively larger number of engineering graduates currently produced in India are in Computer Engineering/Information Technology rather than in conventional disciplines like Civil, Mechanical, Electrical, Electronics and Telecommunications Engineering. This poses another problem of orienting/motivating the manpower in nuclear fields. Considering these problems the author proposes to produce and develop nuclear engineering graduates directly in the academic institutions which will help the nation in reducing the gap between the increasing demand of manpower in view of large number of nuclear plants in the pipeline and the availability of the nuclear engineers. Even large number of industries related to manufacturing and consultancy also

  19. The future of antibiotics

    Science.gov (United States)

    2014-01-01

    Antibiotic resistance continues to spread even as society is experiencing a market failure of new antibiotic research and development (R&D). Scientific, economic, and regulatory barriers all contribute to the antibiotic market failure. Scientific solutions to rekindle R&D include finding new screening strategies to identify novel antibiotic scaffolds and transforming the way we think about treating infections, such that the goal is to disarm the pathogen without killing it or modulate the host response to the organism without targeting the organism for destruction. Future economic strategies are likely to focus on ‘push’ incentives offered by public-private partnerships as well as increasing pricing by focusing development on areas of high unmet need. Such strategies can also help protect new antibiotics from overuse after marketing. Regulatory reform is needed to re-establish feasible and meaningful traditional antibiotic pathways, to create novel limited-use pathways that focus on highly resistant infections, and to harmonize regulatory standards across nations. We need new antibiotics with which to treat our patients. But we also need to protect those new antibiotics from misuse when they become available. If we want to break the cycle of resistance and change the current landscape, disruptive approaches that challenge long-standing dogma will be needed. PMID:25043962

  20. Offshore Sand Resource Needs, Data Availability and Revaluation, and Beach Nourishment Projects in North Carolina

    Science.gov (United States)

    Conery, I.; Walsh, J. P.

    2016-12-01

    Storms and sea-level rise continue to impact the dynamic coastlines of North Carolina. Since the coastal region is economically critical to the state and yields numerous ecosystem services, many towns have planned beach nourishment projects. However, offshore sands compatible for nourishment are limited, and project costs fluctuate with borrow source proximity to the shoreline. Hurricane Sandy (2012) caused high water levels and waves resulting in localized overwash and erosion in the northeastern part of NC. In response, to effectively meet the rising nourishment demands for recovery after future storm events and for long-term resiliency, the Bureau of Ocean Energy Management (BOEM) recognized the need to compile and consolidate all geophysical and geologic information in federal waters (3-8 nm) along the East Coast states. A GIS database was created for NC using bathymetric, seismic reflection, sediment and other relevant data from federal, state and private entities. Information will be accessible to the public, coastal planners and managers to allow for informed decision-making and cost-effective project planning. Priority regions for seismic and core collection were determined based on data gaps and needs across the state. In addition, potential sand resource thickness and volume in northeastern NC were revaluated using comparisons of several overlapping datasets. Shoreline volume losses were calculated using long-term erosion rates and compared to historic and future nourishment projects. Finally, tourism-based revenue by town was evaluated and related to short and long-term nourishment costs.

  1. Empiric antibiotic prescription among febrile under-five Children in ...

    African Journals Online (AJOL)

    limiting viral infection and therefore, would not require antibiotics. Over prescription of antibiotics increases antibiotics exposure and development of resistance among patients. There is need to evaluate empiric antibiotic prescription in order to limit ...

  2. The increasing efficiency of financial resources management at implementation of goods’ purchase, works, services for the state and municipal needs

    Directory of Open Access Journals (Sweden)

    Proskurnja Dar'ja Vladimirovna

    2016-02-01

    Full Text Available The article is devoted to the review of the existing problems in the field of financial resources management at implementation of goods’ purchase, works, services for the state and municipal needs. Determination of the limit prices of purchases is revealed as the most important problem of the increasing efficiency of financial resources management at implementation of goods’ purchase, works, services for the state and municipal needs. The range of problems of determination of the limit prices of purchases is systematized.

  3. Choice of genetic resources needed for achievement of relevant breeding objectives

    International Nuclear Information System (INIS)

    Murty, B.R.

    1984-01-01

    The author points out the importance of exploration, conservation and documentation of genetic resources and reviews the current status of utilization of available genetic resources and the present breeding strategies

  4. An estimate of pocket closure and avoided needs of surgery after scaling and root planing with systemic antibiotics: a systematic review.

    Science.gov (United States)

    Kolakovic, Mirela; Held, Ulrike; Schmidlin, Patrick R; Sahrmann, Philipp

    2014-12-22

    Relevant benefits of adjunctive medication of antibiotica after conventional root surface debridement in terms of enhanced pocket depth (PD) reduction have been shown. However, means and standard deviations of enhanced reductions are difficult to translate into clinical relevant treatment outcomes such as pocket resolution or avoidance of additional surgical interventions. Accordingly, the aim of this systematic review was to calculate odds ratios for relevant cut-off values of PD after mechanical periodontal treatment with and without antibiotics, specifically the combination of amoxicilline and metronidazol, from published studies. As clinical relevant cut-off values "pocket closure" for PD ≤ 3mm and "avoidance of surgical intervention" for PD ≤ 5 mm were determined. The databases PubMed, Embase and Central were searched for randomized clinical studies assessing the beneficial effect of the combination of amoxicillin and metronidazole after non-surgical mechanical debridement. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. From published means and standard deviations for PD after therapy, odds ratios for the clinically relevant cut-off values were calculated using a specific statistical approach. Meta-analyses were performed for the time points 3 and 6 month after mechanical therapy. Generally, a pronounced chance for pocket closure from 3 to 6 months of healing was shown. The administration of antibiotics resulted in a 3.55 and 4.43 fold higher probability of pocket closure after 3 and 6 months as compared to mechanical therapy alone. However, as the estimated risk for residual pockets > 5 mm was 0 for both groups, no odds ratio could be calculated for persistent needs for surgery. Generally, studies showed a moderate to high quality and large heterogeneity regarding treatment protocol, dose of

  5. Mandating the offer of HIV testing in New York: simulating the epidemic impact and resource needs.

    Science.gov (United States)

    Martin, Erika G; MacDonald, Roderick H; Smith, Lou C; Gordon, Daniel E; Tesoriero, James M; Laufer, Franklin N; Leung, Shu-Yin J; Rowe, Kirsten A; OʼConnell, Daniel A

    2015-01-01

    A 2010 New York law requires that patients aged 13-64 years be offered HIV testing in routine medical care settings. Past studies report the clinical outcomes, cost-effectiveness, and budget impact of expanded HIV testing nationally and within clinics but have not examined how state policies affect resource needs and epidemic outcomes. A system dynamics model of HIV testing and care was developed, where disease progression and transmission differ by awareness of HIV status, engagement in care, and disease stage. Data sources include HIV surveillance, Medicaid claims, and literature. The model projected how alternate implementation scenarios would change new infections, diagnoses, linkage to care, and living HIV cases over 10 years. Without the law, the model projects declining new infections, newly diagnosed cases, individuals newly linked to care, and fraction of undiagnosed cases (reductions of 62.8%, 59.7%, 54.1%, and 57.8%) and a slight increase in living diagnosed cases and individuals in care (2.2% and 6.1%). The law will further reduce new infections, diagnosed AIDS cases, and the fraction undiagnosed and initially increase and then decrease newly diagnosed cases. Outcomes were consistent across scenarios with different testing offer frequencies and implementation times but differed according to the level of implementation. A mandatory offer of HIV testing may increase diagnoses and avert infections but will not eliminate the epidemic. Despite declines in new infections, previously diagnosed cases will continue to need access to antiretroviral therapy, highlighting the importance of continued funding for HIV care.

  6. The comparison of printed resources bacterial contamination in libraries of Al-Zahra Hospital and Sciences Faculty of Isfahan University and the determination of their antibiotic sensitivity pattern.

    Science.gov (United States)

    Rafiei, Hosein; Chadeganipour, Mostafa; Ojaghi, Rezvan; Maracy, Mohammad Reza; Nouri, Rasool

    2017-01-01

    During the library loan process, the printed resources can be a carrier of pathogenic bacteria. In this study, it was tried to compare the Bacterial Contamination Rates and their antibiotic sensitivity pattern in printed resources of a hospital and a non-hospital library. This is a cross-sectional study. Returning books from the Al-Zahra hospital library and library of Sciences faculty of Isfahan University provides the research community. The sample size, 96 cases, was calculated using quota sampling. For sampling sterile swab dipped in trypticase soy broth medium and transfer trypticase soy broth medium were used. To identify different type of isolated bacteria from Gram-staining test and biochemical tests such as; TSI, IMViC and etc., were used. 76 (79.2%) and 20 (20.8%) of cultured samples were negative and positive, the respectively. Of 20 positive samples, 11 samples (55%) belong to the family Enterobacteriaceae that after detecting by Differential teste identified all 11 samples of Enterobacter that all of them were sensitive to Gentamicin and Ofloxacin. Also the most resistance to Nitrofurantoin and Amikacin was observed. 9 cases remained (45%) were coagulase-negative Staphylococcus that all of them were sensitive to the Trimethoprim-sulfamethoxazole and Cephalexin antibiotics also the most resistance to Cefixime was observed. Considering that the Enterobacter sp and coagulase-negative Staphylococcus were separated from the books, the books as well as other hospital and medical equipment can transmit the infection to librarians, library users, patients and hospital staff, and also it can produce serious infections in patients with immune deficiency.

  7. Present status and needs of human resource development in nuclear field in Korea

    International Nuclear Information System (INIS)

    Choi, Young-Myung; Lee, Eui-Jin

    2000-01-01

    The Nuclear Training Center (NTC) of KAERI (Korea Atomic Energy Research Institute) began training technical personnel in the field of radioisotope utilization and radiation protection during the 1960's. During the first stage of the nation's nuclear power project in the 1970's, the main effort of the Center focused on training those in nuclear power and nuclear engineering. During a stage of increased technical self-reliance in the 1980's, the Center extended its training role to implement more specific training courses on nuclear power and safety fields. Since 1983, the Center has been empowered at the request of government to provide retraining courses for nuclear-related license holders and qualified engineers. The Center has offered IAEA regional training course annually for Asia and Pacific region member states since 1988. Since 1967, the total number of trainees is up to 27,777 as of the end of 1998. KEPCO (Korea Electric Power Corporation) started Nuclear Power Education Center (NPEC) in 1990. The outlines of KEPCO's in-house training programs are presented in the report. The reactor operators, and the persons engaged in nuclear fuel materials, radioisotope or radiation generating devices need particular licenses in accordance with Korean Atomic Energy Laws and Regulation. NTC/KAERI and NPEC/KEPCO should report annual retraining programs for licensed personnel to Ministry Of Science and Technology (MOST) every year. The outlines of projects, which are directly related to human resources development in nuclear field in Korea, are described in the paper. The International Atomic Energy Agency (IAEA) has made efforts to provide training programs for technical personnel of developing countries for the peaceful uses of nuclear energy. Korea has also received lots of assistance for her manpower development from the Agency. Korea is now on the verge of transforming herself from a technology recipient country in some practical and fundamental fields. The

  8. Traveling-wave reactors: A truly sustainable and full-scale resource for global energy needs

    International Nuclear Information System (INIS)

    Ellis, T.; Petroski, R.; Hejzlar, P.; Zimmerman, G.; McAlees, D.; Whitmer, C.; Touran, N.; Hejzlar, J.; Weave, K.; Walter, J. C.; McWhirter, J.; Ahlfeld, C.; Burke, T.; Odedra, A.; Hyde, R.; Gilleland, J.; Ishikawa, Y.; Wood, L.; Myhrvold, N.; Gates Iii, W. H.

    2010-01-01

    Rising environmental and economic concerns have signaled a desire to reduce dependence on hydrocarbon fuels. These concerns have brought the world to an inflection point and decisions made today will dictate what the global energy landscape will look like for the next half century or more. An optimal energy technology for the future must meet stricter standards than in the past; in addition to being economically attractive, it now must also be environmentally benign, sustainable and scalable to global use. For stationary energy, only one existing resource comes close to fitting all of the societal requirements for an optimal energy source: nuclear energy. Its demonstrated economic performance, power density, and emissions-free benefits significantly elevate nuclear electricity generation above other energy sources. However, the current nuclear fuel cycle has some attributes that make it challenging to expand on a global scale. Traveling-wave reactor (TWR) technology, being developed by TerraPower, LLC, represents a potential solution to these limitations by offering a nuclear energy resource which is truly sustainable at full global scale for the indefinite future and is deployable in the near-term. TWRs are capable of offering a ∼40-fold gain in fuel utilization efficiency compared to conventional light-water reactors burning enriched fuel. Such high fuel efficiency, combined with an ability to use uranium recovered from river water or sea-water (which has been recently demonstrated to be technically and economically feasible) suggests that enough fuel is readily available for TWRs to generate electricity for 10 billion people at United States per capita levels for million-year time-scales. Interestingly, the Earth's rivers carry into the ocean a flux of uranium several times greater than that required to replace the implied rate-of-consumption, so that the Earth's slowly-eroding crust will provide a readily-accessible flow of uranium sufficient for all of

  9. Present status and needs of human resource development in nuclear field in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young-Myung; Lee, Eui-Jin [Nuclear Training Center, Korea Atomic Energy Research Institute, Taejon (Korea)

    2000-12-01

    The Nuclear Training Center (NTC) of KAERI (Korea Atomic Energy Research Institute) began training technical personnel in the field of radioisotope utilization and radiation protection during the 1960's. During the first stage of the nation's nuclear power project in the 1970's, the main effort of the Center focused on training those in nuclear power and nuclear engineering. During a stage of increased technical self-reliance in the 1980's, the Center extended its training role to implement more specific training courses on nuclear power and safety fields. Since 1983, the Center has been empowered at the request of government to provide retraining courses for nuclear-related license holders and qualified engineers. The Center has offered IAEA regional training course annually for Asia and Pacific region member states since 1988. Since 1967, the total number of trainees is up to 27,777 as of the end of 1998. KEPCO (Korea Electric Power Corporation) started Nuclear Power Education Center (NPEC) in 1990. The outlines of KEPCO's in-house training programs are presented in the report. The reactor operators, and the persons engaged in nuclear fuel materials, radioisotope or radiation generating devices need particular licenses in accordance with Korean Atomic Energy Laws and Regulation. NTC/KAERI and NPEC/KEPCO should report annual retraining programs for licensed personnel to Ministry Of Science and Technology (MOST) every year. The outlines of projects, which are directly related to human resources development in nuclear field in Korea, are described in the paper. The International Atomic Energy Agency (IAEA) has made efforts to provide training programs for technical personnel of developing countries for the peaceful uses of nuclear energy. Korea has also received lots of assistance for her manpower development from the Agency. Korea is now on the verge of transforming herself from a technology recipient country in some practical and

  10. Present status and needs of human resource development in the nuclear field in the Philippines

    Energy Technology Data Exchange (ETDEWEB)

    Bernido, Corazon C.; Roceles, Pilar C. [Philippine Nuclear Research Institute, Commonwealth Avenue, Diliman, Quezon (Philippines)

    2000-12-01

    The first nuclear power plant was nearing completion. However, due to change in political climate and support for the nuclear power program, this has been mothballed. There is a possibility for the introduction of nuclear power plant in the country's projected energy sources by the year 2020. The country has one research reactor, but at the present time it is undergoing repair and is not operational. The Philippine Nuclear Research Institute (PNRI), an Institute under the Department of Science and Technology (DOST), is the sole government agency mandated by the law to take charge of all matters pertaining to nuclear science and technology, and the regulation of nuclear energy. There is one another government agency, the Radiation Health Service (RHS) of the Department of Health, which is responsible for regulating the use and application of X-rays and non-ionizing radiation. The PNRI conducts national training courses in nuclear science and technology, and radiation protection to users of radioisotopes. Individual courses are outlined in the paper. Up to the present time, around 7,300 have participated in national training courses conducted by PNRI. Distributions of PNRI trainees are: 53 % for industrial, 12 % medical, 12 % for academe, and 23 % for others. Nuclear science and technology education in schools and universities are presented. The International Atomic Energy Agency (IAEA) training activities availed 77 % of the total foreign training from 1993 to 1998; Japan follows next at 20 %; and others comprise the remaining 3 %. An approach to training and human resources development, which could reach out to more target trainees, is Distance Learning. In 1998, as a part of a Regional Cooperative Agreement (RCA) and IAEA project, the Philippines participated in the trial of distance learning modules in radiation protection. The distance learning modules were developed at the Australian Nuclear Science and Technology Organization (ANSTO). These modules will

  11. Present status and needs of human resource development in the nuclear field in the Philippines

    International Nuclear Information System (INIS)

    Bernido, Corazon C.; Roceles, Pilar C.

    2000-01-01

    The first nuclear power plant was nearing completion. However, due to change in political climate and support for the nuclear power program, this has been mothballed. There is a possibility for the introduction of nuclear power plant in the country's projected energy sources by the year 2020. The country has one research reactor, but at the present time it is undergoing repair and is not operational. The Philippine Nuclear Research Institute (PNRI), an Institute under the Department of Science and Technology (DOST), is the sole government agency mandated by the law to take charge of all matters pertaining to nuclear science and technology, and the regulation of nuclear energy. There is one another government agency, the Radiation Health Service (RHS) of the Department of Health, which is responsible for regulating the use and application of X-rays and non-ionizing radiation. The PNRI conducts national training courses in nuclear science and technology, and radiation protection to users of radioisotopes. Individual courses are outlined in the paper. Up to the present time, around 7,300 have participated in national training courses conducted by PNRI. Distributions of PNRI trainees are: 53 % for industrial, 12 % medical, 12 % for academe, and 23 % for others. Nuclear science and technology education in schools and universities are presented. The International Atomic Energy Agency (IAEA) training activities availed 77 % of the total foreign training from 1993 to 1998; Japan follows next at 20 %; and others comprise the remaining 3 %. An approach to training and human resources development, which could reach out to more target trainees, is Distance Learning. In 1998, as a part of a Regional Cooperative Agreement (RCA) and IAEA project, the Philippines participated in the trial of distance learning modules in radiation protection. The distance learning modules were developed at the Australian Nuclear Science and Technology Organization (ANSTO). These modules will be

  12. Human Resources Development and Career Development: Where Are We, and Where Do We Need to Go

    Science.gov (United States)

    Shuck, Brad; McDonald, Kim; Rocco, Tonette S.; Byrd, Marilyn; Dawes, Elliott

    2018-01-01

    At the 2017 meeting of the Academy of Human Resource Development Annual Town Hall, four scholars discussed their diverse outlooks on the research and practice of career development in the Human Resource Development field. What follows in this curated collection of voices is a look into the perspective of each person who spoke at the 2017 Town Hall…

  13. Skills Students Need in the Real World: Competencies Desired by Agricultural and Natural Resources Industry Leaders

    Science.gov (United States)

    Easterly, R. G., III; Warner, Anna J.; Myers, Brian E.; Lamm, Alexa J.; Telg, Ricky W.

    2017-01-01

    The competencies addressed by undergraduate agricultural education programs should be assessed so programs are effective in supplying a well-prepared agricultural- and natural resources-oriented workforce, and so human capital is optimized. In this study, agricultural and natural resources leaders were surveyed to determine the workforce…

  14. Managing job stress in nursing: what kind of resources do we need?

    Science.gov (United States)

    van den Tooren, Marieke; de Jonge, Jan

    2008-07-01

    This paper is a report of a study to investigate the functionality of different kinds of job resources for managing job stress in nursing. There is increasing recognition that healthcare staff, and especially nurses, are at high risk for burnout and physical complaints. Several researchers have proposed that job resources moderate the relationship between job demands and job-related outcomes, particularly when there is a match between the type of demands, resources, and outcomes. Based on the Demand-Induced Strain Compensation Model, cross-sectional survey data were collected between November 2006 and February 2007 by a paper-and-pencil questionnaire. The final sample consisted of 69 nurses from a Dutch nursing home (response rate 59.4%). Data were analyzed by hierarchical regression analyses. High physical demands had adverse effects on both physical complaints and emotional exhaustion (i.e. burnout), unless employees had high physical resources. A similar pattern was found for high physical demands and emotional resources in predicting emotional exhaustion. The likelihood of finding theoretically-valid moderating effects was related to the degree of match between demands, resources, and outcomes. Job resources do not randomly moderate the relationship between job demands and job-related outcomes. Both physical and emotional resources seem to be important stress buffers for human service employees such as nurses, and their moderating effects underline the importance of specific job resources in healthcare work. Job redesign in nursing homes should therefore primarily focus on matching job resources to job demands in order to diminish poor health and ill-being.

  15. [Antibiotic resistance: measures urgently needed].

    NARCIS (Netherlands)

    Kluytmans, J.; Vandenbroucke-Grauls, C.M.; Meer, J.W.M. van der

    2010-01-01

    Antimicrobial resistance is increasing rapidly and there are hardly any new antimicrobial agents to be expected in the coming years. The number of patients affected by extended spectrum beta-lactamase producing organisms (ESBLs) is rising and there are strong indications that this is caused in part

  16. Interactions of forests, climate, water resources, and humans in a changing environment: research needs

    Science.gov (United States)

    Ge Sun; Catalina Segura

    2013-01-01

    The aim of the special issue “Interactions of Forests, Climate, Water Resources, and Humans in a Changing Environment” is to present case studies on the influences of natural and human disturbances on forest water resources under a changing climate. Studies in this collection of six papers cover a wide range of geographic regions from Australia to Nigeria with spatial...

  17. Interactions of Forests, Climate, Water Resources, and Humans in a Changing Environment: Research Needs

    OpenAIRE

    Sun, Ge; Segura, Catalina

    2013-01-01

    The aim of the special issue “Interactions of Forests, Climate, Water Resources, and Humans in a Changing Environment” is to present case studies on the influences of natural and human disturbances on forest water resources under a changing climate. Studies in this collection of six papers cover a wide range of geographic regions from Australia to Nigeria with spatial research scale spanning from a tree leaf, to a segment of forest road, and large basins with mixed land uses. T...

  18. Preparing for the future: Higher education meeting environmental restoration and waste management human resource needs

    International Nuclear Information System (INIS)

    Wohlpart, Alfred

    1992-01-01

    The Office of Environmental Restoration and Waste Management (ER/WM) of the U.S. Department of Energy (DOE) has as its goal the elimination of risks from hazardous waste to human health and safety and the environment or the reduction of these risks to prescribed safe levels. The achievement of this goal requires the availability of sufficient and appropriately educated scientists, engineers, and technicians. A preliminary workforce needs assessment conducted for the Office of Environmental Restoration and Waste Management in 1990 indicated that the technical workforce involved in ER/WM activities would grow by 50 to 70 percent by 1995. A more exhaustive assessment is currently underway. To ensure the availability of the necessary human resources, the Office has initiated a series of education programs. The programs designed for the college/university levels are expected to increase the number of students pursuing associate, baccalaureate, and advanced degrees in ER/WM relevant science and engineering disciplines and to initiate research and training in technical areas supportive of the ER/WM mission. The ER/WM Scholarship program provides scholarships to undergraduate students pursuing science and engineering degrees at designated two- and four-year academic institutions. Fifty-four four-year and six two-year institutions are involved. The ER/WM Fellowship program supports graduate study and research at designated academic institutions in specified science and engineering disciplines or in interdisciplinary programs, Thirty graduate students are pursuing advanced degrees in disciplines supportive of the ER/WM mission at 14 different academic institutions. Scholars and fellows are required to spend one summer at a DOE facility participating in ongoing ER/WM projects. The fellowship and scholarship programs are expected to create a pool of appropriately educated professionals ready to enter the workforce and contribute to the DOE mission. To ensure the full

  19. Predictors of needs for community and financial resources for families of pre-school children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Bertule D.

    2016-01-01

    Full Text Available An understanding of predictors of family needs for the families of preschool children with cerebral palsy (CP is important for provision of efficient and cost-effective services. The aim of this study was to identify the characteristics of children, families and services that are risk factors to meeting family needs for community and financial resources. 234 parents of pre-school children with CP completed a modified version of the Family Needs Survey (FNS, the Measure of Processes of Care (MPOC-20, and a demographic questionnaire. The gross motor function level and communication function level of children were classified on the basis of the Gross Motor Function Classification System (GMFCS and the Communication Function Classification System (CFCS respectively. Two hierarchical multiple regression models were generated to determine the predictors of unmet family needs. The socialisation and communication skills of children, as well as caregiver employment and family income levels were significant predictors of family needs for community resources (adjusted R2=0.44. Significant risk factors in terms of family needs for financial resources included the child's gross motor limitations, caregiver employment, low levels of family income and no ability to receive services on the basis of enabling and partnership principles (adjusted R2=0.51. A child's limitations in terms of communication, gross motor functions and socialisation, as well as the socioeconomic status of the child's family, must be taken into account when planning services for families with preschool children with CP.

  20. Catering to Cleantech’s resource needs: the strategic importance of board networks in an emerging green industry.

    NARCIS (Netherlands)

    Heemskerk, E.M.; Mans, U.

    2013-01-01

    This paper explores the role of elite networks in shaping business strategies in the cleantech industry. In order to do so, we investigate whether and if so how boards of directors cater to the resource needs of the innovative and expanding cleantech industry. We create a new dataset of the board

  1. Identifying resource manager information needs for the North Pacific Landscape Conservation Cooperative

    Science.gov (United States)

    Woodward, Andrea; Liedtke, Theresa; Jenni, Karen

    2014-01-01

    Landscape Conservation Cooperatives (LCCs) are a network of 22 public-private partnerships, defined by ecoregion, that share and provide science to ensure the sustainability of land, water, wildlife and cultural resources in North America. LLCs were established by the U.S. Department of Interior (DOI) in recognition that response to climate change must be coordinated on a landscape-level basis because important resources, ecosystem processes and resource management challenges extend beyond national wildlife refuges, Bureau of Land Management lands, national parks, and even international boundaries. Therefore, DOI agencies must work with other Federal, State, Tribal (U.S. indigenous peoples), First Nation (Canadian indigenous peoples), and local governments, as well as private landowners, to develop landscape-level strategies for understanding and responding to climate change.

  2. Enhancement of the NEEDS-TIMES Model: Data for Spain on Biomass Resources and Renewable Electricity

    International Nuclear Information System (INIS)

    Labriet, M.; Cabal, H.; Lechon, Y.

    2008-01-01

    The objective of this report is to describe the data related to both electricity generation (focus on distributed generation and Renewable Energy Source) as well as biomass resources and transformation in Spain. It will contribute to the analysis of the renewable energy potential at the European level (RES2020 project). (Author)

  3. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  4. Managing job stress among nurses : what kind of job resources do we need?

    NARCIS (Netherlands)

    Tooren, van den M.; Jonge, de J.

    2008-01-01

    Aim. This paper is a report of a study to investigate the functionality of different kinds of job resources for managing job stress in nursing. Background. There is increasing recognition that healthcare staff, and especially nurses, are at high risk for burnout and physical complaints. Several

  5. Uranium production - needs and 'in the ground' resources, situation in 2007 and perspectives

    International Nuclear Information System (INIS)

    Capus, G.

    2007-01-01

    Under the combined effect of energies price increase and of the worldwide growing fear of global warming effects, nuclear power is again entering a favorable era. The questions of how much and how long it might bring a significant contribution to global power supplies must be addressed. In particular, it is worth considering uranium production capability and its long term perspective, in accordance to the currently available knowledge about uranium resources. Also, the issue of world resources geographic distribution should be analyzed from a security of supply viewpoint. The careful analysis of all available information leads us to the following conclusive remarks. The current tension on uranium market prices is by no mean a signal of 'in the ground' resources depletion. It is just the temporary consequence of a too long depressed market. There are enough identified and foreseen uranium resources to quietly start a huge power plant fleet increase (a doubling or tripling the current installed capacity by 2030). Ultimately, several types within the generation 4 reactors allow us to envisage a very far extended use of currently available fissile and fertile nuclear material, along with a significant expansion of fission based nuclear power. (author)

  6. Enhancement of the NEEDS-TIMES Model: Data for Spain on Biomass Resources and Renewable Electricity

    Energy Technology Data Exchange (ETDEWEB)

    Labriet, M.; Cabal, H.; Lechon, Y.

    2008-07-01

    The objective of this report is to describe the data related to both electricity generation (focus on distributed generation and Renewable Energy Source) as well as biomass resources and transformation in Spain. It will contribute to the analysis of the renewable energy potential at the European level (RES2020 project). (Author)

  7. International Students Using Online Information Resources to Learn: Complex Experience and Learning Needs

    Science.gov (United States)

    Hughes, Hilary

    2013-01-01

    This paper reports the findings of a qualitative study that investigated 25 international students' use of online information resources for study purposes at two Australian universities. Using an expanded critical incident approach, the study viewed international students through an information literacy lens, as information-using learners. The…

  8. Putting Phosphorus First: The Need to Know and Right to Know Call for a Revised Hierarchy of Natural Resources

    Directory of Open Access Journals (Sweden)

    Friedrich-W. Wellmer

    2017-06-01

    Full Text Available The aim of this paper is to develop two concepts regarding phosphorus that will serve as a contribution fulfilling the call for intergenerational equity: to improve knowledge of future resources and to develop a framework by setting priorities for maximizing availability with a hierarchy of natural resources. The increasing human demand for minerals and metals is causing persistent concern about long-term supply security. This holds true particularly for phosphorus. Phosphorus is bioessential; it cannot be substituted. There are no unlimited resources for phosphorus. The question of how large the reserves are and the potential for finding additional reserves and resources for a long-term supply are, therefore, of interest to numerous stakeholders, from governments to individuals. We examine governments’ needs and individuals’ rights to know private exploration data. Because of the essential nature of phosphorus, we emphasize the public’s special right to know as much as possible about phosphate reserves, resources and the geopotential for new discoveries, based upon the basic human right to feed oneself in dignity. To fulfill the call for intergenerational equity, however, knowledge alone is not enough; guidelines for management have to follow. This can be achieved by defining a hierarchy of natural resources for setting priorities. For humankind’s technological and cultural development, a sufficient supply of energy resources must be considered the key element; therefore, efforts to maximize information that will enable best decisions to be made have been the strongest. A hierarchy of natural resources with fossil and nuclear energies at the top was proposed. However, with the new development of renewable forms of energy and the decreasing role of fossil-fuel energy, the hierarchy of natural resources that defines priorities must be revised. We propose a hierarchy that replaces fossil-fuel energy at the top with phosphorus.

  9. Poverty in the midst of plenty: unmet needs and distribution of health care resources in South Korea.

    Directory of Open Access Journals (Sweden)

    Jongho Heo

    Full Text Available BACKGROUND: The unmet needs for health care have been used as an alternative measurement to monitor equity in health services. We sought to examine contextual influences on unmet needs for health care whereas precedent studies have been focused on individual characteristics on them. METHODS AND FINDINGS: The current study conducted multilevel logistic regression analysis to assess the effects of individual- and contextual-level predictors in meeting individual health care needs in South Korea. We sampled 7,200 individuals over the age of 19 in the Fourth Korea National Health and Nutrition Examination Survey in 2009. Included in the regression model were individual predictors such as demographic variables, socio-economic status, and self-rated health; the density of beds and physicians in public and private sectors within different regions were used as contextual-level predictors. This study showed the inverse association between unmet needs and regional resources in private sectors after controlling for the effects of individual-level predictors. CONCLUSION: Our findings suggest that increasing regional resources in private sectors might produce inefficiency in the health care system and inequity in access to health services, particularly where the competition in private health care sectors was highly stimulated under the fee-for-service reimbursement scheme. Policies for the reallocation of health care resources and for reduction of individual health care costs are needed in Korea.

  10. Responding to Community Needs through Community Follow-Up. Junior College Resource Review.

    Science.gov (United States)

    Mehallis, Mantha Vlahos

    This literature review examines the utilization of community needs assessment data in program planning and evaluation efforts at community colleges. The review first defines and looks at the purposes of community needs assessments, noting that while such studies are purported to facilitate the planning and evaluation of credit and non-credit…

  11. Maslow's needs hierarchy as a framework for evaluating hospitality houses' resources and services.

    Science.gov (United States)

    Duncan, Mary Katherine Waibel; Blugis, Ann

    2011-08-01

    As hospitality houses welcome greater numbers of families and families requiring longer stays, they do so in the absence of a widely accepted theory to guide their understanding of guests' needs and evaluations of how well they meet those needs. We propose A. Maslow's (1970) Hierarchy of Needs as a conceptual framework for understanding what makes a hospitality house a home for families of pediatric patients and for guiding the activities of hospitality houses' boards of directors, staff, volunteers, and donors. This article presents findings from a theory-driven evaluation of one hospitality house's ability to meet guests' needs, describes the house's best practice standards for addressing guests' needs, and suggests areas for future research. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A user need study and system plan for an Arizona Natural Resources Information System report to the Arizona state legislature

    Science.gov (United States)

    1980-01-01

    A survey instrument was developed and implemented in order to evaluate the current needs for natural resource information in Arizona and to determine which state agencies have information systems capable of coordinating, accessing and analyzing the data. Data and format requirements were determined for the following categories: air quality, animals, cultural resources, geology, land use, soils, water, vegetation, ownership, and social and economic aspects. Hardware and software capabilities were assessed and a data processing plan was developed. Possible future applications with the next generation LANDSAT were also identified.

  13. [Need-based resource allocation--experiences with the RAWP formula in Great Britain].

    Science.gov (United States)

    Brand, H; Menke, R

    1997-07-01

    The RAWP formula used for resource allocation in Great Britain between 1976 and 1991 is a morbidity-oriented instrument of controlling, which has so far received only little attention in Germany. The development of this model was supported by the intention to intervene in the regional pattern of hospital supply by means of resource allocation and to refine it according to the guiding principles of equity and efficiency. The basic elements-regional population, average bed use, ICD chapter-specific SMRs-are discussed and the various modifications outlined. The RAWP formula's potentials of controlling resulted in a progressive reduction of the apparent disparities between regions in hospital supply, and knee was considered to be a "qualified success". The future development in the sense of an internal market addressed.

  14. Contributing towards the betterment of translational epilepsy research in Africa: needs, challenges, resources, and opportunities.

    Science.gov (United States)

    Woldeamanuel, Yohannes W; Girma, Belaineh

    2014-08-01

    Epilepsy affects approximately 50 million people worldwide. Among them, at least 40 million people are currently living in the developing world, where resources and standards of care are suboptimal. Around 90 % of people with epilepsy in resource-poor countries do not currently receive appropriate treatments, at a time when two thirds of these patients could have achieved good control of their epileptic seizures had they had access to appropriate therapies. Scarcity of epilepsy specialists, poor availability or access to diagnostic facilities and treatments, poor community knowledge about epilepsy-related issues, stigma, and other societal and cultural barriers are only some of the issues contributing to this deficiency. These issues in epilepsy treatment have been well recognized, and ongoing concerted efforts to address them have been undertaken by both local authorities and international organizations. In many cases, patients resort to the use of traditional local and alternative medicines (herbs, religious practices, etc.) that are closer to indigenous cosmovision, are more holistic, and are more culture-friendly, preserving an optimum subtlety of Afrocentric character shading. Compared with imported Western medicines, patients find these approaches to be more relevant to their ways of thinking, their ways of being, and their belief systems, more accessible, and more acceptable methods of dealing with health and disease states. The impressive local wealth in these natural resources has established them as a preferred source of healing in these regions, but has also fueled interest in exploring their therapeutic potential in the very few existing local research centers. In this review, we discuss the known issues related to the epilepsy treatment gap in resource-poor regions, focusing in particular on African countries, introduce the role and issues related to the use and validation of alternative medical therapies in epilepsy, and comment on the importance and

  15. Evaluation of the Need for Antibiotic Prophylaxis During Routine Intra-alveolar Dental Extractions in Healthy Patients: A Randomized Double-Blind Controlled Trial.

    Science.gov (United States)

    Sidana, Sunil; Mistry, Yusuf; Gandevivala, Adil; Motwani, Nitesh

    2017-09-01

    The aim of this randomized double-blind controlled trial was to evaluate the role of antibiotics in the perioperative period of dental extractions in healthy patients. The study population included patients visiting the outpatient department of our institute. Four hundred patients were selected and randomly divided into 4 groups and underwent routine dental extraction. In group A, patients were prescribed only anti-inflammatory drugs in the postoperative period. In group B, patients were prescribed antibiotics for 3 days and concomitant anti-inflammatory drugs in the postoperative period only. In group C, patients were prescribed a single dose of antibiotic 1 hour before the extraction procedure with no postoperative antibiotics, and only anti-inflammatory drugs were prescribed in the postoperative period. In group D, patients were prescribed mouthwash starting 15 minutes before the procedure and continuing twice daily for a period of 7 days along with anti-inflammatory drugs in the postoperative period. Patients were asked to follow up on the seventh postoperative day for suture removal and were evaluated for pain, swelling, dry socket, and local signs of infection. The study was approved by the Internal Ethics Review Committee of the institute. No significant differences were seen among the groups with respect to pain (χ 2  [1, N = 171] = 4.939, P = .552), swelling (χ 2 [1, N = 171] = 10.048, P = .347), or postextraction complications. Prophylactic antibiotics are not required during routine dental extractions in healthy patients. The use of antibiotic therapy without appropriate indications can result in the development of resistant organisms. However, a clear trend is seen in which practitioners overprescribe antibiotics as well as medications in general. The current evidence questions the benefits of prophylactic antibiotic therapy for patients undergoing dental extractions. In our opinion, there is no justification for routine antibiotic

  16. The U.S. natural gas and oil resource base is abundant; but can we produce what the country needs?

    International Nuclear Information System (INIS)

    Ewing, T.E.

    1994-01-01

    Recent studies agree that the United States has abundant resources of gas and oil left to find and produce over the next 50--75 years -- if its exploration and production companies are given the resources to do the job. The NPC's estimate of 1,295 TCF of natural gas (advanced technology case) represents a resource/present production ration of 68 years. A similar estimate for oil gives 62 years. Furthermore, these resource estimates have been increasing through the 1980s, as the effects of new geological, geophysical, and engineering technologies has become more apparent. However, only 30% of this tremendous resource will be available under today's business-as-usual economic regime. The rest of the resource will be accessed if: (1) tax policies (and financial and trade policies) are adopted to stabilize prices and stimulate exploration and production (estimated 27% of the resource base); (2) technology is developed, transferred, and used (17%); (3) environmental regulation is held to a balanced level, considers economic costs as well as environmental benefits, and is applied consistently (13%); (4) access to Federal lands is eased for environmentally responsible drilling and development (13%). To convert America's gas and oil resources into delivered products in a timely manner, assuring the nation's gas users of a reliable supply -- and contribute up to $8.7 trillion to the nation's economy -- a doubling of industry effort is required, even at today's high levels of finding and producing efficiency. Coordinated action by industry, government, and the investment community is required to secure the future development of energy supplies. Government in particular must develop policies that encourage the needed investment in America's natural gas and oil

  17. French energy resources and needs. Incidence on the development of the national nuclear programme

    International Nuclear Information System (INIS)

    Martin, Roger.

    1977-01-01

    The energy flux diagram for France in 1970, underlines the disparity observed between the utilization factors in the final stage: 75% for the domestic and tertiary sector, 75% for industry and siderurgy, 65% for agriculture, and 25% for transports. The total utilization factor is 47.5% (124.4 MTEC used for 137.6 MTEC unused; the unit used being the Million of Tons Equivalent to Coal. Two dates are arbitrarily envisaged (1985 and 2000) in the evolution of the French energy technology and structure. The energy flux diagram predicted for 1985 should asked to atom nearly a quarter of the resources, with an enhanced part from hydraulics (+30%) and should involve geothermy, heat wastes and solar energy. An extrapolation predicts a spectacular-growth for 2000 due to the uranium share as a compensation to the decrease in that from oil, as for the transformation stage a neat increase in the electricity share is predicted together with 'tele-heat' and hydrogen production and, at the stage of utilization the mass penetration of 'tele-heat', especially of nuclear origin. The problem of the evolution of energy resources is also discussed [fr

  18. Country report present status and need of human resource development in nuclear field in Vietnam

    International Nuclear Information System (INIS)

    Ngo Qui Viet; Vu Dang Ninh

    2000-01-01

    Vietnam Atomic Energy Commission (VAEC) was officially established in 1976, and is a national research and development organization in the field of nuclear science and technology for peaceful purposes in Vietnam. Under the VAEC, there are three institutes and one center. Status of main facilities, such as TRIGA MARK II, neutron generator, electron accelerator MT-17, and irradiation facilities are outlined in the paper. At present, the VAEC has a total staff of about 540 persons. The number of staff appears adequate to fulfill the present task on application of isotopes and nuclear techniques. When Vietnam decides to develop nuclear power program, the demand for human resources will be significantly high. During the last five years, Vietnam has been developing and implementing a national regulatory program on Radiation Protection and Nuclear Safety. The Ministry of Science, Technology and Environment (MOSTE) have established independent Vietnam Radiation Protection and Nuclear Safety Authority (VRPA) in 1994. If the Vietnamese Government approves the proposed nuclear power program, human resources training should be a key point for all research and development directions at all revel of personnel. When looking back in the history of formation and development of nuclear science and technology in Vietnam, the international cooperation has played an extremely important role in promoting the program. The exchange of information and direct participation in concrete cooperation activities under the framework of the Forum are expected. (Tanaka, Y.)

  19. Country report present status and need of human resource development in nuclear field in Vietnam

    Energy Technology Data Exchange (ETDEWEB)

    Ngo Qui Viet [Department of Organization and Scientific Human Resource Development, The Ministry of Science, Technology and Environment, Hanoi (Viet Nam); Vu Dang Ninh [Department of Administration and Personnel, The Vietnam Atomic Energy Commission, Hanoi (Viet Nam)

    2000-12-01

    Vietnam Atomic Energy Commission (VAEC) was officially established in 1976, and is a national research and development organization in the field of nuclear science and technology for peaceful purposes in Vietnam. Under the VAEC, there are three institutes and one center. Status of main facilities, such as TRIGA MARK II, neutron generator, electron accelerator MT-17, and irradiation facilities are outlined in the paper. At present, the VAEC has a total staff of about 540 persons. The number of staff appears adequate to fulfill the present task on application of isotopes and nuclear techniques. When Vietnam decides to develop nuclear power program, the demand for human resources will be significantly high. During the last five years, Vietnam has been developing and implementing a national regulatory program on Radiation Protection and Nuclear Safety. The Ministry of Science, Technology and Environment (MOSTE) have established independent Vietnam Radiation Protection and Nuclear Safety Authority (VRPA) in 1994. If the Vietnamese Government approves the proposed nuclear power program, human resources training should be a key point for all research and development directions at all revel of personnel. When looking back in the history of formation and development of nuclear science and technology in Vietnam, the international cooperation has played an extremely important role in promoting the program. The exchange of information and direct participation in concrete cooperation activities under the framework of the Forum are expected. (Tanaka, Y.)

  20. Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

    OpenAIRE

    Adaku, Alex; Okello, James; Lowry, Blakeley; Kane, Jeremy C.; Alderman, Stephen; Musisi, Seggane; Tol, Wietse A.

    2016-01-01

    Background Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interven...

  1. Forgotten antibiotics

    DEFF Research Database (Denmark)

    Pulcini, Céline; Bush, Karen; Craig, William A

    2012-01-01

    In view of the alarming spread of antimicrobial resistance in the absence of new antibiotics, this study aimed at assessing the availability of potentially useful older antibiotics. A survey was performed in 38 countries among experts including hospital pharmacists, microbiologists, and infectious...

  2. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia

    Directory of Open Access Journals (Sweden)

    Ensor Tim

    2012-08-01

    Full Text Available Abstract Background Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. Methods A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Findings Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population

  3. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia.

    Science.gov (United States)

    Ensor, Tim; Firdaus, Hafidz; Dunlop, David; Manu, Alex; Mukti, Ali Ghufron; Ayu Puspandari, Diah; von Roenne, Franz; Indradjaya, Stephanus; Suseno, Untung; Vaughan, Patrick

    2012-08-29

    Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population, particularly numbers of births, infants and children and also key

  4. The Paleontology Portal: An online resource meeting the needs a spectrum of learners

    Science.gov (United States)

    Lindberg, D.; Scotchmoor, J. G.

    2005-12-01

    The Paleontology Portal website provides a central, interactive entry point to high-quality North American paleontology resources on the Internet for multiple audiences: the research community, government and industry, K-16 students, and the general public. The Portal successfully blends research and education, pulling together information with reviewed and annotated website links for a wide variety of informal learners. Using web-based technology and relational databases, users can explore an interactive map and associated stratigraphic column to access information about particular geographic regions, geologic time periods, depositional environments, and representative taxa. Users are also able to search multiple museum collection databases using a single query form of their own design. Other features include highlights of famous fossil sites and assemblages and a fossil image gallery. Throughout the site, users find images and links to information specific to each time period or geographic region, including current research projects and publications, websites, on-line exhibits and educational materials, and information on collecting fossils. The next phase of development will target the development of resource modules on topics such as collection management and fossil preparation, appropriate for users ranging from the general public to professional paleontologists. Another initiative includes developing methods of personalizing the Portal to support exhibits at museums and other venues on geological history and paleontology. The Paleontology Portal, built by the UC Museum of Paleontology, is a joint project of the Society of Vertebrate Paleontology, the Paleontological Society, and the US Geological Survey, in collaboration with the Paleontological Research Institution, the Fort Worth Museum of Science and History, and the Denver Museum of Nature and Science, which serve as hubs for the project. Paleoportal serves as an effective model in two aspects: (1

  5. Educational Outcomes for Students with Special Needs: The Impact of Support and Resources on Teachers' Perceptions

    Science.gov (United States)

    Sharpe, Traci Y.

    2013-01-01

    This article defines a theoretical framework for reviewing factors that affect a teacher's self-efficacy as they work to impact the educational outcomes for students with special needs. Bandura's Social-Cognitive Theory is utilized on the basis that one's belief in his ability to be effective has a direct impact on his effectiveness. This…

  6. Man's Basic Needs. Resource Units, Grade 1. Providence Social Studies Curriculum Project.

    Science.gov (United States)

    Providence Public Schools, RI.

    GRADES OR AGES: Grade 1. SUBJECT MATTER: Social studies; man's basic needs. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into 11 chapters, five of which outline the basic curriculum subunits. These five chapters are laid out in three columns, one each for topics, activities, and materials. Other chapters are in list form. The guide…

  7. Lifting All Boats? Finance Litigation, Education Resources, and Student Needs in the Post-"Rose" Era

    Science.gov (United States)

    Sims, David P.

    2011-01-01

    "Rose v. Council for Better Education" (1989) is often considered a transition point in education finance litigation, heralding an era of increasing concern for measurable adequacy of education across a broad spectrum of student needs. Prior research suggests that post-Rose lawsuits had less effect on the distribution of school spending…

  8. Analyzing the natural resource extension needs of Spanish-speakers: A perspective from Florida

    Science.gov (United States)

    Miriam Wyman; Francisco Escobedo; Sebastian Varela; Cesar Asuaje; Henry Mayer; Mickie Swisher; Annie Hermansen

    2011-01-01

    Hispanics are the country's fastest growing minority group. The study reported here surveyed and assessed Extension agents from two demographically different regions in Florida on perceptions and attitudes about the need, quality, and dissemination of Spanish Extension materials. Results showed Extension programs are important sources of information for Spanish-...

  9. Skill Needs and Human Resources Development in the Emerging Field of Nanotechnology

    Science.gov (United States)

    Yawson, Robert Mayfield

    2010-01-01

    Strong societal requirements and consumer acceptance are the driving force of nanotechnology development. The necessity for qualified experts and strong demand on education in the multi-, trans- and interdisciplinary field of nanotechnology is a logical consequence of this driving force. There is the need for a comprehensive national…

  10. Resources to Meet the Educational Needs of Language Minorities: Teachers in Public Schools.

    Science.gov (United States)

    Waggoner, Dorothy

    Findings are presented from the Teachers Language Skills Survey, the first national survey undertaken to estimate how many teachers currently employed in public schools have the backgrounds, experience, education, and skills needed to teach students with limited-English proficiency. Information was gathered on teachers teaching in the 1976-77…

  11. Crew resource management in the ICU: the need for culture change.

    Science.gov (United States)

    Haerkens, Marck Htm; Jenkins, Donald H; van der Hoeven, Johannes G

    2012-08-22

    Intensive care frequently results in unintentional harm to patients and statistics don't seem to improve. The ICU environment is especially unforgiving for mistakes due to the multidisciplinary, time-critical nature of care and vulnerability of the patients. Human factors account for the majority of adverse events and a sound safety climate is therefore essential. This article reviews the existing literature on aviation-derived training called Crew Resource Management (CRM) and discusses its application in critical care medicine. CRM focuses on teamwork, threat and error management and blame free discussion of human mistakes. Though evidence is still scarce, the authors consider CRM to be a promising tool for culture change in the ICU setting, if supported by leadership and well-designed follow-up.

  12. Information needs of people with low back pain for an online resource: a qualitative study of consumer views.

    Science.gov (United States)

    Nielsen, Mandy; Jull, Gwendolen; Hodges, Paul W

    2014-01-01

    To identify the information needs of people with low back pain (LBP) in Australia, and the preferred methods to present this information online, as a basis for development of a patient-centred website. Available online LBP resources are limited in quality and content and it is not clear if they are meeting the needs of sufferers. Focus groups and semi-structured telephone interviews, involving 28 people with LBP. Seven categories of information were identified: reasons for LBP, treatment and management options, self-help information, psychological and social dimensions, lay stories, quality assurance of information and roles of different healthcare professionals and locally available services. Identified preferences for online presentation included: multimodality, emphasis on visual media, readability and interactivity. Participants had been unable to obtain desired LBP information using existing resources. This study provides important guidance for development of a patient-centred website grounded in the expressed needs and preferences of people with LBP. Understanding the breadth of patients' questions and concerns is essential for provision of patient-centred information and interventions. Incorporating these with the current evidence base would provide an accessible and relevant LBP patient education referral point, which is currently lacking. Implications for Rehabilitation Use of the internet to obtain health information is increasing, although there is little evidence that existing low back pain websites are meeting the expressed needs of health consumers. Our research suggests that people with low back pain have difficulty finding relevant and trustworthy information about the condition on the internet. Taking patient information needs and presentation preferences into account when designing online information material will provide people with low back pain an accessible and relevant educational resource that is currently lacking.

  13. Decellularized human amniotic membrane: more is needed for an efficient dressing for protection of burns against antibiotic-resistant bacteria isolated from burn patients.

    Science.gov (United States)

    Gholipourmalekabadi, M; Bandehpour, M; Mozafari, M; Hashemi, A; Ghanbarian, H; Sameni, M; Salimi, M; Gholami, M; Samadikuchaksaraei, A

    2015-11-01

    Human amniotic membranes (HAMs) have attracted the attention of burn surgeons for decades due to favorable properties such as their antibacterial activity and promising support of cell proliferation. On the other hand, as a major implication in the health of burn patients, the prevalence of bacteria resistant to multiple antibiotics is increasing due to overuse of antibiotics. The aim of this study was to investigate whether HAMs (both fresh and acellular) are an effective antibacterial agent against antibiotic-resistant bacteria isolated from burn patients. Therefore, a HAM was decellularized and tested for its antibacterial activity. Decellularization of the tissue was confirmed by hematoxylin and eosin (H&E) and 4,6-diamidino-2-phenylindole (DAPI) staining. In addition, the cyto-biocompatibility of the acellular HAM was proven by the cell viability test (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide, MTT) and scanning electron microscopy (SEM). The resistant bacteria were isolated from burns, identified, and tested for their susceptibility to antibiotics using both the antibiogram and polymerase chain reaction (PCR) techniques. Among the isolated bacteria, three blaIMP gene-positive Pseudomonas aeruginosa strains were chosen for their high resistance to the tested antibiotics. The antibacterial activity of the HAM was also tested for Klebsiella pneumoniae (American Type Culture Collection (ATCC) 700603) as a resistant ATCC bacterium; Staphylococcus aureus (mecA positive); and three standard strains of ATCC bacteria including Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27833), and S. aureus (ATCC 25923). Antibacterial assay revealed that only the latter three bacteria were susceptible to the HAM. All the data obtained from this study suggest that an alternative strategy is required to complement HAM grafting in order to fully protect burns from nosocomial infections. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  14. Awareness of Rational Medication Use and Antibiotic Self ...

    African Journals Online (AJOL)

    Knowledge on dose, frequency, duration and side-effects of antibiotics among students was ... highlights the need for interventions to assure rational use of antibiotics. Keywords: Antibiotics ... higher education [11-16]. Global tendency is.

  15. Overcoming the current deadlock in antibiotic research.

    Science.gov (United States)

    Schäberle, Till F; Hack, Ingrid M

    2014-04-01

    Antibiotic-resistant bacteria are on the rise, making it harder to treat bacterial infections. The situation is aggravated by the shrinking of the antibiotic development pipeline. To finance urgently needed incentives for antibiotic research, creative financing solutions are needed. Public-private partnerships (PPPs) are a successful model for moving forward. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Improving pediatric cardiac surgical care in developing countries: matching resources to needs.

    Science.gov (United States)

    Dearani, Joseph A; Neirotti, Rodolfo; Kohnke, Emily J; Sinha, Kingshuk K; Cabalka, Allison K; Barnes, Roxann D; Jacobs, Jeffrey P; Stellin, Giovanni; Tchervenkov, Christo I; Cushing, John C

    2010-01-01

    This article reviews a systematic approach to the design and support of pediatric cardiac surgery programs in the developing world with the guidance and strategies of Children's HeartLink, an experienced non-government organization for more than 40 years. An algorithm with criteria for the selection of a partner site is outlined. A comprehensive education strategy from the physician to the allied health care provider is the mainstay for successful program development. In a partner program, the road to successful advancement and change depends on many factors, such as government support, hospital administration support, medical staff leadership, and a committed and motivated faculty with requisite skills, incentives, and resources. In addition to these factors, it is essential that the development effort includes considerations of environment (eg, governmental support, regulatory environment, and social structure) and health system (elements related to affordability, access, and awareness of care) that impact success. Partner programs should be willing to initiate a clinical database with the intent to analyze and critique their results to optimize quality assurance and improve outcomes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  17. Land resource information needs of county government : a case study in Larimer County, Colorado

    Science.gov (United States)

    Alexander, Robert H.

    1983-01-01

    My two colleagues on the study team, Rex Burns of the Larimer County Planning Department, and Glenn McCarty of the Fort Collins office of the Soil Conservation Service, contributed substantially to this report; many of their written words have found their way directly into the text. Jill O'Gara later replaced Rex Burns as the Larimer County coordinator in the study's final stages. John Rold, Colorado State Geologist, assisted in coordinating our efforts at the beginning of this study. Lou Campbell, State Cartographer, gave valuable advice and assistance throughout the effort. Wallace Hansen and James Blakey of the USGS Geologic and Water Resources Divisions, respectively, read the final manuscript and helped in many other ways. Joanna Trolinger served as research assistant and manuscript typist. Many others in the USGS, SCS, and other organizations helped in supplying information and advice. Tom Bates, then Chairman of the USGS Central Region Earth Science Applications Task Force, was the originator of the study, leader of the USGS participation effort, and guiding inspiration throughout. The study was carried out in association with the Program on Environment and Behavior, Institute of Behavioral Science, University of Colorado, Boulder.

  18. Healthcare resources and needs in anticoagulant therapy for patients with nonvalvular atrial fibrillation. SAMOA Study.

    Science.gov (United States)

    Barrios, V; Egocheaga-Cabello, M I; Gállego-Culleré, J; Ignacio-García, E; Manzano-Espinosa, L; Martín-Martínez, A; Mateo-Arranz, J; Polo-García, J; Vargas-Ortega, D

    2017-05-01

    To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients. We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients. A total of 893 physicians participated in the study, 437 of whom worked in primary care and 456 of whom were specialists (mostly cardiologists). Forty-two percent of the family doctors indicated that they assessed and prescribed anticoagulant therapy, and 66% performed the regular follow-up of these patients. In both healthcare settings, the physicians noted the lack of standardised protocols. There was also a lack of quality control in the treatment. The role of primary care in managing anticoagulated patients has grown compared with previous reports. The responses of the participating physicians suggest marked gaps in the standardisation of the healthcare process and several areas for improvement in these patients' follow-up. The promotion of training in direct-acting anticoagulant drugs remains pivotal. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  19. Training needs assessment of andalusian teachers in educational digital resources authoring for virtual learning environments

    Directory of Open Access Journals (Sweden)

    José Javier Romero Díaz de la Guardia

    2012-12-01

    Full Text Available This research work has been conducted within the teacher training plan known as “Escuela TIC 2.0”, implemented by the Spanish Junta de Andalucía. The main aim is to obtain objective data regarding training needs for teachers in the autonomous region of Andalusia in terms of educational digital content authoring. To that end, we carried out a descriptive survey study on Andalusian teachers participating in teacher training courses on e-learning strategies that took place during the 2011- 2012 academic year.

  20. Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.

    Science.gov (United States)

    Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L

    2013-08-01

    To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.

  1. Antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Marianne Frieri

    2017-07-01

    Full Text Available Summary: Antimicrobial resistance in bacterial pathogens is a challenge that is associated with high morbidity and mortality. Multidrug resistance patterns in Gram-positive and -negative bacteria are difficult to treat and may even be untreatable with conventional antibiotics. There is currently a shortage of effective therapies, lack of successful prevention measures, and only a few new antibiotics, which require development of novel treatment options and alternative antimicrobial therapies. Biofilms are involved in multidrug resistance and can present challenges for infection control. Virulence, Staphylococcus aureus, Clostridium difficile infection, vancomycin-resistant enterococci, and control in the Emergency Department are also discussed. Keywords: Antibiotic resistance, Biofilms, Infections, Public health, Emergency Department

  2. Job demands and resources and their associations with early retirement intentions through recovery need and work enjoyment

    Directory of Open Access Journals (Sweden)

    Bert Schreurs

    2011-05-01

    Research purpose: The objective of this study was to examine the mechanisms through which job characteristics associate with early retirement intention, using the Job Demands-Resources (JD-R model as a theoretical framework. Motivation of the study: Early retirement presents a threat to existing health and pension systems, and to organisational functioning. Therefore, it is important to examine how workrelated factors contribute to early retirement decisions. Research design, approach and method: Two parallel processes were theorised to shape early retirement intention: a health impairment process (i.e. job demands → recovery need → early retirement intention and a motivational process (i.e. job resources → work enjoyment → early retirement intention. Survey data were collected from a heterogeneous sample of 1812 older workers (age > 45. Structural equation modeling was used to test the hypotheses. Main findings: Job demands and job resources were both associated with work enjoyment, which was associated with early retirement intention. Recovery need did not add to the prediction of early retirement intention. Practical/managerial implications: To retain older workers, companies should promote work conditions and practices that keep older workers motivated. Good health may be a necessary condition for retaining older workers, but it does not appear to be a sufficient one. Contribution/value-add: The results suggest that – for early retirement intention – the motivational process is more prominent than the health impairment process.

  3. Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.

    Science.gov (United States)

    Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto

    2013-05-01

    Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

  4. Low-rank coal study: national needs for resource development. Volume 3. Technology evaluation

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    Technologies applicable to the development and use of low-rank coals are analyzed in order to identify specific needs for research, development, and demonstration (RD and D). Major sections of the report address the following technologies: extraction; transportation; preparation, handling and storage; conventional combustion and environmental control technology; gasification; liquefaction; and pyrolysis. Each of these sections contains an introduction and summary of the key issues with regard to subbituminous coal and lignite; description of all relevant technology, both existing and under development; a description of related environmental control technology; an evaluation of the effects of low-rank coal properties on the technology; and summaries of current commercial status of the technology and/or current RD and D projects relevant to low-rank coals.

  5. Antibiotics produced by Streptomyces.

    Science.gov (United States)

    Procópio, Rudi Emerson de Lima; Silva, Ingrid Reis da; Martins, Mayra Kassawara; Azevedo, João Lúcio de; Araújo, Janete Magali de

    2012-01-01

    Streptomyces is a genus of Gram-positive bacteria that grows in various environments, and its shape resembles filamentous fungi. The morphological differentiation of Streptomyces involves the formation of a layer of hyphae that can differentiate into a chain of spores. The most interesting property of Streptomyces is the ability to produce bioactive secondary metabolites, such as antifungals, antivirals, antitumorals, anti-hypertensives, immunosuppressants, and especially antibiotics. The production of most antibiotics is species specific, and these secondary metabolites are important for Streptomyces species in order to compete with other microorganisms that come in contact, even within the same genre. Despite the success of the discovery of antibiotics, and advances in the techniques of their production, infectious diseases still remain the second leading cause of death worldwide, and bacterial infections cause approximately 17 million deaths annually, affecting mainly children and the elderly. Self-medication and overuse of antibiotics is another important factor that contributes to resistance, reducing the lifetime of the antibiotic, thus causing the constant need for research and development of new antibiotics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  6. Use of antibiotics in animal agriculture & emergence of methicillin-resistant Staphylococcus aureus (MRSA) clones: need to assess the impact on public health.

    Science.gov (United States)

    Mehndiratta, P L; Bhalla, P

    2014-09-01

    Widespread use of antibiotics in human, veterinary medicine and agricultural settings has played a significant role in the emergence of resistant MRSA clones due to selection pressure. MRSA has now become established in human population as well as in various animal species. An animal associated clone, MRSA ST 398 has been reported from animal foods and also from human infections in the community as well as from the health care associated infections. Clonal relationship between strains of animal and human origins are indicators of interspecies transmission of clones. Spread of these organisms may pose a great impact on public health if animal associated strains enter into the community and health care settings. Surveillance is important to correlate the genetic changes associated with their epidemiological shift and expansion to predict its impact on public health. Strict regulations on the use of antibiotics in humans as well as in animal food production are required to control the emergence of drug resistant clones. t0 his article reviews the information available on the role of antibiotics in emergence of MRSA strains, their epidemiological shift between humans and animals and its impact on the public health.

  7. Household level domestic fuel consumption and forest resource in relation to agroforestry adoption: Evidence against need-based approach

    Energy Technology Data Exchange (ETDEWEB)

    Sood, Kamal Kishor [Division of Agroforestry, Shere-Kashmir University of Agricultural Sciences and Technology of Jammu Main Campus-Chatha, Jammu (J and K) 180 009 (India); Mitchell, C. Paul [Institute of Energy Technologies, Fraser Noble Building, University of Aberdeen, Aberdeen AB24 3UE (United Kingdom)

    2011-01-15

    The need-based approach (assuming that higher consumption of tree products would motivate farmers to adopt agroforestry) has led to uneven success, in many cases failure, of many agroforestry projects. Current study investigated the association between fuelwood and forest resource use, and agroforestry adoption based on a survey of 401 households in the Indian Western Himalaya. Data on household domestic fuel utilisation and forest resource use were collected using a questionnaire in personal interviews. Agroforestry adoption increased significantly with increase in distance of nearest State forest from the house, distance travelled to collect fuelwood, and consumption of cattle dung, crop residues, charcoal, kerosene and liquid petroleum gas as domestic fuels by the household. Agroforestry adoption was also significantly higher in households with non-forest than those with State forests as primary source of fuelwood and timber. The proportion of adopters decreased significantly with increase in quantity of fuelwood used for domestic consumption, frequency of collection from State forests, total domestic energy consumption, fuelwood dependency, timber consumption and availability of timber through rights of households on State forests. Logistic regression analysis revealed that none of the factors related to need (quantity of fuelwood and timber used) appeared in the model but primary source of fuelwood, distance travelled to collect fuelwood and availability of timber through rights on the State forests appeared as important factors. This implies that need of the tree products is not a necessary condition to motivate farmers to adopt agroforestry, rather, it is accessibility of tree products which influence agroforestry adoption. (author)

  8. Meeting the oral health needs of 12-year-olds in China: human resources for oral health

    Directory of Open Access Journals (Sweden)

    Xiangyu Sun

    2017-06-01

    Full Text Available Abstract Background An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. Methods We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus, dentally-related behaviour (frequency of toothbrushing and sugar intake, and social factors (parental education. Children’s risk for dental caries was classified in four levels from low (level 1 to high (level 4. We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%. Results We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%. Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16–4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with

  9. Meeting the oral health needs of 12-year-olds in China: human resources for oral health.

    Science.gov (United States)

    Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Zheng, Shuguo; Gallagher, Jennifer E

    2017-06-20

    An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education). Children's risk for dental caries was classified in four levels from low (level 1) to high (level 4). We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%). We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%). Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16-4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with minimum intervention based on a HROH spending 90% of

  10. Ethics consultation in paediatric and adult emergency departments: an assessment of clinical, ethical, learning and resource needs.

    Science.gov (United States)

    Colaco, Keith A; Courtright, Alanna; Andreychuk, Sandra; Frolic, Andrea; Cheng, Ji; Kam, April Jacqueline

    2018-01-01

    We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments (EDs) in order to build ethics capacity and provide a foundation for the development of an ethics education programme. This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Of the 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress (16%), conflict management with patients or families (16%) and resource issues (15%). Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams (42%) was the most desired method. Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Semi-domesticated and Irreplaceable Genetic Resource Gayal ( Needs Effective Genetic Conservation in Bangladesh: A Review

    Directory of Open Access Journals (Sweden)

    Md. Rasel Uzzaman

    2014-09-01

    Full Text Available Several studies arduously reported that gayal (Bos frontalis is an independent bovine species. The population size is shrinking across its distribution. In Bangladesh, it is the only wild relative of domestic cattle and also a less cared animal. Their body size is much bigger than Bangladeshi native cattle and has prominent beef type characters along with the ability to adjust in any adverse environmental conditions. Human interactions and manipulation of biodiversity is affecting the habitats of gayals in recent decades. Besides, the only artificial reproduction center for gayals, Bangladesh Livestock Research Institute (BLRI, has few animals and could not carry out its long term conservation scheme due to a lack of an objective based scientific mission as well as financial support. This indicates that the current population is much more susceptible to stochastic events which might be natural catastrophes, environmental changes or mutations. Further reduction of the population size will sharply reduce genetic diversity. In our recent investigation with 80K indicine single nucleotide polymorphism chip, the FIS (within-population inbreeding value was reported as 0.061±0.229 and the observed (0.153±0.139 and expected (0.148±0.143 heterozygosities indicated a highly inbred and less diverse gayal population in Bangladesh. Prompt action is needed to tape the genetic information of this semi-domesticated bovine species with considerable sample size and try to investigate its potentials together with native zebu cattle for understanding the large phenotypic variations, improvement and conservation of this valuable creature.

  12. Antibiotics for sore throat.

    Science.gov (United States)

    Spinks, Anneliese; Glasziou, Paul P; Del Mar, Chris B

    2013-11-05

    Sore throat is a common reason for people to present for medical care. Although it remits spontaneously, primary care doctors commonly prescribe antibiotics for it. To assess the benefits of antibiotics for sore throat for patients in primary care settings. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to July week 1, 2013) and EMBASE (January 1990 to July 2013). Randomised controlled trials (RCTs) or quasi-RCTs of antibiotics versus control assessing typical sore throat symptoms or complications. Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. We contacted trial authors from three studies for additional information. We included 27 trials with 12,835 cases of sore throat. We did not identify any new trials in this 2013 update. 1. Symptoms Throat soreness and fever were reduced by about half by using antibiotics. The greatest difference was seen at day three. The number needed to treat to benefit (NNTB) to prevent one sore throat at day three was less than six; at week one it was 21. 2. Non-suppurative complications The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure. Several studies found antibiotics reduced acute rheumatic fever by more than two-thirds within one month (risk ratio (RR) 0.27; 95% confidence interval (CI) 0.12 to 0.60). 3. Suppurative complications Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0.30; 95% CI 0.15 to 0.58); acute sinusitis within 14 days (RR 0.48; 95% CI 0.08 to 2.76); and quinsy within two months (RR 0.15; 95% CI 0.05 to 0.47) compared to those taking placebo. 4. Subgroup analyses of symptom reduction Antibiotics were more effective against symptoms at day three (RR 0.58; 95% CI 0.48 to 0.71) if throat swabs were positive for Streptococcus, compared to RR 0.78; 95% CI 0.63 to 0.97 if negative. Similarly at week one the RR was 0.29 (95% CI 0.12 to 0

  13. Biotherapeutics as alternatives to antibiotics

    Science.gov (United States)

    Increasing pressure to limit antibiotic use in agriculture is heightening the need for alternative methods to reduce the adverse effects of clinical and subclinical disease on livestock performance that are currently managed by in-feed antibiotic usage. Immunomodulators have long been sought as such...

  14. The Role of Intrinsic Motivation and the Satisfaction of Basic Psychological Needs Under Conditions of Severe Resource Scarcity.

    Science.gov (United States)

    van Egmond, Marieke Christina; Navarrete Berges, Andrés; Omarshah, Tariq; Benton, Jennifer

    2017-06-01

    An emerging field of research is beginning to examine the ways in which socioeconomic disparities affect emotional, cognitive, and social processes. In this study, we took a two-step approach to examining the role that resource scarcity plays in the predictive power of intrinsic motivation on school attendance, as well as its influence on the precursors of intrinsic motivation: the psychological needs of relatedness, autonomy, and competence. Results revealed that intrinsic motivation predicts school attendance even under conditions of extreme adversity. The satisfaction of the basic needs is more important for participants who are exposed to severe rather than mild levels of deprivation. Our findings illustrate ecological effects on the mechanism underlying goal-directed behavior. They provide evidence in favor of self-determination theory's depiction of humans as active, growth-oriented organisms and for the potential of psychological interventions to reduce poverty.

  15. Exploring family home food environments: Household resources needed to utilise weekly deliveries of free fruits and vegetables.

    Science.gov (United States)

    Carty, Sophie A; Mainvil, Louise A; Coveney, John D

    2017-04-01

    An adapted ethnographic approach was used to explore household factors that influence family fruit and vegetable consumption when access and cost barriers are removed. 'Structural' barriers, such as food affordability and accessibility, are likely to influence fruit and vegetable consumption in disadvantaged households, but households may require additional resources (human and social) to increase consumption. Five low-income and five high-income households with children (N = 39 individuals) were observed in their home environment for three months. Including both advantaged and disadvantaged families allowed exploration of socioeconomic factors influencing these households. Each household received a free box of fresh fruit and vegetables each week for 10-12 weeks, delivered to their home, and were home-visited twice a week by a researcher (40+ hours per household). An inductive analysis of rich observational and discussion data revealed themes describing factors influencing household fruit and vegetable consumption. Household food cultures were dynamic and influenced by available resources. Even when free produce was delivered to homes, these households required human resource (personal drivers influenced by early life exposure and household dynamics) and external social networks to make use of them. When household finances and/or labour were limited, there was greater dependence on external organisations for tangible support. Even when structural barriers were removed, disadvantaged families needed a range of resources across the life course to improve eating behaviours, including sufficient, motivated and skilled labour and harmonious family relationships. Strategies targeting these households must consider structural, social, cultural and intra-familial influences on food choice. © 2016 Dietitians Association of Australia.

  16. Consumer attitudes and use of antibiotics.

    Science.gov (United States)

    Vanden Eng, Jodi; Marcus, Ruthanne; Hadler, James L; Imhoff, Beth; Vugia, Duc J; Cieslak, Paul R; Zell, Elizabeth; Deneen, Valerie; McCombs, Katherine Gibbs; Zansky, Shelley M; Hawkins, Marguerite A; Besser, Richard E

    2003-09-01

    Recent antibiotic use is a risk factor for infection or colonization with resistant bacterial pathogens. Demand for antibiotics can be affected by consumers' knowledge, attitudes, and practices. In 1998-1999, the Foodborne Diseases Active Surveillance Network (FoodNet( conducted a population-based, random-digit dialing telephone survey, including questions regarding respondents' knowledge, attitudes, and practices of antibiotic use. Twelve percent had recently taken antibiotics; 27% believed that taking antibiotics when they had a cold made them better more quickly, 32% believed that taking antibiotics when they had a cold prevented more serious illness, and 48% expected a prescription for antibiotics when they were ill enough from a cold to seek medical attention. These misguided beliefs and expectations were associated with a lack of awareness of the dangers of antibiotic use; 58% of patients were not aware of the possible health dangers. National educational efforts are needed to address these issues if patient demand for antibiotics is to be reduced.

  17. Towards the just and sustainable use of antibiotics.

    Science.gov (United States)

    Merrett, Gemma L Buckland; Bloom, Gerald; Wilkinson, Annie; MacGregor, Hayley

    2016-01-01

    The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. It highlights the main areas of intervention that could provide the key to addressing the sustainable long term use and availability of antibiotics. A focus on the synergies between interventions addressing access strategies, antibiotic quality, diagnostics for low-resource settings, measures to encourage just and sustainable decision making and help seeking optimal therapeutic and dosing strategies are key levers for the sustainable future of antibiotic use. Successful integration of such strategies will be dependent on effective governance mechanisms, effective partnerships and coalition building and accurate evaluation systems at national, regional and global levels.

  18. Antibiotic Resistance

    DEFF Research Database (Denmark)

    Munck, Christian

    morbidity and mortality as well as an increase in the cost of treatment. Understanding how bacteria respond to antibiotic exposure gives the foundations for a rational approach to counteract antimicrobial resistance. In the work presented in this thesis, I explore the two fundamental sources...... of antimicrobial resistance: (1) adaptive mutations and (2) horizontal acquisition of resistance genes from antibiotic gene reservoirs. By studying the geno- and phenotypic changes of E. coli in response to single and drug-pair exposures, I uncover the evolutionary trajectories leading to adaptive resistance. I...... to rationally design drug combinations that limit the evolution of antibiotic resistance due to counteracting evolutionary trajectories. My results highlight that an in-depth knowledge about the genetic responses to the individual antimicrobial compounds enables the prediction of responses to drug combinations...

  19. Antibiotic effectiveness: balancing conservation against innovation.

    Science.gov (United States)

    Laxminarayan, Ramanan

    2014-09-12

    Antibiotic effectiveness is a natural societal resource that is diminished by antibiotic use. As with other such assets, keeping it available requires both conservation and innovation. Conservation encompasses making the best use of current antibiotic effectiveness by reducing demand through vaccination, infection control, diagnostics, public education, incentives for clinicians to prescribe fewer antibiotics, and restrictions on access to newer, last-resort antibiotics. Innovation includes improving the efficacy of current drugs and replenishing effectiveness by developing new drugs. In this paper, I assess the relative benefits and costs of these two approaches to maintaining our ability to treat infections. Copyright © 2014, American Association for the Advancement of Science.

  20. Antibiotics: Use and misuse in pediatric dentistry

    OpenAIRE

    F C Peedikayil

    2011-01-01

    Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Most often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains. Dentists want to make their patients well and to prevent unpleasant complications. These desires, coupled with the belief that many oral problems are infectious, stimulate the prescribing of antibiotics. Good knowledge about the indications of antibiotics is the need of the hour in prescr...

  1. Probiotic approach to prevent antibiotic resistance.

    Science.gov (United States)

    Ouwehand, Arthur C; Forssten, Sofia; Hibberd, Ashley A; Lyra, Anna; Stahl, Buffy

    2016-01-01

    Probiotics are live microorganisms, mainly belonging to the genera Lactobacillus and Bifidobacterium, although also strain of other species are commercialized, that have a beneficial effect on the host. From the perspective of antibiotic use, probiotics have been observed to reduce the risk of certain infectious disease such as certain types of diarrhea and respiratory tract infection. This may be accompanied with a reduced need of antibiotics for secondary infections. Antibiotics tend to be effective against most common diseases, but increasingly resistance is being observed among pathogens. Probiotics are specifically selected to not contribute to the spread of antibiotic resistance and not carry transferable antibiotic resistance. Concomitant use of probiotics with antibiotics has been observed to reduce the incidence, duration and/or severity of antibiotic-associated diarrhea. This contributes to better adherence to the antibiotic prescription and thereby reduces the evolution of resistance. To what extent probiotics directly reduce the spread of antibiotic resistance is still much under investigation; but maintaining a balanced microbiota during antibiotic use may certainly provide opportunities for reducing the spread of resistances. Key messages Probiotics may reduce the risk for certain infectious diseases and thereby reduce the need for antibiotics. Probiotics may reduce the risk for antibiotic-associated diarrhea Probiotics do not contribute to the spread of antibiotic resistance and may even reduce it.

  2. Nanoinformatics workshop report: Current resources, community needs, and the proposal of a collaborative framework for data sharing and information integration.

    Science.gov (United States)

    Harper, Stacey L; Hutchison, James E; Baker, Nathan; Ostraat, Michele; Tinkle, Sally; Steevens, Jeffrey; Hoover, Mark D; Adamick, Jessica; Rajan, Krishna; Gaheen, Sharon; Cohen, Yoram; Nel, Andre; Cachau, Raul E; Tuominen, Mark

    2013-01-01

    The quantity of information on nanomaterial properties and behavior continues to grow rapidly. Without a concerted effort to collect, organize and mine disparate information coming out of current research efforts, the value and effective use of this information will be limited at best. Data will not be translated to knowledge. At worst, erroneous conclusions will be drawn and future research may be misdirected. Nanoinformatics can be a powerful approach to enhance the value of global information in nanoscience and nanotechnology. Much progress has been made through grassroots efforts in nanoinformatics resulting in a multitude of resources and tools for nanoscience researchers. In 2012, the nanoinformatics community believed it was important to critically evaluate and refine currently available nanoinformatics approaches in order to best inform the science and support the future of predictive nanotechnology. The Greener Nano 2012: Nanoinformatics Tools and Resources Workshop brought together informatics groups with materials scientists active in nanoscience research to evaluate and reflect on the tools and resources that have recently emerged in support of predictive nanotechnology. The workshop goals were to establish a better understanding of current nanoinformatics approaches and to clearly define immediate and projected informatics infrastructure needs of the nanotechnology community. The theme of nanotechnology environmental health and safety (nanoEHS) was used to provide real-world, concrete examples on how informatics can be utilized to advance our knowledge and guide nanoscience. The benefit here is that the same properties that impact the performance of products could also be the properties that inform EHS. From a decision management standpoint, the dual use of such data should be considered a priority. Key outcomes include a proposed collaborative framework for data collection, data sharing and information integration.

  3. Nanoinformatics workshop report: current resources, community needs and the proposal of a collaborative framework for data sharing and information integration

    International Nuclear Information System (INIS)

    Harper, Stacey L; Hutchison, James E; Baker, Nathan; Ostraat, Michele; Tinkle, Sally; Steevens, Jeffrey; Hoover, Mark D; Adamick, Jessica; Rajan, Krishna; Gaheen, Sharon; Cohen, Yoram; Nel, Andre; Cachau, Raul E; Tuominen, Mark

    2013-01-01

    The quantity of information on nanomaterial properties and behavior continues to grow rapidly. Without a concerted effort to collect, organize and mine disparate information coming out of current research efforts, the value and effective use of this information will be limited at best. Data will not be translated to knowledge. At worst, erroneous conclusions will be drawn and future research may be misdirected. Nanoinformatics can be a powerful approach to enhance the value of global information in nanoscience and nanotechnology. Much progress has been made through grassroots efforts in nanoinformatics resulting in a multitude of resources and tools for nanoscience researchers. In 2012, the nanoinformatics community believed it was important to critically evaluate and refine currently available nanoinformatics approaches in order to best inform the science and support the future of predictive nanotechnology. The Greener Nano 2012: Nanoinformatics Tools and Resources Workshop brought together informatics groups with materials scientists active in nanoscience research to evaluate and reflect on the tools and resources that have recently emerged in support of predictive nanotechnology. The workshop goals were to establish a better understanding of current nanoinformatics approaches and to clearly define immediate and projected informatics infrastructure needs of the nanotechnology community. The theme of nanotechnology environmental health and safety (nanoEHS) was used to provide real-world, concrete examples on how informatics can be utilized to advance our knowledge and guide nanoscience. The benefit here is that the same properties that impact the performance of products could also be the properties that inform EHS. From a decision management standpoint, the dual use of such data should be considered a priority. Key outcomes include a proposed collaborative framework for data collection, data sharing and information integration. (paper)

  4. Antibiotics for acute bronchitis.

    Science.gov (United States)

    Smith, Susan M; Fahey, Tom; Smucny, John; Becker, Lorne A

    2017-06-19

    The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. To assess the effects of antibiotics in improving outcomes and to assess adverse effects of antibiotic therapy for people with a clinical diagnosis of acute bronchitis. We searched CENTRAL 2016, Issue 11 (accessed 13 January 2017), MEDLINE (1966 to January week 1, 2017), Embase (1974 to 13 January 2017), and LILACS (1982 to 13 January 2017). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 5 April 2017. Randomised controlled trials comparing any antibiotic therapy with placebo or no treatment in acute bronchitis or acute productive cough, in people without underlying pulmonary disease. At least two review authors extracted data and assessed trial quality. We did not identify any new trials for inclusion in this 2017 update. We included 17 trials with 5099 participants in the primary analysis. The quality of trials was generally good. At follow-up there was no difference in participants described as being clinically improved between the antibiotic and placebo groups (11 studies with 3841 participants, risk ratio (RR) 1.07, 95% confidence interval (CI) 0.99 to 1.15). Participants given antibiotics were less likely to have a cough (4 studies with 275 participants, RR 0.64, 95% CI 0.49 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) 6) and a night cough (4 studies with 538 participants, RR 0.67, 95% CI 0.54 to 0.83; NNTB 7). Participants given antibiotics had a shorter mean cough duration (7 studies with 2776 participants, mean difference (MD) -0.46 days, 95% CI -0.87 to -0.04). The differences in presence of a productive cough at follow-up and MD of productive cough did not reach statistical significance.Antibiotic-treated participants were more likely to be improved according to clinician's global assessment (6 studies

  5. [News of the inquiry about nursing needs and resources in the Brazilian Journal of Nursing (1955-1958)].

    Science.gov (United States)

    Malta, Daniela Vieira; Pereira, Laís de Araújo; Santos, Tânia Cristina Franco

    2014-01-01

    Social historical study that has as object news related to the Assessment of the Resources and Needs of Nursing in Brazil published in the Revista Brasileira de Enfermagem between 1955 and 1958. The primary source is constituted of copies of Revista Brasileira de Enfermagem published within the selected period of the study. The secondary sources are constituted of books, papers, dissertations and thesis related to the Nursing history. The data analysis was supported by the secondary sources and the thought of the sociologist Pierre Bourdieu. The results evidenced that Revista Brasileira de Enfermagem, in addition to making possible the dissemination of news about the Assessment provided visibility to it and, at last, had the symbolic effect of giving power and prestige to the Brazilian Nursing.

  6. High prevalence of antibiotic-resistant Mycoplasma genitalium in nongonococcal urethritis: the need for routine testing and the inadequacy of current treatment options.

    Science.gov (United States)

    Pond, Marcus J; Nori, Achyuta V; Witney, Adam A; Lopeman, Rose C; Butcher, Philip D; Sadiq, Syed Tariq

    2014-03-01

     Empirical antibiotic therapy for nongonococcal urethritis (NGU) and cervicitis is aimed at Chlamydia trachomatis, but Mycoplasma genitalium, which also commonly causes undiagnosed NGU, necessitates treatment with macrolides or fluoroquinolones rather than doxycycline, the preferred chlamydia treatment. Prevalence of M. genitalium and associated genotypic markers of macrolide and fluoroquinolone resistance among men symptomatic of urethritis were investigated. Genetic diversity of M. genitalium populations was determined to infer whether findings were applicable beyond our setting.  Mycoplasma genitalium and other NGU pathogens were detected using nucleic acid amplification methods, and DNA sequencing was used to detect genotypic resistance markers of macrolide and fluoroquinolone antibiotics in 23S ribosomal RNA, gyrA, gyrB, and parC genes. MG191 single-nucleotide polymorphism typing and MG309 variable number tandem analysis were combined to assign a dual locus sequence type (DLST) to each positive sample.  Among 217 men, M. genitalium prevalence was 16.7% (95% confidence interval [CI], 9.5%-24.0%) and C. trachomatis prevalence was 14.7% (95% CI, 7.8%-21.6%) in NGU cases. Nine of 22 (41%; 95% CI, 20%-62%) patients with M. genitalium were infected with DLSTs possessing genotypic macrolide resistance and 1 patient was infected with a DLST having genotypic fluoroquinolone resistance. Typing assigned M. genitalium DLSTs to 2 major clusters, broadly distributed among previously typed international strains. Genotypic macrolide resistance was spread within these 2 clusters.  Mycoplasma genitalium is a frequent undiagnosed cause of NGU in this population with rates of macrolide resistance higher than those previously documented. Current guidelines for routine testing and empirical treatment of NGU should be modified to reduce treatment failure of NGU and the development of further resistance.

  7. Impact of perception and attitude towards the study of African languages on Human Resource needs: A case for Zimbabwe

    Directory of Open Access Journals (Sweden)

    Gora, Ruth Babra

    2015-12-01

    Full Text Available This article argues that the Zimbabwean high school curriculum has remained largely irrelevant to human resource needs for professions that draw expertise from African languages, such as teaching, translating, broadcasting and interpreting. Despite some curriculum reforms after the attainment of political independence, effects of colonial language policy and language planning with regard to the Zimbabwean education system seem to have remained intact. As a result, observations have been made that the system continues to churn out Africans who are still deeply rooted in the belief that the study of foreign languages, English in particular, prepares them for a better and brighter future than African languages would. The belief is largely that a pass in English guarantees them better, higher-paying, more prestigious and more readily available jobs than would African languages. The education system in Zimbabwe today, this paper argues, has negative perceptions and attitudes towards the study of African languages. African languages-related professions are therefore filled by people with little or no sound background knowledge in the area. In addition, those who end up being absorbed in professions that draw from the African languages area, in most cases, are not satisfied. The same can be said of most other African countries that were subjected to colonialism in the past and neo-colonialism today, under the vague and obscure concepts of globalisation and modernisation. Against this backdrop, the article advocates for the re-engineering of the Zimbabwean school core-curriculum by incorporating mandatory study of an indigenous language, at least up to ‘O’ level, in a bid to preserve and promote African languages and at the same time meet human resource needs of professions that draw from the discipline over time.

  8. Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment.

    Science.gov (United States)

    Adaku, Alex; Okello, James; Lowry, Blakeley; Kane, Jeremy C; Alderman, Stephen; Musisi, Seggane; Tol, Wietse A

    2016-01-01

    Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions. We conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45). Data from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included "overthinking", ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were

  9. Adapting a geographical information system-based water resource management to the needs of the Romanian water authorities.

    Science.gov (United States)

    Soutter, Marc; Alexandrescu, Maria; Schenk, Colin; Drobot, Radu

    2009-08-01

    The need for global and integrated approaches to water resources management, both from the quantitative and the qualitative point of view, has long been recognized. Water quality management is a major issue for sustainable development and a mandatory task with respect to the implementation of the European Water Framework Directive as well as the Swiss legislation. However, data modelling to develop relational databases and subsequent geographic information system (GIS)-based water management instruments are a rather recent and not that widespread trend. The publication of overall guidelines for data modelling along with the EU Water Framework Directive is an important milestone in this area. Improving overall water quality requires better and more easily accessible data, but also the possibility to link data to simulation models. Models are to be used to derive indicators that will in turn support decision-making processes. For this whole chain to become effective at a river basin scale, all its components have to become part of the current daily practice of the local water administration. Any system, tool, or instrument that is not designed to meet, first of all, the fundamental needs of its primary end-users has almost no chance to be successful in the longer term. Although based on a pre-existing water resources management system developed in Switzerland, the methodological approach applied to develop a GIS-based water quality management system adapted to the Romanian context followed a set of well-defined steps: the first and very important step is the assessment of needs (on the basis of a careful analysis of the various activities and missions of the water administration and other relevant stakeholders in water management related issues). On that basis, a conceptual data model (CDM) can be developed, to be later on turned into a physical database. Finally, the specifically requested additional functionalities (i.e. functionalities not provided by classical

  10. Combating Antibiotic Resistance

    Science.gov (United States)

    ... Bacteria Phasing Out Certain Antibiotic Use in Farm Animals FDA: Cutting-Edge Technology Sheds Light on Antibiotic Resistance For More Information Antibiotics and Antibiotic Resistance Antimicrobial Resistance Information for Consumers and Health Professionals CDC: ...

  11. Natural resource mitigation, adaptation and research needs related to climate change in the Great Basin and Mojave Desert

    Science.gov (United States)

    Hughson, Debra L.; Busch, David E.; Davis, Scott; Finn, Sean P.; Caicco, Steve; Verburg, Paul S.J.

    2011-01-01

    This report synthesizes the knowledge, opinions, and concerns of many Federal and State land managers, scientists, stakeholders, and partners from a workshop, held at the University of Nevada, Las Vegas, on April 20-22, 2010. Land managers, research scientists, and resource specialists identified common concerns regarding the potential effects of climate change on public lands and natural resources in the Great Basin and Mojave Desert and developed recommendations for mitigation, adaptation, and research needs. Water and, conversely, the effects of drought emerged as a common theme in all breakout sessions on terrestrial and aquatic species at risk, managing across boundaries, monitoring, and ecosystem services. Climate change models for the southwestern deserts predict general warming and drying with increasing precipitation variability year to year. Scientists noted that under these changing conditions the past may no longer be a guide to the future in which managers envision increasing conflicts between human water uses and sustaining ecosystems. Increasing environmental stress also is expected as a consequence of shifting ecosystem boundaries and species distributions, expansion of non-native species, and decoupling of biotic mutualisms, leading to increasingly unstable biologic communities. Managers uniformly expressed a desire to work across management and agency boundaries at a landscape scale but conceded that conflicting agency missions and budgetary constraints often impede collaboration. More and better science is needed to cope with the effects of climate change but, perhaps even more important is the application of science to management issues using the methods of adaptive management based on long-term monitoring to assess the merits of management actions. Access to data is essential for science-based land management. Basic inventories, spatial databases, baseline condition assessments, data quality assurance, and data sharing were identified as top

  12. Dissemination of health information through social networks: twitter and antibiotics.

    Science.gov (United States)

    Scanfeld, Daniel; Scanfeld, Vanessa; Larson, Elaine L

    2010-04-01

    This study reviewed Twitter status updates mentioning "antibiotic(s)" to determine overarching categories and explore evidence of misunderstanding or misuse of antibiotics. One thousand Twitter status updates mentioning antibiotic(s) were randomly selected for content analysis and categorization. To explore cases of potential misunderstanding or misuse, these status updates were mined for co-occurrence of the following terms: "cold + antibiotic(s)," "extra + antibiotic(s)," "flu + antibiotic(s)," "leftover + antibiotic(s)," and "share + antibiotic(s)" and reviewed to confirm evidence of misuse or misunderstanding. Of the 1000 status updates, 971 were categorized into 11 groups: general use (n = 289), advice/information (n = 157), side effects/negative reactions (n = 113), diagnosis (n = 102), resistance (n = 92), misunderstanding and/or misuse (n = 55), positive reactions (n = 48), animals (n = 46), other (n = 42), wanting/needing (n = 19), and cost (n = 8). Cases of misunderstanding or abuse were identified for the following combinations: "flu + antibiotic(s)" (n = 345), "cold + antibiotic(s)" (n = 302), "leftover + antibiotic(s)" (n = 23), "share + antibiotic(s)" (n = 10), and "extra + antibiotic(s)" (n = 7). Social media sites offer means of health information sharing. Further study is warranted to explore how such networks may provide a venue to identify misuse or misunderstanding of antibiotics, promote positive behavior change, disseminate valid information, and explore how such tools can be used to gather real-time health data. 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  13. Dimensions of Poverty and Health Outcomes Among People Living with HIV Infection: Limited Resources and Competing Needs.

    Science.gov (United States)

    Kalichman, Seth C; Hernandez, Dominica; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O; Grebler, Tamar

    2015-08-01

    HIV infection is concentrated in populations living in poverty. We examined the overlapping and independent effects of multiple poverty indicators on HIV-related health status. Because substance use can create competing survival needs when resources are limited, we also sought to objectively measure expenditures on food relative to alcohol and tobacco products. To achieve these aims, 459 men and 212 women living with HIV infection in Atlanta, GA completed measures of socio-demographic and heath characteristics as well as multiple indicators of poverty including housing stability, transportation, food insecurity, and substance use. Participants were given a $30 grocery gift card for their participation and we collected receipts which were coded for alcohol (beer, wine, liquors) and tobacco purchases. Results showed that participants with unsuppressed HIV replication were significantly more likely to experience multiple indicators of poverty. In addition, one in four participants purchased alcohol or tobacco products with their gift cards, with as much as one-fourth of money spent on these products. A multivariable logistic regression model showed that food insecurity was independently associated with unsuppressed HIV, and purchasing alcohol or tobacco products did not moderate this association. Results confirm previous research to show the primacy of food insecurity in relation to HIV-related health outcomes. Competing survival needs, including addictive substances, should be addressed in programs that aim to alleviate poverty to enhance the health and well-being of people with HIV infection.

  14. Prescribing Antibiotics

    DEFF Research Database (Denmark)

    Pedersen, Inge Kryger; Jepsen, Kim Sune

    2018-01-01

    The medical professions will lose an indispensable tool in clinical practice if even simple infections cannot be cured because antibiotics have lost effectiveness. This article presents results from an exploratory enquiry into “good doctoring” in the case of antibiotic prescribing at a time when...... the knowledge base in the healthcare field is shifting. Drawing on in-depth interviews about diagnosing and prescribing, the article demonstrates how the problem of antimicrobial resistance is understood and engaged with by Danish general practitioners. When general practitioners speak of managing “non......-medical issues,” they refer to routines, clinical expertise, experiences with their patients, and decision-making based more on contextual circumstances than molecular conditions—and on the fact that such conditions can be hard to assess. This article’s contribution to knowledge about how new and global health...

  15. Influence of Clinical Communication on Parents' Antibiotic Expectations for Children With Respiratory Tract Infections.

    Science.gov (United States)

    Cabral, Christie; Ingram, Jenny; Lucas, Patricia J; Redmond, Niamh M; Kai, Joe; Hay, Alastair D; Horwood, Jeremy

    2016-03-01

    The purpose of this study was to understand clinicians' and parents' perceptions of communication within consultations for respiratory tract infections (RTI) in children and what influence clinician communication had on parents' understanding of antibiotic treatment. We video recorded 60 primary care consultations for children aged 3 months to 12 years who presented with RTI and cough in 6 primary care practices in England. We then used purposive sampling to select 27 parents and 13 clinicians for semistructured video-elicitation interviews. The videos were used as prompts to investigate participants' understanding and views of communication within the consultations. We analyzed the interview data thematically. While clinicians commonly told parents that antibiotics are not effective against viruses, this did not have much impact on parents' beliefs about the need to consult or on their expectations concerning antibiotics. Parents believed that antibiotics were needed to treat more severe illnesses, a belief that was supported by the way clinicians accompanied viral diagnoses with problem-minimizing language and antibiotic prescriptions with more problem-oriented language. Antibiotic prescriptions tended to confirm parents' beliefs about what indicated illness severity, which often took into account the wider impact on a child's life. While parents understood antimicrobial resistance poorly, most held beliefs that supported reduced antibiotic prescribing. A minority attributed it to resource rationing, however. Clinician communication and prescribing behavior confirm parents' beliefs that antibiotics are needed to treat more severe illnesses. Interventions to reduce antibiotic expectations need to address communication within the consultation, prescribing behavior, and lay beliefs. © 2016 Annals of Family Medicine, Inc.

  16. How well has biophysical research served the needs of water resource management? Lessons from the Sabie-Sand catchment

    CSIR Research Space (South Africa)

    Van Wyk, E

    2001-09-01

    Full Text Available frameworks proposed for integrated water resource management. The fundamental changes in the approach to water resource management warrant a critical evaluation of the information generated by past research and of the relevance of this activity and associated...

  17. A national quality incentive scheme to reduce antibiotic overuse in hospitals: evaluation of perceptions and impact.

    Science.gov (United States)

    Islam, J; Ashiru-Oredope, D; Budd, E; Howard, P; Walker, A S; Hopkins, S; Llewelyn, M J

    2018-02-28

    In 2016/2017, a financially linked antibiotic prescribing quality improvement initiative Commissioning for Quality and Innovation (AMR-CQUIN) was introduced across acute hospitals in England. This aimed for >1% reductions in DDDs/1000 admissions of total antibiotics, piperacillin/tazobactam and carbapenems compared with 2013/2014 and improved review of empirical antibiotic prescriptions. To assess perceptions of staff leading antimicrobial stewardship activity regarding the AMR-CQUIN, the investments made by hospitals to achieve it and how these related to achieving reductions in antibiotic use. We invited antimicrobial stewardship leads at acute hospitals across England to complete a web-based survey. Antibiotic prescribing data were downloaded from the PHE Antimicrobial Resistance Local Indicators resource. Responses were received from 116/155 (75%) acute hospitals. Owing to yearly increases in antibiotic use, most trusts needed to make >5% reductions in antibiotic consumption to achieve the AMR-CQUIN goal of 1% reduction. Additional funding was made available at 23/113 (20%) trusts and, in 18 (78%), this was trend for increased antibiotic use reversed in 2016/2017. In 2014/2015, year-on-year changes were +3.7% (IQR -0.8%, +8.4%), +9.4% (+0.2%, +19.5%) and +5.8% (-6.2%, +18.2%) for total antibiotics, piperacillin/tazobactam and carbapenems, respectively, and +0.1% (-5.4%, +4.0%), -4.8% (-16.9%, +3.2%) and -8.0% (-20.2%, +4.0%) in 2016/2017. Hospitals where staff believed they could reduce antibiotic use were more likely to do so (P < 0.001). Introducing the AMR-CQUIN was associated with a reduction in antibiotic use. For individual hospitals, achieving the AMR-CQUIN was associated with favourable perceptions of staff and not availability of funding.

  18. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    Science.gov (United States)

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

    2016-01-01

    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  19. Stakeholder-led science: engaging resource managers to identify science needs for long-term management of floodplain conservation lands

    Science.gov (United States)

    Bouska, Kristin L.; Lindner, Garth; Paukert, Craig P.; Jacobson, Robert B.

    2016-01-01

    Floodplains pose challenges to managers of conservation lands because of constantly changing interactions with their rivers. Although scientific knowledge and understanding of the dynamics and drivers of river-floodplain systems can provide guidance to floodplain managers, the scientific process often occurs in isolation from management. Further, communication barriers between scientists and managers can be obstacles to appropriate application of scientific knowledge. With the coproduction of science in mind, our objectives were the following: (1) to document management priorities of floodplain conservation lands, and (2) identify science needs required to better manage the identified management priorities under nonstationary conditions, i.e., climate change, through stakeholder queries and interactions. We conducted an online survey with 80 resource managers of floodplain conservation lands along the Upper and Middle Mississippi River and Lower Missouri River, USA, to evaluate management priority, management intensity, and available scientific information for management objectives and conservation targets. Management objectives with the least information available relative to priority included controlling invasive species, maintaining respectful relationships with neighbors, and managing native, nongame species. Conservation targets with the least information available to manage relative to management priority included pollinators, marsh birds, reptiles, and shore birds. A follow-up workshop and survey focused on clarifying science needs to achieve management objectives under nonstationary conditions. Managers agreed that metrics of inundation, including depth and extent of inundation, and frequency, duration, and timing of inundation would be the most useful metrics for management of floodplain conservation lands with multiple objectives. This assessment provides guidance for developing relevant and accessible science products to inform management of highly

  20. Green Is the New Black: The Need for a New Currency That Values Water Resources in Rapidly Developing Landscapes

    Science.gov (United States)

    Creed, I. F.; Webster, K. L.; Kreutzweiser, D. P.; Beall, F.

    2014-12-01

    Canada's boreal forest supports many aquatic ecosystem services (AES) due to the intimate linkage between aquatic systems and their surrounding terrestrial watersheds in forested landscapes. There is an increasing risk to AES because natural development activities (forest management, mining, energy) have resulted in disruptions that deteriorate aquatic ecosystems at local (10s of km2) to regional (100s of km2) scales. These activities are intensifying and expanding, placing at risk the healthy aquatic ecosystems that provide AES and may threaten the continued development of the energy, forest, and mining sectors. Remarkably, we know little about the consequences of these activities on AES. The idea that AES should be explicitly integrated into modern natural resource management regulations is gaining broad acceptance. A major need is the ability to measure cumulative effects and determine thresholds (the points where aquatic ecosystems and their services cannot recover to a desired state within a reasonable time frame) in these cumulative effects. However, there is no single conceptual approach to assessing cumulative effects that is widely accepted by both scientists and managers. We present an integrated science-policy framework that enables the integration of AES into forest management risk assessment and prevention/mitigation strategies. We use this framework to explore the risk of further deterioration of AES by (1) setting risk criteria; (2) using emerging technologies to map process-based indicators representing causes and consequences of risk events to the deterioration of AES; (3) assessing existing prevention and mitigation policies in place to avoid risk events; and (4) identifying priorities for policy change needed to reduce risk event. Ultimately, the success of this framework requires that higher value be placed on AES, and in turn to improve the science and management of the boreal forest.

  1. Systemic antibiotic therapy in periodontics

    Directory of Open Access Journals (Sweden)

    Anoop Kapoor

    2012-01-01

    Full Text Available Systemic antibiotics in conjunction with scaling and root planing (SRP, can offer an additional benefit over SRP alone in the treatment of periodontitis, in terms of clinical attachment loss (CAL and pocket depth change, and reduced risk of additional CAL loss. However, antibiotics are not innocuous drugs. Their use should be justified on the basis of a clearly established need and should not be substituted for adequate local treatment. The aim of this review is to discuss the rationale, proper selection, dosage and duration for antibiotic therapy so as to optimize the usefulness of drug therapy.

  2. The actual status of uranium ore resources at Eko Remaja Sector: the need of verification of resources computation and geometrical form of mineralization zone by mining test

    International Nuclear Information System (INIS)

    Johan Baratha; Muljono, D.S.; Agus Sumaryanto; Handoko Supalal

    1996-01-01

    Uranium ore resources calculation was done after ending all of geological work step. Estimation process of ore resources was started from evaluation drilling, continued with borehole logging. From logging, the result has presented in anomaly graphs, then was processed to determine thickness and grade value of ore. Those mineralization points were correlated one another to form mineralization zones which have direction of N 270 degree to N 285 degree with 70 degree dip to North. From Grouping the mineralization distribution, 19 mineralization planes was constructed which contain 553 ton of U 3 O 8 measured. It is suggested that before expanding measured ore deposit area, mining test should be done first at certain mineralization planes to prove the method applied to calculate the reserve. Results form mining test could be very useful to reevaluate all the work-step done. (author); 4 refs; 2 tabs; 8 figs

  3. Antibiotic Resistance

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Hoffmann, Tammy C; McCullough, Amanda R

    2015-01-01

    hygiene, and possibly vaccination and exercise, may be effective. Also, a large range of complementary and alternative medicines (e.g. zinc, vitamin C and probiotics) are proposed for preventing and treating ARIs, but evidence for efficacy is scarce. General practitioners' (GPs) attitudes towards...... wrong. Shared decision making might be a solution, as it enables clinician and patient to participate jointly in making a health decision, having discussed the options together with the evidence for their harms as well as benefits. Furthermore, GPs' diagnostic uncertainty - often leading...... will greatly improve the use of antibiotics for ARIs. However, used in concert, combinations are likely to enable clinicians and health care systems to implement the strategies that will reduce antimicrobial resistance in the future....

  4. Review of the human resources needed for development of the activity in a service hospital radio physics

    International Nuclear Information System (INIS)

    Almansa, J. F.; Burgos, D. E.; Guerrero, R.

    2011-01-01

    The age of the recommendations on minimum human and material resources of the SEFM, along with the emergence of new imaging techniques and new equipment, plus analysis of recent international publications relating to the subject and the establishment of relative value units in several Spanish regions, justify a revision of the minimum necessary human resources to carry out the tasks of Radio physics service with adequate safety and quality.

  5. Managing physical therapy resources: an analogy to the freedom of the commons and the need for collective action.

    Science.gov (United States)

    Brennan, Gerard P

    2012-06-01

    Tragedy results when we each pursue our own best interest in a society that believes in the freedom of a commons, such as clean air, fresh water, or natural fishing grounds. The purpose of this editorial is to consider how resources related to healthcare, and specifically to the delivery of physical therapy, can suffer the tragedy of the commons, and to consider an alternative strategy by which we can manage physical therapy resources effectively through collective action.

  6. Antibiotic prescribing in dental practice in Belgium.

    Science.gov (United States)

    Mainjot, A; D'Hoore, W; Vanheusden, A; Van Nieuwenhuysen, J-P

    2009-12-01

    To assess the types and frequency of antibiotic prescriptions by Belgian dentists, the indications for antibiotic prescription, and dentists' knowledge about recommended practice in antibiotic use. In this cross-sectional survey, dental practitioners were asked to record information about all antibiotics prescribed to their patients during a 2-week period. The dental practitioners were also asked to complete a self-administered questionnaire regarding demographic data, prescribing practices, and knowledge about antibiotic use. A random sample of 268 Belgian dentists participated in the survey. During the 2-week period, 24 421 patient encounters were recorded; 1033 patients were prescribed an antibiotic (4.2%). The median number of prescriptions per dentist for the 2 weeks was 3. Broad spectrum antibiotics were most commonly prescribed: 82% of all prescriptions were for amoxycillin, amoxycillin-clavulanic acid and clindamycin. Antibiotics were often prescribed in the absence of fever (92.2%) and without any local treatment (54.2%). The most frequent diagnosis for which antibiotics were prescribed was periapical abscess (51.9%). Antibiotics were prescribed to 63.3% of patients with periapical abscess and 4.3% of patients with pulpitis. Patterns of prescriptions were confirmed by the data from the self-reported practice. Discrepancies between observed and recommended practice support the need for educational initiatives to promote rational use of antibiotics in dentistry in Belgium.

  7. Reusing Treated Wastewater: Consideration of the Safety Aspects Associated with Antibiotic-Resistant Bacteria and Antibiotic Resistance Genes

    Directory of Open Access Journals (Sweden)

    Pei-Ying Hong

    2018-02-01

    Full Text Available As more countries engage in water reuse, either intended or de facto, there is an urgent need to more comprehensively evaluate resulting environmental and public health concerns. While antibiotic-resistant bacteria (ARB and antibiotic resistance genes (ARGs are increasingly coming under the spotlight, as emerging contaminants, existing water reuse regulations and guidelines do not adequately address these concerns. This perspectives paper seeks to frame the various challenges that need to be resolved to identify meaningful and realistic target types and levels of antibiotic resistance benchmarks for water reuse. First, there is the need for standardized and agreed-upon methodologies to identify and quantify ARB and ARGs. Second, even if methodologies are available, identifying which ARB and ARGs to monitor that would best relate to the occurrence of disease burden remains unknown. Third, a framework tailored to assessing the risks associated with ARB and ARGs during reuse is urgently needed. Fourth, similar to protecting drinking water sources, strategies to prevent dissemination of ARB and ARGs via wastewater treatment and reuse are required to ensure that appropriate barriers are emplaced. Finally, current wastewater treatment technologies could benefit from modification or retrofit to more effectively remove ARB and ARGs while also producing a high quality product for water and resource recovery. This perspectives paper highlights the need to consider ARB and ARGs when evaluating the overall safety aspects of water reuse and ways by which this may be accomplished.

  8. Reusing Treated Wastewater: Consideration of the Safety Aspects Associated with Antibiotic-Resistant Bacteria and Antibiotic Resistance Genes

    KAUST Repository

    Hong, Pei-Ying

    2018-02-27

    As more countries engage in water reuse, either intended or de facto, there is an urgent need to more comprehensively evaluate resulting environmental and public health concerns. While antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are increasingly coming under the spotlight, as emerging contaminants, existing water reuse regulations and guidelines do not adequately address these concerns. This perspectives paper seeks to frame the various challenges that need to be resolved to identify meaningful and realistic target types and levels of antibiotic resistance benchmarks for water reuse. First, there is the need for standardized and agreed-upon methodologies to identify and quantify ARB and ARGs. Second, even if methodologies are available, identifying which ARB and ARGs to monitor that would best relate to the occurrence of disease burden remains unknown. Third, a framework tailored to assessing the risks associated with ARB and ARGs during reuse is urgently needed. Fourth, similar to protecting drinking water sources, strategies to prevent dissemination of ARB and ARGs via wastewater treatment and reuse are required to ensure that appropriate barriers are emplaced. Finally, current wastewater treatment technologies could benefit from modification or retrofit to more effectively remove ARB and ARGs while also producing a high quality product for water and resource recovery. This perspectives paper highlights the need to consider ARB and ARGs when evaluating the overall safety aspects of water reuse and ways by which this may be accomplished.

  9. Philippines -- country wide water development projects and funds needed. Water crisis in Manila coincide with parliamentarians seminar on water resources and population.

    Science.gov (United States)

    1997-01-01

    The Philippines' Clean Water Act was developed to protect the country's remaining water resources by institutionalizing mechanisms to monitor, regulate, and control human and industrial activities which contribute to the ongoing environmental degradation of marine and freshwater resources. Approximately 70 participants attended the Philippine Parliamentarians' Conference on Water Resources, Population and Development held December 3-4, 1997, at the Sulo Hotel in Quezon City. Participants included the legislative staff of the members of the House of Representatives and the Senate, Committee Secretaries of the House and Senate, and government and nongovernmental organization officials. Following the opening programs, panel discussions were held on the role of nongovernmental organizations as legitimate monitors of governments' activities; the need to evaluate water sector assessment methods, water policy and strategy, and water legislation standards; and waste water treatment and sewerage systems used in households and industries. The following issues were raised during the conference's open forum: the need to implement new methods in water resource management; the handling of water for both economic and social purposes; the need to implement guidelines, policies, and pricing mechanisms on bottled water; regulating the construction of recreational facilities such as golf courses; and transferring watershed rehabilitation from the Department of Environment and Natural Resources to local water districts. A declaration was prepared and signed by the participants at the close of the conference.

  10. Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

    Directory of Open Access Journals (Sweden)

    Jane W. Muchiri

    2012-10-01

    Full Text Available Diabetes self-management education is crucial in diabetes care. Education that is tailored to the needs of the patient is considered the most effective in improving health outcomes. Diet, a critical element of diabetes treatment, is reported as the most difficult to adhere to by both patients and health professionals. Tailored nutrition education (NE could benefit diabetic individuals with low socio-economic status, who are amongst those noted to have poor health outcomes. This qualitative interpretive phenomenological study aimed to explore and describe the NE needs of adults with type 2 diabetes mellitus to guide development of a tailored NE programme for resource-poor settings. Participants were 31 non-insulin-dependent type 2 diabetic patients (convenience sample and 10 health professionals. Focus group discussions using semi-structured questions were held with the diabetics, and open-ended self-administered questionnaires were used with the health professionals. Data analysis was done using Krueger’s framework approach. Disease-related knowledge deficits and inappropriate self-reported dietary practices, including intake of unbalanced meals, problems with food portion control and unsatisfactory intake of fruits and vegetables, were observed. Recommendations for the NE programme included topics related to the disease and others related to diet. Group education at the clinic, a competent educator and comprehensive education were indicated by the patients. Participation of family and provision of pamphlets were aspects recommended by patients and health professionals. Barriers that could impact the NE included financial constraints, food insecurity, conflict in family meal arrangements and access to appropriate foods. Support from family and health professionals and empowerment through education were identified as facilitators to following dietary recommendations by both groups of participants. Knowledge deficits, inappropriate dietary

  11. Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

    Directory of Open Access Journals (Sweden)

    Jane W. Muchiri

    2012-10-01

    Full Text Available Diabetes self-management education is crucial in diabetes care. Education that is tailored to the needs of the patient is considered the most effective in improving health outcomes. Diet, a critical element of diabetes treatment, is reported as the most difficult to adhere to by both patients and health professionals. Tailored nutrition education (NE could benefit diabetic individuals with low socio-economic status, who are amongst those noted to have poor health outcomes. This qualitative interpretive phenomenological study aimed to explore and describe the NE needs of adults with type 2 diabetes mellitus to guide development of a tailored NE programme for resource-poor settings. Participants were 31 non-insulin-dependent type 2 diabetic patients (convenience sample and 10 health professionals. Focus group discussions using semi-structured questions were held with the diabetics, and open-ended self-administered questionnaires were used with the health professionals. Data analysis was done using Krueger’s framework approach. Disease-related knowledge deficits and inappropriate self-reported dietary practices, including intake of unbalanced meals, problems with food portion control and unsatisfactory intake of fruits and vegetables, were observed. Recommendations for the NE programme included topics related to the disease and others related to diet. Group education at the clinic, a competent educator and comprehensive education were indicated by the patients. Participation of family and provision of pamphlets were aspects recommended by patients and health professionals. Barriers that could impact the NE included financial constraints, food insecurity, conflict in family meal arrangements and access to appropriate foods. Support from family and health professionals and empowerment through education were identified as facilitators to following dietary recommendations by both groups of participants. Knowledge deficits, inappropriate dietary

  12. Ecosystems, ecological restoration, and economics: does habitat or resource equivalency analysis mean other economic valuation methods are not needed?

    Science.gov (United States)

    Shaw, W Douglass; Wlodarz, Marta

    2013-09-01

    Coastal and other area resources such as tidal wetlands, seagrasses, coral reefs, wetlands, and other ecosystems are often harmed by environmental damage that might be inflicted by human actions, or could occur from natural hazards such as hurricanes. Society may wish to restore resources to offset the harm, or receive compensation if this is not possible, but faces difficult choices among potential compensation projects. The optimal amount of restoration efforts can be determined by non-market valuation methods, service-to-service, or resource-to-resource approaches such as habitat equivalency analysis (HEA). HEA scales injured resources and lost services on a one-to-one trade-off basis. Here, we present the main differences between the HEA approach and other non-market valuation approaches. Particular focus is on the role of the social discount rate, which appears in the HEA equation and underlies calculations of the present value of future damages. We argue that while HEA involves elements of economic analysis, the assumption of a one-to-one trade-off between lost and restored services sometimes does not hold, and then other non-market economic valuation approaches may help in restoration scaling or in damage determination.

  13. Do geography and resources influence the need for colostomy in Hirschsprung's disease and anorectal malformations? A Canadian association of paediatric surgeons: association of paediatric surgeons of Nigeria survey.

    Science.gov (United States)

    Abdur-Rahman, Lukman O; Shawyer, Anna; Vizcarra, Rachel; Bailey, Karen; Cameron, Brian H

    2014-01-01

    This survey compared surgical management of Hirschsprung's disease (HD) and anorectal malformations (ARM) in high and low resource settings. An online survey was sent to 208 members of the Canadian Association of Paediatric Surgeons (CAPS) and the Association of Paediatric Surgeons of Nigeria (APSON). The response rate was 76.8% with 127 complete surveys (APSON 34, CAPS 97). Only 29.5% of APSON surgeons had frozen section available for diagnosis of HD. They were more likely to choose full thickness rectal biopsy (APSON 70.6% vs. CAPS 9.4%, P colostomy for HD (APSON 23.5% vs. CAPS 0%, P colostomy in females with vestibular fistula varied widely independent of geography. APSON surgeons were less likely to have enterostomal therapists and patient education resources. Local resources which vary by geographic location affect the management of HD and ARM including colostomy. Collaboration between CAPS and APSON members could address resource and educational needs to improve patient care.

  14. Inclusion of Students with Special Education Needs in French as a Second Language Programs: A Review of Canadian Policy and Resource Documents

    Science.gov (United States)

    Muhling, Stefanie; Mady, Callie

    2017-01-01

    This article describes a document analysis of policy and resource documents pertaining to inclusion of students with special education needs (SSEN) in Canadian French as a Second Language (FSL) programs. By recognizing gaps and acknowledging advancements, we aim to inform current implementation and future development of inclusive policy. Document…

  15. Global women's health is more than maternal health: a review of gynecology care needs in low-resource settings.

    Science.gov (United States)

    Robinson, Nuriya; Stoffel, Cynthia; Haider, Sadia

    2015-03-01

    Women's health care efforts in low-resource settings are often focused primarily on prenatal and obstetric care. However, women all over the world experience significant morbidity and mortality related to cervical cancer, sexually transmitted infections, and urogynecologic conditions as well as gynecologic care provision including insufficient and ineffective family planning services. Health care providers with an interest in clinical care in low-resource settings should be aware of the scope of the burden of gynecologic issues and strategies in place to combat the problems. This review article discusses the important concerns both in the developing world as well as highlights similar disparities that exist in the United States by women's age, race and ethnicity, and socioeconomic status. Ultimately, this review article aims to inform and update health care providers on critical gynecologic issues in low-resource settings.

  16. An antibiotic's journey from marketing authorization to use, Norway.

    Science.gov (United States)

    Årdal, Christine; Blix, Hege Salvesen; Plahte, Jens; Røttingen, John-Arne

    2017-03-01

    Here we describe in detail marketing authorization and reimbursement procedures for medicinal products in Norway, with particular reference to nine novel antibiotics that received marketing authorization between 2005 and 2015. The description illustrates that, in places like Norway, with effective antibiotic stewardship policies and an associated low prevalence of antibiotic-resistant bacterial infection, there is little need for newer, more expensive antibiotics whose therapeutic superiority to existing compounds has not been demonstrated. Since resistance begins to emerge as soon as an antibiotic is used, Norway's practice of leaving newer antibiotics on the shelf is consistent with the goal of prolonging the effectiveness of newer antibiotics. An unintended consequence is that the country has signalled to the private sector that there is little commercial value in novel antibiotics, which may nevertheless still be needed to treat rare or emerging infections. Every country aims to improve infection control and to promote responsible antibiotic use. However, as progress is made, antibiotic-resistant bacteria should become less common and, consequently, the need for, and the commercial value of, novel antibiotics will probably be reduced. Nevertheless, antibiotic innovation continues to be essential. This dilemma will have to be resolved through the introduction of alternative reward systems for antibiotic innovation. The DRIVE-AB (Driving re-investment in research and development and responsible antibiotic use) research consortium in Europe has been tasked with identifying ways of meeting this challenge.

  17. Reusing Treated Wastewater: Consideration of the Safety Aspects Associated with Antibiotic-Resistant Bacteria and Antibiotic Resistance Genes

    KAUST Repository

    Hong, Pei-Ying; Julian, Timothy; Pype, Marie-Laure; Jiang, Sunny; Nelson, Kara; Graham, David; Pruden, Amy; Manaia, Cé lia

    2018-01-01

    As more countries engage in water reuse, either intended or de facto, there is an urgent need to more comprehensively evaluate resulting environmental and public health concerns. While antibiotic-resistant bacteria (ARB) and antibiotic resistance

  18. Synthetic membrane-targeted antibiotics.

    Science.gov (United States)

    Vooturi, S K; Firestine, S M

    2010-01-01

    Antimicrobial resistance continues to evolve and presents serious challenges in the therapy of both nosocomial and community-acquired infections. The rise of resistant strains like methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Staphylococcus aureus (VRSA) and vancomycin-resistant enterococci (VRE) suggests that antimicrobial resistance is an inevitable evolutionary response to antimicrobial use. This highlights the tremendous need for antibiotics against new bacterial targets. Agents that target the integrity of bacterial membrane are relatively novel in the clinical armamentarium. Daptomycin, a lipopeptide is a classical example of membrane-bound antibiotic. Nature has also utilized this tactic. Antimicrobial peptides (AMPs), which are found in all kingdoms, function primarily by permeabilizing the bacterial membrane. AMPs have several advantages over existing antibiotics including a broad spectrum of activity, rapid bactericidal activity, no cross-resistance with the existing antibiotics and a low probability for developing resistance. Currently, a small number of peptides have been developed for clinical use but therapeutic applications are limited because of poor bioavailability and high manufacturing cost. However, their broad specificity, potent activity and lower probability for resistance have spurred the search for synthetic mimetics of antimicrobial peptides as membrane-active antibiotics. In this review, we will discuss the different classes of synthetic membrane-bound antibiotics published since 2004.

  19. Determining the Number of Participants Needed for the Usability Evaluation of E-Learning Resources: A Monte Carlo Simulation

    Science.gov (United States)

    Davids, Mogamat Razeen; Harvey, Justin; Halperin, Mitchell L.; Chikte, Usuf M. E.

    2015-01-01

    The usability of computer interfaces has a major influence on learning. Optimising the usability of e-learning resources is therefore essential. However, this may be neglected because of time and monetary constraints. User testing is a common approach to usability evaluation and involves studying typical end-users interacting with the application…

  20. Maternal Perceptions of the Importance of Needs and Resources for Children with Asperger Syndrome and Nonverbal Learning Disorders.

    Science.gov (United States)

    Little, Liza

    2003-01-01

    A survey examined the perceptions of 404 mothers on the availability and importance of various resources for their children (ages 4-17) with Asperger syndrome or nonverbal learning disorder. A significant number (20-30%) reported that pragmatics training, social skills training, smaller classes, or a trained aide were not made available. (Contains…

  1. Forestry cooperatives: what today's resource professionals need to know. Proceedings of a satellite conference; 2003 November 18

    Science.gov (United States)

    P. Jakes

    2006-01-01

    Nonindustrial private forest (NIPF) land represents approximately 48 percent of the forest land cover in the United States, and conscientious stewardship of these forests is a perennial issue facing natural resource professionals. In an attempt to draw on the strengths of NIPF ownership, some entrepreneurial forest landowners are developing forest landowner...

  2. Why Micro-foundations for Resource-Based Theory Are Needed and What They May Look Like

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul

    2011-01-01

    One of the important events in the development of resource-based theory (RBT) over the past decade has been the call for establishing micro-foundations for RBT. However, the micro-foundations project is still largely an unfulfilled promise. This article clarifies the nature of the micro-foundatio...

  3. The Keyhole[R] Rainbow Resource Kit: Meeting the Needs of Parents of Newly Diagnosed Preschoolers with ASD

    Science.gov (United States)

    McConkey, Roy; MacLeod, Sue; Cassidy, Arlene

    2011-01-01

    A resource kit containing information booklets about ASD, selected toys and playthings, and communication aids was developed and evaluated with 29 volunteer mothers supported by service personnel who visited on an average of six occasions. A mix of qualitative and quantitative methodologies was used in the evaluation. Nearly all mothers found the…

  4. Demographics of antibiotic persistence

    DEFF Research Database (Denmark)

    Kollerova, Silvia; Jouvet, Lionel; Steiner, Ulrich

    Persister cells, cells that can survive antibiotic exposure but lack heritable antibiotic resistance, are assumed to play a crucial role for the evolution of antibiotic resistance. Persistence is a stage associated with reduced metabolic activity. Most previous studies have been done on batch...... even play a more prominent role for the evolution of resistance and failures of medical treatment by antibiotics as currently assumed....

  5. Information Seeking Behavior & Information Resources Management:Mental Process Selecting Subjects & Identifying Information Needs Case study: Graduate Students in Women seminaries of Shiraz of Academic year 1393- 1394(

    Directory of Open Access Journals (Sweden)

    Zohre Eftekhar

    2016-08-01

    Full Text Available The aim of this research is Information Resources Management: Mental Process Selecting Subjects &  Identifying Information Needs. The research method used in this study is a Quantitative method. Sampling is purposeful. This means that it includes graduate Students in Women seminaries of Shiraz who have information-seeking experience and are able to express their views and information needs. The sample was selected according to the random sampling method with Cochran formula from 710 students. According to this sampling method there is 241 Graduate Students included in 1392-1393 seminaries year of  Women seminaries of Shiraz. This is a survey research Which has been carried out by employing a questionnaire and SPSS for windows to analyze data. The results showed that students for selecting subjects,  identifying information needs used methods and media such as Prying Mind, reviewing of information resources, Consulting with subject specialists.

  6. Antibiotics and oral contraceptives.

    Science.gov (United States)

    DeRossi, Scott S; Hersh, Elliot V

    2002-10-01

    and warn all oral contraceptive users of a potential reduction in efficacy during antibiotic therapy. These opinions are not evidence-based and rely heavily on one or two legal proceedings that cannot even be substantiated. On the other hand, there is one recently published legal proceeding in which the outcome was in favor of the oral surgeon. There is clearly a need for additional scientific research in oral contraceptive users that incorporates larger sample sizes, different time courses (prophylactic use versus standard 7-10 day use versus extended use), and different delivery systems (systemic administration versus local-controlled delivery) of antibiotic therapy. Though experts on this topic still recommend informing oral contraceptive users of the potential for a rare interaction, and for clinicians to advise them to employ additional barrier techniques of birth control during antibiotic therapy and for at least 1 week beyond the last dose [40], it is hoped that a set of guidelines regarding this controversy will eventually be published that is evidence-based, and not solely the results of anecdotal reports, expert opinions, and legal proceedings.

  7. Antibiotic research and development: business as usual?

    NARCIS (Netherlands)

    Harbarth, S.; Theuretzbacher, U.; Hackett, J.; Hulscher, M.; et al.,

    2015-01-01

    The global burden of antibiotic resistance is tremendous and, without new anti-infective strategies, will continue to increase in the coming decades. Despite the growing need for new antibiotics, few pharmaceutical companies today retain active antibacterial drug discovery programmes. One reason is

  8. Antibiotic prophylaxis in obstetric procedures.

    Science.gov (United States)

    van Schalkwyk, Julie; Van Eyk, Nancy

    2010-09-01

    To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June 2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. SUMMARY STATEMENTS: 1. Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following operative vaginal delivery. (II-1) 2. There is insufficient evidence to argue for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta. (III) 3. There is insufficient evidence to argue for or against the use of

  9. Lessons from the Environmental Antibiotic Resistome.

    Science.gov (United States)

    Surette, Matthew D; Wright, Gerard D

    2017-09-08

    Antibiotic resistance is a global public health issue of growing proportions. All antibiotics are susceptible to resistance. The evidence is now clear that the environment is the single largest source and reservoir of resistance. Soil, aquatic, atmospheric, animal-associated, and built ecosystems are home to microbes that harbor antibiotic resistance elements and the means to mobilize them. The diversity and abundance of resistance in the environment is consistent with the ancient origins of antibiotics and a variety of studies support a long natural history of associated resistance. The implications are clear: Understanding the evolution of resistance in the environment, its diversity, and mechanisms is essential to the management of our existing and future antibiotic resources.

  10. Pakistan's resources proficiency in global fever, greenhouse gases and atmospheric pollution control and need of their mobilization

    International Nuclear Information System (INIS)

    Malik, M.N.

    1997-01-01

    The temperature of earth planet is rising at an alarming rate and environmental changes, green house gasses emission and atmospheric pollution are approaching very critical limits. Ozone layer hole is increasing at very fast rate. On account of these very serious issues, the earth planet is heading at a very fast rate towards total collapse of life on it. For overcoming these very dangerous global problems Pakistan has very ideal resources subject to their proper management and well planned and timely mobilization. The efficient scientific utilization of these resources will not resolve its own pollution problems along contributing towards its own agricultural, industrial and economic growth, but also heavily contribute to the very critical global issues endangering the very existence of life on the earth along with contributing towards its own agricultural, industrial and economic growth. This will also forbid it to join hand with the rations already engaged in contributing toward the world's destruction by adding to these highly dangerous factors. In this work role of proper management of its water flow, gradient and storage resources in hydroelectric power generation and irrigation of its vast fertile agricultural fields and substantial control of these very dangerous global issues in highlighted. Also the economic boost of Pakistan due to its firm footing in respect economy, agricultural and industrial output, energy employment and flood damages control as a result of this mobilization is elaborated. At the end world's political leaders, electronic media, scientific and financial institutions are urged to help Pakistan in playing its role not only for welfare but very existence of mankind on this planet. (author)

  11. Needs assessment of science teachers in secondary schools in Kumasi, Ghana: A basis for in-service education training programs at the Science Resource Centers

    Science.gov (United States)

    Gyamfi, Alexander

    The purpose of this study was twofold. First, it identified the priority needs common to all science teachers in secondary schools in Kumasi, Ghana. Second, it investigated the relationship existing between the identified priority needs and the teacher demographic variables (type of school, teacher qualification, teaching experience, subject discipline, and sex of teacher) to be used as a basis for implementing in-service education training programs at the Science Resource Centers in Kumasi Ghana. An adapted version of the Moore Assessment Profile (MAP) survey instrument and a set of open-ended questions were used to collect data from the science teachers. The researcher handed out one hundred and fifty questionnaire packets, and all one hundred and fifty (100%) were collected within a period of six weeks. The data were analyzed using descriptive statistics, content analysis, and inferential statistics. The descriptive statistics reported the frequency of responses, and it was used to calculate the Need Index (N) of the identified needs of teachers. Sixteen top-priority needs were identified, and the needs were arranged in a hierarchical order according to the magnitude of the Need Index (0.000 ≤ N ≤ 1.000). Content analysis was used to analyze the responses to the open-ended questions. One-way analysis of variance (ANOVA) was used to test the null hypotheses of the study on each of the sixteen identified top-priority needs and the teacher demographic variables. The findings of this study were as follows: (1) The science teachers identified needs related to "more effective use of instructional materials" as a crucial area for in-service training. (2) Host and Satellite schools exhibited significant difference on procuring supplementary science books for students. Subject discipline of teachers exhibited significant differences on utilizing the library and its facilities by students, obtaining information on where to get help on effective science teaching

  12. Psychosocial resources and burnout risk factors in medical school: A cross-sectional study and analysis of needs for preventive curricular interventions

    OpenAIRE

    Aster-Schenck, IU; Schuler, M; Fischer, MR; Neuderth, S

    2010-01-01

    [english] Background: Epidemiologic health data show an increased incidence of psychosomatic disorders in medical doctors and undergraduate medical students as compared with the general public. There is little knowledge about students’ self-assessment of needs with respect to preventive health-promoting interventions.Objectives: Analysis of the psychosocial health resources and risk patterns of medical students at different times throughout their studies. Analysis of students’ self-assessment...

  13. Environmental dissemination of antibiotic resistance genes and correlation to anthropogenic contamination with antibiotics

    Science.gov (United States)

    Berglund, Björn

    2015-01-01

    Antibiotic resistance is a growing problem which threatens modern healthcare globally. Resistance has traditionally been viewed as a clinical problem, but recently non-clinical environments have been highlighted as an important factor in the dissemination of antibiotic resistance genes (ARGs). Horizontal gene transfer (HGT) events are likely to be common in aquatic environments; integrons in particular are well suited for mediating environmental dissemination of ARGs. A growing body of evidence suggests that ARGs are ubiquitous in natural environments. Particularly, elevated levels of ARGs and integrons in aquatic environments are correlated to proximity to anthropogenic activities. The source of this increase is likely to be routine discharge of antibiotics and resistance genes, for example, via wastewater or run-off from livestock facilities and agriculture. While very high levels of antibiotic contamination are likely to select for resistant bacteria directly, the role of sub-inhibitory concentrations of antibiotics in environmental antibiotic resistance dissemination remains unclear. In vitro studies have shown that low levels of antibiotics can select for resistant mutants and also facilitate HGT, indicating the need for caution. Overall, it is becoming increasingly clear that the environment plays an important role in dissemination of antibiotic resistance; further studies are needed to elucidate key aspects of this process. Importantly, the levels of environmental antibiotic contamination at which resistant bacteria are selected for and HGT is facilitated at should be determined. This would enable better risk analyses and facilitate measures for preventing dissemination and development of antibiotic resistance in the environment. PMID:26356096

  14. Developing a Contemporary Dairy Foods Extension Program: A Training and Technical Resource Needs Assessment of Pennsylvania Dairy Foods Processors

    Science.gov (United States)

    Syrko, Joseph; Kaylegian, Kerry E.

    2015-01-01

    Growth in the dairy industry and the passage of the Food Safety Modernization Act have renewed interest in dairy foods processing extension positions. A needs assessment survey was sent to Pennsylvania dairy processors and raw milk providers to guide priorities for a dairy foods extension program. The successful development and delivery of…

  15. Natural Gas Resources of the Greater Green River and Wind River Basins of Wyoming (Assessing the Technology Needs of Sub-economic Resources, Phase I: Greater Green River and Wind river Basins, Fall 2002)

    Energy Technology Data Exchange (ETDEWEB)

    Boswell, Ray; Douds, Ashley; Pratt, Skip; Rose, Kelly; Pancake, Jim; Bruner, Kathy (EG& G Services); Kuuskraa, Vello; Billingsley, Randy (Advanced Resources International)

    2003-02-28

    In 2000, NETL conducted a review of the adequacy of the resource characterization databases used in its Gas Systems Analysis Model (GSAM). This review indicated that the most striking deficiency in GSAM’s databases was the poor representation of the vast resource believed to exist in low-permeability sandstone accumulations in western U.S. basins. The model’s databases, which are built primarily around the United States Geological Survey (USGS) 1995 National Assessment (for undiscovered resources), reflected an estimate of the original-gas-inplace (OGIP) only in accumulations designated “technically-recoverable” by the USGS –roughly 3% to 4% of the total estimated OGIP of the region. As these vast remaining resources are a prime target of NETL programs, NETL immediately launched an effort to upgrade its resource characterizations. Upon review of existing data, NETL concluded that no existing data were appropriate sources for its modeling needs, and a decision was made to conduct new, detailed log-based, gas-in-place assessments.

  16. Antibiotic resistance status of Escherichia coli isolated from healthy ...

    African Journals Online (AJOL)

    The research revealed a high level of antibiotic resistance among E. coli. The percentage of resistance observed for the antibiotics included in this study reflected the degree of their respective uses in pig production in the study area. This work further supports the need for prudent use of each of the antibiotics in animal ...

  17. Forces shaping the antibiotic resistome.

    Science.gov (United States)

    Perry, Julie A; Wright, Gerard D

    2014-12-01

    Antibiotic resistance has become a problem of global scale. Resistance arises through mutation or through the acquisition of resistance gene(s) from other bacteria in a process called horizontal gene transfer (HGT). While HGT is recognized as an important factor in the dissemination of resistance genes in clinical pathogens, its role in the environment has been called into question by a recent study published in Nature. The authors found little evidence of HGT in soil using a culture-independent functional metagenomics approach, which is in contrast to previous work from the same lab showing HGT between the environment and human microbiome. While surprising at face value, these results may be explained by the lack of selective pressure in the environment studied. Importantly, this work suggests the need for careful monitoring of environmental antibiotic pollution and stringent antibiotic stewardship in the fight against resistance. © 2014 WILEY Periodicals, Inc.

  18. Antibiotic research and development: business as usual?

    Science.gov (United States)

    Harbarth, S; Theuretzbacher, U; Hackett, J

    2015-01-01

    The global burden of antibiotic resistance is tremendous and, without new anti-infective strategies, will continue to increase in the coming decades. Despite the growing need for new antibiotics, few pharmaceutical companies today retain active antibacterial drug discovery programmes. One reason is that it is scientifically challenging to discover new antibiotics that are active against the antibiotic-resistant bacteria of current clinical concern. However, the main hurdle is diminishing economic incentives. Increased global calls to minimize the overuse of antibiotics, the cost of meeting regulatory requirements and the low prices of currently marketed antibiotics are strong deterrents to antibacterial drug development programmes. New economic models that create incentives for the discovery of new antibiotics and yet reconcile these incentives with responsible antibiotic use are long overdue. DRIVE-AB is a €9.4 million public-private consortium, funded by the EU Innovative Medicines Initiative, that aims to define a standard for the responsible use of antibiotics and to develop, test and recommend new economic models to incentivize investment in producing new anti-infective agents. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Needs assessment for fire department services and resources for the Los Alamos National Laboratory, Los Alamos, New Mexico. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-15

    This report has been developed in response to a request from the Los Alamos National Laboratory (LANL) to evaluate the need for fire department services so as to enable the Laboratory to plan effective fire protection and thereby: meet LANL`s regulatory and contractual obligations; interface with the Department of Energy (DOE) and other agencies on matters relating to fire and emergency services; and ensure appropriate protection of the community and environment. This study is an outgrowth of the 1993 Fire Department Needs Assessment (prepared for DOE) but is developed from the LANL perspective. Input has been received from cognizant and responsible representatives at LANL, DOE, Los Alamos County (LAC) and the Los Alamos Fire Department (LAFD).

  20. Analysis of Environmental Issues Related to Small-Scale Hydroelectric Development V: Instream Flow Needs for Fishery Resources

    Energy Technology Data Exchange (ETDEWEB)

    Loar, James M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Sale, Michael J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    1981-10-01

    The purpose of this document is to provide guidance to developers of small-scale hydroelectric projects on the assessment of instream flow needs. While numerous methods have been developed to assess the effects of stream flow regulation on aquatic biota in coldwater streams in the West, no consensus has been reached regarding their general applicability, especially to streams in the eastern United States. This report presents and reviews these methods (Section 2.0), which is intended to provide the reader with general background information that is the basis for the critical evaluation of the methods (Section 3.0). The strategy for instream flow assessment presented in Section 4.0 is, in turn, based on the implicit assumptions, data needs, costs, and decision-making capabilities of the various methods as discussed in Section 3.0.

  1. Addressing the immediate need for emergency providers in resource-limited settings: the model of a six-month emergency medicine curriculum in Haiti.

    Science.gov (United States)

    Rouhani, Shada A; Israel, Kerling; Leandre, Fernet; Pierre, Sosthène; Bollman, Brennan; Marsh, Regan H

    2018-04-06

    In many resource-limited settings, emergency medicine (EM) is underdeveloped and formal EM training limited. Residencies and fellowships are an ideal long-term solution but cannot meet immediate needs for emergency providers, while short-term programs are often too limited in content. We describe a third method successfully implemented in Haiti: a medium-duration certificate program to meet the immediate need for emergency specialists. In conjunction with the Haitian Ministry of Health and National Medical School, we developed and implemented a novel, 6-month EM certificate program to build human resources for health and emergency care capacity. The program consisted of didactic and supervised clinical components, covering core content in EM. Didactics included lectures, simulations, hands-on skill-sessions, and journal clubs. Supervised clinical time reinforced concepts and taught an EM approach to patient care. Fourteen physicians from around Haiti successfully completed the program; all improved from their pre-test to post-test. At the end of the program and 9-month post-program evaluations, participants rated the program highly, and most felt they used their new knowledge daily. Participants found clinical supervision and simulation particularly useful. Key components to our program's success included collaboration with the Ministry of Health and National Medical School, supervised clinical time, and the continual presence of a course director. The program could be improved by a more flexible curriculum and by grouping participants by baseline knowledge levels. Medium-duration certificate programs offer a viable option for addressing immediate human resource gaps in emergency care, and our program offers a model for implementation in resource-limited settings. Similar options should be considered for other emerging specialties in resource-limited settings.

  2. "Practical knowledge" and perceptions of antibiotics and antibiotic resistance among drugsellers in Tanzanian private drugstores

    Directory of Open Access Journals (Sweden)

    Tomson Göran

    2010-09-01

    resistance based on practical experience. Conclusions The drugsellers have considerable "practical knowledge" of antibiotics and a perception of antibiotic resistance based on practical experience. In the process of upgrading private drugstores and formalizing the sale of antibiotics from these outlets in resource-constrained settings, their "practical knowledge" as well as their perceptions must be taken into account in order to attain rational dispensing practices.

  3. The antibiotic resistome.

    Science.gov (United States)

    Wright, Gerard D

    2010-08-01

    Antibiotics are essential for the treatment of bacterial infections and are among our most important drugs. Resistance has emerged to all classes of antibiotics in clinical use. Antibiotic resistance has, proven inevitable and very often it emerges rapidly after the introduction of a drug into the clinic. There is, therefore, a great interest in understanding the origins, scope and evolution of antibiotic resistance. The review discusses the concept of the antibiotic resistome, which is the collection of all genes that directly or indirectly contribute to antibiotic resistance. The review seeks to assemble current knowledge of the resistome concept as a means of understanding the totality of resistance and not just resistance in pathogenic bacteria. The concept of the antibiotic resistome provides a framework for the study and understanding of how resistance emerges and evolves. Furthermore, the study of the resistome reveals strategies that can be applied in new antibiotic discoveries.

  4. Assessing information needs and use of online resources for disease self-management in patients with rheumatoid arthritis: a qualitative study.

    Science.gov (United States)

    des Bordes, Jude K A; Gonzalez, Elsa; Lopez-Olivo, Maria A; Shethia, Maithili; Nayak, Pratibha; Suarez-Almazor, Maria E

    2018-07-01

    To explore the information needs of patients with rheumatoid arthritis (RA) and their acceptance of online resources and Facebook in particular, as a source of information, interaction, and support among peers. Participants were adults with RA of ≤ 10 years duration, had ongoing or prior treatment with disease-modifying anti-rheumatic drugs or biologic agents, and internet access. We conducted 20 in-depth interviews using semi-structured interview guide to explore: (1) RA information needs, (2) use of self-management health behaviors, (3) use of internet resources for disease management, (4) role of peer support in health self-management, and (5) use of social networking sites (SNS) such as Facebook in disease management. Data were analyzed using content analysis and constant comparative methods. Participants were mainly female (85%), White (70%), and over 50 years old (70%). Specific information needs included knowledge regarding medications, disease course, pain control, diet, and exercise. Most participants had a narrow perception of SNS as a tool for disease management. However, they found SNS acceptable and were open to participating in a support group on Facebook with reasonable assurance of privacy. Although the overarching theme was RA information needs, the other themes contribute in supporting the robust emergence of Internet media in informing patients about their health and support systems. Our findings can inform the choice and format of materials to be considered for online education on self-management and social networking for RA patients.

  5. Twenty-ninth day: accommodating human needs and numbers to the Earth's resources. [ecological impacts of overpopulation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, L.R.

    1978-01-01

    The global lily pond in which four billion of us live may already be half full. The author believes that UN projections showing world population continuing to grow until it reaches ten to sixteen billion is unrealistic. In this analysis of the four principal biological systems on which humanity depends - fisheries, forests, grasslands, and croplands - the author shows that the demands at current levels of population and per capita consumption often exceed the long-term carrying capacity. The effects of overfishing, deforestation, and overgrazing that are gradually undermining human life-support systems are documented. With energy shortages anticipated inthe early eighties and the projected downturn in world oil production in the early nineties, the world must quickly shift to renewable energy resources. These accommodations constitute an enormous challenge and suggest changes that will affect virtually every facet of human existence. The coming transformation will surely give rise to new social structures and to an economic system materially different from any we know today. Like other periods of convulsive change, it will put great stress on both individuals and institutions. 106 references, 17 figures, 18 tables.

  6. [Collections of human biological resources for research purposes: from regulations to the need of a guide of good collection practices].

    Science.gov (United States)

    Le Roux, N; de Montgolfier, S; di Donato, J-H; Boccon-Gibod, L; Teillac, P; Hervé, C; Berthon, P

    2003-12-01

    In France, collections of human biological resources are regulated by the "Bioethics Law", currently in revision. Hence, we analyse the regulatory and ethical issues of these practices in the context of scientific research. The ultimate aim of such collections is to improve biological and medical knowledge. We think that the French regulatory system is quite complicated and non-explicit for "collection holders". The multiplicity of legal texts concerning this activity has made their application difficult, especially in the absence of application decrees. The project amending the actual law has clarified the legal status of collections but it did not shed light on the status of human body detached parts. Furthermore, the text is still very far from the international bioethical recommendations, and does not reflect the actual collection's implementation. The establishment of a guideline of Good Collection Practices, based on clear principles, should help to simplify the situation, especially when it is imbedded in the regulation and linked to control procedures. It would allow a balance between collective interests and the protection of individuals, taking into account of the international highly competitive scientific and economical constraints. The major issue is to preserve and to perpetuate the existing and future collections because of their precious value as an important tool for biomedical knowledge. The efficiency of a regulation depends on its legibility and accessibility, two requirements that seem to determine the acceptance of the regulatory tool and its application allowing subsequently to reach fairness in proceedings.

  7. A Comprehensive Study of the Tocks Island Lake Project and Alternatives. Part C. Analysis of Alternatives to Supply Resource Needs

    Science.gov (United States)

    1975-06-01

    power. It requires no boiler ; needs no water for cooling; involves minimal siting, housing and foundation problems; and requires a minimum of power...8217-P I .U)0 5 4 co 0) 0 $4 t ) 5 U) . U) 0 CL 0 410 0 P40 O0 o 0 C 0 z 0 r. c H r- caH A 4jdr-00 Uj :HO HHO 0)HO OHd O Hr 00 0 10 OE4-4 P4;1pm46 H XVI

  8. Costing commodity and human resource needs for integrated community case management in thie differing community health strategies of Ethiopia, Kenya and Zambia.

    Science.gov (United States)

    Nefdt, Rory; Ribaira, Eric; Diallo, Khassoum

    2014-10-01

    To ensure correct and appropriate funding is available, there is a need to estimate resource needs for improved planning and implementation of integrated Community Case Management (iCCM). To compare and estimate costs for commodity and human resource needs for iCCM, based on treatment coverage rates, bottlenecks and national targets in Ethiopia, Kenya and Zambia from 2014 to 2016. Resource needs were estimated using Ministry of Health (MoH) targets fronm 2014 to 2016 for implementation of case management of pneumonia, diarrhea and malaria through iCCM based on epidemiological, demographic, economic, intervention coverage and other health system parameters. Bottleneck analysis adjusted cost estimates against system barriers. Ethiopia, Kenya and Zambia were chosen to compare differences in iCCM costs in different programmatic implementation landscapes. Coverage treatment rates through iCCM are lowest in Ethiopia, followed by Kenya and Zambia, but Ethiopia had the greatest increases between 2009 and 2012. Deployment of health extension workers (HEWs) in Ethiopia is more advanced compared to Kenya and Zambia, which have fewer equivalent cadres (called commu- nity health workers (CHWs)) covering a smaller proportion of the population. Between 2014 and 2016, the propor- tion of treatments through iCCM compared to health centres are set to increase from 30% to 81% in Ethiopia, 1% to 18% in Kenya and 3% to 22% in Zambia. The total estimated cost of iCCM for these three years are USD 75,531,376 for Ethiopia, USD 19,839,780 for Kenya and USD 33,667,742 for Zambia. Projected per capita expen- diture for 2016 is USD 0.28 for Ethiopia, USD 0.20 in Kenya and USD 0.98 in Zambia. Commodity costs for pneumonia and diarrhea were a small fraction of the total iCCM budget for all three countries (less than 3%), while around 80% of the costs related to human resources. Analysis of coverage, demography and epidemiology data improves estimates of fimding requirements for iCCM. Bottleneck

  9. Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

    Science.gov (United States)

    Furtado, Kheya Melo; Kar, Anita

    2014-04-01

    There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

  10. Know When Antibiotics Work

    Centers for Disease Control (CDC) Podcasts

    2015-04-15

    This podcast provides a brief background about antibiotics and quick tips to help prevent antibiotic resistance.  Created: 4/15/2015 by Division of Bacterial Diseases (DBD), National Center for Immunization and Respiratory Disease (NCIRD), Get Smart: Know When Antibiotics Work Program.   Date Released: 4/16/2015.

  11. Antibiotics: Miracle Drugs

    Centers for Disease Control (CDC) Podcasts

    The overuse of antibiotics has led to the development of resistance among bacteria, making antibiotics ineffective in treating certain conditions. This podcast discusses the importance of talking to your healthcare professional about whether or not antibiotics will be beneficial if you've been diagnosed with an infectious disease.

  12. Mentorship needs at academic institutions in resource-limited settings: a survey at makerere university college of health sciences

    Directory of Open Access Journals (Sweden)

    Nakwagala Fred

    2011-07-01

    Full Text Available Abstract Background Mentoring is a core component of medical education and career success. There is increasing global emphasis on mentorship of young scientists in order to train and develop the next leaders in global health. However, mentoring efforts are challenged by the high clinical, research and administrative demands. We evaluated the status and nature of mentoring practices at Makerere University College of Health Sciences (MAKCHS. Methods Pre-tested, self-administered questionnaires were sent by email to all Fogarty alumni at the MAKCHS (mentors and each of them was requested to complete and email back the questionnaire. In addition to training level and number of mentors, the questionnaires had open-ended questions covering themes such as; status of mentorship, challenges faced by mentors and strategies to improve and sustain mentorship within MAKCHS. Similarly, open-ended questionnaires were sent and received by email from all graduate students (mentees registered with the Uganda Society for Health Scientists (USHS. Qualitative data from mentors and mentees was analyzed manually according to the pre-determined themes. Results Twenty- two out of 100 mentors responded (14 email and 8 hard copy responses. Up to 77% (17/22 of mentors had Master's-level training and only 18% (4/22 had doctorate-level training. About 40% of the mentors had ≥ two mentees while 27% had none. Qualitative results showed that mentors needed support in terms of training in mentoring skills and logistical/financial support to carry out successful mentorship. Junior scientists and students reported that mentorship is not yet institutionalized and it is currently occurring in an adhoc manner. There was lack of awareness of roles of mentors and mentees. The mentors mentioned the limited number of practicing mentors at the college and thus the need for training courses and guidelines for faculty members in regard to mentorship at academic institutions. Conclusions

  13. Enhancing participatory approach in water resources management: development of a survey to evaluate stakeholders needs and priorities related to software capabilities

    Science.gov (United States)

    Foglia, L.; Rossetto, R.; Borsi, I.; Josef, S.; Boukalova, Z.; Triana, F.; Ghetta, M.; Sabbatini, T.; Bonari, E.; Cannata, M.; De Filippis, G.

    2016-12-01

    The EU H2020 FREEWAT project (FREE and open source software tools for WATer resource management) aims at simplifying the application of EU-water related Directives, by developing an open source and public domain, GIS-integrated platform for planning and management of ground- and surface-water resources. The FREEWAT platform is conceived as a canvas, where several distributed and physically-based simulation codes are virtually integrated. The choice of such codes was supported by the result of a survey performed by means of questionnaires distributed to 14 case study FREEWAT project partners and several stakeholders. This was performed in the first phase of the project within the WP 6 (Enhanced science and participatory approach evidence-based decision making), Task 6.1 (Definition of a "needs/tools" evaluation grid). About 30% among all the invited entities and institutions from several EU and non-EU Countries expressed their interest in contributing to the survey. Most of them were research institutions, government and geoenvironmental companies and river basin authorities.The result of the questionnaire provided a spectrum of needs and priorities of partners/stakeholders, which were addressed during the development phase of the FREEWAT platform. The main needs identified were related to ground- and surface-water quality, sustainable water management, interaction between groundwater/surface-water bodies, and design and management of Managed Aquifer Recharge schemes. Needs and priorities were then connected to the specific EU Directives and Regulations to be addressed.One of the main goals of the questionnaires was to collect information and suggestions regarding the use of existing commercial/open-source software tools to address needs and priorities, and regarding the needs to address specific water-related processes/problems.

  14. Will the Needs-Based Planning of Health Human Resources Currently Undertaken in Several Countries Lead to Excess Supply and Inefficiency?

    Science.gov (United States)

    Basu, Kisalaya; Pak, Maxwell

    2016-01-01

    Recently, the emphasis on health human resources (HHR) planning has shifted away from a utilization-based approach toward a needs-based one in which planning is based on the projected health needs of the population. However, needs-based models that are currently in use rely on a definition of 'needs' that include only the medical circumstances of individuals and not personal preferences or other socio-economic factors. We examine whether planning based on such a narrow definition will maximize social welfare. We show that, in a publicly funded healthcare system, if the planner seeks to meet the aggregate need without taking utilization into consideration, then oversupply of HHR is likely because 'needs' do not necessarily translate into 'usage.' Our result suggests that HHR planning should track the healthcare system as access gradually improves because, even if health care is fully accessible, individuals may not fully utilize it to the degree prescribed by their medical circumstances. Copyright © 2014 John Wiley & Sons, Ltd.

  15. The expression of antibiotic resistance genes in antibiotic-producing bacteria.

    Science.gov (United States)

    Mak, Stefanie; Xu, Ye; Nodwell, Justin R

    2014-08-01

    Antibiotic-producing bacteria encode antibiotic resistance genes that protect them from the biologically active molecules that they produce. The expression of these genes needs to occur in a timely manner: either in advance of or concomitantly with biosynthesis. It appears that there have been at least two general solutions to this problem. In many cases, the expression of resistance genes is tightly linked to that of antibiotic biosynthetic genes. In others, the resistance genes can be induced by their cognate antibiotics or by intermediate molecules from their biosynthetic pathways. The regulatory mechanisms that couple resistance to antibiotic biosynthesis are mechanistically diverse and potentially relevant to the origins of clinical antibiotic resistance. © 2014 John Wiley & Sons Ltd.

  16. Systemic antibiotics in periodontics.

    Science.gov (United States)

    Slots, Jørgen

    2004-11-01

    This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.

  17. Antibiotic Resistance in Pediatric Urinary Tract Infections.

    Science.gov (United States)

    Stultz, Jeremy S; Doern, Christopher D; Godbout, Emily

    2016-12-01

    Urinary tract infections (UTIs) are a common problem in pediatric patients. Resistance to common antibiotic agents appears to be increasing over time, although resistance rates may vary based on geographic region or country. Prior antibiotic exposure is a pertinent risk factor for acquiring resistant organisms during a first UTI and recurrent UTI. Judicious prescribing of antibiotics for common pediatric conditions is needed to prevent additional resistance from occurring. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase-producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking.

  18. Probiotics in antibiotic associated diarrhea in children

    Directory of Open Access Journals (Sweden)

    Matjaž Homan

    2013-10-01

    Full Text Available The use of antibiotics that disturb the gastrointestinal microbiota is associated with diarrhea, which occurs in up to half of treated children. Symptoms are usually mild and children do not need hospitalization. Probiotics are live microorganisms, which restore intestinal microbiota during antibiotic therapy through different mechanisms such as stimulation of immunity, secretion of anti-inflammatory factors, and production of antimicrobial substances. The use of different strains of probiotics in antibiotic-associated diarrhea was evaluated in several studies in adults but less frequently in pediatric population. They also confirmed the value of probiotics in the prevention of antibiotic-associated diarrhea in children, particularly Lactobacillus strain GG and Saccharomyces boulardii. The use of probiotics in childhood is safe. A proper strain must be introduced at the beginning of antibiotic treatment in a sufficient concentration.

  19. Microbial Contamination Detection in Water Resources: Interest of Current Optical Methods, Trends and Needs in the Context of Climate Change

    Directory of Open Access Journals (Sweden)

    Aude-Valérie Jung

    2014-04-01

    Full Text Available Microbial pollution in aquatic environments is one of the crucial issues with regard to the sanitary state of water bodies used for drinking water supply, recreational activities and harvesting seafood due to a potential contamination by pathogenic bacteria, protozoa or viruses. To address this risk, microbial contamination monitoring is usually assessed by turbidity measurements performed at drinking water plants. Some recent studies have shown significant correlations of microbial contamination with the risk of endemic gastroenteresis. However the relevance of turbidimetry may be limited since the presence of colloids in water creates interferences with the nephelometric response. Thus there is a need for a more relevant, simple and fast indicator for microbial contamination detection in water, especially in the perspective of climate change with the increase of heavy rainfall events. This review focuses on the one hand on sources, fate and behavior of microorganisms in water and factors influencing pathogens’ presence, transportation and mobilization, and on the second hand, on the existing optical methods used for monitoring microbiological risks. Finally, this paper proposes new ways of research.

  20. The HIV Treatment Gap: Estimates of the Financial Resources Needed versus Available for Scale-Up of Antiretroviral Therapy in 97 Countries from 2015 to 2020.

    Directory of Open Access Journals (Sweden)

    Arin Dutta

    2015-11-01

    Full Text Available The World Health Organization (WHO released revised guidelines in 2015 recommending that all people living with HIV, regardless of CD4 count, initiate antiretroviral therapy (ART upon diagnosis. However, few studies have projected the global resources needed for rapid scale-up of ART. Under the Health Policy Project, we conducted modeling analyses for 97 countries to estimate eligibility for and numbers on ART from 2015 to 2020, along with the facility-level financial resources required. We compared the estimated financial requirements to estimated funding available.Current coverage levels and future need for treatment were based on country-specific epidemiological and demographic data. Simulated annual numbers of individuals on treatment were derived from three scenarios: (1 continuation of countries' current policies of eligibility for ART, (2 universal adoption of aspects of the WHO 2013 eligibility guidelines, and (3 expanded eligibility as per the WHO 2015 guidelines and meeting the Joint United Nations Programme on HIV/AIDS "90-90-90" ART targets. We modeled uncertainty in the annual resource requirements for antiretroviral drugs, laboratory tests, and facility-level personnel and overhead. We estimate that 25.7 (95% CI 25.5, 26.0 million adults and 1.57 (95% CI 1.55, 1.60 million children could receive ART by 2020 if countries maintain current eligibility plans and increase coverage based on historical rates, which may be ambitious. If countries uniformly adopt aspects of the WHO 2013 guidelines, 26.5 (95% CI 26.0 27.0 million adults and 1.53 (95% CI 1.52, 1.55 million children could be on ART by 2020. Under the 90-90-90 scenario, 30.4 (95% CI 30.1, 30.7 million adults and 1.68 (95% CI 1.63, 1.73 million children could receive treatment by 2020. The facility-level financial resources needed for scaling up ART in these countries from 2015 to 2020 are estimated to be US$45.8 (95% CI 45.4, 46.2 billion under the current scenario, US$48.7 (95

  1. Evaluation of levels of antibiotic resistance in groundwater-derived E. coli isolates in the Midwest of Ireland and elucidation of potential predictors of resistance

    Science.gov (United States)

    O'Dwyer, Jean; Hynds, Paul; Pot, Matthieu; Adley, Catherine C.; Ryan, Michael P.

    2017-06-01

    Antibiotic-resistant (pathogenic and non-pathogenic) organisms and genes are now acknowledged as significant emerging aquatic contaminants with potentially adverse human and ecological health impacts, and thus require monitoring. This study is the first to investigate levels of resistance among Irish groundwater (private wells) samples; Escherichia coli isolates were examined against a panel of commonly prescribed human and veterinary therapeutic antibiotics, followed by determination of the causative factors of resistance. Overall, 42 confirmed E. coli isolates were recovered from a groundwater-sampling cohort. Resistance to the human panel of antibiotics was moderate; nine (21.4%) E. coli isolates demonstrated resistance to one or more human antibiotics. Conversely, extremely high levels of resistance to veterinary antibiotics were found, with all isolates presenting resistance to one or more veterinary antibiotics. Particularly high levels of resistance (93%) were found with respect to the aminoglycoside class of antibiotics. Results of statistical analysis indicate a significant association between the presence of human (multiple) antibiotic resistance ( p = 0.002-0.011) and both septic tank density and the presence of vulnerable sub-populations (<5 years). For the veterinary antibiotics, results point to a significant relationship ( p = <0.001) between livestock (cattle) density and the prevalence of multiple antibiotic resistant E. coli. Groundwater continues to be an important resource in Ireland, particularly in rural areas; thus, results of this preliminary study offer a valuable insight into the prevalence of antibiotic resistance in the hydrogeological environment and establish a need for further research with a larger geological diversity.

  2. The costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs: A systematic review of international evidence.

    Science.gov (United States)

    Salamanca-Balen, Natalia; Seymour, Jane; Caswell, Glenys; Whynes, David; Tod, Angela

    2018-02-01

    Patients with palliative care needs do not access specialist palliative care services according to their needs. Clinical Nurse Specialists working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective. To present results from a systematic review of the international evidence on the costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover or stabilize. Systematic review following PRISMA methodology. Medline, Embase, CINAHL and Cochrane Library up to 2015. Studies focusing on the outcomes of Clinical Nurse Specialist interventions for patients with palliative care needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna Briggs Institute. A total of 79 papers were included: 37 randomized controlled trials, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly. Clinical Nurse Specialist interventions may be effective in reducing specific resource use such as hospitalizations/re-hospitalizations/admissions, length of stay and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that Clinical Nurse Specialists' roles and activities are clearly described and evaluated.

  3. Ribosomal Antibiotics: Contemporary Challenges

    Directory of Open Access Journals (Sweden)

    Tamar Auerbach-Nevo

    2016-06-01

    Full Text Available Most ribosomal antibiotics obstruct distinct ribosomal functions. In selected cases, in addition to paralyzing vital ribosomal tasks, some ribosomal antibiotics are involved in cellular regulation. Owing to the global rapid increase in the appearance of multi-drug resistance in pathogenic bacterial strains, and to the extremely slow progress in developing new antibiotics worldwide, it seems that, in addition to the traditional attempts at improving current antibiotics and the intensive screening for additional natural compounds, this field should undergo substantial conceptual revision. Here, we highlight several contemporary issues, including challenging the common preference of broad-range antibiotics; the marginal attention to alterations in the microbiome population resulting from antibiotics usage, and the insufficient awareness of ecological and environmental aspects of antibiotics usage. We also highlight recent advances in the identification of species-specific structural motifs that may be exploited for the design and the creation of novel, environmental friendly, degradable, antibiotic types, with a better distinction between pathogens and useful bacterial species in the microbiome. Thus, these studies are leading towards the design of “pathogen-specific antibiotics,” in contrast to the current preference of broad range antibiotics, partially because it requires significant efforts in speeding up the discovery of the unique species motifs as well as the clinical pathogen identification.

  4. Children as agents of change in combatting antibiotic resistance.

    Science.gov (United States)

    Molnar, Andreea

    2017-01-01

    Antibiotic resistance is a worldwide problem and changes are needed in the way antibiotics are used. The value of engaging children as key contributors in health care campaigns to increase the appropriate use of antibiotics has not been fully recognized. Little is known about how to design educational materials for children in order to enable them to be agents of change in their communities. Science education needs to improve the way it engages children so as to give them the tools needed to make responsible decisions on antibiotic use.

  5. Workforce capacity to address obesity: a Western Australian cross-sectional study identifies the gap between health priority and human resources needed.

    Science.gov (United States)

    Begley, Andrea; Pollard, Christina Mary

    2016-08-25

    The disease burden due to poor nutrition, physical inactivity and obesity is high and increasing. An adequately sized and skilled workforce is required to respond to this issue. This study describes the public health nutrition and physical activity (NAPA) practice priorities and explores health managers and practitioner's beliefs regarding workforce capacity to deliver on these priorities. A workforce audit was conducted including a telephone survey of all managers and a postal survey of practitioners working in the area of NAPA promotion in Western Australia in 2004. Managers gave their perspective on workforce priorities, current competencies and future needs, with a 70 % response rate. Practitioners reported on public health workforce priorities, qualifications and needs, with a 56 % response rate. The top practice priorities for managers were diabetes (35 %), alcohol and other drugs (33 %), and cardiovascular disease (27 %). Obesity (19 %), poor nutrition (15 %) and inadequate physical activity (10 %) were of lower priority. For nutrition, managers identified lack of staff (60.4 %), organisational and management factors (39.5 %) and insufficient financial resources (30.2 %) as the major barriers to adequate service delivery. For physical activity services, insufficient financial resources (41.7 %) and staffing (35.4 %) and a lack of specific physical activity service specifications (25.0 %) were the main barriers. Practitioners identified inadequate staffing as the main barrier to service delivery for nutrition (42.3 %) and physical activity (23.3 %). Ideally, managers said they required 152 % more specialist nutritionists in the workforce and 131 % specialists for physical activity services to meet health outcomes in addition to other generalist staff. Human and financial resources and organisational factors were the main barriers to meeting obesity, and public health nutrition and physical activity outcomes. Services were being delivered by

  6. Priorities for antibiotic resistance surveillance in Europe

    DEFF Research Database (Denmark)

    Fluit, A. C.; van der Bruggen, J. T.; Aarestrup, Frank Møller

    2006-01-01

    Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. To achieve this, surveillance studies must have standardised methodologies, be longitud......Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. To achieve this, surveillance studies must have standardised methodologies...... to the various reservoirs of antibiotic-resistant bacteria, such as hospitalised patients, nursing homes, the community, animals and food. Two studies that could serve as examples of tailored programmes are the European Antimicrobial Resistance Surveillance System (EARSS), which collects resistance data during...... of antibiotic resistance....

  7. Coping with antibiotic resistance: combining nanoparticles with antibiotics and other antimicrobial agents.

    Science.gov (United States)

    Allahverdiyev, Adil M; Kon, Kateryna Volodymyrivna; Abamor, Emrah Sefik; Bagirova, Malahat; Rafailovich, Miriam

    2011-11-01

    The worldwide escalation of bacterial resistance to conventional medical antibiotics is a serious concern for modern medicine. High prevalence of multidrug-resistant bacteria among bacteria-based infections decreases effectiveness of current treatments and causes thousands of deaths. New improvements in present methods and novel strategies are urgently needed to cope with this problem. Owing to their antibacterial activities, metallic nanoparticles represent an effective solution for overcoming bacterial resistance. However, metallic nanoparticles are toxic, which causes restrictions in their use. Recent studies have shown that combining nanoparticles with antibiotics not only reduces the toxicity of both agents towards human cells by decreasing the requirement for high dosages but also enhances their bactericidal properties. Combining antibiotics with nanoparticles also restores their ability to destroy bacteria that have acquired resistance to them. Furthermore, nanoparticles tagged with antibiotics have been shown to increase the concentration of antibiotics at the site of bacterium-antibiotic interaction, and to facilitate binding of antibiotics to bacteria. Likewise, combining nanoparticles with antimicrobial peptides and essential oils generates genuine synergy against bacterial resistance. In this article, we aim to summarize recent studies on interactions between nanoparticles and antibiotics, as well as other antibacterial agents to formulate new prospects for future studies. Based on the promising data that demonstrated the synergistic effects of antimicrobial agents with nanoparticles, we believe that this combination is a potential candidate for more research into treatments for antibiotic-resistant bacteria.

  8. Antibiotics and Breastfeeding.

    Science.gov (United States)

    de Sá Del Fiol, Fernando; Barberato-Filho, Silvio; de Cássia Bergamaschi, Cristiane; Lopes, Luciane Cruz; Gauthier, Timothy P

    2016-01-01

    During the breastfeeding period, bacterial infections can occur in the nursing mother, requiring the use of antibiotics. A lack of accurate information may lead health care professionals and mothers to suspend breastfeeding, which may be unnecessary. This article provides information on the main antibiotics that are appropriate for clinical use and the interference of these antibiotics with the infant to support medical decisions regarding the discontinuation of breastfeeding. We aim to provide information on the pharmacokinetic factors that interfere with the passage of antibiotics into breast milk and the toxicological implications of absorption by the infant. Publications related to the 20 most frequently employed antibiotics and their transfer into breast milk were evaluated. The results demonstrate that most antibiotics in clinical use are considered suitable during breastfeeding; however, the pharmacokinetic profile of each drug must be observed to ensure the resolution of the maternal infection and the safety of the infant. © 2016 S. Karger AG, Basel.

  9. High Antibiotic Consumption

    DEFF Research Database (Denmark)

    Malo, Sara; José Rabanaque, María; Feja, Cristina

    2014-01-01

    Heavy antibiotic users are those individuals with the highest exposure to antibiotics. They play an important role as contributors to the increasing risk of antimicrobial resistance. We applied different methods to identify and characterize the group of heavy antibiotic users in Spain as well...... as their exposure to antibiotics. Data on outpatient prescribing of antimicrobials (ATC J01) in 2010 were obtained from a prescription database covering Aragón (northeastern Spain). The antimicrobial consumption at the individual level was analysed both according to the volume of DDD and the number of packages...... purchased per year. Heavy antibiotic users were identified according to Lorenz curves and characterized by age, gender, and their antimicrobial prescription profile. Lorenz curves demonstrated substantial differences in the individual use of antimicrobials. Heavy antibiotic users (5% of individuals...

  10. [Patient safety in antibiotics administration: Risk assessment].

    Science.gov (United States)

    Maqueda Palau, M; Pérez Juan, E

    To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix. A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected. In this period, 257 patients received antimicrobial treatment and 26 antibiotics were evaluated. Variables studied: A risk assessment of each antibiotic using the scale Risk Assessment Tool, of the National Patient Safety Agency, as well as pH, osmolarity, type of catheter recommended for administration, and compatibility and incompatibility with other antibiotics studied. Almost two-thirds (65.3%) of antibiotics had more than 3 risk factors (represented by a yellow stripe), with the remaining 34.7% of antibiotics having between 0 and 2 risk factors (represented by a green stripe). There were no antibiotics with 6 or more risk factors (represented by a red stripe). Most drugs needed reconstitution, additional dilution, and the use of part of the vial to administer the prescribed dose. More than half of the antibiotics studied had a moderate risk level; thus measures should be adopted in order to reduce it. The risk matrix is a useful tool for the assessment and detection of weaknesses associated with the preparation and administration of intravenous antibiotics. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Structure of polysaccharide antibiotics

    International Nuclear Information System (INIS)

    Matutano, L.

    1966-01-01

    Study of the structure of antibiotics having two or several sugars in their molecule. One may distinguish: the polysaccharide antibiotics themselves, made up of two or several sugars either with or without nitrogen, such as streptomycin, neomycins, paromomycine, kanamycin, chalcomycin; the hetero-polysaccharide antibiotics made up of one saccharide part linked to an aglycone of various type through a glucoside: macrolide, pigment, pyrimidine purine. Amongst these latter are: erythromycin, magnamycin, spiramycin, oleandomycin, cinerubin and amicetin. The sugars can either play a direct role in biochemical reactions or act as a dissolving agent, as far as the anti-microbe power of these antibiotics is concerned. (author) [fr

  12. Antibiotics: Miracle Drugs

    Centers for Disease Control (CDC) Podcasts

    2015-04-16

    The overuse of antibiotics has led to the development of resistance among bacteria, making antibiotics ineffective in treating certain conditions. This podcast discusses the importance of talking to your healthcare professional about whether or not antibiotics will be beneficial if you’ve been diagnosed with an infectious disease.  Created: 4/16/2015 by Division of Bacterial Diseases (DBD), National Center for Immunization and Respiratory Disease (NCIRD), Get Smart: Know When Antibiotics Work Program.   Date Released: 4/16/2015.

  13. Pervasive antibiotic misuse in the Cambodian community: antibiotic-seeking behaviour with unrestricted access

    Directory of Open Access Journals (Sweden)

    Chhorvoin Om

    2017-03-01

    Full Text Available Abstract Background Antibiotic misuse is widespread in resource-limited countries such as Cambodia where the burden of infectious diseases is high and access to antibiotics is unrestricted. We explored healthcare seeking behaviour related to obtaining antibiotics and drivers of antibiotic misuse in the Cambodian community. Methods In-depth interviews were held with family members of patients being admitted in hospitals and private pharmacies termed pharmacy attendants in the catchment areas of the hospitals. Nurses who run community primary healthcare centres located within the hospital catchment areas were invited to attend focus group discussions. Nvivo version 10 was used to code and manage thematic data analysis. Results We conducted individual interviews with 35 family members, 7 untrained pharmacy attendants and 3 trained pharmacists and 6 focus group discussions with 30 nurses. Self-medication with a drug-cocktail was widespread and included broad-spectrum antibiotics for mild illness. Unrestricted access to antibiotics was facilitated by various community enablers including pharmacies or drug outlets, nurse suppliers and unofficial village medical providers referred to as “village Pett” whose healthcare training has historically been in the field and not at university. These enablers supplied the community with various types of antibiotics including broad spectrum fluoroquinolones and cephalosporins. When treatment was perceived to be ineffective patients would prescriber-shop various suppliers who would unfailingly provide them with antibiotics. The main driver of the community’s demand for antibiotics was a mistaken belief in the benefits of antibiotics for a common cold, high temperature, pain, malaria and ‘Roleak’ which includes a broad catch-all for perceived inflammatory conditions. For severe illnesses, patients would attend a community healthcare centre, hospital, or when their finances permitted, a private prescriber

  14. Handling Time-dependent Variables : Antibiotics and Antibiotic Resistance

    NARCIS (Netherlands)

    Munoz-Price, L. Silvia; Frencken, Jos F.; Tarima, Sergey; Bonten, Marc

    2016-01-01

    Elucidating quantitative associations between antibiotic exposure and antibiotic resistance development is important. In the absence of randomized trials, observational studies are the next best alternative to derive such estimates. Yet, as antibiotics are prescribed for varying time periods,

  15. Hybrid antibiotics - clinical progress and novel designs.

    Science.gov (United States)

    Parkes, Alastair L; Yule, Ian A

    2016-07-01

    There is a growing need for new antibacterial agents, but success in development of antibiotics in recent years has been limited. This has led researchers to investigate novel approaches to finding compounds that are effective against multi-drug resistant bacteria, and that delay onset of resistance. One such strategy has been to link antibiotics to produce hybrids designed to overcome resistance mechanisms. The concept of dual-acting hybrid antibiotics was introduced and reviewed in this journal in 2010. In the present review the authors sought to discover how clinical candidates described had progressed, and to examine how the field has developed. In three sections the authors cover the clinical progress of hybrid antibiotics, novel agents produced from hybridisation of two or more small-molecule antibiotics, and novel agents produced from hybridisation of antibiotics with small-molecules that have complementary activity. Many key questions regarding dual-acting hybrid antibiotics remain to be answered, and the proposed benefits of this approach are yet to be demonstrated. While Cadazolid in particular continues to progress in the clinic, suggesting that there is promise in hybridisation through covalent linkage, it may be that properties other than antibacterial activity are key when choosing a partner molecule.

  16. Antibiotic use and resistance in emerging economies: a situation analysis for Viet Nam.

    Science.gov (United States)

    Nguyen, Kinh Van; Thi Do, Nga Thuy; Chandna, Arjun; Nguyen, Trung Vu; Pham, Ca Van; Doan, Phuong Mai; Nguyen, An Quoc; Thi Nguyen, Chuc Kim; Larsson, Mattias; Escalante, Socorro; Olowokure, Babatunde; Laxminarayan, Ramanan; Gelband, Hellen; Horby, Peter; Thi Ngo, Ha Bich; Hoang, Mai Thanh; Farrar, Jeremy; Hien, Tran Tinh; Wertheim, Heiman F L

    2013-12-10

    Antimicrobial resistance is a major contemporary public health threat. Strategies to contain antimicrobial resistance have been comprehensively set forth, however in developing countries where the need for effective antimicrobials is greatest implementation has proved problematic. A better understanding of patterns and determinants of antibiotic use and resistance in emerging economies may permit more appropriately targeted interventions.Viet Nam, with a large population, high burden of infectious disease and relatively unrestricted access to medication, is an excellent case study of the difficulties faced by emerging economies in controlling antimicrobial resistance. Our working group conducted a situation analysis of the current patterns and determinants of antibiotic use and resistance in Viet Nam. International publications and local reports published between 1-1-1990 and 31-8-2012 were reviewed. All stakeholders analyzed the findings at a policy workshop and feasible recommendations were suggested to improve antibiotic use in Viet Nam.Here we report the results of our situation analysis focusing on: the healthcare system, drug regulation and supply; antibiotic resistance and infection control; and agricultural antibiotic use. Market reforms have improved healthcare access in Viet Nam and contributed to better health outcomes. However, increased accessibility has been accompanied by injudicious antibiotic use in hospitals and the community, with predictable escalation in bacterial resistance. Prescribing practices are poor and self-medication is common - often being the most affordable way to access healthcare. Many policies exist to regulate antibiotic use but enforcement is insufficient or lacking.Pneumococcal penicillin-resistance rates are the highest in Asia and carbapenem-resistant bacteria (notably NDM-1) have recently emerged. Hospital acquired infections, predominantly with multi-drug resistant Gram-negative organisms, place additional strain on

  17. Generic antibiotic industries: Challenges and implied strategies with regulatory perspectives

    Directory of Open Access Journals (Sweden)

    M Venkatesh

    2011-01-01

    Full Text Available Ever since the discovery of antibiotics, the quality of human life greatly improved in the 20 th century. The discovery of penicillin transformed the medicine industry and initiated a search for a better antibiotic every time resulting in several synthetic and semi-synthetic antibiotics. Beginning with the 1937 sulfa drug tragedy, the drug regulations had a parallel growth along with the antibiotics and the antibiotic-based generic Pharma industries. This review article is focused on the scenario depicting current global Pharma industries based on generic antibiotics. Several regulatory aspects involved with these industries have been discussed along with the complexity of the market, issues that could affect their growth, their struggle for quality, and their compliance with the tightened regulations. With the skyrocketing commercialization of antibiotics through generics and the leveraging technologic renaissance, generic industries are involved in providing maximum safer benefits for the welfare of the people, highlighting its need today.

  18. Nonmedical Uses of Antibiotics: Time to Restrict Their Use?

    Science.gov (United States)

    Meek, Richard William; Vyas, Hrushi; Piddock, Laura Jane Violet

    2015-10-01

    The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted.

  19. Nonmedical Uses of Antibiotics: Time to Restrict Their Use?

    Directory of Open Access Journals (Sweden)

    Richard William Meek

    2015-10-01

    Full Text Available The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted.

  20. Generic antibiotic industries: Challenges and implied strategies with regulatory perspectives

    Science.gov (United States)

    Venkatesh, M.; Bairavi, V. G.; Sasikumar, K. C.

    2011-01-01

    Ever since the discovery of antibiotics, the quality of human life greatly improved in the 20th century. The discovery of penicillin transformed the medicine industry and initiated a search for a better antibiotic every time resulting in several synthetic and semi-synthetic antibiotics. Beginning with the 1937 sulfa drug tragedy, the drug regulations had a parallel growth along with the antibiotics and the antibiotic-based generic Pharma industries. This review article is focused on the scenario depicting current global Pharma industries based on generic antibiotics. Several regulatory aspects involved with these industries have been discussed along with the complexity of the market, issues that could affect their growth, their struggle for quality, and their compliance with the tightened regulations. With the skyrocketing commercialization of antibiotics through generics and the leveraging technologic renaissance, generic industries are involved in providing maximum safer benefits for the welfare of the people, highlighting its need today.. PMID:21430959

  1. Botanical alternatives to antibiotics for use in organic poultry production.

    Science.gov (United States)

    Diaz-Sanchez, Sandra; D'Souza, Doris; Biswas, Debrabrata; Hanning, Irene

    2015-06-01

    The development of antibiotic resistant pathogens has resulted from the use of sub-therapeutic concentrations of antibiotics delivered in poultry feed. Furthermore, there are a number of consumer concerns regarding the use of antibiotics in food animals including residue contamination of poultry products and antibiotic resistant bacterial pathogens. These issues have resulted in recommendations to reduce the use of antibiotics as growth promoters in livestock in the United States. Unlike conventional production, organic systems are not permitted to use antibiotics. Thus, both conventional and organic poultry production need alternative methods to improve growth and performance of poultry. Herbs, spices, and various other plant extracts are being evaluated as alternatives to antibiotics and some do have growth promoting effects, antimicrobial properties, and other health-related benefits. This review aims to provide an overview of herbs, spices, and plant extracts, currently defined as phytobiotics as potential feed additives. © 2015 Poultry Science Association Inc.

  2. [Antibiotics: present and future].

    Science.gov (United States)

    Bérdy, János

    2013-04-14

    The author discuss the up to date interpretation of the concept of antibiotics and antibiotic research, as well as the present role of various natural, semisynthetic and synthetic antibiotic compounds in various areas of the human therapy. The origin and the total number of all antibiotics and applied antibiotics in the practice, as well as the bioactive microbial metabolites (antibiotics) in other therapeutical, non-antibiotic fields (including agriculture) are also reviewed. The author discusses main problems, such as increasing (poly)resistance, virulence of pathogens and the non-scientific factors (such as a decline of research efforts and their sociological, economic, financial and regulatory reasons). A short summary of the history of Hungarian antibiotic research is also provided. The author briefly discusses the prospects in the future and the general advantages of the natural products over synthetic compounds. It is concluded that new approaches for the investigation of the unlimited possibilities of the living world are necessary. The discovery of new types or simply neglected (micro)organisms and their biosynthetic capabilities, the introduction of new biotechnological and genetic methods (genomics, metagenom, genome mining) are absolutely required in the future.

  3. Bacterial biofilms and antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Liliana Caldas-Arias

    2015-04-01

    Full Text Available Biofilms give to bacteria micro-environmental benefits; confers protection against antimicrobials. Bacteria have antibiotic resistance by conventional and unusual mechanisms leading to delayed wound healing, to increase recurrent chronic infections and nosocomial contamination of medical devices. Objective: This narrative review aims to introduce the characteristics of Bacteria-biofilms, antimicrobial resistance mechanisms and potential alternatives for prevention and control of its formation. Methods: Search strategy was performed on records: PubMed / Medline, Lilacs, Redalyc; with suppliers such as EBSCO and thesaurus MeSH and DeCS. Conclusions: Knowledge and research performance of biofilm bacteria are relevant in the search of technology for detection and measuring sensitivity to antibiotics. The identification of Bacterial-biofilms needs no-traditional microbiological diagnosis.

  4. Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014

    Directory of Open Access Journals (Sweden)

    Sumanth Gandra

    2016-09-01

    Conclusion: Increasing resistance to antibiotics of last-resort, particularly among Gram-negatives, suggests an urgent need for new antibiotics and improved antimicrobial stewardship programs in India.

  5. Antibiotics in acute necrotizing pancreatitis --- perspective of a developing country

    International Nuclear Information System (INIS)

    Khan, A.; Khan, S.

    2010-01-01

    Prophylactic antibiotics in acute necrotizing pancreatitis is controversial. The mortality of acute necrotizing pancreatitis is 8-25% in the western world. In view of the limited resources available for managing the complications of infected pancreatitis in developing countries, the use of prophylactic antibiotics may be recommended in selected cases. Various antibiotics show good penetration into the pancreatic tissue; imipenem and quinolones have better penetration. Clinical trials on the use of prophylactic antibiotics in necrotizing pancreatitis have been reviewed. Prophylactic antibiotics have been considered if greater than 30% pancreatic necrosis as documented by CT scan. Imipenem can be given for a duration of 10 to 14 days if no systemic complications are present. In a developing country where the cost of managing complications of pancreatitis can be a limiting factor for patients, the use of prophylactic antibiotics early on in the disease in selected cases can be beneficial. (author)

  6. History of Antibiotics Research.

    Science.gov (United States)

    Mohr, Kathrin I

    2016-01-01

    For thousands of years people were delivered helplessly to various kinds of infections, which often reached epidemic proportions and have cost the lives of millions of people. This is precisely the age since mankind has been thinking of infectious diseases and the question of their causes. However, due to a lack of knowledge, the search for strategies to fight, heal, and prevent the spread of communicable diseases was unsuccessful for a long time. It was not until the discovery of the healing effects of (antibiotic producing) molds, the first microscopic observations of microorganisms in the seventeenth century, the refutation of the abiogenesis theory, and the dissolution of the question "What is the nature of infectious diseases?" that the first milestones within the history of antibiotics research were set. Then new discoveries accelerated rapidly: Bacteria could be isolated and cultured and were identified as possible agents of diseases as well as producers of bioactive metabolites. At the same time the first synthetic antibiotics were developed and shortly thereafter, thousands of synthetic substances as well as millions of soil borne bacteria and fungi were screened for bioactivity within numerous microbial laboratories of pharmaceutical companies. New antibiotic classes with different targets were discovered as on assembly line production. With the beginning of the twentieth century, many of the diseases which reached epidemic proportions at the time-e.g., cholera, syphilis, plague, tuberculosis, or typhoid fever, just to name a few, could be combatted with new discovered antibiotics. It should be considered that hundred years ago the market launch of new antibiotics was significantly faster and less complicated than today (where it takes 10-12 years in average between the discovery of a new antibiotic until the launch). After the first euphoria it was quickly realized that bacteria are able to develop, acquire, and spread numerous resistance mechanisms

  7. Antibiotics in Canadian poultry productions and anticipated alternatives

    Directory of Open Access Journals (Sweden)

    Moussa Sory Diarra

    2014-06-01

    Full Text Available The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics in feed (growth promoters need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can easily spread within microbial communities. In Canada, poultry production involves more than 2,600 regulated chicken producers. There are several antibiotics approved as feed additives available for poultry farmers. Feed recipes and mixtures greatly vary geographically and from one farm to another, making links between use of a specific antibiotic feed additive and production yields or selection of specific antibiotic-resistant bacteria difficult to establish. Many on-farm studies have revealed the widespread presence of antibiotic-resistant bacteria in broiler chickens. While sporadic reports linked the presence of antibiotic-resistant organisms to the use of feed supplemented with antibiotics, no recent studies could clearly demonstrate the benefit of antimicrobial growth promoters on performance and production yields. With modern biosecurity and hygienic practices, there is a genuine concern that intensive utilization of antibiotics or use of antimicrobial growth promoters in feed might no longer be useful. Public pressure and concerns about food and environmental safety (antibiotic residues, antibiotic-resistant pathogens have driven researchers to actively look for alternatives to antibiotics. Some of the alternatives include pre- and probiotics, organic acids and essential oils. We will describe here the properties of some bioactive molecules, like those found in cranberry, which have shown interesting polyvalent antibacterial and immuno

  8. Antibiotics for mastitis in breastfeeding women

    Directory of Open Access Journals (Sweden)

    Shayesteh Jahanfar

    Full Text Available ABSTRACT: BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus . The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment. OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation. METHODS: Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012, contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles. Selection criteria: We selected randomised controlled trials (RCTs and quasi-RCTs comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author. MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25 compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as 'supportive therapy' versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic. AUTHORS CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded RCTs to determine whether antibiotics should be used in this

  9. Public Beliefs about Antibiotics, Infection and Resistance: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Helen Madden

    2013-11-01

    Full Text Available We aimed to gain an in-depth understanding of public views and ways of talking about antibiotics. Four focus groups were held with members of the public. In addition, 39 households were recruited and interviews, diaries of medicine taking, diaries of any contact with medication were used to explore understanding and use of medication. Discussions related to antibiotics were identified and analyzed. Participants in this study were worried about adverse effects of antibiotics, particularly for recurrent infections. Some were concerned that antibiotics upset the body’s “balance”, and many used strategies to try to prevent and treat infections without antibiotics. They rarely used military metaphors about infection (e.g., describing bacteria as invading armies but instead spoke of clearing infections. They had little understanding of the concept of antibiotic resistance but they thought that over-using antibiotics was unwise because it would reduce their future effectiveness. Previous studies tend to focus on problems such as lack of knowledge, or belief in the curative powers of antibiotics for viral illness, and neglect the concerns that people have about antibiotics, and the fact that many people try to avoid them. We suggest that these concerns about antibiotics form a resource for educating patients, for health promotion and social marketing strategies.

  10. Antibiotic Application and Emergence of Multiple Antibiotic Resistance (MAR) in Global Catfish Aquaculture.

    Science.gov (United States)

    Chuah, Li-Oon; Effarizah, M E; Goni, Abatcha Mustapha; Rusul, Gulam

    2016-06-01

    Catfish is one of the most cultivated species worldwide. Antibiotics are usually used in catfish farming as therapeutic and prophylactic agents. In the USA, only oxytetracycline, a combination of sulfadimethoxine and ormetoprim, and florfenicol are approved by the Food Drug Administration for specific fish species (e.g., catfish and salmonids) and their specific diseases. Misuse of antibiotics as prophylactic agents in disease prevention, however, is common and contributes in the development of antibiotic resistance. Various studies had reported on antibiotic residues and/or resistance in farmed species, feral fish, water column, sediments, and, in a lesser content, among farm workers. Ninety percent of the world aquaculture production is carried out in developing countries, which lack regulations and enforcement on the use of antibiotics. Hence, efforts are needed to promote the development and enforcement of such a regulatory structure. Alternatives to antibiotics such as antibacterial vaccines, bacteriophages and their lysins, and probiotics have been applied to curtail the increasing emergence of antibiotic-resistant bacteria due to the imprudent application of antibiotics in aquaculture.

  11. Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.

    Directory of Open Access Journals (Sweden)

    Martha Ingrid Preddie

    2008-03-01

    one correct answer was due to the answers from 5 (10.9% questions changing from correct to incorrect, while the answers to 6 questions (13.0% changed from incorrect to correct. The ability to provide correct answers differed among the various resources. Google and Cochrane provided the correct answers about 50% of the time while PubMed, Ovid MEDLINE, UpToDate, Ovid Evidence Based Medicine Reviews and InfoPOEMs were more likely to be associated with incorrect answers. Physicians also seemed unable to determine when they needed to search for informationi n order to make an accurate decision.Conclusion – Clinician‐selected electronic information resources did not guarantee accuracy in the answers provided to simulated clinical questions. At times the use of these resources caused physicians to change self‐determined correct answers to incorrect ones. The authors state that this was possibly due to factors such as poor choice of resources, ineffective search strategies, time constraints and automation bias. Library and information practitioners have an important role to play in identifying and advocating for appropriate information resources to be integrated into the electronic medical record systems provided by healthcare institutions to ensure evidence based health care delivery.

  12. Injudicious Provision of Subtherapeutic Doses of Antibiotics in Community Pharmacies

    Directory of Open Access Journals (Sweden)

    Mohamed E Amin

    2017-02-01

    Results: The simulated client visited 104 pharmacies and was sold an antibiotic at 68 pharmacies in total. A cold group with one or more antibiotic pills was provided in 31 pharmacies. Upon request for two antibiotic pills, 2-8 antibiotic pills were provided in 30 pharmacies whereas an antibiotic carton was provided in three pharmacies. In four pharmacies, the simulated client was sold a cold group containing an antibiotic as well as another antibiotic upon request. Beta-lactam antibiotics comprised 76% of antibiotics provided. In five encounters, the simulated client was told that the cold group contained an antibiotic when, in fact, it did not. Conclusions: Subtherapeutic doses of antibiotics are provided at dangerous rates in Alexandria’s community pharmacies. Interventions are urgently needed to tackle different factors contributing to this dangerous practice. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Original Research

  13. Antibiotics for acute maxillary sinusitis in adults.

    Science.gov (United States)

    Ahovuo-Saloranta, Anneli; Rautakorpi, Ulla-Maija; Borisenko, Oleg V; Liira, Helena; Williams, John W; Mäkelä, Marjukka

    2014-02-11

    ). Five studies at low risk of bias comparing penicillin or amoxicillin to placebo provided information on the main outcome: clinical failure rate at 7 to 15 days follow-up, defined as a lack of full recovery or improvement, for participants with symptoms lasting at least seven days. In these studies antibiotics decreased the risk of clinical failure (pooled RR of 0.66, 95% CI 0.47 to 0.94, 1084 participants randomised, 1058 evaluated, moderate quality evidence). However, the clinical benefit was small. Cure or improvement rates were high in both the placebo group (86%) and the antibiotic group (91%) in these five studies. When clinical failure was defined as a lack of full recovery (n = five studies), results were similar: antibiotics decreased the risk of failure (pooled RR of 0.73, 95% CI 0.63 to 0.85, high quality evidence) at 7 to 15 days follow-up.Adverse effects in seven of the nine placebo-controlled studies (comparing penicillin, amoxicillin, azithromycin or moxicillin to placebo) were more common in antibiotic than in placebo groups (median of difference between groups 10.5%, range 2% to 23%). However, drop-outs due to adverse effects were rare in both groups: 1.5% in antibiotic groups and 1% in control groups.In the 10 head-to-head comparisons, none of the antibiotic preparations were superior to another. However, amoxicillin-clavulanate had significantly more drop-outs due to adverse effects than cephalosporins and macrolides. There is moderate evidence that antibiotics provide a small benefit for clinical outcomes in immunocompetent primary care patients with uncomplicated acute sinusitis. However, about 80% of participants treated without antibiotics improved within two weeks. Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects at both the individual and general population levels.

  14. Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries.

    Science.gov (United States)

    Stenberg, Karin; Hanssen, Odd; Edejer, Tessa Tan-Torres; Bertram, Melanie; Brindley, Callum; Meshreky, Andreia; Rosen, James E; Stover, John; Verboom, Paul; Sanders, Rachel; Soucat, Agnès

    2017-09-01

    The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries' advancement towards global targets is constrained by their health system's assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability. We estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario-the equivalent of an additional $41 (range 15-102) or $58 (22-167) per person, respectively, by the final years of scale-up. In the ambitious scenario, total health-care spending would increase to a population-weighted mean of $271 per person (range 74-984) across country contexts, and the share of gross

  15. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions

    NARCIS (Netherlands)

    Leibovici, Leonard; Paul, Mical; Garner, Paul; Sinclair, David J; Afshari, Arash; Pace, Nathan Leon; Cullum, Nicky; Williams, Hywel C; Smyth, Alan; Skoetz, Nicole; Del Mar, Chris; Schilder, Anne G M; Yahav, Dafna; Tovey, David

    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies. This

  16. Fighting antibiotic resistance in the intensive care unit using antibiotics.

    Science.gov (United States)

    Plantinga, Nienke L; Wittekamp, Bastiaan H J; van Duijn, Pleun J; Bonten, Marc J M

    2015-01-01

    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to classical infection prevention protocols and surveillance programs, counterintuitive interventions, such as selective decontamination with antibiotics and antibiotic rotation have been applied and investigated to control the emergence of antibiotic resistance. This review provides an overview of selective oropharyngeal and digestive tract decontamination, decolonization of methicillin-resistant Staphylococcus aureus and antibiotic rotation as strategies to modulate antibiotic resistance in the intensive care unit.

  17. Macrolide antibiotics for bronchiectasis.

    Science.gov (United States)

    Kelly, Carol; Chalmers, James D; Crossingham, Iain; Relph, Nicola; Felix, Lambert M; Evans, David J; Milan, Stephen J; Spencer, Sally

    2018-03-15

    Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance. To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis. We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial registries and reference lists of primary studies. We conducted all searches on 18 January 2018. We included randomised controlled trials (RCTs) of at least four weeks' duration that compared macrolide antibiotics with placebo or no intervention for the long-term management of stable bronchiectasis in adults or children with a diagnosis of bronchiectasis by bronchography, plain film chest radiograph, or high-resolution computed tomography. We excluded studies in which participants had received continuous or high-dose antibiotics immediately before enrolment or before a diagnosis of cystic fibrosis, sarcoidosis, or allergic bronchopulmonary aspergillosis. Our primary outcomes were exacerbation, hospitalisation, and serious adverse events. Two review authors independently screened the titles and abstracts of 103 records. We independently screened the full text of 40 study reports and included 15 trials from 30 reports. Two review authors independently extracted outcome data and assessed risk of bias for each study. We analysed

  18. A Standardized Needs Assessment Tool to Inform the Curriculum Development Process for Pediatric Resuscitation Simulation-Based Education in Resource-Limited Settings

    Directory of Open Access Journals (Sweden)

    Nicole Shilkofski

    2018-02-01

    burden reported by respondents was relatively consistent with WHO country-specific UFMR statistics in each setting. Results of the needs assessment survey were subsequently used to refine goals and objectives for the simulation curriculum and to ensure delivery of pragmatic educational content with recommendations that were contextualized for local capacity and resource availability. Effective use of the tool in two different settings increases its potential generalizability.

  19. Selection of antibiotic resistance at very low antibiotic concentrations

    OpenAIRE

    Sandegren, Linus

    2014-01-01

    Human use of antibiotics has driven the selective enrichment of pathogenic bacteria resistant to clinically used drugs. Traditionally, the selection of resistance has been considered to occur mainly at high, therapeutic levels of antibiotics, but we are now beginning to understand better the importance of selection of resistance at low levels of antibiotics. The concentration of an antibiotic varies in different body compartments during treatment, and low concentrations of antibiotics are fou...

  20. Antibiotic alternatives: the substitution of antibiotics in animal husbandry?

    OpenAIRE

    Cheng, Guyue; Hao, Haihong; Xie, Shuyu; Wang, Xu; Dai, Menghong; Huang, Lingli; Yuan, Zonghui

    2014-01-01

    It is a common practice for decades to use of sub-therapeutic dose of antibiotics in food-animal feeds to prevent animals from diseases and to improve production performance in modern animal husbandry. In the meantime, concerns over the increasing emergence of antibiotic-resistant bacteria due to the unreasonable use of antibiotics and an appearance of less novelty antibiotics have prompted efforts to develop so-called alternatives to antibiotics. Whether or not the alternatives could really ...

  1. Microfluidics for Antibiotic Susceptibility and Toxicity Testing

    Directory of Open Access Journals (Sweden)

    Jing Dai

    2016-10-01

    Full Text Available The recent emergence of antimicrobial resistance has become a major concern for worldwide policy makers as very few new antibiotics have been developed in the last twenty-five years. To prevent the death of millions of people worldwide, there is an urgent need for a cheap, fast and accurate set of tools and techniques that can help to discover and develop new antimicrobial drugs. In the past decade, microfluidic platforms have emerged as potential systems for conducting pharmacological studies. Recent studies have demonstrated that microfluidic platforms can perform rapid antibiotic susceptibility tests to evaluate antimicrobial drugs’ efficacy. In addition, the development of cell-on-a-chip and organ-on-a-chip platforms have enabled the early drug testing, providing more accurate insights into conventional cell cultures on the drug pharmacokinetics and toxicity, at the early and cheaper stage of drug development, i.e., prior to animal and human testing. In this review, we focus on the recent developments of microfluidic platforms for rapid antibiotics susceptibility testing, investigating bacterial persistence and non-growing but metabolically active (NGMA bacteria, evaluating antibiotic effectiveness on biofilms and combinatorial effect of antibiotics, as well as microfluidic platforms that can be used for in vitro antibiotic toxicity testing.

  2. Discovery and preclinical development of new antibiotics.

    Science.gov (United States)

    Hughes, Diarmaid; Karlén, Anders

    2014-05-01

    Antibiotics are the medical wonder of our age, but an increasing frequency of resistance among key pathogens is rendering them less effective. If this trend continues the consequences for cancer patients, organ transplant patients, and indeed the general community could be disastrous. The problem is complex, involving abuse and overuse of antibiotics (selecting for an increasing frequency of resistant bacteria), together with a lack of investment in discovery and development (resulting in an almost dry drug development pipeline). Remedial approaches to the problem should include taking measures to reduce the selective pressures for resistance development, and taking measures to incentivize renewed investment in antibiotic discovery and development. Bringing new antibiotics to the clinic is critical because this is currently the only realistic therapy that can ensure the level of infection control required for many medical procedures. Here we outline the complex process involved in taking a potential novel antibiotic from the initial discovery of a hit molecule, through lead and candidate drug development, up to its entry into phase I clinical trials. The stringent criteria that a successful drug must meet, balancing high efficacy in vivo against a broad spectrum of pathogens, with minimal liabilities against human targets, explain why even with sufficient investment this process is prone to a high failure rate. This emphasizes the need to create a well-funded antibiotic discovery and development pipeline that can sustain the continuous delivery of novel candidate drugs into clinical trials, to ensure the maintenance of the advanced medical procedures we currently take for granted.

  3. Necessity of Antibiotics following Simple Exodontia

    Directory of Open Access Journals (Sweden)

    Waqas Yousuf

    2016-01-01

    Full Text Available Introduction. The aim of our study is to assess the need for postoperative antibiotics following simple exodontia and determine its role in minimizing patient discomfort and postoperative complications. Material and Methods. All the patients undergoing simple extractions were grouped into two categories: Group 1, patients receiving antibiotics, and Group 2, patients receiving no antibiotics. Patients were recalled on the sixth day to assess postoperative complications. On recall, patients were evaluated for signs of persistent inflammation and signs of dry socket. Presence of persistent inflammation and/or suppuration on the 6th day was considered as wound infection. Results. A total of 146 patients were included in this study. Out of the total sample, 134 (91.8% presented with no postoperative complications and 12 (8.2% had postoperative complications, out of which 11 (7.5% patients presented with dry socket (alveolar osteitis, 5 (3.4% in the antibiotic group and 6 (4.1% in the nonantibiotic group. Only 1 patient (0.7% was reported with infection of the extraction socket in the nonantibiotic group, whereas no case of infection was found in the antibiotic group. Conclusion. Antibiotics are not required after simple extractions in patients who are not medically comprised nor do they have any role in preventing postoperative complications.

  4. Antibiotic-Resistant Gonorrhea

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Gonorrhea Note: Javascript is disabled or is not supported ... on Facebook Sexually Transmitted Diseases (STDs) Antibiotic-Resistant Gonorrhea Recommend on Facebook Tweet Share Compartir Low Resolution ...

  5. Glycopeptide antibiotic biosynthesis.

    Science.gov (United States)

    Yim, Grace; Thaker, Maulik N; Koteva, Kalinka; Wright, Gerard

    2014-01-01

    Glycopeptides such as vancomycin, teicoplanin and telavancin are essential for treating infections caused by Gram-positive bacteria. Unfortunately, the dwindled pipeline of new antibiotics into the market and the emergence of glycopeptide-resistant enterococci and other resistant bacteria are increasingly making effective antibiotic treatment difficult. We have now learned a great deal about how bacteria produce antibiotics. This information can be exploited to develop the next generation of antimicrobials. The biosynthesis of glycopeptides via nonribosomal peptide assembly and unusual amino acid synthesis, crosslinking and tailoring enzymes gives rise to intricate chemical structures that target the bacterial cell wall. This review seeks to describe recent advances in our understanding of both biosynthesis and resistance of these important antibiotics.

  6. Antibiotics for uncomplicated diverticulitis

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel M; Wille-Jørgensen, Peer

    2012-01-01

    Diverticulitis is an inflammatory complication to the very common condition diverticulosis. Uncomplicated diverticulitis has traditionally been treated with antibiotics with reference to the microbiology, extrapolation from trials on complicated intra-abdominal infections and clinical experience....

  7. Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice.

    Science.gov (United States)

    Lum, Elaine P M; Page, Katie; Nissen, Lisa; Doust, Jenny; Graves, Nicholas

    2017-10-10

    Consumers receive over 27 million antibiotic prescriptions annually in Australian primary healthcare. Hence, consumers are a key group to engage in the fight against antibiotic resistance. There is a paucity of research pertaining to consumers in the Australian healthcare environment. This study aimed to investigate the perspectives, attitudes and behaviours of Australian consumers on antibiotic use and antibiotic resistance, to inform national programs for reducing inappropriate antibiotic consumption. Semi-structured interviews with 32 consumers recruited via convenience and snowball sampling from a university population in South East Queensland. Interview transcripts were deductively and inductively coded. Main themes were identified using iterative thematic analysis. Three themes emerged from the analysis, to elucidate factors affecting antibiotic use: (a) prescription type; (b) consumer attitudes, behaviours, skills and knowledge; and (c) consumer engagement with antibiotic resistance. Consumers held mixed views regarding the use of delayed antibiotic prescriptions, and were often not made aware of the use of repeat antibiotic prescriptions. Consumers with regular general practitioners were more likely to have shared expectations regarding minimising the use of antibiotics. Even so, advice or information mediated by general practitioners was influential with all consumers; and helped to prevent inappropriate antibiotic use behaviours. Consumers were not aware of the free Return of Unwanted Medicines service offered by pharmacies and disposed of leftover antibiotics through household waste. To engage with mitigating antibiotic resistance, consumers required specific information. Previous public health campaigns raising awareness of antibiotics were largely not seen by this sample of consumers. Australian consumers have specific information needs regarding prescribed antibiotics to enable appropriate antibiotic use behaviours. Consumers also have expectations

  8. Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice

    Directory of Open Access Journals (Sweden)

    Elaine P. M. Lum

    2017-10-01

    Full Text Available Abstract Background Consumers receive over 27 million antibiotic prescriptions annually in Australian primary healthcare. Hence, consumers are a key group to engage in the fight against antibiotic resistance. There is a paucity of research pertaining to consumers in the Australian healthcare environment. This study aimed to investigate the perspectives, attitudes and behaviours of Australian consumers on antibiotic use and antibiotic resistance, to inform national programs for reducing inappropriate antibiotic consumption. Method Semi-structured interviews with 32 consumers recruited via convenience and snowball sampling from a university population in South East Queensland. Interview transcripts were deductively and inductively coded. Main themes were identified using iterative thematic analysis. Results Three themes emerged from the analysis, to elucidate factors affecting antibiotic use: (a prescription type; (b consumer attitudes, behaviours, skills and knowledge; and (c consumer engagement with antibiotic resistance. Consumers held mixed views regarding the use of delayed antibiotic prescriptions, and were often not made aware of the use of repeat antibiotic prescriptions. Consumers with regular general practitioners were more likely to have shared expectations regarding minimising the use of antibiotics. Even so, advice or information mediated by general practitioners was influential with all consumers; and helped to prevent inappropriate antibiotic use behaviours. Consumers were not aware of the free Return of Unwanted Medicines service offered by pharmacies and disposed of leftover antibiotics through household waste. To engage with mitigating antibiotic resistance, consumers required specific information. Previous public health campaigns raising awareness of antibiotics were largely not seen by this sample of consumers. Conclusions Australian consumers have specific information needs regarding prescribed antibiotics to enable

  9. Phenotypic Resistance to Antibiotics

    Directory of Open Access Journals (Sweden)

    Jose L. Martinez

    2013-04-01

    Full Text Available The development of antibiotic resistance is usually associated with genetic changes, either to the acquisition of resistance genes, or to mutations in elements relevant for the activity of the antibiotic. However, in some situations resistance can be achieved without any genetic alteration; this is called phenotypic resistance. Non-inherited resistance is associated to specific processes such as growth in biofilms, a stationary growth phase or persistence. These situations might occur during infection but they are not usually considered in classical susceptibility tests at the clinical microbiology laboratories. Recent work has also shown that the susceptibility to antibiotics is highly dependent on the bacterial metabolism and that global metabolic regulators can modulate this phenotype. This modulation includes situations in which bacteria can be more resistant or more susceptible to antibiotics. Understanding these processes will thus help in establishing novel therapeutic approaches based on the actual susceptibility shown by bacteria during infection, which might differ from that determined in the laboratory. In this review, we discuss different examples of phenotypic resistance and the mechanisms that regulate the crosstalk between bacterial metabolism and the susceptibility to antibiotics. Finally, information on strategies currently under development for diminishing the phenotypic resistance to antibiotics of bacterial pathogens is presented.

  10. Strategies to Minimize Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Sang Hee Lee

    2013-09-01

    Full Text Available Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs and various data such as pharmacokinetic (PK and pharmacodynamic (PD properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST, clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care, the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing. The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

  11. Projected impacts of climate change on hydrology, water resource use and adaptation needs for the Chu and Talas cross-border rivers basin, Central Asia

    Science.gov (United States)

    Shamil Iliasov, Shamil; Dolgikh, Svetlana; Lipponen, Annukka; Novikov, Viktor

    2014-05-01

    The observed long-term trends, variability and projections of future climate and hydrology of the Chu and Talas transboundary rivers basin were analysed using a common approach for Kazakhstan and Kyrgyzstan parts of the basin. Historical, current and forecasted demands and main uses of water in the basin were elaborated by the joint effort of both countries. Such cooperative approach combining scientific data, water practitioners' outlook with decision making needs allowed the first time to produce a comprehensive assessment of climate change impacts on water resources in the Chu-Talas transboundary rivers basin, identify future needs and develop the initial set of adaptation measures and recommendations. This work was carried out under the project "Promoting Cooperation to Adapt to Climate Change in the Chu and Talas Transboundary Basin", supported by the United Nations Economic Commission for Europe (UNECE) and the United Nations Development Programme (UNDP). Climate change projections, including air temperatures and rainfall in the 21st century were determined with a spatial resolution 0.5 degrees based on the integration of 15 climate change model outputs (derived from IPCC's 4th Assessment Report, and partially 5th Assessment Report) combined with locally-designed hydrology and glacier models. A significant increase in surface air temperatures by 3-6°C may be expected in the basin area, especially in summer and autumn. This change is likely to be accompanied by rainfall increase during the cold season and a decrease in the warm half of the year. As a result, a deterioration of moisture conditions during the summer-autumn period is possible. Furthermore, milder winters and hotter summers can be expected. Mountains will likely receive more liquid precipitation, than snow, while the area and volume of glaciers may significantly reduce. Projected changes in climate and glaciers have implications for river hydrology and different sectors of the economy dependent

  12. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As All specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants; In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  13. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As all specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants;In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  14. Use of antibiotics in paediatric long-term care facilities.

    Science.gov (United States)

    Murray, M T; Johnson, C L; Cohen, B; Jackson, O; Jones, L K; Saiman, L; Larson, E L; Neu, N

    2018-06-01

    Adult long-term care (LTC) facilities have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC facilities. To describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. A retrospective cohort study was conducted from September 2012 to December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAIs), antimicrobial use and diagnostic testing. Logistic regression was used to identify predictors for antibiotic use. The association between susceptibility testing results and appropriate antibiotic coverage was determined using Chi-squared test. Fifty-eight percent (413/717) of residents had at least one HAI, and 79% (325/413) of these residents were treated with at least one antibiotic course, totalling 2.75 antibiotic courses per 1000 resident-days. Length of enrolment greater than one year, having a neurological disorder, having a tracheostomy, and being hospitalized at least once during the study period were significantly associated with receiving antibiotics when controlling for facility (all P facilities is widespread. There is further need to assess antibiotic use in paediatric LTC facilities. Evaluation of the adverse outcomes associated with inappropriate antibiotic use, including the prevalence of resistant organisms in paediatric LTC facilities, is critical. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. Treatment, promotion, commotion: Antibiotic alternatives in food-producing animals

    Science.gov (United States)

    Alternatives to antibiotics in animal agriculture are urgently needed but present a complex problem because of their various uses: disease treatment, disease prevention, and feed efficiency improvement. Numerous antibiotic alternatives, such as feed amended with pre- and probiotics, have been propos...

  16. Antibiotic Resistance and Antibiotic Resistance Genes in Escherichia coli Isolates from Hospital Wastewater in Vietnam.

    Science.gov (United States)

    Lien, La Thi Quynh; Lan, Pham Thi; Chuc, Nguyen Thi Kim; Hoa, Nguyen Quynh; Nhung, Pham Hong; Thoa, Nguyen Thi Minh; Diwan, Vishal; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

    2017-06-29

    The environmental spread of antibiotic-resistant bacteria has been recognised as a growing public health threat for which hospitals play a significant role. The aims of this study were to investigate the prevalence of antibiotic resistance and antibiotic resistance genes (ARGs) in Escherichia coli isolates from hospital wastewater in Vietnam. Wastewater samples before and after treatment were collected using continuous sampling every month over a year. Standard disk diffusion and E-test were used for antibiotic susceptibility testing. Extended-spectrum beta-lactamase (ESBL) production was tested using combined disk diffusion. ARGs were detected by polymerase chain reactions. Resistance to at least one antibiotic was detected in 83% of isolates; multidrug resistance was found in 32%. The highest resistance prevalence was found for co-trimoxazole (70%) and the lowest for imipenem (1%). Forty-three percent of isolates were ESBL-producing, with the bla TEM gene being more common than bla CTX-M . Co-harbouring of the bla CTX-M , bla TEM and qepA genes was found in 46% of isolates resistant to ciprofloxacin. The large presence of antibiotic-resistant E. coli isolates combined with ARGs in hospital wastewater, even post-treatment, poses a threat to public health. It highlights the need to develop effective processes for hospital wastewater treatment plants to eliminate antibiotic resistant bacteria and ARGs.

  17. Energy needs

    International Nuclear Information System (INIS)

    Maxey, M.N.

    1982-06-01

    There seems to be a trend towards expecting energy conservation to be a panacea for the world's ills. In fact, a global perspective on energy needs shows that more, not less, energy is needed and technological innovation in energy sources is essential in order to meet the needs of more than just the developed countries. Energy-intensive technology is the amplification of our natural resources rather than their depletion. A fundamental bioethical principle must be established if we are to analyze and organize scientific evidence about hazards from currently feasible energy resources, and separate genuine from counterfeit claims to credibility. In particular, public fears about radiation hazards and radioactive waste disposal are influenced too much by rhetorical cleverness and forensic skills of a vociferous minority. Potential hazard management is ethically equitable only if it is proportioned to actual basic harm that can be identified and reduced by expenditures of human effort, time and money

  18. Access to antibiotics in New Delhi, India: implications for antibiotic policy.

    Science.gov (United States)

    Kotwani, Anita; Holloway, Kathleen

    2013-01-01

    generation antibiotics, which may currently be bought without prescription, is likely to lead to their over-use and increased resistance. All providers should follow the EML of whichever of the three concerned Delhi public sector agencies that it is under and these EMLs should follow the essential medicine concept. The Indian regulatory authorities need to consider urgently, drug schedules and pricing policies that will curtail inappropriate access to new generation antibiotics.

  19. Antibiotics for URTI and UTI -- prescribing in Malaysian primary care settings.

    Science.gov (United States)

    Teng, Cheong Lieng; Tong, Seng Fah; Khoo, Ee Ming; Lee, Verna; Zailinawati, Abu Hassan; Mimi, Omar; Chen, Wei Seng; Nordin, Salleh

    2011-05-01

    Overprescription of antibiotics is a continuing problem in primary care. This study aims to assess the antibiotic prescribing rates and antibiotic choices for upper respiratory tract infections (URTI) and urinary tract infections (UTI) in Malaysian primary care. Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia. Analysis was performed of 1,163 URTI and 105 UTI encounters. Antibiotic prescribing rates for URTI and UTI were 33.8% and 57.1% respectively. Antibiotic prescribing rates were higher in private clinics compared to public clinics for URTI, but not for UTI. In URTI encounters, the majority of antibiotics prescribed were penicillins and macrolides, but penicillin V was notably underused. In UTI encounters, the antibiotics prescribed were predominantly penicillins or cotrimoxazole. Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.

  20. How to measure the impacts of antibiotic resistance and antibiotic development on empiric therapy: new composite indices.

    Science.gov (United States)

    Hughes, Josie S; Hurford, Amy; Finley, Rita L; Patrick, David M; Wu, Jianhong; Morris, Andrew M

    2016-12-16

    We aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. As an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto academic intensive care unit. We developed two complementary indices to summarise the clinical impact of antibiotic resistance and drug availability on empiric therapy. The Empiric Coverage Index (ECI) measures susceptibility of common bacterial infections to available empiric antibiotics as a percentage. The Empiric Options Index (EOI) varies from 0 to 'the number of treatment options available', and measures the empiric value of the current stock of antibiotics as a depletable resource. The indices account for drug availability and the relative clinical importance of pathogens. We demonstrate meaning and use by examining the potential impact of new drugs and threatening bacterial strains. In our intensive care unit coverage of device-associated infections measured by the ECI remains high (98%), but 37-44% of treatment potential measured by the EOI has been lost. Without reserved drugs, the ECI is 86-88%. New cephalosporin/β-lactamase inhibitor combinations could increase the EOI, but no single drug can compensate for losses. Increasing methicillin-resistant Staphylococcus aureus (MRSA) prevalence would have little overall impact (ECI=98%, EOI=4.8-5.2) because many Gram-positives are already resistant to β-lactams. Aminoglycoside resistance, however, could have substantial clinical impact because they are among the few drugs that provide coverage of Gram-negative infections (ECI=97%, EOI=3.8-4.5). Our proposed indices summarise the local impact of antibiotic resistance on empiric coverage (ECI) and available empiric treatment options (EOI) using readily available data. Policymakers and drug developers can use the

  1. Antibiotics for acute otitis media in children.

    Science.gov (United States)

    Venekamp, Roderick P; Sanders, Sharon L; Glasziou, Paul P; Del Mar, Chris B; Rovers, Maroeska M

    2015-06-23

    Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 1997 and previously updated in 1999, 2005, 2009 and 2013. To assess the effects of antibiotics for children with AOM. We searched CENTRAL (2015, Issue 3), MEDLINE (1966 to April week 3, 2015), OLDMEDLINE (1958 to 1965), EMBASE (January 1990 to April 2015), Current Contents (1966 to April 2015), CINAHL (2008 to April 2015) and LILACS (2008 to April 2015). Randomised controlled trials (RCTs) comparing 1) antimicrobial drugs with placebo and 2) immediate antibiotic treatment with expectant observation (including delayed antibiotic prescribing) in children with AOM. Two review authors independently assessed trial quality and extracted data. For the review of antibiotics against placebo, 13 RCTs (3401 children and 3938 AOM episodes) from high-income countries were eligible and had generally low risk of bias. The combined results of the trials revealed that by 24 hours from the start of treatment, 60% of the children had recovered whether or not they had placebo or antibiotics. Pain was not reduced by antibiotics at 24 hours (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.78 to 1.01) but almost a third fewer had residual pain at two to three days (RR 0.70, 95% CI 0.57 to 0.86; number needed to treat for an additional beneficial outcome (NNTB) 20). A quarter fewer had pain at four to seven days (RR 0.76, 95% CI 0.63 to 0.91; NNTB 16) and two-thirds fewer had pain at 10 to 12 days (RR 0.33, 95% CI 0.17 to 0.66; NNTB 7) compared with placebo. Antibiotics did reduce the number of children with abnormal tympanometry findings at two to four weeks (RR 0.82, 95% CI 0.74 to 0.90; NNTB 11), at six to eight weeks (RR 0.88, 95% CI 0.78 to 1.00; NNTB 16) and the number of children with tympanic

  2. The multifaceted roles of antibiotics and antibiotic resistance in nature

    Directory of Open Access Journals (Sweden)

    Saswati eSengupta

    2013-03-01

    Full Text Available Antibiotics are chemotherapeutic agents, which have been a very powerful tool in the clinical management of bacterial diseases since the 1940s. However, benefits offered by these magic bullets have been substantially lost in subsequent days following the widespread emergence and dissemination of antibiotic resistant strains. While it is obvious that excessive and imprudent use of antibiotics significantly contributes to the emergence of resistant strains, antibiotic-resistance is also observed in natural bacteria of remote places unlikely to be impacted by human intervention. Both antibiotic biosynthetic genes and resistance-conferring genes have been known to evolve billions of years ago, long before clinical use of antibiotics. Hence it appears that antibiotics and antibiotics resistance determinants have some other roles in nature, which often elude our attention because of overemphasis on the therapeutic importance of antibiotics and the crisis imposed by the antibiotic-resistance in pathogens. In the natural milieu, antibiotics are often found to be present in subinhibitory concentrations acting as signalling molecules supporting quorum sensing and biofilm formation. They also play an important role in the production of virulence factors and influence host-parasite interactions (e.g., phagocytosis, adherence to the target cell and so on. The evolutionary and ecological aspects of antibiotics and antibiotic-resistance in the naturally occurring microbial community are little understood. Therefore, the actual role of antibiotics in nature warrants in-depth investigations. Studies on such an intriguing behaviour of the microorganisms promise insight into the intricacies of the microbial physiology and are likely to provide some lead in controlling the emergence and subsequent dissemination of antibiotic resistance. This article highlights some of the recent findings on the role of antibiotics and genes that confer resistance to antibiotics in

  3. Alternatives to antibiotics-a pipeline portfolio review.

    Science.gov (United States)

    Czaplewski, Lloyd; Bax, Richard; Clokie, Martha; Dawson, Mike; Fairhead, Heather; Fischetti, Vincent A; Foster, Simon; Gilmore, Brendan F; Hancock, Robert E W; Harper, David; Henderson, Ian R; Hilpert, Kai; Jones, Brian V; Kadioglu, Aras; Knowles, David; Ólafsdóttir, Sigríður; Payne, David; Projan, Steve; Shaunak, Sunil; Silverman, Jared; Thomas, Christopher M; Trust, Trevor J; Warn, Peter; Rex, John H

    2016-02-01

    Antibiotics have saved countless lives and enabled the development of modern medicine over the past 70 years. However, it is clear that the success of antibiotics might only have been temporary and we now expect a long-term and perhaps never-ending challenge to find new therapies to combat antibiotic-resistant bacteria. A broader approach to address bacterial infection is needed. In this Review, we discuss alternatives to antibiotics, which we defined as non-compound approaches (products other than classic antibacterial agents) that target bacteria or any approaches that target the host. The most advanced approaches are antibodies, probiotics, and vaccines in phase 2 and phase 3 trials. This first wave of alternatives to antibiotics will probably best serve as adjunctive or preventive therapies, which suggests that conventional antibiotics are still needed. Funding of more than £1·5 billion is needed over 10 years to test and develop these alternatives to antibiotics. Investment needs to be partnered with translational expertise and targeted to support the validation of these approaches in phase 2 trials, which would be a catalyst for active engagement and investment by the pharmaceutical and biotechnology industry. Only a sustained, concerted, and coordinated international effort will provide the solutions needed for the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Mild colonic diverticulitis can be treated without antibiotics. a case-control study

    NARCIS (Netherlands)

    de Korte, N.; Kuyvenhoven, J.P.; van der Peet, D.L.; Felt-Bersma, R.J.F.; Cuesta, M.A.; Stockmann, H.B.A.C.

    2012-01-01

    Aim Conservative treatment of mild colonic diverticulitis usually consists of observation, restriction of oral intake, intravenous fluids and antibiotics. The beneficiary effect of antibiotics remains unclear. The aim of this study is to evaluate the need for antibiotics in mild colonic

  5. Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan.

    Science.gov (United States)

    Darwish, Dana A; Abdelmalek, Suzanne; Abu Dayyih, Wael; Hamadi, Salim

    2014-05-14

    Antimicrobial resistance is a serious global health concern. It has considerable implications on societies' health and resources. In Jordan, there is a large Iraqi community due to the ongoing turmoil in Iraq. Unfortunately, health awareness and practices of this community are under-investigated due to scarcity of research. This paper assesses the awareness of antibiotic use and antimicrobial resistance in the Iraqi community residing in Amman, Jordan. Their level of interaction with health care professionals regarding antibiotics and differences in their antibiotic use between Iraq and Jordan are also discussed. A cross-sectional questionnaire-based survey involving randomly selected Iraqis residing in Amman, Jordan was conducted. The study involved 508 participants. Sixty-two percent of participants agreed with buying antibiotics without a prescription, 29% agreed with obtaining antibiotics from friends or relatives, and 46% agreed with keeping leftover antibiotics for future use. Furthermore, 60% disagreed with not completing an antibiotic course and almost 90% of the sample listed viral diseases as an indication for antibiotics. Forty-four percent of participants abided by physicians' instructions on antibiotic use. Half of the participants believed that pharmacists provided instructions on antibiotics all the time, whereas physicians were perceived to do so by 29% of participants. Gaps exist in knowledge of antibiotic use and reasons for antimicrobial resistance among Iraqis residing in Jordan. These gaps should serve in planning educational campaigns to raise the community's awareness of responsible antibiotic use. Law enforcement to restrict access to antibiotics is also pivotal to tackle their misuse.

  6. Antibiotics and antibiotic resistance in agroecosystems: State of the science

    Science.gov (United States)

    We propose a simple causal model depicting relationships involved in dissemination of antibiotics and antibiotic resistance in agroecosystems and potential effects on human health, functioning of natural ecosystems, and agricultural productivity. Available evidence for each causal link is briefly su...

  7. Overdosing on Antibiotics

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Du, a Beijing resident in her 60s, believes that an antibiotic is a panacea for the maladies of her now 6-year-old grand- daughter Guoguo. Du began to take care of her granddaugh- ter since the child was merely 2 months old, for the gid's parents were busy. She is comfortable with her caretaker duties except when the girl runs high fevers. Then, the anxious grandma will feed the girl antibiotics or take her to a private child clinic nearby for intravenous infusion.

  8. Antibiotics in Animal Products

    Science.gov (United States)

    Falcão, Amílcar C.

    The administration of antibiotics to animals to prevent or treat diseases led us to be concerned about the impact of these antibiotics on human health. In fact, animal products could be a potential vehicle to transfer drugs to humans. Using appropri ated mathematical and statistical models, one can predict the kinetic profile of drugs and their metabolites and, consequently, develop preventive procedures regarding drug transmission (i.e., determination of appropriate withdrawal periods). Nevertheless, in the present chapter the mathematical and statistical concepts for data interpretation are strictly given to allow understanding of some basic pharma-cokinetic principles and to illustrate the determination of withdrawal periods

  9. Efficacy of postoperative prophylactic antibiotics in reducing permanent pacemaker infections.

    Science.gov (United States)

    Lee, Wen-Huang; Huang, Ting-Chun; Lin, Li-Jen; Lee, Po-Tseng; Lin, Chih-Chan; Lee, Cheng-Han; Chao, Ting-Hsing; Li, Yi-Heng; Chen, Ju-Yi

    2017-08-01

    Despite limited evidence, postoperative prophylactic antibiotics are often used in the setting of permanent pacemaker implantation or replacement. The aim of this study is to investigate the efficacy of postoperative antibiotics. Postoperative prophylactic antibiotics may be not clinically useful. We recruited 367 consecutive patients undergoing permanent pacemaker implantation or generator replacement at a tertiary referral center. Baseline demographics, clinical characteristics, and procedure information were collected, and all patients received preoperative prophylactic antibiotics. Postoperative prophylactic antibiotics were administered at the discretion of the treating physician, and all patients were seen in follow-up every 3 to 6 months for an average follow-up period of 16 months. The primary endpoint was device-related infection. A total of 110 patients were treated with preoperative antibiotics only (group 1), whereas 257 patients received both preoperative and postoperative antibiotics (group 2). After a mean follow-up period of 16 months, 1 patient in group 1 (0.9%) and 4 patients in group 2 (1.5%) experienced a device-related infection. There was no significant difference in the rate of infection between the 2 groups (P = 0.624). In the univariate analysis, only the age (60 ± 11 vs 75 ± 12 years, P antibiotics had a similar rate of infection as those treated with preoperative antibiotics alone. Further studies are needed to confirm these preliminary findings. © 2017 Wiley Periodicals, Inc.

  10. Pharmaceutical Approaches to Target Antibiotic Resistance Mechanisms.

    Science.gov (United States)

    Schillaci, Domenico; Spanò, Virginia; Parrino, Barbara; Carbone, Anna; Montalbano, Alessandra; Barraja, Paola; Diana, Patrizia; Cirrincione, Girolamo; Cascioferro, Stella

    2017-10-26

    There is urgent need for new therapeutic strategies to fight the global threat of antibiotic resistance. The focus of this Perspective is on chemical agents that target the most common mechanisms of antibiotic resistance such as enzymatic inactivation of antibiotics, changes in cell permeability, and induction/activation of efflux pumps. Here we assess the current landscape and challenges in the treatment of antibiotic resistance mechanisms at both bacterial cell and community levels. We also discuss the potential clinical application of chemical inhibitors of antibiotic resistance mechanisms as add-on treatments for serious drug-resistant infections. Enzymatic inhibitors, such as the derivatives of the β-lactamase inhibitor avibactam, are closer to the clinic than other molecules. For example, MK-7655, in combination with imipenem, is in clinical development for the treatment of infections caused by carbapenem-resistant Enterobacteriaceae and Pseudomonas aeruginosa, which are difficult to treat. In addition, other molecules targeting multidrug-resistance mechanisms, such as efflux pumps, are under development and hold promise for the treatment of multidrug resistant infections.

  11. Improving antibiotic use in daily hospital practice : The antibiotic checklist

    NARCIS (Netherlands)

    van Daalen, F.V.

    2018-01-01

    Better use of current antibiotic agents is necessary to help control antimicrobial resistance (AMR). Antibiotic stewardship programs (ASPs) are introduced to coordinate activities to measure and improve appropriate antibiotic use in daily hospital practice. This thesis shows how the introduction of

  12. Maltese Antibiotic Stewardship Programme in the Community (MASPIC): protocol of a prospective quasiexperimental social marketing intervention

    OpenAIRE

    Saliba-Gustafsson, Erika A; Borg, Michael A; Rosales-Klintz, Senia; Nyberg, Anna; StålsbyLundborg, Cecilia

    2017-01-01

    Introduction Antibiotic misuse is a key driver of antibiotic resistance. In 2015/2016, Maltese respondents reported the highest proportions of antibiotic consumption in Europe. Since antibiotics are prescription-only medicines in Malta, research on effective strategies targeting general practitioners’ (GPs) knowledge and behaviour is needed. Multifaceted behaviour change (BC) interventions are likely to be effective. Social marketing (SM) can provide the tools to promote sustained BC; however...

  13. Reversing Bacterial Resistance to Antibiotics by Phage-Mediated Delivery of Dominant Sensitive Genes

    OpenAIRE

    Edgar, Rotem; Friedman, Nir; Molshanski-Mor, Shahar; Qimron, Udi

    2012-01-01

    Pathogen resistance to antibiotics is a rapidly growing problem, leading to an urgent need for novel antimicrobial agents. Unfortunately, development of new antibiotics faces numerous obstacles, and a method that resensitizes pathogens to approved antibiotics therefore holds key advantages. We present a proof of principle for a system that restores antibiotic efficiency by reversing pathogen resistance. This system uses temperate phages to introduce, by lysogenization, the genes rpsL and gyrA...

  14. Oral versus inhaled antibiotics for bronchiectasis.

    Science.gov (United States)

    Spencer, Sally; Felix, Lambert M; Milan, Stephen J; Normansell, Rebecca; Goeminne, Pieter C; Chalmers, James D; Donovan, Tim

    2018-03-27

    . Two review authors independently applied study inclusion criteria to the searches and we planned for two authors to independently extract data, assess risk of bias and assess overall quality of the evidence using GRADE criteria. We also planned to obtain missing data from the authors where possible and to report results with 95% confidence intervals (CIs). We identified 313 unique records through database searches and a further 21 records from trial registers. We excluded 307 on the basis of title and abstract alone and a further 27 after examining full-text reports. No studies were identified for inclusion in the review. There is currently no evidence indicating whether orally administered antibiotics are more beneficial compared to inhaled antibiotics. The recent ERS bronchiectasis guidelines provide a practical approach to the use of long-term antibiotics. New research is needed comparing inhaled versus oral antibiotic therapies for bronchiectasis patients with a history of frequent exacerbations, to establish which approach is the most effective in terms of exacerbation prevention, quality of life, treatment burden, and antibiotic resistance.

  15. An assessment of factors influencing the prescribing of antibiotics in ...

    African Journals Online (AJOL)

    Questionnaire study involving patients and general practitioners. Population: ... The patient's views and expectations regarding the need for antibiotics, the doctor's perceptions of .... Table I: Frequency table of patient/parent views. Questions to ...

  16. The KL24 gene cluster and a genomic island encoding a Wzy polymerase contribute genes needed for synthesis of the K24 capsular polysaccharide by the multiply antibiotic resistant Acinetobacter baumannii isolate RCH51.

    Science.gov (United States)

    Kenyon, Johanna J; Kasimova, Anastasiya A; Shneider, Mikhail M; Shashkov, Alexander S; Arbatsky, Nikolay P; Popova, Anastasiya V; Miroshnikov, Konstantin A; Hall, Ruth M; Knirel, Yuriy A

    2017-03-01

    The whole-genome sequence of the multiply antibiotic resistant Acinetobacter baumannii isolate RCH51 belonging to sequence type ST103 (Institut Pasteur scheme) revealed that the set of genes at the capsule locus, KL24, includes four genes predicted to direct the synthesis of 3-acetamido-3,6-dideoxy-d-galactose (d-Fuc3NAc), and this sugar was found in the capsular polysaccharide (CPS). One of these genes, fdtE, encodes a novel bifunctional protein with an N-terminal FdtA 3,4-ketoisomerase domain and a C-terminal acetyltransferase domain. KL24 lacks a gene encoding a Wzy polymerase to link the oligosaccharide K units to form the CPS found associated with isolate RCH51, and a wzy gene was found in a small genomic island (GI) near the cpn60 gene. This GI is in precisely the same location as another GI carrying wzy and atr genes recently found in several A. baumannii isolates, but it does not otherwise resemble it. The CPS isolated from RCH51, studied by sugar analysis and 1D and 2D 1H and 13C NMR spectroscopy, revealed that the K unit has a branched pentasaccharide structure made up of Gal, GalNAc and GlcNAc residues with d-Fuc3NAc as a side branch, and the K units are linked via a β-d-GlcpNAc-(1→3)-β-d-Galp linkage formed by the Wzy encoded by the GI. The functions of the glycosyltransferases encoded by KL24 were assigned to formation of specific bonds. A correspondence between the order of the genes in KL24 and other KL and the order of the linkages they form was noted, and this may be useful in future predictions of glycosyltransferase specificities.

  17. Bacterial cheating limits antibiotic resistance

    Science.gov (United States)

    Xiao Chao, Hui; Yurtsev, Eugene; Datta, Manoshi; Artemova, Tanya; Gore, Jeff

    2012-02-01

    The widespread use of antibiotics has led to the evolution of resistance in bacteria. Bacteria can gain resistance to the antibiotic ampicillin by acquiring a plasmid carrying the gene beta-lactamase, which inactivates the antibiotic. This inactivation may represent a cooperative behavior, as the entire bacterial population benefits from removing the antibiotic. The cooperative nature of this growth suggests that a cheater strain---which does not contribute to breaking down the antibiotic---may be able to take advantage of cells cooperatively inactivating the antibiotic. Here we find experimentally that a ``sensitive'' bacterial strain lacking the plasmid conferring resistance can invade a population of resistant bacteria, even in antibiotic concentrations that should kill the sensitive strain. We observe stable coexistence between the two strains and find that a simple model successfully explains the behavior as a function of antibiotic concentration and cell density. We anticipate that our results will provide insight into the evolutionary origin of phenotypic diversity and cooperative behaviors.

  18. EDITORIAL THE TREASURE CALLED ANTIBIOTICS

    African Journals Online (AJOL)

    pneumonia, typhoid fever, plaque, tuberculosis, typhus, syphilis, etc. were rampant.1 ... the bacteria to resist the effect of antibiotic for which they were initially ... research and development of new antibiotics, vaccines, diagnostic and other tools.

  19. Self-Medication with Antibiotics, Attitude and Knowledge of Antibiotic Resistance among Community Residents and Undergraduate Students in Northwest Nigeria

    Directory of Open Access Journals (Sweden)

    Olumide Ajibola

    2018-04-01

    Full Text Available This study set out to evaluate self-medicated antibiotics and knowledge of antibiotic resistance among undergraduate students and community members in northern Nigeria. Antibiotic consumption pattern, source of prescription, illnesses commonly treated, attitude towards antibiotics, and knowledge of antibiotic resistance were explored using a structured questionnaire. Responses were analyzed and summarized using descriptive statistics. Of the 1230 respondents from undergraduate students and community members, prescription of antibiotics by a physician was 33% and 57%, respectively, amongst undergraduate students and community members. We tested the respondents’ knowledge of antibiotic resistance (ABR and found that undergraduate students displayed less knowledge that self-medication could lead to ABR (32.6% and 42.2% respectively. Self-medication with antibiotics is highly prevalent in Northwest Nigeria, with most medicines being purchased from un-licensed stores without prescription from a physician. We also observed a significant gap in respondents’ knowledge of ABR. There is an urgent need for public health authorities in Nigeria to enforce existing laws on antibiotics sales and enlighten the people on the dangers of ABR.

  20. Topical antibiotic monotherapy prescribing practices in acne vulgaris.

    Science.gov (United States)

    Hoover, William D; Davis, Scott A; Fleischer, Alan B; Feldman, Steven R

    2014-04-01

    The aim of this study is to evaluate the frequency of dosing topical antibiotics as monotherapy in the treatment of acne vulgaris, and physician specialty prescribing these medications. This study is a retrospective review of all visits with a sole diagnosis of acne vulgaris (ICD-9-CM code 706.1) found on the National Ambulatory Medical Care Survey (NAMCS) in 1993-2010. We recorded the number of visits surveyed where acne vulgaris was the sole diagnosis, number of visits where topical antibiotics were the only treatment prescribed, and the specialty of physician in each encounter. Topical erythromycin or clindamycin were the sole medication prescribed in 0.81% of the visits recorded, with 60% of these prescriptions arising from dermatologists and 40% from non-dermatologists. The trend of prescribing topical antibiotic monotherapy is declining (p acnes to topical antibiotic regimens has led to the need to re-evaluate the use of topical antibiotics in the treatment of acne vulgaris. While the rate of topical antibiotic monotherapy is declining, their use should be reserved for situations where the direct need for antibiotics arises. If a clinician feels that antibiotics are a necessary component to acne therapy, they should be used as part of a combination regimen.

  1. Antibiotic resistance reservoirs

    NARCIS (Netherlands)

    Versluis, Dennis

    2016-01-01

    One of the major threats to human health in the 21st century is the emergence of pathogenic bacteria that are resistant to multiple antibiotics, thereby limiting treatment options. An important route through which pathogens become resistant is via acquisition of resistance genes from

  2. Mechanisms of Antibiotic Resistance

    Science.gov (United States)

    Munita, Jose M.; Arias, Cesar A.

    2015-01-01

    Emergence of resistance among the most important bacterial pathogens is recognized as a major public health threat affecting humans worldwide. Multidrug-resistant organisms have emerged not only in the hospital environment but are now often identified in community settings, suggesting that reservoirs of antibiotic-resistant bacteria are present outside the hospital. The bacterial response to the antibiotic “attack” is the prime example of bacterial adaptation and the pinnacle of evolution. “Survival of the fittest” is a consequence of an immense genetic plasticity of bacterial pathogens that trigger specific responses that result in mutational adaptations, acquisition of genetic material or alteration of gene expression producing resistance to virtually all antibiotics currently available in clinical practice. Therefore, understanding the biochemical and genetic basis of resistance is of paramount importance to design strategies to curtail the emergence and spread of resistance and devise innovative therapeutic approaches against multidrug-resistant organisms. In this chapter, we will describe in detail the major mechanisms of antibiotic resistance encountered in clinical practice providing specific examples in relevant bacterial pathogens. PMID:27227291

  3. Antibiotic resistance in Salmonella

    NARCIS (Netherlands)

    Vo, A.T.T.

    2007-01-01

    Immediately after their introduction in the beginning of the fourties of the previous century, the agents used to combat infectious diseases caused by bacteria were regarded with suspicion, but not long thereafter antibiotics had the status of miracle drugs. For decades mankind has lived under the

  4. Antibiotic Resistance in Foodborne Pathogens

    OpenAIRE

    Walsh, Ciara; Duffy, Geraldine

    2013-01-01

    Wide-spread antibiotic resistance among bacterial pathogens is now a serious public health issue and multi-antibiotic resistance has been reported in many foodborne pathogens including Salmonella and E. coli. A study to determine antibiotic resistance profiles of a range of Salmonella and Verocytotoxigenic E.coli (VTEC) isolated from Irish foods revealed significant levels of antibiotic resistance in the strains. S. typhimurium DT104 were multiantibiotic resistant with 97% resistant to 7 anti...

  5. Monitoring Antibiotic Residues and Corresponding Antibiotic Resistance Genes in an Agroecosystem

    Directory of Open Access Journals (Sweden)

    Yasser M. Awad

    2015-01-01

    Full Text Available Antibiotic resistance genes (ARGs have been commonly reported due to the overuse worldwide of antibiotics. Antibiotic overuse disturbs the environment and threatens public human health. The objective of this study was to measure the residual concentrations of veterinary antibiotics in the tetracycline group (TCs, including tetracycline (TC and chlortetracycline (CTC, as well as those in the sulfonamide group (SAs, including sulfamethazine (SMT, sulfamethoxazole (SMX, and sulfathiazole (STZ. We also isolated the corresponding ARGs in the agroecosystem. Four sediment samples and two rice paddy soil samples were collected from sites near a swine composting facility along the Naerincheon River in Hongcheon, Korea. High performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS was employed with a solid-phase extraction method to measure the concentration of each antibiotic. ARGs were identified by the qualitative polymerase chain-reaction using synthetic primers. SAs and their corresponding ARGs were highly detected in sediment samples whereas TCs were not detected except for sediments sample #1. ARGs for TCs and SAs were detected in rice paddy soils, while ARGs for TCs were only found in sediment #2 and #4. Continuous monitoring of antibiotic residue and its comprehensive impact on the environment is needed to ensure environmental health.

  6. When and How to Take Antibiotics

    Science.gov (United States)

    ... bacterial balance, it may cause stomach upsets, diarrhea, vaginal infections, or other problems. If you take antibiotics unnecessarily ... before taking antibiotics? Antibiotics often lead to a vaginal yeast infection. Because antibiotics kill the normal bacteria in the ...

  7. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions

    DEFF Research Database (Denmark)

    Leibovici, Leonard; Paul, Mical; Garner, Paul

    2016-01-01

    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies....... This omission creates a skewed view, which emphasizes short-term efficacy and ignores the long-term consequences to the patient and other people. We offer a framework for addressing antibiotic resistance in systematic reviews. We suggest that the data on background resistance in the original trials should...... controlled trials or systematic reviews....

  8. Attitudes of College Graduates, Faculty, and Human Resource Managers Regarding the Importance of Skills Acquired in College and Needed for Job Performance and Career Advancement Potential in the Retail Sector

    Science.gov (United States)

    Heimler, Ronald

    2010-01-01

    The purpose of this study was to empirically examine college graduate, faculty, and human resource manager descriptions of needed, received, and further training in eight employability dimensions of literacy and numeracy, critical thinking, management, leadership, interpersonal, information technology, systems thinking skills, and work ethic…

  9. Combined administration of antibiotics and direct oral anticoagulants: a renewed indication for laboratory monitoring?

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J; Mattiuzzi, Camilla

    2014-10-01

    The recent development and marketing of novel direct oral anticoagulants (DOACs) represents a paradigm shift in the management of patients requiring long-term anticoagulation. The advantages of these compounds over traditional therapy with vitamin K antagonists include a reportedly lower risk of severe hemorrhages and the limited need for laboratory measurements. However, there are several scenarios in which testing should be applied. The potential for drug-to-drug interaction is one plausible but currently underrecognized indication for laboratory assessment of the anticoagulant effect of DOACs. In particular, substantial concern has been raised during Phase I studies regarding the potential interaction of these drugs with some antibiotics, especially those that interplay with permeability glycoprotein (P-gp) and cytochrome 3A4 (CYP3A4). A specific electronic search on clinical trials published so far confirms that clarithromycin and rifampicin significantly impair the bioavailability of dabigatran, whereas clarithromycin, erythromycin, fluconazole, and ketoconazole alter the metabolism of rivaroxaban in vivo. Because of their more recent development, no published data were found for apixaban and edoxaban, or for potential interactions of DOACs with other and widely used antibiotics. It is noteworthy, however, that an online resource based on Food and Drug Administration and social media information, reports several hemorrhagic and thrombotic events in patients simultaneously taking dabigatran and some commonly used antibiotics such as amoxicillin, cephalosporin, and metronidazole. According to these reports, the administration of antibiotics in patients undergoing therapy with DOACs would seem to require accurate evaluation as to whether dose adjustments (personalized or antibiotic class driven) of the anticoagulant drug may be advisable. This might be facilitated by direct laboratory assessments of their anticoagulant effect ex vivo. Thieme Medical Publishers

  10. Filling two needs with one deed: Potentials to simultaneously improve phosphorus and nitrogen management in Austria as an example for coupled resource management systems.

    Science.gov (United States)

    Tanzer, Julia; Zoboli, Ottavia; Zessner, Matthias; Rechberger, Helmut

    2018-06-04

    The tremendous increase in resource consumption over the past century and the environmental challenges it entails has spurred discussions for a shift from a linear to a circular resource use. However, to date most resource studies are restricted to one material or a single sector or process. In this work, a coupled material flow analysis taking the national phosphorus (P) and nitrogen (N) system of Austria as an example for two closely connected resource systems is conducted. Effects of different measures aimed at reducing P and/or N-demand, increasing recycling or reducing emissions to air and water are compared to a reference state (representing the actual situation in 2015). Changes in the mineral fertilizer demand of the system, P and N losses in the waste sector, water emissions of P and N, P soil accumulation and atmospheric N emissions are analyzed. Overall positive feedbacks between measures and between different goals of one measure always outweigh negative ones, which is why the highest efficiency gains (57±4%) can be achieved by a combination of all the 16 measures studied. Potentials for the reduction of mineral fertilizer demand are larger than for emission reduction though, confirming the past priority of environmental protection over resource protection. Although coupling significantly raises model complexity it can be shown that material flows of more than one substance can be simultaneously analyzed in a rather complex system. This may reveal interrelations, co-benefits and trade-offs between different resources that might have been omitted in a mono-substance analysis and thus improve judgment of sustainability and viability of different management strategies. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Selection of antibiotic resistance at very low antibiotic concentrations.

    Science.gov (United States)

    Sandegren, Linus

    2014-05-01

    Human use of antibiotics has driven the selective enrichment of pathogenic bacteria resistant to clinically used drugs. Traditionally, the selection of resistance has been considered to occur mainly at high, therapeutic levels of antibiotics, but we are now beginning to understand better the importance of selection of resistance at low levels of antibiotics. The concentration of an antibiotic varies in different body compartments during treatment, and low concentrations of antibiotics are found in sewage water, soils, and many water environments due to natural production and contamination from human activities. Selection of resistance at non-lethal antibiotic concentrations (below the wild-type minimum inhibitory concentration) occurs due to differences in growth rate at the particular antibiotic concentration between cells with different tolerance levels to the antibiotic. The minimum selective concentration for a particular antibiotic is reached when its reducing effect on growth of the susceptible strain balances the reducing effect (fitness cost) of the resistance determinant in the resistant strain. Recent studies have shown that resistant bacteria can be selected at concentrations several hundred-fold below the lethal concentrations for susceptible cells. Resistant mutants selected at low antibiotic concentrations are generally more fit than those selected at high concentrations but can still be highly resistant. The characteristics of selection at low antibiotic concentrations, the potential clinical problems of this mode of selection, and potential solutions will be discussed.

  12. Environmental pollution by antibiotics and by antibiotic resistance determinants

    International Nuclear Information System (INIS)

    Martinez, Jose Luis

    2009-01-01

    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  13. Environmental pollution by antibiotics and by antibiotic resistance determinants

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Jose Luis, E-mail: jlmtnez@cnb.csic.e [Departamento de Biotecnologia Microbiana, Centro Nacional de Biotecnologia, Consejo Superior de Investigaciones Cientificas, Darwin 3, Cantoblanco, 28049 Madrid, and CIBERESP (Spain)

    2009-11-15

    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  14. Reducing antibiotic prescribing in Australian general practice: time for a national strategy.

    Science.gov (United States)

    Del Mar, Christopher B; Scott, Anna Mae; Glasziou, Paul P; Hoffmann, Tammy; van Driel, Mieke L; Beller, Elaine; Phillips, Susan M; Dartnell, Jonathan

    2017-11-06

    In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult. Categories of interventions that may support general practitioners to reduce prescribing antibiotics are: regulatory (eg, changing the default to "no repeats" in electronic prescribing, changing the packaging of antibiotics to facilitate tailored amounts of antibiotics for the right indication and restricting access to prescribing selected antibiotics to conserve them), externally administered (eg, academic detailing and audit and feedback on total antibiotic use for individual GPs), interventions that GPs can individually implement (eg, delayed prescribing, shared decision making, public declarations in the practice about conserving antibiotics, and self-administered audit), supporting GPs' access to near-patient diagnostic testing, and public awareness campaigns. Many unanswered clinical research questions remain, including research into optimal implementation methods. Reducing antibiotic use in Australian general practice will require a range of approaches (with various intervention categories), a sustained effort over many years and a commitment of appropriate resources and support.

  15. Do You Need ERP? In the Business World, Enterprise Resource Planning Software Keeps Costs down and Productivity up. Should Districts Follow Suit?

    Science.gov (United States)

    Careless, James

    2007-01-01

    Enterprise resource planning (ERP) software does what school leaders have always wanted their computer systems to do: It sees all. By integrating every IT application an organization has--from purchasing and inventory control to payroll--ERPs create a single unified system. Not only does this give IT managers a holistic view to what is happening…

  16. Do You Need ERP? In the Business World, Enterprise Resource Planning Software Keeps Costs down and Productivity up. Should Districts Follow Suit?

    Science.gov (United States)

    Careless, James

    2007-01-01

    Enterprise resource planning software does what school leaders have always wanted their computer systems to do: It sees all. By integrating every IT application an organization has--from purchasing and inventory control to payroll--ERPs create a single unified system. Not only does this give IT managers a holistic view to what is happening in the…

  17. Natural resource inventory and monitoring for Ulaan Taiga Specially Protected Areas—An assessment of needs and opportunities in northern Mongolia

    Science.gov (United States)

    Moore, Peggy E.; Meyer, Joseph B.; Chow, Leslie S.

    2017-03-10

    Between 1997 and 2011, Mongolia established three specially protected areas in the north-central part of the country to protect various high-value resources. These areas are jointly referred to as the Ulaan Taiga Specially Protected Areas. In accordance with the goals of the draft general management plan, this report identifies options for initiating an inventory and monitoring program for the three protected areas. Together, the three areas comprise over 1.5 million hectares of mountainous terrain west of Lake Hovsgol and bordering the Darkhad Valley. The area supports numerous rare ungulates, endangered fish, and over 40 species of threatened plants. Illegal mining, illegal logging, and poaching pose the most immediate threats to resources. As a first step, a review of published literature would inform natural resource management at the Ulaan Taiga Specially Protected Areas because it would inform other inventories.Vegetation classification and mapping also would inform other inventory efforts because the process incorporates geographic analysis to identify environmental gradients, fine-scale sampling that captures species composition and structure, and landscape-scale results that represent the variety and extent of habitats for various organisms. Mapping using satellite imagery reduces the cost per hectare.Following a determination of existing knowledge, field surveys of vertebrates and vascular plants would serve to build species lists and fill in gaps in existing knowledge. For abiotic resources, a focus on monitoring air quality, evaluating and monitoring water quality, and assembling and storing weather data would provide information for correlating resource response status with changing environmental conditions.Finally, we identify datasets that, if incorporated into a geographic information system, would inform resource management. They include political boundaries, infrastructure, topography, surficial geology, hydrology, fire history, and soils.In terms

  18. Generic antibiotics in Japan.

    Science.gov (United States)

    Fujimura, Shigeru; Watanabe, Akira

    2012-08-01

    Generic drugs have been used extensively in many developed countries, although their use in Japan has been limited. Generic drugs reduce drug expenses and thereby national medical expenditure. Because generic drugs provide advantages for both public administration and consumers, it is expected that they will be more widely used in the future. However, the diffusion rate of generic drugs in Japan is quite low compared with that of other developed countries. An investigation on generic drugs conducted by the Ministry of Health, Labour and Welfare in Japan revealed that 17.2 % of doctors and 37.2 % of patients had not used generic drugs. The major reasons for this low use rate included distrust of off-patent products and lower drug price margin compared with the brand name drug. The generic drugs available in the market include external drugs such as wet packs, antihypertensive agents, analgesics, anticancer drugs, and antibiotics. Among them, antibiotics are frequently used in cases of acute infectious diseases. When the treatment of these infections is delayed, the infection might be aggravated rapidly. The pharmacokinetics-pharmacodynamics (PK-PD) theory has been adopted in recent chemotherapy, and in many cases, the most appropriate dosage and administration of antibiotics are determined for individual patients considering renal function; high-dosage antibiotics are used preferably for a short duration. Therefore, a highly detailed antimicrobial agent is necessary. However, some of the generic antibiotics have less antibacterial potency or solubility than the brand name products. We showed that the potency of the generic products of vancomycin and teicoplanin is lower than that of the branded drugs by 14.6 % and 17.3 %, respectively. Furthermore, we confirmed that a generic meropenem drug for injection required about 82 s to solubilize in saline, whereas the brand product required only about 21 s. It was thought that the cause may be the difference in size of bulk

  19. Microbial-derived products as potential new antimicrobials: A report from the Second Alternatives to Antibiotics Symposium

    Science.gov (United States)

    Because of the continuing global concerns involving antibiotic resistance, there is a pressing need to have scientific forums to assess scientific advancements regarding development of antimicrobials to combat the global increase in antibiotic resistance among bacterial pathogens. The objectives of ...

  20. Fate and effects of veterinary antibiotics in soil.

    Science.gov (United States)

    Jechalke, Sven; Heuer, Holger; Siemens, Jan; Amelung, Wulf; Smalla, Kornelia

    2014-09-01

    Large amounts of veterinary antibiotics are applied worldwide to farm animals and reach agricultural fields by manure fertilization, where they might lead to an increased abundance and transferability of antibiotic-resistance determinants. In this review we discuss recent advances, limitations, and research needs in determining the fate of veterinary antibiotics and resistant bacteria applied with manure to soil, and their effects on the structure and function of soil microbial communities in bulk soils and the rhizosphere. The increased abundance and mobilization of antibiotic-resistance genes (ARGs) might contribute to the emergence of multi-resistant human pathogens that increasingly threaten the successful antibiotic treatment of bacterial infections. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

    Science.gov (United States)

    Bosco, Joseph A; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett

    2015-08-01

    Infection is a rare, serious complication following total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  2. Study of antibiotic prescribing among dental practitioners in Shiraz, Islamic Republic of Iran.

    Science.gov (United States)

    Vessal, G; Khabiri, A; Mirkhani, H; Cookson, B D; Askarian, M

    2011-10-01

    Inappropriate prescribing of antibiotics by health care professionals is a worldwide concern. This study evaluated the knowledge and practices of dental practitioners in the city of Shiraz, Islamic Republic of Iran regarding their therapeutic use of antibiotics for patients with dentoalveolar infections. Of 219 (48.6%) dentists responding to the questionnaire more than 40% would prescribe antibiotics for localized fluctuant swelling and for problems for which antibiotics are not required according to good practice guidelines (acute pulpitis, chronic apical infection, periodontal abscess, chronic gingivitis, chronic periodontitis, pericoronitis and dry socket). A majority correctly prescribed antibiotics for acute periapical infection (77.2%), cellulitis (75.3%) and acute ulcerated gingivitis (63.0%). Amoxicillin was the most frequently prescribed antibiotic for all clinical conditions but there was a wide variation in dosage, frequency and duration for all antibiotics used. Guidelines on rational antibiotic use are needed for dental practitioners in the Islamic Republic of Iran.

  3. Antibiotic use and microbiome function.

    Science.gov (United States)

    Ferrer, Manuel; Méndez-García, Celia; Rojo, David; Barbas, Coral; Moya, Andrés

    2017-06-15

    Our microbiome should be understood as one of the most complex components of the human body. The use of β-lactam antibiotics is one of the microbiome covariates that influence its composition. The extent to which our microbiota changes after an antibiotic intervention depends not only on the chemical nature of the antibiotic or cocktail of antibiotics used to treat specific infections, but also on the type of administration, duration and dose, as well as the level of resistance that each microbiota develops. We have begun to appreciate that not all bacteria within our microbiota are vulnerable or reactive to different antibiotic interventions, and that their influence on both microbial composition and metabolism may differ. Antibiotics are being used worldwide on a huge scale and the prescription of antibiotics is continuing to rise; however, their effects on our microbiota have been reported for only a limited number of them. This article presents a critical review of the antibiotics or antibiotic cocktails whose use in humans has been linked to changes in the composition of our microbial communities, with a particular focus on the gut, oral, respiratory, skin and vaginal microbiota, and on their molecular agents (genes, proteins and metabolites). We review the state of the art as of June 2016, and cover a total of circa 68 different antibiotics. The data herein are the first to compile information about the bacteria, fungi, archaea and viruses most influenced by the main antibiotic treatments prescribed nowadays. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Prescribing antibiotics in general practice:

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Pedersen, Line Bjørnskov; Plejdrup Hansen, Malene

    Objectives The majority of antibiotics are prescribed from general practice. The use of broad-spectrum antibiotics increases the risk of development of bacteria resistant to antibiotic treatment. In spite of guidelines aiming to minimize the use of broad-spectrum antibiotics we see an increase...... in the use of these agents. The overall aim of the project is to explore factors influencing the decision process and the prescribing behaviour of the GPs when prescribing antibiotics. We will study the impact of microbiological testing on the choice of antibiotic. Furthermore the project will explore how...... the GPs’ prescribing behaviour is influenced by selected factors. Method The study consists of a register-based study and a questionnaire study. The register-based study is based on data from the Register of Medicinal Product Statistics (prescribed antibiotics), Statistics Denmark (socio-demographic data...

  5. Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications

    Directory of Open Access Journals (Sweden)

    Christy Manyi-Loh

    2018-03-01

    Full Text Available Due to the increased demand of animal protein in developing countries, intensive farming is instigated, which results in antibiotic residues in animal-derived products, and eventually, antibiotic resistance. Antibiotic resistance is of great public health concern because the antibiotic-resistant bacteria associated with the animals may be pathogenic to humans, easily transmitted to humans via food chains, and widely disseminated in the environment via animal wastes. These may cause complicated, untreatable, and prolonged infections in humans, leading to higher healthcare cost and sometimes death. In the said countries, antibiotic resistance is so complex and difficult, due to irrational use of antibiotics both in the clinical and agriculture settings, low socioeconomic status, poor sanitation and hygienic status, as well as that zoonotic bacterial pathogens are not regularly cultured, and their resistance to commonly used antibiotics are scarcely investigated (poor surveillance systems. The challenges that follow are of local, national, regional, and international dimensions, as there are no geographic boundaries to impede the spread of antibiotic resistance. In addition, the information assembled in this study through a thorough review of published findings, emphasized the presence of antibiotics in animal-derived products and the phenomenon of multidrug resistance in environmental samples. This therefore calls for strengthening of regulations that direct antibiotic manufacture, distribution, dispensing, and prescription, hence fostering antibiotic stewardship. Joint collaboration across the world with international bodies is needed to assist the developing countries to implement good surveillance of antibiotic use and antibiotic resistance.

  6. Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications.

    Science.gov (United States)

    Manyi-Loh, Christy; Mamphweli, Sampson; Meyer, Edson; Okoh, Anthony

    2018-03-30

    Due to the increased demand of animal protein in developing countries, intensive farming is instigated, which results in antibiotic residues in animal-derived products, and eventually, antibiotic resistance. Antibiotic resistance is of great public health concern because the antibiotic-resistant bacteria associated with the animals may be pathogenic to humans, easily transmitted to humans via food chains, and widely disseminated in the environment via animal wastes. These may cause complicated, untreatable, and prolonged infections in humans, leading to higher healthcare cost and sometimes death. In the said countries, antibiotic resistance is so complex and difficult, due to irrational use of antibiotics both in the clinical and agriculture settings, low socioeconomic status, poor sanitation and hygienic status, as well as that zoonotic bacterial pathogens are not regularly cultured, and their resistance to commonly used antibiotics are scarcely investigated (poor surveillance systems). The challenges that follow are of local, national, regional, and international dimensions, as there are no geographic boundaries to impede the spread of antibiotic resistance. In addition, the information assembled in this study through a thorough review of published findings, emphasized the presence of antibiotics in animal-derived products and the phenomenon of multidrug resistance in environmental samples. This therefore calls for strengthening of regulations that direct antibiotic manufacture, distribution, dispensing, and prescription, hence fostering antibiotic stewardship. Joint collaboration across the world with international bodies is needed to assist the developing countries to implement good surveillance of antibiotic use and antibiotic resistance.

  7. Antibiotic resistance pattern in uropathogens

    Directory of Open Access Journals (Sweden)

    Gupta V

    2002-01-01

    Full Text Available Uropathogenic strains from inpatient and outpatient departments were studied from April 1997 to March 1999 for their susceptibility profiles. The various isolates were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter baumanii and Enterococcus faecalis. Antibiotic susceptibility pattern of these isolates revealed that for outpatients, first generation cephalosporins, nitrofurantoin, norfloxacin/ciprofloxacin were effective for treatment of urinary tract infection but for inpatients, parenteral therapy with newer aminoglycosides and third generation cephalosporins need to be advocated as the organisms for nosocomial UTI exhibit a high degree of drug resistance. Trimethoprim and sulphamethoxazole combination was not found to be effective for the treatment of urinary tract infections as all the uropathogens from inpatients and outpatients showed high degree of resistance to co-trimoxazole. Culture and sensitivity of the isolates from urine samples should be done as a routine before advocating the therapy.

  8. An Assessment of the Employability Skills Needed by Graduates in the College of Agriculture, Food and Natural Resources at the University of Missouri

    Science.gov (United States)

    Robinson, J. Shane; Garton, Bryan L.

    2008-01-01

    The purposes of this descriptive study were to assess graduates' perception of the importance and competence levels of performing identified transferable skills in the workplace and use the Borich (1980) needs assessment model to identify the skills most in need to enhance the curriculum. The findings revealed that solving problems, working…

  9. [Antibiotic prescribing in acute respiratory tract infections in general practice].

    Science.gov (United States)

    Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

    2015-06-01

    Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  10. Surveillance of antibiotic resistance

    Science.gov (United States)

    Johnson, Alan P.

    2015-01-01

    Surveillance involves the collection and analysis of data for the detection and monitoring of threats to public health. Surveillance should also inform as to the epidemiology of the threat and its burden in the population. A further key component of surveillance is the timely feedback of data to stakeholders with a view to generating action aimed at reducing or preventing the public health threat being monitored. Surveillance of antibiotic resistance involves the collection of antibiotic susceptibility test results undertaken by microbiology laboratories on bacteria isolated from clinical samples sent for investigation. Correlation of these data with demographic and clinical data for the patient populations from whom the pathogens were isolated gives insight into the underlying epidemiology and facilitates the formulation of rational interventions aimed at reducing the burden of resistance. This article describes a range of surveillance activities that have been undertaken in the UK over a number of years, together with current interventions being implemented. These activities are not only of national importance but form part of the international response to the global threat posed by antibiotic resistance. PMID:25918439

  11. Environmental cycle of antibiotic resistance encoded genes: A systematic review

    Directory of Open Access Journals (Sweden)

    R. ghanbari

    2017-12-01

    Full Text Available Antibiotic-resistant bacteria and genes enter the environment in different ways. The release of these factors into the environment has increased concerns related to public health. The aim of the study was to evaluate the antibiotic resistance genes (ARGs in the environmental resources. In this systematic review, the data were extracted from valid sources of information including ScienceDirect, PubMed, Google Scholar and SID. Evaluation and selection of articles were conducted on the basis of the PRISMA checklist. A total of 39 articles were included in the study, which were chosen from a total of 1249 papers. The inclusion criterion was the identification of genes encoding antibiotic resistance against the eight important groups of antibiotics determined by using the PCR technique in the environmental sources including municipal and hospital wastewater treatment plants, animal and agricultural wastes, effluents from treatment plants, natural waters, sediments, and drinking waters. In this study, 113 genes encoding antibiotic resistance to eight groups of antibiotics (beta-lactams, aminoglycosides, tetracyclines, macrolides, sulfonamides, chloramphenicol, glycopeptides and quinolones were identified in various environments. Antibiotic resistance genes were found in all the investigated environments. The investigation of microorganisms carrying these genes shows that most of the bacteria especially gram-negative bacteria are effective in the acquisition and the dissemination of these pollutants in the environment. Discharging the raw wastewaters and effluents from wastewater treatments acts as major routes in the dissemination of ARGs into environment sources and can pose hazards to public health.

  12. Preparing Nascent And Early Stage Entrepreneurs For Their Entrepreneurial Journey: What Psychological Resources Do They Need And How Can They Be Acquired?

    OpenAIRE

    Pease, Peter; Cunningham, James

    2016-01-01

    Introduction - Based on the growing focus on how best to train, educate and prepare all types of entrepreneurs (Fayolle, 2013, Nabi et al., 2016, Thrane et al., 2016) this development paper seeks to extend the psychological dimensions of entrepreneurship through the development of a model of entrepreneurial psychological capital (EPC). EPC attempts to identify those psychological resources which are open to development, and which help potential, nascent and early stage entrepreneurs achieve p...

  13. Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States.

    Science.gov (United States)

    Durkin, Michael J; Feng, Qianxi; Warren, Kyle; Lockhart, Peter B; Thornhill, Martin H; Munshi, Kiraat D; Henderson, Rochelle R; Hsueh, Kevin; Fraser, Victoria J

    2018-05-01

    The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All

  14. Prevalence of antibiotic prescription in southern Italian outpatients: real-world data analysis of socioeconomic and sociodemographic variables at a municipality level.

    Science.gov (United States)

    Russo, Veronica; Monetti, Valeria Marina; Guerriero, Francesca; Trama, Ugo; Guida, Antonella; Menditto, Enrica; Orlando, Valentina

    2018-01-01

    underlines the lack of shared therapeutic protocols and the need for careful monitoring. Our results can be useful for decision makers to plan educational interventions, thus optimizing health resources and improving rational drug use.

  15. The analysis of tetracyclines, quinolones, macrolides, lincosamides, pleuromutilins, and sulfonamides in chicken feathers using UHPLC-MS/MS in order to monitor antibiotic use in the poultry sector

    NARCIS (Netherlands)

    Jansen, Larissa J.M.; Bolck, Yvette J.C.; Rademaker, Janneau; Zuidema, Tina; Berendsen, Bjorn J.A.

    2017-01-01

    In The Netherlands, all antibiotic treatments should be registered at the farm and in a central database. To enforce correct antibiotic use and registration, and to enforce prudent use of antibiotics, there is a need for methods that are able to detect antibiotic treatments. Ideally, such a method

  16. 'Struggling to be a defender of health' -a qualitative study on the pharmacists' perceptions of their role in antibiotic consumption and antibiotic resistance in Romania.

    Science.gov (United States)

    Ghiga, I; Stålsby Lundborg, C

    2016-01-01

    Antibiotic resistance is a serious global public health problem directly correlated to high antibiotic consumption. Romania is one of the European countries with the highest rates of antibiotic consumption, non-prescription antibiotics use and resistance of several pathogens to antibiotics. Pharmacists are an important stakeholder in respect to antibiotic management and context specific research on this topic is needed. The aim of the research is to increase the understanding of how community pharmacists in Romania perceive their roles in respect to antibiotic consumption and antibiotic resistance. Semi-structured interviews with 18 pharmacists were conducted to explore the perceptions and attitudes of pharmacists towards their roles on antibiotics consumption and antibiotic resistance. Manifest and latent qualitative content analysis was used to analyse interview transcripts. Three sub-themes emerged from the analysis. 'Maintaining equilibrium between ethics, law and economy' expresses how pharmacists often feel when trying to fulfil their duties considering all the dimensions of the pharmacist profession.' Antibiotic resistance problem rooted in a low social capital environment' reflects the pharmacists' perceptions of the deep causes of antibiotic resistance and the underlying problems that perpetuate the status quo and impact their role in relation to this problem. Wanting to fulfil their educational role illustrates how the pharmacists feel they could best contribute to improving the present situation. The overarching theme 'Undervalued medicines' professionals struggling with agency related and structural barriers to meet their deontological duties'- meaning the ethical responsibilities that come with the pharmacy practice, reflects that the pharmacists see their roles as being challenged by several barriers. A health system and societal context perspective is helpful in order to understand the pharmacists' roles in respect to antibiotic consumption and

  17. Think twice: A cognitive perspective of an antibiotic timeout intervention to improve antibiotic use.

    Science.gov (United States)

    Jones, Makoto; Butler, Jorie; Graber, Christopher J; Glassman, Peter; Samore, Matthew H; Pollack, Lori A; Weir, Charlene; Goetz, Matthew Bidwell

    2017-07-01

    To understand clinicians' impressions of and decision-making processes regarding an informatics-supported antibiotic timeout program to re-evaluate the appropriateness of continuing vancomycin and piperacillin/tazobactam. We implemented a multi-pronged informatics intervention, based on Dual Process Theory, to prompt discontinuation of unwarranted vancomycin and piperacillin/tazobactam on or after day three in a large Veterans Affairs Medical Center. Two workflow changes were introduced to facilitate cognitive deliberation about continuing antibiotics at day three: (1) teams completed an electronic template note, and (2) a paper summary of clinical and antibiotic-related information was provided to clinical teams. Shortly after starting the intervention, six focus groups were conducted with users or potential users. Interviews were recorded and transcribed. Iterative thematic analysis identified recurrent themes from feedback. Themes that emerged are represented by the following quotations: (1) captures and controls attention ("it reminds us to think about it"), (2) enhances informed and deliberative reasoning ("it makes you think twice"), (3) redirects decision direction ("…because [there was no indication] I just [discontinued] it without even trying"), (4) fosters autonomy and improves team empowerment ("the template… forces the team to really discuss it"), and (5) limits use of emotion-based heuristics ("my clinical concern is high enough I think they need more aggressive therapy…"). Requiring template completion to continue antibiotics nudged clinicians to re-assess the appropriateness of specified antibiotics. Antibiotic timeouts can encourage deliberation on overprescribed antibiotics without substantially curtailing autonomy. An effective nudge should take into account clinician's time, workflow, and thought processes. Published by Elsevier Inc.

  18. The path of least resistance: paying for antibiotics in non-human uses.

    Science.gov (United States)

    Hollis, Aidan; Ahmed, Ziana

    2014-11-01

    Antibiotic resistance is a critical threat to human and animal health. Despite the importance of antibiotics, regulators continue to allow antibiotics to be used in low-value applications--subtherapeutic dosing in animals, and spraying tobacco plants for blue mold, for example--where the benefits are unlikely to outweigh the costs in terms of increased resistance. We explore the application of a user fee in non-human uses of antibiotics. Such a fee would efficiently deter low value uses while also providing funding to support the development of the urgently needed new antibiotics. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Comment on: "Recent revisions of phosphate rock reserves and resources: a critique" by Edixhoven et al. (2014) - Phosphate reserves and resources: what conceptions and data do stakeholders need for sustainable action?

    Science.gov (United States)

    Scholz, R. W.; Wellmer, F.-W.

    2015-01-01

    Several recent papers predict a scarcity of phosphate reserves in the near future. The paper by Edixhoven et al. (2014), for instance, expresses the doubts about whether the upward estimate of reserves by the IFDC (2010) and the USGS (2010) provide an accurate, reliable, and comparable picture, as they are based on reports that do not clearly differentiate between phosphate ore and phosphate products (i.e., marketable phosphate rock concentrate). Further the indistinct use of the terms reserves and resources is criticized. Edixhoven et al. ask for a differentiated inventory of world phosphate reserves including "guidelines which determine the appropriate drill hole distances." The claim that humanity is on the safe side with respect to future phosphate is supply is doubted as the validity of the IFDC's upgrading of the Moroccan data to 50 Gt phosphate is questioned. The present paper identifies and discusses basic conceptual errors of the paper by Edixhoven et al. and related papers that predict a short or mid-term phosphorus scarcity. These include the non-acknowledgment of the dynamic nature of reserves (which depends on price, technology, and innovation for exploiting low-grade deposits, etc.), the mixing of finiteness and staticness of the ultimate recoverable resources (i.e., phosphorus that may be mined economically in the long-term future), the improper use of the Hubbert analysis (which, e.g., simply uses the USGS estimates of reserves as a substitute of an estimate of ultimate recoverable resources) and the geostatistical naive/unprofessional demand for fixed drilling plans to assess reserves. We reconstruct the IFDC and USGS estimates and conclude that there is no evidence for considering the 50 Gt phosphate concentrate as an unreasonable estimate for Moroccan reserves. However, the partial mixing of different units (e.g., phosphate ore and phosphate concentrate or marketable product) in the USGS data may be avoided by improving the data base and using

  20. Deoxyribonucleoside kinases activate nucleoside antibiotics in severely pathogenic bacteria

    DEFF Research Database (Denmark)

    Sandrini, Michael; Shannon, O.; Clausen, A.R.

    2007-01-01

    Common bacterial pathogens are becoming progressively more resistant to traditional antibiotics, representing a major public-health crisis. Therefore, there is a need for a variety of antibiotics with alternative modes of action. In our study, several nucleoside analogs were tested against pathog...... alternative for combating pathogenic bacteria.......Common bacterial pathogens are becoming progressively more resistant to traditional antibiotics, representing a major public-health crisis. Therefore, there is a need for a variety of antibiotics with alternative modes of action. In our study, several nucleoside analogs were tested against...... pathogenic staphylococci and streptococci. We show that pyrimidine-based nucleoside analogs, like 3'-azido-3'-deoxythymidine (AZT) and 2',2'-difluoro-2'deoxycytidine (gemcitabine), are specifically activated by the endogenous bacterial deoxyribonucleoside kinases, leading to cell death. Deoxyribonucleoside...

  1. A study of antibiotic prescribing

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Radzeviciene-Jurgute, R.; Jurgutis, A.

    2012-01-01

    Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated...... clinically or pharmacologically. Methods. 22 Lithuanian and 29 Russian GPs participated in five focus group discussions. Thematic analysis was used to analyse the data. Results. We identified four main thematic categories: patients' faith in antibiotics as medication for upper respiratory tract infections......; patient potential to influence a GP's decision to prescribe antibiotics for upper respiratory tract infections; impediments perceived by GPs in advocating clinically grounded antibiotic prescribing with their patients, and strategies applied in physician-patient negotiation about antibiotic prescribing...

  2. Antibiotics in late clinical development.

    Science.gov (United States)

    Fernandes, Prabhavathi; Martens, Evan

    2017-06-01

    Most pharmaceutical companies have stopped or have severely limited investments to discover and develop new antibiotics to treat the increasing prevalence of infections caused by multi-drug resistant bacteria, because the return on investment has been mostly negative for antibiotics that received marketing approved in the last few decades. In contrast, a few small companies have taken on this challenge and are developing new antibiotics. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund discovery of new antibiotics are described. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Antibiotic prevention of postcataract endophthalmitis

    DEFF Research Database (Denmark)

    Kessel, Line; Flesner, Per; Andresen, Jens

    2015-01-01

    Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL......, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one...... with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one...

  4. Current and future availability of and need for human resources for sexual, reproductive, maternal and newborn health in 41 countries in Sub-Saharan Africa.

    Science.gov (United States)

    Guerra Arias, Maria; Nove, Andrea; Michel-Schuldt, Michaela; de Bernis, Luc

    2017-05-03

    The WHO African region, covering the majority of Sub-Saharan Africa, faces the highest rates of maternal and neonatal mortality in the world. This study uses data from the State of the World's Midwifery 2014 survey to cast a spotlight on the WHO African region, highlight the specific characteristics of its sexual, reproductive, maternal and newborn health (SRMNH) workforce and describe and compare countries' different trajectories in terms of meeting the population need for services. Using data from 41 African countries, this study used a mathematical model to estimate potential met need for SRMNH services, defined as "the percentage of a universal SRMNH package that could potentially be obtained by women and newborns given the composition, competencies and available working time of the SRMNH workforce." The model defined the 46 key interventions included in this universal SRMNH package and allocated them to the available health worker time and skill set in each country to estimate the potential met need. Based on the current and projected potential met need in the future, the countries were grouped into three categories: (1) 'making or maintaining progress' (expected to meet more, or the same level, of the need in the future than currently): 14 countries including Ghana, Senegal and South Africa, (2) 'at risk' (currently performing relatively well but expected to deteriorate due to the health workforce not keeping pace with population growth): 6 countries including Gabon, Rwanda and Zambia, and (3) 'low performing' (not performing well and not expected to improve): 21 countries including Burkina Faso, Eritrea and Sierra Leone. The three groups face different challenges, and policy solutions to increasing met need should be tailored to the specific context of the country. National health workforce accounts should be strengthened so that workforce planning can be evidence-informed.

  5. [Justification of off-label antibiotics uses in hospitalized children].

    Science.gov (United States)

    Berthod, Christelle; Kassaï, Behrouz; Boussageon, Remy; Adelaide, Léopold; Jacquet-Lagrèze, Matthias; Lajoinie, Audrey

    2017-12-01

    Unlicensed and off-label (UL/OL) drugs are commonly used in pediatrics wards, especially the antibiotics. It remains unclear if this strategy is justified by randomized controlled trials of good quality? The aim of this study was to compare the level of evidence of UL/OL antibiotics prescription in hospitalized children. The initial hypothesis was that the UL/OL antibiotics prescriptions had a lower level of evidence than licensed antibiotics. This observational study assessed the antibiotics prescription in the children mother and women hospital of Lyon. Each antibiotic medicine courses was classified depending on: (i) they were licensed, UL or OL, (ii) their level of evidence for efficiency (sufficient evidence, insufficient evidence, no evidence) and (iii) the existence or not of randomized controlled trials (RCT) or not. The antibiotics medicine courses in atypical cases were excluded (rare disease, lack of diagnosis, comorbidities modifying antibiotic use). Data were collected with computerized patient file data. The data were compared using Fisher exact test and χ 2 . One hundred and eight medicine courses were identified, corresponding to 72 mono, bi or tri-antibiotic therapies administered to 62 patients; 34% were OL and 66% were licensed. No prescriptions were UL. Thirty-two prescriptions were excluded from the evidence assessment. No proof of efficiency was found for any of the 76 analyzed medicine courses. RCTs were found for 36 of the analyzed medicine courses (47%); licensed medicine courses were significantly more justified by RCTs than UL/OL medicine courses (63% vs. 16%, Pantibiotics in pediatrics, regardless their license status. Nevertheless, the licensed prescriptions have shown more data of efficiency than OL prescriptions. Still, even when data were found, no antibiotics prescriptions reach the threshold of good quality studies. New clinical trials should respond to the patient needs. Copyright © 2017 Société française de pharmacologie et

  6. Antibiotic residues in milk from small dairy farms in rural Peru.

    Science.gov (United States)

    Redding, L E; Cubas-Delgado, F; Sammel, M D; Smith, G; Galligan, D T; Levy, M Z; Hennessy, S

    2014-01-01

    The use of antibiotics in livestock can pose a public health threat, especially if antibiotic residues remain in the food product. Understanding how often and why farmers sell products with antibiotic residues is critical to improving the quality of these products. To understand how often milk with antibiotic residues is sold on small farms in a major dairy-producing region of Peru and identify factors associated with selling milk with antibiotic residues, we tested milk samples for antibiotic residues from every provider on three routes of commercial milk companies and from bulk tanks of farmers currently treating cows with antibiotics. We also asked farmers if they sold milk from treated cows and examined factors associated with the tendency to do so. The prevalence of milk contamination with antibiotic residues on commercial routes was low (0-4.2%); however, 33/36 farmers treating their animals with antibiotics sold milk that tested positive for antibiotic residues. The self-reported sale of milk from treated cows had a sensitivity, specificity, and positive and negative predictive values of 75.8%, 100%, 100% and 27.2%, respectively (with testing of milk for residues as the gold standard). Finally, 69/156 randomly selected farmers reported selling milk from treated cows, and farmers' knowledge of antibiotics and the milk purchaser were significantly associated with a farmer's tendency to report doing so. Educating farmers on the risks associated with antibiotics and enforcement of penalties for selling contaminated milk by milk companies are needed to improve milk quality.

  7. Antibiotics from predatory bacteria

    Directory of Open Access Journals (Sweden)

    Juliane Korp

    2016-03-01

    Full Text Available Bacteria, which prey on other microorganisms, are commonly found in the environment. While some of these organisms act as solitary hunters, others band together in large consortia before they attack their prey. Anecdotal reports suggest that bacteria practicing such a wolfpack strategy utilize antibiotics as predatory weapons. Consistent with this hypothesis, genome sequencing revealed that these micropredators possess impressive capacities for natural product biosynthesis. Here, we will present the results from recent chemical investigations of this bacterial group, compare the biosynthetic potential with that of non-predatory bacteria and discuss the link between predation and secondary metabolism.

  8. Bioinformatics tools and database resources for systems genetics analysis in mice-a short review and an evaluation of future needs

    NARCIS (Netherlands)

    Durrant, Caroline; Swertz, Morris A.; Alberts, Rudi; Arends, Danny; Moeller, Steffen; Mott, Richard; Prins, Pjotr; van der Velde, K. Joeri; Jansen, Ritsert C.; Schughart, Klaus

    During a meeting of the SYSGENET working group 'Bioinformatics', currently available software tools and databases for systems genetics in mice were reviewed and the needs for future developments discussed. The group evaluated interoperability and performed initial feasibility studies. To aid future

  9. Bioinformatics tools and database resources for systems genetics analysis in miceça short review and an evaluation of future needs

    NARCIS (Netherlands)

    Durrant, M.C.; Swertz, M.A.; Alberts, R.; Arends, D.; Möller, S.; Mott, R.; Prins, J.C.P.; Velde, van der K.J.; Jansen, R.C.; Schughart, K.

    2012-01-01

    During a meeting of the SYSGENET working group ‘Bioinformatics’, currently available software tools and databases for systems genetics in mice were reviewed and the needs for future developments discussed. The group evaluated interoperability and performed initial feasibility studies. To aid future

  10. Achievement of Abraham Maslow's Needs Hierarchy Theory among Teachers: Implications for Human Resource Management in the Secondary School System in Rivers State

    Science.gov (United States)

    Adiele, E.E.; Abraham, Nath. M.

    2013-01-01

    The study investigated the achievement of Abraham Maslow's need hierarchy theory among secondary school teachers in Rivers State. A 25-item questionnaire was designed, validated and administered on a sample of 500 teachers drawn from 245 secondary schools in Rivers State. The result revealed that secondary school teachers indicated insignificant…

  11. No antibiotics in acute uncomplicated diverticulitis: does it work?

    Science.gov (United States)

    Isacson, Daniel; Andreasson, Kalle; Nikberg, Maziar; Smedh, Kenneth; Chabok, Abbas

    2014-12-01

    The first randomized multicenter study evaluating the need for antibiotic treatment in patients with acute uncomplicated diverticulitis (AUD) could not demonstrate any benefit gained from antibiotic use. The aim of this study was to review the application of the no antibiotic policy and its consequences in regard to complications and recurrence. This retrospective population-based cohort study included all patients diagnosed with all types of colonic diverticulitis during the year 2011 at Västmanland Hospital Västerås, Sweden. All medical records were carefully reviewed. Primary outcomes were the types of treatment adopted for diverticulitis, complications and recurrence. In total, 246 patients with computer tomography-verified diverticulitis were identified, 195 with primary AUD and 51 with acute complicated diverticulitis. Age, sex, and temperature at admission were similar between the groups but there was a significant difference in white blood cell count, C-reactive protein, and length of hospital stay. In the AUD group, 178 (91.3%) patients were not treated with antibiotics. In this group, there were six (3.4%) readmissions but only two developed an abscess. Of the remaining 17 patients (8.7%) who were treated with antibiotics in the AUD group, one developed an abscess. Twenty-five (12.8%) patients in the AUD group presented with a recurrence within 1 year. The no-antibiotic policy for AUD is safe and applicable in clinical practice. The previous results of a low complication and recurrence rate in AUD are confirmed. There is no need for antibiotic treatment for AUD. What does this paper add to the literature? Despite published papers with excellent results, there are still doubts about patient safety against the policy to not use antibiotics in acute uncomplicated diverticulitis. This is the first paper, in actual clinical practice, to confirm that the no antibiotic policy for acute uncomplicated diverticulitis is applicable and safe.

  12. The antibiotic resistome: what's new?

    Science.gov (United States)

    Perry, Julie Ann; Westman, Erin Louise; Wright, Gerard D

    2014-10-01

    The antibiotic resistome is dynamic and ever expanding, yet its foundations were laid long before the introduction of antibiotics into clinical practice. Here, we revisit our theoretical framework for the resistome concept and consider the many factors that influence the evolution of novel resistance genes, the spread of mobile resistance elements, and the ramifications of these processes for clinical practice. Observing the trends and prevalence of genes within the antibiotic resistome is key to maintaining the efficacy of antibiotics in the clinic. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. [Usage of antibiotics in hospitals].

    Science.gov (United States)

    Ternák, G; Almási, I

    1996-12-29

    The authors publish the results of a survey conducted among hospital records of patients discharged from eight inpatient's institutes between 1-31st of January 1995 to gather information on the indications and usage of antibiotics. The institutes were selected from different part of the country to represent the hospital structure as much as possible. Data from the 13,719 documents were recorded and analysed by computer program. It was found that 27.6% of the patients (3749 cases) received antibiotic treatment. 407 different diagnosis and 365 different surgical procedures (as profilaxis) were considered as indications of antibiotic treatment (total: 4450 indications for 5849 antibiotic treatment). The largest group of patients receiving antibiotics was of antibiotic profilaxis (24.56%, 1093 cases), followed by lower respiratory tract infections (19.89%, 849 cases), uroinfections (10.53%, 469 cases) and upper respiratory tract infections. Relatively large group of patients belonged to those who had fever or subfebrility without known reason (7.35%, 327 cases) and to those who did not have any proof in their document indicating the reasons of antibiotic treatment (6.4%, 285 cases). We can not consider the antibiotic indications well founded in those groups of patients (every sixth or every fifth cases). The most frequently used antibiotics were of [2-nd] generation cefalosporins. The rate of nosocomial infections were found as 6.78% average. The results are demonstrated on diagrams and table.

  14. Antibiotic use at dental implant placement.

    Science.gov (United States)

    Veitz-Keenan, Analia; Keenan, James R

    2015-06-01

    Cochrane Oral Health Groups Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID and EMBASE via OVID. Databases were searched with no language or date restrictions. Two authors independently reviewed the titles and the abstracts for inclusion. Disagreements were resolved by discussion. If needed, a third author was consulted. Included were randomised clinical trials with a follow-up of at least three months which evaluated the use of prophylactic antibiotic compared to no antibiotic or a placebo and examined different antibiotics of different doses and durations in patients undergoing dental implant placement. The outcomes were implant failure (considered as implant mobility, removal of implant due to bone loss or infection) and prosthesis failure (prosthesis could not be placed). Standard Cochrane methodology procedures were followed. Risk of bias was completed independently and in duplicate by two review authors. Results were expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes with 95% confidence intervals (CI). The statistical unit was the participant and not the prosthesis or implant. Heterogeneity including both clinical and methodological factors was investigated. Six randomised clinical trials with 1162 participants were identified for the review. Three trials compared 2 g of preoperative amoxicillin versus placebo (927 participants). One trial compared 3 g of preoperative amoxicillin versus placebo (55 participants). Another trial compared 1 g of preoperative amoxicillin plus 500 mg four times a day for two days versus no antibiotic (80 participants). An additional trial compared four groups: (1) 2 g of preoperative amoxicillin; (2) 2 g of preoperative amoxicillin plus 1 g twice a day for seven days; (3) 1 g of postoperative amoxicillin twice a day for seven days and (4) no antibiotics (100 participants). The overall body of the evidence was considered moderate.The meta-analysis of the

  15. Identification of the Critical Nontechnical Skills for Surgeons Needed for High Performance in a Variable-resource Context (NOTSS-VRC).

    Science.gov (United States)

    Scott, John W; Lin, Yihan; Ntakiyiruta, Georges; Mutabazi, Zeta; Davis, William A; Morris, Megan A; Smink, Douglas S; Riviello, Robert; Yule, Steven

    2018-05-17

    To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described. Using a constructivist grounded theory approach, 52 intraoperative team observations as well as 34 critical incident interviews with surgical providers (surgeons, anesthetists, and nurses) were performed at the 4 tertiary referral hospitals in Rwanda. Interview transcripts and field notes from observations were analyzed using line-by-line coding to identify emerging themes until thematic saturation was achieved. Four skill categories of situation awareness, decision-making, communication/teamwork, and leadership emerged. This provided the framework for a contextually informed skills taxonomy consisting of 12 skill elements with examples of specific behaviors indicative of high performance. While the main skill categories were consistent with those encountered in high-income countries, the specific behaviors associated with these skills often focused on overcoming the frequently encountered variability in resources, staff, systems support, and language in this context. This is the first description of the critical nontechnical skills, and associated example behaviors, used by surgeons in a VRC to overcome common challenges to safe and effective surgical patient care. Improvements in the NTS used by surgeons operating in VRCs have the potential to improve surgical care delivery worldwide.

  16. Do preoperative antibiotics prevent dental implant complications?

    Science.gov (United States)

    Balevi, Ben

    2008-01-01

    The Cochrane Oral Health Group's Trials Registry, the Cochrane Central Register of Controlled Trials, Medline and Embase were consulted to find relevant work. Searches were made by hand of numerous journals pertinent to oral implantology. There were no language restrictions. Randomised controlled clinical trials (RCT) with a followup of at least 3 months were chosen. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Two reviewers independently assessed the quality and extracted relevant data from included studies. The estimated effect of the intervention was expressed as a risk ratio together with its 95% confidence interval (CI). Numbers-needed-to-treat (NNT) were calculated from numbers of patients affected by implant failures. Meta-analysis was done only if there were studies with similar comparisons that reported the same outcome measure. Significance of any discrepancies between studies was assessed by means of the Cochran's test for heterogeneity and the I2 statistic. Only two RCT met the inclusion criteria. Meta-analysis of these two trials showed a statistically significantly higher number of patients experiencing implant failures in the group not receiving antibiotics (relative risk, 0.22; 95% CI, 0.06-0.86). The NNT to prevent one patient having an implant failure is 25 (95%CI, 13-100), based on a patient implant failure rate of 6% in people not receiving antibiotics. The following outcomes were not statistically significantly linked with implant failure: prosthesis failure, postoperative infection and adverse events (eg, gastrointestinal effects, hypersensitivity). There is some evidence suggesting that 2 g of amoxicillin given orally 1 h preoperatively significantly reduces failures of dental implants placed in ordinary conditions. It remains unclear whether postoperative antibiotics are beneficial, and which is the most effective antibiotic. One dose of

  17. Fighting antibiotic resistance in the intensive care unit using antibiotics

    NARCIS (Netherlands)

    Plantinga, Nienke L.; Wittekamp, Bastiaan H J; Van Duijn, Pleun J.; Bonten, Marc J M

    2015-01-01

    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to

  18. Healthy scents: microbial volatiles as new frontier in antibiotic research?

    NARCIS (Netherlands)

    Avalos Garcia, M.; van Wezel, G.P.; Raaijmakers, J.M.; Garbeva, P.V.

    2018-01-01

    Microorganisms represent a large and still resourceful pool for the discovery of novel compounds to combat antibiotic resistance in human and animal pathogens. The ability of microorganisms to produce structurally diverse volatile compounds has been known for decades, yet their biological functions

  19. Antibiotic resistance in animals.

    Science.gov (United States)

    Barton, Mary D; Pratt, Rachael; Hart, Wendy S

    2003-01-01

    There is currently no systematic surveillance or monitoring of antibiotic resistance in Australian animals. Registration of antibiotics for use in animals is tightly controlled and has been very conservative. Fluoroquinolones have not been registered for use in food producing animals and other products have been removed from the market because of human health concerns. In the late 1970s, the Animal Health Committee coordinated a survey of resistance in Salmonella and Escherichia coli isolates from cattle, pigs and poultry and in bovine Staphylococcus aureus. Some additional information is available from published case reports. In samples collected prior to the withdrawal of avoparcin from the market, no vancomycin resistant Enterococcus faecium or Enterococcus faecalis were detected in samples collected from pigs, whereas some vanA enterococci, including E. faecium and E. faecalis, were found in chickens. No vanB enterococci were detected in either species. Virginiamycin resistance was common in both pig and poultry isolates. Multiple resistance was common in E. coli and salmonellae isolates. No fluoroquinolone resistance was found in salmonellae, E. coli or Campylobacter. Beta-lactamase production is common in isolates from bovine mastitis, but no methicillin resistance has been detected. However, methicillin resistance has been reported in canine isolates of Staphylococcus intermedius and extended spectrum beta-lactamase producing E. coli has been found in dogs.

  20. Novel approaches are needed to develop tomorrow's antibacterial therapies.

    Science.gov (United States)

    Spellberg, Brad; Bartlett, John; Wunderink, Rich; Gilbert, David N

    2015-01-15

    Society faces a crisis of rising antibiotic resistance even as the pipeline of new antibiotics has been drying up. Antibiotics are a public trust; every individual's use of antibiotics affects their efficacy for everyone else. As such, responses to the antibiotic crisis must take a societal perspective. The market failure of antibiotics is due to a combination of scientific challenges to discovering and developing new antibiotics, unfavorable economics, and a hostile regulatory environment. Scientific solutions include changing the way we screen for new antibiotics. More transformationally, developing new treatments that seek to disarm pathogens without killing them, or that modulate the host inflammatory response to infection, will reduce selective pressure and hence minimize resistance emergence. Economic transformation will require new business models to support antibiotic development. Finally, regulatory reform is needed so that clinical development programs are feasible, rigorous, and clinically relevant. Pulmonary and critical care specialists can have tremendous impact on the continued availability of effective antibiotics. Encouraging use of molecular diagnostic tests to allow pathogen-targeted, narrow-spectrum antibiotic therapy, using short rather than unnecessarily long course therapy, reducing inappropriate antibiotic use for probable viral infections, and reducing infection rates will help preserve the antibiotics we have for future generations.

  1. Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

    Directory of Open Access Journals (Sweden)

    Francesco Napolitano

    Full Text Available BACKGROUND: The appropriate use of antibiotics prophylaxis in the prevention and reduction in the incidence of surgical site infection is widespread. This study evaluates the appropriateness of the prescription of antibiotics prophylaxis prior to surgery amongst hospitalized patients in the geographic area of Avellino, Caserta, and Naples (Italy and the factors associated with a poor adherence. METHODS: A sample of 382 patients admitted to 23 surgical wards and undergoing surgery in five hospitals were randomly selected. RESULTS: Perioperative antibiotic prophylaxis was appropriate in 18.1% of cases. The multivariate logistic regression analysis showed that patients with hypoalbuminemia, with a clinical infection, with a wound clean were more likely to receive an appropriate antibiotic prophylaxis. Compared with patients with an American Society of Anesthesiologists (ASA score ≥4, those with a score of 2 were correlated with a 64% reduction in the odds of having an appropriate prophylaxis. The appropriateness of the timing of prophylactic antibiotic administration was observed in 53.4% of the procedures. Multivariate logistic regression model showed that such appropriateness was more frequent in older patients, in those admitted in general surgery wards, in those not having been underwent an endoscopic surgery, in those with a higher length of surgery, and in patients with ASA score 1 when a score ≥4 was chosen as the reference category. The most common antibiotics used inappropriately were ceftazidime, sultamicillin, levofloxacin, and teicoplanin. CONCLUSIONS: Educational interventions are needed to improve perioperative appropriate antibiotic prophylaxis.

  2. Pros and cons of antibiotic therapy for pouchitis.

    Science.gov (United States)

    Navaneethan, Udayakumar; Shen, Bo

    2009-10-01

    Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for patients with medically refractory ulcerative colitis or ulcerative colitis with dysplasia and for the majority of patients with familial adenomatous polyposis. However, pouchitis and other pouch-associated complications frequently occur following surgery. Pouchitis is the most common long-term complication of ileal pouch-anal anastomosis in patients with ulcerative colitis, with a cumulative prevalence of up to 50%. The pathogenesis of pouchitis is probably associated with alterations in commensal bacterial flora, and most patients with pouchitis respond favorably to antibiotic therapy. Antibiotic therapy is the mainstay of treatment for active pouchitis, with ciprofloxacin or metronidazole traditionally being first-line agents. Some patients may develop dependency on antibiotics, thus requiring long-term maintenance therapy. In a subset of patients, the disease course may be refractory to antibiotic therapy, which is one of the common causes of pouch failure, requiring permanent ileostomy or pouch excision. On the other hand, long-term antibiotic use is expensive and can be associated with adverse effects and bacterial resistance. There may also be the risk of secondary infections, such as Clostridium difficile and fungal infections. The risks and benefits should be carefully balanced in patients who require long-term antibiotic therapy, and safe, efficacious, non-antibiotic-based agents are needed.

  3. Antibiotic Resistance of Diverse Bacteria from Aquaculture in Borneo

    Directory of Open Access Journals (Sweden)

    M. M. Kathleen

    2016-01-01

    Full Text Available The administration of antimicrobials in aquaculture provides a selective pressure creating a reservoir of multiple resistant bacteria in the cultured fish and shrimps as well as the aquaculture environment. The objective of this study was to determine the extent of antibiotic resistance in aquaculture products and aquaculture’s surrounding environment in Sarawak, Malaysian Borneo. Ninety-four identified bacterial isolates constituted of 17 genera were isolated from sediment, water, and cultured organisms (fish and shrimp in selected aquaculture farms. These isolates were tested for their antibiotic resistance against 22 antibiotics from several groups using the disk diffusion method. The results show that the highest resistance was observed towards streptomycin (85%, n=20, while the lowest resistance was towards gentamicin (1.1%, n=90. The multiple antibiotic resistant (MAR index of the isolates tested ranged between 0 and 0.63. It was suggested that isolates with MAR index > 0.2 were recovered from sources with high risk of antibiotic resistant contamination. This study revealed low level of antibiotic resistance in the aquaculture bacterial isolates except for streptomycin and ampicillin (>50% resistance, n=94 which have been used in the aquaculture industry for several decades. Antibiotic resistant patterns should be continuously monitored to predict the emergence and widespread of MAR. Effective action is needed to keep the new resistance from further developing and spreading.

  4. Seasonality and physician-related factors associated with antibiotic prescribing: A cross-sectional study in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Leila Safaeian

    2015-01-01

    Conclusions: These findings showed the widespread use of antibiotics by general practitioners that was associated with the physicians′ gender, time since graduation and practice location and also season of prescribing. More researches are needed on other factors related to the overprescribing of antibiotics and they could be used to project educational programs for improvement of antibiotic prescribing quality in our country.

  5. A natural resource: what happens when oil interests conflict with the needs of a northern caribou herd and the people who depend on it?

    Energy Technology Data Exchange (ETDEWEB)

    Parker, R. J.

    1999-09-30

    Although the Alaska National Interest Lands Conservation Act (ANILCA) established a wildlife refuge to protect the calving grounds of the Porcupine caribou, striking oil in Prudhoe Bay led to the construction of a pipeline, which even in decline delivers one million barrels of oil a day to the Port of Valdez. Given the money generated by the oil industry, it is not surprising that most Alaska legislators favour extraction of the nature reserve's petroleum resources. So far, legislation by the President, supported by a group of senators, managed to keep the drilling rigs out of the nursery of the Porcupine caribou. In Canada, too, aboriginal leaders and environmentalist groups have worked hard to ensure that the federal government continues to oppose the leasing of the coastal plain to developers. Development would negatively affect the Porcupine caribou herd, the traditional way of life of aboriginal communities, and the ecological integrity of Ivvavik National Park. Although the fate of the calving ground will ultimately be decided in Washington, the health of the Porcupine caribou herd is a true cross-border issue. So far, the two governments have managed to stave off development and to assert that such a relatively pristine and intact biosphere should remain intact. However, the pressure by the oil industry giants is relentless, and requires constant vigilance.

  6. A natural resource: what happens when oil interests conflict with the needs of a northern caribou herd and the people who depend on it?

    International Nuclear Information System (INIS)

    Parker, R.J.

    1999-01-01

    Although the Alaska National Interest Lands Conservation Act (ANILCA) established a wildlife refuge to protect the calving grounds of the Porcupine caribou, striking oil in Prudhoe Bay led to the construction of a pipeline, which even in decline delivers one million barrels of oil a day to the Port of Valdez. Given the money generated by the oil industry, it is not surprising that most Alaska legislators favour extraction of the nature reserve's petroleum resources. So far, legislation by the President, supported by a group of senators, managed to keep the drilling rigs out of the nursery of the Porcupine caribou. In Canada, too, aboriginal leaders and environmentalist groups have worked hard to ensure that the federal government continues to oppose the leasing of the coastal plain to developers. Development would negatively affect the Porcupine caribou herd, the traditional way of life of aboriginal communities, and the ecological integrity of Ivvavik National Park. Although the fate of the calving ground will ultimately be decided in Washington, the health of the Porcupine caribou herd is a true cross-border issue. So far, the two governments have managed to stave off development and to assert that such a relatively pristine and intact biosphere should remain intact. However, the pressure by the oil industry giants is relentless, and requires constant vigilance

  7. A new antibiotic kills pathogens without detectable resistance.

    Science.gov (United States)

    Ling, Losee L; Schneider, Tanja; Peoples, Aaron J; Spoering, Amy L; Engels, Ina; Conlon, Brian P; Mueller, Anna; Schäberle, Till F; Hughes, Dallas E; Epstein, Slava; Jones, Michael; Lazarides, Linos; Steadman, Victoria A; Cohen, Douglas R; Felix, Cintia R; Fetterman, K Ashley; Millett, William P; Nitti, Anthony G; Zullo, Ashley M; Chen, Chao; Lewis, Kim

    2015-01-22

    Antibiotic resistance is spreading faster than the introduction of new compounds into clinical practice, causing a public health crisis. Most antibiotics were produced by screening soil microorganisms, but this limited resource of cultivable bacteria was overmined by the 1960s. Synthetic approaches to produce antibiotics have been unable to replace this platform. Uncultured bacteria make up approximately 99% of all species in external environments, and are an untapped source of new antibiotics. We developed several methods to grow uncultured organisms by cultivation in situ or by using specific growth factors. Here we report a new antibiotic that we term teixobactin, discovered in a screen of uncultured bacteria. Teixobactin inhibits cell wall synthesis by binding to a highly conserved motif of lipid II (precursor of peptidoglycan) and lipid III (precursor of cell wall teichoic acid). We did not obtain any mutants of Staphylococcus aureus or Mycobacterium tuberculosis resistant to teixobactin. The properties of this compound suggest a path towards developing antibiotics that are likely to avoid development of resistance.

  8. Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study.

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Hobbs, F D Richard; Butler, Chris C; Hay, Alastair D; Delaney, Brendan; Campbell, John; Broomfield, Sue; Barratt, Paula; Hood, Kerenza; Everitt, Hazel; Mullee, Mark; Williamson, Ian; Mant, David; Moore, Michael

    2014-03-01

    Data from trials suggest that antibiotics reduce the risk of complications of sore throat by at least 50%, but few trials for complications have been done in modern settings, and datasets of delayed antibiotic prescription are underpowered. Observational evidence is important in view of poor compliance with antibiotic treatment outside trials, but no prospective observational cohort studies have been done to date. We generated a large prospective cohort from the DESCARTE study, and the PRISM component of DESCARTE, of 12,829 adults presenting with sore throat (≤ 2 weeks duration) in primary care. Our follow-up of the cohort was based on a detailed and structured review of routine medical records, and analysis of the comparison of three antibiotic prescription strategies (no antibiotic prescription, immediate antibiotic prescription, and delayed antibiotic prescription) to control for the propensity to prescribe antibiotics. Information about antibiotic prescription was recorded in 12,677 individuals (4805 prescribed no antibiotics, 6088 prescribed antibiotics immediately, and 1784 prescribed delayed antibiotics). We documented by review of patients' notes (n=11,950) the development of suppurative complications (eg, quinsy, impetigo and cellulitis, otitis media, and sinusitis) or reconsultation with new or non-resolving symptoms). We used multivariate analysis to control for variables significantly related to the propensity to prescribe antibiotics and for clustering by general practitioner. 164 (1.4%) of the 11,950 patients with information available developed complications; otitis media and sinusitis were the most common complications (101 patients [62%]). Compared with no antibiotic prescription, immediate antibiotic prescription was associated with fewer complications (adjusted risk ratio [RR] 0.62, 95% CI 0.43-0.91, estimated number needed to treat [NNT 193) as was delayed prescription of antibiotics (0.58, 0.34-0.98; NNT 174). 1787 of the 11,950 patients (15

  9. Antibiotics, pediatric dysbiosis, and disease.

    Science.gov (United States)

    Vangay, Pajau; Ward, Tonya; Gerber, Jeffrey S; Knights, Dan

    2015-05-13

    Antibiotics are by far the most common medications prescribed for children. Recent epidemiological data suggests an association between early antibiotic use and disease phenotypes in adulthood. Antibiotic use during infancy induces imbalances in gut microbiota, called dysbiosis. The gut microbiome's responses to antibiotics and its potential link to disease development are especially complex to study in the changing infant gut. Here, we synthesize current knowledge linking antibiotics, dysbiosis, and disease and propose a framework for studying antibiotic-related dysbiosis in children. We recommend future studies into the microbiome-mediated effects of antibiotics focused on four types of dysbiosis: loss of keystone taxa, loss of diversity, shifts in metabolic capacity, and blooms of pathogens. Establishment of a large and diverse baseline cohort to define healthy infant microbiome development is essential to advancing diagnosis, interpretation, and eventual treatment of pediatric dysbiosis. This approach will also help provide evidence-based recommendations for antibiotic usage in infancy. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Antimicrobial stewardship: a qualitative study of the development of national guidelines for antibiotic use in hospitals

    Directory of Open Access Journals (Sweden)

    Eli Feiring

    2017-11-01

    Full Text Available Abstract Background As effective antibiotics are becoming a scarce resource, governmental regulation is needed to promote responsible use. Implementation of antibiotic stewardship and practice guidelines in health care facilities seems to be crucial to this effort. Empirical studies suggest, however, that guidelines have limited influence on health professionals’ behavior and practice. Barriers and facilitators to guideline implementability are much studied, but little attention has been given to health professionals’ perceptions of normative acceptability of guidelines as a condition for compliance. The aim of the present study was first, to examine if and how aspects potentially promoting acceptability and compliance among clinical target users were addressed during development of Norwegian national guidelines for antibiotic use in hospitals and second, to identify procedural characteristics of the development process that were perceived by target users to yield legitimate guidelines. Methods Qualitative deductive thematic analysis was used. A theoretical framework inspired by the AGREE II Instrument and the Accountability for reasonableness framework assisted data gathering and interpretation. Archival data was collected and used to detail the guideline development process. Semi-structured, in-depth interviews with eight clinicians with extensive knowledge of the guidelines were carried out. Results Guideline development was characterized by i broad agreement about scope and purpose, ii broad involvement of stakeholders in the development process, iii use of systematic methods to search for and apply evidence, iv easily identifiable and specific recommendations, v provision of tools on how to put recommendations into practice, and vi editorial independence. Several procedural characteristics were perceived by the interviewees as promoting guideline legitimacy; i diverse perspectives systematically involved in the process, ii accessibility

  11. Antimicrobial stewardship: a qualitative study of the development of national guidelines for antibiotic use in hospitals.

    Science.gov (United States)

    Feiring, Eli; Walter, Anne Berit

    2017-11-21

    As effective antibiotics are becoming a scarce resource, governmental regulation is needed to promote responsible use. Implementation of antibiotic stewardship and practice guidelines in health care facilities seems to be crucial to this effort. Empirical studies suggest, however, that guidelines have limited influence on health professionals' behavior and practice. Barriers and facilitators to guideline implementability are much studied, but little attention has been given to health professionals' perceptions of normative acceptability of guidelines as a condition for compliance. The aim of the present study was first, to examine if and how aspects potentially promoting acceptability and compliance among clinical target users were addressed during development of Norwegian national guidelines for antibiotic use in hospitals and second, to identify procedural characteristics of the development process that were perceived by target users to yield legitimate guidelines. Qualitative deductive thematic analysis was used. A theoretical framework inspired by the AGREE II Instrument and the Accountability for reasonableness framework assisted data gathering and interpretation. Archival data was collected and used to detail the guideline development process. Semi-structured, in-depth interviews with eight clinicians with extensive knowledge of the guidelines were carried out. Guideline development was characterized by i) broad agreement about scope and purpose, ii) broad involvement of stakeholders in the development process, iii) use of systematic methods to search for and apply evidence, iv) easily identifiable and specific recommendations, v) provision of tools on how to put recommendations into practice, and vi) editorial independence. Several procedural characteristics were perceived by the interviewees as promoting guideline legitimacy; i) diverse perspectives systematically involved in the process, ii) accessibility and transparency of the rationales for decision

  12. Do geography and resources influence the need for colostomy in Hirschsprung′s disease and anorectal malformations? A Canadian association of paediatric surgeons: Association of paediatric surgeons of Nigeria survey

    Directory of Open Access Journals (Sweden)

    Lukman O. Abdur-Rahman

    2014-01-01

    Full Text Available Background: This survey compared surgical management of Hirschsprung′s disease (HD and anorectal malformations (ARM in high and low resource settings. Materials and Methods: An online survey was sent to 208 members of the Canadian Association of Paediatric Surgeons (CAPS and the Association of Paediatric Surgeons of Nigeria (APSON. Results: The response rate was 76.8% with 127 complete surveys (APSON 34, CAPS 97. Only 29.5% of APSON surgeons had frozen section available for diagnosis of HD. They were more likely to choose full thickness rectal biopsy (APSON 70.6% vs. CAPS 9.4%, P < 0.05 and do an initial colostomy for HD (APSON 23.5% vs. CAPS 0%, P < 0.05. Experience with trans-anal pull-through for HD was similar in both groups (APSON 76.5%, CAPS 66.7%. CAPS members practising in the United States were more likely to perform a one-stage pull-through for HD during the initial hospitalization (USA 65.4% vs. Canada 28.3%, P < 0.05. The frequency of colostomy in females with vestibular fistula varied widely independent of geography. APSON surgeons were less likely to have enterostomal therapists and patient education resources. Conclusions: Local resources which vary by geographic location affect the management of HD and ARM including colostomy. Collaboration between CAPS and APSON members could address resource and educational needs to improve patient care.

  13. Antibiotic prophylaxis for patients undergoing elective endoscopic ...

    African Journals Online (AJOL)

    Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. M Brand, D Bisoz. Abstract. Background. Antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is controversial. We set out to assess the current antibiotic prescribing practice among ...

  14. Energy and Resources: A plan is outlined according to which solar and wind energy would supply Denmark's needs by the year 2050.

    Science.gov (United States)

    Sørensen, B

    1975-07-25

    Two possible futures for the industrial world may be distinguished: (i) Large amounts of low-cost energy become available and the more energy-intensive methods for extracting resources from lowergrade deposits continue to sustain industrial expansion until either the environmental impact becomes unacceptable or ultimate limits, such as climate disruptions, put an end to such growth. (ii) The cost of nonrenewable energy resources continue to rise, but a fixed amount of energy from continuous sources may be utilized at constant cost. In this case a lower production level may be set by the amount of energy that is available from renewable sources, and society may thus have to be reshaped with energy economization in focus. If it is possible to choose between these two alternatives, the choice should be based on a discussion of the pros and cons of each one, and in particular on the desirability of having to process an increasing fraction of the earth's crust in search of raw materials in order to maintain growth as long as possible. However, the availability, of the first option is far from certain and it thus seems reasonable to plan for the second alternative. I have tried to propose such a plan for a small, homogeneous geographical region, namely Denmark. The ceiling on the consumption of energy from continuous sources is chosen in accordance with the criterion of not having to convert a major part of the land area to energy-collecting systems. The proposed annual average energy consumption of 19 gigawatts by the year 2050 corresponds to solar energy collecting panels (in use only 50 percent of the time) with an area of roughly 180 square kilometers and a windmill swept area of about 150 square kilometers. These (vertical) areas constitute less than 1 percent of the total land area. The selection of solar or wind energy for different applications has been based on known technology and may be subject to adjustments. The project has been shown to be economically

  15. Developing New Antimicrobial Therapies: Are Synergistic Combinations of Plant Extracts/Compounds with Conventional Antibiotics the Solution?

    Science.gov (United States)

    Cheesman, Matthew J.; Ilanko, Aishwarya; Blonk, Baxter; Cock, Ian E.

    2017-01-01

    The discovery of penicillin nearly 90 years ago revolutionized the treatment of bacterial disease. Since that time, numerous other antibiotics have been discovered from bacteria and fungi, or developed by chemical synthesis and have become effective chemotherapeutic options. However, the misuse of antibiotics has lessened the efficacy of many commonly used antibiotics. The emergence of resistant strains of bacteria has seriously limited our ability to treat bacterial illness, and new antibiotics are desperately needed. Since the discovery of penicillin, most antibiotic development has focused on the discovery of new antibiotics derived from microbial sources, or on the synthesis of new compounds using existing antibiotic scaffolds to the detriment of other lines of discovery. Both of these methods have been fruitful. However, for a number of reasons discussed in this review, these strategies are unlikely to provide the same wealth of new antibiotics in the future. Indeed, the number of newly developed antibiotics has decreased dramatically in recent years. Instead, a reexamination of traditional medicines has become more common and has already provided several new antibiotics. Traditional medicine plants are likely to provide further new antibiotics in the future. However, the use of plant extracts or pure natural compounds in combination with conventional antibiotics may hold greater promise for rapidly providing affordable treatment options. Indeed, some combinational antibiotic therapies are already clinically available. This study reviews the recent literature on combinational antibiotic therapies to highlight their potential and to guide future research in this field. PMID:28989242

  16. Vesicoureteral reflux and continuous prophylactic antibiotics

    Directory of Open Access Journals (Sweden)

    Ted Lee

    2017-06-01

    Full Text Available Vesicoureteral reflux (VUR management must be tailored based on the risk for further infections and renal scarring, gender, likelihood of spontaneous resolution, and parental preferences. Because we now understand that sterile VUR is benign and most reflux spontaneously resolves over time, the initial approach in majority of children is non-surgical with continuous antibiotic prophylaxis (CAP and correction of bladder and bowel dysfunction. Despite increasing utilization of CAP over the past four decades, the efficacy of antibiotic prophylaxis has been questioned due to conflicting results of studies plagued with design flaws and inadequate subject sample size. The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR trial, which was designed to address many of the limitations from previous studies, provided much needed answers. In this review, we sought to describe the controversy surrounding VUR management, highlight the results of RIVUR trial, and discuss how the RIVUR findings impact our understanding of CAP in the management of VUR.

  17. Antibiotics to prevent complications following tooth extractions.

    Science.gov (United States)

    Lodi, Giovanni; Figini, Lara; Sardella, Andrea; Carrassi, Antonio; Del Fabbro, Massimo; Furness, Susan

    2012-11-14

    the risk of dry socket by 38% (RR 0.62 (95% CI 0.41 to 0.95) P = 0.03, 1429 participants, moderate quality evidence) which means that 38 people (range 24-250) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. There is also some evidence that patients who have prophylactic antibiotics may have less pain (MD -8.17 (95% CI -11.90 to -4.45) P antibiotics and placebo in the outcomes of fever (RR 0.34, 95% CI 0.06 to 1.99), swelling (RR 0.92, 95% CI 0.65 to 1.30) or trismus (RR 0.84, 95% CI 0.42 to 1.71) 7 days after tooth extraction.Antibiotics are associated with an increase in generally mild and transient adverse effects compared to placebo (RR 1.98 (95% CI 1.10 to 3.59) P = 0.02) which means that for every 21 people (range 8-200) who receive antibiotics, an adverse effect is likely. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, there were no trials identified which evaluated the role of antibiotic prophylaxis in this group of patients in this setting. All of the trials included in this review included healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. There is evidence that prophylactic antibiotics reduce the risk of infection, dry socket and pain following third molar extraction and result in an increase in mild and transient adverse effects. It is unclear whether the evidence in this review is generalisable to those with concomitant illnesses or immunodeficiency, or those undergoing the extraction of teeth due to severe caries or periodontitis. However, patients at a higher risk of infection are more likely to benefit from prophylactic antibiotics, because infections in this group are likely to be more frequent, associated with complications and be more difficult to treat. Due to the increasing prevalence of bacteria which are resistant to treatment by currently available antibiotics, clinicians should

  18. Antibiotic tolerance and microbial biofilms

    DEFF Research Database (Denmark)

    Folkesson, Anders

    Increased tolerance to antimicrobial agents is thought to be an important feature of microbes growing in biofilms. We study the dynamics of antibiotic action within hydrodynamic flow chamber biofilms of Escherichia coli and Pseudomonas aeruginosa using isogenic mutants and fluorescent gene...... expression reporters and we address the question of how biofilm organization affects antibiotic susceptibility. The dynamics of microbial killing is monitored by viable count determination, and confocal laser microscopy. Our work shows that the apparent increased antibiotic tolerance is due to the formation...... of antibiotic tolerant subpopulations within the biofilm. The formation of these subpopulations is highly variable and dependent on the antibiotic used, the biofilm structural organization and the induction of specific tolerance mechanisms....

  19. The Prehistory of Antibiotic Resistance.

    Science.gov (United States)

    Perry, Julie; Waglechner, Nicholas; Wright, Gerard

    2016-06-01

    Antibiotic resistance is a global problem that is reaching crisis levels. The global collection of resistance genes in clinical and environmental samples is the antibiotic "resistome," and is subject to the selective pressure of human activity. The origin of many modern resistance genes in pathogens is likely environmental bacteria, including antibiotic producing organisms that have existed for millennia. Recent work has uncovered resistance in ancient permafrost, isolated caves, and in human specimens preserved for hundreds of years. Together with bioinformatic analyses on modern-day sequences, these studies predict an ancient origin of resistance that long precedes the use of antibiotics in the clinic. Understanding the history of antibiotic resistance is important in predicting its future evolution. Copyright © 2016 Cold Spring Harbor Laboratory Press; all rights reserved.

  20. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... are the most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...

  1. Antibiotic prescribing for acute bronchitis

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars

    2016-01-01

    INTRODUCTION: Acute bronchitis is a self-limiting infectious disease characterized by acute cough with or without sputum but without signs of pneumonia. About 90% of cases are caused by viruses. AREAS COVERED: Antibiotics for acute bronchitis have been associated with an approximately half......-day reduction in duration of cough. However, at follow-up there are no significant differences in overall clinical improvement inpatients treated with antibiotics compared with those receiving placebo. Despite this, antibiotics are administered to approximately two thirds of these patients. This review...... discusses the reason for this antibiotic overprescription. Other therapies targeted to control symptoms have also demonstrated a marginal or no effect. EXPERT COMMENTARY: Clinicians should be aware of the marginal effectiveness of antibiotic therapy. Some strategies like the use of rapid tests, delayed...

  2. Rational use of medicine in dentistry: do dentists prescribe antibiotics in appropriate indications?

    Science.gov (United States)

    Koyuncuoglu, Cenker Z; Aydin, Mehtap; Kirmizi, N Ipek; Aydin, Volkan; Aksoy, Mesil; Isli, Fatma; Akici, Ahmet

    2017-08-01

    There are concerns regarding appropriate use of antibiotics in dentistry practice. Data on dental antibiotic prescribing patterns by dentists is relatively limited. This nationwide study aimed to examine dentists' antibiotic prescriptions in a diagnosis-based manner in Turkey. This retrospective study on utilization of systemic antibiotics for dental problems was based on the national health data of the dentists obtained from Prescription Information System between January 2013 and August 2015. Only those prescriptions containing single diagnosis and at least one systemic antibiotic were included in the study. Antibiotic prescribing was compared by diagnoses and expertise of dentists. A total of 9,293,410 antibiotics were detected in 9,214,956 prescriptions that contained "single diagnosis and at least one antibiotic." The number of antibiotics per prescription was 1.01. "Periapical abscess without sinus" (28.1%), "dental examination" (20.7%), and "dental caries" (16.2%) were the three most common indications in which antibiotics were prescribed by dentists. While only 3.4% of antibiotics were prescribed upon the single and appropriate "cellulitis and abscess of mouth" diagnosis, the remaining 96.6% was prescribed for irrational/uncertain indications. Consistent in all diagnoses, "amoxicillin + enzyme inhibitor" (58.6%) was the mainly prescribed antibiotic. Analysis of the most preferred "amoxicillin + enzyme inhibitor" prescriptions by expertise of dentists showed significantly much higher prescription rates among Group A specialists and Group B specialists (67.0 and 67.8%, respectively) than those in unidentified dental practitioners (58.2%, p < 0.0001). This study showed that dentists prescribed antibiotics in an arbitrary and mostly unnecessary manner. In general, their antibiotic choices for examined diagnoses could be regarded as irrational. These results indicate the urgent need for improvement of rational antibiotic prescribing habits of dentists.

  3. Nano-antibiotics in chronic lung infection therapy against Pseudomonas aeruginosa.

    Science.gov (United States)

    Hadinoto, Kunn; Cheow, Wean Sin

    2014-04-01

    Antibiotic encapsulation into nanoparticle carriers has emerged as a promising inhaled antibiotic formulation for treatment of chronic Pseudomonas aeruginosa lung infection prevalent in chronic obstructive pulmonary diseases. Attributed to their prolonged lung retention, sustained antibiotic release, and mucus penetrating ability, antibiotic nanoparticles, or nano-antibiotics in short, can address the principal weakness of inhaled antibiotic solution, i.e. low antibiotic exposure in the vicinity of P. aeruginosa biofilm colonies resulting in diminished anti-pseudomonal efficacy after repeated uses. This review details the current state of development and limitations of the two most widely studied forms of nano-antibiotics, i.e. liposomes and polymer nanoparticles. Factors in their formulation that influence the anti-pseudomonal efficacy in vitro and in vivo, such as liposome's membrane rigidity, surface charge, size, and polymer hydrophobicity, are discussed. This review reveals that the superior anti-pseudomonal efficacy of liposomal antibiotics to free antibiotics has been clearly established when they are correctly formulated, with several liposomal antibiotic formulations are currently undergoing clinical trials. Liposomal antibiotics, nevertheless, are not without limitation due to their weak physicochemical stability. In contrast, only mucus penetrating ability of the more stable polymeric nano-antibiotics has been established, while their anti-pseudomonal efficacy has only been examined in vitro from which their superiority to free antibiotics has not been ascertained. Lastly, future research needs to bring liposome and polymer-based nano-antibiotics closer to their clinical realization are identified. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Potential of Biological Processes to Eliminate Antibiotics in Livestock Manure: An Overview

    Science.gov (United States)

    Massé, Daniel I.; Cata Saady, Noori M.; Gilbert, Yan

    2014-01-01

    Simple Summary Beside their use to treat infections, antibiotics are used excessively as growth promoting factors in livestock industry. Animals discharge in their feces and urine between 70%–90% of the antibiotic administrated unchanged or in active metabolites. Because livestock manure is re-applied to land as a fertilizer, concerns are growing over spread of antibiotics in water and soil. Development of antibiotic resistant bacteria is a major risk. This paper reviewed the potential of anaerobic digestion to degrade antibiotics in livestock manure. Anaerobic digestion can degrade manure-laden antibiotic to various extents depending on the concentration and class of antibiotic, bioreactor operating conditions, type of feedstock and inoculum sources. Abstract Degrading antibiotics discharged in the livestock manure in a well-controlled bioprocess contributes to a more sustainable and environment-friendly livestock breeding. Although most antibiotics remain stable during manure storage, anaerobic digestion can degrade and remove them to various extents depending on the concentration and class of antibiotic, bioreactor operating conditions, type of feedstock and inoculum sources. Generally, antibiotics are degraded during composting > anaerobic digestion > manure storage > soil. Manure matrix variation influences extraction, quantification, and degradation of antibiotics, but it has not been well investigated. Fractioning of manure-laden antibiotics into liquid and solid phases and its effects on their anaerobic degradation and the contribution of abiotic (physical and chemical) versus biotic degradation mechanisms need to be quantified for various manures, antibiotics types, reactor designs and temperature of operations. More research is required to determine the kinetics of antibiotics’ metabolites degradation during anaerobic digestion. Further investigations are required to assess the degradation of antibiotics during psychrophilic anaerobic digestion. PMID

  5. Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China.

    Science.gov (United States)

    Lv, Bing; Zhou, Zhongliang; Xu, Guiping; Yang, Dingkun; Wu, Lina; Shen, Qian; Jiang, Minghuan; Wang, Xiao; Zhao, Guilan; Yang, Shimin; Fang, Yu

    2014-07-01

    To evaluate the knowledge, attitude and behaviours of university students on the use of antibiotics. A knowledge-attitude-practice questionnaire was developed and distributed to undergraduate students of Xi'an Jiaotong University, comprising 18 schools/colleges in Shaanxi Province, western China. Chi-square test and logistic regression analysis were applied to identify risk factors associated with self-medication with antibiotics. Of the 731 respondents (response rate = 73.1%), 294 (40.2%) had self-medicated with antibiotics in the past 6 months. Most of the antibiotics (59.2%) for self-medication were purchased without prescription in retail pharmacies. The median score of students' knowledge about antibiotics was 4 (IQR: 3-6) of a maximum possible score of 10. Students had moderately accurate beliefs towards antibiotics. More than half of the students (56.5%) were storing antibiotics frequently. During self-medication, 16.7% of students claimed to have experienced adverse reactions, and 30.6% had used antibiotics to prevent common colds. The majority preferred to use broad-spectrum antibiotics, and nearly half preferred intravenous antibiotics. Over 44% of students had changed antibiotic dosage, and 36.5% had switched to another antibiotic during the treatment course. Logistic regression analysis identified college and home town as independent risk factors for self-medication with antibiotics (P students had inadequate knowledge, moderately accurate beliefs and inappropriate practices concerning antibiotics, and a high rate of self-medication. This highlights the need for focused educational intervention and stricter governmental regulation concerning antibiotic use and sale in retail pharmacies. © 2014 John Wiley & Sons Ltd.

  6. What motivates antibiotic dispensing in accredited drug dispensing outlets in Tanzania? A qualitative study.

    Science.gov (United States)

    Dillip, Angel; Embrey, Martha; Shekalaghe, Elizabeth; Ross-Degnan, Dennis; Vialle-Valentin, Catherine; Kimatta, Suleiman; Liana, Jafary; Rutta, Edmund; Valimba, Richard; Chalker, John

    2015-01-01

    Tanzania introduced the accredited drug dispensing outlet (ADDO) program more than a decade ago. Previous evaluations have generally shown that ADDOs meet defined standards of practice better than non-accredited outlets. However, ADDOs still face challenges with overuse of antibiotics for acute respiratory infections (ARI) and simple diarrhea, which contributes to the emergence of drug resistance. This study aimed to explore the attitudes of ADDO owners and dispensers toward antibiotic dispensing and to learn how accreditation has influenced their dispensing behavior. The study used a qualitative approach. We conducted in-depth interviews with ADDO owners and dispensers in Ruvuma and Tanga regions where the government implemented the ADDO program under centralized and decentralized approaches, respectively; a secondary aim was to compare differences between the two regions. Findings indicate that the ADDO program has brought about positive changes in knowledge of dispensing practices. Respondents were able to correctly explain treatment guidelines for ARI and diarrhea. Almost all dispensers and owners indicated that unnecessary use of antibiotics contributed to antimicrobial resistance. Despite this knowledge, translating it to appropriate dispensing practice is still low. Dispensers' behavior is driven by customer demand, habit ("mazoea"), following inappropriate health facility prescriptions, and the need to make a profit. Although the majority of dispensers reported that they had intervened in situations where customers asked for antibiotics unnecessarily, they tended to give in to clients' requests. Small variations were noted between the two study regions; for example, some dispensers in Ruvuma reported sending clients with incorrect prescriptions back to the health facility, a practice that may reflect regional differences in ADDO implementation and in Integrated Management of Childhood Illness training. Dispensers in rural settings reported more challenges

  7. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    Science.gov (United States)

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

  8. Worldwide pattern of antibiotic prescription in endodontic infections.

    Science.gov (United States)

    Segura-Egea, Juan José; Martín-González, Jenifer; Jiménez-Sánchez, María Del Carmen; Crespo-Gallardo, Isabel; Saúco-Márquez, Juan José; Velasco-Ortega, Eugenio

    2017-08-01

    Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions. © 2017 FDI World Dental Federation.

  9. Enteropathogens and antibiotics.

    Science.gov (United States)

    González-Torralba, Ana; García-Esteban, Coral; Alós, Juan-Ignacio

    2018-01-01

    Infectious gastroenteritis remains a public health problem. The most severe cases are of bacterial origin. In Spain, Campylobacter and Salmonella are the most prevalent bacterial genus, while Yersinia and Shigella are much less frequent. Most cases are usually self-limiting and antibiotic therapy is not generally indicated, unless patients have risk factors for severe infection and shigellosis. Ciprofloxacin, third generation cephalosporins, azithromycin, ampicillin, cotrimoxazole and doxycycline are the most recommended drugs. The susceptibility pattern of the different bacteria determines the choice of the most appropriate treatment. The aim of this review is to analyse the current situation, developments, and evolution of resistance and multidrug resistance in these 4 enteric pathogens. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  10. Macrolide antibiotic interaction and resistance on the bacterial ribosome.

    Science.gov (United States)

    Poehlsgaard, Jacob; Douthwaite, Stephen

    2003-02-01

    Our understanding of the fine structure of many antibiotic target sites has reached a new level of enlightenment in the last couple of years due to the advent, by X-ray crystallography, of high-resolution structures of the bacterial ribosome. Many classes of clinically useful antibiotics bind to the ribosome to inhibit bacterial protein synthesis. Macrolide, lincosamide and streptogramin B (MLSB) antibiotics form one of the largest groups, and bind to the same site on the 50S ribosomal subunit. Here, we review the molecular details of the ribosomal MLSB site to put into perspective the main points from a wealth of biochemical and genetic data that have been collected over several decades. The information is now available to understand, at atomic resolution, how macrolide antibiotics interact with their ribosomal target, how the target is altered to confer resistance, and in which directions we need to look if we are to rationally design better drugs to overcome the extant resistance mechanisms.

  11. AN AUDIT OF PRESCRIPTION FOR ANTIBIOTIC IN A TERTIARY CARE HOSPITAL IN KOLKATA, INDIA

    Directory of Open Access Journals (Sweden)

    Anjan Adhikari

    2012-12-01

    Full Text Available Antibiotics are most commonly prescribed drugs in tertiary care hospitals; more than 30% of the hospitalised patients were treated with antibiotics. Rational use of antibiotics is very important to ensure the optimum treatment outcomes and to limit the emergence of bacterial resistance. Present study is a hospital based cross-sectional study carried out for a period of three months in different clinical departments of a tertiary care hospital to find out the antibiotics prescribing pattern. Out of total 551 evaluated prescriptions, an antibiotic was prescribed in 45.5% cases. The most commonly prescribed antibiotics were Moxifloxacin 19.5%, Metronidazole 10.4% and Amoxicillin+Cloxacillin 10.2%, broad spectrum antibiotics usage was higher & 87.7% of the antibiotics were prescribed by brand names. The appropriate use of antibiotic is a greatest need of the current situation all over the world. The rising antibiotic resistance is a global problem which is directly related with the irrational prescription of antibiotics.

  12. Dissemination of antibiotic resistance genes from antibiotic producers to pathogens

    DEFF Research Database (Denmark)

    Jiang, Xinglin; Ellabaan, Mostafa M Hashim; Charusanti, Pep

    2017-01-01

    It has been hypothesized that some antibiotic resistance genes (ARGs) found in pathogenic bacteria derive from antibiotic-producing actinobacteria. Here we provide bioinformatic and experimental evidence supporting this hypothesis. We identify genes in proteobacteria, including some pathogens...... and experimentally test a 'carry-back' mechanism for the transfer, involving conjugative transfer of a carrier sequence from proteobacteria to actinobacteria, recombination of the carrier sequence with the actinobacterial ARG, followed by natural transformation of proteobacteria with the carrier-sandwiched ARG. Our...... results support the existence of ancient and, possibly, recent transfers of ARGs from antibiotic-producing actinobacteria to proteobacteria, and provide evidence for a defined mechanism....

  13. Novel classes of antibiotics or more of the same?

    Science.gov (United States)

    Coates, Anthony RM; Halls, Gerry; Hu, Yanmin

    2011-01-01

    The world is running out of antibiotics. Between 1940 and 1962, more than 20 new classes of antibiotics were marketed. Since then, only two new classes have reached the market. Analogue development kept pace with the emergence of resistant bacteria until 10–20 years ago. Now, not enough analogues are reaching the market to stem the tide of antibiotic resistance, particularly among gram-negative bacteria. This review examines the existing systemic antibiotic pipeline in the public domain, and reveals that 27 compounds are in clinical development, of which two are new classes, both of which are in Phase I clinical trials. In view of the high attrition rate of drugs in early clinical development, particularly new classes and the current regulatory hurdles, it does not seem likely that new classes will be marketed soon. This paper suggests that, if the world is to return to a situation in which there are enough antibiotics to cope with the inevitable ongoing emergence of bacterial resistance, we need to recreate the prolific antibiotic discovery period between 1940 and 1962, which produced 20 classes that served the world well for 60 years. If another 20 classes and their analogues, particularly targeting gram-negatives could be produced soon, they might last us for the next 60 years. How can this be achieved? Only a huge effort by governments in the form of finance, legislation and providing industry with real incentives will reverse this. Industry needs to re-enter the market on a much larger scale, and academia should rebuild its antibiotic discovery infrastructure to support this effort. The alternative is Medicine without effective antibiotics. LINKED ARTICLES This article is part of a themed issue on Respiratory Pharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue-1 PMID:21323894

  14. Novel classes of antibiotics or more of the same?

    Science.gov (United States)

    Coates, Anthony R M; Halls, Gerry; Hu, Yanmin

    2011-05-01

    The world is running out of antibiotics. Between 1940 and 1962, more than 20 new classes of antibiotics were marketed. Since then, only two new classes have reached the market. Analogue development kept pace with the emergence of resistant bacteria until 10-20 years ago. Now, not enough analogues are reaching the market to stem the tide of antibiotic resistance, particularly among gram-negative bacteria. This review examines the existing systemic antibiotic pipeline in the public domain, and reveals that 27 compounds are in clinical development, of which two are new classes, both of which are in Phase I clinical trials. In view of the high attrition rate of drugs in early clinical development, particularly new classes and the current regulatory hurdles, it does not seem likely that new classes will be marketed soon. This paper suggests that, if the world is to return to a situation in which there are enough antibiotics to cope with the inevitable ongoing emergence of bacterial resistance, we need to recreate the prolific antibiotic discovery period between 1940 and 1962, which produced 20 classes that served the world well for 60 years. If another 20 classes and their analogues, particularly targeting gram-negatives could be produced soon, they might last us for the next 60 years. How can this be achieved? Only a huge effort by governments in the form of finance, legislation and providing industry with real incentives will reverse this. Industry needs to re-enter the market on a much larger scale, and academia should rebuild its antibiotic discovery infrastructure to support this effort. The alternative is Medicine without effective antibiotics. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  15. Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia.

    Science.gov (United States)

    Ab Rahman, Norazida; Teng, Cheong Lieng; Sivasampu, Sheamini

    2016-05-17

    Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing

  16. Is antibiotic prophylaxis in nasal packing for anterior epistaxis needed?

    Directory of Open Access Journals (Sweden)

    Francisco Pérez

    2016-03-01

    Full Text Available La epistaxis es un problema extremadamente común que en ocasiones requiere de taponamiento anterior. Usualmente se indican antibióticos de forma concomitante para la prevención de complicaciones infecciosas, aunque el rol de esta medida es controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática que incluye tres estudios primarios, ninguno de ellos controlado y aleatorizado. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si los antibióticos profilácticos disminuyen las complicaciones infecciosas en pacientes con taponamiento nasal por epistaxis anterior porque la certeza de la evidencia es muy baja.

  17. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Science.gov (United States)

    Hong, Pei-Ying; Al-Jassim, Nada; Ansari, Mohd Ikram; Mackie, Roderick I.

    2013-01-01

    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water. PMID:27029309

  18. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    KAUST Repository

    Hong, Pei-Ying; Aljassim, Nada I.; Ansari, Mohd Ikram; Mackie, Roderick

    2013-01-01

    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  19. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    Directory of Open Access Journals (Sweden)

    Roderick I. Mackie

    2013-07-01

    Full Text Available Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  20. Environmental and Public Health Implications of Water Reuse: Antibiotics, Antibiotic Resistant Bacteria, and Antibiotic Resistance Genes

    KAUST Repository

    Hong, Pei-Ying

    2013-07-31

    Water scarcity is a global problem, and is particularly acute in certain regions like Africa, the Middle East, as well as the western states of America. A breakdown on water usage revealed that 70% of freshwater supplies are used for agricultural irrigation. The use of reclaimed water as an alternative water source for agricultural irrigation would greatly alleviate the demand on freshwater sources. This paradigm shift is gaining momentum in several water scarce countries like Saudi Arabia. However, microbial problems associated with reclaimed water may hinder the use of reclaimed water for agricultural irrigation. Of particular concern is that the occurrence of antibiotic residues in the reclaimed water can select for antibiotic resistance genes among the microbial community. Antibiotic resistance genes can be associated with mobile genetic elements, which in turn allow a promiscuous transfer of resistance traits from one bacterium to another. Together with the pathogens that are present in the reclaimed water, antibiotic resistant bacteria can potentially exchange mobile genetic elements to create the “perfect microbial storm”. Given the significance of this issue, a deeper understanding of the occurrence of antibiotics in reclaimed water, and their potential influence on the selection of resistant microorganisms would be essential. In this review paper, we collated literature over the past two decades to determine the occurrence of antibiotics in municipal wastewater and livestock manure. We then discuss how these antibiotic resistant bacteria may impose a potential microbial risk to the environment and public health, and the knowledge gaps that would have to be addressed in future studies. Overall, the collation of the literature in wastewater treatment and agriculture serves to frame and identify potential concerns with respect to antibiotics, antibiotic resistant bacteria, and antibiotic resistance genes in reclaimed water.

  1. Antibiotics and inflammatory bowel diseases.

    Science.gov (United States)

    Scribano, Maria Lia; Prantera, Cosimo

    2013-01-01

    Inflammatory bowel diseases are characterized by an altered composition of gut microbiota (dysbiosis) that may contribute to their development. Antibiotics can alter the bacterial flora, and a link between antibiotic use and onset of Crohn's disease (CD), but not ulcerative colitis, has been reported. The hypothesis that Mycobacterium avium subspecies paratuberculosis (MAP) could be an etiologic agent of CD has not been confirmed by a large study on patients treated by an association of antibiotics active against MAP. The observations supporting a role of intestinal microbiota in CD pathogenesis provide the rationale for a therapeutic manipulation of the intestinal flora through the employment of antibiotics. However, current data do not strongly support a therapeutic benefit from antibiotics, and there is still controversy regarding their use as primary therapy for treatment of acute flares of CD, and for postoperative recurrence prevention. Nevertheless, clinical practice and some studies suggest that a subgroup of patients with colonic involvement, early disease, and abnormal laboratory test of inflammation may respond better to antibiotic treatment. Since their long-term use is frequently complicated by a high rate of side effects, the use of antibiotics that work locally appears to be promising.

  2. Antibiotic Sensitivity in Pseudomonas aeruginosa of Diabetic Patient’s Foot Ulcer

    OpenAIRE

    Pratiwi Apridamayanti; Khairunnisa Azani Meilinasary; Rafika Sari

    2016-01-01

    Diabetes Mellitus (DM) patients are at risk to have the diabetic ulcer. The main reason for DM’s patient with ulcer complication to be treated and healed in hospital is bacterial infection. One of many bacteria that infects diabetic ulcer is Pseudomonas aeruginosa. This conditian can be treated by antibiotic. The using antibiotic is often inaccurate causing the microbe resistance. To choose the right antibiotic, it needs to test the antibiotic’s sensitivity towards Pseudomonas aeruginosa. The...

  3. Cost-effectiveness of antibiotics for COPD management: observational analysis using CPRD data.

    Science.gov (United States)

    Ronaldson, Sarah J; Raghunath, Anan; Torgerson, David J; Van Staa, Tjeerd

    2017-04-01

    It is often difficult to determine the cause of chronic obstructive pulmonary disease (COPD) exacerbations, and antibiotics are frequently prescribed. This study conducted an observational cost-effectiveness analysis of prescribing antibiotics for exacerbations of COPD based on routinely collected data from patient electronic health records. A cohort of 45 375 patients aged 40 years or more who attended their general practice for a COPD exacerbation during 2000-2013 was identified from the Clinical Practice Research Datalink. Two groups were formed ("immediate antibiotics" or "no antibiotics") based on whether antibiotics were prescribed during the index general practice (GP) consultation, with data analysed according to subsequent healthcare resource use. A cost-effectiveness analysis was undertaken from the perspective of the UK National Health Service, using a time horizon of 4 weeks in the base case. The use of antibiotics for COPD exacerbations resulted in cost savings and an improvement in all outcomes analysed; i.e. GP visits, hospitalisations, community respiratory team referrals, all referrals, infections and subsequent antibiotics prescriptions were lower for the antibiotics group. Hence, the use of antibiotics was dominant over no antibiotics. The economic analysis suggests that use of antibiotics for COPD exacerbations is a cost-effective alternative to not prescribing antibiotics for patients who present to their GP, and remains cost-effective when longer time horizons of 3 months and 12 months are considered. It would be useful for a definitive trial to be undertaken in this area to determine the cost-effectiveness of antibiotics for COPD exacerbations.

  4. Health care need

    DEFF Research Database (Denmark)

    Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter

    2006-01-01

    The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...

  5. Cultural Resource Predictive Modeling

    Science.gov (United States)

    2017-10-01

    CR cultural resource CRM cultural resource management CRPM Cultural Resource Predictive Modeling DoD Department of Defense ESTCP Environmental...resource management ( CRM ) legal obligations under NEPA and the NHPA, military installations need to demonstrate that CRM decisions are based on objective...maxim “one size does not fit all,” and demonstrate that DoD installations have many different CRM needs that can and should be met through a variety

  6. Fate of antibiotic resistant bacteria and genes during wastewater chlorination: implication for antibiotic resistance control.

    Directory of Open Access Journals (Sweden)

    Qing-Bin Yuan

    Full Text Available This study investigated fates of nine antibiotic-resistant bacteria as well as two series of antibiotic resistance genes in wastewater treated by various doses of chlorine (0, 15, 30, 60, 150 and 300 mg Cl2 min/L. The results indicated that chlorination was effective in inactivating antibiotic-resistant bacteria. Most bacteria were inactivated completely at the lowest dose (15 mg Cl2 min/L. By comparison, sulfadiazine- and erythromycin-resistant bacteria exhibited tolerance to low chlorine dose (up to 60 mg Cl2 min/L. However, quantitative real-time PCRs revealed that chlorination decreased limited erythromycin or tetracycline resistance genes, with the removal levels of overall erythromycin and tetracycline resistance genes at 0.42 ± 0.12 log and 0.10 ± 0.02 log, respectively. About 40% of erythromycin-resistance genes and 80% of tetracycline resistance genes could not be removed by chlorination. Chlorination was considered not effective in controlling antimicrobial resistance. More concern needs to be paid to the potential risk of antibiotic resistance genes in the wastewater after chlorination.

  7. Antibiotic Sensitivity of Micrococcus radiodurans

    Science.gov (United States)

    Hawiger, J.; Jeljaszewicz, J.

    1967-01-01

    A wild-type strain of Micrococcus radiodurans and its nonpigmented mutant W1 were tested for sensitivity to 10 antibiotics selected from the standpoint of their mechanism of action. Representatives of groups of antibiotics inhibiting deoxyribonucleic acid (DNA) synthesis, DNA-dependent ribonucleic acid synthesis, protein synthesis, and cell wall synthesis were selected. M. radiodurans and its mutant exhibited full susceptibility to all antibiotics tested (mitomycin C, actinomycin D, chloramphenicol, dihydrostreptomycin, erythromycin, neomycin, kanamycin, benzylpenicillin, bacitracin, and vancomycin), the degree of susceptibility being of the same order as that of a standard strain of Staphylococcus aureus 209 P, with the exception of dihydrostreptomycin. PMID:4166078

  8. Antibiotics as CECs: An Overview of the Hazards Posed by Antibiotics and Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Geoffrey Ivan Scott

    2016-04-01

    Full Text Available ABSTRACTMonitoring programs have traditionally monitored legacy contaminants but are shifting focus to Contaminants of Emerging Concern (CECs. CECs present many challenges for monitoring and assessment, because measurement methods don't always exist nor have toxicological studies been fully conducted to place results in proper context. Also some CECs affect metabolic pathways to produce adverse outcomes that are not assessed through traditional toxicological evaluations. Antibiotics are CECs that pose significant environmental risks including development of both toxic effects at high doses and antibiotic resistance at doses well below the Minimum Inhibitory Concentration (MIC which kill bacteria and have been found in nearly half of all sites monitored in the US. Antimicrobial resistance has generally been attributed to the use of antibiotics in medicine for humans and livestock as well as aquaculture operations. The objective of this study was to assess the extent and magnitude of antibiotics in the environment and estimate their potential hazards in the environment. Antibiotics concentrations were measured in a number of monitoring studies which included Waste Water Treatment Plants (WWTP effluent, surface waters, sediments and biota. A number of studies reported levels of Antibiotic Resistant Microbes (ARM in surface waters and some studies found specific ARM genes (e.g. the blaM-1 gene in E. coli which may pose additional environmental risk. High levels of this gene were found to survive WWTP disinfection and accumulated in sediment at levels 100-1000 times higher than in the sewerage effluent, posing potential risks for gene transfer to other bacteria.in aquatic and marine ecosystems. Antibiotic risk assessment approaches were developed based on the use of MICs and MIC Ratios [High (Antibiotic Resistant/Low (Antibiotic Sensitive MIC] for each antibiotic indicating the range of bacterial adaptability to each antibiotic to help define the No

  9. INTEGRATIVE SAMPLING OF ANTIBIOTICS AND OTHER ...

    Science.gov (United States)

    Pharmaceuticals from human and veterinary use continually enter the environment through municipal wastewater treatment plants (WWTPs), surface runoff from animal waste, and direct disposal of unused medications. The presence of these chemicals, albeit often at subtherapeutic trace levels, may be partly responsible for development of antibiotic-resistant bacteria and sublethal effects in aquatic organisms. Conventional sampling techniques (i.e., grab sampling) often are insufficient for detecting these trace levels. A new sampling technique, the Polar Organic Chemical Integrative Sampler (POCIS), developed by scientists at the USGS's Columbia Environmental Research Center, can provide the time-weighted average concentrations of these complex mixtures. A pilot study targeting the antibiotic azithromycin involved deploying the POCIS for 30 days in the effluents of three WWTPs in Nevada, Utah, and South Carolina. Azithromycin was detected at each WWTP at 19 to 66 ng/L. This translates to a yearly loading, into each of the three receiving waters, of 0.4 to 4 kg/year. In a separate study investigating potential impacts of confined animal feeding operations on national wildlife refuges in the Delmarva peninsula, the antibiotic tetracycline and the natural hormone 17B-estradiol were detected at multiple sites. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and

  10. Prophylactic antibiotics versus post- operative antibiotics in herniorraphy

    Directory of Open Access Journals (Sweden)

    Abedulla Khan Kayamkani

    2015-07-01

    Full Text Available Postoperative surgical site infections are a major source of illness.  Infection results in longer hospital stay and higher costs.  Uses of preoperative antibiotics have been standardized and are being used routinely in most clinical surgeries and include controversial areas like breast surgery and herniorraphy. Objective of the study is to find out the benefit of prophylactic use of antibiotics in the management of herniorraphy.This project was carried out in a multispeciality tertiary care teaching hospital from 1st-30th April in 2002. Group 1 patients were treated prophylactically half an hour before surgery with single dose of I.V. antibiotics (injection.  Ampicillin 1gm + injection.  Gentamicin 80mg. Group 2 patients were treated post surgery with capsule. Ampicillin 500mg 4 times a day for 7 days and injection. Gentamicin twice a day for first 4 days. In case of group 1 patients only one out of 20 patients (5% was infected.  Whereas in-group 2 patients 5 out of 20 patients (25% were infected. The cost of prophylactic antibiotic treatment was Rs. 25.56 per patient.  The postoperative antibiotic treatment cost was Rs. 220.4 per patient.  That means postoperative treatment is around 8.62 times costlier than prophylactic treatment.             From this study it is evident that prophylactic (preoperative treatment is better than postoperative treatment with antibiotics.

  11. Addressing resistance to antibiotics in systematic reviews of antibiotic interventions.

    Science.gov (United States)

    Leibovici, Leonard; Paul, Mical; Garner, Paul; Sinclair, David J; Afshari, Arash; Pace, Nathan Leon; Cullum, Nicky; Williams, Hywel C; Smyth, Alan; Skoetz, Nicole; Del Mar, Chris; Schilder, Anne G M; Yahav, Dafna; Tovey, David

    2016-09-01

    Antibiotics are among the most important interventions in healthcare. Resistance of bacteria to antibiotics threatens the effectiveness of treatment. Systematic reviews of antibiotic treatments often do not address resistance to antibiotics even when data are available in the original studies. This omission creates a skewed view, which emphasizes short-term efficacy and ignores the long-term consequences to the patient and other people. We offer a framework for addressing antibiotic resistance in systematic reviews. We suggest that the data on background resistance in the original trials should be reported and taken into account when interpreting results. Data on emergence of resistance (whether in the body reservoirs or in the bacteria causing infection) are important outcomes. Emergence of resistance should be taken into account when interpreting the evidence on antibiotic treatment in randomized controlled trials or systematic reviews. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Parents' Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care.

    Science.gov (United States)

    Coxeter, Peter D; Mar, Chris Del; Hoffmann, Tammy C

    2017-03-01

    Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents' beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. © 2017 Annals of Family Medicine, Inc.

  13. What are school children in Europe being taught about hygiene and antibiotic use?

    Science.gov (United States)

    Lecky, Donna M; McNulty, Cliodna A M; Adriaenssens, Niels; Koprivová Herotová, Tereza; Holt, Jette; Touboul, Pia; Merakou, Kyriakoula; Koncan, Raffaella; Olczak-Pienkowska, Anna; Avô, António Brito; Campos, José; Farrell, David; Kostkova, Patty; Weinberg, Julius

    2011-06-01

    e-Bug is a pan-European antibiotic and hygiene teaching resource that aims to reinforce awareness in school children of microbes, prudent antibiotic use, hygiene and the transmission of infection. Prior to the production of the resource, it was essential to examine the educational structure across each partner country and assess what school children were being taught on these topics. A questionnaire was devised for distribution to each European partner (Belgium, Czech Republic, Denmark, England, France, Greece, Italy, Poland, Portugal and Spain), exploring their educational structure and examining educational resources or campaigns currently available. From the data collected it was evident that the majority of European schools have structured hand hygiene practices in place from a young age. The curricula in all countries cover the topic of human health and hygiene, but limited information is provided on antibiotics and their prudent use. School educational resources that link to the national curriculum and implement National Advice to the Public campaigns in the classroom are limited. The Microbes en question mobile health education campaign in France is an example of a successful children's education campaign and an innovative programme. Evaluation of the impact of school education on attitude and change of behaviour is also limited throughout many European countries. Not enough is currently being done across Europe to educate school children on the importance of appropriate antibiotic use and antibiotic resistance. The data from this research were used to develop e-Bug, a European Union-funded antibiotic and hygiene teaching resource.

  14. Antibiotic resistance--consequences for animal health, welfare, and food production.

    Science.gov (United States)

    Bengtsson, Björn; Greko, Christina

    2014-05-01

    Most of the literature on the consequences of emergence and spread of bacteria resistant to antibiotics among animals relate to the potential impact on public health. But antibiotics are used to treat sick animals, and resistance in animal pathogens may lead to therapy failure. This has received little scientific attention, and therefore, in this article, we discuss examples that illustrate the possible impact of resistance on animal health and consequences thereof. For all animals, there may be a negative effect on health and welfare when diseases cannot be treated. Other consequences will vary depending on why and how different animal species are kept. Animals kept as companions or for sports often receive advanced care, and antibiotic resistance can lead to negative social and economic consequences for the owners. Further, spread of hospital-acquired infections can have an economic impact on the affected premises. As to animals kept for food production, antibiotics are not needed to promote growth, but, if infectious diseases cannot be treated when they occur, this can have a negative effect on the productivity and economy of affected businesses. Antibiotic resistance in animal bacteria can also have positive consequences by creating incentives for adoption of alternative regimes for treatment and prevention. It is probable that new antibiotic classes placed on the market in the future will not reach veterinary medicine, which further emphasizes the need to preserve the efficacy of currently available antibiotics through antibiotic stewardship. A cornerstone in this work is prevention, as healthy animals do not need antibiotics.

  15. Antibiotics and specialized metabolites from the human microbiota.

    Science.gov (United States)

    Mousa, Walaa K; Athar, Bilal; Merwin, Nishanth J; Magarvey, Nathan A

    2017-11-15

    Covering: 2000 to 2017Decades of research on human microbiota have revealed much of their taxonomic diversity and established their direct link to health and disease. However, the breadth of bioactive natural products secreted by our microbial partners remains unknown. Of particular interest are antibiotics produced by our microbiota to ward off invasive pathogens. Members of the human microbiota exclusively produce evolved small molecules with selective antimicrobial activity against human pathogens. Herein, we expand upon the current knowledge concerning antibiotics derived from human microbiota and their distribution across body sites. We analyze, using our in-house chem-bioinformatic tools and natural products database, the encoded antibiotic potential of the human microbiome. This compilation of information may create a foundation for the continued exploration of this intriguing resource of chemical diversity and expose challenges and future perspectives to accelerate the discovery rate of small molecules from the human microbiota.

  16. [Methodology of Screening New Antibiotics: Present Status and Prospects].

    Science.gov (United States)

    Trenin, A S

    2015-01-01

    Due to extensive distribution of pathogen resistance to available pharmaceuticals and serious problems in the treatment of various infections and tumor diseases, the necessity of new antibiotics is urgent. The basic methodological approaches to chemical synthesis of antibiotics and screening of new antibiotics among natural products, mainly among microbial secondary metabolites, are considered in the review. Since the natural compounds are very much diverse, screening of such substances gives a good opportunity to discover antibiotics of various chemical structure and mechanism of action. Such an approach followed by chemical or biological transformation, is capable of providing the health care with new effective pharmaceuticals. The review is mainly concentrated on screening of natural products and methodological problems, such as: isolation of microbial producers from the habitats, cultivation of microorganisms producing appropriate substances, isolation and chemical characterization of microbial metabolites, identification of the biological activity of the metabolites. The main attention is paid to the problems of microbial secondary metabolism and design of new models for screening biologically active compounds. The last achievements in the field of antibiotics and most perspective approaches to future investigations are discussed. The main methodological approach to isolation and cultivation of the producers remains actual and needs constant improvement. The increase of the screening efficiency can be achieved by more rapid chemical identification of antibiotics and design of new screening models based on the biological activity detection.

  17. Genomics of antibiotic-resistance prediction in Pseudomonas aeruginosa.

    Science.gov (United States)

    Jeukens, Julie; Freschi, Luca; Kukavica-Ibrulj, Irena; Emond-Rheault, Jean-Guillaume; Tucker, Nicholas P; Levesque, Roger C

    2017-06-02

    Antibiotic resistance is a worldwide health issue spreading quickly among human and animal pathogens, as well as environmental bacteria. Misuse of antibiotics has an impact on the selection of resistant bacteria, thus contributing to an increase in the occurrence of resistant genotypes that emerge via spontaneous mutation or are acquired by horizontal gene transfer. There is a specific and urgent need not only to detect antimicrobial resistance but also to predict antibiotic resistance in silico. We now have the capability to sequence hundreds of bacterial genomes per week, including assembly and annotation. Novel and forthcoming bioinformatics tools can predict the resistome and the mobilome with a level of sophistication not previously possible. Coupled with bacterial strain collections and databases containing strain metadata, prediction of antibiotic resistance and the potential for virulence are moving rapidly toward a novel approach in molecular epidemiology. Here, we present a model system in antibiotic-resistance prediction, along with its promises and limitations. As it is commonly multidrug resistant, Pseudomonas aeruginosa causes infections that are often difficult to eradicate. We review novel approaches for genotype prediction of antibiotic resistance. We discuss the generation of microbial sequence data for real-time patient management and the prediction of antimicrobial resistance. © 2017 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

  18. Rapid determination of antibiotic resistance in E. coli using dielectrophoresis

    International Nuclear Information System (INIS)

    Hoettges, Kai F; Dale, Jeremy W; Hughes, Michael P

    2007-01-01

    In recent years, infections due to antibiotic-resistant strains of bacteria such as methillicin-resistant Staphylococcus aureus and ciprofloxacin-resistant Escherichia coli are on the rise, and with them the demand for rapid antibiotic testing is also rising. Conventional tests, such as disc diffusion testing, require a primary sample to be tested in the presence of a number of antibiotics to verify which antibiotics suppress growth, which take approximately 24 h to complete and potentially place the patient at severe risk. In this paper we describe the use of dielectrophoresis as a rapid marker of cell death, by detecting changes in the electrophysiology of the cell caused by the administration of an antibiotic. In contrast to other markers, the electrophysiology of the cell changes rapidly during cell death allowing live cells to be distinguished from dead (or dying) cells without the need for culturing. Using polymyxin B as an example antibiotic, our studies indicate that significant changes in cell characteristics can be observed as soon as 1 h passes after isolating a culture from nutrient broth

  19. Antibiotic managment in renal failure.

    Science.gov (United States)

    Winter, R E

    1976-06-01

    This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

  20. Use of antibiotics in children

    DEFF Research Database (Denmark)

    Pottegård, Anton; Broe, A.; Aabenhus, R.

    2015-01-01

    Background: We aimed to describe the use of systemic antibiotics among children in Denmark. Methods: National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0 to 11 years from January 1, 2000...... to December 31, 2012. Results: We obtained data on 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children. The most used single substances were phenoxymethylpenicillin (45%), amoxicillin (34%) and erythromycin (6%). The highest incidence rate of antibiotic treatment episodes......-1. There was little evidence of heavy users. Conclusion: Prescribing rate of antibiotics to children in Denmark remained stable at a high level from 2000 to 2012. An increase in the use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adhered well to National guidelines...

  1. The determinants of the antibiotic resistance process.

    Science.gov (United States)

    Franco, Beatriz Espinosa; Altagracia Martínez, Marina; Sánchez Rodríguez, Martha A; Wertheimer, Albert I

    2009-01-01

    The use of antibiotic drugs triggers a complex interaction involving many biological, sociological, and psychological determinants. Resistance to antibiotics is a serious worldwide problem which is increasing and has implications for morbidity, mortality, and health care both in hospitals and in the community. To analyze current research on the determinants of antibiotic resistance and comprehensively review the main factors in the process of resistance in order to aid our understanding and assessment of this problem. We conducted a MedLine search using the key words "determinants", "antibiotic", and "antibiotic resistance" to identify publications between 1995 and 2007 on the determinants of antibiotic resistance. Publications that did not address the determinants of antibiotic resistance were excluded. The process and determinants of antibiotic resistance are described, beginning with the development of antibiotics, resistance and the mechanisms of resistance, sociocultural determinants of resistance, the consequences of antibiotic resistance, and alternative measures proposed to combat antibiotic resistance. Analysis of the published literature identified the main determinants of antibiotic resistance as irrational use of antibiotics in humans and animal species, insufficient patient education when antibiotics are prescribed, lack of guidelines for treatment and control of infections, lack of scientific information for physicians on the rational use of antibiotics, and lack of official government policy on the rational use of antibiotics in public and private hospitals.

  2. [Self-medication with antibiotics in Poland

    NARCIS (Netherlands)

    Olczak, A.; Grzesiowski, P.; Hryniewicz, W.; Haaijer-Ruskamp, F.M.

    2006-01-01

    Antibiotic resistance, the important public health threat, depends on antibiotic overuse/misuse. Self-medication with antibiotics is of serious medical concern. The aim of the study, as a part of SAR project (Self-medication with antibiotic in Europe) was to survey the incidence of this phenomenon.

  3. Antibiotic resistance and virulence genes in coliform water isolates.

    Science.gov (United States)

    Stange, C; Sidhu, J P S; Tiehm, A; Toze, S

    2016-11-01

    Widespread fecal pollution of surface water may present a major health risk and a significant pathway for dissemination of antibiotic resistance bacteria. The River Rhine is one of the longest and most important rivers in Europe and an important raw water source for drinking water production. A total of 100 coliform isolates obtained from River Rhine (Germany) were examined for their susceptibility to seven antimicrobial agents. Resistances against amoxicillin, trimethoprim/sulfamethoxazole and tetracycline were detected in 48%, 11% and 9% of isolates respectively. The antibiotic resistance could be traced back to the resistance genes bla TEM , bla SHV , ampC, sul1, sul2, dfrA1, tet(A) and tet(B). Whereby, the ampC gene represents a special case, because its presence is not inevitably linked to a phenotypic antibiotic resistance. Multiple antibiotics resistance was often accompanied by the occurrence of class 1 or 2 integrons. E. coli isolates belonging to phylogenetic groups A and B1 (commensal) were more predominant (57%) compared to B2 and D groups (43%) which are known to carry virulent genes. Additionally, six E. coli virulence genes were also detected. However, the prevalence of virulence genes in the E. coli isolates was low (not exceeding 4.3% per gene) and no diarrheagenic E. coli pathotypes were detected. This study demonstrates that surface water is an important reservoir of ARGs for a number of antibiotic classes such as sulfonamide, trimethoprim, beta-lactam-antibiotics and tetracycline. The occurrence of antibiotic resistance in coliform bacteria isolated from River Rhine provides evidence for the need to develop management strategies to limit the spread of antibiotic resistant bacteria in aquatic environment. Copyright © 2016 Elsevier GmbH. All rights reserved.

  4. Determination of Antibiotic Residues in Milk by Microbial Inhibitory Tests

    Directory of Open Access Journals (Sweden)

    Juščáková D.

    2017-09-01

    Full Text Available Undesirable substances enter the organism of animals mostly via feed, water or veterinary medicines and their residues pass subsequently into the products of animal origin. In dairy cows, sheep and goats these residues are eliminated particularly in milk. Milk intended for human consumption must comply with safety criteria also with respect to residues of antibiotics. The aim of this study was to determine the presence or absence of antibiotic residues in the milk using the tests Milchtest and Premi®Test. While the Milchtest was developed for the determination of antibiotic residues in cow, sheep and goat milk, the Premi®Test is intended for the determination of antibiotic residues in meat juice, liver, kidneys, fish, eggs and in the urine of animals treated with antibiotics. As examined matrices, we used 45 samples of raw cow’s milk collected at 3 agricultural farms and 10 samples of milk offered to consumers at grocery stores. When using the Milchtest, 8 samples tested positive and 10 provided dubious results while testing with the Premi®Test showed that only 6 samples were positive for antibiotics. Comparison of the results confirmed a higher detection sensitivity of Milchtest reflected in higher numbers of positive samples and the detection of dubious results in samples of raw cow’s milk. However, it should be noted that even the Premi®Test, although not intended preferably for the determination of antibiotics in milk, can be used, if needed, for the preliminary screening of antibiotic residues in such a matrix.

  5. Evaluation of antibiotic usage in swine reproduction farms in Umbria region based on the quantitative analysis of antimicrobial consumption

    Directory of Open Access Journals (Sweden)

    Fausto Scoppetta

    2017-09-01

    Full Text Available Antibiotic use in food-producing animals has considerable impact on public health, especially with respect to the development and spread of antibiotic resistance. Pigs represent one of the main species in which antibiotics are frequently used for different purposes. Surveillance of antibiotic consumption and dose appropriateness, through novel approaches based on defined daily doses, is strongly needed to assess farms’ antibiotic risk, in terms of spread of antibiotic resistance and possibile presence of residues in meat. In this study, antibiotic consumption was monitored in 14 swine reproduction farms, together with managerial, structural, and health aspects. Most of the controlled farms (65% were classified as at medium antibiotic risk, 21% at high antibiotic risk, and 14% at low antibiotic risk. Critical aspects of antibiotic administration concerned treatments for suckling and weaner piglets, oral antibiotic administration, treatment and diagnosis of gastroenteric infections, and use of critically important antimicrobials for human medicine, especially colistin. These aspects could be considered critical aspects of antibiotic use in from-farrow-to-wean/finish swine farms in the Umbria region and must be controlled to minimize risks. Even though a small number of farms in Umbria region are at high antibiotic risk, the risk of antibiotic resistance should be minimized, and management and biosecurity of the farms should be improved by extending the use of antimicrobial susceptibility tests and optimizing the diagnostic methods for infectious diseases. Furthermore, farmers’ and veterinarians’ knowledge of antibiotic resistance should be improved and the prudent use of antibiotics encouraged to prevent the development and spread of resistant microorganisms.

  6. Expedient antibiotics production: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Bienkowski, P.R.; Byers, C.H.; Lee, D.D.

    1988-05-01

    The literature on the manufacture, separation and purification, and clinical uses of antibiotics was reviewed, and a bibliography of the pertinent material was completed. Five antimicrobial drugs, penicillin V and G, (and amoxicillin with clavulanic acid), Cephalexin (a cephalosporin), tetracycline and oxytetracycline, Bacitracin (topical), and sulfonamide (chemically produced) were identified for emergency production. Plants that manufacture antibiotics in the continental United States, Mexico, and Puerto Rico have been identified along with potential alternate sites such as those where SCP, enzyme, and fermentation ethanol are produced. Detailed process flow sheets and process descriptions have been derived from the literature and documented. This investigation revealed that a typical antibiotic-manufacturing facility is composed of two main sections: (1) a highly specialized, but generic, fermentation unit and (2) a multistep, complex separation and purification unit which is specific to a particular antibiotic product. The fermentation section requires specialized equipment for operation in a sterile environment which is not usually available in other industries. The emergency production of antibiotics under austere conditions will be feasible only if a substantial reduction in the complexity and degree of separation and purity normally required can be realized. Detailed instructions were developed to assist state and federal officials who would be directing the resumption of antibiotic production after a nuclear attack. 182 refs., 54 figs., 26 tabs.

  7. Antibiotics in the chemical communication of fungi.

    Science.gov (United States)

    Kettering, Melanie; Sterner, Olov; Anke, Timm

    2004-01-01

    In dual cultures Oudemansiella mucida and Xerula melanotricha (basidiomycetes) react to the presence of living Penicillium notatum or P. turbatum with an increased production of strobilurin A (1) or X (2). P. notatum in turn reacts to the two basidiomycetes or their antibiotic strobilurin A alone with the production of N-(2-hydroxypropanoyl)-2-aminobenzoic acid amide (3) or chrysogine (4). P. melinii and P. urticae overgrow O. mucida due to complete resistance to strobilurin A. P. brevicompactum, P. citrinum, P. janczewskii and the other Penicillium strains are all sensitive but apparently do not induce O. mucida to produce the amounts of strobilurin A needed to inhibit their growth.

  8. Online Resources

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Online Resources. Journal of Genetics. Online Resources. Volume 97. 2018 | Online resources. Volume 96. 2017 | Online resources. Volume 95. 2016 | Online resources. Volume 94. 2015 | Online resources. Volume 93. 2014 | Online resources. Volume 92. 2013 | Online resources ...

  9. [The antibiotic policy. The Infection Committee and antimicrobial use].

    Science.gov (United States)

    Cisneros, José Miguel; Pérez-Moreno, M Antonia; Gil-Navarro, M Victoria

    2014-10-01

    The antibiotic policy is the set of strategies and activities undertaken to organize the antimicrobial treatment in the hospital, and achieve health outcomes for patients. The basic principles are to be direct evidence-based medicine, local epidemiology and freedom for prescribing physicians. An antibiotic policy is now more necessary than ever for clinical, epidemiological and economic reasons. The Infection Committee is responsible for the antibiotics policy in hospitals. Its functions as an advisory body to the medical directorate are the analysis of the epidemiology of the infections in the center, measures for its prevention and control, improving the appropriate use of antimicrobials, training, and knowledge production. To achieve clinical, environmental and economic policy objectives of antibiotics is not easy. The agreement of hundreds of professionals for recommendations on indications, dosage and duration of antibiotic treatment, based on the best scientific evidence and local guides is complex, but it can be done. The key to this is that the Infection Committee develops antimicrobial stewardship through a multidisciplinary team and professional leadership, and has the institutional support to ensure that the proper use of antimicrobials is a priority for the center, and therefore of each of the services involved, and that the team has the resources for antimicrobial stewardship. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.