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Sample records for antibiotics resources needed

  1. [European Antibiotic Awareness Day--why needed?].

    Science.gov (United States)

    Hryniewicz, Waleria; Mazińska, Beata

    2009-10-01

    Antibiotic resistance is a major European and global public health problem. There are a number of reasons for its emergence; however, the main reasons are the excessive and improper use of this group of antimicrobial drugs. Several recommendations on the prudent use of antibiotics have been developed by various national and intemational authorities. The main message is to use them more responsibly and rationally, since the very dynamic emergence and spread of resistant microorganisms, plus a lack of new antimicrobial drugs in the pipelines of pharmaceutical companies, may result in our inability to treat infections successfully in the near future. To strengthen the message on prudent use, an initiative of the ECDC resulted in a decision by the European Commission to establish the 18th of November as European Antibiotic Awareness Day every year.

  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. Antibiotic Resistance: The Need For a Global Strategy.

    Science.gov (United States)

    Elder, David P; Kuentz, Martin; Holm, René

    2016-08-01

    The development of antibiotic resistance is a major problem for mankind and results in fatal consequences on a daily basis across the globe. There are a number of reasons for this situation including increasing globalization with worldwide travel, health tourism, over use and ineffective use (both in man and animals), and counterfeiting of the antimicrobial drug products we have available currently. Although there are huge economical, demographic, legal and logistic differences among the global communities, there are also differences regarding the best approach to dealing with antibiotic resistance. However, as resistant bacteria do not respect international borders, there is clearly a need for a global strategy to minimize the spread of antibiotic resistance, to optimize the use of antibiotics, and to facilitate the development of new and effective medications. This commentary provides an insight into the issues and some of the ongoing programs to ensure an effective treatment for the future. Copyright © 2016. Published by Elsevier Inc.

  5. 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...

  6. Cancer caregivers information needs and resource preferences.

    Science.gov (United States)

    Longacre, Margaret L

    2013-06-01

    This study sought to characterize the need for information about personal psychosocial care, providing direct care, and managing care among cancer caregivers and to explore preferred resources for caregiving information. Data come from cross-sectional telephone interviews of 1,247 family caregivers, which included 104 cancer caregivers. A majority of cancer caregivers expressed one or more information need for each of the three content categories. Four out of ten caregivers expressed needing information about managing physical and emotional stress. A significantly higher percentage of male caregivers reported needing more information pertinent to providing direct care than females. Heightened objective burden was significantly associated with caregivers preferring to receive information from health professionals than informal sources (e.g., Internet), while the opposite was found among caregivers with lower objective burden. These findings suggest that specific types of information and resources may be most relevant to specific subgroups of cancer caregivers.

  7. Antibiotics and Antibiotic Resistance

    Science.gov (United States)

    ... Drugs Resources for You Information for Consumers (Drugs) Buying & Using Medicine Safely Antibiotics and Antibiotic Resistance Antibiotics ... Antibiotic Resistance and Protect Public Health The White House Blog FDA’s Take on the Executive Order and ...

  8. Children with meningeal signs: predicting who needs empiric antibiotic treatment

    NARCIS (Netherlands)

    R. Oostenbrink (Rianne); K.G.M. Moons (Karel); M.J. Twijnstra; D.E. Grobbee (Diederick); H.A. Moll (Henriëtte)

    2002-01-01

    textabstractBACKGROUND: Since delayed diagnosis and treatment of bacterial meningitis worsens patient prognosis, clinicians have a low threshold to perform a lumbar puncture or to start empiric antibiotic treatment in patients suspected of having meningitis. OBJECTIVE: To develop a

  9. 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)

  10. Research Needs for Wind Resource Characterization

    Science.gov (United States)

    Schreck, S. J.; Lundquist, J. K.; Shaw, W. J.

    2008-12-01

    Currently, wind energy provides about 1 percent of U.S. electricity generation. A recent analysis by DOE, NREL, and AWEA showed the feasibility of expanding U.S. wind energy capacity to 20 percent, comprising approximately 300 gigawatts. Though not a prediction of the future, this represents a plausible scenario for U.S. wind energy. To exploit these opportunities, a workshop on Research Needs for Wind Resource Characterization was held during January 2008. This event was organized on behalf of two DOE organizations; the Office of Biological and Environmental Research and the Office of Energy Efficiency and Renewable Energy. Over 120 atmospheric science and wind energy researchers attended the workshop from industry, academia, and federal laboratories in North America and Europe. Attendees identified problems that could impede achieving the 20 percent wind scenario and formulated research recommendations to attack these problems. Findings were structured into four focus areas: 1) Turbine Dynamics, 2) Micrositing and Array Effects, 3) Mesoscale Processes, and 4) Climate Effects. In the Turbine Dynamics area, detailed characterizations of inflows and turbine flow fields were deemed crucial to attaining accuracy levels in aerodynamics loads required for future designs. To address the complexities inherent in this area, an incremental approach involving hierarchical computational modeling and detailed measurements was recommended. Also recommended was work to model extreme and anomalous atmospheric inflow events and aerostructural responses of turbines to these events. The Micrositing and Array Effects area considered improved wake models important for large, multiple row wind plants. Planetary boundary layer research was deemed necessary to accurately determine inflow characteristics in the presence of atmospheric stability effects and complex surface characteristics. Finally, a need was identified to acquire and exploit large wind inflow data sets, covering heights

  11. The consequences of generic marketing on antibiotic consumption and the spread of microbial resistance: the need for new antibiotics.

    Science.gov (United States)

    Toutain, P-L; Bousquet-Melou, A

    2013-10-01

    In both human and veterinary medicine, it has been shown that flooding the market with different generics and/or 'me-too' branded drugs has increased overall antibiotic consumption correlating with the emergence and spread of bacterial resistance to antibiotics. Another possible undesirable consequence of the promotion of generics is the promotion of an economic incentive that encourages the use of old drug products with very poor oral bioavailability, marketed with historical dosage regimens and extensively excreted in the environment. What veterinary medicine rather needs is new innovative and 'ecofriendly' antibiotics to actually enforce a more prudent use of antibiotics. For a pharmaceutical company, generics are inexpensive to manufacture and on a short-term basis, the generic market is very appealing. However, on a long-term basis, this marketing orientation provides a disincentive to the development of new and innovative products that will be required to meet the therapeutic needs of the veterinary community while being consistent with public health concerns. Indeed, for veterinary medicine, the key issue surrounding antibiotics is public health. It is the opinion of the authors that veterinary antibiotics and/or veterinary drug formulations should be innovative in terms of selectivity (no or minimal impact on the commensal gut flora), biodegradable (with minimal environmental disruption), and more expensive, with a strictly regulated market rather than unselective, cheap, and freely available drugs. © 2013 John Wiley & Sons Ltd.

  12. Antibiotic Resistant Bacteria--What Everyone Needs To Know.

    Science.gov (United States)

    Pascoe, Neil; Felkner, Marilyn; Maldonado, Maria

    2003-01-01

    Notes the overuse of antibiotics and the resulting resistant bacterial strains. Describes how to control and prevent staphylococcal infections specifically, and almost all infectious diseases generally. Specific sections address: (1) what are staph infections; (2) preventing staph infections; (3) caring for wounds; and (4) controlling staph…

  13. 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

  14. 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...

  15. Plant Genetic Resources: Needs, Rights, and Opportunities.

    Science.gov (United States)

    Roa, Carolina; Hamilton, Ruaraidh Sackville; Wenzl, Peter; Powell, Wayne

    2016-08-01

    Technological advances allow us to tap into genetic resources to address food and nutritional security in the face of population growth, urbanization, climate change, and environmental degradation. It is vital, particularly for developing countries, to ensure that the policy framework regulating access and use of genetic resources keeps pace with technological developments. Copyright © 2016. Published by Elsevier Ltd.

  16. 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 ...

  17. Intracanalicular antibiotics may obviate the need for surgical management of chronic suppurative canaliculitis

    Directory of Open Access Journals (Sweden)

    Mohan E

    2008-01-01

    Full Text Available Chronic suppurative lacrimal canaliculitis is an important cause of ocular surface discomfort. Treatment with topical antibiotics is often inadequate and surgical treatment by canaliculotomy and canalicular curettage has been the mainstay of treatment in the past. The role of canalicular antibiotic irrigation has been inadequately studied. We report the clinical features, microbiological profile and treatment outcome in a series of 12 patients with suppurative lacrimal canaliculitis. Two patients had Actinomyces infection, five had Nocardia infection and seven patients had polymicrobial infection. Three patients had resolution of canaliculitis on combination broad-spectrum topical antibiotic therapy using ciprofloxacin and fortified cefazolin. In nine patients, topical antibiotic therapy was combined with canalicular irrigation using fortified cefazolin. All patients had excellent resolution of canaliculitis without the need for surgical treatment. Availability of broad-spectrum antibiotics and canalicular irrigation may offer an alternative to surgery in the management of suppurative lacrimal canaliculitis.

  18. 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.

  19. Do geography and resources influence the need for colostomy in ...

    African Journals Online (AJOL)

    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.

  20. A qualitative study of hospital pharmacists and antibiotic governance: negotiating interprofessional responsibilities, expertise and resource constraints.

    Science.gov (United States)

    Broom, Alex; Plage, Stefanie; Broom, Jennifer; Kirby, Emma; Adams, Jon

    2016-02-06

    Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance (AMR). The impact of Antimicrobial Stewardship (AMS) programs seeking to preserve viable antibiotic drugs by governing their use in hospitals has hitherto been limited. Pharmacists have been delegated a critical role in antibiotic governance in AMS teams within hospitals but the experience of pharmacists in influencing antibiotic use has received limited attention. In this study we explore the experiences of pharmacists in antibiotic decision-making in two Australian hospitals. We conducted 19 semi-structured interviews to explore hospital-based pharmacists' perceptions and experiences of antibiotic use and governance. The analysis was conducted with NVivo10 software, utilising the framework approach. Three major themes emerged in the pharmacist interviews including (1) the responsibilities of pharmacy in optimising antibiotic use and the interprofessional challenges therein; (2) the importance of antibiotic streamlining and the constraints placed on pharmacists in achieving this; and (3) the potential, but often under-utilised expertise, pharmacists bring to antibiotic optimisation. Pharmacists have a critical role in AMS teams but their capacity to enact change is limited by entrenched interprofessional dynamics. Identifying how hospital pharmacy's antibiotic gatekeeping is embedded in the interprofessional nature of clinical decision-making and limited by organisational environment has important implications for the implementation of hospital policies seeking to streamline antibiotic use. Resource constraints (i.e. time limitation and task prioritisation) in particular limit the capacity of pharmacists to overcome the interprofessional barriers through development of stronger collaborative relationships. The results of this study suggest that to enact change in antibiotic use in hospitals, pharmacists must be supported in their negotiations

  1. Do tradeoffs structure antibiotic inhibition, resistance, and resource use among soil-borne Streptomyces?

    Science.gov (United States)

    Schlatter, Daniel C; Kinkel, Linda L

    2015-09-15

    Tradeoffs among competing traits are believed to be crucial to the maintenance of diversity in complex communities. The production of antibiotics to inhibit competitors and resistance to antibiotic inhibition are two traits hypothesized to be critical to microbial fitness in natural habitats, yet data on costs or tradeoffs associated with these traits are limited. In this work we characterized tradeoffs between antibiotic inhibition or resistance capacities and growth efficiencies or niche widths for a broad collection of Streptomyces from soil. Streptomyces isolates tended to have either very little or very high inhibitory capacity. In contrast, Streptomyces isolates were most commonly resistant to antibiotic inhibition by an intermediate number of other isolates. Streptomyces with either very high antibiotic inhibitory or resistance capacities had less efficient growth and utilized a smaller number of resources for growth (smaller niche width) than those with low inhibition or resistance capacities, suggesting tradeoffs between antibiotic inhibitory or resistance and resource use phenotypes. This work suggests that life-history tradeoffs may be crucial to the maintenance of the vast diversity of antibiotic inhibitory and resistance phenotypes found among Streptomyces in natural communities.

  2. 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.

  3. Human resources needed to perform antimicrobial stewardship teams' activities in French hospitals.

    Science.gov (United States)

    Le Coz, P; Carlet, J; Roblot, F; Pulcini, C

    2016-06-01

    In January 2015, the French ministry of Health set up a task force on antibiotic resistance. Members of the task force's "antimicrobial stewardship" group conducted a study to evaluate the human resources needed to implement all the required activities of the multidisciplinary antimicrobial stewardship teams (AST - antibiotic/infectious disease lead supervisors, microbiologists, and pharmacists) in French healthcare facilities. We conducted an online cross-sectional nationwide survey. The questionnaire was designed based on regulatory texts and experts' consensus. The survey took place between March and May 2015. We used the mailing list of the French Infectious Diseases Society (SPILF) to send out questionnaires. A total of 65 healthcare facilities completed the questionnaire. The human resources needed to implement all AST's activities were estimated at 3.6 full-time equivalent (FTE) positions/1000 acute care beds for antibiotic/infectious disease lead supervisors, at 2.5 FTE/1000 beds for pharmacists, and at 0.6 FTE/1000 beds for microbiologists. This almost amounts to a total of 2000 FTE positions for all healthcare facilities (public and private) in France and to an annual cost of 200 million euros. Dedicated and sustainable funding for AST is urgently needed to implement comprehensive and functional AST programs in all healthcare facilities. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. 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

  5. The need for equity in resource allocation in the Nigerian ...

    African Journals Online (AJOL)

    This paper highlights the need for equity in resource allocation in the Nigerian educational system and its implication for technology education. It observes that the secondary education level is a very important stage in the educational system and as such resources required to make the system functional should be put in ...

  6. 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

  7. Resource Needs for English Learners: Getting Down to Policy Recommendations

    Science.gov (United States)

    Gandara, Patricia; Maxwell-Jolly, Julie; Rumberger, Russell W.

    2008-01-01

    This document is an extension of "Resource Needs for California's English Learners" and is the result of deliberations from several informal meetings and two formal meetings of major stakeholders in the area of English Learner (EL) education. Its intent is to suggest a series of policy options, based on data examined in the initial…

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

    African Journals Online (AJOL)

    ... peruse the objectives of human resource accounting, different valuation methods from various literature emphasizing the need to show human asset in the balance sheet and finally sensitizing professional accountants to an in-depth look at the balance sheet and for professional bodies to bring up Accounting Standards ...

  9. The Murray collection of pre-antibiotic era Enterobacteriacae: a unique research resource.

    OpenAIRE

    Baker, KS; Burnett, E; McGregor, H; Deheer-Graham, A; Boinett, C; Langridge, GC; Wailan, AM; Cain, AK; Thomson, NR; Russell, JE; Parkhill, J

    2015-01-01

    Studies of historical isolates inform on the evolution and emergence of important pathogens and phenotypes, including antimicrobial resistance. Crucial to studying antimicrobial resistance are isolates that predate the widespread clinical use of antimicrobials. The Murray collection of several hundred bacterial strains of pre-antibiotic era Enterobacteriaceae is an invaluable resource of historical strains from important pathogen groups. Studies performed on the Collection to date merely exem...

  10. 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.

  11. Antibiotics.

    Science.gov (United States)

    Hariprasad, Seenu M; Mieler, William F

    2016-01-01

    The Endophthalmitis Vitrectomy Study (EVS) provided ophthalmologists with evidence-based management strategies to deal with endophthalmitis for the first time. However, since the completion of the EVS, numerous unresolved issues remain. The use of oral antibiotics has important implications for the ophthalmologist, particularly in the prophylaxis and/or management of postoperative, posttraumatic, or bleb-associated bacterial endophthalmitis. One can reasonably conclude that significant intraocular penetration of an antibiotic after oral administration may be a property unique to the newer-generation fluoroquinolones. Prophylactic use of mupirocin nasal ointment resulted in significant reduction of conjunctival flora with or without preoperative topical 5% povidone-iodine preparation. Ocular fungal infections have traditionally been very difficult to treat due to limited therapeutic options both systemically and intravitreally. Because of its broad spectrum of coverage, low MIC90 levels for the organisms of concern, good tolerability, and excellent bioavailability, voriconazole through various routes of administration may be useful to the ophthalmologist in the primary treatment of or as an adjunct to the current management of ocular fungal infections. © 2016 S. Karger AG, Basel.

  12. 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.

  13. Our Natural Resources: Basic Research Needs in Forestry and Renewable Natural Resources.

    Science.gov (United States)

    National Task Force on Basic Research in Forestry and Renewable Natural Resources.

    This report examines basic research needs in forestry and renewable natural resources and determines benefits to be gained from greater investments in basic research. It was prepared by a group of 17 research scientists, each an accomplished investigator in one or more fields. Each contributor reflected on research needs within his own discipline…

  14. Health service resource needs for pandemic influenza in developing countries : a linked transmission dynamics, interventions and resource demand model

    NARCIS (Netherlands)

    Krumkamp, R.; Kretzschmar, M.; Rudge, J. W.; Ahmad, A.; Hanvoravongchai, P.; Westenhoefer, J.; Stein, M.; Putthasri, W.; Coker, R.

    We used a mathematical model to describe a regional outbreak and extrapolate the underlying health-service resource needs. This model was designed to (i) estimate resource gaps and quantities of resources needed, (ii) show the effect of resource gaps, and (iii) highlight which particular resources

  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. Medical resources after nuclear war. Availability v need.

    Science.gov (United States)

    Abrams, H L

    1984-08-03

    In defining capacity to "survive" a massive nuclear exchange, it is important to assess the medical resources that will be available in the post-nuclear war world. Approximately 80% of these resources--hospital beds and personnel, blood, drugs, and medical supplies--will have been destroyed, since they are located in or near the densely populated areas that constitute primary targets of attack. Casualty estimates published by federal agencies, together with data from the Hiroshima-Nagasaki experience, suggest the numbers and types of injuries that will afflict the US population. With a probable 48,000 surviving physicians to treat 32 million casualties, there will be one physician for every 663 patients. Of the trauma and burn victims, approximately 55% will require hospitalization; this will mean 64 patients for each available hospital bed. Data from recent wars have been utilized to determine the trauma-related blood requirements in the post-nuclear war world. Of the 64 million units of whole blood needed, only 14,000 will be available. Other medical resources will be in equally short supply. This disparity between need and availability indicates the difficulty of developing a meaningful medical response for the surviving injured.

  17. Urgent Need to Antibiotic Pharmacokinetic Services for Iranian Health Care Centers

    Directory of Open Access Journals (Sweden)

    Alireza Hayatshahi

    2013-02-01

    Full Text Available Considering the emergence of both Gram negative and Gram positive resistant bacterial strains in the recent years, makes it more prominent to utilize the existed antibiotics in an appropriate and justified way in the treatment of drug resistant infections. Many of the agents currently used to treat bacterial, viral and fungal infections do not need to be pharmacokinetically monitored; it means we do not require their serum levels in order to adjust the dose in a routine manner. Examples of these antibiotics are penicillins, cephalosporins, macrolides, tetracyclines, fluoroquinolones, etc. Of course these agents need dose adjustment based on renal and hepatic functions. On the other hand there are antibiotics which need to be monitored through their serum levels because of three main following reasons: 1-      To avoid overdosing patient and reduce the incidence of toxicities. 2-      To avoid underdosing patient, this may lead to the emergence of resistant strains and treatment failure. 3-      To optimize the dose of antibiotic to achieve the bactericidal or bacteriostatic effects needed to suppress the infective agent. At this point, we are using vancomycin as a broad spectrum Gram positive agent and aminoglycosides both for the synergism for Gram positive coverage and also for treatment of Gram negative infection in combination with other agents. According to the guidelines published by the accredited organizations like Infectious Diseases Society of America (IDSA and American Society of Healthcare Pharmacists (ASHP, it is crucially important to perform therapeutic drug monitoring (TDM for both vancomycin and aminoglycosides based on their serum levels for all patients on these agents. In the other word, it is a wrong antibiotic therapy without monitoring the levels. Almost in all medical centers nationwide including teaching hospitals the clinicians prescribe vancomycin very often and aminoglycosides like gentamicin and

  18. 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

  19. Having Their Say: Sex Workers Discuss Their Needs and Resources.

    Science.gov (United States)

    Mastin, Teresa; Murphy, Alexandra G; Riplinger, Andrew J; Ngugi, Elizabeth

    2016-01-01

    In many countries where HIV/AIDS is prevalent, social, cultural, and economic factors often mitigate the adoption of healthy reproductive behaviors and practices. One group that is particularly susceptible to mitigating influences is women who work in the sex trade. In this article, we utilize a culture-centered approach to determine how a population of sex workers in Nairobi, Kenya, perceives their individual, social, and structural needs and resources in relation to the public, their families, friends, and peers. We conclude the article with next steps regarding collaboration with media representatives and policymakers.

  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. PMID:24349015

  1. 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.

  2. 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.

  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. 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

  5. Environmental research needs for geothermal resources development. Volume I

    Energy Technology Data Exchange (ETDEWEB)

    Carstea, D.

    1977-04-01

    A detailed analysis was conducted to determine the adequacy of the total research efforts regarding the potential environmental impacts related to the exploration, drilling, production, and transmission stages of vapor-dominated, liquid-dominated, geopressured, and hot-dry-rock geothermal resources. The following environmental considerations were selected and analyzed in detail: air emissions (hydrogen sulfide, ammonia, mercury, boron, radon, etc.); liquid emissions (brine, and toxic chemicals); land subsidence; seismic activity; and noise. Following the definition of the problem and the assessment of the past and ongoing research efforts, environmental research needs were then recommended based on: (1) the severity of the environmental problems as perceived by literature and contacts with the research community; (2) probability of occurrence; (3) and the research dependency for a solution to that particular problem. The recommended research needs consisted of: (1) an evaluation of the past and ongoing research efforts to ascertain gaps in knowledge for a particular pollutant, process, or control technology; (2) baseline studies of air, soil, water, and ecology around the existing geothermal facilities and in the locations scheduled for future geothermal development; (3) need for the development of appropriate models for predicting concentration and dispersion of pollutants; (4) development of predictive models for potential health and environmental effects associated with geothermal operations; and (5) development of appropriate control technology to destroy, remove or reduce harmful emissions in order to prevent the occurrence of environmental and health hazards and to comply with existing standards and criteria.

  6. 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

  7. 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.

  8. 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)

  9. 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

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

    International Nuclear Information System (INIS)

    Ghoniem, Ahmed F.

    2011-01-01

    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. (author)

  12. 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.

  13. The Murray collection of pre-antibiotic era Enterobacteriacae: a unique research resource.

    Science.gov (United States)

    Baker, Kate S; Burnett, Edward; McGregor, Hannah; Deheer-Graham, Ana; Boinett, Christine; Langridge, Gemma C; Wailan, Alexander M; Cain, Amy K; Thomson, Nicholas R; Russell, Julie E; Parkhill, Julian

    2015-09-28

    Studies of historical isolates inform on the evolution and emergence of important pathogens and phenotypes, including antimicrobial resistance. Crucial to studying antimicrobial resistance are isolates that predate the widespread clinical use of antimicrobials. The Murray collection of several hundred bacterial strains of pre-antibiotic era Enterobacteriaceae is an invaluable resource of historical strains from important pathogen groups. Studies performed on the Collection to date merely exemplify its potential, which will only be realised through the continued effort of many scientific groups. To enable that aim, we announce the public availability of the Murray collection through the National Collection of Type Cultures, and present associated metadata with whole genome sequence data for over half of the strains. Using this information we verify the metadata for the collection with regard to subgroup designations, equivalence groupings and plasmid content. We also present genomic analyses of population structure and determinants of mobilisable antimicrobial resistance to aid strain selection in future studies. This represents an invaluable public resource for the study of these important pathogen groups and the emergence and evolution of antimicrobial resistance.

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

    African Journals Online (AJOL)

    Toshiba

    Net Investments in Human Resources. Other Assets. Liabilities and Stockholder's Equity. Total Current Liabilities. Long Term Debt, Excluding Current Installments. Deferred Compensation. Deferred Federal Income Tax Based upon. Full Tax Deduction for Human Resource Cost. 16,408,620. 3,371,943. 1,288,454. 183,152.

  15. 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.

  16. 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

  17. The urgent need for risk assessment on the antibiotic resistance spread via sewage sludge land application.

    Science.gov (United States)

    Bondarczuk, Kinga; Markowicz, Anna; Piotrowska-Seget, Zofia

    2016-02-01

    Sewage sludge is an ever-increasing by-product of the wastewater treatment process frequently used as a soil fertiliser. To control its quality and prevent any possible hazardous impact of fertilisation, some mandatory limits of heavy metal content have been established by the European Commission (Sewage Sludge Directive). However, since the implementation of the limits, new emerging contaminants have been reported worldwide. Regardless of the wastewater treatment process, sewage sludge contains antibiotics, antibiotic-resistant bacteria and antibiotic resistance genes, which can be released into the environment through its land application. Such a practice may even boost the dissemination and further development of antibiotic resistance phenomenon - already a global problem challenging modern medicine. Due to the growing pharmaceutical pollution in the environment, the time is ripe to assess the risk for the human and environmental health of sewage sludge land application in the context of antibiotic resistance spread. In this review we present the current knowledge in the field and we emphasise the necessity for more studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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.

  19. Antibiotic administration in the critically ill – in need of intensive care!

    African Journals Online (AJOL)

    Sepsis claims. 10 000 lives globally every day.[1] Antimicrobials, a major weapon in our armamentarium to combat infections, are arguably the most poorly ... and the duration of therapy was appropriate in just over a quarter of the patients.[3]. A recent commentary aptly suggested that the major reason that antibiotics are.

  20. 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. PMID:27379026

  1. aBiofilm: a resource of anti-biofilm agents and their potential implications in targeting antibiotic drug resistance

    OpenAIRE

    Rajput, Akanksha; Thakur, Anamika; Sharma, Shivangi; Kumar, Manoj

    2017-01-01

    Abstract Biofilms play an important role in the antibiotic drug resistance, which is threatening public health globally. Almost, all microbes mimic multicellular lifestyle to form biofilm by undergoing phenotypic changes to adapt adverse environmental conditions. Many anti-biofilm agents have been experimentally validated to disrupt the biofilms during last three decades. To organize this data, we developed the ‘ aBiofilm ’ resource (http://bioinfo.imtech.res.in/manojk/abiofilm/) that harbors...

  2. Situation Aware Assessment of Regulating Power Need and Resource

    DEFF Research Database (Denmark)

    Heussen, Kai

    2009-01-01

    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...... 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...

  3. 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.

  4. [Percutaneous intradiscal oxygen-ozone injection for lumbar disc herniation: no need of perioperative antibiotic prophylaxis].

    Science.gov (United States)

    Wei, Chuan-jun; Li, Yan-hao; Chen, Yong; Wang, Jiang-yun; Zeng, Qing-le; Zhao, Jian-bo; Mei, Que-lin

    2007-03-01

    To evaluate the feasibility of no antibiotic administration to prevent infection during the perioperative period of percutaneous intradiscal ozone-injection for treatment of lumbar disc herniation. Seventy-two patients with lumbar disc herniation but normal body temperature as well as normal results of three routine tests (blood, urine, stool) and C-reactive protein (CRP) level were randomly divided into two groups. The patients in prophylaxis group were given cephalothin V(2.0 g) intravenous 30 min before the operation, and the control group did not use any antibiotics. All the patients were injected with 6-10 ml ozone (40 microg/ml) for medical use into the discs with 21G needles under fluoroscopic guidance, followed by 10 ml ozone into the paravertebral space. Three days later the general examinations and CRP measurement were repeated. No infection was found in these patients, nor were any significant differences noted in the results of the examinations between the two groups after controlling in patients with above-normal white blood cell count, neutrophil percentage and CRP level. Prophylaxis antibiotics is not necessary during the perioperative period of percutaneous intradiscal ozone injection for lumbar disc herniation.

  5. Achieving Inclusion? Effective Resourcing of Students with Special Educational Needs

    Science.gov (United States)

    Banks, Joanne; Frawley, Denise; McCoy, Selina

    2015-01-01

    In line with the increasing policy emphasis on inclusive education, there is now a greater focus on how best to provide for students special educational needs (SEN) in mainstream schools. However, there is little consensus internationally as to the most equitable way in which to support these students. Despite ongoing evaluations of the existing…

  6. 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

  7. 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...

  8. 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 ...

  9. 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.

  10. 15 CFR 270.204 - Provision of additional resources and services needed by a Team.

    Science.gov (United States)

    2010-01-01

    ... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

  11. Natural Resources Level One Inventories: What are the Needs and Process for Corps Projects?

    Science.gov (United States)

    2006-09-01

    ERDC TN-EMRRP-EM-04 September 2006 Natural Resources Level One Inventories: What are the Needs and Process for Corps Projects? By Chester O...4. TITLE AND SUBTITLE Natural Resources Level One Inventories: What are the Needs and Process for Corps Projects? 5a. CONTRACT NUMBER 5b. GRANT

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

    Directory of Open Access Journals (Sweden)

    Alessia Diana

    Full Text Available 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.

  13. 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.

  14. 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

  15. 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.

  16. 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…

  17. 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.

  18. Antibiotic therapy prior to hospital admission is associated with reduced septic shock and need for mechanical ventilation in patients with community-acquired pneumonia.

    Science.gov (United States)

    Amaro, Rosanel; Sellarés, Jacobo; Polverino, Eva; Cillóniz, Catia; Ferrer, Miquel; Fernández-Barat, Laia; Mensa, Josep; Niederman, Michael S; Torres, Antoni

    2017-05-01

    A subgroup of patients admitted to the hospital with a diagnosis of community-acquired pneumonia (CAP) have received antibiotic therapy prior to admission for the current episode of pneumonia. The objective of this study was to assess the clinical course of patients receiving antibiotics prior to admission, compared to patients not previously treated. An observational cohort of 3364 CAP patients consecutively admitted to our hospital, and prospectively included, were studied. We collected clinical, microbiological and biochemical parameters, focusing on recent antibiotics received prior to admission. 610 (18%) patients received antibiotics prior to hospital admission for the current CAP episode. Patients with previous antibiotic use developed septic shock less frequently (4% vs. 7%, p = 0.007) and required invasive ventilation less often (3% vs. 6%, p = 0.002). After adjustment by different covariate factors and propensity score, antibiotic therapy was still independently associated with a lower incidence of septic shock at admission (OR 0.54 [95% CI 0.31-0.95], p = 0.03) and less need for invasive ventilation (OR 0.38 [95% CI 0.16-0.91], p = 0.03). In this cohort, recent use of antibiotics before hospital admission in CAP seems to be associated with a lower incidence of septic shock on admission and a lower need for invasive ventilation. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  19. 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…

  20. 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...

  1. 25 CFR 20.307 - What resources does the Bureau consider when determining need?

    Science.gov (United States)

    2010-04-01

    ... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Determining Need and Income § 20.307... Assistance eligibility and payment levels, we consider income and other resources as specified in §§ 20.308...

  2. 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

  3. 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.

  4. aBiofilm: a resource of anti-biofilm agents and their potential implications in targeting antibiotic drug resistance

    Science.gov (United States)

    Rajput, Akanksha; Thakur, Anamika; Sharma, Shivangi

    2018-01-01

    Abstract Biofilms play an important role in the antibiotic drug resistance, which is threatening public health globally. Almost, all microbes mimic multicellular lifestyle to form biofilm by undergoing phenotypic changes to adapt adverse environmental conditions. Many anti-biofilm agents have been experimentally validated to disrupt the biofilms during last three decades. To organize this data, we developed the ‘aBiofilm’ resource (http://bioinfo.imtech.res.in/manojk/abiofilm/) that harbors a database, a predictor, and the data visualization modules. The database contains biological, chemical, and structural details of 5027 anti-biofilm agents (1720 unique) reported from 1988–2017. These agents target over 140 organisms including Gram-negative, Gram-positive bacteria, and fungus. They are mainly chemicals, peptides, phages, secondary metabolites, antibodies, nanoparticles and extracts. They show the diverse mode of actions by attacking mainly signaling molecules, biofilm matrix, genes, extracellular polymeric substances, and many more. The QSAR based predictor identifies the anti-biofilm potential of an unknown chemical with an accuracy of ∼80.00%. The data visualization section summarized the biofilm stages targeted (Circos plot); interaction maps (Cytoscape) and chemicals diversification (CheS-Mapper) of the agents. This comprehensive platform would help the researchers to understand the multilevel communication in the microbial consortium. It may aid in developing anti-biofilm therapeutics to deal with antibiotic drug resistance menace. PMID:29156005

  5. aBiofilm: a resource of anti-biofilm agents and their potential implications in targeting antibiotic drug resistance.

    Science.gov (United States)

    Rajput, Akanksha; Thakur, Anamika; Sharma, Shivangi; Kumar, Manoj

    2018-01-04

    Biofilms play an important role in the antibiotic drug resistance, which is threatening public health globally. Almost, all microbes mimic multicellular lifestyle to form biofilm by undergoing phenotypic changes to adapt adverse environmental conditions. Many anti-biofilm agents have been experimentally validated to disrupt the biofilms during last three decades. To organize this data, we developed the 'aBiofilm' resource (http://bioinfo.imtech.res.in/manojk/abiofilm/) that harbors a database, a predictor, and the data visualization modules. The database contains biological, chemical, and structural details of 5027 anti-biofilm agents (1720 unique) reported from 1988-2017. These agents target over 140 organisms including Gram-negative, Gram-positive bacteria, and fungus. They are mainly chemicals, peptides, phages, secondary metabolites, antibodies, nanoparticles and extracts. They show the diverse mode of actions by attacking mainly signaling molecules, biofilm matrix, genes, extracellular polymeric substances, and many more. The QSAR based predictor identifies the anti-biofilm potential of an unknown chemical with an accuracy of ∼80.00%. The data visualization section summarized the biofilm stages targeted (Circos plot); interaction maps (Cytoscape) and chemicals diversification (CheS-Mapper) of the agents. This comprehensive platform would help the researchers to understand the multilevel communication in the microbial consortium. It may aid in developing anti-biofilm therapeutics to deal with antibiotic drug resistance menace. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  6. Resources

    Science.gov (United States)

    ... Colon cancer - resources Cystic fibrosis - resources Depression - resources Diabetes - resources Digestive disease - resources Drug abuse - resources Eating disorders - resources Elder care - resources Epilepsy - resources Family ...

  7. System Impacts from Interconnection of Distributed Resources: Current Status and Identification of Needs for Further Development

    Energy Technology Data Exchange (ETDEWEB)

    Basso, T. S.

    2009-01-01

    This report documents and evaluates system impacts from the interconnection of distributed resources to transmission and distribution systems, including a focus on renewable distributed resource technologies. The report also identifies system impact-resolution approaches and actions, including extensions of existing approaches. Lastly, the report documents the current challenges and examines what is needed to gain a clearer understanding of what to pursue to better avoid or address system impact issues.

  8. Support needs and resources of sexual minority women with breast cancer.

    Science.gov (United States)

    Paul, Laurie B; Pitagora, Dulcinea; Brown, Brienne; Tworecke, Adrian; Rubin, Lisa

    2014-05-01

    The current paper utilizes qualitative methods to better understand the support needs and resources of sexual minority women (SMW) breast cancer patients. Thirteen semi-structured interviews were conducted with SMW, who were recruited from community-based organizations and had undergone mastectomy for treatment of breast cancer. Interviews explored support needs and resources. Data were analyzed using thematic analysis. Three key domains emerged: support groups, family of origin support, and partner support. Participants emphasized the value of cancer support groups and resources tailored to SMW while stating that other dimensions of identity or experience, particularly age and cancer stage, were also important. Participants noted the dearth of social support resources for same-sex partners. Family of origin and partners were typically participants' primary sources of tangible and emotional support; participants often engaged in protective buffering to mitigate caregivers' distress. Single women faced the greatest challenges in terms of support needs and resources. Former partners were often key sources of support. SMW and their partners have many shared and unique support resources and barriers. Heteronormativity that is implicit in the structure of support resources can serve as a barrier to support for SMW and their partners. Flexibility in relationship roles enabling some SMW to include former partners as significant means of support may be a source of resiliency, particularly for unpartnered SMW cancer patients. Support needs and resources of SMW are best understood through an intersectionality framework that considers sexual orientation, relationship status, cancer stage, age, healthcare access, and other important identities and experiences. Copyright © 2013 John Wiley & Sons, Ltd.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. Antibiotic Resistance

    DEFF Research Database (Denmark)

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

    2015-01-01

    Numerous opportunities are available in primary care for alleviating the crisis of increasing antibiotic resistance. Preventing patients from developing an acute respiratory infection (ARI) will obviate any need for antibiotic use downstream. Hygiene measures such as physical barriers and hand...... 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....... antibiotic prescribing are a major factor in the prescribing for ARIs. Professional interventions with educational components are effective, although they have modest effects, and are expensive. GPs' perceptions - that mistakenly assume as a default that patients want antibiotics for their ARIs - are often...

  16. Return to sender: the need to re-address patient antibiotic allergy labels in Australia and New Zealand.

    Science.gov (United States)

    Trubiano, J A; Worth, L J; Urbancic, K; Brown, T M; Paterson, D L; Lucas, M; Phillips, E

    2016-11-01

    Antibiotic allergies are frequently reported and have significant impacts upon appropriate prescribing and clinical outcomes. We surveyed infectious diseases physicians, allergists, clinical immunologists and hospital pharmacists to evaluate antibiotic allergy knowledge and service delivery in Australia and New Zealand. An online multi-choice questionnaire was developed and endorsed by representatives of the Australasian Society of Clinical Immunology and Allergy (ASCIA) and the Australasian Society of Infectious Diseases (ASID). The 37-item survey was distributed in April 2015 to members of ASCIA, ASID, the Society of Hospital Pharmacists of Australia and the Royal Australasian College of Physicians. Of 277 respondents, 94% currently use or would utilise antibiotic allergy testing (AAT) and reported seeing up to 10 patients/week labelled as antibiotic-allergic. Forty-two per cent were not aware of or did not have AAT available. Most felt that AAT would aid antibiotic selection, antibiotic appropriateness and antimicrobial stewardship (79, 69 and 61% respectively). Patients with the histories of immediate hypersensitivity were more likely to be referred than those with delayed hypersensitivities (76 vs 41%, P = 0.0001). Lack of specialist physicians (20%) and personal experience (17%) were barriers to service delivery. A multidisciplinary approach was a preferred AAT model (53%). Knowledge gaps were identified, with the majority overestimating rates of penicillin/cephalosporin (78%), penicillin/carbapenem (57%) and penicillin/monobactam (39%) cross-reactivity. A high burden of antibiotic allergy labelling and demand for AAT is complicated by a relative lack availability or awareness of AAT services in Australia and New Zealand. Antibiotic allergy education and deployment of AAT, accessible to community and hospital-based clinicians, may improve clinical decisions and reduce antibiotic allergy impacts. A collaborative approach involving infectious diseases

  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...... to support livestock management decisions. To do the latter, pastoralists need information pertaining to the availability of grazing resources in various areas, the onset date of the rains, flooding events, and finescale information on rainfall amount during the first weeks of the rainy season...

  18. 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.

  19. The Future Fiscal Needs of Ontario's College System: Total Resource Development and Strategic Philanthropy

    Science.gov (United States)

    Gouveia, Cindy

    2014-01-01

    This paper discusses the idea that for Ontario's colleges to meet the intentions and legal requirements of their original mandates, they will need to consider extending the scope of their advancement departments to implement key components of both the Total Resource Development Model (Worth, 2002, ascited by Barrette, 2013) and the Strategic…

  20. 76 FR 34684 - Offshore Renewable Energy; Public Meeting on Information Needs for Resource Assessment and Design...

    Science.gov (United States)

    2011-06-14

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Offshore Renewable Energy; Public Meeting on Information Needs for Resource Assessment and Design Conditions AGENCY: Office of Energy Efficiency and Renewable Energy, Department of Energy (DOE). ACTION: Notice of public meeting...

  1. 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.

  2. 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.

  3. The need for continued monitoring of antibiotic resistance patterns in clinical isolates of Staphylococcus aureus from London and Malta

    Directory of Open Access Journals (Sweden)

    Easmon Sue

    2010-07-01

    Full Text Available Abstract Background Antibiotic resistance is an increasing problem in isolates of Staphylococcus aureus (S. aureus worldwide. In 2001 The National Health Service in the UK introduced a mandatory bacteraemia surveillance scheme for the reporting of S. aureus and methicillin-resistant S. aureus (MRSA. This surveillance initiative reports on the percentage of isolates that are methicillin resistant. However, resistance to other antibiotics is not currently reported and therefore the scale of emerging resistance is currently unclear in the UK. In this study, multiple antibiotic resistance (MAR profiles against fourteen antimicrobial drugs were investigated for 705 isolates of S. aureus collected from two European study sites in the UK (London and Malta. Results All isolates were susceptible to linezolid, teicoplanin and vancomycin. Multiple antibiotic resistance profiles from both countries were determined, a total of forty-two and forty-five profiles were seen in the UK cohort (MRSA and MSSA respectively and comparatively, sixty-two and fifty-two profiles were shown in the Maltese group. The largest MAR profile contained six antibiotics (penicillin G, methicillin, erythromycin, ciprofloxacin, clindamycin and clarithromycin and was observed in the MRSA isolates in both the UK and Maltese cohorts. Conclusion The data presented here suggests that the monitoring of changing resistance profiles locally in maintaining treatment efficacy to resistant pathogens.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

    Directory of Open Access Journals (Sweden)

    Teemul Karen

    2004-12-01

    Full Text Available Abstract Background Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals. The liberal use of third-generation cephalosporins (3GCs in these hospitals has been associated with the emergence of extended-spectrum beta- lactamases (ESBLs presenting concerns for bacterial resistance in therapeutics. We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic prescribed these drugs. Methods Clinical data of patients (≥ 13 years admitted to the General Hospital, Port of Spain (POSGH from January to June 2000, and who had received 3GCs based on the Pharmacy records were studied. The Sanford Antibiotic Guide 2000, was used to determine appropriateness of therapy. The agency which procures drugs for the Ministry of Health supplied the cost of drugs. Results The prevalence rate of use of 3GCs was 9.5 per 1000 admissions and was higher in surgical and gynecological admissions (21/1000 compared with medical and orthopedic (8 /1000 services (p Conclusions There is extensive inappropriate 3GC utilization in tertiary care in Trinidad. We recommend hospital laboratories undertake continuous surveillance of antibiotic resistance patterns so that appropriate changes in prescribing guidelines can be developed and implemented. Though guidelines for rational antibiotic use were developed they have not been re-visited or encouraged, suggesting urgent antibiotic review of the hospital formulary and instituting an infection control team. Monitoring antibiotic use with microbiology laboratory support can promote rational drug utilization, cut costs, halt inappropriate 3GC prescribing, and delay the emergence of resistant organisms. An ongoing antibiotic peer audit is suggested.

  9. The growing need for resources to help older adults manage their financial and healthcare choices.

    Science.gov (United States)

    MacLeod, Stephanie; Musich, Shirley; Hawkins, Kevin; Armstrong, Douglas G

    2017-04-11

    Both financial literacy (managing personal finances) and health literacy (managing personal health) become increasingly important for older adults, potentially impacting their quality of life. Resources in these constructs of literacy tend to be distinct, although the skills and decision-making involved overlap as financial issues impact healthcare choices. Thus the primary purpose of this commentary is to propose a new area of research focus that defines the intersection of financial and health literacy (i.e., financial health literacy). We conducted a limited literature review related to financial, health, and health insurance literacy to demonstrate gaps in the literature and support our position. Online search engines were utilized to identify research in our primary areas of interest. We define the intersection of financial and health literacy as an area of need labeled financial health literacy, with a focus on four domains. These include: 1) the ability to manage healthcare expenses; 2) pay medical bills; 3) determine health needs and understand treatment options; and 4) make sound healthcare decisions with financial resources available. Despite some overlap with health insurance literacy, financial health literacy would define an area of need encompassing health management choices and health plan selections integrated with other financial management issues including living arrangements, financial planning, and retirement planning. Potential initiatives should be considered to help at-risk older adults find resources to improve their financial health literacy, which in turn will enhance their abilities to manage medical choices in the environment of an increasingly complex healthcare system.

  10. 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.

  11. Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

    Science.gov (United States)

    Pinto Pereira, Lexley M; Phillips, Marjorie; Ramlal, Hema; Teemul, Karen; Prabhakar, P

    2004-01-01

    Background Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals. The liberal use of third-generation cephalosporins (3GCs) in these hospitals has been associated with the emergence of extended-spectrum beta- lactamases (ESBLs) presenting concerns for bacterial resistance in therapeutics. We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic) prescribed these drugs. Methods Clinical data of patients (≥ 13 years) admitted to the General Hospital, Port of Spain (POSGH) from January to June 2000, and who had received 3GCs based on the Pharmacy records were studied. The Sanford Antibiotic Guide 2000, was used to determine appropriateness of therapy. The agency which procures drugs for the Ministry of Health supplied the cost of drugs. Results The prevalence rate of use of 3GCs was 9.5 per 1000 admissions and was higher in surgical and gynecological admissions (21/1000) compared with medical and orthopedic (8 /1000) services (p < 0.05). Ceftriaxone was the most frequently used 3GC. Sixty-nine (36%) patients without clinical evidence of infection received 3Gcs and prescribing was based on therapeutic recommendations in 4% of patients. At least 62% of all prescriptions were inappropriate with significant associations for patients from gynaecology (p < 0.003), empirical prescribing (p < 0.48), patients with undetermined infection sites (p < 0.007), and for single drug use compared with multiple antibiotics (p < 0.001). Treatment was twice as costly when prescribing was inappropriate Conclusions There is extensive inappropriate 3GC utilization in tertiary care in Trinidad. We recommend hospital laboratories undertake continuous surveillance of antibiotic resistance patterns so that appropriate changes in prescribing guidelines can be developed and

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Role of educational institutions in identifying and responding to emerging health human resources needs.

    Science.gov (United States)

    Tzountzouris, John-Paul; Gilbert, John H V

    2009-01-01

    The healthcare system continues to evolve, requiring innovation to promote patient-centred, fiscally responsible healthcare delivery. This evolution includes changes to the skills and competencies required of the health human resources (HHR), both regulated and unregulated, who are central supports to healthcare delivery. This has become a priority agenda item at the international, national, provincial, regional and local levels. This paper describes the system factors that drive the emergence of HHR skill and competency needs, and explores the roles of various institutions in the identification of and response to HHR needs. Educational institutions play an important role in responding to emerging HHR needs. Their actual response to HHR skill and competency needs will ultimately depend on the risk posed to the organizations of either addressing, or not addressing, these needs. These decisions are complex and are balanced against strategic, operational and educational risks, benefits and realities within each given educational institution. Educational institutions - through their linkages with the workplace, industry, professional organizations and government - have a unique view and understanding of many facets of the complexity of HHR planning. This paper proposes that educational institutions play a pivotal role as levers in a more coordinated response to emerging HHR needs and, as such, should be intimately involved in comprehensive HHR planning.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Moving beyond obsolescence: an important role for educational institutions in health human resources needs.

    Science.gov (United States)

    Leggat, Sandra G

    2009-01-01

    The plan proposed by Tzountzouris and Gilbert is a useful framework for those of us in educational settings to gather and analyze the information to assist in forming our "educational response" to issues of health human resources. But I am concerned that the proposed plan and process encourages us to continue to survey the HHR carnage from our ivory towers, waiting for someone else to pick up the pieces. Instead, academics in education institutions should use their competencies to provide external leadership, building bridges between the policy directions and the local needs.

  3. Human resources needed to affter health prevention and promotion to adults in primary health care.

    Directory of Open Access Journals (Sweden)

    Jacqueline Elizabeth Alcalde-Rabanal

    2013-05-01

    Full Text Available Objective. To estimate human resources (HR needed to deliver prevention and health promotion actions to the population of 20 years and more in units of primary health care (UPHC. Materials and methods. We included 20 UPHC; one urban and one rural for each of the ten selected Mexican states. HR were estimated based on the time to do prevention and health promotion activities, from which a budget was calculated. Measures of central tendency and dispersion were reported, using the ANOVA test and the Wilcoxon test. Results. The number of health professionals estimated in UPHC with spent time is less than the number estimated with required time. Conclusions. The estimated density of health professionals per population needed to offer prevention and health promotion activities for people 20 years and more in UPHC is greater than the current density of health professionals.

  4. Identifying structures, processes, resources and needs of research ethics committees in Egypt

    Directory of Open Access Journals (Sweden)

    Sleem Hany

    2010-06-01

    Full Text Available Abstract Background Concerns have been expressed regarding the adequacy of ethics review systems in developing countries. Limited data are available regarding the structural and functional status of Research Ethics Committees (RECs in the Middle East. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges. Methods We distributed a self-administered survey tool to Egyptian RECs to collect information on the following domains: general characteristics of the REC, membership composition, ethics training, workload, process of ethics review, perceived challenges to effective functioning, and financial and material resources. We used basic descriptive statistics to evaluate the quantitative data. Results We obtained responses from 67% (12/18 of the identified RECs. Most RECs (10/12 have standard operating procedures and many (7/12 have established policies to manage conflicts of interests. The average membership was 10.3 with a range from 7-19. The predominant member type was physicians (69.5% of all of the REC members with little lay representation (13.7%. Most RECs met at least once/month and the average number of protocols reviewed per meeting was 3.8 with a range from 1-10. Almost three-quarters of the members from all of the 12 RECs indicated they received some formal training in ethics. Regarding resources, roughly half of the RECs have dedicated capital equipment (e.g., meeting room, computers, office furniture, etc; none of the RECs have a formal operating budget. Perceived challenges included the absence of national research ethics guidelines and national standards for RECs and lack of ongoing training of its members in research ethics. Conclusion Our study documents several areas of strengths and areas for improvements in the operations of Egyptian RECs. Regarding strengths, many of the existing RECs meet frequently, have a majority of members

  5. Caring for Children with Special Health Care Needs: Profiling Pediatricians and Their Health Care Resources.

    Science.gov (United States)

    Okumura, Megumi J; Knauer, Heather A; Calvin, Kris E; Takayama, John I

    2018-03-01

    Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers. We performed a logistic regression model on having an "above average proportion" of CSHCN in practice, adjusting for demographics, practice type (rural vs. suburban/urban) and medical resources, care satisfaction, and ease of subspecialty access. Results Our response rate was 50.2% (n = 1290); 75% of respondents reported providing some primary care services, with many primary care pediatricians caring for a high proportion of CSHCN. Pediatricians reported an average of 28% CSHCN in their practices. Rural pediatricians lacked subspecialty access (10-59% reporting no access to the various subspecialties). Factors relating to higher CSHCN in practice included being in academic medical centers and satisfaction in caring for CSHCN. Conclusions Pediatricians report lack of access to mental health services, care coordination and case management. Academic medical centers and higher physician satisfaction in care delivery for CSHCN are associated with more CSHCN in practice. Promoting ways to support pediatricians, such as practice collaboration with behavioral specialists, may be necessary to encourage primary care pediatricians to provide medical homes for CSHCN.

  6. 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.

  7. 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.

  8. HERO (Health Economics in Radiation Oncology): a pan-European project on radiotherapy resources and needs.

    Science.gov (United States)

    Lievens, Y; Dunscombe, P; Defourny, N; Gasparotto, C; Borras, J M; Grau, C

    2015-02-01

    Radiotherapy continues to evolve at a rapid rate in technology and techniques, with both driving up costs in an era in which health care budgets are of increasing concern at every governmental level. Against this background, it is clear that the radiotherapy community needs to quantify the costs of state of the art practice and then to justify those costs through rigorous cost-effectiveness analyses. The European Society for Radiotherapy and Oncology-Health Economics in Radiation Oncology project is directed towards tackling this issue in the European context. The first step has been to provide a validated picture of the European radiotherapy landscape in terms of the availability of equipment, personnel and guidelines. An 84-item questionnaire was distributed to the 40 countries of the European Cancer Observatory, of which 34 provided partial or complete responses. There was a huge variation in the availability and sophistication of treatment equipment and staffing levels across Europe. The median number of MV units per million inhabitants was 5.3, but there was a seven-fold variation across the European countries. Likewise, although average staffing figures per million inhabitants were 12.8 for radiation oncologists, 7.6 for physicists, 3.5 for dosimetrists, 26.6 for radiation therapists and 14.8 for nurses, there was a 20-fold variation, even after grouping personnel with comparable duties in the radiotherapy process. Guidelines for capital and human resources were declared for most countries, but without explicitly providing metrics for developing capital and human resource inventories in many cases. Although courses delivered annually per resource item – be it equipment or staff – increase with decreasing gross national income (GNI) per capita, differences were observed in equipment and staff availability in countries with a higher GNI/n, indicating that health policy has a significant effect on the provision of services. Although more needs to be done to

  9. 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

  10. 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

  11. OPPORTUNITIES AND LIMITATIONS IN THE PROVISION OF SELF-HELP LEGAL RESOURCES TO CITIZENS IN NEED

    Directory of Open Access Journals (Sweden)

    Merran Lawler

    2012-02-01

    Full Text Available This article considers the utility of resources designed to assist people undertaking their own legal work. Four in-depth case studies are used to explore the tensions inherent in providing coherent and user-oriented resources to legal self-helpers in environments where service providers attempt to convey complex legal information, knowledge and skills to people at the point of legal exigency. The needs of the consumer for basic process oriented and solutions focused resources do not always coincide with the objectives of providers to impart sufficient legal knowledge, information and skills to allow the consumer to work through those processes as an informed citizen. Cet article porte sur l’utilité des ressources conçues pour aider les gens à effectuer eux-mêmes le travail juridique qu’ils requièrent. Quatre études de cas approfondies servent à examiner les tensions inhérentes à la distribution de ressources d’auto-assistance juridique cohérentes axées sur l’utilisateur dans des milieux où les fournisseurs de services cherchent à transmettre des connaissances, de l’information et des compétences juridiques complexes, selon les exigences de la loi. La nécessité pour le client d’obtenir des ressources axées sur les solutions et les procédures de base ne va pas toujours dans le sens de l’objectif des fournisseurs de services, qui consiste à lui transmettre des connaissances, de l’information et des compétences juridiques suffisantes pour qu’il puisse mener à bien ces procédures en tant que citoyen informé.

  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

    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.

  14. 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

  15. 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)

  16. Cessation support for smokers with mental health problems: a survey of resources and training needs.

    Science.gov (United States)

    Simonavicius, Erikas; Robson, Debbie; McEwen, Andy; Brose, Leonie S

    2017-09-01

    Around thirty percent of smokers have a mental health problem. Smoking cessation has been associated with mental health benefits, but smoking prevalence remains high in populations with mental health problems. This study aimed to assess mental health related knowledge, practice, and training needs of practitioners supporting smoking cessation. UK stop smoking practitioners (n=717) recruited via a database of a national provider of smoking cessation training in June 2016 sufficiently completed an online survey about available resources, knowledge, confidence, and training needs related to smoking cessation and mental health. Responses were described and compared between practitioners with a mental health lead and those without such a lead in their service using chi-square statistics and t-tests. A considerable proportion agreed (37%) or were undecided (28.9%) that smoking helped people with mental health problems feel better and agreed (17.2%) or were undecided (30.2%) that cessation would exacerbate mental health symptoms. Only 11.6% said their service had designated funding for smokers with mental health problems and 26.5% were or had a staff member who was a dedicated lead practitioner for mental health work. Practitioners from services that had a dedicated mental health lead were more confident in supporting smokers with different mental health problems and using different pharmacotherapies (all ptraining, particularly about smoking cessation effects on psychiatric medication (84.3% of n=632) and how to tailor stop smoking support to clients with mental health problems (82.4%). Practitioners who support smoking cessation have limited knowledge about mental health and smoking but are willing to learn and improve. However, they are hindered by a lack of resources. Copyright © 2017. Published by Elsevier Inc.

  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. 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.

  20. Sexual Assault: Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve

    Science.gov (United States)

    2017-02-01

    the commanding officer of an accused servicemember. 21Army Regulation 600-20 defines sexual harassment as a form of gender discrimination that...SEXUAL ASSAULT Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army...Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve What GAO Found The Army National Guard

  1. 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.

  2. Stratification of Highest-Risk Patients with Chronic Skin Ulcers in a Stanford Retrospective Cohort Includes Diabetes, Need for Systemic Antibiotics, and Albumin Levels

    Directory of Open Access Journals (Sweden)

    Omar Amir

    2012-01-01

    Full Text Available Chronic nonsurgical skin wounds such as venous stasis and diabetic ulcers have been associated with a number of comorbid conditions; however, the strength of these associations has not been compared. We utilized the Stanford Translational Research Integrated Database Environment (STRIDE system to identify a cohort of 637 patients with chronic skin ulcers. Preliminary analysis ( showed that 49.7% of the patients had a poor prognosis such as amputation or a nonhealing ulcer for at least a year. Factors significantly associated ( with these outcomes included diabetes mellitus, chronic kidney disease, peripheral neuropathy, peripheral arterial disease, and need for systemic antibiotics. Patients with poor outcomes also tended to have lower hemoglobin levels (, higher WBC levels (, and lower albumin levels (. On multivariate analysis, however, only diabetes mellitus (OR 5.87, 1.36–25.3, need for systemic antibiotics (OR 3.88, 1.06–14.2, and albumin levels (0.20 per unit, 0.07–0.60 remained significant independent predictors of poor wound-healing outcomes. These data identify patients at the highest risk for poor wound-healing and who may benefit the most from more aggressive wound care and treatment.

  3. Resource Needs for Adolescent Friendly Health Services: Estimates for 74 Low- and Middle-Income Countries

    Science.gov (United States)

    Deogan, Charlotte; Ferguson, Jane; Stenberg, Karin

    2012-01-01

    Background In order to achieve Millennium Development Goals 4, 5 and 6, it is essential to address adolescents’ health. Objective To estimate the additional resources required to scale up adolescent friendly health service interventions with the objective to reduce mortality and morbidity among individuals aged 10 to 19 years in 74 low- and middle- income countries. Methods A costing model was developed to estimate the financial resources needed to scale-up delivery of a set of interventions including contraception, maternity care, management of sexually transmitted infections, HIV testing and counseling, safe abortion services, HIV harm reduction, HIV care and treatment and care of injuries due to intimate partner physical and sexual violence. Financial costs were estimated for each intervention, country and year using a bottom-up ingredients approach, defining costs at different levels of delivery (i.e., community, health centre, and hospital level). Programme activity costs to improve quality of care were also estimated, including activities undertaken at national-, district- and facility level in order to improve adolescents’ use of health services (i.e., to render health services adolescent friendly). Results Costs of achieving universal coverage are estimated at an additional US$ 15.41 billion for the period 2011–2015, increasing from US$ 1.86 billion in 2011 to US$ 4,31 billion in 2015. This corresponds to approximately US$ 1.02 per adolescent in 2011, increasing to 4.70 in 2015. On average, for all 74 countries, an annual additional expenditure per capita ranging from of US$ 0.38 in 2011 to US$ 0.82 in 2015, would be required to support the scale-up of key adolescent friendly health services. Conclusion The estimated costs show a substantial investment gap and are indicative of the additional investments required to scale up health service delivery to adolescents towards universal coverage by 2015. PMID:23300548

  4. Canadian ENGOs in governance of water resources: information needs and monitoring practices.

    Science.gov (United States)

    Kebo, Sasha; Bunch, Martin J

    2013-11-01

    Water quality monitoring involves a complex set of steps and a variety of approaches. Its goals include understanding of aquatic habitats, informing management and facilitating decision making, and educating citizens. Environmental nongovernmental organizations (ENGOs) are increasingly engaged in water quality monitoring and act as environmental watchdogs and stewards of water resources. These organizations exhibit different monitoring mandates. As government involvement in water quality monitoring continues to decline, it becomes essential that we understand their modi operandi. By doing so, we can enhance efficacy and encourage data sharing and communication. This research examined Canadian ENGOs that collect their own data on water quality with respect to water quality monitoring activities and information needs. This work had a twofold purpose: (1) to enhance knowledge about the Canadian ENGOs operating in the realm of water quality monitoring and (2) to guide and inform development of web-based geographic information systems (GIS) to support water quality monitoring, particularly using benthic macroinvertebrate protocols. A structured telephone survey was administered across 10 Canadian provinces to 21 ENGOs that undertake water quality monitoring. This generated information about barriers and challenges of data sharing, commonly collected metrics, human resources, and perceptions of volunteer-collected data. Results are presented on an aggregate level and among different groups of respondents. Use of geomatics technology was not consistent among respondents, and we found no noteworthy differences between organizations that did and did not use GIS tools. About one third of respondents did not employ computerized systems (including databases and spreadsheets) to support data management, analysis, and sharing. Despite their advantage as a holistic water quality indicator, benthic macroinvertebrates (BMIs) were not widely employed in stream monitoring. Although

  5. 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

  6. Proceedings for the DoD Cultural Resources Workshop: Prioritizing Cultural Resources Needs in Support of a Sound Investment Strategy

    Science.gov (United States)

    2006-07-01

    Benning 8 or 9 years ago we signed a memorandum for the recordation—before demolition —of the historic base theater—a wonderful art deco structure built...5-1 WHITE PAPERS: STATE OF THE SCIENCE, ART , KNOWLEDGE, AND MANAGEMENT iv TABLE OF CONTENTS...state-of-the- art in science and technology for CRM. 1-4 DoD Cultural Resources Workshop Proceedings • To identify potential technologies that

  7. 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.

  8. Facing up to the Plurality of Goals, Methods, Needs and Resources in HCI

    Directory of Open Access Journals (Sweden)

    Stephen Draper

    1996-05-01

    Full Text Available Most analyses of how humans use artifacts, and interactive software in particular, have a strong tendency to assign 1:1 correspondences between goals and methods: to see software as supporting one task, users as having one way of executing a task, one thing to learn when learning a command, and one source for discovering the information. In fact this is a rare case, and multiplicity of goals, methods, information needs, and information resources is the rule even in simple software. How this causes problems for the design and testing of user interfaces can be illustrated by examples from a wide range of domains and levels of design, including studies on learning by exploration, the effect of machine delays on user strategies, the Icamability of icon sets, evaluation studies of Computer Assisted Learning, and an analysis of the concept of affordance. Such plurality can he a source of robustness for the performance of interfaces: it is a problem main for analysis and HCI research, which struggle to account for the frequent case of high average performance levels mixed with a few residual problems. To address this plurality, we must extend our analyses to cover sets of alternative methods for tasks rather than single user procedures, and perhaps draw on concepts such as Activity Theory to address users' mental organisation of such plurality.

  9. Resources endowment, income distribution and needs for techno-logies among peri-urban smallholders in the Gambia

    Directory of Open Access Journals (Sweden)

    Tollens E.

    2006-01-01

    Full Text Available One reason of the modest adoption of improved technologies by smallholder farmers is that the majority of them are resource constrained. Structural constraints at the households level and institutional weaknesses have often prevented most of the farmers from joining the economic development process. This study analyses the production resources in relation with the income and the needs for improved technologies of the peri-urban farm households in The Gambia. The results are compelling. The majority of the production resources are owned by small fraction of the smallholders. As a consequence, their income is higher and mostly derived from agriculture, while the poor-resource households rely on a relatively wide variety of activities to compensate their low income. The poor-resource households have also the greatest need for improved technologies, although many would also need some kind of subsidies to uptake them. There is a clear need for more agricultural research, expertise and policy-making to transcend the traditional global understanding of smallholder farmers, and consider their heterogeneity in terms of production resources.

  10. 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

  11. 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

  12. 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

  13. 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

  14. Serving the needs of Latino recreation visitors to urban proximate natural resource recreation areas

    Science.gov (United States)

    Deborah J. Chavez

    2008-01-01

    A major shift has occurred in the ethnic and racial profile of the United States, with large increases in the Latino population. Beyond the demographic profiles are the influences on other aspects of life in the United States, including urban-proximate natural resource recreation area management. Latino groups may have different expectations about natural resource...

  15. An enquiry on forest areas reported to the global forest resources assessment—is harmonization needed?

    Science.gov (United States)

    Karl ​Gabler; Klemens Schadauer; Erkki Tomppo; Claude Vidal; Camille Bonhomme; Ronald E. McRoberts; Thomas. Gschwantner

    2012-01-01

    For international reporting purposes, information on forest resources often has to be supplied according to international definitions. Nevertheless, the country reports of the Food and Agriculture Organization (FAO) Global Forest Resources Assessment 2005 indicate that countries either prefer to use their own forest definitions or use national classes of forest and...

  16. 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…

  17. Antibiotic policy

    OpenAIRE

    Gyssens, Inge

    2011-01-01

    There is a clear association between antibiotic use and resistance both on individual and population levels. In the European Union, countries with large antibiotic consumption have higher resistance rates. Antibiotic resistance leads to failed treatments, prolonged hospitalisations, increased costs and deaths. With few new antibiotics in the Research & Development pipeline, prudent antibiotic use is the only option to delay the development of resistance. Antibiotic policy consists of prescrib...

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

    OpenAIRE

    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 research scale spanning from a tree leaf, to a segment of forest road, and large basins with mixed land uses. T...

  19. 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...

  20. 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

  1. Single-dose compared with multiple day antibiotic prophylaxis for cesarean section in low-resource settings, a randomized controlled, noninferiority trial.

    Science.gov (United States)

    Westen, Esther H M N; Kolk, Pascal R; van Velzen, Christine L; Unkels, Regine; Mmuni, Nicholaus S; Hamisi, Alex D; Nakua, Ritha E; Vlek, Anne L M; van Beekhuizen, Heleen J

    2015-01-01

    To investigate the efficacy of a single prophylactic dose of ampicillin combined with metronidazole to prevent postcesarean section infections compared with a multiple day regimen in low-resource settings. An evaluator-blinded randomized, controlled, noninferiority trial. Two rural hospitals in Tanzania. Of 181 enrolled eligible women with an indication for cesarean section, information on 176 was analyzed by intention-to-treat. The women were randomly assigned to either the intervention group who received a single dose of ampicillin and metronidazole, or to the control group who received a multiple-day regimen of ampicillin/amoxicillin and metronidazole. The primary outcome was maternal postcesarean infection. Secondary outcomes were severity of these infections, other maternal complications, and the duration of hospital stay. In the intervention group (n = 89), six women (6.7%) developed a wound infection compared with nine (10.3%) in the control group (n = 87) (difference 3.60; 95% CI -4.65 to 11.85) (p = 0.40). A single dose of prophylactic ampicillin and metronidazole is equally effective as a multiple-day regimen in preventing postcesarean wound infections in low-resource settings, therefore it can be considered as a good strategy in low-resource settings. The reduced quantity of prophylactic antibiotics will reduce costs without increasing the risk of maternal infection. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. 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.

  3. 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

  4. 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.

  5. Best practice smoking cessation intervention and resource needs of prenatal care providers.

    Science.gov (United States)

    Hartmann, Katherine E; Wechter, Mary E; Payne, Patricia; Salisbury, Kathryn; Jackson, Renee D; Melvin, Cathy L

    2007-10-01

    To describe smoking cessation interventions by prenatal care providers and to identify factors associated with best practice. A mailed survey assessed implementation of the "5 A's" of best practice (Ask about smoking; Advise patients to quit; Assess willingness to quit; Assist with a cessation plan; and Arrange follow-up), practice characteristics, intervention training, resources, barriers, and attitudes toward reimbursement. Each factor in association with provider type and best practice implementation was analyzed. Of 1,138 eligible North Carolina health professionals, 844 responded (74%); 549 were providing prenatal care and returned completed surveys. Most asked about smoking (98%) and advised cessation (100%). Across provider type, one third (31%) consistently implemented all "5 A's" of best practice. Most providers (90%) had at least one material resource (eg, pamphlets), which correlated with nearly 10 times the adjusted odds of best practice (odds ratio [OR] 9.6, 95% confidence interval [CI] 1.3-72.9). Seventy percent had at least one counseling resource. Having a counseling resource (OR 2.5, 95% CI 1.4-4.4) and a written protocol to identify staff responsibilities (OR 2.5, 95% CI 1.5-4.3) were equally associated with best practice. More than one half of providers endorsed reimbursement as influential on best practice. Best practice is well-established to promote prenatal smoking cessation yet implemented by only one third of prenatal care providers in North Carolina. In this study, best practice was associated with resources, practice organization, and reimbursement. Augmented use of available resources (eg, toll-free hotlines) and adequate reimbursement may promote best practice implementation.

  6. E-learning resources for vascular surgeons: a needs analysis study.

    Science.gov (United States)

    Mâtheiken, Seán J; Verstegen, Daniëlle; Beard, Jonathan; van der Vleuten, Cees

    2012-01-01

    To obtain the views of vascular surgeons about online resources in their specialty as a guide to future e-learning development. A focused questionnaire regarding e-learning resources in vascular surgery was circulated online. A combination of structured and open-ended questions addressed users' ranking of various resource types, examples of presently used websites, suggestions for future growth, and the opportunity to become actively involved in e-learning development. The responses were collected over a 4-week period and remained anonymous. The study was conducted online at http://www.vasculareducation.com as part of an ongoing project on e-learning for vascular surgeons by the Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. The survey population consisted of vascular surgeons and surgical trainees in Europe. The participants were contacted via their membership of the European Society for Vascular Surgery and national academic or administrative vascular surgical organizations. Demographic information was collected about clinical seniority and country of work. In all, 252 responses were obtained. Respondents favored the development of a variety of online resources in vascular surgery. The strongest demand was for illustrations and videos of surgical techniques, followed by an interactive calendar and peer-reviewed multiple-choice questions. Overall, 46% of respondents wished to contribute actively toward e-learning development, with consultants being more willing than trainees to do so. Members of the vascular surgical community value online resources in their specialty, especially for procedural techniques. Vascular surgeons would like to be actively involved in subsequent development of e-learning resources. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. 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 ...

  8. Is there a need to revise the antibiotic concentration in Clinical and Laboratory Standards Institute-Recommended Oxacillin Screen Agar?

    Directory of Open Access Journals (Sweden)

    Niveditha Nagasundaram

    2017-01-01

    Full Text Available Introduction: In routine diagnostic microbiology laboratories, Clinical and Laboratory Standards Institute (CLSI recommends the use of cefoxitin disc, in addition to oxacillin screen agar (OSA of 6 μg/ml for the detection of methicillin-resistant Staphylococcus aureus (MRSA, whereas minimum inhibitory concentration values of oxacillin for S. aureus are ≤2 μg/ml (susceptible and ≥4 μg/ml (resistant. Hence, the study was carried out to evaluate the ability of screen agar with lower concentrations of oxacillin to identify the isolates of MRSA and to compare this with cefoxitin disc diffusion (CDD. Materials and Methods: Six hundred and seventy-six isolates of S. aureus were screened for methicillin resistance by OSA with 2 μg/ml and 4 μg/ml and 6 μg/ml of oxacillin concentration as well as CDD. Polymerase chain reaction for mecA gene was carried out for all isolates which grew on OSA 2, 4 and 6 μg/ml regardless of their cefoxitin susceptibility. Latex agglutination test for penicillin-binding protein 2a was performed for the isolates which grew on OSA 2 and or 4 μg/ml but not on OSA 6 μg/ml. Results: Eight per cent of MRSA isolates was missed by using OSA 6 μg/ml, when compared with other methods. Sensitivities of OSA 2 μg/ml, OSA 6 μg/ml and CDD were found to be 100%, 92.5% and 97.5%, respectively, and specificities for the same were found to be 100%, 100% and 98%, respectively. As per FDA criteria, categorical agreement for OSA 2 μg/ml was found to be 100% in comparison with the reference broth microdilution method. No major and very major discrepancies were documented. Conclusion: Similar findings on a larger and more heterogeneous collection of isolates may indicate the need to revise the concentration of OSA to 2 μg/ml for the detection of MRSA.

  9. 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…

  10. The Human Dimension: Balancing People Needs and Resources. AIR Forum Paper 1978.

    Science.gov (United States)

    Howard, Harold C.

    The call for accountability in higher education has resulted in a demand for the effective use of scarce resources and institutional survival is affected. Since the vitality of an institution is the true measure of its strength, all decisions, including cost-based ones, should be made in terms of their effect on morale and motivation. Faculty, by…

  11. 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)

  12. 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)

  13. Resource Guide for Linguistically and Culturally Different Pupils with Exceptional Needs.

    Science.gov (United States)

    Vasquez, Maria, Comp.; Carpenter, Linda J., Comp.

    The resource guide is intended to introduce a sample of relevant literature to professionals interested in bilingual special education. Section I lists bibliographical citations and brief summaries for 16 position papers. The next section addresses reports of research completed (19 studies), while section III lists brief information summaries…

  14. 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.

  15. 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.

  16. 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.

  17. The growing need for resources to help older adults manage their financial and healthcare choices

    OpenAIRE

    MacLeod, Stephanie; Musich, Shirley; Hawkins, Kevin; Armstrong, Douglas G.

    2017-01-01

    Background Both financial literacy (managing personal finances) and health literacy (managing personal health) become increasingly important for older adults, potentially impacting their quality of life. Resources in these constructs of literacy tend to be distinct, although the skills and decision-making involved overlap as financial issues impact healthcare choices. Thus the primary purpose of this commentary is to propose a new area of research focus that defines the intersection of financ...

  18. 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

  19. Systems approach to materials policy. [Role of renewable resources for energy needs

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, K C; Bhagat, N

    1976-01-01

    A comprehensive systems framework for materials policy analysis, the Reference Materials System (RMS), has been developed and is described in this paper. Specifically, the RMS provides a systematic approach to organizing engineering process-type information regarding material flows, energy requirements, costs, and environmental impacts corresponding to various materials on all processes ranging from extraction of resources through their refinement, transportation, fabrication, installation, and maintenance at the point of end use, as well as recycling. This system can be used for the assessment of material technologies, substitutions and policies, and has been applied to assess the role of renewable materials as substitutes for energy-intensive nonrenewables.

  20. Resourcing the clinical complementary medicine information needs of Australian medical students: Results of a grounded theory study.

    Science.gov (United States)

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2016-09-01

    The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines. © 2016 John Wiley & Sons Australia, Ltd.

  1. 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

  2. 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.)

  3. 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.)

  4. 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

  5. Human Resource Needs, Educational Challenges, and Professionalism in the Agronomic Sciences.

    Science.gov (United States)

    Barnes, R. F.

    1987-01-01

    Discusses some of the ways the role of agronomists in agriculture is changing. Cites a recent study which indicates that there will be fewer graduates going directly into farming and ranching in the near future, and those that do will need to be more highly trained. (TW)

  6. Obstructed Labour in Resource-poor Settings: The Need for Revival ...

    African Journals Online (AJOL)

    This paper highlights our experiences with symphysiotomy in a rural Roman Catholic hospital providing evidence on the safety of symphysiotomy and the need for its revival and reinstatement in the obstetric arsenal in Nigeria and similar countries in sub-Saharan Africa where maternal mortality as a result of prolonged and ...

  7. 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…

  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. Unmet needs in asthma treatment in a resource-limited setting ...

    African Journals Online (AJOL)

    Introduction: The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients' perception and treatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians and patients in Nigeria, with the goal of ...

  11. 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…

  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. Antibiotic Agents

    Science.gov (United States)

    ... Superbugs and Drugs" Home | Contact Us General Background: Antibiotic Agents What is an antibacterial and how are ... with the growth and reproduction of bacteria. While antibiotics and antibacterials both attack bacteria, these terms have ...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Housing Resources and Needs in Light of Modern Urban Transformations: the Case of Poznan

    Directory of Open Access Journals (Sweden)

    Palicki Sławomir

    2017-06-01

    Full Text Available Polish cities have been at the stage of a dynamic suburban development for over a decade (which has led to the phenomenon of urban sprawl beyond any control. The population of big urban areas, together with their agglomerations is continuously increasing; however, migration tendencies towards suburban areas are strong as well. In such a situation, the question arises regarding the possibilities and the methods of suppressing the outflow of people to the neighboring communities, and once again, making the city an attractive place to live. The attempt to explain such an issue requires research into both the housing infrastructure and its inhabitants. Poznan has been severely affected by suburbanization. The diagnosis and assessment of Poznan housing resources and the preferences of its inhabitants are the starting point for taking further steps in making the housing conditions more attractive. The article shows the initial results of widespread research regarding housing in the capital city of the Wielkopolska Province (comprising over 2,500 households. A similar study for the entire agglomeration (Poznan County is due to be completed soon. It will allow for a comparative analysis and formulating recommendations regarding the conditions and the direction of changes on the real estate market which would increase the attractiveness of central cities suffering from suburbanization. In a wider context, the publication might be seen as an analysis of one of the elements of modern urban changes, such as either market driven, or free and spontaneous processes of urban sprawl, and conscious actions taken by local governments (together with developers regarding the integrated urban revitalization policy.

  19. 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.

  20. 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.

  1. Preparing This Generation to be the Next Generation: Educator Climate Literacy Practices and Needs, Desirable Attainments, and Exemplar Resources

    Science.gov (United States)

    Buhr Sullivan, S. M.; Gold, A. U.; Lynds, S. E.; Ledley, T. S.

    2014-12-01

    Today's students are increasingly aware of climate change and the relationship between climate change, energy use, society and sustainability. Scientific knowledge about these topics is advancing at a rapid pace, and the Next Generation Science Standards (NGSS) include performance expectations about energy, sustainability and climate. If we intend to prepare this generation of students for their roles as the next generation of citizens, scientists, and professionals of all sorts, what knowledge, skills and habits of mind will be important, and how do these occur in the NGSS? This presentation will outline these teaching targets, and will describe educator teaching practices and needs around climate and energy literacy dimensions, as derived from surveys and interviews of a group of educators grades 6-16. This presentation will also present examples of resources, including peer-reviewed resources from the Climate Literacy and Energy Awareness Network collection which can contribute to achieving these newly emphasized learning desirata.

  2. The Human Resources Challenge to Community Based Rehabilitation: The Need for a Scientific, Systematic and Coordinated Global Response

    Directory of Open Access Journals (Sweden)

    Eilish McAuliffe

    2013-02-01

    Full Text Available The World Report on Disability highlights some of the major challenges in the path to realisation of the rights of persons with disabilities as per the United Nations Convention. While the recently published guidelines on Community Based Rehabilitation show the way to address these challenges, effective implementation would require not only higher levels of investment in human resources, but also a significantly newer and different skill-set for the additional personnel.  The authors suggest that a scientifically sophisticated, systematic and coordinated research programme, with global reach and participation, is needed for the establishment of a useful and robust evidence-base for Community Based Rehabilitation interventions. It is also suggested that the development of a new cadre of rehabilitation workers could be a key component of the programme, and could help to alleviate the extant crisis in human resources for health in many low-income countries.

  3. Resources

    Science.gov (United States)

    English in Australia, 1973

    1973-01-01

    Contains seven short resources''--units, lessons, and activities on the power of observation, man and his earth, snakes, group discussion, colloquial and slang, the continuous story, and retelling a story. (DD)

  4. 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

  5. Coresidence with elderly parents in contemporary China: the role of filial piety, reciprocity, socioeconomic resources, and parental needs.

    Science.gov (United States)

    Zhang, Zhenmei; Gu, Danan; Luo, Ye

    2014-09-01

    This paper examines how adult children's expressed filial piety, receipt of help from parents, socioeconomic resources, and parents' needs are associated with the likelihood of parent-child coresidence in contemporary China. Drawing on the 2002 wave of the Chinese Survey of Family Dynamics and the 2002 wave of the Chinese Longitudinal Healthy Longevity Survey, we used logistic regression to analyze correlates of coresidence with parents of 3,938 married adult children, aged 35 to 65. Results show that the stronger the filial piety expressed by adult children, the higher their likelihood of coresiding with their parents. Married adult children are also more likely to coreside with elderly parents who have provided intensive grandchild care and financial support or with those who need financial, physical, and emotional support. However, adult children who own homes are significantly less likely to live with their parents than are those who do not. These findings suggest that coresidence in contemporary China is influenced not only by parents' needs but also by children's values, socioeconomic resources, and past receipt of parental help.

  6. Meeting the human resources needs for the Philippine nuclear power plant project

    International Nuclear Information System (INIS)

    Palabrica, R.J.

    1978-01-01

    This article presents a major responsibility of the Philippine Atomic Energy Commission (PAEC) - that of providing highly qualified and well-trained personpel for the Nuclear Power Plant Project. It discusses the accomplishments of the program. For the twenty period from 1959 to 1977, approximately 25% of the fellowships have been nuclear power related, a total of 630 fellows have been given specialized training, 150 of which have been trained in nuclear engineering and reactor technology, and others in the field of radioisotopes application. Supplementary to the local training program as well as foreign fellowships undertaken by PAEC are the efforts of the National Power Corporation and Westinghouse in the training of professional staff, and Ebasco in on-the-job training. In a nutshell, the PAEC, seriously aware of its responsibility, long before the decision was made to imbark on the nuclear project, has launched a strong training program adequate to meet the needs of the nuclear power plant project in its different stages of development. (RTD)

  7. 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

  8. 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.

  9. Classroom risks and resources: Teacher burnout, classroom quality and children's adjustment in high needs elementary schools.

    Science.gov (United States)

    Hoglund, Wendy L G; Klingle, Kirsten E; Hosan, Naheed E

    2015-10-01

    The current paper presents two related sets of findings on the classroom context in high needs elementary schools. First, we investigated change over one school term in teacher burnout (emotional exhaustion, depersonalization, personal accomplishment) and classroom quality (emotional and instructional support, organization) and assessed the degree to which burnout and classroom quality co-varied over the term with each other and with aggregate externalizing behaviors (average child externalizing behaviors in the classroom). These analyses describe the classroom context in which the children are nested. Second, we examined change over one school term in children's social adjustment (relationship quality with teachers and friends) and academic adjustment (school engagement, literacy skills) and assessed how adjustment co-varied over time with child externalizing behaviors and was predicted by teacher burnout, classroom quality and aggregate externalizing behaviors. These models were tested with a sample of low-income, ethnically diverse children in kindergarten to grade 3 and their teachers. The children and teachers were assessed three times over one school term. Personal accomplishment co-varied positively with overall classroom quality. Reciprocally, classroom organization co-varied positively with overall teacher burnout. Aggregate externalizing behaviors co-varied positively with depersonalization and negatively with personal accomplishment and overall classroom quality, including emotional support and organization. In turn, teacher burnout interacted with aggregate externalizing behaviors to predict change in child social and academic adjustment. Alternatively, classroom quality interacted with aggregate and child externalizing behaviors to predict change in child social and academic adjustment. Copyright © 2015 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  10. 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.

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

    DEFF Research Database (Denmark)

    Tofte, Nete; Nielsen, Alex C.Y.; Trøstrup, Hannah

    2017-01-01

    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...

  12. 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.

  13. Optimizing the mix of basic dental services for Southern Thai schoolchildren based on resource consumption, service needs and parental preference.

    Science.gov (United States)

    Tianviwat, Sukanya; Chongsuvivatwong, Virasakdi; Birch, Stephen

    2009-08-01

    To identify the optimal levels and mix of basic dental services (sealants and fillings for permanent teeth and extraction of primary teeth) under two different dental settings: hospital-based and mobile dental clinics under specified resource constraints. A linear programming model is used based on explicit identification of system objectives and resource constraints. The objective was to maximize benefits as measured by parental willingness to pay (WTP) for basic dental services provided to schoolchildren subject to constraints on total resources, service need and parental preferences among different dental care settings. Optimization was identified to require 270, 180, 552, 828, 228 and 532 cases of hospital sealant, mobile sealant, hospital filling, mobile filling, hospital extraction and mobile extraction, respectively. The corresponding current service levels were 48, 281, 191, 170, 479, and 677 respectively. The optimal service configuration produced a total WTP of 485 860 baht which exceeded the WTP for the current service configuration by more than 75.4%. Mobile clinic fillings were the highest priority among basic dental services. The current service configurations fail to reflect the setting preferences and provide greater emphasis to extractions than the optimal configuration with less emphasis given to preventive and restorative services.

  14. Did introduction of pneumococcal vaccines in the Netherlands decrease the need for respiratory antibiotics in children? Analysis of 2002 to 2013 data

    NARCIS (Netherlands)

    Gefenaite, G.; Bijlsma, M. J.; Bos, H. J.; Hak, E.

    2014-01-01

    To estimate the effect of the introduction of the 7- and 10-valentpneumococcal vaccines in 2006 and 2011, respectively in the Netherlands, we assessed respiratory antibiotic use in one to nine year-old children between 2002 and 2013. Seasonal autoregressive integrated moving-average models were

  15. 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.

  16. An online resource of digital stories about cancer genetics: qualitative study of patient preferences and information needs.

    Science.gov (United States)

    Iredale, Rachel; Mundy, Lisa; Hilgart, Jennifer

    2011-09-30

    The Cancer Genetics Service for Wales (CGSW) was established in 1998 as an all-Wales service for individuals with concerns about their family history of cancer. CGSW offers a range of services such as risk assessment, genetic counseling, and genetic testing. Individuals referred to cancer genetics services often have unmet information and support needs, and they value access to practical and experiential information from other patients and health professionals. As a result of the lifelong nature of genetic conditions, a fundamental challenge is to meet the ongoing needs of these patients by providing easily accessible and reliable information. Our aims were to explore how the long-term information and support needs of CGSW patients could be met and to assess whether an online bank of digital stories about cancer genetics would be acceptable to patients. In 2009, CGSW organized patient panels across Wales. During these events, 169 patients were asked for their feedback about a potential online resource of digital stories from CGSW patients and staff. A total of 75 patients registered to take part in the project and 23 people from across Wales agreed to share their story. All participants took part in a follow-up interview. Patient preferences for an online collection of cancer genetics stories were collected at the patient panels. Key topics to be covered by the stories were identified, and this feedback informed the development of the website to ensure that patients' needs would be met. The 23 patient storytellers were aged between 28 and 75 years, and 19 were female. The digital stories reflect patients' experiences within CGSW and the implications of living with or at risk of cancer. Follow-up interviews with patient storytellers showed that they shared their experiences as a means of helping other patients and to increase understanding of the cancer genetics service. Digital stories were also collected from 12 members of staff working at CGSW. The digital

  17. Scenario Planning to Identify Science Needs for the Management of Energy and Resource Development in the Arctic

    Science.gov (United States)

    Lassuy, D.

    2013-12-01

    The North Slope Science Initiative (NSSI) is an intergovernmental science collaboration forum in Arctic Alaska (USA). NSSI has initiated a 'Scenario Planning' effort with the focal question: 'What is the future of energy development, resource extraction, and associated support activities on the North Slope and adjacent seas through 2040?' With over 500 thousand square kilometers of land and sea, the area of the North Slope and adjacent seas is believed to have some of the largest oil, gas, and coal potential remaining in the United States, but it is also home to a diverse array of fish, wildlife, and plant resources that support a vibrant subsistence culture. Our scenario planning will involve a full and collaborative dialogue among a wide range of U.S. Arctic stakeholders, including Alaska Native subsistence users, local communities, academia, non-governmental organizations, and a variety of industries (oil and gas, mining, transportation, etc.) and government agencies (federal, state, local). The formulation of development scenarios and an understanding of their implications will provide a practical context for NSSI member agencies to make informed decisions about the research and monitoring that will be needed to sustain these resources and to plan for safe energy and resource development in the face of impending changes. The future of Arctic America is difficult to accurately predict, particularly in an era of intense pressures from both energy development and climate warming. However, it will almost surely be characterized by highly consequential and unprecedented changes. Complex and uncertain are appropriate descriptors of the Arctic and its future; and scenario planning has proven an effective tool to help engage diverse stakeholders in a focused dialogue and systematic thinking about plausible futures in complex and uncertain settings. The NSSI leadership recognized the critical need for this dialogue and has begun a scenario planning effort for the North

  18. A Model for Identifying Patients Who May Not Need Neurologic Intensive Care Unit Admission: Resource Utilization Study.

    Science.gov (United States)

    Sadaka, Farid; Cytron, Margaret A; Fowler, Kimberly; Javaux, Victoria M; O'Brien, Jacklyn

    2016-03-01

    Limited resources, neurointensivists, and neurologic intensive care unit (neuro-ICU) beds warrant investigating models for predicting who will benefit from admission to neuro-ICU. This study presents a possible model for identifying patients who might be too well to benefit from admission to a neuro-ICU. We retrospectively identified all patients admitted to our 16-bed neuro-ICU between November 2009 and February 2013. We used the Acute Physiology and Chronic Health Evaluation (APACHE) outcomes database to identify patients who on day 1 of neuro-ICU admission received 1 or more of 30 subsequent active life-supporting treatments. We compared 2 groups of patients: low-risk monitor (LRM; patients who did not receive active treatment [AT] on the first day and whose risk of ever receiving AT was ≤ 10%) and AT (patients who received at least 1 of the 30 ICU treatments on any day of their ICU admission). There were 873 (46%) admissions in the LRM group and 1006 (54%) admissions in the AT group. The ICU length of stay in days was 1.7 (± 1.9) for the LRM group versus 4.5 (± 5.5) for the AT group. The ICU mortality was 0.8% for the LRM group compared to 14% for the AT group (odds ratio [OR] = 17.6; 95% confidence interval [CI], 8.2-37.8, P intensive care. This may provide a measure of neuro-ICU resource use. Improved resource use and reduced costs might be achieved by strategies to provide care for these patients on floors or intermediate care units. This model will need to be validated in other neuro-ICUs and prospectively studied before it can be adopted for triaging admissions to neuro-ICUs. © The Author(s) 2014.

  19. 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)

  20. 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.

  1. 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

    2014-01-01

    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. PMID:24454543

  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. [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.

  4. State of the art in the validation of screening methods for the control of antibiotic residues: is there a need for further development?

    Science.gov (United States)

    Gaudin, Valérie

    2017-09-01

    Screening methods are used as a first-line approach to detect the presence of antibiotic residues in food of animal origin. The validation process guarantees that the method is fit-for-purpose, suited to regulatory requirements, and provides evidence of its performance. This article is focused on intra-laboratory validation. The first step in validation is characterisation of performance, and the second step is the validation itself with regard to pre-established criteria. The validation approaches can be absolute (a single method) or relative (comparison of methods), overall (combination of several characteristics in one) or criterion-by-criterion. Various approaches to validation, in the form of regulations, guidelines or standards, are presented and discussed to draw conclusions on their potential application for different residue screening methods, and to determine whether or not they reach the same conclusions. The approach by comparison of methods is not suitable for screening methods for antibiotic residues. The overall approaches, such as probability of detection (POD) and accuracy profile, are increasingly used in other fields of application. They may be of interest for screening methods for antibiotic residues. Finally, the criterion-by-criterion approach (Decision 2002/657/EC and of European guideline for the validation of screening methods), usually applied to the screening methods for antibiotic residues, introduced a major characteristic and an improvement in the validation, i.e. the detection capability (CCβ). In conclusion, screening methods are constantly evolving, thanks to the development of new biosensors or liquid chromatography coupled to tandem-mass spectrometry (LC-MS/MS) methods. There have been clear changes in validation approaches these last 20 years. Continued progress is required and perspectives for future development of guidelines, regulations and standards for validation are presented here.

  5. 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...

  6. 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...

  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. 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

  9. 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.

  10. 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...

  11. Antibiotic Safety

    Science.gov (United States)

    ... Antibiotics www.healthsci.tufts.edu Georgia-Pacific Health Smart Institute www.gphealthsmart.com Special thanks to Rhonda ... effectiveness of other medications such as birth control pills? 7. Are there any possible adverse reactions if ...

  12. 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; 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

  13. 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.

  14. Rationalizing antibiotic use to limit antibiotic resistance in India+

    Science.gov (United States)

    2011-01-01

    Antibiotic resistance, a global concern, is particularly pressing in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. The Global Antibiotic Resistance Partnership (GARP) was established to develop actionable policy recommendations specifically relevant to low- and middle-income countries where suboptimal access to antibiotics - not a major concern in high-income countries - is possibly as severe a problem as is the spread of resistant organisms. This report summarizes the situation as it is known regarding antibiotic use and growing resistance in India and recommends short and long term actions. Recommendations aim at (i) reducing the need for antibiotics; (ii) lowering resistance-enhancing drug pressure through improved antibiotic targeting, and (iii) eliminating antibiotic use for growth promotion in agriculture. The highest priority needs to be given to (i) national surveillance of antibiotic resistance and antibiotic use - better information to underpin decisions on standard treatment guidelines, education and other actions, as well as to monitor changes over time; (ii) increasing the use of diagnostic tests, which necessitates behavioural changes and improvements in microbiology laboratory capacity; (iii) setting up and/or strengthening infection control committees in hospitals; and (iv) restricting the use of antibiotics for non-therapeutic uses in agriculture. These interventions should help to reduce the spread of antibiotic resistance, improve public health directly, benefit the populace and reduce pressure on the healthcare system. Finally, increasing the types and coverage of childhood vaccines offered by the government would reduce the disease burden enormously and spare antibiotics. PMID:21985810

  15. HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

    Science.gov (United States)

    Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

    2011-11-01

    Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. Need humanities be so useless? Justifying the place and role of humanities as a critical resource for performance and practice.

    Science.gov (United States)

    Edgar, A; Pattison, S

    2006-12-01

    Justifying the existence, position, and relevance of academic humanities scholarship may be difficult in the face of chronic practical needs in health care. Such scholarship may seem parasitic on human activity and performance that directly contributes to human wellbeing and health care. Here, a possible and partial justification for the importance of scholarship in the humanities as a critical resource for practice and performance is undertaken by two humanities scholars. Human identity and emotion are reflected and defined by performances, both in the traditional disciplines of the humanities, such as art and literature, and in the sciences and medicine. The critical attitude that such performances might inadvertently undermine is sustained by the humanities. The humanities disciplines ask the question: "What is it to be human?" Uncritical emotion and expression, arising, for example, from understanding developments in medicine and science, which might exclude or corrupt much that is of value in the healthcare sector and other areas of practical performance, can be constrained by this.

  17. 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.

  18. Levels of wound calprotectin and other inflammatory biomarkers aid in deciding which patients with a diabetic foot ulcer need antibiotic therapy (INDUCE study).

    Science.gov (United States)

    Ingram, J R; Cawley, S; Coulman, E; Gregory, C; Thomas-Jones, E; Pickles, T; Cannings-John, R; Francis, N A; Harding, K; Hood, K; Piguet, V

    2018-02-01

    Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C-reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation. In a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers. Antibiotic prescribing decisions were based on clinicians' baseline assessments and participants were reviewed 1 week later; ulcer infection was defined by clinicians' overall impression from their two assessments. Some 363 potential participants were screened, of whom 67 were recruited, 29 with mildly infected diabetic foot ulcers and 38 with no infection. One participant withdrew early in each group. Ulcer area was 1.32 cm 2 [interquartile range (IQR) 0.32-3.61 cm 2 ] in infected ulcers and 0.22 cm 2 (IQR 0.09-1.46 cm 2 ) in uninfected ulcers. Baseline CRP for mild infection was 9.00 mg/ml and 6.00 mg/ml for uninfected ulcers; most procalcitonin levels were undetectable. Median calprotectin level in infected diabetic foot ulcers was 1437 ng/ml and 879 ng/ml in uninfected diabetic foot ulcers. Area under the receiver operating characteristic curve for a composite algorithm incorporating calprotectin, CRP, white cell count and ulcer area was 0.68 (95% confidence intervals 0.52-0.82), sensitivity 0.64, specificity 0.81. A composite algorithm including CRP, calprotectin, white cell count and ulcer area may help to distinguish uninfected from mildly infected diabetic foot ulcers. Venous procalcitonin is unhelpful for mild diabetic foot ulcer infection. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd

  19. You can't always get what you want : How entrepreneur's perceived resource needs affect the incubator's assertiveness

    NARCIS (Netherlands)

    van Weele, Marijn; van Rijnsoever, Frank J.; Nauta, Frans

    2017-01-01

    A possible explanation for the disappointing performance of incubators is that start-ups do not take full advantage of the resources offered by the incubator. In explaining the low usage of the incubator's resources, existing studies neglect that incubated entrepreneurs may not be aware of the gaps

  20. Antibiotic allergy.

    Science.gov (United States)

    Caimmi, S; Caimmi, D; Lombardi, E; Crisafulli, G; Franceschini, F; Ricci, G; Marseglia, G L

    2011-01-01

    Antibiotics are commonly injected during the perioperative period and are responsible of 15 percent of the anaphylactic reactions. Anaphylaxis triggered by antibiotics primarily involves penicillin and cephalosporin. The management of patients with histories of allergic reactions to antibiotics is a common situation in clinical practice. The confirmation or invalidation of the allergic nature of the reported reaction is not based on in vitro tests, but on a rigorous allergological work-up based on detailed analysis of clinical history, skin tests and drug provocation test. Considering a possible cross-reactivity between penicillins, once an immediate penicillin allergy has been diagnosed, skin testing with the alternative molecule (cephalosporin, carbapenem, aztreonam) is mandatory and, if negative, the relevant drug should be given in an appropriate setting at increasing doses.

  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. Hydrid Antibiotics

    Czech Academy of Sciences Publication Activity Database

    Běhal, Vladislav

    2003-01-01

    Roč. 48, č. 1 (2003), s. 17-25 ISSN 0015-5632 R&D Projects: GA ČR GA204/01/1004 Institutional research plan: CEZ:AV0Z5020903 Keywords : hydrid * antibiotics Subject RIV: EE - Microbiology, Virology Impact factor: 0.857, year: 2003

  3. 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.

  4. Putting phosphorus first: The need to know and right to know call for a revised hierarchy of natural resources

    OpenAIRE

    Wellmer, F.-W.; Scholz, R.W.

    2017-01-01

    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...

  5. Combating Antibiotic Resistance

    Science.gov (United States)

    ... 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: Get Smart: Know When Antibiotics Work More in Consumer Updates ...

  6. 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.

  7. Resistance-resistant antibiotics.

    Science.gov (United States)

    Oldfield, Eric; Feng, Xinxin

    2014-12-01

    New antibiotics are needed because drug resistance is increasing while the introduction of new antibiotics is decreasing. We discuss here six possible approaches to develop 'resistance-resistant' antibiotics. First, multitarget inhibitors in which a single compound inhibits more than one target may be easier to develop than conventional combination therapies with two new drugs. Second, inhibiting multiple targets in the same metabolic pathway is expected to be an effective strategy owing to synergy. Third, discovering multiple-target inhibitors should be possible by using sequential virtual screening. Fourth, repurposing existing drugs can lead to combinations of multitarget therapeutics. Fifth, targets need not be proteins. Sixth, inhibiting virulence factor formation and boosting innate immunity may also lead to decreased susceptibility to resistance. Although it is not possible to eliminate resistance, the approaches reviewed here offer several possibilities for reducing the effects of mutations and, in some cases, suggest that sensitivity to existing antibiotics may be restored in otherwise drug-resistant organisms. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. 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

  9. 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

  10. 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.

  11. 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.

  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.

    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 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.

  13. 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…

  14. Development of Career Opportunities for Technicians in the Nuclear Medicine Field, Phase I. Interim Report Number 1: Survey of Job Characteristics, Manpower Needs and Training Resources, July 1969.

    Science.gov (United States)

    Technical Education Research Center, Cambridge, MA.

    Phase I of a multiphase research program in progress at the Technical Education Research Center, Inc., was conducted to analyze needs and resources in terms of job performance tasks, career opportunities, and training requirements for nuclear medical technicians. Data were gathered through personal interviews with 203 persons, mostly physicians,…

  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. Collective antibiotic tolerance: mechanisms, dynamics and intervention.

    Science.gov (United States)

    Meredith, Hannah R; Srimani, Jaydeep K; Lee, Anna J; Lopatkin, Allison J; You, Lingchong

    2015-03-01

    Bacteria have developed resistance against every antibiotic at a rate that is alarming considering the timescale at which new antibiotics are developed. Thus, there is a critical need to use antibiotics more effectively, extend the shelf life of existing antibiotics and minimize their side effects. This requires understanding the mechanisms underlying bacterial drug responses. Past studies have focused on survival in the presence of antibiotics by individual cells, as genetic mutants or persisters. Also important, however, is the fact that a population of bacterial cells can collectively survive antibiotic treatments lethal to individual cells. This tolerance can arise by diverse mechanisms, including resistance-conferring enzyme production, titration-mediated bistable growth inhibition, swarming and interpopulation interactions. These strategies can enable rapid population recovery after antibiotic treatment and provide a time window during which otherwise susceptible bacteria can acquire inheritable genetic resistance. Here, we emphasize the potential for targeting collective antibiotic tolerance behaviors as an antibacterial treatment strategy.

  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. 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......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...

  19. Antibiotic Resistance

    DEFF Research Database (Denmark)

    Munck, Christian

    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......Bacteria can avoid extinction during antimicrobial exposure by becoming resistant. They achieve this either via adaptive mutations or horizontally acquired resistance genes. If resistance emerges in clinical relevant species, it can lead to treatment failure and ultimately result in increasing...... 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...

  20. Management options for reducing the release of antibiotics and antibiotic resistance genes to the environment

    DEFF Research Database (Denmark)

    Pruden, Amy; Larsson, D.G. Joakim; Amézquita, Alejandro

    2013-01-01

    Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic resistance...... of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little...... associated with antibiotic resistance strongly indicate the need for action....

  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. 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…

  3. 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.

  4. 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.

  5. DOD Financial Management: Improvements Needed in Army’s Efforts to Ensure the Reliability of Its Statement of Budgetary Resources

    Science.gov (United States)

    2014-05-01

    of the Under Secretary of Defense (Comptroller) SBA Schedule of Budgetary Activity SBR Statement of Budgetary Resources SOA Statement of...deficiency (in evidence of internal control implementation). Army officials stated that the IPA exams were beneficial in giving commands experience in...undergoing an audit. However, an IPA exam to validate audit readiness assertions can be costly, not only in terms of IPA fees, but also in terms of

  6. WITHDRAWN. Antibiotics for treating leptospirosis.

    Science.gov (United States)

    Guidugli, Fábio; Castro, Aldemar A; Atallah, Alvaro N; Araújo, Maurício G

    2010-01-20

    Leptospirosis is a parasitic disease transmitted by animals. Severe leptospirosis may result in hospitalisation and about five per cent of the patients die. In clinical practice, penicillin is widely used for treating leptospirosis. To evaluate the effectiveness and safety of antibiotics versus placebo or other antibiotic regimens in treating leptospirosis. We addressed the following clinical questions: a) Are treatment regimens with antibiotics more efficient than placebo for leptospirosis? b) Are treatment regimens with antibiotics safe when compared to placebo for leptospirosis? c) Which antibiotic regimen is the most efficient and safest in treating leptospirosis? Electronic searches and searches of the identified articles were combined. Randomised clinical trials in which antibiotics were used as treatment for leptospirosis. Language, date, or other restrictions were not applied. Patients with clinical manifestations of leptospirosis. Any antibiotic regimen compared with a control group (placebo or another antibiotic regimen). Data and methodological quality of each trial were independently extracted and assessed by two reviewers. The random effects model was used irrespective of significant statistical heterogeneity. Three trials met inclusion criteria. Allocation concealment and double blind methods were not clearly described in two. Of the patients enrolled, 75 were treated with placebo and 75 with antibiotics: 61 (81.3%) penicillin and 14 (18.6%) doxycycline. The patients assigned to antibiotics compared to placebo showed: a) Mortality: 1% (1/75) versus 4% (3/75); risk difference -2%, 95% confidence interval -8% to 4%. b) Duration of hospital stay (days): weighted mean difference 0.30, 95% confidence interval -1.26 to 1.86. c) Prolonged hospital stay (> seven days): 30% (7/23) versus 74% (14/19); risk difference -43%, 95% confidence interval -70% to -16%. Number needed-to-treat 3, 95% confidence interval 2 to 7. d) Period of disappearance of fever (days

  7. 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

  8. Ability of the Physiologic Criteria of the Field Triage Guidelines to Identify Children Who Need the Resources of a Trauma Center.

    Science.gov (United States)

    Lerner, E Brooke; Drendel, Amy L; Cushman, Jeremy T; Badawy, Mohamed; Shah, Manish N; Guse, Clare E; Cooper, Arthur

    2017-01-01

    There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria. Children were considered to have needed a trauma center if they had non-orthopedic surgery within 24 hours, ICU admission, or died. This data was obtained through a structured hospital record review. The over- and under-triage rates and positive likelihood ratios (+LR) were calculated for the overall Physiologic Criteria and each individual criterion. Interviews were conducted for 5,610 pediatric patients; outcome data were available for 5,594 (99.7%): 5% of all patients needed the resources of a trauma center and 19% met the physiologic criteria. Using the physiologic criteria alone, 51% of children who needed a trauma center would have been under-triaged and 18% would have been over-triaged (+LR 2.8, 95% CI 2.4-3.2). Glasgow Coma Score (GCS) children trauma center need for children. Missing or inaccurate vital signs may be limiting the predictive value of the Physiologic Criteria.

  9. 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...

  10. 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.

  11. 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…

  12. Future Space Requirements for Indiana's Institutions of Higher Education. Higher Education in Indiana. Long Range Needs and Resources.

    Science.gov (United States)

    Bayless, Paul C.; And Others

    Based on data obtained in earlier phases of a comprehensive planning study, this report presents--(1) the development of a space projection model responsive to unique institutional requirements, and (2) a forecast of the aggregate academic space needs of higher education in Indiana for a given future enrollment level. The scope of the study and a…

  13. 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.

  14. 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.

  15. European Antibiotic Awareness Day 2012: general practitioners encouraged to TARGET antibiotics through guidance, education and tools.

    Science.gov (United States)

    McNulty, Cliodna A M

    2012-11-01

    On 18 November 2012, the UK will once again support the annual European Antibiotic Awareness Day (EAAD). In particular, hospitals will be asked to promote the Start Smart-Then Focus guidance for hospitals launched in 2011, while the Royal College of General Practitioners will publish the TARGET Antibiotics toolkit on their web site. TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) emphasizes the need for both primary care staff and the public to use antibiotics responsibly, and provides guidance, education and tools. The web site has been developed by a multiprofessional group and hosts national antibiotic guidance, an antibiotic app, leaflets designed to be shared by patients during consultations, a presentation for clinicians, an interactive self-assessment tool, audit tools, posters and videos for the waiting room and links to other materials. The EAAD is still very relevant and worth promoting enthusiastically through all clinical professionals in an effort to encourage responsible use of antibiotics and thereby control antibiotic resistance.

  16. Resistance diagnosis and the changing epidemiology of antibiotic resistance.

    Science.gov (United States)

    McAdams, David

    2017-01-01

    Widespread adoption of point-of-care resistance diagnostics (POCRD) reduces ineffective antibiotic use but could increase overall antibiotic use. Indeed, in the context of a standard susceptible-infected epidemiological model with a single antibiotic, POCRD accelerates the rise of resistance in the disease-causing bacterial population. When multiple antibiotics are available, however, POCRD may slow the rise of resistance even as more patients receive antibiotic treatment, belying the conventional wisdom that antibiotics are "exhaustible resources" whose increased use necessarily promotes the rise of resistance. © 2017 New York Academy of Sciences.

  17. 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.

  18. 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).

  19. 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.

  20. 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

    2018-03-02

    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.

  1. Antibiotic Adjuvants: Rescuing Antibiotics from Resistance.

    Science.gov (United States)

    Wright, Gerard D

    2016-11-01

    Rooted in the mechanism of action of antibiotics and subject to bacterial evolution, antibiotic resistance is difficult and perhaps impossible to overcome. Nevertheless, strategies can be used to minimize the emergence and impact of resistance. Antibiotic adjuvants offer one such approach. These are compounds that have little or no antibiotic activity themselves but act to block resistance or otherwise enhance antibiotic action. Antibiotic adjuvants are therefore delivered in combination with antibiotics and can be divided into two groups: Class I agents that act on the pathogen, and Class II agents that act on the host. Adjuvants offer a means to both suppress the emergence of resistance and rescue the activity of existing drugs, offering an orthogonal strategy complimentary to new antibiotic discovery VIDEO ABSTRACT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. 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.

  3. Practical Management of Antibiotic Hypersensitivity in 2017.

    Science.gov (United States)

    Macy, Eric; Romano, Antonino; Khan, David

    Antibiotics are the most common class of medications that individuals report allergy or intolerance to. Adverse reactions are reported at a predictable rate with all antibiotic use that vary by antibiotic. Antibiotic allergy incidence rates are sex dependent, higher in females than in males. Most of these events are not reproducible or immunologically mediated. Antibiotic allergy prevalence increases with increasing age and is more common in hospitalized populations and in populations that use more antibiotics. Determining potential mechanisms for the observed symptoms of the adverse reactions is the starting point for effective management of antibiotic hypersensitivity. Skin testing and direct challenges are the primary tools used to determine acute tolerance in 2017. Commercially available in vitro testing is not currently clinically useful in determining antibiotic hypersensitivity, with rare exceptions. Desensitization can be used when acute-onset immunologically mediated hypersensitivity is confirmed to safely administer a needed antibiotic. Desensitization is not possible when clinically significant T-cell-mediated delayed-type hypersensitivity is present. Effective management of antibiotic allergy is an important part of a comprehensive antibiotic stewardship program. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Kheya Melo Furtado

    2014-01-01

    Full Text Available Background: 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. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: 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. Results: 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. Conclusions: 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.

  6. Antibiotics for leptospirosis.

    Science.gov (United States)

    Brett-Major, David M; Coldren, Rodney

    2012-02-15

    for or against the use of antibiotics in the therapy for leptospirosis. Among survivors who were hospitalised for leptospirosis, use of antibiotics for leptospirosis may have decreased the duration of clinical illness by two to four days, though this result was not statistically significant. When electing to treat with an antibiotic, selection of penicillin, doxycycline, or cephalosporin does not seem to impact mortality nor duration of fever. The benefit of antibiotic therapy in the treatment of leptospirosis remains unclear, particularly for severe disease. Further clinical research is needed to include broader panels of therapy tested against placebo.

  7. 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.

  8. Necessity of Antibiotics following Simple Exodontia

    OpenAIRE

    Yousuf, Waqas; Khan, Moiz; Mehdi, Hasan; Mateen, Sana

    2016-01-01

    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 wer...

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

    Science.gov (United States)

    Dutta, Arin; Barker, Catherine; Kallarakal, Ashley

    2015-11-01

    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% CI 47

  15. 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

  16. Programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean.

    Science.gov (United States)

    Kelly, J A; Somlai, A M; Benotsch, E G; Amirkhanian, Y A; Fernandez, M I; Stevenson, L Y; Sitzler, C A; McAuliffe, T L; Brown, K D; Opgenorth, K M

    2006-01-01

    This study assessed the programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in 75 countries in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. Multiple databases and expert recommendations were used to identify one major HIV-prevention NGO in the capital or a large city in each country, and in-depth interviews were conducted with each NGO Director. Most NGOs are carrying out their programmes with minimal funding and few regularly employed personnel. Most are highly dependent on international donors, but reliance on small grants with short funding periods limits programme development capacity. HIV-prevention activities varied by region, with African NGOs most likely to use peer education and community awareness events; Eastern European NGOs most likely to offer needle exchange; Latin American NGOs to have resource centres and offer risk reduction programmes; and Caribbean organizations to use mass education approaches. Across regions, NGOs most often targeted the general public and youth, although specialized at-risk groups were the additional focus of attention in some regions. Limited funding, governmental indifference or opposition, AIDS stigma, and social discomfort discussing sex were often cited as barriers to new HIV-prevention programmes. NGOs are critical service providers. However, their funding, programmes, and resource capacities must be strengthened if NGOs are to realize their full potential in HIV prevention.

  17. 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.

  18. [Psychosocial working conditions of physician assistants: results from a qualitative study on occupational stress, resources, possible approaches to prevention and intervention needs].

    Science.gov (United States)

    Vu-Eickmann, Patricia; Loerbroks, Adrian

    2017-10-01

    Numerous studies have documented adverse psychosocial working conditions among health care staff. Working conditions may not only impair the health outcomes of this professional group, but can also affect the quality of care they deliver to patients. Previous work stress research has mainly focused on physicians and nurses. Comparable evidence remains limited, however, for physician assistants (Medizinische Fachangestellte, MFAs), who represent the largest professional group in German primary care. This study aimed to gain insights into work stressors and resources experienced by MFAs and to explore both possible approaches to prevention and intervention needs. Participants were recruited from a criterion-based sample of medical practices in and around the city of Düsseldorf (Germany) and with assistance provided by the Medical Staff Association (VMF e. V.). In total, 26 qualitative in-depth interviews were conducted (11/2015-02/2016), transcribed and content analyzed using MaxQDA. MFAs reported a high workload and unforeseeable incidents as salient occupational stressors. Additional stressors included interpersonal relationship problems with superiors and a lack of social support from colleagues. At the same time though, support from superiors and colleagues can provide a key resource for coping with work stressors. Furthermore, social interactions with patients and diversified tasks were perceived as supportive professional resources. Possible approaches to prevention were exclusively seen to operate at the organizational level. The perceived need for intervention primarily concerned adequate wages and appreciation from superiors and society. Physician assistants described their working conditions as being characterized by high demands, low job control and low rewards. We suggest basic approaches for employers to improve the working experience of MFAs, which may represent the starting point for further research efforts to develop preventive measures. Copyright

  19. Antibiotics in dental implants: A review of literature

    Directory of Open Access Journals (Sweden)

    Hemchand Surapaneni

    2016-01-01

    Full Text Available The routine use of antibiotics in oral implant treatment seems to be widespread. The pre- or post-operative use of antibiotics in conjunction with implant surgery and its correlation with failure and success rates are poorly documented in the literature. The debate regarding overprescription of antibiotics raises the need for a critical evaluation of proper antibiotic coverage in association with implant treatment. The benefits of prophylactic antibiotics are well-recognized in dentistry. However, their routine use in the placement of endosseous dental implants remains controversial. The purpose of this review is to know the efficacy of antibiotic prophylaxis in implant dentistry.

  20. Meeting Needs with Limited Resources.

    Science.gov (United States)

    Kirkpatrick, Bettie M.

    1979-01-01

    The media specialist in a small organization should enlist the support of top management, describe the program fully, obtain detailed cost estimates, promote use of media, and realistically start small. (CMV)

  1. 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

  2. treatment of common respiratory infections: the antibiotic dilemma

    African Journals Online (AJOL)

    Enrique

    antibiotic. Importantly, the study excluded patients with chronic bronchitis, asthma or chronic obstructive pulmonary disease. (COPD), and concluded that interventions are needed to reduce antibiotic prescribing to limit the progression of antibiotic resist- ance. How should clinicians responsibly approach the management of.

  3. Plasmid profile of multi antibiotic resistant staphylococcus aureus ...

    African Journals Online (AJOL)

    Multi-drug resistant bacterial strains evolving worldwide has created a great public health problem that needs urgent attention; as such bacteria show resistance to the drug of choice for treatment as well as being resistant to newer and last line antibiotics. In this study, the antibiotic susceptibility, multi antibiotic resistance ...

  4. 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 ...

  5. Antibiotics and antibiotic-resistant bacteria in waters associated with a hospital in Ujjain, India

    Directory of Open Access Journals (Sweden)

    Marothi Yogyata

    2010-07-01

    the hospital wastewater. Wastewater samples collected in the afternoon contained both a higher number and higher levels of antibiotics compared to samples collected in the morning hours. No amikacin was found in the wastewater, but E.coli isolates from all wastewater samples were resistant to amikacin. Although ciprofloxacin was the most prevalent antibiotic detected in the wastewater, E.coli was not resistant to it. Conclusions Antibiotics are entering the aquatic environment of countries like India through hospital effluent. In-depth studies are needed to establish the correlation, if any, between the quantities of antibiotics prescribed in hospitals and the levels of antibiotic residues found in hospital effluent. Further, the effect of this on the development of bacterial resistance in the environment and its subsequent public health impact need thorough assessment.

  6. 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.

  7. "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.

  8. Do antibiotics have environmental side-effects? Impact of synthetic antibiotics on biogeochemical processes.

    Science.gov (United States)

    Roose-Amsaleg, Céline; Laverman, Anniet M

    2016-03-01

    Antibiotic use in the early 1900 vastly improved human health but at the same time started an arms race of antibiotic resistance. The widespread use of antibiotics has resulted in ubiquitous trace concentrations of many antibiotics in most environments. Little is known about the impact of these antibiotics on microbial processes or "non-target" organisms. This mini-review summarizes our knowledge of the effect of synthetically produced antibiotics on microorganisms involved in biogeochemical cycling. We found only 31 articles that dealt with the effects of antibiotics on such processes in soil, sediment, or freshwater. We compare the processes, antibiotics, concentration range, source, environment, and experimental approach of these studies. Examining the effects of antibiotics on biogeochemical processes should involve environmentally relevant concentrations (instead of therapeutic), chronic exposure (versus acute), and monitoring of the administered antibiotics. Furthermore, the lack of standardized tests hinders generalizations regarding the effects of antibiotics on biogeochemical processes. We investigated the effects of antibiotics on biogeochemical N cycling, specifically nitrification, denitrification, and anammox. We found that environmentally relevant concentrations of fluoroquinolones and sulfonamides could partially inhibit denitrification. So far, the only documented effects of antibiotic inhibitions were at therapeutic doses on anammox activities. The most studied and inhibited was nitrification (25-100 %) mainly at therapeutic doses and rarely environmentally relevant. We recommend that firm conclusions regarding inhibition of antibiotics at environmentally relevant concentrations remain difficult due to the lack of studies testing low concentrations at chronic exposure. There is thus a need to test the effects of these environmental concentrations on biogeochemical processes to further establish the possible effects on ecosystem functioning.

  9. Antibiotic-Resistant Gonorrhea

    Science.gov (United States)

    ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Antibiotic-Resistant Gonorrhea Recommend on Facebook Tweet Share Compartir ... Threat Gonorrhea has progressively developed resistance to the antibiotic drugs prescribed to treat it. Following the spread ...

  10. Antibiotics and Resistance: Glossary

    Science.gov (United States)

    ... Work Contact Us ABOUT THE ISSUE What is Antibiotic Resistance? General Background Science of Resistance Glossary References ... for Adaptation Genetics and Drug Resistance Reservoirs of Antibiotic Resistance Project (ROAR) INTERNATIONAL CHAPTERS APUA Chapter Network ...

  11. Prevalence and correlates of antibiotic sharing in the Philippines: antibiotic misconceptions and community-level access to non-medical sources of antibiotics.

    Science.gov (United States)

    Barber, Daniel A; Casquejo, Efren; Ybañez, Purita L; Pinote, Magdaleno T; Casquejo, Luz; Pinote, Lucia S; Estorgio, Magdalena; Young, April M

    2017-05-01

    To identify sociodemographic, knowledge and attitudinal correlates to antibiotic sharing among a community-based sample of adults (age 18 and older) in a low-income setting of the Philippines and to explore community-level data on informal antibiotic distribution in roadside stands (i.e., sari-sari stands). Participants (n = 307) completed self-administered surveys. Correlates to antibiotic sharing were assessed using logistic regression with Firth's bias-adjusted estimates. Study staff also visited 106 roadside stands and collected data on availability and characteristics of antibiotics in the stands. 78% had shared antibiotics in their lifetime, most often with family members. In multivariable analysis, agreement with the belief that it is safe to prematurely stop an antibiotic course (OR: 2.8, CI: 1.3-5.8) and concerns about antibiotic side effects (OR: 2.1, CI: 1.1-4.4) were significantly associated with increased odds of reported antibiotic sharing. Antibiotic sharing was not associated with sociodemographic characteristics or antibiotic knowledge. Antibiotics were widely available in 60% of sampled sari-sari stands, in which 59% of antibiotics were missing expiration dates. Amoxicillin and cephalexin were the most commonly available antibiotics for sale at the stands (60% and 21%, respectively). Antibiotic sharing was common and was associated with misconceptions about proper antibiotic use. Antibiotics were widely available in sari-sari stands, and usually without expiration information. This study suggests that multipronged and locally tailored approaches to curbing informal antibiotic access are needed in the Philippines and similar Southeast-Asian countries. © 2017 John Wiley & Sons Ltd.

  12. 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.

  13. Antibiotic-Associated Diarrhea

    Science.gov (United States)

    ... antibiotic-associated colitis, which can occur after the antibiotic therapy upsets the balance of good and bad bacteria in your intestinal tract. Besides loose stools, C. difficile infection can ... and symptoms of antibiotic-associated diarrhea. These signs and symptoms are common ...

  14. [How to raise awareness about antibiotics and vaccination among French teenagers?

    Science.gov (United States)

    Touboul Lundgren, Pia; Khouri, Pauline; Pradier, Christian

    2017-04-27

    Introduction: Bacterial resistance to antibiotics is a growing concern in Europe, vaccination coverage is inadequate, and young adults, who are the highest antibiotic consumers, have the lowest level of knowledge. Extension of the e-Bug project, a European educational school programme concerning microbes, antibiotics and vaccination, to 15-18-year-olds implies the development of educational resources based on social marketing to promote sustainable behavioural changes. The objectives of the present study, which is part of the needs assessment in France, are to explore the attitudes, knowledge and behaviour of 15-18-year-olds concerning antibiotics and vaccination and their health education needs. Methods: Individual semi-structured interviews were conducted using purposeful sampling of 15- to 18-year-olds, until data saturation, and were transcribed and analysed. Results: The results confirm that teenagers are high antibiotic consumers with poor knowledge. They are interested in their health, but less so in antibiotics and vaccination. Health information is mainly obtained from the Internet, but tends to be criticised. General practitioners play an important role in terms of health information and are also influenced by peers and family. Teenagers believe school should play an important role in health education, which they would prefer to be more interactive: debates, case-stories, sharing experience with peers, parents and health professionals, based on relevant concrete examples, via new technologies. Conclusion: Knowledge gaps revealed among young people during this survey confirm that this age-group should be targeted by a specifically tailored approach. Responders are receptive to information provided by reliable and easily accessible sources. High schools, as well as general practitioners, play an important role in health education in general for this age-group and particularly concerning antibiotics and vaccinations. The Internet is a relevant medium for

  15. Self-medication with antibiotics in Lithuania.

    Science.gov (United States)

    Berzanskyte, Ausra; Valinteliene, Rolanda; Haaijer-Ruskamp, Flora M; Gurevicius, Romualdas; Grigoryan, Larissa

    2006-01-01

    Excessive and not always proper use of antibiotic give rise to numerous problems, of which antimicrobial resistance, currently cause for worldwide concern, is the major one. Few single studies of antibiotic use have been carried out in some countries. This study was performed to estimate the prevalence of antibiotic use in the general population of Lithuania with special interest in self-medication with antibiotics and sources of their acquisition. Structured questionnaires on antibiotic use during the last 12 months were mailed to randomly selected adults and 746 of them were finally analyzed. It was found that 39.9% of respondents reported antibiotic use during the last 12 months preceding the study and 53.2% of those used them in self-medication. In general, 22.0% (95%CI: 19.1-25.1) of respondents used antibiotics without prescription, whereas 45.0% (95%CI: 41.3-48.7) of them used antibiotics for intended self-administration. Adjustment for all the factors revealed the impact of the occupation, place of residence and presence of chronic disease on self-medication with antibiotics. Representatives of managerial, executive and professional occupations used non-prescribed antibiotics 8.38 times more often (95% CI: 1.76-39.91, p = 0.01) than retired people. Healthy people showed the tendency to self-medication 2.04 times more frequently than those with chronic diseases (95%CI: 1.11-3.75, p = 0.02). Rural people used non-prescribed antibiotics 1.79 times more often than inhabitants of urban areas (95%CI: 1.00-3.18, p = 0.049). Community pharmacies proved to be the most frequent (86.0%) source of over-the-counter antibiotics. Tonsillitis, bronchitis, and upper respiratory infections were the major reasons for self-medication with antibiotics. The high prevalence of self-medication with antibiotics was found in Lithuania. The study indicated the need for more strict control of antibiotic sales and promotion of education of the correct use of antibiotic among Lithuanian

  16. 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.

  17. Novel antibiotics: are we still in the pre-post-antibiotic era?

    Science.gov (United States)

    Draenert, R; Seybold, U; Grützner, E; Bogner, J R

    2015-04-01

    Therapeutic efficacy and safety in infections due to multidrug-resistant bacteria can be improved by the clinical development of new compounds and devising new derivatives of already useful antibiotics. Due to a striking global increase in multidrug-resistant Gram-positive but even more Gram-negative organisms, new antibiotics are urgently needed. This paper provides a review of novel antibiotic compounds which are already in clinical development, mainly in phase III clinical trials. Each of these new trials increases the possibility of new antibiotics receiving approval.

  18. WITHDRAWN: Antibiotics for preventing leptospirosis.

    Science.gov (United States)

    Guidugli, Fábio; Castro, Aldemar A; Atallah, Alvaro N

    2009-07-08

    antibiotics group compared with the ones assigned to the placebo group showed: Symptomatic, verified leptospirosis: 0.6% (3/509) versus 4.9% (25/ 513); risk difference (random effects model) -4.1%, 95% confidence interval -5.9% to -2.3%. Number needed-to-treat 24 (95% confidence interval 17 to 43). Adverse effects: 3% (13/469 participants) versus 0.2% (1/471 participants); random effects model 2.6%, 95% confidence interval 1.0% to 4.1%. Number needed-to-harm 39 (95% confidence interval 25 to 100). Prophylaxis of leptospirosis may be achieved by administration of doxycycline to soldiers training in endemic areas with a high risk of exposure to leptospirosis. Whether these findings apply to other scenarios or not remains to be proven.

  19. Superbugs and antibiotics in the newborn

    Directory of Open Access Journals (Sweden)

    Alessandro Borghesi

    2015-10-01

    Full Text Available Antibiotic resistance has become an urgent and global issue, with 700,000 deaths attributable to multidrug-resistance occurring each year worldwide. The overuse of antibiotics, both in animal industry and in clinical settings, and the generated selective pressure, are the main factors implicated in the emergence of resistant strains. The Centers for Disease Control and Prevention (CDC have pointed out that more than half of hospital patients receive an antibiotic during their stay, and nearly a third receive a broad-spectrum antibiotic. In neonatal units, previous antibiotic exposure to third-generation cephalosporin and carbapenem were identified as independent risk factors for infection caused by multi-drug resistant strains. While resistant ‘superbugs’ emerge, the arsenal to fight these microorganisms is progressively shrinking, as the number of newly discovered antibiotics approved by the Food and Drug administration each year is dropping. In face of global spread of antibiotic resistance and of the limited development of new drugs, policies and rules are under study by agencies (CDC, World Health Organization and governments, in order to: i facilitate and foster the discovery of new antibiotic compounds; ii develop new, alternative therapies able to potentiate or modulate the host immune response or to abrogate the resistance and virulence factors in the microorganisms; and iii prevent the emergence of resistance through antibiotic stewardship programs, educational programs, and reduction of antibiotic use in livestock; the field of neonatal medicine will need its own, newborn-tailored, antibiotic stewardship programs to be implemented in the NICUs. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai

  20. Antibiotic use among medical specialties in a community hospital.

    Science.gov (United States)

    Jogerst, G J; Dippe, S E

    1981-02-27

    Antibiotic use in a community hospital was evaluated to demonstrate specialty variations. A chart review was performed using the Veterans Administration's "Guidelines for Peer Review" to determine appropriate antibiotic use. Of the 1,054 patients discharged in August 1977, three hundred ten (29.4%) received 479 courses of antibiotics of which two hundred eighty-seven (60%) were considered appropriate. Seventy-two percent of the therapeutic courses and 36% of the prophylactic courses were appropriate. Prophylactic antibiotics were used in 12% of the hospitalized patients and accounted for 33% of the total antibiotics. No notable difference in appropriate antibiotic use was found among general surgeons (73%), internists (72%), orthopedists (71%), and family practitioners (67%). Substantially lower levels were found among urologists (54%), otolaryngologists (44%), and obstetricians (36%). Continued education in proper antibiotic use is needed especially for prophylaxis. Educational programs directed at specific specialties may be the most fruitful way to effect improved overall antibiotic use.

  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. 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

  3. Antibiotic resistance: are we all doomed?

    Science.gov (United States)

    Collignon, P

    2015-11-01

    Antibiotic resistance is a growing and worrying problem associated with increased deaths and suffering for people. Overall, there are only two factors that drive antimicrobial resistance, and both can be controlled. These factors are the volumes of antimicrobials used and the spread of resistant micro-organisms and/or the genes encoding for resistance. The One Health concept is important if we want to understand better and control antimicrobial resistance. There are many things we can do to better control antimicrobial resistance. We need to prevent infections. We need to have better surveillance with good data on usage patterns and resistance patterns available across all sectors, both human and agriculture, locally and internationally. We need to act on these results when we see either inappropriate usage or resistance levels rising in bacteria that are of concern for people. We need to ensure that food and water sources do not spread multi-resistant micro-organisms or resistance genes. We need better approaches to restrict successfully what and how antibiotics are used in people. We need to restrict the use of 'critically important' antibiotics in food animals and the entry of these drugs into the environment. We need to ensure that 'One Health' concept is not just a buzz word but implemented. We need to look at all sectors and control not only antibiotic use but also the spread and development of antibiotic resistant bacteria - both locally and internationally. © 2015 Royal Australasian College of Physicians.

  4. A Review on Antibiotic Resistance: Alarm Bells are Ringing.

    Science.gov (United States)

    Zaman, Sojib Bin; Hussain, Muhammed Awlad; Nye, Rachel; Mehta, Varshil; Mamun, Kazi Taib; Hossain, Naznin

    2017-06-28

    Antibiotics are the 'wonder drugs' to combat microbes. For decades, multiple varieties of antibiotics have not only been used for therapeutic purposes but practiced prophylactically across other industries such as agriculture and animal husbandry. Uncertainty has arisen, as microbes have become resistant to common antibiotics while the host remains unaware that antibiotic resistance has emerged. The aim of this review is to explore the origin, development, and the current state of antibiotic resistance, regulation, and challenges by examining available literature. We found that antibiotic resistance is increasing at an alarming rate. A growing list of infections i.e., pneumonia, tuberculosis, and gonorrhea are becoming harder and at times impossible to treat while antibiotics are becoming less effective. Antibiotic-resistant infections correlate with the level of antibiotic consumption. Non-judicial use of antibiotics is mostly responsible for making the microbes resistant. The antibiotic treatment repertoire for existing or emerging hard-to-treat multidrug-resistant bacterial infections is limited, resulting in high morbidity and mortality report. This review article reiterates the optimal use of antimicrobial medicines in human and animal health to reduce antibiotic resistance. Evidence from the literature suggests that the knowledge regarding antibiotic resistance in the population is still scarce. Therefore, the need of educating patients and the public is essential to fight against the antimicrobial resistance battle.

  5. Duration of antibiotic therapy in the intensive care unit

    Science.gov (United States)

    Zilahi, Gabor; McMahon, Mary Aisling; Povoa, Pedro

    2016-01-01

    There are certain well defined clinical situations where prolonged therapy is beneficial, but prolonged duration of antibiotic therapy is associated with increased resistance, medicalising effects, high costs and adverse drug reactions. The best way to decrease antibiotic duration is both to stop antibiotics when not needed (sterile invasive cultures with clinical improvement), not to start antibiotics when not indicated (treating colonization) and keep the antibiotic course as short as possible. The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown, however, there is a growing evidence that reduction in the length of antibiotic courses to 7–8 days can minimize the consequences of antibiotic overuse in critical care, including antibiotic resistance, adverse effects, collateral damage and costs. Biomarkers like C-reactive protein (CRP) and procalcitonin (PCT) do have a valuable role in helping guide antibiotic duration but should be interpreted cautiously in the context of the clinical situation. On the other hand, microbiological criteria alone are not reliable and should not be used to justify a prolonged antibiotic course, as clinical cure does not equate to microbiological eradication. We do not recommend a ‘one size fits all’ approach and in some clinical situations, including infection with non-fermenting Gram-negative bacilli (NF-GNB) clinical evaluation is needed but shortening the antibiotic course is an effective and safe way to decrease inappropriate antibiotic exposure. PMID:28149576

  6. Repairing the broken market for antibiotic innovation.

    Science.gov (United States)

    Outterson, Kevin; Powers, John H; Daniel, Gregory W; McClellan, Mark B

    2015-02-01

    Multidrug-resistant bacterial diseases pose serious and growing threats to human health. While innovation is important to all areas of health research, it is uniquely important in antibiotics. Resistance destroys the fruit of prior research, making it necessary to constantly innovate to avoid falling back into a pre-antibiotic era. But investment is declining in antibiotics, driven by competition from older antibiotics, the cost and uncertainty of the development process, and limited reimbursement incentives. Good public health practices curb inappropriate antibiotic use, making return on investment challenging in payment systems based on sales volume. We assess the impact of recent initiatives to improve antibiotic innovation, reflecting experience with all sixty-seven new molecular entity antibiotics approved by the Food and Drug Administration since 1980. Our analysis incorporates data and insights derived from several multistakeholder initiatives under way involving governments and the private sector on both sides of the Atlantic. We propose three specific reforms that could revitalize innovations that protect public health, while promoting long-term sustainability: increased incentives for antibiotic research and development, surveillance, and stewardship; greater targeting of incentives to high-priority public health needs, including reimbursement that is delinked from volume of drug use; and enhanced global collaboration, including a global treaty. Project HOPE—The People-to-People Health Foundation, Inc.

  7. 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.

  8. Robust, cross-laboratory validated PCR methods to track antibiotic resistance in agricultural settings

    Science.gov (United States)

    In order to make informed decisions on how best to manage agricultural antibiotics, we need to be able to track and quantify the antibiotic resistant bacteria, and antibiotic resistance genes. PCR-based methods are widely used to both detect and quantify antibiotic resistance genes, however there ar...

  9. 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.

  10. Countermeasures to Antibiotics Crisis: a Global Priority List of Antibiotic-Resistant Bacteria for Research and Development of New Antibiotics

    OpenAIRE

    Editorial

    2017-01-01

    On 27 Feb., 2017, the World Health Organization (WHO) announced the first list of important antibiotic-resistant bacteria (http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/en/), which tremendously threat human-being’s health. This list included 12 kinds of bacteria that were categorized into three priority tiers: Critical, High and Medium. In the first tier, Critical, three Gram negative bacteria were included: Acinetobacter baumannii with carbapenem-resis...

  11. 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

  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. 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.

  14. 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.

  15. 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

  16. 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

  17. 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...... cultures, rather than the individual level. Here, we used individual level bacteria data to confirm previous studies in how fast cells switch into a persistence stage, but our results challenge the fundamental idea that persistence comes with major costs of reduced growth (cell elongation) and division due...... even play a more prominent role for the evolution of resistance and failures of medical treatment by antibiotics as currently assumed....

  18. 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

  19. [Antibiotic treatments in urology].

    Science.gov (United States)

    Chaussade, H; Sunder, S; Bernard, L; Coloby, P; Guy, L; Karsenty, G; Bastide, C; Bruyère, F

    2013-11-01

    To define prescription modalities for the use of antibiotics in urology. A bibliographic research was performed using the MEDLINE database concerning all the antibiotics usable in urology. Treatments were classified by families; modes of action, indications in urology and adverse events have been detailed. Administrative files for commercial use have been consulted and associated with literature analysis. About 8 classes of antibiotics are usable in urology in a routine use. How they work, indications in urology and adverse events are discussed. Knowing that bacterial resistance to quinilones is increasing dramatically, it seems imperative to control the use of 8 classes of antibiotics. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. 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.

  1. Determinants of antibiotic prescription in paediatric patients: The ...

    African Journals Online (AJOL)

    Background. The need for healthcare in paediatric patients is often due to respiratory diseases, acute diarrhoea and viral fever, which suggests a limited need for the use of antibiotics. Objectives. To identify the determinants of antibiotic prescription in hospitalised paediatric patients in Mozambique. Methods.

  2. Prevalence of septicaemia and antibiotic sensitivity pattern of ...

    African Journals Online (AJOL)

    Bloodstream infections are important causes of mortality and morbidity. Rapid empiric antibiotic therapy is often needed. Knowledge of epidemiological data of common pathogens and their antibiotic sensitivity pattern is needed for rapid therapy. This study was aimed at determining the common causes of septicaemia and ...

  3. Implementation of HPV vaccination guidelines in a diverse population in Los Angeles: Results from an environmental scan of local HPV resources and needs.

    Science.gov (United States)

    Baezconde-Garbanati, Lourdes; Lienemann, Brianna A; Robles, Marisela; Johnson, Ethel; Sanchez, Kathleen; Singhal, Rita; Steinberg, Jane; Jaque, Jenny M; Pentz, Mary Ann; Gruber, Stephen

    2017-09-05

    Research shows that vaccination against human papillomavirus (HPV) infection is one of the most effective methods for reducing risk for cervical cancer; it also protects against other HPV-related cancers. Controversies exist regarding HPV vaccination in several communities; which may in part explain why although rates of HPV vaccination are increasing nationwide, Los Angeles County (LAC) data show that many adolescents are still not vaccinated. These adolescents remain at high-risk for infection. Using community-based participatory principles, we conducted an environmental scan that included a literature review, the development of a community advisory board, community feedback from HPV community meetings, and interviews with stakeholders to understand attitudes toward HPV vaccination and their impact in follow through with HPV vaccines. Twenty-eight key stakeholders participated in our coalition comprised of community organizations and clinics with strong ties to the local community. This is the only coalition dedicated exclusively to improving HPV vaccine uptake in LAC. Of these, twenty-one participated in an environmental scan via qualitative interviews about HPV vaccination programs, service delivery priorities, and proposed steps to increase HPV vaccination uptake in LAC. The environmental scan revealed targets for future efforts, barriers to HPV uptake, and next steps for improving local HPV vaccination uptake rates. The environmental scan also identified local HPV vaccination interventions and resources. Although LAC has developed important efforts for vaccination, some interventions are no longer being implemented due to lack of funds; others have not been evaluated with sufficient outcome data. The risk for cervical and other HPV-related cancers could be greatly reduced in LAC if a multilevel, multicultural, and multilingual approach is taken to better understand rates of HPV vaccination uptake, particularly among racial/ethnic minorities and LGBTQ youth

  4. 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

  5. Isolation of ESBL-producing Bacteria from Sputum in Community-acquired Pneumonia or Healthcare-associated Pneumonia Does Not Indicate the Need for Antibiotics with Activity against This Class.

    Science.gov (United States)

    Horie, Hideyuki; Ito, Isao; Konishi, Satoshi; Yamamoto, Yuki; Yamamoto, Yuko; Uchida, Tatsuya; Ohtani, Hideo; Yoshida, Yoshiharu

    2018-02-15

    Objective In the past decade, extended-spectrum β-lactamase (ESBL)-producing bacteria have increasingly frequently been isolated from various kinds of clinical specimens. However, the appropriate treatment of pneumonia in which ESBL-producing bacteria are isolated from sputum culture is poorly understood. To investigate whether or not ESBL-producing bacteria isolated from sputum in pneumonia cases should be treated as the causative bacteria. Methods and Patients In this retrospective study, we screened for patients, admitted between January 2009 and December 2015 in whom pneumonia was suspected and for whom sputum cultures yielded Escherichia coli or Klebsiella spp. isolates. We identified patients with community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) from whom ESBL-producing bacteria had been isolated from sputum culture and to whom antibiotic treatment had been given with a diagnosis of pneumonia. We analyzed the patients' backgrounds and the effect of the antibiotic treatment for the initial 3-5 days. Results From 400 patients initially screened, 27 with ESBL-producing bacteria were secondarily screened. In this subset of patients, 15 were diagnosed with pneumonia, including 7 with CAP (5 E. coli and 2 K. pneumoniae) and 8 with HCAP (8 E. coli). These patients exhibited an average age of 84.1 years old, and 9 of 15 were men. No patients were initially treated with antimicrobials that are effective against isolated ESBL-producing bacteria. However, 13 of 15 patients showed improvement of pneumonia following the initial antibiotic treatment. Conclusion ESBL-producing bacteria isolated from sputum are not likely to be the actual causative organisms of pneumonia.

  6. Antibiotic Resistance in Severe Orofacial Infections.

    Science.gov (United States)

    Kim, Min Kyoung; Chuang, Sung-Kiang; August, Meredith

    2017-05-01

    This study assessed the antibiotic resistance profile in patients with severe orofacial infections treated at a single institution from 2009 through 2014. Factors contributing to resistance were studied. The resistance profile was compared with that of a cohort of similar patients treated a decade previously to identify changes in antibiotic resistance. In addition, the effect of antibiotic resistance on in-hospital course was studied. This was a 5-year retrospective cohort study. Patients were identified through the oral and maxillofacial surgery data registry. Inclusion criteria were patients treated for orofacial infection requiring hospital admission, surgical drainage, and availability of complete medical, surgical, and microbiological data. Patients with incomplete data or treated as outpatients or nonsurgically were excluded. Sixty patient charts were identified for review. Demographic data; medical, dental, and surgical histories; and hospital course and treatment specifics were obtained for each patient. Linear regression and logistic analyses were used to analyze the data. Men composed 60% of the cohort (mean age, 45 yr). Average hospital stay was 5.5 days. Penicillin resistance was found in 32.5% of aerobic isolates and clindamycin resistance was found in 29.3%. Streptococcus viridans and Staphylococcus species showed increased resistance to clindamycin and erythromycin compared with historic controls. Younger patient age, surgical history, and number of cultured aerobes showed a relevant correlation to antibiotic resistance. The need for changes in antibiotics, repeat surgical drainage, and increased serum urea nitrogen levels correlated with longer hospital stay. A serious increase in clindamycin and erythromycin resistance was found for S viridans and Staphylococcus species. Age, surgical history, and number of cultured aerobes showed a statistically meaningful correlation to antibiotic resistance. Presence of antibiotic resistance failed to show

  7. 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.

  8. 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,

  9. Evaluation of antibiotic usage in swine reproduction farms in Umbria region based on the quantitative analysis of antimicrobial consumption

    OpenAIRE

    Scoppetta, Fausto; Sensi, Marco; Franciosini, Maria Pia; Capuccella, Marinella

    2017-01-01

    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...

  10. Predictors of Total Antibiotic Use among a National Network of Academic Hospitals

    Science.gov (United States)

    Holmer, Haley K; McGregor, Jessina C; Elman, Miriam R; Hohmann, Samuel; Kuper, Kristi; Pakyz, Amy

    2017-01-01

    Abstract Background The Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) provides hospitals a mechanism to report antibiotic use (AU) data to benchmark against peer institutions and direct antibiotic stewardship efforts. Differences in patient populations need to be adjusted for to ensure unbiased comparisons across hospitals. Our objective was to identify predictors of total AU across a nationwide network of hospitals. Methods Data from 126 academic hospitals were extracted from the Vizient Clinical Data Base Resource Manager for adult inpatients (age ≥ 18 years) in 2015. AU was expressed as total antibiotic days of therapy/patient-days. We constructed a negative binomial regression model to explore potential predictors of AU including age, race, sex, case mix index, hospital bed size, length of stay, geographic region, transfer cases, service line, and illness severity. A backwards stepwise approach based on likelihood ratio test was used to identify significant (P service line 0.45 0.25, 0.81 Major illness severity 3.24 1.04, 10.09 Conclusion The current NHSN AU risk adjustment metric, the standardized antimicrobial administration ratio (SAAR), has been developed separately for different antibiotic groupings and adjusts for a limited set of facility characteristics. Further work is needed to assess if the independent predictors identified in this model can improve upon the performance of existing SAAR metrics and aid in directing stewardship strategies. Disclosures All authors: No reported disclosures.

  11. 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.

  12. 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.

  13. Effect of tailored antibiotic stewardship programmes on the appropriateness of antibiotic prescribing in nursing homes.

    Science.gov (United States)

    van Buul, Laura W; van der Steen, Jenny T; Achterberg, Wilco P; Schellevis, François G; Essink, Rob T G M; de Greeff, Sabine C; Natsch, Stephanie; Sloane, Philip D; Zimmerman, Sheryl; Twisk, Jos W R; Veenhuizen, Ruth B; Hertogh, Cees M P M

    2015-07-01

    To evaluate the effect of tailored interventions on the appropriateness of decisions to prescribe or withhold antibiotics, antibiotic use and guideline-adherent antibiotic selection in nursing homes (NHs). We conducted a quasi-experimental study in 10 NHs in the Netherlands. A participatory action research (PAR) approach was applied, with local stakeholders in charge of selecting tailored interventions based on opportunities for improved antibiotic prescribing that they derived from provided baseline data. An algorithm was used to evaluate the appropriateness of prescribing decisions, based on infections recorded by physicians. Effects of the interventions on the appropriateness of prescribing decisions were analysed with a multilevel logistic regression model. Pharmacy data were used to calculate differences in antibiotic use and recorded infections were used to calculate differences in guideline-adherent antibiotic selection. The appropriateness of 1059 prescribing decisions was assessed. Adjusting for pre-test differences in the proportion of appropriate prescribing decisions (intervention, 82%; control, 70%), post-test appropriateness did not differ between groups (crude: P = 0.26; adjusted for covariates: P = 0.35). We observed more appropriate prescribing decisions at the start of data collection and before receiving feedback on prescribing behaviour. No changes in antibiotic use or guideline-adherent antibiotic selection were observed in intervention NHs. The PAR approach, or the way PAR was applied in the study, was not effective in improving antibiotic prescribing behaviour. The study findings suggest that drawing prescribers' attention to prescribing behaviour and monitoring activities, and increasing use of diagnostic resources may be promising interventions to improve antibiotic prescribing in NHs. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For

  14. 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)

  15. 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.

  16. Antibiotic-Resistant Bacteria.

    Science.gov (United States)

    Longenecker, Nevin E.; Oppenheimer, Dan

    1982-01-01

    A study conducted by high school advanced bacteriology students appears to confirm the hypothesis that the incremental administration of antibiotics on several species of bacteria (Escherichia coli, Staphylococcus epidermis, Bacillus sublitus, Bacillus megaterium) will allow for the development of antibiotic-resistant strains. (PEB)

  17. Antibiotic-Resistant Gonorrhea (ARG)

    Science.gov (United States)

    ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Antibiotic-Resistant Gonorrhea Basic Information Recommend on Facebook Tweet Share Compartir Antibiotic-Resistant Gonorrhea: An Overview Antibiotic resistance is the ...

  18. 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

  19. 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

  20. Appropriate Antibiotic Therapy.

    Science.gov (United States)

    Allison, Michael G; Heil, Emily L; Hayes, Bryan D

    2017-02-01

    Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that determine the optimal breadth of antimicrobial therapy. Cultures should be drawn before antibiotic therapy if it does not significantly delay administration. Combination antibiotic therapy against gram-negative infections is not routinely required, and combination therapy involving vancomycin and piperacillin/tazobactam is associated with an increase in acute kidney injury. Emergency practitioners should be aware of special considerations in the administration and dosing of antibiotics in order to deliver optimal care to septic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Report: EPA Needs to Better Implement Plan for Protecting Critical Infrastructure and Key Resources Used to Respond to Terrorist Attacks and Disasters

    Science.gov (United States)

    Report #2006-P-00022, April 26, 2006. Assignment of formal authority and more accountability is required to ensure the initiatives in the Critical Infrastructure and Key Resources Protection Plan are accomplished in a timely manner.

  2. 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.

  3. 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

  4. Physical, technical, and economic accessibility of resources and reserves need to be distinguished by grade: Application to the case of phosphorus.

    Science.gov (United States)

    Springer, Nathaniel P

    2017-01-15

    The amount of phosphorus in the total environment is finite, yet recent estimates suggest that more than enough phosphate ore resources exist in the lithosphere to meet future increases in demand during the next century. Still, it remains unclear how the accessibility of this resource stock - which is heterogeneous in terms of grade and location - will change as currently accessible resources are utilized, as extraction and processing technologies develop, and as the relative economic costs vary. This study uses an economic framework, the World Trade Model with Rectangular Choice-of-Technology, to link estimates of known geological resources of various grades with the technically and economically accessible reserves. Using the most recent public data on phosphate ore stocks and mining and technological capacity, this study estimates that the ~400,000teragrams (Tg) of known apatite ore (>1% P 2 O 5 content) equate to ~110,000Tg when converted to potential reserves (~30% P 2 O 5 ) using existing technologies, with over half of these remaining potential reserves converted from resources with grades below 20% P 2 O 5 . Corresponding global reserves are estimated at ~70,000Tg using the Rectangular Choice-of-Technology model, but since any reserve estimate is contingent on the state of the world economy, a set of five illustrative scenarios are constructed to show how this estimate can vary between ~67,000 and ~98,000Tg with only a small number of changes to the economic and technical parameters and variables. Calculating accessibility using consistent definitions for resources and reserves while distinguishing between grades not only creates a clearer picture of remaining non-renewable resources, but creates a framework that can be used to explore future geopolitical scenarios about ore availability, extraction technologies, supply networks, and global commodity prices. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Solving the Antibiotic Crisis.

    Science.gov (United States)

    Wright, Gerard D

    2015-02-13

    Antibiotics are essential for both treating and preventing infectious diseases. Paradoxically, despite their importance as pillars of modern medicine, we are in danger of losing antibiotics because of the evolution and dissemination of resistance mechanisms throughout all pathogenic microbes. This fact, coupled with an inability to bring new drugs to market at a pace that matches resistance, has resulted in a crisis of global proportion. Solving this crisis requires the actions of many stakeholders, but chemists, chemical biologists, and microbiologists must drive the scientific innovation that is required to maintain our antibiotic arsenal. This innovation requires (1) a deep understanding of the evolution and reservoirs of resistance; (2) full knowledge of the molecular mechanisms of antibiotic action and resistance; (3) the discovery of chemical and genetic probes of antibiotic action and resistance; (4) the integration of systems biology into antibiotic discovery; and (5) the discovery of new antimicrobial chemical matter. Addressing these pressing scientific gaps will ensure that we can meet the antibiotic crisis with creativity and purpose.

  6. Antibiotic stewardship: overcoming implementation barriers.

    Science.gov (United States)

    Bal, Abhijit M; Gould, Ian M

    2011-08-01

    Antimicrobial stewardship is now recognized as a formal strategy for curbing the upward trend in antibiotic resistance. Literature on antimicrobial stewardship has focused on areas of strategic importance and operational delivery. A number of barriers have been recognized in the implementation of successful programs. These include lack of physician participation, lack of diagnostic facility, absence of formal mechanism of data collection, variation between countries, and lack of cooperative strategies. In this review, we suggest strategies to overcome these barriers. In the last few years, it has been recognized that an executive program is necessary for successful implementation of strategies to control the growing antibiotic resistance. Efforts have been made at higher levels of government through organizations such as the European Centre for Disease Prevention and Control. The need for community healthcare involvement has also been recognized. At a local level, strategies to promote cooperation between various committees (e.g. infection control and antimicrobial management teams) have been proposed and adopting antibiotic care bundles as part of patient safety and healthcare is being explored. We suggest that executive level planning, local cooperation, sustained education, emphasis on de-escalation, and use of care bundles could stem the tide of growing resistance.

  7. 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…

  8. Synergistic Photothermal and Antibiotic Killing of Biofilm-Associated Staphylococcus aureus Using Targeted Antibiotic-Loaded Gold Nanoconstructs

    OpenAIRE

    Meeker, Daniel G.; Jenkins, Samir V.; Miller, Emily K.; Beenken, Karen E.; Loughran, Allister J.; Powless, Amy; Muldoon, Timothy J.; Galanzha, Ekaterina I.; Zharov, Vladimir P.; Smeltzer, Mark S.; Chen, Jingyi

    2016-01-01

    Resistance to conventional antibiotics is a growing public health concern that is quickly outpacing the development of new antibiotics. This has led the Infectious Diseases Society of America (IDSA) to designate Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species as ?ESKAPE pathogens? on the basis of the rapidly decreasing availability of useful antibiotics. This emphasizes the urgent need for alternativ...

  9. 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

  10. 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.

  11. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance

    Science.gov (United States)

    2014-01-01

    Background Greater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community. Methods Both gray literature and published scientific literature in English and other European languages was examined. Multiple regression analysis was used to analyse whether studies found a positive relationship between antibiotic consumption and resistance. A subsequent meta-analysis and meta-regression was conducted for studies for which a common effect size measure (odds ratio) could be calculated. Results Electronic searches identified 974 studies but only 243 studies were considered eligible for inclusion by the two independent reviewers who extracted the data. A binomial test revealed a positive relationship between antibiotic consumption and resistance (p resistance than other regions. Conclusions Using a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated several significant predictors. Countries in southern Europe produced a stronger link between consumption and resistance than other regions so efforts at reducing antibiotic consumption may need to be strengthened in this area. Increased consumption of antibiotics may not only produce greater resistance at the individual patient level but may also produce greater resistance at the community, country, and regional levels, which can harm individual patients. PMID:24405683

  12. Pediatric antibiotic stewardship: successful interventions to reduce broad-spectrum antibiotic use on general pediatric wards.

    Science.gov (United States)

    Kreitmeyr, Katharina; von Both, Ulrich; Pecar, Alenka; Borde, Johannes P; Mikolajczyk, Rafael; Huebner, Johannes

    2017-08-01

    Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy. Medical records on four general pediatric wards were reviewed daily to analyze: (1) antibiotic consumption, (2) antibiotic dosage ranges according to local guidelines, and (3) guideline adherence for community-acquired pneumonia (CAP). Antibiotic prescribing for 273 patients (pre-intervention) was compared to 263 patients (post-intervention). Antibiotic prescription rate did not change (30.6 vs. 30.5%). However, overall days-of-therapy and length-of-therapy decreased by 10.5 and 7.7%, respectively. Use of cephalosporins and fluoroquinolones decreased by 35.5 and 59.9%, whereas the use of penicillins increased by 15.0%. An increase in dosage accuracy was noted (78.8 vs. 97.6%) and guideline adherence for CAP improved from 39.5 to 93.5%. Between the two study periods, no adverse effects regarding length of hospital stay and in-hospital mortality were observed. Our data demonstrate that implementation of an ASP was associated with a profound improvement of rational antibiotic use and, therefore, patient safety. Considering the relatively short observation period, the long-term effects of our ASP bundle need to be further investigated.

  13. New antibiotic development: barriers and opportunities

    Directory of Open Access Journals (Sweden)

    Ercole Concia

    2016-12-01

    Full Text Available Antibiotic resistance represents a serious threat to public health worldwide, leading to increased healthcare costs, prolonged hospital stays, treatment failures and deaths. To address the emergency of multidrug-resistance, the major international societies of infectious diseases and public health have developed strategies and guidelines to reduce unnecessary antimicrobial use as well as to incite the development of new antibiotics targeting multidrug-resistant pathogens. Even though pharmaceutical companies have been developing new antibiotics since 2010, the global situation is still worrisome. Indeed, the currently available data regarding new antibiotics are limited to microbiological activity and pharmacokinetic profile and their use for the treatment of life-threatening infections (i.e., sepsis is often off-label. The aim of this article is to present the antibiotic molecules recently commercialized and with which clinicians will deal quite often in next years. We describe ceftolozane/tazobactam, ceftazidime/avibactam, eravacycline, plazomicin, dalbavancin, oritavancin and tedizolid in terms of mechanism of action, antimicrobial spectrum, trials behind the approval and possible indications for the future. In last few years, the US Food and Drug Administration (FDA and the European Medicines Agency (EMA approved many new antibiotic molecules but, unfortunately, they lack in biological innovation and in wide clinical indications. These agents show appealing properties for off-label use, as we propose in the article, but caution is still needed considering that high-quality clinical data are limited.

  14. 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.

  15. 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.

  16. Necessity of Antibiotics following Simple Exodontia.

    Science.gov (United States)

    Yousuf, Waqas; Khan, Moiz; Mehdi, Hasan; Mateen, Sana

    2016-01-01

    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.

  17. 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…

  18. How little do we need to know about Enterprise Resource Planning (ERP)? - A critical review of information systems research on ERP

    DEFF Research Database (Denmark)

    Koch, Christian; Olsen, Martin; Tambo, Torben

    2010-01-01

    Enterprise Resource Planning (ERP) systems continue, even in 2010, to be an important change agenda in business. With a long term development spanning 15 years ERP-systems have changed profoundly, and diversified into a number of businesses. Yet this article is addressing two major issues left...

  19. 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

  20. 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....

  1. High Antibiotic Consumption

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... with highest consumption) were responsible for 21% of the total DDD consumed and received ≥6 packages per year. Elderly adults (≥60 years) and small children (0-9 years) were those exposed to the highest volume of antibiotics and with the most frequent exposure, respectively. Heavy users received a high...

  2. 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 ...

  3. 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

  4. 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

  5. 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.

  6. Comparison of antibiotic resistance patterns between laboratories in ...

    African Journals Online (AJOL)

    Antibiotic resistance is increasing rapidly and developing countries are the worse affected since they provide conditions and practices that support the development and spread of resistant microbes. For better health policy on antibiotic use a national surveillance program is needed to provide baseline data from different ...

  7. The challenges of overcoming antibiotic resistance: Plant extracts as ...

    African Journals Online (AJOL)

    The problem of antibiotic resistance, which has limited the use of cheap and old antibiotics, has necessitated the need for a continued search for new antimicrobial compounds. Understanding the mechanisms of resistance is important in the development of strategies to solving the problem. Active efflux of drugs, alteration of ...

  8. Genomic and metagenomic analysis of antibiotic resistance in dairy animals

    Science.gov (United States)

    The extent to which carriage of antibiotic resistant bacteria in food animals is responsible for the burden of antibiotic resistance in human infections is currently not well known. Thus, there is a need to further evaluate the genomic diversity of multidrug resistant (MDR) bacteria and the microbi...

  9. A framework for global surveillance of antibiotic resistance

    NARCIS (Netherlands)

    Grundmann, Hajo; Klugman, Keith P.; Walsh, Timothy; Ramon-Pardo, Pilar; Sigauque, Betuel; Khan, Wasif; Laxminarayan, Ramanan; Heddini, Andreas; Stelling, John

    The foreseen decline in antibiotic effectiveness explains the needs for data to inform the global public health agenda about the magnitude and evolution of antibiotic resistance as a serious threat to human health and development. Opportunistic bacterial pathogens are the cause of the majority of

  10. 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...

  11. Molecular epidemiology of antibiotic-associated diarrhoea due to ...

    African Journals Online (AJOL)

    Background: As we are living in the era of antibiotic overuse, antibiotic associated diarrhea (AAD) is considered now a distinct health problem with a need for more attention. Aim of the Study: was to perform a highly specific detection and definition of pathogenic Clostridium perfringens and Clostridium difficile related AAD in ...

  12. [Determination of antibiotics using luminescent Escherichia coli and serum].

    Science.gov (United States)

    Vlasova, I I; Asrieli, T V; Gavrilova, E M; Danilov, V S

    2007-01-01

    The methodical bases for detecting antibiotics using a bioluminescent assay and blood serum are briefed. Antibiotics inhibit the luminescence of a genetically engineered Escherichia coli strain. The degree of inhibition depended on the type of antibiotic, its concentration, and the time of cell incubation with antibiotic. The highest cell sensitivity was recorded towards the aminoglycoside antibiotics, which amounted to 85 +/- 10 ng/ml for gentamicin and streptomycin. The sensitivity of this system to a number of antibiotics essentially increased when the cells were previously activated with blood serum. The sensitivity of this method for gentamicin and streptomycin in the presence of blood serum amounted to 2.5 +/- 0.5 ng/ml; for tetracycline, 45 +/- 8 ng/ml. Use of the sera containing specific antibodies to the antibiotic detected provided a high sensitivity of the biosensor tested. Comparison of the luminescences of E. coli cells activated with normal and specific antisera upon incubation with an antibiotic allows the type of antibiotic and its quantitative content in the sample to be determined. Characteristic of the analysis of antibiotics with the help of recombinant E. coli are a high accuracy, sensitivity, specificity, simplicity, and a short time needed for measurement.

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

    Science.gov (United States)

    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

    2017-01-01

    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 blaTEM gene being more common than blaCTX-M. Co-harbouring of the blaCTX-M, blaTEM 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. PMID:28661465

  14. 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.

  15. A New Product Development Partnership Model for Antibiotic Resistance.

    Science.gov (United States)

    Billington, John K

    2016-05-01

    Antibiotics have prevented countless deaths from common infections and have made possible many modern medical procedures. Over the past few decades, antibiotic-resistant bacteria have become a global threat, spreading between healthcare facilities and throughout communities worldwide at an alarming pace. Antibiotic overuse and misuse in humans, animals, and the environment accelerate resistance by selecting for bacteria with antibiotic-resistant traits, which then become predominant and infect others. Meanwhile, few antibiotics remain active against the most resistant bacteria. There is an urgent need for new antibiotics and other antibacterial products to replace second-line and last resort therapies when they no longer work. This Article proposes a new U.S.-based, non-governmental, not-for-profit product development partnership (PDP) model specifically designed for antibacterial development. This new model should both supplement and complement existing government-led efforts and should be built with mechanisms in place to balance the values of innovation, access, and conservation.

  16. Antibiotic treatment of CF lung disease: from bench to bedside.

    Science.gov (United States)

    Bals, Robert; Hubert, Dominique; Tümmler, Burkhard

    2011-06-01

    Chronic infection of the respiratory tract is a hallmark of cystic fibrosis (CF). Antibiotic treatment has been used as one of the mainstays of therapy and together with other treatment modalities has resulted in increased survival of CF patients. Increasing resistance of CF-specific pathogens to various classes of antibiotics explains the need for novel antibiotic strategies. This review focuses on the future development of new antibiotic therapies, including: (1) New targets, (2) novel antibiotic regimens in CF, (3) new antibiotics, and (4) other investigational therapies. In addition, we briefly summarize developments in the area of microbial diagnostics and discuss interactions between the complex pulmonary microflora. Copyright © 2011 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  17. The Antibiotic Resistant Target Seeker (ARTS), an exploration engine for antibiotic cluster prioritization and novel drug target discovery

    DEFF Research Database (Denmark)

    Alanjary, Mohammad; Kronmiller, Brent; Adamek, Martina

    2017-01-01

    With the rise of multi-drug resistant pathogens and the decline in number of potential new antibiotics in development there is a fervent need to reinvigorate the natural products discovery pipeline. Most antibiotics are derived from secondary metabolites produced by microorganisms and plants....... To avoid suicide, an antibiotic producer harbors resistance genes often found within the same biosynthetic gene cluster (BGC) responsible for manufacturing the antibiotic. Existing mining tools are excellent at detecting BGCs or resistant genes in general, but provide little help in prioritizing...... and identifying gene clusters for compounds active against specific and novel targets. Here we introduce the 'Antibiotic Resistant Target Seeker' (ARTS) available at https://arts.ziemertlab.com. ARTS allows for specific and efficient genome mining for antibiotics with interesting and novel targets. The aim...

  18. 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.

  19. Can Gaming Increase Antibiotic Awareness in Children? A Mixed-Methods Approach.

    Science.gov (United States)

    Hale, Alexander R; Young, Vicki Louise; Grand, Ann; McNulty, Cliodna Ann Miriam

    2017-03-24

    e-Bug is a pan-European educational resource for junior and senior school children, which contains activities covering prudent antibiotic use and the spread, treatment, and prevention of infection. Teaching resources for children aged 7-15 years are complemented by a student website that hosts games and interactive activities for the children to continue their learning at home. The aim of this study was to appraise young people's opinions of 3 antibiotic games on the e-Bug student website, exploring children's views and suggestions for improvements, and analyzing change in their knowledge around the learning outcomes covered. The 3 games selected for evaluation all contained elements and learning outcomes relating to antibiotics, the correct use of antibiotics, and bacteria and viruses. A mixed methodological approach was undertaken, wherein 153 pupils aged 9-11 years in primary schools and summer schools in the Bristol and Gloucestershire area completed a questionnaire with antibiotic and microbe questions, before and after playing 3 e-Bug games for a total of 15 minutes. The after questionnaire also contained open-ended and Likert scale questions. In addition, 6 focus groups with 48 students and think-aloud sessions with 4 students who had all played the games were performed. The questionnaire data showed a significant increase in knowledge for 2 out of 7 questions (P=.01 and Pgame "Body Busters" was the most popular, closely followed by "Doctor Doctor," and "Microbe Mania" the least popular. This study shows that 2 of the e-Bug antibiotic educational games are valuable. "Body Busters" effectively increased antibiotic knowledge in children and had the greatest flow and enjoyment. "Doctor Doctor" also resulted in increased knowledge, but was less enjoyable. "Microbe Mania" had neither flow nor knowledge gain and therefore needs much modification and review. The results from the qualitative part of this study will be very important to inform future modifications

  20. Association between public knowledge regarding antibiotics and self-medication with antibiotics in Teling Atas Community Health Center, East Indonesia

    Directory of Open Access Journals (Sweden)

    Kurniawan Kurniawan

    2017-05-01

    Full Text Available Background: Self-medication with antibiotics increases the risk of resistance, which leads to higher morbidity and mortality. The community plays an important role in preventing and controlling the spread of antibiotic resistance. This study aims to determine factors associated with antibiotics self-medication practices in the community, which are the key to developing effective intervention programs.Methods: This cross-sectional study was conducted between September and October 2015 at Teling Atas Community Health Center in Wanea, a sub-district of East Indonesia region. Data was collected by a questionnaire-guided interview. There were 35 questions which cover respondent demographics, antibiotic use, and respondents’ knowledge about antibiotics. Logistic regression was used to analyze the association between self-medication with antibiotics and respondents’ level of knowledge as well as other factors.Results: Among 400 respondents, there were 240 (60% who had used antibiotics within 6 months prior to the interview and 180 (45.0% who had self-medicated. Wounds or skin diseases (32.2% were main reasons for self-medication. The majority of respondents self-medicated on their own initiatives (70.6% and purchased antibiotics in pharmacies (52.2%. The mean score for respondent knowledge about antibiotic was categorized as “moderate” (score 7.14±2.49. Respondents with lower knowledge scores had higher probabilities to self-medicate with antibiotics than those with higher scores (OR= 16.86; 95% CI= 4.25–66.83.Conclusion: Self-medication practices with antibiotics in this study are associated with age, family income, and knowledge. Since poorer knowledge about antibiotics is associated with a higher probability of self-medication with antibiotics, education programs to improve public awareness are needed.

  1. 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

  2. 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

  3. Partnering with students to explore the health needs of an ethnically diverse, low-resource school: an innovative large group assessment approach.

    Science.gov (United States)

    Vaughn, Lisa M; Jacquez, Farrah; Zhao, Juanjuan; Lang, Maria

    2011-01-01

    School-based health programs have a unique and powerful potential to meet the health needs of children because students spend more time in schools than in any other environment away from home. We conducted a participatory needs assessment called a Group Level Assessment (GLA) in collaboration with an economically disadvantaged and ethnically diverse school to facilitate the students' identification of and subsequent action toward important health needs. A total of 68 students in Kindergarten through eighth grade participated in the GLA. Four major themes emerged: the desire for more sports and after-school activities, better school lunches, enjoyment of friends and families, and overall happiness. Other health issues identified by the students included limited health/medical care, stress resulting from schoolwork and grades, positive self-image, and the desire for more art opportunities. The salient themes identified by students are consistent with many factors identified in the academic literature as important in child socioemotional functioning.

  4. 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

  5. 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.

  6. "Ten Commandments" for the Appropriate use of Antibiotics by the Practicing Physician in an Outpatient Setting

    DEFF Research Database (Denmark)

    Levy-Hara, Gabriel; Amábile-Cuevas, Carlos F; Gould, Ian

    2011-01-01

    A multi-national working group on antibiotic stewardship, from the International Society of Chemotherapy, put together ten recommendations to physicians prescribing antibiotics to outpatients. These recommendations are: (1) use antibiotics only when needed; teach the patient how to manage symptoms...

  7. 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

  8. Tetracycline Antibiotics and Resistance.

    Science.gov (United States)

    Grossman, Trudy H

    2016-04-01

    Tetracyclines possess many properties considered ideal for antibiotic drugs, including activity against Gram-positive and -negative pathogens, proven clinical safety, acceptable tolerability, and the availability of intravenous (IV) and oral formulations for most members of the class. As with all antibiotic classes, the antimicrobial activities of tetracyclines are subject to both class-specific and intrinsic antibiotic-resistance mechanisms. Since the discovery of the first tetracyclines more than 60 years ago, ongoing optimization of the core scaffold has produced tetracyclines in clinical use and development that are capable of thwarting many of these resistance mechanisms. New chemistry approaches have enabled the creation of synthetic derivatives with improved in vitro potency and in vivo efficacy, ensuring that the full potential of the class can be explored for use against current and emerging multidrug-resistant (MDR) pathogens, including carbapenem-resistant Enterobacteriaceae, MDR Acinetobacter species, and Pseudomonas aeruginosa. Copyright © 2016 Cold Spring Harbor Laboratory Press; all rights reserved.

  9. Making Reasonable Adjustments for Pupils with Special Educational Needs and Disabilities: Pre-Service Teachers' Perceptions of an Online Support Resource

    Science.gov (United States)

    Morley, David; Maher, Anthony; Walsh, Barbara; Dinning, Track; Lloyd, Diane; Pratt, Andrea

    2017-01-01

    The Equality Act called on British schools to "avoid as far as possible by reasonable means, the disadvantage which a disabled pupil experiences". Teachers, therefore, must be creative and flexible in order to meet the needs and optimise the capabilities of all pupils. Using focus group interviews, this article explores the influence of…

  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. Comparison of Resource and Energy Yield Assessment Procedures 2011-2015: What have we learned and what needs to be done?

    DEFF Research Database (Denmark)

    Mortensen, Niels Gylling; Nielsen, Morten; Ejsing Jørgensen, Hans

    2015-01-01

    studies for medium- to large-scale offshore wind farms in the Irish Sea. A total of 157 submissions were received, 97 land-based and 60 offshore, and all four exercises were analysed and presented previously by DTU Wind Energy. Results are summarised here for each of seven specific steps in the resource...... and energy yield assessment procedure: Site wind observation, long-term extrapolation, vertical extrapolation, horizontal extrapolation, wake modelling, technical losses estimation, uncertainty estimation and calculation. For each step and each wind farm a summary is given of the magnitude of the effects......, the spread of the predictions, the methodologies used, and some general, qualitative conclusions. For one offshore wind farm, Barrow, the predicted yield was found to be 104% of the observed yield, with a spread of predictions of 3%. Based on the results of the four case studies and the statistics...

  12. Building a simulation-based crisis resource management course for emergency medicine, phase 1: Results from an interdisciplinary needs assessment survey.

    Science.gov (United States)

    Hicks, Christopher M; Bandiera, Glen W; Denny, Christopher J

    2008-11-01

    Emergency department (ED) resuscitation requires the coordinated efforts of an interdisciplinary team. Human errors are common and have a negative impact on patient safety. Although crisis resource management (CRM) skills are utilized in other clinical domains, most emergency medicine (EM) caregivers currently receive no formal CRM training. The objectives were to compile and compare attitudes toward CRM training among EM staff physicians, nurses, and residents at two Canadian academic teaching hospitals. Emergency physicians (EPs), residents, and nurses were asked to complete a Web survey that included Likert scales and short answer questions. Focus groups and pilot testing were used to inform survey development. Thematic content analysis was performed on the qualitative data set and compared to quantitative results. The response rate was 75.7% (N = 84). There was strong consensus regarding the importance of core CRM principles (i.e., effective communication, team leadership, resource utilization, problem-solving, situational awareness) in ED resuscitation. Problems with coordinating team actions (58.8%), communication (69.6%), and establishing priorities (41.3%) were among factors implicated in adverse events. Interdisciplinary collaboration (95.1%), efficiency of patient care (83.9%), and decreased medical error (82.6%) were proposed benefits of CRM training. Communication between disciplines is a barrier to effective ED resuscitation for 94.4% of nurses and 59.7% of EPs (p = 0.008). Residents reported a lack of exposure to (64.3%), yet had interest in (96.4%) formal CRM education using human patient simulation. Nurses rate communication as a barrier to teamwork more frequently than physicians. EM residents are keen to learn CRM skills. An opportunity exists to create a novel interdisciplinary CRM curriculum to improve EM team performance and mitigate human error.

  13. Antibiotic resistance in the wild: an eco-evolutionary perspective.

    Science.gov (United States)

    Hiltunen, Teppo; Virta, Marko; Laine, Anna-Liisa

    2017-01-19

    The legacy of the use and misuse of antibiotics in recent decades has left us with a global public health crisis: antibiotic-resistant bacteria are on the rise, making it harder to treat infections. At the same time, evolution of antibiotic resistance is probably the best-documented case of contemporary evolution. To date, research on antibiotic resistance has largely ignored the complexity of interactions that bacteria engage in. However, in natural populations, bacteria interact with other species; for example, competition and grazing are import interactions influencing bacterial population dynamics. Furthermore, antibiotic leakage to natural environments can radically alter bacterial communities. Overall, we argue that eco-evolutionary feedback loops in microbial communities can be modified by residual antibiotics and evolution of antibiotic resistance. The aim of this review is to connect some of the well-established key concepts in evolutionary biology and recent advances in the study of eco-evolutionary dynamics to research on antibiotic resistance. We also identify some key knowledge gaps related to eco-evolutionary dynamics of antibiotic resistance, and review some of the recent technical advantages in molecular microbiology that offer new opportunities for tackling these questions. Finally, we argue that using the full potential of evolutionary theory and active communication across the different fields is needed for solving this global crisis more efficiently.This article is part of the themed issue 'Human influences on evolution, and the ecological and societal consequences'. © 2016 The Authors.

  14. Antibiotic resistance in the wild: an eco-evolutionary perspective

    Science.gov (United States)

    Virta, Marko

    2017-01-01

    The legacy of the use and misuse of antibiotics in recent decades has left us with a global public health crisis: antibiotic-resistant bacteria are on the rise, making it harder to treat infections. At the same time, evolution of antibiotic resistance is probably the best-documented case of contemporary evolution. To date, research on antibiotic resistance has largely ignored the complexity of interactions that bacteria engage in. However, in natural populations, bacteria interact with other species; for example, competition and grazing are import interactions influencing bacterial population dynamics. Furthermore, antibiotic leakage to natural environments can radically alter bacterial communities. Overall, we argue that eco-evolutionary feedback loops in microbial communities can be modified by residual antibiotics and evolution of antibiotic resistance. The aim of this review is to connect some of the well-established key concepts in evolutionary biology and recent advances in the study of eco-evolutionary dynamics to research on antibiotic resistance. We also identify some key knowledge gaps related to eco-evolutionary dynamics of antibiotic resistance, and review some of the recent technical advantages in molecular microbiology that offer new opportunities for tackling these questions. Finally, we argue that using the full potential of evolutionary theory and active communication across the different fields is needed for solving this global crisis more efficiently. This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences'. PMID:27920384

  15. The Biogeography of Putative Microbial Antibiotic Production.

    Directory of Open Access Journals (Sweden)

    Hélène Morlon

    Full Text Available Understanding patterns in the distribution and abundance of functional traits across a landscape is of fundamental importance to ecology. Mapping these distributions is particularly challenging for species-rich groups with sparse trait measurement coverage, such as flowering plants, insects, and microorganisms. Here, we use likelihood-based character reconstruction to infer and analyze the spatial distribution of unmeasured traits. We apply this framework to a microbial dataset comprised of 11,732 ketosynthase alpha gene sequences extracted from 144 soil samples from three continents to document the spatial distribution of putative microbial polyketide antibiotic production. Antibiotic production is a key competitive strategy for soil microbial survival and performance. Additionally, novel antibiotic discovery is highly relevant to human health, making natural antibiotic production by soil microorganisms a major target for bioprospecting. Our comparison of trait-based biogeographical patterns to patterns based on taxonomy and phylogeny is relevant to our basic understanding of microbial biogeography as well as the pressing need for new antibiotics.

  16. No. 247-Antibiotic Prophylaxis in Obstetric Procedures.

    Science.gov (United States)

    van Schalkwyk, Julie; Van Eyk, Nancy

    2017-09-01

    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 June2009 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. RECOMMENDATIONS. Copyright © 2017. Published by Elsevier Inc.

  17. 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

  18. 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.

  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. 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

  1. 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.

  2. Dispensing of antibiotics without prescription in Greece, 2008: another link in the antibiotic resistance chain.

    Science.gov (United States)

    Plachouras, D; Kavatha, D; Antoniadou, A; Giannitsioti, E; Poulakou, G; Kanellakopoulou, K; Giamarellou, H

    2010-02-18

    Antibiotic resistance has been associated with the use of antibiotics. The dispensing of antimicrobials without prescription is a potential source of inappropriate antibiotic use. In our study, antibiotics were requested without prescription from pharmacies in the metropolitan area of Athens in Greece in 2008. Twenty-one collaborators visited 174 pharmacies and asked for either amoxicillin/clavulanate acid or ciprofloxacin without providing a prescription or any other justification for the request. In Greece additional restrictions for fluoroquinolone prescriptions were implemented in 2003 after which a separate specific prescription form needs to be filled in by the prescriber, justifying the choice of any fluoroquinolone. Amoxicillin/clavulanate acid was dispensed in all cases. Furthermore, despite the regulation restricting the prescription of ciprofloxacin, this drug was dispensed by 53% of the pharmacies. It appears that the implementation of measures to restrict the use of certain antibiotics (e.g. ciprofloxacin that was studied in our case) was effective in reducing, although not eliminating, inappropriate dispensing. Overall, dispensing of antimicrobials without prescription is a widespread practice in the studied area and is contributing to the overuse of antibiotics.

  3. 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.

  4. 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

  5. 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

  6. 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 environmental

  7. Antibiotics in laboratory medicine

    National Research Council Canada - National Science Library

    Lorian, Victor

    2005-01-01

    ... in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in the USA Library of Congress Cataloging-in-Publication Data Antibiotics in laboratory medicine / [edited by] Victor Lorian. - 5th ed...

  8. Antibiotic therapy of cholera*

    Science.gov (United States)

    Lindenbaum, John; Greenough, William B.; Islam, M. R.

    1967-01-01

    Recent clinical trials having established the value of tetracycline as an adjunct to fluid and electrolyte replacement in cholera treatment, a controlled trial of antibiotic therapy was conducted in Dacca on 318 adults hospitalized for cholera. The effects of 4 antibiotics orally administered in varying dosage schedules were studied. Cholera therapy with tetracycline or chloramphenicol caused a highly significant reduction in the duration of diarrhoea and of positive culture, in stool volume, and in intravenous fluid requirement as compared with the results in controls who received intravenous fluid therapy only. Streptomycin was also effective, but to a lesser degree; paromomycin was of little value. The severity of dehydration on admission was significantly related to subsequent duration of diarrhoea regardless of whether antibiotics were given. Increasing age was associated with more prolonged purging in patients receiving antibiotics. Increasing the dose of tetracycline to 2 to 3 times that usually administered, or prolonging treatment from 2 to 4 days, did not enhance the therapeutic results. The effect of tetracycline was apparent within a few hours of administration. Bacteriological relapses were seen after discontinuation of therapy in all treatment groups, but were not due to the development of resistant bacteria. PMID:4865453

  9. 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

  10. 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...

  11. When and How to Take Antibiotics

    Science.gov (United States)

    ... Contact Us General Background: When & How to take Antibiotics When should you take antibiotics? What is the proper dosage? How safe are antibiotics? How does a physician decide which antibiotic to ...

  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. How much information about antibiotics do people recall after consulting in primary care?

    Science.gov (United States)

    McNulty, Cliodna A M; Lecky, Donna M; Hawking, Meredith K D; Roberts, Christine; Quigley, Anna; Butler, Chris C

    2016-08-01

    Sharing information with patients within a consultation about their infection and value of antibiotics can help reduce antibiotic prescriptions for respiratory tract infections. However, we do not know how often information is given about antibiotics or infections, and if this is related to knowledge and attitudes. To determine the public's reported use of antibiotics, receipt of information from health professionals about antibiotics and resistance, trust in health professionals and knowledge levels about antibiotics and resistance. Face-to-face computer-assisted survey with 1625 adults over 15 years in randomly selected households using multistage sampling. Rim weighting was used to correct for any selection biases. About 88% trusted their GP to determine the need for antibiotics. Of those who took antibiotics in the past year, 62% were for a throat infection, 60% for sinus infection and 42% for a cough. Although 67% who had been prescribed an antibiotic recalled being given advice about their infection or antibiotics, only 8% recalled information about antibiotic resistance. Those in lower social grades were less likely to recall advice. About 44% correctly indicated that antibiotics effectively treat bacterial rather than viral infections. Only 45% agreed that 'healthy people can carry antibiotic resistant bacteria'. GPs and health carers are trusted decision-makers, but could share more information with patients about the need or not for antibiotics, self-care and antibiotic resistance, especially with younger patients and those of lower social grade. Better ways are needed for effective sharing of information about antibiotic resistance. © The Author 2016. Published by Oxford University Press.

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

    Science.gov (United States)

    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 replace antibiotics remains a controversial issue. This review summarizes recent development and perspectives of alternatives to antibiotics. The mechanism of actions, applications, and prospectives of the alternatives such as immunity modulating agents, bacteriophages and their lysins, antimicrobial peptides, pro-, pre-, and synbiotics, plant extracts, inhibitors targeting pathogenicity (bacterial quorum sensing, biofilm, and virulence), and feeding enzymes are thoroughly discussed. Lastly, the feasibility of alternatives to antibiotics is deeply analyzed. It is hard to conclude that the alternatives might substitute antibiotics in veterinary medicine in the foreseeable future. At the present time, prudent use of antibiotics and the establishment of scientific monitoring systems are the best and fastest way to limit the adverse effects of the abuse of antibiotics and to ensure the safety of animal-derived food and environment.

  15. Antibiotic Alternatives: The Substitution of Antibiotics in Animal Husbandry?

    Directory of Open Access Journals (Sweden)

    Guyue eCheng

    2014-05-01

    Full Text Available 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 relly replace antibiotics remains a controversial issue. This review summarizes recent development and perspectives of alternatives to antibiotics. The mechanism of actions, applications, and prospectives of the alternatives such as immunity modulating agents, bacteriophages and their lysins, antimicrobial peptides, pro-, pre- and synbiotics, plant extracts, inhibitors targeting pathogenicity (bacterial quorum sensing, biofilm and virulence, and feeding enzymes are thoroughly discussed. Lastly, the feasibility of alternatives to antibiotics is deeply analyzed. It is hard to conclude that the alternatives might substitute antibiotics in veterinary medicine in the foreseeable future. At the present time, prudent use of antibiotics and the establishment of scientific monitoring systems are the best and fastest way to limit the adverse effects of the abuse of antibiotics and to ensure the safety of animal-derived food and environment.

  16. 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.

  17. 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.

  18. 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.

  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. 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.

  1. Development of new antibiotics: taking off finally?

    Science.gov (United States)

    Bettiol, Esther; Harbarth, Stephan

    2015-01-01

    Since 2010, awareness of the global threat caused by antimicrobial resistance (AMR) has risen considerably and multiple policy and research initiatives have been implemented. Research and development (R&D) of much-needed new antibiotics active against multiresistant pathogens is a key component of all programmes aiming at fighting AMR, but it has been lagging behind owing to scientific, regulatory and economic challenges. Although a few new antibiotics might be available in Switzerland in the next 5 years, these new agents are not based on new mechanisms of action and are not necessarily active against resistant pathogens for which there is the highest unmet medical need, i.e. multiresistant Gram-negative bacteria. Of the three new antibiotics with pending authorisation in Switzerland for systemic treatment of severe infections, oritavancin and tedizolid target Gram-positive pathogens, while only ceftolozane+tazobactam partially covers multiresistant Gram-negative pathogens. Among six antibiotics currently in phase III of clinical development, delafloxacin and solithromycin will also be useful mostly for Gram-positive infections. Importantly, the four other compounds are active against multiresistant Gram-negative pathogens: ceftazidime+avibactam, meropenem+RPX7009, eravacycline and plazomicin. The three last compounds are also active against carbapenem-resistant Enterobacteriaceae (CRE). A few compounds active against such pathogens are currently in earlier clinical development, but their number may decrease, considering the risk of failure over the course of clinical development. At last, through public and political awareness of pathogens with high public health impact and unmet medical need, development of innovative economic incentives and updated regulatory guidance, R&D of new antibiotics is slowly taking off again.

  2. Antibiotic failure mediated by a resistant subpopulation in Enterobacter cloacae.

    Science.gov (United States)

    Band, Victor I; Crispell, Emily K; Napier, Brooke A; Herrera, Carmen M; Tharp, Greg K; Vavikolanu, Kranthi; Pohl, Jan; Read, Timothy D; Bosinger, Steven E; Trent, M Stephen; Burd, Eileen M; Weiss, David S

    2016-05-09

    Antibiotic resistance is a major public health threat, further complicated by unexplained treatment failures caused by bacteria that appear antibiotic susceptible. We describe an Enterobacter cloacae isolate harbouring a minor subpopulation that is highly resistant to the last-line antibiotic colistin. This subpopulation was distinct from persisters, became predominant in colistin, returned to baseline after colistin removal and was dependent on the histidine kinase PhoQ. During murine infection, but in the absence of colistin, innate immune defences led to an increased frequency of the resistant subpopulation, leading to inefficacy of subsequent colistin therapy. An isolate with a lower-frequency colistin-resistant subpopulation similarly caused treatment failure but was misclassified as susceptible by current diagnostics once cultured outside the host. These data demonstrate the ability of low-frequency bacterial subpopulations to contribute to clinically relevant antibiotic resistance, elucidating an enigmatic cause of antibiotic treatment failure and highlighting the critical need for more sensitive diagnostics.

  3. Antibiotic failure mediated by a resistant subpopulation in Enterobacter cloacae

    Science.gov (United States)

    Band, Victor I.; Crispell, Emily K.; Napier, Brooke A.; Herrera, Carmen M.; Tharp, Greg K.; Vavikolanu, Kranthi; Pohl, Jan; Read, Timothy D.; Bosinger, Steven E.; Trent, M. Stephen; Burd, Eileen M.; Weiss, David S.

    2016-01-01

    Antibiotic resistance is a major public health threat, further complicated by unexplained treatment failures caused by bacteria that appear antibiotic susceptible. We describe an Enterobacter cloacae isolate harbouring a minor subpopulation that is highly resistant to the last-line antibiotic colistin. This subpopulation was distinct from persisters, became predominant in colistin, returned to baseline after colistin removal and was dependent on the histidine kinase PhoQ. During murine infection, but in the absence of colistin, innate immune defences led to an increased frequency of the resistant subpopulation, leading to inefficacy of subsequent colistin therapy. An isolate with a lower-frequency colistin-resistant subpopulation similarly caused treatment failure but was misclassified as susceptible by current diagnostics once cultured outside the host. These data demonstrate the ability of low-frequency bacterial subpopulations to contribute to clinically relevant antibiotic resistance, elucidating an enigmatic cause of antibiotic treatment failure and highlighting the critical need for more sensitive diagnostics. PMID:27572838

  4. Combating antibiotic resistance, mitigating future threats and ongoing initiatives.

    Science.gov (United States)

    Velez, Roseann; Sloand, Elizabeth

    2016-07-01

    To emphasise the impact of antibiotic resistance as a persistent, global health threat and highlight efforts to improve this complex problem. Political agendas, legislation, development of therapies and educational initiatives are essential to mitigate the increasing rate of antibiotic resistance. Original manuscript. Prescribers, policymakers and researchers are charged with the complex task of mitigating antibiotic resistance in an era when new treatments for bacterial infections are limited. Monitoring, surveillance and incentivising of practice, policy and new treatments provide solutions to antibiotic resistance in both the human and agricultural sectors. This article emphasises the complexity of antibiotic resistance and highlights the need for a multifaceted approach to improve health care outcomes. © 2016 John Wiley & Sons Ltd.

  5. Bactericidal antibiotics increase hydroxyphenyl fluorescein signal by altering cell morphology.

    Directory of Open Access Journals (Sweden)

    Wilhelm Paulander

    Full Text Available It was recently proposed that for bactericidal antibiotics a common killing mechanism contributes to lethality involving indirect stimulation of hydroxyl radical (OH• formation. Flow cytometric detection of OH• by hydroxyphenyl fluorescein (HPF probe oxidation was used to support this hypothesis. Here we show that increased HPF signals in antibiotics-exposed bacterial cells are explained by fluorescence associated with increased cell size, and do not reflect reactive oxygen species (ROS concentration. Independently of antibiotics, increased fluorescence was seen for elongated cells expressing the oxidative insensitive green fluorescent protein (GFP. Although our data question the role of ROS in lethality of antibiotics other research approaches point to important interplays between basic bacterial metabolism and antibiotic susceptibility. To underpin such relationships, methods for detecting bacterial metabolites at a cellular level are needed.

  6. Bactericidal Antibiotics Increase Hydroxyphenyl Fluorescein Signal by Altering Cell Morphology

    Science.gov (United States)

    Folkesson, Anders; Charbon, Godefroid; Løbner-Olesen, Anders; Ingmer, Hanne

    2014-01-01

    It was recently proposed that for bactericidal antibiotics a common killing mechanism contributes to lethality involving indirect stimulation of hydroxyl radical (OH•) formation. Flow cytometric detection of OH• by hydroxyphenyl fluorescein (HPF) probe oxidation was used to support this hypothesis. Here we show that increased HPF signals in antibiotics-exposed bacterial cells are explained by fluorescence associated with increased cell size, and do not reflect reactive oxygen species (ROS) concentration. Independently of antibiotics, increased fluorescence was seen for elongated cells expressing the oxidative insensitive green fluorescent protein (GFP). Although our data question the role of ROS in lethality of antibiotics other research approaches point to important interplays between basic bacterial metabolism and antibiotic susceptibility. To underpin such relationships, methods for detecting bacterial metabolites at a cellular level are needed. PMID:24647480

  7. Opportunities for synthetic biology in antibiotics: expanding glycopeptide chemical diversity.

    Science.gov (United States)

    Thaker, Maulik N; Wright, Gerard D

    2015-03-20

    Synthetic biology offers a new path for the exploitation and improvement of natural products to address the growing crisis in antibiotic resistance. All antibiotics in clinical use are facing eventual obsolesce as a result of the evolution and dissemination of resistance mechanisms, yet there are few new drug leads forthcoming from the pharmaceutical sector. Natural products of microbial origin have proven over the past 70 years to be the wellspring of antimicrobial drugs. Harnessing synthetic biology thinking and strategies can provide new molecules and expand chemical diversity of known antibiotic scaffolds to provide much needed new drug leads. The glycopeptide antibiotics offer paradigmatic scaffolds suitable for such an approach. We review these strategies here using the glycopeptides as an example and demonstrate how synthetic biology can expand antibiotic chemical diversity to help address the growing resistance crisis.

  8. Density-dependent adaptive resistance allows swimming bacteria to colonize an antibiotic gradient.

    Science.gov (United States)

    Hol, Felix J H; Hubert, Bert; Dekker, Cees; Keymer, Juan E

    2016-01-01

    During antibiotic treatment, antibiotic concentration gradients develop. Little is know regarding the effects of antibiotic gradients on populations of nonresistant bacteria. Using a microfluidic device, we show that high-density motile Escherichia coli populations composed of nonresistant bacteria can, unexpectedly, colonize environments where a lethal concentration of the antibiotic kanamycin is present. Colonizing bacteria establish an adaptively resistant population, which remains viable for over 24 h while exposed to the antibiotic. Quantitative analysis of multiple colonization events shows that collectively swimming bacteria need to exceed a critical population density in order to successfully colonize the antibiotic landscape. After colonization, bacteria are not dormant but show both growth and swimming motility under antibiotic stress. Our results highlight the importance of motility and population density in facilitating adaptive resistance, and indicate that adaptive resistance may be a first step to the emergence of genetically encoded resistance in landscapes of antibiotic gradients.

  9. 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.

  10. Intimate partner violence prevention services and resources in Los Angeles: issues, needs, and challenges for assisting lesbian, gay, bisexual, and transgender clients.

    Science.gov (United States)

    Ford, Chandra L; Slavin, Terra; Hilton, Karin L; Holt, Susan L

    2013-11-01

    Intimate partner violence (IPV) is as prevalent in lesbian, gay, bisexual, and transgender (LGBT) relationships as it is in heterosexual ones; however, the issues, needs, and challenges associated with assisting or advocating on behalf of LGBT persons are poorly understood. Using community-based participatory approaches, we conducted a brief survey of professionals (e.g., shelter staff, domestic violence prevention and intervention programs, law enforcement) affiliated with one or more domestic violence prevention and/or intervention networks in Los Angeles, California. The sample, which included professionals (N = 54) from diverse programs/agencies, was obtained using purposive and snowball sampling. Participants self-administered a 33-item, online questionnaire. Analyses primarily involved descriptive statistics (frequencies, proportions). Most respondents had little or no training in LGBT IPV; nevertheless, nearly 50% of them reported having assisted LGBTs "sometimes" or "often" in the past year. Nearly all (92%) reported that their agencies/programs lack staff with dedicated responsibilities to LGBT IPV. The most frequent requests for assistance respondents reported receiving from LGBTs were for counseling, safe housing, legal assistance, and assistance navigating the medical system. The findings suggest that staff believe their agencies/programs inadequately address LGBT IPV but that many of the inadequacies (e.g., lack of staff training on LGBT IPV) are remediable.

  11. 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.

  12. The Comprehensive Antibiotic Resistance Database

    Science.gov (United States)

    McArthur, Andrew G.; Waglechner, Nicholas; Nizam, Fazmin; Yan, Austin; Azad, Marisa A.; Baylay, Alison J.; Bhullar, Kirandeep; Canova, Marc J.; De Pascale, Gianfranco; Ejim, Linda; Kalan, Lindsay; King, Andrew M.; Koteva, Kalinka; Morar, Mariya; Mulvey, Michael R.; O'Brien, Jonathan S.; Pawlowski, Andrew C.; Piddock, Laura J. V.; Spanogiannopoulos, Peter; Sutherland, Arlene D.; Tang, Irene; Taylor, Patricia L.; Thaker, Maulik; Wang, Wenliang; Yan, Marie; Yu, Tennison

    2013-01-01

    The field of antibiotic drug discovery and the monitoring of new antibiotic resistance elements have yet to fully exploit the power of the genome revolution. Despite the fact that the first genomes sequenced of free living organisms were those of bacteria, there have been few specialized bioinformatic tools developed to mine the growing amount of genomic data associated with pathogens. In particular, there are few tools to study the genetics and genomics of antibiotic resistance and how it impacts bacterial populations, ecology, and the clinic. We have initiated development of such tools in the form of the Comprehensive Antibiotic Research Database (CARD; http://arpcard.mcmaster.ca). The CARD integrates disparate molecular and sequence data, provides a unique organizing principle in the form of the Antibiotic Resistance Ontology (ARO), and can quickly identify putative antibiotic resistance genes in new unannotated genome sequences. This unique platform provides an informatic tool that bridges antibiotic resistance concerns in health care, agriculture, and the environment. PMID:23650175

  13. 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......) and the Danish Microbiology Database (performed microbiological testing). We will assess and quantify the use of microbiological testing prior to antibiotic prescription. Furthermore we will investigate associations between GP characteristics, use of microbiological investigations and description patterns...

  14. 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.

  15. [Change in attitude towards antibiotic prescriptions among Icelandic general practitioners].

    Science.gov (United States)

    Matthíasdóttir, Anna Mjöll; Guðnason, Thórólfur; Halldórsson, Matthías; Haraldsson, Ásgeir; Kristinsson, Karl G

    2016-01-01

    Antibiotic use is a leading cause of antibiotic resistance and it is therefore important to reduce unnecessary prescribing in Iceland where antibiotic use is relatively high. The purpose of this study was to explore antibiotic prescribing practices among Icelandic physicians and compare the results with results of comparable studies from 1991 and 1995 conducted by the Directorate of Health, Iceland. A descriptive cross-sectional study was carried out among all general practitioners registered in Iceland in 1991 and 1995 and all physicians registered in March 2014. Data was collected with questionnaires regarding diagnosis and treatment of simple urinary tract infection, acute otitis media and pharyngitis. A multiple logistic regression analysis was performed and level of significance p≤0.05. Response rates were 85% and 93% in 1991 and 1995 but 31% in 2014. Proportion of physicians who consider themselves prescribing antibiotics more than 10 times per week was 36% in 1991, 32% in 1995 and 21% in 2014. Proportion of trimethoprim-sulfamethoxazole as first choice for simple urinary tract infection reduced from 43% and 45% to 8% in 2014. In 2014, general practitioners considered themselves 87% less likely to prescribe an antibiotic for acute otitis media than in 1991 (pAntibiotic prescribing practices have changed significantly in the past two decades in Iceland becoming more in line with clinical guidelines. Improvements are still needed to further reduce inappropriate antibiotic use.

  16. Socioeconomic determinants of outpatient antibiotic use in Europe.

    Science.gov (United States)

    Masiero, Giuliano; Filippini, Massimo; Ferech, Matus; Goossens, Herman

    2010-10-01

    Outpatient antibiotic consumption widely varies across Europe. The investigation of the causes of such variation may help to identify interventions that would improve the efficient use of antibiotics. The aim of this study was to assess the impact of socioeconomic determinants and the role played by information about bacterial resistance. Comparable data on systemically administered antibiotics and socioeconomic determinants in 17 European countries were available between 2000 and 2005. We estimated an ad hoc econometric model by means of a hybrid log-log functional form and random effects generalised least squares regressions. Lagged values and the instrumental variable method were applied to address endogeneity of bacterial resistance and infections. Bacterial resistance was measured by the rate of penicillin non-susceptible Streptococcus pneumoniae isolates (PNSP) and methicillin-resistant Staphylococcus aureus (MRSA). The population income, demographic structure, density of general practitioners and their remuneration method appeared to be significant determinants of antibiotic consumption. Although countries with higher levels of bacterial resistance exhibited significantly higher levels of per capita antibiotic use, ceteris paribus, the responsiveness of antibiotic use to changes in bacterial resistance was relatively low (0.09-0.18). The study confirms that socioeconomic factors should be taken into account while explaining differences in outpatient antibiotic use across countries. The impact of supply-side factors and incentives attached to payment schemes for physicians need to be considered in government interventions to reduce inequalities and improve effectiveness in antibiotic utilisation.

  17. Antibiotic resistance trends and mechanisms in the foodborne pathogen, Campylobacter.

    Science.gov (United States)

    Tang, Yizhi; Fang, Liangxing; Xu, Changyun; Zhang, Qijing

    2017-11-23

    Campylobacter is a major foodborne pathogen and is commonly present in food producing animals. This pathogenic organism is highly adaptable and has become increasingly resistant to various antibiotics. Recently, both the Centers for Disease Control and Prevention and the World Health Organization have designated antibiotic-resistant Campylobacter as a serious threat to public health. For the past decade, multiple mechanisms conferring resistance to clinically important antibiotics have been described in Campylobacter, and new resistance mechanisms constantly emerge in the pathogen. Some of the recent examples include the erm(B) gene conferring macrolide resistance, the cfr(C) genes mediating resistance to florfenicol and other antimicrobials, and a functionally enhanced variant of the multidrug resistance efflux pump, CmeABC. The continued emergence of new resistance mechanisms illustrates the extraordinary adaptability of Campylobacter to antibiotic selection pressure and demonstrate the need for innovative strategies to control antibiotic-resistant Campylobacter. In this review, we will briefly summarize the trends of antibiotic resistance in Campylobacter and discuss the mechanisms of resistance to antibiotics used for animal production and important for clinical therapy in humans. A special emphasis will be given to the newly discovered antibiotic resistance.

  18. ANTIBIOTIC PROPHYLAXIS ON ESTOMATOLOGY

    OpenAIRE

    Rodríguez Alfaro, Miguel; Responsable de la cátedra de Farmacología de la Facultad de Odontología UNMSM.; Burga Sánchez, Jonny; Catedrático de Farmacología de la Facultad de Odontología UNMSM.; Chumpitaz Cerrate, Víctor; Catedrático de Farmacología de la Facultad de Odontología UNMSM.; Varas Hilario, Roberto; Catedrático de Farmacología de la Facultad de Odontología UNMSM.; Guerra Sanguinetti, Jaime; Cirujano Dentista de la Facultad de Odontología UNMSM.; López Bellido, Roger; Bachiller de la Facultad de Odontología UNMSM.; Zegarra Cuya, Juan; Interno de la Facultad de OdontoIogia UNMSM.

    2014-01-01

    Surgical antibiotic prophylaxis consists in the use of an antimicrobial drug in a preventive way, that must be active against microorganisms that in high frequency causes posterior infections of our surgical wounds and maintain effective tissue concentrations along the surgery procedure and the posterior time when appears the bacteremia. To reach a successful treatment is necessary to have the knowledge of the resident bactemial flora and the pathogenous flora that infects our surgical wounds...

  19. 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

  20. [Antibiotic use in Mexico: review of problems and policies].

    Science.gov (United States)

    Dreser, Anahí; Wirtz, Veronika J; Corbett, Kitty K; Echániz, Gabriela

    2008-01-01

    The inappropriate use of antibiotics signifies a risk for individual health and a waste of health resources. It triggers the development of antibiotic resistance, which increases expenditures and mortality related to infectious disease, and is hence considered a serious public health problem. The World Health Organization has thus recommended a series of strategies to be included within national pharmaceutical policies. In Mexico, diverse factors related to the inappropriate use of antibiotics have been documented. While the response has been mainly in the form of educational and managerial interventions directed toward physicians in public health services, as well as epidemiological surveillance, there is a paucity of research and interventions focused on consumers, pharmacies, and the private sector. Fundamentally, a comprehensive national strategy for antibiotics is not incorporated into health and pharmaceutical policies.

  1. 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

  2. 有你要的嗎? 探討幼稚園教師對網站資源的需求 Have You Got What You Want? Exploring Kindergarten Teachers’ Needs from the Resources on Websites

    Directory of Open Access Journals (Sweden)

    Shu-Hui Chiu*

    2009-09-01

    Full Text Available 本研究以問卷調查台北縣市 433 名幼稚園教師的教學資訊需求,初 步檢視幼教老師可能使用之網站並將之分類,再使用內容分析法檢 視 32 名幼教老師常用之資源網站,了解幼教相關網站提供之資訊是 否符合幼教老師的需求。研究發現教師對幼教資訊的需求含括教學、 輔導、保育、教師專業成長、行政等五面向。其中最需要的為教學 相關資源,包括圖片與影音素材、各領域輔助教材、學習單、教學 活動設計、繪本及軟體推薦等。幼教網站可依其提供之資訊與使用 對象分為四類:包括幼教資訊、教學資源、親子互動、在職進修等, 但沒有網站能將所有資源加以整合、分類,並提供良好檢索功能。 分析幼教網站內容發現,除在教案與教材上能有半數以上網站提供, 多數教師需要的資源仍相當匱乏。This study surveyed 433 kindergarten teachers to examine their information searching behaviors on the network and their information needs. In addition, the content of 32 early childhood education related websites were evaluated based on kindergarten teachers’ information needs. Findings indicated that searching on the network was the primary information searching approach teachers used when they need certain resource. However, they have difficulties in finding what they need on the network. The primary resources Kindergarten teachers need from the network web were pictures, videos, teaching plans, work-sheets for children, and book-recommendations. However, rarely few web sites provided these resources for kindergarten teachers.

  3. Ready for a world without antibiotics? The Pensières Antibiotic Resistance Call to Action

    Directory of Open Access Journals (Sweden)

    Carlet Jean

    2012-02-01

    Full Text Available Abstract Resistance to antibiotics has increased dramatically over the past few years and has now reached a level that places future patients in real danger. Microorganisms such as Escherichia coli and Klebsiella pneumoniae, which are commensals and pathogens for humans and animals, have become increasingly resistant to third-generation cephalosporins. Moreover, in certain countries, they are also resistant to carbapenems and therefore susceptible only to tigecycline and colistin. Resistance is primarily attributed to the production of beta-lactamase genes located on mobile genetic elements, which facilitate their transfer between different species. In some rare cases, Gram-negative rods are resistant to virtually all known antibiotics. The causes are numerous, but the role of the overuse of antibiotics in both humans and animals is essential, as well as the transmission of these bacteria in both the hospital and the community, notably via the food chain, contaminated hands, and between animals and humans. In addition, there are very few new antibiotics in the pipeline, particularly for Gram-negative bacilli. The situation is slightly better for Gram-positive cocci as some potent and novel antibiotics have been made available in recent years. A strong and coordinated international programme is urgently needed. To meet this challenge, 70 internationally recognized experts met for a two-day meeting in June 2011 in Annecy (France and endorsed a global call to action ("The Pensières Antibiotic Resistance Call to Action". Bundles of measures that must be implemented simultaneously and worldwide are presented in this document. In particular, antibiotics, which represent a treasure for humanity, must be protected and considered as a special class of drugs.

  4. 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...... 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...

  5. '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

  6. A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis.

    Science.gov (United States)

    Kip, Michelle M A; Kusters, Ron; IJzerman, Maarten J; Steuten, Lotte M G

    2015-01-01

    Procalcitonin (PCT) is a specific marker for differentiating bacterial from non-infective causes of inflammation. It can be used to guide initiation and duration of antibiotic therapy in intensive care unit (ICU) patients with suspected sepsis, and might reduce the duration of hospital stay. Limiting antibiotic treatment duration is highly important because antibiotic over-use may cause patient harm, prolonged hospital stay, and resistance development. Several systematic reviews show that a PCT algorithm for antibiotic discontinuation is safe, but upfront investment required for PCT remains an important barrier against implementation. The current study investigates to what extent this PCT algorithm is a cost-effective use of scarce healthcare resources in ICU patients with sepsis compared to current practice. A decision tree was developed to estimate the health economic consequences of the PCT algorithm for antibiotic discontinuation from a Dutch hospital perspective. Input data were obtained from a systematic literature review. When necessary, additional information was gathered from open interviews with clinical chemists and intensivists. The primary effectiveness measure is defined as the number of antibiotic days, and cost-effectiveness is expressed as incremental costs per antibiotic day avoided. The PCT algorithm for antibiotic discontinuation is expected to reduce hospital spending by circa € 3503 per patient, indicating savings of 9.2%. Savings are mainly due to reductions in length of hospital stay, number of blood cultures performed, and, importantly, days on antibiotic therapy. Probabilistic and one-way sensitivity analyses showed the model outcome to be robust against changes in model inputs. Proven safe, a PCT algorithm for antibiotic discontinuation is a cost-effective means of reducing antibiotic exposure in adult ICU patients with sepsis, compared to current practice. Additional resources required for PCT are more than offset by downstream cost

  7. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? A comparison study.

    Science.gov (United States)

    Ivanovska, Verica; Leufkens, Hubert G; Rademaker, Carin Ma; Zisovska, Elizabeta; Pijnenburg, Mariëlle W; van Dijk, Liset; Mantel-Teeuwisse, Aukje K

    2017-04-01

    There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of antibiotics listed on pertinent formularies that were not on the WHO Essential Medicines List for Children (EMLc). We compared four medicines lists versus the EMLc and contrasted paediatric antibiotic formulations in relation to administration routes, dosage forms and/or drug strengths. The additional formulations on comparator lists that differed from the EMLc formulations were evaluated for their added clinical values and costs. The analysis was based on 26 EMLc antibiotics. Seven oral and two parenteral formulations were considered clinically relevant for paediatric use. Frequently quoted benefits of oral formulations included: filling the gap of unmet therapeutic needs in certain age/weight groups (phenoxymethylpenicillin and metronidazole oral liquids, and nitrofurantoin capsules), and simplified administration and supply advantages (amoxicillin dispersible tablets, clyndamycin capsules, cloxacillin tablets, and sulfamethoxazole+trimethoprim tablets). Lower doses of ampicillin and cefazolin powder for injection could simplify the dosing in newborns and infants, reduce the risk of medical errors, and decrease the waste of medicines, but may target only narrow age/weight groups. The identified additional formulations of paediatric antibiotics on comparator lists may offer clinical benefits for low-resource settings, including simplified administration and increased dosing accuracy. The complexity of both procuring and managing multiple strengths and formulations also needs to be considered. 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/.

  8. Suppression of antibiotic resistance acquisition by combined use of antibiotics.

    Science.gov (United States)

    Suzuki, Shingo; Horinouchi, Takaaki; Furusawa, Chikara

    2015-10-01

    We analyzed the effect of combinatorial use of antibiotics with a trade-off relationship of resistance, i.e., resistance acquisition to one drug causes susceptibility to the other drug, and vice versa, on the evolution of antibiotic resistance. We demonstrated that this combinatorial use of antibiotics significantly suppressed the acquisition of resistance. Copyright © 2015 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  9. Mobile Health Technology Can Objectively Capture Physical Activity (PA) Targets Among African-American Women Within Resource-Limited Communities-the Washington, D.C. Cardiovascular Health and Needs Assessment.

    Science.gov (United States)

    Thomas, S; Yingling, L; Adu-Brimpong, J; Mitchell, V; Ayers, C R; Wallen, G R; Peters-Lawrence, M; Brooks, A T; Sampson, D M; Wiley, K L; Saygbe, J; Henry, J; Johnson, A; Graham, A; Graham, L; Powell-Wiley, T M

    2016-12-02

    Little is understood about using mobile health (mHealth) technology to improve cardiovascular (CV) health among African-American women in resource-limited communities. We conducted the Washington, D.C. CV Health and Needs Assessment in predominantly African-American churches in city wards 5, 7, and 8 with the lowest socioeconomic status based on community-based participatory research (CBPR) principles. The assessment measured CV health factors: body mass index (BMI), fasting blood glucose and cholesterol, blood pressure, fruit/vegetable (F/V) intake, physical activity (PA), and smoking. Participants were trained to use a PA monitoring wristband to measure 30 days of PA, wirelessly upload the PA data to hubs at the participating churches, and access their data from a church/home computer. CV health factors were compared across weight classes. Among females (N = 78; 99 % African-American; mean age = 59 years), 90 % had a BMI categorized as overweight/obese. Across weight classes, PA decreased and self-reported sedentary time (ST) increased (p ≤ 0.05). Diastolic blood pressure and glucose increased across weight classes (p ≤ 0.05); however, cholesterol, glucose, and BP were near intermediate CV health goals. Decreased PA and increased ST are potential community intervention targets for overweight and obese African-American women in resource-limited Washington D.C. areas. mHealth technology can assist in adapting CBPR intervention resources to improve PA for African-American women in resource-limited communities.

  10. 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......, that appear to be closely related to actinobacterial ARGs known to confer resistance against clinically important antibiotics. Furthermore, we identify two potential examples of recent horizontal transfer of actinobacterial ARGs to proteobacterial pathogens. Based on this bioinformatic evidence, we propose...... 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....

  11. Perceptions among Swedish hospital physicians on prescribing of antibiotics and antibiotic resistance.

    Science.gov (United States)

    Björkman, I; Berg, J; Röing, M; Erntell, M; Lundborg, C S

    2010-12-01

    To explore and describe perceptions of antibiotic prescribing among Swedish hospital physicians, with special reference to whether the perceptions included awareness of antibiotic resistance (AR). A phenomenographic approach was used and data were collected in face-to-face interviews. Hospitals in seven different counties in central Sweden. A strategic sample of 20 hospital physicians specialising in internal medicine, surgery or urology. The variation of perceptions of antibiotic prescribing. Five qualitative different perceptions were found. AR was considered in two of the perceptions. Reasons for not considering AR included a dominating focus on the care of the patient combined with lack of focus on restrictive antibiotic use, or uncertainty about how to manage infectious diseases or the pressure from the healthcare organisation. Parallels between the five perceptions and the stages in the transtheoretical model of health behaviour change were seen. In three of the perceptions, AR was not considered when antibiotics were prescribed. Physicians who primarily express these three perceptions do not seem to be prepared to change to restrictive prescribing. Our findings can be useful in designing activities that encourage AR prevention. Organisational changes are also needed.

  12. Investigating the biosynthesis of the streptomycete antibiotic pacidamycin

    OpenAIRE

    Tromans, Daniel

    2013-01-01

    Abstract There is an ever increasing need for the development of new antibiotics to fight the emergence of antibacterial resistant strains of pathogens. Developing antimicrobials with ‘novel scaffolds’ and modes of action is an effective way to combat pathogens that are resistant to compounds currently in clinical use. The pacidamycins are a member of the uridyl peptide class of antibiotics that are produced by the soil dwelling bacterium Streptomyces coeruleorubidus. They s...

  13. Probing minority population of antibiotic-resistant bacteria.

    Science.gov (United States)

    Huang, Tianxun; Zheng, Yan; Yan, Ya; Yang, Lingling; Yao, Yihui; Zheng, Jiaxin; Wu, Lina; Wang, Xu; Chen, Yuqing; Xing, Jinchun; Yan, Xiaomei

    2016-06-15

    The evolution and spread of antibiotic-resistant pathogens has become a major threat to public health. Advanced tools are urgently needed to quickly diagnose antibiotic-resistant infections to initiate appropriate treatment. Here we report the development of a highly sensitive flow cytometric method to probe minority population of antibiotic-resistant bacteria via single cell detection. Monoclonal antibody against TEM-1 β-lactamase and Alexa Fluor 488-conjugated secondary antibody were used to selectively label resistant bacteria green, and nucleic acid dye SYTO 62 was used to stain all the bacteria red. A laboratory-built high sensitivity flow cytometer (HSFCM) was applied to simultaneously detect the side scatter and dual-color fluorescence signals of single bacteria. By using E. coli JM109/pUC19 and E. coli JM109 as the model systems for antibiotic-resistant and antibiotic-susceptible bacteria, respectively, as low as 0.1% of antibiotic-resistant bacteria were accurately quantified. By monitoring the dynamic population change of a bacterial culture with the administration of antibiotics, we confirmed that under the antimicrobial pressure, the original low population of antibiotic-resistant bacteria outcompeted susceptible strains and became the dominant population after 5hours of growth. Detection of antibiotic-resistant infection in clinical urine samples was achieved without cultivation, and the bacterial load of susceptible and resistant strains can be faithfully quantified. Overall, the HSFCM-based quantitative method provides a powerful tool for the fundamental studies of antibiotic resistance and holds the potential to provide rapid and precise guidance in clinical therapies. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Countermeasures to Antibiotics Crisis: a Global Priority List of Antibiotic-Resistant Bacteria for Research and Development of New Antibiotics

    Directory of Open Access Journals (Sweden)

    Editorial

    2017-03-01

    Full Text Available On 27 Feb., 2017, the World Health Organization (WHO announced the first list of important antibiotic-resistant bacteria (http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/en/, which tremendously threat human-being’s health. This list included 12 kinds of bacteria that were categorized into three priority tiers: Critical, High and Medium. In the first tier, Critical, three Gram negative bacteria were included: Acinetobacter baumannii with carbapenem-resistant, Pseudomonas aeruginosa with carbapenem-resistant; and Enterobacteriaceae with carbapenem-resistant, the third generation cephalosporin-resistant. In the second tier, High, six bacteria were suggested: Enterococcus faecium with vancomycin-resistant, Staphylococcus aureus with methicillin-resistant, vancomycin intermediate and resistant, Helicobacter pylori with clarithromycin-resistant, Campylobacter with fluoroquinolone-resistant, Salmonella spp. with fluoroquinolone-resistant, Neisseria gonorrhoeae with the third generation cephalosporin-resistant, fluoroquinolone-resistant. In the third tier, Medium, three bacteria were listed: Streptococcus pneumonia with penicillin-non-susceptible, Haemophilus influenza with ampicillin-resistant, and Shigella spp. with fluoroquinolone-resistant. This list was proposed by an expert panel, chaired by Dr. E. Tacconelli from Infectious Diseases, DZIF Center, Tübingen University, Germany and Dr. N. Magrini from EMP Department of WHO. This proposal recommended some key steps to countermeasure the challenges posed by multi-drug- and extensively drug-resistant bacteria, including research and development of new classes of antibiotics for the paediatric population, for preventing cross- and co-resistance to existing classes of antibiotics, and for oral formulations for community-acquired diseases with a high morbidity burden. This list will guide our future research and development of new antibiotics in future.

  15. 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.

  16. The macrolide antibiotic renaissance.

    Science.gov (United States)

    Dinos, George P

    2017-09-01

    Macrolides represent a large family of protein synthesis inhibitors of great clinical interest due to their applicability to human medicine. Macrolides are composed of a macrocyclic lactone of different ring sizes, to which one or more deoxy-sugar or amino sugar residues are attached. Macrolides act as antibiotics by binding to bacterial 50S ribosomal subunit and interfering with protein synthesis. The high affinity of macrolides for bacterial ribosomes, together with the highly conserved structure of ribosomes across virtually all of the bacterial species, is consistent with their broad-spectrum activity. Since the discovery of the progenitor macrolide, erythromycin, in 1950, many derivatives have been synthesised, leading to compounds with better bioavailability and acid stability and improved pharmacokinetics. These efforts led to the second generation of macrolides, including well-known members such as azithromycin and clarithromycin. Subsequently, in order to address increasing antibiotic resistance, a third generation of macrolides displaying improved activity against many macrolide resistant strains was developed. However, these improvements were accompanied with serious side effects, leading to disappointment and causing many researchers to stop working on macrolide derivatives, assuming that this procedure had reached the end. In contrast, a recent published breakthrough introduced a new chemical platform for synthesis and discovery of a wide range of diverse macrolide antibiotics. This chemical synthesis revolution, in combination with reduction in the side effects, namely, 'Ketek effects', has led to a macrolide renaissance, increasing the hope for novel and safe therapeutic agents to combat serious human infectious diseases. © 2017 The British Pharmacological Society.

  17. 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

  18. 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.

  19. Appropriate Use of Prophylactic Antibiotic Agents in Gynecologic Surgeries at a Midwestern Teaching Hospital.

    Science.gov (United States)

    Uppendahl, Locke; Chiles, Caitlin; Shields, Stephanie; Dong, Fanglong; Kraft, Elizabeth; Duong, Jennifer; Delmore, James

    2018-02-16

    The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included. Based on published guidelines for prophylactic antibiotic agents for gynecologic surgery by ACOG, procedures were classified as antibiotic-indicated or antibiotic-not-indicated. Chi-square and Fisher exact test analysis were used to identify factors associated with antibiotic use. Of the 1,735 cases eligible for inclusion, 1,045 (60.2%) had antibiotic agents recommended per guidelines, and appropriate antibiotic agents were given in 1,031 (98.7%) of those cases. In 690 (39.8%) cases, prophylactic antibiotics were either not recommended or the guidelines are not well defined. Of the 690 cases without indication for antibiotic agents, 394 (57.1%) received prophylactic antibiotic agents. Agreement with guidelines varied substantially based on patient age, race, insurance status, area of residence, and if the procedure was a resident case (p gynecologic surgeries for which published guidelines are not well defined. Future studies need to identify strategies to reduce antibiotic use in surgical procedures unlikely to benefit from prophylaxis.

  20. 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

  1. Ultrathin antibiotic walled microcapsules.

    Science.gov (United States)

    Khopade, Ajay J; Arulsudar, N; Khopade, Surekha A; Hartmann, J

    2005-01-01

    Ultrathin microcapsules comprised of anionic polyelectrolytes (PE) and a polycationic aminoglycoside (AmG) antibiotic drug were prepared by depositing PE/AmG multilayers on zinc oxide (ZnO) colloid particles using the layer-by-layer self-assembly technique and subsequently dissolving the ZnO templated cores. The polyelectrolytes, dextran sulfate sodium (DxS) and poly(styrenesulfonate) (PSS), were selected owing to their different backbone structure. An aminoglycoside, tobramycin sulfate (TbS), was used for studying DxS/TbS or PSS/TbS multilayer films. The multilayer growth on ZnO cores was characterized by alternating zeta potential values that were different for the DxS/TbS and PSS/TbS multilayers due to the PE chemistry and its interaction with Zn(2+) ions. Transmission and scanning electron microscopy provide evidence of PE/TbS multilayer coating on ZnO core particles. The slow acid-decomposition of the ZnO cores using weak organic acids and the presence of sufficient quantity of Zn(2+) in the dispersion were required to produce antibiotic multilayer capsules. There was no difference in the morphological characteristics of the two types of capsules; although, the yield for [PSS/TbS](5) capsules was significantly higher than for [DxS/TbS](5) capsules which was related to the physicochemical properties of DxS/TbS/Zn(2+) and PSS/TbS/Zn(2+) complexes forming the capsule wall. The TbS quantity in the multilayer films was determined using a quartz crystal microbalance and high performance liquid chromatography techniques which showed less TbS loading in both, capsules and multilayers on planar gold substrate, than the theoretical DxS:TbS or PSS:TbS stoichiometric ratio. The decomposition of the [PE/TbS](6) multilayers was fastest in physiological buffer followed by mannitol and water. The decomposition rate of the [PSS/TbS](6) multilayers was slower than [DxS/TbS](6) monolayers. The incomplete decomposition of DxS/TbS under saline conditions suggests the major role of

  2. 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.

  3. Algorithm for the management of antibiotic prophylaxis in onychocryptosis surgery.

    Science.gov (United States)

    Córdoba-Fernández, Antonio; Ruiz-Garrido, Gloria; Canca-Cabrera, Angela

    2010-12-01

    Antibiotic prophylaxis in nail surgery is not clearly established, and there is scant scientific evidence regarding the need for its use in preventing surgical site infection, hematogenous total joint infection, and infective endocarditis. To propose an algorithm based on the evidence for the management of antibiotic prophylaxis in onychocryptosis surgery. A literature review was performed in Medline, Pubmed, Cochrane database and Scopus and recent prospective studies were examined. The most-current authoritative guidelines together with new classification system of the pathology have been taken into account. In non-risk patients with onychocryptosis stage II or III phenol technique can be used without the need for antibiotics. In stages IV and V, specific antibiotic treatment should be administered before surgery together with partial ablation of nail until the infection is resolved and the process remits to stage II or III. In the case of long-developing onychocryptosis, osteomyelitis should be ruled out, and specific antibiotic treatment besides the preoperative dose should be administered. In high-risk cardiac patients with infective onychocryptosis, the need for prophylaxis for bacterial endocarditis should be considered. Current evidence does not support the use of preoperative antibiotic prophylaxis in onychocrytosis surgery except in special patients with infective onychocryptosis. Published by Elsevier Ltd.

  4. Antibiotic Resistance in Nephrological Practice

    Directory of Open Access Journals (Sweden)

    O.I. Taran

    2017-02-01

    Full Text Available The problem of antibiotic resistance is a serious threat to the global public health and requires action by both the state and the public. The World Health Organization identified 15 most dangerous and prevalent superbugs, which it ranked based on three levels of threat they present to the public health. At the heart of the fight against antibiotic resistance lies the increased awareness of the health professionals and general public that incorrect and excessive use of antibiotics amid poor practices in infection prevention and control contributes to the acceleration of antibiotic resistance.

  5. Antibiotics and Pregnancy: What's Safe?

    Science.gov (United States)

    ... of antibiotics during pregnancy and risk of spontaneous abortion. CMAJ. 2017;189:625. American College of Obstetricians ... Foundation for Medical Education and Research (MFMER). All rights reserved.

  6. Surveillance of life-long antibiotics: a review of antibiotic prescribing practices in an Australian Healthcare Network.

    Science.gov (United States)

    Lau, Jillian S Y; Kiss, Christopher; Roberts, Erika; Horne, Kylie; Korman, Tony M; Woolley, Ian

    2017-01-18

    suppress infections thought incurable, but also as primary and secondary prophylaxis and as anti-inflammatory agents. More research is needed to understand the impact of long-term antibiotic consumption on both patients and microbial ecology.

  7. 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

  8. 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.

  9. Cardiac surgery antibiotic prophylaxis and calculated empiric antibiotic therapy.

    Science.gov (United States)

    Gorski, Armin; Hamouda, Khaled; Özkur, Mehmet; Leistner, Markus; Sommer, Sebastian-Patrick; Leyh, Rainer; Schimmer, Christoph

    2015-03-01

    Ongoing debate exists concerning the optimal choice and duration of antibiotic prophylaxis as well as the reasonable calculated empiric antibiotic therapy for hospital-acquired infections in critically ill cardiac surgery patients. A nationwide questionnaire was distributed to all German heart surgery centers concerning antibiotic prophylaxis and the calculated empiric antibiotic therapy. The response to the questionnaire was 87.3%. All clinics that responded use antibiotic prophylaxis, 79% perform it not longer than 24 h (single-shot: 23%; 2 doses: 29%; 3 doses: 27%; 4 doses: 13%; and >5 doses: 8%). Cephalosporin was used in 89% of clinics (46% second-generation, 43% first-generation cephalosporin). If sepsis is suspected, the following diagnostics are performed routinely: wound inspection 100%; white blood cell count 100%; radiography 99%; C-reactive protein 97%; microbiological testing of urine 91%, blood 81%, and bronchial secretion 81%; procalcitonin 74%; and echocardiography 75%. The calculated empiric antibiotic therapy (depending on the suspected focus) consists of a multidrug combination with broad-spectrum agents. This survey shows that existing national guidelines and recommendations concerning perioperative antibiotic prophylaxis and calculated empiric antibiotic therapy are well applied in almost all German heart centers. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. 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

  11. 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.

  12. Biosynthesis of Tetrahydroisoquinoline Antibiotics.

    Science.gov (United States)

    Tang, Gong-Li; Tang, Man-Cheng; Song, Li-Qiang; Zhang, Yue

    2016-01-01

    The tetrahydroisoquinoline (THIQ) alkaloids are naturally occurring antibiotics isolated from a variety of microorganisms and marine invertebrates. This family of natural products exhibit broad spectrum antimicrobial and strong antitumor activities, and the potency of clinical application has been validated by the marketing of ecteinascidin 743 (ET-743) as anticancer drug. In the past 20 years, the biosynthetic gene cluster of six THIQ antibiotics has been characterized including saframycin Mx1 from Myxococcus xanthus, safracin-B from Pseudomonas fluorescens, saframycin A, naphthyridinomycin, and quinocarcin from Streptomyces, as well as ET-743 from Ecteinascidia turbinata. This review gives a brief summary of the current status in understanding the molecular logic for the biosynthesis of these natural products, which provides new insights on the biosynthetic machinery involved in the nonribosomal peptide synthetase system. The proposal of the THIQ biosynthetic pathway not only shows nature's route to generate such complex molecules, but also set the stage to develop a different process for production of ET-743 by synthetic biology.

  13. Bacterial meningitis antibiotic treatment.

    Science.gov (United States)

    Cohen, R; Raymond, J; Hees, L; Pinquier, D; Grimprel, E; Levy, C

    2017-12-01

    The implementation of pneumococal conjugate vaccines (PCVs) 7 then 13 valent (Prevenar13 ®) in 2010-2011 has significantly changed the profile of pneumococcal meningitis. Since 3 years, the National Pediatric Meningitis Network of the Pediatric Infectious Disease Group (GPIP) and the National Reference Centre of Pneumococci have reported no cases of meningitis due to pneumococcus resistant to third-generation cephalosporins (3GC): cefotaxime or ceftriaxone. In the light of these new data, vancomycin should no longer be prescribed at the initial phase of pneumococcal meningitis treatment (confirmed or only suspected) and this antibiotic should only be added when 3GC minimum inhibitory concentration of the strain isolated is greater than 0.5mg/L. For meningococcal meningitis, nearly 20% of strains have decreased susceptibility to penicillin and amoxicillin, but all remain susceptible to 3GC. The National Pediatric Meningitis Network is a valuable tool because it has been sufficiently exhaustive and sustainable over 15 years. Maintaining this epidemiologic surveillance will allow us to adapt, if necessary, new regimens for subsequent changes that could be induced by vaccination and/or antibiotic uses. © 2017 Elsevier Masson SAS. Tous droits réservés.

  14. 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.

  15. Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation.

    Science.gov (United States)

    Fleming, Aoife; Bradley, Colin; Cullinan, Shane; Byrne, Stephen

    2014-11-05

    To explore healthcare professionals' views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the theoretical domains framework (TDF), and the behaviour change wheel and behaviour change technique (BCT) taxonomy were used to recommend future intervention strategies. Interviews were conducted with 37 healthcare professionals who work in LTCFs (10 general practitioners, 4 consultants, 14 nurses, 9 pharmacists) between December 2012 and March 2013. Interviews were conducted in the greater Cork region. The main domains from the TDF which emerged were: 'Knowledge', 'Environmental context and resources', 'Social influences', 'Beliefs about consequences', 'Memory, attention and decision making', with the findings identifying a need for 'Behavioural regulation'. Many participants believed that antibiotic prescribing was satisfactory at their LTCF, despite the lack of surveillance activities. This study, using the TDF and BCT taxonomy, has found that antibiotic prescribing in LTCFs is influenced by many social and contextual factors. The challenges of the setting and patient population, the belief about consequences to the patient, and the lack of implementation of guidelines and knowledge regarding antibiotic prescribing patterns are significant challenges to address. On the basis of the study findings and the application of the TDF and BCT taxonomy, we suggest some practical intervention functions for antimicrobial stewardship in LTCFs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. 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 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...

  17. 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.

  18. Counteracting antibiotic resistance: breaking barriers among antibacterial strategies.

    Science.gov (United States)

    Baquero, Fernando; Coque, Teresa M; Cantón, Rafael

    2014-08-01

    To fight against antibiotic resistance, prevention-only is no longer an acceptable strategy. The old concept 'one-infection, one-bug, one-drug', genocentrism in antibiotic discovery, and lack of integration between different antimicrobial strategies have probably contributed to current weaknesses in confronting antibiotic resistance. Resistance should be combatted in all fronts simultaneously, in the patient (complex therapy), the group (where resistance is maintained), and the significant environment (polluted by resistance). This paper is reviewing why specific 'therapeutic' approaches are needed in each of these fronts, using different types of 'drugs' directed to a variety of targets, in the goal of inhibiting antibiotic resistant bacteria. Multi-target integrated combination strategies and therapies should be more extensively evaluated, not only in the infected patient (using novel formats for clinical trials), but as associations of 'therapeutic strategies' in the different compartments where antibiotic resistance emerges and flows (measuring global effects in resistance). Multi-targeted therapeutic approaches require a relaxation of barriers among the various compounds, including systemic and topic antibiotics, antiseptics, biocides, anti-resistant clones vaccination, phages, decontamination products, and in general eco-evo drugs acting on factors influencing ecology and evolution of resistant bacteria. The application of methods of systems biology will facilitate such a multi-lateral attack to antibiotic resistance. Such advances should be paralleled by a simultaneous progress in regulatory sciences and close coordination among all stakeholders.

  19. [The assessment of family resources and need for help: Construct validity and reliability of the Systematic Exploration and Process Inventory for health professionals in early childhood intervention services (SEVG)].

    Science.gov (United States)

    Scharmanski, Sara; Renner, Ilona

    2016-12-01

    Health professionals in early childhood intervention and prevention make an important contribution by helping burdened families with young children cope with everyday life and child raising issues. A prerequisite for success is the health professionals' ability to tailor their services to the specific needs of families. The "Systematic Exploration and Process Inventory for health professionals in early childhood intervention services (SEVG)" can be used to identify each family's individual resources and needs, enabling a valid, reliable and objective assessment of the conditions and the process of counseling service. The present paper presents the statistical analyses that were used to confirm the reliability of the inventory. Based on the results of the reliability analysis and principal component analysis (PCA), the SEVG seems to be a reliable and objective inventory for assessing families' need for support. It also allows for calculation of average values of each scale. The development of valid and reliable assessments is essential to quality assurance and the professionalization of interventions in early childhood service. Copyright © 2016. Published by Elsevier GmbH.

  20. Antibiotic adjuvants - A strategy to unlock bacterial resistance to antibiotics.

    Science.gov (United States)

    González-Bello, Concepción

    2017-09-15

    Resistance to available antibiotics in pathogenic bacteria is currently a global challenge since the number of strains that are resistant to multiple types of antibiotics has increased dramatically each year and has spread worldwide. To unlock this problem, the use of an 'antibiotic adjuvant' in combination with an antibiotic is now being exploited. This approach enables us to prolong the lifespan of these life-saving drugs. This digests review provides an overview of the main types of antibiotic adjuvants, the basis of their operation and the remaining issues to be tackled in this field. Particular emphasis is placed on those compounds that are already in clinical development, namely β-lactamase inhibitors. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.